Ventricular enlargement in new-onset pediatric epilepsies

Abstract

Summary Purpose To examine baseline and prospective (2-year) changes in third, fourth, and lateral ventricle volumes in children with new-onset idiopathic epilepsies and controls (age 8–18 years). Methods Structural magnetic resonance imaging (MRI) were collected from children with idiopathic generalized epilepsy (IGE, n = 29), idiopathic localization-related epilepsy (ILRE, n = 30), and healthy controls (HCs, n = 49). Volumes of the third, fourth, and lateral ventricles were derived and compared across groups, followed by shape analyses, to identify specific regions of ventricular abnormality. Of the initial cohort, a consecutive sample of 71 children returned 2 years later for reimaging and determination of progressive changes in the ventricular system. Key Findings At baseline, children with new-onset IGE had significantly larger lateral and third ventricle volumes relative to the HC group. In addition, lateral ventricle enlargement in IGE was significantly greater compared to new-onset ILRE. Shape analysis of the lateral ventricles revealed that volume expansion in IGE was selective for the anterior horn, a region surrounded by the lateral and medial frontal lobes as well as basal ganglia. These abnormalities did not progress over a 2-year interval. Significance Abnormalities in brain development prior to onset and diagnosis of epilepsy are evident and reflected in expansion of the ventricular system, especially among children with IGE. These abnormalities appear to represent an antecedent and possibly static finding given the lack of progressive ventricular expansion over the 2-year interval following diagnosis and treatment.

A Mechanism of Rapidly Reversible Cerebral Ventricular Enlargement Independent of Tissue Atrophy

“…Biochemical evaluation of tissue is accomplished with MR spectroscopy (MRS). Levels of the predominant MRS signal from N-acetylaspartate (NAA) are irreversibly reduced in diseases in which neuronal loss incontrovertibly occurs (eg, epilepsy or ischemia) (Bengzon et al, 2002;Jackson et al, 2011), but are only transiently reduced in conditions where recovery is possible (eg, following detoxification from chronic alcoholism) (Bendszus et al, 2001). The MRS signal composed of choline-containing compounds (Cho) is elevated in multiple sclerosis (Butzkueven et al, 2008) and often interpreted as representing neuroinflammation (De Stefano et al, 2005) or demyelination (Mader et al, 2008).…”

Morphometric abnormalities of the lateral ventricles in methamphetamine-dependent subjects

“…Current analysis excluded the temporal horns of the lateral ventricles as in other studies using the morphometric approach because of the low resolution of its connection to the main body of the lateral ventricle (Styner et al, 2005; Jackson et al, 2011; Vidal et al, 2008). Our findings should thus be interpreted within the focused regions that were included in the analysis.…”

“…Three-dimensional surface-based morphometric analysis of the lateral ventricles, as implemented in the current study, has methodological advantages in terms of a greater sensitivity to identify focal changes related to diseases (Styner et al, 2005; Apostolova et al, 2012; Jackson et al, 2011). In this study, we found that chronic methamphetamine use might be related to focal lateral ventricular expansion primarily located in areas adjacent to prefrontal-ventral striatal-thalamic circuits.…”

“…A recent trend to assess morphometric variability of the lateral ventricles has enabled the detection of more subtle changes in shape composition, which could be imperceptible upon volumetric measurement (Styner et al, 2005; Apostolova et al, 2012; Jackson et al, 2011). Further, specific anatomical information with respect to regional changes in the lateral ventricles by surface-based morphometric analysis may also permit evaluation of structural change in surrounding brain structures (Apostolova et al, 2012; Jackson et al, 2011). However, to the best of our knowledge, structural changes in the lateral ventricles have not been studied in methamphetamine-dependent subjects in terms of shape deformation.…”

Measures of Ventricles and Evans' Index: From Neonate to Adolescent

“…Ventriculomegaly has been observed in many other neurological and psychiatric disorders, including dementia, cerebral atrophy, multiple sclerosis and autism spectrum disorder [4]. …”