Longitudinal and cross-sectional analysis of atrophy in pharmacoresistant temporal lobe epilepsy

Bernhardt, Boris C.; Worsley, Keith J.; Kim, H.; Evans, Alan C.; Bernasconi, Andrea; Bernasconi, Neda

doi:10.1212/01.wnl.0000345969.57574.f5

Cited by 236 publications

(248 citation statements)

References 43 publications

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“…Gray matter volume reduction also correlates with epilepsy duration and has been reported for the hippocampus, entorhinal cortex [94], and thalamus [7]. It is more widespread in refractory TLE [90] and more severe in patients with MTS [7].…”

Section: Volumetric and Morphological Analysismentioning

confidence: 74%

“…Longitudinal analysis over 2.5 years showed ipsilateral temporopolar and central, as well as contralateral orbitofrontal, insular, and angular region, cortical atrophy. Atrophy in somatomotor and parahippocampal regions in medial temporal lobe epilepsy (MTLE) has also been reported [94]. In patients with idiopathic generalised epilepsy (IGE), a 3.2 % decrease in global mean cortical thickness and focal cortical thinning in frontal, precentral, central, and lateral temporal regions has been described.…”

Section: Volumetric and Morphological Analysismentioning

confidence: 99%

“…Unfortunately, most longitudinal MRI epilepsy studies have had a small number of patients or limited follow-up. Therefore, long-term longitudinal documentation of these changes may help characterize the epileptogenic process per se in the future [94].…”

Section: Volumetric and Morphological Analysismentioning

confidence: 99%

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Neuroimaging the Epileptogenic Process

et al. 2014

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Epilepsy is one of the most common chronic neurological conditions worldwide. Anti-epileptic drugs (AEDs) can suppress seizures, but do not affect the underlying epileptic state, and many epilepsy patients are unable to attain seizure control with AEDs. To cure or prevent epilepsy, disease-modifying interventions that inhibit or reverse the disease process of epileptogenesis must be developed. A major limitation in the development and implementation of such an intervention is the current poor understanding, and the lack of reliable biomarkers, of the epileptogenic process. Neuroimaging represents a non-invasive medical and research tool with the ability to identify early pathophysiological changes involved in epileptogenesis, monitor disease progression, and assess the effectiveness of possible therapies. Here we will provide an overview of studies conducted in animal models and in patients with epilepsy that have utilized various neuroimaging modalities to investigate epileptogenesis.

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Section: Volumetric and Morphological Analysismentioning

confidence: 74%

Section: Volumetric and Morphological Analysismentioning

confidence: 99%

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Neuroimaging the Epileptogenic Process

et al. 2014

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“…Current clinical magnetic resonance imaging (MRI) protocols lack sensitivity, as more than 30% of patients have no evidence of brain lesions (Sylaja et al, 2004). Quantitative techniques such as diffusion tensor imaging (DTI), relaxometry mapping, voxel-based morphometry, and cortical thickness analysis have demonstrated increased sensitivity in lesion detection over routine or clinical MRI protocols (Bernasconi et al, 2000(Bernasconi et al, , 2004Bernhardt et al, 2009). These techniques have the potential to better delineate the epileptogenic zone and thus improve surgical outcomes, however, validation is currently needed to investigate and describe histopathological correlates of these imaging techniques (Eriksson et al, 2007;Howe et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Registration of in-vivo to ex-vivo MRI of surgically resected specimens: A pipeline for histology to in-vivo registration

Goubran

Ribaupierre

Hammond

et al. 2015

Journal of Neuroscience Methods

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h i g h l i g h t s• We present a protocol for registration of in-vivo to ex-vivo brain specimens.• This protocol completes a registration pipeline for histology to in-vivo MRI.• A TRE of 1.35 ± 0.11 mm (neocortex) and 1.41 ± 0.33 mm (hippocampus) was found.• Deformable registration significantly improved the registration accuracy.• This pipeline allows for the assessment of pathological correlates in MRI. a r t i c l e i n f o t r a c tBackground: Advances in MRI have the potential to improve surgical treatment of epilepsy through improved identification and delineation of lesions. However, validation is currently needed to investigate histopathological correlates of these new imaging techniques. The purpose of this work is to develop and evaluate a protocol for deformable image registration of in-vivo to ex-vivo resected brain specimen MRI. This protocol, in conjunction with our previous work on ex-vivo to histology registration, completes a registration pipeline for histology to in-vivo MRI, enabling voxel-based validation of novel and existing MRI techniques with histopathology. New method: A combination of image-based and landmark-based 3D registration was used to register in-vivo MRI and the ex-vivo MRI from patients (N = 10) undergoing epilepsy surgery. Target registration error (TRE) was used to assess accuracy and the added benefit of deformable registration. Results: A mean TRE of 1.35 ± 0.11 and 1.41 ± 0.33 mm was found for neocortical and hippocampal specimens respectively. Statistical analysis confirmed that the deformable registration significantly improved the registration accuracy for both specimens.Comparison with existing methods: Image registration of surgically resected brain specimens is a unique application which presents numerous technical challenges and that have not been fully addressed in previous literature. Our computed TRE are comparable to previous attempts tackling similar applications, as registering in-vivo MRI to whole brain or serial histology. Conclusion: The presented registration pipeline finds dense and accurate spatial correspondence between in-vivo MRI and histology and allows for the spatially local and quantitative assessment of pathological correlates in MRI.

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“…Uncontrolled epilepsy can lead to further injury of the brain and is associated with increased morbidity and mortality [2]. The etiology of epilepsy reflects a complex interaction between genetic and environmental factors that have bearing on treatment and prognosis.…”

Section: Introductionmentioning

confidence: 99%