Fast Spin‐Echo, Magnetic Resonance Imaging‐Measured Hippocampal Volume: Correlation with Neuronal Density in Anterior Temporal Lobectomy Patients

Lee, Namsoo; Tien, R D; Lewis, Darrell V.; Friedman, Allan H.; Felsberg, Gary J.; Crain, Barbara J.; Hulette, Christine M.; Osumi, Alan K.; Smith, Jean S.; VanLandingham, Kevan; Radtke, Rodney A.

doi:10.1111/j.1528-1157.1995.tb01633.x

Cited by 58 publications

(22 citation statements)

References 24 publications

(10 reference statements)

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“…4). The right versus left discrepancy is consistent with previous reports (4,8,10,13,25). A gender discrepancy has been reported by some groups (8, 9) but not others (4,13,26).…”

Section: Discussionsupporting

confidence: 83%

“…Both histologic and volumetric studies have shown that hippocampal sclerosis in TLE tends to occur ipsilateral to the epileptogenic temporal lobe, but bilateral volume loss can also be present (4,6,7). Side-to-side comparison of hippocampal volumes can identify hippocampal sclerosis on the atrophic side, but absolute hippocampal volumes must be used to reliably detect bilateral atrophy (1,4). Correcting hippocampal volumes for total intracranial volume has been shown to further increase sensitivity to bilateral hippocampal sclerosis (8).…”

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confidence: 99%

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A Reliable Method for Measurement and Normalization of Pediatric Hippocampal Volumes

et al. 2001

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A robust standardized method for segmentation, quantification, and normalization of pediatric hippocampal volumes using magnetic resonance imaging is presented. The method will find application in time course measurements of hippocampal volumes in pediatric patients who suffer from temporal lobe epilepsy and was tested prospectively on six control patients (13-60 mo of age). The un-normalized hippocampal volumes obtained using our segmentation method ranged from 3.85 to 6.38 mL, in agreement with previously published results. Inter-and intraobserver variability of the segmentation method was determined to be 13.3% and 2.8%, respectively. Four different methods of volume normalization were tested. Normalization is required to adjust for age-related increases in hippocampal volume. The normalization approach that seemed to compensate best for growth-related hippocampal volume changes was based on a simple estimation of intracranial volumes. This is the first report of a consistent and reliable method for segmentation and normalization of hippocampi from pediatric patients that can be used to study the progression of neurologic diseases in children. Noninvasive neuroimaging techniques can be used to examine the structural and pathophysiologic bases underlying numerous disease processes. MRI is the imaging technique of choice for evaluating patients with epilepsy inasmuch as TLE often leads to anatomic lesions (1).The primary features of the mesial temporal sclerosis associated with TLE can be detected with MRI, and these features correlate well with known histologic features (2, 3). Hippocampal atrophy and increased signal on T 2 -weighted magnetic resonance (MR) images can be determined by qualitative visual analysis of MR images. Although visual analysis of hippocampal sclerosis can achieve a sensitivity of 98% and a specificity of 93%, the additional advantages of quantitative volume analysis include reliable lateralization of atrophy and increased objectivity of analysis (3). Absolute hippocampal volumes measured from fast spin-echo MR images have been shown to correlate with the hippocampal neuronal density of CA1, CA2, and CA3; such a correlation was absent with visual analysis of increased T 2 signal (4). Van Paesschen et al. (5) demonstrated that increased T 2 signal has a neuropathological basis different from that of hippocampal volume loss. Thus, hippocampal volumetric analysis can provide a reliable, noninvasive method for identification of hippocampal sclerosis from MRI.Visual analysis of MR images may detect gross hippocampal atrophy, but smaller degrees of volume loss may be overlooked and small asymmetries of shape may be misinterpreted as volume loss. Both histologic and volumetric studies have shown that hippocampal sclerosis in TLE tends to occur ipsilateral to the epileptogenic temporal lobe, but bilateral volume loss can also be present (4, 6, 7). Side-to-side comparison of hippocampal volumes can identify hippocampal sclerosis on the atrophic side, but absolute hippocampal volumes must be us...

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“…4). The right versus left discrepancy is consistent with previous reports (4,8,10,13,25). A gender discrepancy has been reported by some groups (8, 9) but not others (4,13,26).…”

Section: Discussionsupporting

confidence: 83%

mentioning

confidence: 99%

A Reliable Method for Measurement and Normalization of Pediatric Hippocampal Volumes

et al. 2001

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“…Calculation of hippocampal volumes was performed using standard procedures [12][13][14]. As there are no control studies of normal infants and children in the medical literature, 3 children of the same age group (having MRI studies performed for headache or nonseizure reasons including fast spin echo coronal scans) were studied with measurement of hippocampal volumes.…”

Section: Methodsmentioning

confidence: 99%

The clinical syndrome of early‐life bilateral hippocampal sclerosis

1997

Annals of Neurology

101

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Four infants had bilateral hippocampal sclerosis by magnetic resonance scans, including oblique coronal fast spin echo images of the temporal lobes; [18F]fluorodeoxyglucose-positron emission tomographic scans, done in 2 infants, showed isolated bilateral anterior temporal lobe hypometabolism. All had epilepsy with episodes of status epilepticus. Despite adequate motor and sensory functions, all failed to develop language (or lost attained language), social skills, and complex purposive or adaptive activity, even after epilepsy was controlled. Bilateral hippocampal dysfunction in early life appears to be associated with a profound failure of cognitive capacities, including language learning and learning of complex social and adaptive skills in general. The deficits correspond to the cognitive deficits of severe infantile autism. Hippocampal function, or more generally medial temporal lobe function, appears necessary for language learning in the infant, as well as for complex social and adaptive learning.

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“…In patients with mesial TLE quantified densiometric techniques reveal secondary declines in hippocampal neuron density with long histories of habitual seizures [34][35][36]. Although hippocampal volume and neuron density measures are correlated [11,27], some studies relating TLE duration to hippocampal volume fail to find a relationship [12,61]. However, recent studies suggest a secondary decline in hippocampal volume either ipsilaterally or contralaterally to the primary temporal seizure focus [4,48,60].…”

Section: Introductionmentioning

confidence: 94%

Bilateral reductions of hippocampal volume, glucose metabolism, and Wada hemispheric memory performance are related to the duration of mesial temporal lobe epilepsy

Jokeit¹,

Ebner²,

Arnold³

et al. 1999

Journal of Neurology

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In refractory temporal lobe epilepsy (TLE) temporal lobe structures and functions are continuously or intermittently affected by abnormal brain electrical events, noxious neurochemical agents, and metabolic disturbances. There is conflicting evidence regarding the relationship between the duration of refractory mesial TLE and quantitative measures of temporal lobe functions and volumes of the hippocampi. Twenty patients (aged 28 +/- 7 years, 14 males) with an initial precipitating injury before the age of 5 years were subjected to high-resolution magnetic resonance imaging, fluoro-2-deoxy-d-glucose positron-emission tomography (PET), and the Wada test. We investigated whether the duration of unilateral refractory TLE (12 left, 8 right) affects hippocampal volume, glucose metabolism, or Wada hemispheric memory performance. Ipsilateral to the epileptogenic zone the hippocampal volume, metabolism, and Wada hemispheric memory performance were reduced compared to the corresponding contralateral measures. The duration of epilepsy controlled for age at investigation, side of seizure origin, underlying cause, and sex were negatively correlated with ipsi- and contralateral hippocampal volume, hippocampal metabolism, and Wada hemispheric memory performance. Moreover, ipsilateral Wada hemispheric memory performance and contralateral hippocampal glucose metabolism were correlated with the frequency of habitual seizures. Refractory TLE seems to be associated with a slow but ongoing bilateral temporal lobe damage. These cross-sectional results require verification by longitudinal studies carried out over a period of more than two decades.

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Fast Spin‐Echo, Magnetic Resonance Imaging‐Measured Hippocampal Volume: Correlation with Neuronal Density in Anterior Temporal Lobectomy Patients

Cited by 58 publications

References 24 publications

A Reliable Method for Measurement and Normalization of Pediatric Hippocampal Volumes

A Reliable Method for Measurement and Normalization of Pediatric Hippocampal Volumes

The clinical syndrome of early‐life bilateral hippocampal sclerosis

Bilateral reductions of hippocampal volume, glucose metabolism, and Wada hemispheric memory performance are related to the duration of mesial temporal lobe epilepsy

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