Cortical remodeling before and after successful temporal lobe epilepsy surgery

Li, Wei; Jiang, Yuchao; Qin, Yingjie; Li, Xiuli; Lei, Du; Zhang, Heng; Luo, Cheng; Gong, Qiyong; Zhou, Dong; An, Dongmei

doi:10.1111/ane.13631

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…Studies of postsurgical brain anatomy in DRE adults have yielded conflicting findings: whereas some have reported reduction, and even reversal, of progressive cortical thinning (i.e. an increase in CxT) 5, 6, 10, 13,48 and cortical atrophy, 5 others have noted ongoing, progressive atrophy, 13 even in regions remote from the resection site or hemisphere 7, 12 (although concerns regarding the methodologies have been expressed). 7 Almost all such studies have been carried out in adults with temporal lobe epilepsy or anterior temporal lobectomy, and have largely focused on just one variable, such as CxT or CV (but see Zhao et al 15 for both).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Prior morphometry studies, primarily carried out in adults with temporal lobe epilepsy, have typically studied one variable (e.g., CxT or CV) and have also yielded mixed findings 2–5, 37 . Here, we comprehensively characterized the structural integrity of the preserved hemisphere in DRE patients who underwent surgery in childhood , a time of greater plasticity than in adulthood 38 .…”

Section: Discussionmentioning

confidence: 99%

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Morphometrics of the preserved post-surgical hemisphere in pediatric drug-resistant epilepsy

Granovetter,

Maallo,

Patterson

et al. 2023

Preprint

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Characterisation of the postoperative structural integrity of cortex in adults who have undergone cortical resection surgery for the management of epilepsy has yielded mixed findings. In some cases, patients show persistent or accelerated cortical atrophy, while in others, atrophy decelerates or even reverses. Whether this variability applies as well to a paediatric population, for whom postoperative plasticity may be greater, remains to be determined. In this case-control study, high resolution structural T1 MRI data were acquired from 32 patients with childhood epilepsy surgery and 51 non-neurological matched controls. Using enhanced automated segmentation capabilities of FreeSurfer Software Suite, we quantified morphometrics of the preserved hemisphere at the level of gross anatomy (lateral ventricle size, volume of grey matter and white matter). Additionally, cortical thickness, volume, and surface area were measured for 34 cortical regions segmented based on the Desikan-Killiany atlas, and, last, volumes of nine subcortical regions were also measured. Morphometry comparisons were made between patients' preserved hemisphere be it left (LH) or right (RH) against the corresponding hemisphere of age-matched, typically developing controls; and then the two patients groups (LH versus RH) were compared. Patient groups had larger ventricles and reduced total white matter volume relative to controls, and only patients with a preserved RH, but not patients with a preserved LH, had reduced total grey matter volume relative to controls. Furthermore, patients with a preserved RH had lower cortical thickness and cortical volume and significantly greater cortical surface area of several cortical regions, relative to controls. Patients with a preserved LH had largely no differences in thickness, volume, or area, of any of the 34 cortical regions, relative to controls. Moreover, both LH and RH patients showed reduced volumes in select subcortical structures, relative to controls. That left-sided, but not right-sided, resection is associated with more pronounced reduction in cortical thickness and volume and increased cortical surface area relative to typically developing, age-matched controls suggests that the preserved RH undergoes plastic processes to an extent not observed in cases of right-sided paediatric resection. Given the importance of understanding outcomes following surgery to the LH versus RH, the post-operative characterisation of morphometrics noted here provides a foundation for future work to understand differences in plasticity as a function of the side preserved post-resection. Future work probing the association of the current findings with neuropsychological outcomes will be necessary to understand the implications of these structural findings for clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Morphometrics of the preserved post-surgical hemisphere in pediatric drug-resistant epilepsy

Granovetter,

Maallo,

Patterson

et al. 2023

Preprint

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“…Partially reversible hypometabolism has been observed in patients with epilepsy after surgery 50 . However, whether postoperative recovery of cortical volume occurs after temporal lobectomy remains controversial 51 , 52 .…”

Section: Discussionmentioning

confidence: 99%

Morphological and metabolic asymmetries of the thalamic subregions in temporal lobe epilepsy predict cognitive functions

Tung,

Tsai,

Huang

et al. 2023

Sci Rep

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Both morphological and metabolic imaging were used to determine how asymmetrical changes of thalamic subregions are involved in cognition in temporal lobe epilepsy (TLE). We retrospectively recruited 24 left-TLE and 15 right-TLE patients. Six thalamic subnuclei were segmented by magnetic resonance imaging, and then co-registered onto Positron emission tomography images. We calculated the asymmetrical indexes of the volumes and normalized standard uptake value ratio (SUVR) of the entire and individual thalamic subnuclei. The SUVR of ipsilateral subnuclei were extensively and prominently decreased compared with the volume loss. The posterior and medial subnuclei had persistently lower SUVR in both TLE cases. Processing speed is the cognitive function most related to the metabolic asymmetry. It negatively correlated with the metabolic asymmetrical indexes of subregions in left-TLE, while positively correlated with the subnuclei volume asymmetrical indexes in right-TLE. Epilepsy duration negatively correlated with the volume asymmetry of most thalamic subregions in left-TLE and the SUVR asymmetry of ventral and intralaminar subnuclei in right-TLE. Preserved metabolic activity of contralateral thalamic subregions is the key to maintain the processing speed in both TLEs. R-TLE had relatively preserved volume of the ipsilateral thalamic volume, while L-TLE had relatively decline of volume and metabolism in posterior subnucleus.

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