Volumetric and shape analysis of hippocampal subfields in unilateral mesial temporal lobe epilepsy with hippocampal atrophy

Kim, Ho Jin; Suh, Sang Il; Kim, Ji Hyun

doi:10.1016/j.eplepsyres.2015.09.004

Cited by 24 publications

(26 citation statements)

References 56 publications

(84 reference statements)

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“…For the MTLE group, our finding of GMV decrease in the majority of the hippocampal subfields is consistent with recent studies (Kim, Suh, & Kim, ; Schoene‐Bake et al., ). The specific pattern of GMV reduction also differed slightly, as Kim et al.…”

Section: Discussionsupporting

confidence: 93%

Hippocampal involvement in nonpathological déjà vu: Subfield vulnerability rather than temporal lobe epilepsy equivalent

et al. 2018

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IntroductionMorphological correlates of nonpathological déjà vu (DV) have been identified recently within the human brain. Significantly reduced gray matter volume (GMV) within a set of cortical and subcortical regions reported in subjects experiencing DV seems to mirror the distribution of GMV reduction in mesial temporal lobe epilepsy (MTLE) patients but vary in terms of the hippocampus. Another condition associated with hippocampal GMV reduction and DV alike disturbance in memory processing is schizophrenia (SCH). Here, we tested the hypothesis that hippocampal involvement in nonpathological DV resembles more closely the pattern of GMV decrease observed in MTLE compared with that occurring in SCH.MethodsUsing automated segmentation of the MRI data we compared the medians of GMV within 12 specific hippocampal subfields in healthy individuals that do (DV+; N = 87) and do not report déjà vu experience (DV−; N = 26), and patients with MTLE (N = 47) and SCH (N = 29). By Pearson correlation, we then evaluated the similarity of MTLE and SCH groups to DV+ group with respect to spatial distribution of GMV deviation from DV− group.ResultsSignificant GMV decrease was found in MTLE group in most of the subfields. There were just trends in the hippocampal GMV decrease found in DV+ or SCH groups. Concerning the spatial distribution of GMV decrease, we revealed statistically significant correlation for the left hippocampus for SCH vs DV+. Otherwise there was no statistically significant correlation.ConclusionsOur findings reveal structural features of hippocampal involvement in nonpathological DV, MTLE, and SCH. Despite our expectations, the pattern of GMV reduction in the DV+ relative to the DV− group does not resemble the pattern observed in MTLE any more than that observed in SCH. The highly similar patterns of the three clinical groups rather suggest an increased vulnerability of certain hippocampal subfields; namely, Cornu Ammonis (CA)4, CA3, dentate gyrus granular cell layer (GC‐DG), hippocampal–amygdaloid transition area (HATA) and subiculum.

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Section: Discussionsupporting

confidence: 93%

Hippocampal involvement in nonpathological déjà vu: Subfield vulnerability rather than temporal lobe epilepsy equivalent

et al. 2018

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“…Both showed the significant decreased volume of the hippocampus compared to their respective controls. Patients with MTLE had a 28.38% reduction of hippocampal volume unilaterally as compared with their healthy controls (p < 0.05), consistent with previous findings (33,35). Patients with AD had an average 32.70% reduction of hippocampal volume bilaterally as compared with healthy controls (p < 0.05), without significant differences between the left and right sides.…”

Section: Quantitative Atrophy Of Hippocampussupporting

confidence: 88%

“…Statistical analysis was then performed by non-parametric permutation testing with the threshold set at cluster-level p < 0.05, corrected for multiple comparisons using family-wise error (FWE). The regional morphological changes of the hippocampus within the groups were explored (FWEcorrected, p < 0.05) (19,33,34).…”

Section: Automated Segmentation and Comparisonmentioning

confidence: 99%

“…Limitations of this study include its relatively small sample sizes and variable clinical characteristics within and among the groups. The patients with MTLE were variable in epilepsy duration, seizure onset age, seizure frequency, seizure intractability, and medications (33,35). The patients with AD had variability in their dementia onset age, disease duration, APOE ε4 genotype and education years (44)(45)(46).…”

Section: Limitationsmentioning

confidence: 99%

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Identifying Morphological Patterns of Hippocampal Atrophy in Patients With Mesial Temporal Lobe Epilepsy and Alzheimer Disease

et al. 2020

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Purpose: Mesial temporal lobe epilepsy (MTLE) and Alzheimer's disease (AD) are two distinct neurological disorders associated with hippocampal atrophy. Our goal is to analyze the morphologic patterns of hippocampal atrophy to better understand the underlying pathological and clinical characteristics of the two conditions. Methods: Twenty-five patients with AD and 20 healthy controls with matched age and gender were recruited into the AD group. Twenty-three MTLE patients and 28 healthy controls with matched age and gender were recruited into the MTLE group. All subjects were scanned on 3T-MRI scanner. Automated volumetric analysis was applied to measure and compare the hippocampal volume of the two respective groups. Vertex-based morphologic analysis was applied to characterize the morphologic patterns of hippocampal atrophy within and between groups, and a correlation analysis was performed. Results: Volumetric analysis revealed significantly decreased hippocampal volume in both AD and MTLE patients compared to the controls. In the patients with AD, the mean total hippocampal volume was 32.70% smaller than that of healthy controls, without a significant difference between the left and the right hippocampus (p < 0.05). In patients with MTLE, a significant reduction in unilateral hippocampal volume was observed, with a mean volume reduction of 28.38% as compared with healthy controls (p < 0.05). Vertex-based morphologic analysis revealed a generalized shrinkage of the hippocampi in AD patients, especially in bilateral medial and lateral regions. In MTLE group, atrophy was seen in the ipsilateral head, ipsilateral lateral body and slightly contralateral tail of the hippocampus (FWE-corrected, p < 0.05). Conclusions: MTLE and AD have distinctive morphologic patterns of hippocampal atrophy, which provide new insight into the radiology-pathology correlation in these diseases.

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“…This is consistent with previous work that indicates that HS may be a direct and immediate consequence of an initial precipitating injury (eg, febrile seizures/infection/genetic defects); hippocampal subfield volume loss may not be primarily influenced by the chronicity/severity of the disorder as the majority of neuron loss occurs during epileptogenesis before onset of seizures 40, 41. It is worth noting that one study reported a relationship between a longer duration of epilepsy corrected for age and volumes of left CA1, presubiculum, and subiculum in left TLE and right CA1 in right TLE 42. There is evidence from cross‐sectional studies that progressive hippocampal atrophy may occur in patients with TLE; however, longitudinal multicohort studies are needed to differentiate between normal aging and disease progression 43…”

Section: Discussionmentioning

confidence: 99%

Hippocampal subfield segmentation in temporal lobe epilepsy: Relation to outcomes

et al. 2018

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ObjectiveTo investigate the clinical and surgical outcome correlates of preoperative hippocampal subfield volumes in patients with refractory temporal lobe epilepsy (TLE) using a new magnetic resonance imaging (MRI) multisequence segmentation technique.MethodsWe recruited 106 patients with TLE and hippocampal sclerosis (HS) who underwent conventional T1‐weighted and T2 short TI inversion recovery MRI. An automated hippocampal segmentation algorithm was used to identify twelve subfields in each hippocampus. A total of 76 patients underwent amygdalohippocampectomy and postoperative seizure outcome assessment using the standardized ILAE classification. Semiquantitative hippocampal internal architecture (HIA) ratings were correlated with hippocampal subfield volumes.ResultsPatients with left TLE had smaller volumes of the contralateral presubiculum and hippocampus‐amygdala transition area compared to those with right TLE. Patients with right TLE had reduced contralateral hippocampal tail volumes and improved outcomes. In all patients, there were no significant relationships between hippocampal subfield volumes and clinical variables such as duration and age at onset of epilepsy. There were no significant differences in any hippocampal subfield volumes between patients who were rendered seizure free and those with persistent postoperative seizure symptoms. Ipsilateral but not contralateral HIA ratings were significantly correlated with gross hippocampal and subfield volumes.ConclusionsOur results suggest that ipsilateral hippocampal subfield volumes are not related to the chronicity/severity of TLE. We did not find any hippocampal subfield volume or HIA rating differences in patients with optimal and unfavorable outcomes. In patients with TLE and HS, sophisticated analysis of hippocampal architecture on MRI may have limited value for prediction of postoperative outcome.

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Volumetric and shape analysis of hippocampal subfields in unilateral mesial temporal lobe epilepsy with hippocampal atrophy

Cited by 24 publications

References 56 publications

Hippocampal involvement in nonpathological déjà vu: Subfield vulnerability rather than temporal lobe epilepsy equivalent

Hippocampal involvement in nonpathological déjà vu: Subfield vulnerability rather than temporal lobe epilepsy equivalent

Identifying Morphological Patterns of Hippocampal Atrophy in Patients With Mesial Temporal Lobe Epilepsy and Alzheimer Disease

Hippocampal subfield segmentation in temporal lobe epilepsy: Relation to outcomes

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