“Magnetic Resonance Imaging Negative Positron Emission Tomography Positive” Temporal Lobe Epilepsy: FDG-PET Pattern Differs from Mesial Temporal Lobe Epilepsy

Carne, Ross; Cook, Mark; MacGregor, Lachlan; Kilpatrick, Christine; Hicks, Rodney J.; O’Brien, Terence J.

doi:10.1007/s11307-006-0073-0

Cited by 30 publications

(13 citation statements)

References 33 publications

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“…Previous studies using ROI approaches found subtle although significant structural abnormalities in the ipsilateral amygdala, entorhinal cortex, thalamus or diffuse hemispheric volume losses in TLE-no compared to controls (Bernasconi et al 2001, Bowers et al, 2003;Natsume et al, 2003; Mueller et al, 2007; Briellmann et al, 1998; Carne et al, 2007). Studies using unbiased whole brain analyses, i.e., voxel-based morphometry (VBM), found either no or only very subtle and diffuse cortical abnormalities in comparisons of TLE-no with controls (Mueller et al, 2006; Woermann et al ,1999; Riederer et al ,2008).…”

Section: Discussionmentioning

confidence: 93%

“…Functional studies, i.e., depth EEG (Vossler et al 2004) and PET imaging (Carne et al 2007) suggest that the initial seizure onset zone in TLE-no is not restricted to the hippocampus but encompasses a more widespread area in the anterior inferior medial temporal lobe of which the hippocampus may or may not be a part. The cortical thinning in the ipsilateral mesial-inferior temporal region found in this study indicates that these functional abnormalities are associated with a structural correlate, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…In regions not synaptically connected to the primary region or epileptogenic focus, the correlation in the mixed population (TLE and controls) will not be different from the correlation in each subgroup. According to the a priori hypothesis about the localization of epileptogenic focus in TLE-MTS and TLE-no, a linear regression analysis was performed in which volume respectively cortical thickness in the presumed epileptogenic focus (volume of ipsilateral hippocampal for the correlation in TLE-MTS and controls, mean thickness of the inferior temporal gyrus for the correlation in TLE-no and controls (Carne et al, 2007; Mueller et al, 2007) was correlated with the thickness in the remaining cortex in TLE-MTS and controls, TLE-no and controls and controls alone. Age was modeled as a co-variate to correct for age-related volume loss, a FDR of p ≤ 0.05 was applied to correct for multiple comparisons.…”

Section: Methodsmentioning

confidence: 99%

“…To identify regions of cortical thinning in TLE-no. We expected extrafocal thinning in TLE-no to affect neocortical regions in the inferior medial temporal lobe (Carne et al, 2007; Vossler et al, 2004; Mueller et al 2007) and regions receiving projections from these regions, i.e., to show a different distribution than the one found in TLE-MTS.…”

Section: Introductionmentioning

confidence: 96%

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Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis

et al. 2009

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Purpose: Extrafocal structural abnormalities have been consistently described in temporal lobe epilepsy (TLE) with mesial temporal lobe sclerosis (TLE-MTS). In TLE without MTS (TLE-no) extrafocal abnormalities are more subtle and often require region of interest analyses for their detection. Cortical thickness measurements might be better suited to detect such subtle abnormalities than conventional whole brain volumetric techniques which are often negative in TLE-no. The aim of this study was to seek and characterize patterns of cortical thinning in TLE-MTS and TLE-no.Methods: T1 weighted whole brain images were acquired on a 4T magnet in 66 subjects (35 controls, 15 TLE-MTS, 16 TLE-no). Cortical thickness measurements were obtained using the FreeSurfer software routine. Group comparisons and correlation analyses were done using the statistical routine of FreeSurfer (FDR, p = 0.05).Results: TLE-MTS and TLE-no showed both widespread temporal and extratemporal cortical thinning. In TLE-MTS, the inferior medial and posterior temporal regions were most prominently affected while lateral temporal and opercular regions were more affected in TLE-no. The correlation analysis showed a significant correlation between the ipsilateral hippocampal volume and regions of thinning in TLE-MTS and between inferior temporal cortical thickness and thinning in extratemporal cortical regions in TLE-no. Conclusion:The pattern of thinning in TLE-no was different from the pattern in TLE-MTS. This finding suggests that different epileptogenic networks could be involved in TLE-MTS and TLE and further supports the hypothesis that TLE-MTS and TLE-no might represent two distinct TLE syndromes.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis

et al. 2009

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“…Structural MRI studies have shown different patterns of gray matter abnormalities (cortical thinning, volume loss) in the two sub-types: In TLE-mts the most prominent abnormalities are found in the ipsilateral mesial temporal lobe, but also in the parietal and frontal lobes and basal ganglia/thalamus. In TLE-no, abnormalities affect the ipsilateral inferior lateral temporal cortex, but also insular and frontal regions [1–4]. …”

Section: Introductionmentioning

confidence: 99%

Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis

et al. 2013

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Temporal lobe epilepsy with (TLE-mts) and without (TLE-no) mesial temporal sclerosis display different patterns of cortical neuronal loss, suggesting that the distribution of white matter damage may also differ between the sub-groups. The purpose of this study was to examine patterns of white matter damage in TLE-mts and TLE-no and to determine if identified changes are related to neuronal loss at the presumed seizure focus. The 4 T diffusion tensor imaging (DTI) and T1-weighted data were acquired for 22 TLE-mts, 21 TLE-no and 31 healthy controls. Tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) maps and voxel-based morphometry (VBM) was used to identify grey matter (GM) volume atrophy. Correlation analysis was conducted between the FA maps and neuronal loss at the presumed seizure focus. In TLE-mts, reduced FA was identified in the genu, body and splenium of the corpus callosum, bilateral corona radiata, cingulum, external capsule, ipsilateral internal capsule and uncinate fasciculus. In TLE-no, FA decreases were identified in the genu, the body of the corpus callosum and ipsilateral anterior corona radiata. The FA positively correlated with ipsilateral hippocampal volume. Widespread extra-focal GM atrophy was associated with both sub-groups. Despite widespread and extensive GM atrophy displaying different anatomical patterns in both sub-groups, TLE-mts demonstrated more extensive FA abnormalities than TLE-no. The microstructural organization in the corpus callosum was related to hippocampal volume in both patients and healthy subjects demonstrating the association of these distal regions.

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PET and SPECT in Presurgical Evaluation of Epilepsy

Paesschen¹,

Goffin

Laere³

2004

The Treatment of Epilepsy

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“Magnetic Resonance Imaging Negative Positron Emission Tomography Positive” Temporal Lobe Epilepsy: FDG-PET Pattern Differs from Mesial Temporal Lobe Epilepsy

Abstract: These data support the hypothesis that focal hypometabolism involves primarily lateal neocortical rather than mesial temporal structures in 'MRI-negative PET-positive TLE.'

Cited by 30 publications

References 33 publications

Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis

Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis

Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis

PET and SPECT in Presurgical Evaluation of Epilepsy

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