Widespread affections of large fiber tracts in postoperative temporal lobe epilepsy

Schoene-Bake, Jan-Christoph; Faber, Jennifer; Trautner, Peter; Kaaden, Sabine; Tittgemeyer, Marc; Elger, Christian E.; Weber, Bernd

doi:10.1016/j.neuroimage.2009.03.013

Cited by 67 publications

(67 citation statements)

References 49 publications

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“…[25][26][27][28][29] For example, studies have shown regional differences in GM and WM between groups of patients with TLE and healthy controls that extend beyond the temporal lobe; these differences are also observed in brain tissue connected to hippocampal structures such as the cingulum, thalamus, and frontal lobe. [29][30][31][32][33][34][35] Our data are in line with other reports showing reduced GM and WM volumes in temporolimbic and frontal areas. 31,33 Abnormalities in these regions in patients with mesial TLE have been reported by others by using diffusion tensor imaging.…”

Section: Discussionsupporting

confidence: 93%

Extratemporal Damage in Temporal Lobe Epilepsy: Magnetization Transfer Adds Information to Volumetric MR Imaging: Fig 1.

Diniz

Velasco²,

Salmon³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:MTS is characterized by gliosis and atrophy of the hippocampus and related limbic structures. However, the damage is not limited to those structures with atrophy and has been reported in extratemporal regions. Because volumetric studies are nonspecific, the pathophysiology of the brain damage remains to be solved. MTI is an MR imaging technique more sensitive to subtle neuropathologic changes than conventional MR imaging. Here we combined MTI with VBM analysis to evaluate extratemporal damage in patients with TLE.

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Section: Discussionsupporting

confidence: 93%

Extratemporal Damage in Temporal Lobe Epilepsy: Magnetization Transfer Adds Information to Volumetric MR Imaging: Fig 1.

Diniz

Velasco²,

Salmon³

et al. 2011

AJNR Am J Neuroradiol

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“…While mesial temporal sclerosis (MTS) is the most commonly observed pathology in TLE, DTI studies have shown white matter abnormalities in several bundles not necessarily limited to the temporal lobe nor the hemisphere ipsilateral to seizure focus (Arfanakis et al, 2002;Gross et al, 2006;Rodrigo et al, 2007;Focke et al, 2008;McDonald et al, 2008;Nilsson et al, 2008;Yogarajah et al, 2008;Schoene-Bake et al, 2009). We have previously demonstrated that TLE patients with unilateral MTS (TLEϩuMTS) have DTI abnormalities of the fimbria-fornix (Concha et al, 2005b) that are not observed in TLE patients who do not have MTS (TLEϪMTS) (Concha et al, 2009).…”

Section: Introductionmentioning

confidence: 96%

In VivoDiffusion Tensor Imaging and Histopathology of the Fimbria-Fornix in Temporal Lobe Epilepsy

Concha¹,

Livy²,

Beaulieu³

et al. 2010

J. Neurosci.

198

165

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While diffusion tensor imaging (DTI) has been extensively used to infer micro-structural characteristics of cerebral white matter in human conditions, correlations between human in vivo DTI and histology have not been performed. Temporal lobe epilepsy (TLE) patients with mesial temporal sclerosis (MTS) have abnormal DTI parameters of the fimbria-fornix (relative to TLE patients without MTS) which are presumed to represent differences in axonal/myelin integrity. Medically intractable TLE patients who undergo temporal lobe resection including the fimbria-fornix provide a unique opportunity to study the anatomical correlates of water diffusion abnormalities in freshly excised tissue. Eleven patients with medically intractable TLE were recruited (six with and five without MTS) for presurgical DTI followed by surgical excision of a small specimen of the fimbria-fornix which was processed for electron microscopy. Blinded quantitative analysis of the microphotographs included axonal diameter, density and area, cumulative axon membrane circumference, and myelin thickness and area. As predicted by DTI the fimbria-fornix of TLE patients with MTS had increased extra-axonal fraction, and reduced cumulative axonal membrane circumference and myelin area. Consistent with the animal literature, water diffusion anisotropy over the crus of the fimbria-fornix was strongly correlated with axonal membranes (cumulative membrane circumference) within the surgical specimen (ϳ15% of what was analyzed with DTI). The demonstration of a correlation between histology and human in vivo DTI, in combination with the observation that in vivo DTI accurately predicted white matter abnormalities in a human disease condition, provides strong validation of the application of DTI as a noninvasive marker of white matter pathology.

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“…6 Resting state fMRI can be used to capture correlated neural signaling, identifying the network of gray matter regions that are biased toward neural communication, although no research has yet evaluated its surgical applicability. 37 DTI can be used to evaluate the integrity of and specify the anatomical connectivity between the functionally relevant gray matter regions. One published study has reported that a change in fractional anisotropy correlates with good language outcome following temporal lobectomy, but this study lacked a normal control group.…”

mentioning

confidence: 99%

Functional MRI, resting state fMRI, and DTI for predicting verbal fluency outcome following resective surgery for temporal lobe epilepsy

Osipowicz

Sperling²,

Sharan

et al. 2016

JNS

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929cliNical article J Neurosurg 124:929-937, 2016 P redicting outcome following resective brain surgery remains a high-priority goal in neurology and neurosurgery. Recently, a need for classifying surgical outcome on the basis of functional status, such as cognition, rather than just seizure control, has been articulated. 44 A number of neuroimaging techniques give us insight into the neuroanatomical correlates of cognition. These techniques are increasingly being used as part of presurgical planning algorithms, 11,19,20,28 providing an opportunity to not only gain insights into the functional neuroanatomy of "at-risk" cognition and how it relates to the underlying pathology, but also use such insights to predict cognitive outcome following surgery, such as anterior temporal lobectomy (ATL) for epilepsy.The predictive power and the combined clinical utility of 3 major MRI techniques (functional MRI [fMRI], resting state fMRI [rsfMRI], and diffusion tensor imaging [DTI]) are unknown and untested. These 3 modalities can be conceptually combined to obtain a more complete view of the neural modules and connectivity networks implementing cognition and driving adaptive or maladaptive neuroplasticity responses in the brain. Functional MRI can be used to define an active network implementing a key function that might be "at risk" with temporal lobe surgery (e.g., verbal fluency), although the validity of this approach needs to be established in prospective studies.5 Preoperative fMRI has been shown to be sensitive to language and verbal memory laterality 9 and is a known predictor of cogabbreviatioNs ATL = anterior temporal lobectomy; DTI = diffusion tensor imaging; fMRI = functional MRI; RCI = Reliable Change Index; rsfMRI = resting state fMRI; TLE = temporal lobe epilepsy. obJective Predicting cognitive function following resective surgery remains an important clinical goal. Each MRI neuroimaging technique can potentially provide unique and distinct insight into changes that occur in the structural or functional organization of "at-risk" cognitive functions. The authors tested for the singular and combined power of 3 imaging techniques (functional MRI [fMRI], resting state fMRI, diffusion tensor imaging) to predict cognitive outcome following left (dominant) anterior temporal lobectomy for intractable epilepsy. methods The authors calculated the degree of deviation from normal, determined the rate of change in this measure across the pre- and postsurgical imaging sessions, and then compared these measures for their ability to predict verbal fluency changes following surgery. results The data show that the 3 neuroimaging techniques, in a combined model, can reliably predict cognitive outcome following anterior temporal lobectomy for medically intractable temporal lobe epilepsy. coNclusioNs These findings suggest that these 3 imaging modalities can be used effectively, in an additive fashion, to predict functional reorganization and cognitive outcome following anterior temporal lobectomy.

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Widespread affections of large fiber tracts in postoperative temporal lobe epilepsy

Cited by 67 publications

References 49 publications

Extratemporal Damage in Temporal Lobe Epilepsy: Magnetization Transfer Adds Information to Volumetric MR Imaging: Fig 1.

Extratemporal Damage in Temporal Lobe Epilepsy: Magnetization Transfer Adds Information to Volumetric MR Imaging: Fig 1.

In VivoDiffusion Tensor Imaging and Histopathology of the Fimbria-Fornix in Temporal Lobe Epilepsy

Functional MRI, resting state fMRI, and DTI for predicting verbal fluency outcome following resective surgery for temporal lobe epilepsy

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