Neocortical thinning in “benign” mesial temporal lobe epilepsy
Open Access
- 31 March 2011
- Vol. 52 (4), 712-717
- https://doi.org/10.1111/j.1528-1167.2011.03038.x
Abstract
In refractory mesial temporal lobe epilepsy (MTLE) extrahippocampal and neocortical abnormalities have been described in patients with or without mesial temporal sclerosis (MTS). Recently we observed gray matter reductions in regions outside the hippocampus in benign MTLE with or without MTS. Cortical thickness has been proposed as a viable methodologic alternative for assessment of neuropathologic changes in extratemporal regions. Herein, we aimed to use this technique to describe cortical abnormalities in patients with benign TLE. Whole-brain cortical thickness analysis (FreeSurfer) was performed in 32 unrelated patients with benign TLE [16 patients with signs of MTS on magnetic resonance imaging (MRI), pMTLE; 16 without, nMTLE] and 44 healthy controls. In the pMTLE group, the most significant thinning was found in the sensorimotor cortex bilaterally but was more extensive in the left hemisphere (false discovery rate, p < 0.05). Other areas were localized in the occipital cortex, left supramarginal gyrus, left superior parietal gyrus, left paracentral sulcus, left inferior/middle/superior frontal gyrus, left inferior frontal sulcus, right cingulate cortex, right superior frontal gyrus, right inferior parietal gyrus, right fusiform gyrus, and cuneus/precuneus. In the nMTLE, a similar neurodegenerative pattern was detected, although not surviving correction for multiple comparisons. Direct comparison between pMTLE and nMTLE did not reveal significant changes. Patients with either benign pMTLE or nMTLE showed comparable cortical thinning, mainly confined to the sensorimotor cortex. This finding that is not appreciated on routine MRI supports the hypothesis that similar to refractory MTLE, even in benign MTLE, pathology in neocortical regions maybe implicated in the pathophysiology of this syndrome.This publication has 32 references indexed in Scilit:
- Voxel‐based morphometry of sporadic epileptic patients with mesiotemporal sclerosisEpilepsia, 2010
- Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosisNeuroImage, 2009
- Longitudinal and cross-sectional analysis of atrophy in pharmacoresistant temporal lobe epilepsyNeurology, 2009
- Hippocampal and thalamic atrophy in mild temporal lobe epilepsyNeurology, 2008
- Mapping limbic network organization in temporal lobe epilepsy using morphometric correlations: Insights on the relation between mesiotemporal connectivity and cortical atrophyNeuroImage, 2008
- Extrahippocampal gray matter atrophy and memory impairment in patients with medial temporal lobe epilepsyHuman Brain Mapping, 2007
- Voxel-based morphometry of the thalamus in patients with refractory medial temporal lobe epilepsyNeuroImage, 2005
- Voxel-Based Morphometry—The MethodsNeuroImage, 2000
- Cortical Surface-Based Analysis: II: Inflation, Flattening, and a Surface-Based Coordinate SystemNeuroImage, 1999
- Cortical Surface-Based Analysis: I. Segmentation and Surface ReconstructionNeuroImage, 1999