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An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning

In mesial temporal lobe epilepsy (mTLE), the correlation between disease duration, seizure laterality, and rostro-caudal location of hippocampal sclerosis has not been examined in the context of seizure severity and global cortical thinning. In this retrospective study, we analyzed structural 3 T MR...

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Autores principales: Mansouri, Alireza, Germann, Jurgen, Boutet, Alexandre, Elias, Gavin J. B., Karmur, Brij, Neudorfer, Clemens, Loh, Aaron, McAndrews, Mary Pat, Ibrahim, George M., Lozano, Andres M., Valiante, Taufik A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907189/
https://www.ncbi.nlm.nih.gov/pubmed/33633325
http://dx.doi.org/10.1038/s41598-021-84281-y
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author Mansouri, Alireza
Germann, Jurgen
Boutet, Alexandre
Elias, Gavin J. B.
Karmur, Brij
Neudorfer, Clemens
Loh, Aaron
McAndrews, Mary Pat
Ibrahim, George M.
Lozano, Andres M.
Valiante, Taufik A.
author_facet Mansouri, Alireza
Germann, Jurgen
Boutet, Alexandre
Elias, Gavin J. B.
Karmur, Brij
Neudorfer, Clemens
Loh, Aaron
McAndrews, Mary Pat
Ibrahim, George M.
Lozano, Andres M.
Valiante, Taufik A.
author_sort Mansouri, Alireza
collection PubMed
description In mesial temporal lobe epilepsy (mTLE), the correlation between disease duration, seizure laterality, and rostro-caudal location of hippocampal sclerosis has not been examined in the context of seizure severity and global cortical thinning. In this retrospective study, we analyzed structural 3 T MRI from 35 mTLE subjects. Regions of FLAIR hyperintensity (as an indicator of sclerosis)—based on 2D coronal FLAIR sequences—in the hippocampus were manually segmented, independently and in duplicate; degree of segmentation agreement was confirmed using the DICE index. Segmented lesions were used for separate analyses. First, the correlation of cortical thickness with disease duration and seizure focus laterality was explored using linear model regression. Then, the relationship between the rostro-caudal location of the FLAIR hyperintense signal and seizure severity, based on the Cleveland Clinic seizure freedom score (ccSFS), was explored using probabilistic voxel-wise mapping and functional connectivity analysis from normative data. The mean DICE Index was 0.71 (range 0.60–0.81). A significant correlation between duration of epilepsy and decreased mean whole brain cortical thickness was identified, regardless of seizure laterality (p < 0.05). The slope of cortical volume loss over time, however, was greater in subjects with right seizure focus. Based on probabilistic voxel-wise mapping, FLAIR hyperintensity in the posterior hippocampus was significantly associated with lower ccSFS scores (greater seizure severity). Finally, the right hippocampus was found to have greater brain-wide connectivity, compared to the left side, based on normative connectomic data. We have demonstrated a significant correlation between duration of epilepsy and right-sided seizure focus with global cortical thinning, potentially due to greater brain-wide connectivity. Sclerosis along the posterior hippocampus was associated with greater seizure severity, potentially serving as an important biomarker of seizure outcome after surgery.
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spelling pubmed-79071892021-02-26 An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning Mansouri, Alireza Germann, Jurgen Boutet, Alexandre Elias, Gavin J. B. Karmur, Brij Neudorfer, Clemens Loh, Aaron McAndrews, Mary Pat Ibrahim, George M. Lozano, Andres M. Valiante, Taufik A. Sci Rep Article In mesial temporal lobe epilepsy (mTLE), the correlation between disease duration, seizure laterality, and rostro-caudal location of hippocampal sclerosis has not been examined in the context of seizure severity and global cortical thinning. In this retrospective study, we analyzed structural 3 T MRI from 35 mTLE subjects. Regions of FLAIR hyperintensity (as an indicator of sclerosis)—based on 2D coronal FLAIR sequences—in the hippocampus were manually segmented, independently and in duplicate; degree of segmentation agreement was confirmed using the DICE index. Segmented lesions were used for separate analyses. First, the correlation of cortical thickness with disease duration and seizure focus laterality was explored using linear model regression. Then, the relationship between the rostro-caudal location of the FLAIR hyperintense signal and seizure severity, based on the Cleveland Clinic seizure freedom score (ccSFS), was explored using probabilistic voxel-wise mapping and functional connectivity analysis from normative data. The mean DICE Index was 0.71 (range 0.60–0.81). A significant correlation between duration of epilepsy and decreased mean whole brain cortical thickness was identified, regardless of seizure laterality (p < 0.05). The slope of cortical volume loss over time, however, was greater in subjects with right seizure focus. Based on probabilistic voxel-wise mapping, FLAIR hyperintensity in the posterior hippocampus was significantly associated with lower ccSFS scores (greater seizure severity). Finally, the right hippocampus was found to have greater brain-wide connectivity, compared to the left side, based on normative connectomic data. We have demonstrated a significant correlation between duration of epilepsy and right-sided seizure focus with global cortical thinning, potentially due to greater brain-wide connectivity. Sclerosis along the posterior hippocampus was associated with greater seizure severity, potentially serving as an important biomarker of seizure outcome after surgery. Nature Publishing Group UK 2021-02-25 /pmc/articles/PMC7907189/ /pubmed/33633325 http://dx.doi.org/10.1038/s41598-021-84281-y Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Mansouri, Alireza
Germann, Jurgen
Boutet, Alexandre
Elias, Gavin J. B.
Karmur, Brij
Neudorfer, Clemens
Loh, Aaron
McAndrews, Mary Pat
Ibrahim, George M.
Lozano, Andres M.
Valiante, Taufik A.
An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title_full An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title_fullStr An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title_full_unstemmed An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title_short An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
title_sort exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907189/
https://www.ncbi.nlm.nih.gov/pubmed/33633325
http://dx.doi.org/10.1038/s41598-021-84281-y
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