The impact of epilepsy duration in a series of patients with mesial temporal lobe epilepsy due to unilateral hippocampal sclerosis

•Lower hippocampal cell density correlates to a longer epilepsy duration.•Thinning and dispersion of the granular cells are related to longer epilepsy duration.•Lower ipsilateral hippocampal volume is associated with a longer epilepsy duration.•Ipsilateral hippocampal volume correlates to the estima...

Full description

Saved in:
Bibliographic Details
Published in:Epilepsy research 2018-11, Vol.147, p.51-57
Main Authors: Duarte, Jeana Torres Corso, Jardim, Anaclara Prada, Comper, Sandra Mara, De Marchi, Luciana Rodrigues, Gaça, Larissa Botelho, Garcia, Maria Teresa Fernandes Castilho, Sandim, Gabriel Barbosa, Assunção-Leme, Idaiane Batista, Carrete, Henrique, Centeno, Ricardo Silva, Lancellotti, Carmen Lúcia Penteado, Jackowski, Andrea P., Cavalheiro, Esper Abrão, Guaranha, Mirian Salvadori Bittar, Yacubian, Elza Márcia Targas
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Brain - diagnostic imaging
Brain - pathology
Brain Mapping
Cell Count
Epilepsy, Temporal Lobe - complications
Epilepsy, Temporal Lobe - pathology
Female
FreeSurfer volumetry
Hippocampal sclerosis
Hippocampus - diagnostic imaging
Hippocampus - pathology
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Mesial temporal lobe epilepsy
Middle Aged
Neurons - metabolism
Neurons - pathology
Phosphopyruvate Hydratase - metabolism
Sclerosis - diagnostic imaging
Sclerosis - pathology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Lower hippocampal cell density correlates to a longer epilepsy duration.•Thinning and dispersion of the granular cells are related to longer epilepsy duration.•Lower ipsilateral hippocampal volume is associated with a longer epilepsy duration.•Ipsilateral hippocampal volume correlates to the estimated hippocampal cell density. To evaluate if the duration of epilepsy influences MRI volumes of the hippocampus, amygdala, parahippocampal gyrus, entorhinal cortex and temporal pole of both hemispheres and epileptogenic hippocampus neuronal cell density and dentate gyrus granular cells distribution in patients with refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS). Seventy-seven patients with refractory MTLE/HS submitted to surgery were included. Histopathological analysis included: (1) quantitative: hippocampal subfields and total estimated hippocampal cell density (HCD), thickness of the dentate gyrus – normal, thinning or dispersion; (2) qualitative: type of HS and granule cells pathology in the dentate gyrus (normal, neuronal cell loss, dispersion and bilamination). Automated MRI-derived measurements from bilateral temporal structures (hippocampus, amygdala, parahippocampal gyrus, temporal pole, entorhinal cortex) were obtained for 58 subjects. Histopathological and imaging findings were compared with data from specimens obtained in autopsies of age-matched individuals and living controls, respectively, and the data were adjusted for the age at epilepsy onset and the frequency of focal impaired awareness seizures/month. Forty-two (54.5%) patients presented right HS. The greater the duration of epilepsy, the smaller the total estimated HCD (p = 0.025; r = −0.259). Patients with a normal distribution of the granular cells had a shorter epilepsy duration than those with dispersion (p = 0.018) or thinning (p = 0.031). A reduced ipsilateral hippocampal volume (r = −0.551, p = 0.017) and a smaller hippocampal asymmetry index (r = −0.414, p = 0.002) were correlated to a longer epilepsy duration. The estimated HCD was correlated to the volume of the ipsilateral hippocampus (r = 0.420, p = 0.001). Our study showed an increasing atrophy of the ipsilateral hippocampus in patients with a longer epilepsy duration. Our data suggest that this reduction in hippocampal volume is related to neuronal loss. Besides that, we also showed an increased probability of exhibiting an abnormal distribution of the granular cells in the dentate gyrus in pati
ISSN:0920-1211
1872-6844
DOI:10.1016/j.eplepsyres.2018.08.009