Magnetic resonance imaging–based volume studies in temporal lobe epilepsy: Pathological correlations

Cascino, Gregory D.; Jack, Clifford R.; Parisi, Joseph E.; Sharbrough, Frank W.; Hirschorn, Kathryn A.; Meyer, Fredric B.; Marsh, W. Richard; O’Brien, Peter C.

doi:10.1002/ana.410300107

Cited by 443 publications

(211 citation statements)

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“…13 In 1.5T MRI, a good correlation of volume and signal abnormalities detected by quantification analysis and histopathology of HS has been demonstrated. 29 More recently, histologic studies have proposed that different patterns of neuronal loss in the hippocampus might be associated with different seizure outcome after surgical removal of the temporal lobe. 30 Also, it has been shown that quantitative measures in 3T MRI can demonstrate ultrastructural details of HS pathology not detectable with lower field scanners.…”

Section: Discussionmentioning

confidence: 99%

3T MRI Quantification of Hippocampal Volume and Signal in Mesial Temporal Lobe Epilepsy Improves Detection of Hippocampal Sclerosis

Coan

Kubota

Bergo

et al. 2013

AJNR Am J Neuroradiol

141

123

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BACKGROUND AND PURPOSE:In mesial temporal lobe epilepsy, MR imaging quantification of hippocampal volume and T2 signal can improve the sensitivity for detecting hippocampal sclerosis. However, the current contributions of these analyses for the diagnosis of hippocampal sclerosis in 3T MRI are not clear. Our aim was to compare visual analysis, volumetry, and signal quantification of the hippocampus for detecting hippocampal sclerosis in 3T MRI.

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Section: Discussionmentioning

confidence: 99%

3T MRI Quantification of Hippocampal Volume and Signal in Mesial Temporal Lobe Epilepsy Improves Detection of Hippocampal Sclerosis

Coan

Kubota

Bergo

et al. 2013

AJNR Am J Neuroradiol

141

123

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“…Histopathological studies of TLE reveal that 30 to 40% of hippocampal specimens do not have classic MTS (at least 30-50% neuronal cell loss in hippocampal subfields CA1, CA3, and CA4) [24][25][26]. These specimens have either mild or limited neuronal loss and variable gliosis, or even no pathological change.…”

Section: Discussionmentioning

confidence: 99%

“…These specimens have either mild or limited neuronal loss and variable gliosis, or even no pathological change. MRI detects classic MTS (93% sensitivity and 100% specificity) [26]. Yet, approximately 50% of patients without hippocampal atrophy on MRI have good surgical outcomes [5,27].…”

Section: Discussionmentioning

confidence: 99%

“…However, the role of FDG-PET in the presurgical evaluation among presently available advanced MR techniques is unclear. In particular, which imaging techniques reliably lateralize TLE in patients without MRI evidence of MTS is unanswered.Histopathological studies of TLE reveal that 30 to 40% of hippocampal specimens do not have classic MTS (at least 30-50% neuronal cell loss in hippocampal subfields CA1, CA3, and CA4) [24][25][26]. These specimens have either mild or limited neuronal loss and variable gliosis, or even no pathological change.…”

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confidence: 99%

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Presurgical multimodality neuroimaging in electroencephalographic lateralized temporal lobe epilepsy

Knowlton

Laxer

Ende

et al. 1997

Annals of Neurology

127

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The purpose of this study was to compare 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), hippocampal volumetry (HV), T2 relaxometry, and proton magnetic resonance spectroscopic imaging ( 1 H-MRSI) in the presurgical neuroimaging lateralization of patients with nonlesional, electroencephalogram (EEG)-defined unilateral temporal lobe epilepsy (TLE). Twenty-five patients were prospectively studied, along with age-matched controls. T2 relaxometry examinations were performed in 13 patients. Comparison of FDG-PET, HV, and 1 H-MRSI was possible in 23 patients. FDG-PET lateralized 87% of patients, HV 65%, N-acetyl aspartate (NAA)/(choline [Cho] + creatine [Cr]) 61%, and [NAA] 57%. Combined HV and NAA/(Cho + Cr) results lateralized 83% of the patients, a value similar to PET. Of 10 patients with normal magnetic resonance imaging (MRI) scans, 2 were lateralized with HV, 6 with FDG-PET, 4 with NAA/(Cho + Cr), and 3 with [NAA]. T2 relaxometry lateralized no patients without hippocampal atrophy. Bilateral abnormality was present in 29 to 33% of patients with 1 H-MRSI measures and 17% with HV. Only hippocampal atrophy correlated with postoperative seizure-free outcome. FDG-PET remains the most sensitive imaging method to correlate with EEG-lateralized TLE. Both FDG-PET and 1 H-MRSI can lateralize patients with normal MRI, but only the presence of relative unilateral hippocampal atrophy is predictive of seizure-free outcome. Bilaterally abnormal MRI and 1 H-MRSI measures do not preclude good surgical outcome.Multiple imaging methods are available to help lateralize temporal lobe epilepsy (TLE). To minimize the requirement for intracranial electrodes and to localize the epileptogenic zone with increased confidence, 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) are used to provide confirmatory localizing information. Relative temporal lobe (TL) hypometabolism on FDG-PET and hippocampal atrophy or prolonged T2 signal on MRI predict reliably lateralization of the epileptogenic temporal lobe [1][2][3][4][5]. Localized TL hypometabolism on FDG-PET is reported to be more sensitive than the detection of lateralized abnormality on MRI [3]; however, little has been published on the direct comparison of FDG-PET to advanced MRI and magnetic resonance spectroscopic imaging (MRSI) techniques. Gaillard and colleagues [6] compared FDG-PET with MRI-based hippocampal volumetry (HV) and showed that although FDG-PET was more Copyright © 1997 Patients and Methods Patients and Epilepsy EvaluationPatient selection commenced in April 1994 as part of a prospective imaging project with PET and MRSI at University of California, San Francisco (UCSF). Informed consent was obtained from all subjects according to guidelines of the UCSF Committee on Human Research. All surgical candidates suspected to have seizures arising from the TLs between April 1994 and June 1995 were screened for selection. After scalp-sphenoidal EEG/video telemetry, 36 patients were su...

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“…Evidence is accumulating to suggest that the prefrontal cortex is specifically involved in retrieval effort, with the medial temporal lobe system, in contrast, mediating the experience of conscious recollection (11). Patients with left temporal lobe epilepsy (TLE) show evidence of mesial temporal lobe hippocampal atrophy, as measured through magnetic resonance imaging (MRI) volumetry (16)(17)(18)(19)(20). Their deficits in explicit memory are well documented (21)(22)(23)(24)(25).…”

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confidence: 99%

A Dissociation between Implicit and Explicit Verbal Memory in Left Temporal Lobe Epilepsy

et al. 2004

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Summary: Purpose: Temporal lobe epilepsy patients are well known to present deficits on explicit verbal memory procedures (e.g., recall, recognition). The integrity of implicit memory procedures in these patients is not established. Previous studies in this area used implicit memory measures contaminated by the effects of explicit memory.Methods: We examined the integrity of verbal implicit and explicit memory in left temporal lobe epilepsy (LTLE) patients and hypothesized that a clear dissociation in performance would be found with a relative preservation of implicit memory. TLE patients (n = 15) and age-and education-matched healthy normal patients (n = 15) were shown a 40-word study list, followed by a test phase requiring completion of word stems based on the study words or new/unseen words. Experimental conditions involved instructions to provide either the old (study) words or novel/nonlist words when completing the stem. Measures of automaticity and recollection provided uncontaminated indices of implicit and explicit memory, respectively.Results: The data showed a significant difference (p < 0.001) between the patients (Recollection, 0.12; SD, 0.18) and controls (0.50, SD, 0.15) on the measure of explicit memory. In contrast, the patients (Automaticity, 0.51; SD, 0.11) and controls (0.45, SD, 0.18) performed similarly on the implicit memory measure, with patient scores clearly at normative levels based on other Process Dissociation Procedure data.Conclusions: The data demonstrate the integrity of implicit memory in LTLE patients. Finding a dissociation between the two forms of verbal memory in LTLE patients provides evidence that they rely on different neuroanatomic systems.

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Magnetic resonance imaging–based volume studies in temporal lobe epilepsy: Pathological correlations

Cited by 443 publications

References 14 publications

3T MRI Quantification of Hippocampal Volume and Signal in Mesial Temporal Lobe Epilepsy Improves Detection of Hippocampal Sclerosis

3T MRI Quantification of Hippocampal Volume and Signal in Mesial Temporal Lobe Epilepsy Improves Detection of Hippocampal Sclerosis

Presurgical multimodality neuroimaging in electroencephalographic lateralized temporal lobe epilepsy

A Dissociation between Implicit and Explicit Verbal Memory in Left Temporal Lobe Epilepsy

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