Download PDF
CC BY-NC-ND 4.0 · International Journal of Epilepsy 2014; 01(01): 001-007
DOI: 10.1016/j.ijep.2014.05.003
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Diffusion tensor imaging correlates of hippocampal sclerosis and anterior temporal lobe T2 signal changes in pharmacoresistant epilepsy

Kevin Spitler
a   Department of Radiological Science, University of California at Los Angeles, USA
,
Francis Tirol
b   Department of Neurology, University of California at Los Angeles, USA
,
Itzhak Fried
c   Department of Neurosurgery, University of California at Los Angeles, USA
,
Jerome Engel Jr
b   Department of Neurology, University of California at Los Angeles, USA
,
Noriko Salamon
a   Department of Radiological Science, University of California at Los Angeles, USA
› Author Affiliations
Subject Editor:
Further Information

Publication History

Received: 29 January 2013

Accepted: 24 May 2014

Publication Date:
04 May 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Background and purpose Our goal was to determine fiber tract integrity in hippocampal sclerosis (HS) using diffusion tensor imaging (DTI) and to correlate white matter damage with other pathology in this disease.

Methods Twenty-six patients and eight controls were studied with DTI tractography for 8 pairs of white matter fiber tracts and 2 commissural tracts. Fractional anisotropy (FA) of the fiber tracts was compared with controls. The FA of select fiber tracts was also compared with change in T2 signal in the anterior temporal lobe (ATC), and the performance on neuropsychological tests.

Results In comparison with controls, subjects with left sided hippocampal sclerosis (L-HS) had 3 ipsilateral fiber tracts with decreased FA. The FA of fiber tracts was similar in right sided HS (R-HS) to controls. The ipsilateral inferior longitudinal fasciculus had a decrease in FA that correlated with the ATC (T2 signal change). The right superior longitudinal fasciculus had a decrease in FA proportional to lower performance on tests of memory and language.

Conclusion The subjects with L-HS had more extensive structural abnormalities involving white matter tracts, both ipsilateral and contralateral. In contrast, subjects with R-HS had limited changes in white matter integrity. Pathology of white matter appears to be involved in deficits associated with HS, including ATC and cognitive performance.

Keywords

Hippocampal sclerosis - Diffusion tensor imaging - Anterior temporal lobe
 

  • References

  • 1 Engel Jr J. Mesial temporal lobe epilepsy: what have we learned?. Neuroscientist 7 2001; 340-352
    CrossrefPubMedGoogle Scholar
  • 2 Spooner CG, Berkovic SF, Mitchell LA, Wrennall JA, Harvey AS. New-onset temporal lobe epilepsy in children: lesion on MRI predicts poor seizure outcome. Neurology 67 2006; 2147-2153
    CrossrefPubMedGoogle Scholar
  • 3 Spencer SS. When should temporal-lobe epilepsy be treated surgically?. Lancet Neurol 1 2002; 375-382
    CrossrefPubMedGoogle Scholar
  • 4 Lencz T, McCarthy G, Bronen RA. et al. Quantitative magnetic resonance imaging in temporal lobe epilepsy: relationship to neuropathology and neuropsychological function. Ann Neurol 31 1992; 629-637
    CrossrefPubMedGoogle Scholar
  • 5 Meiners LC, van Gils A, Jansen GH. et al. Temporal lobe epilepsy: the various MR appearances of histologically proven mesial temporal sclerosis. AJNR Am J Neuroradiol 15 1994; 1547-1555
    PubMedGoogle Scholar
  • 6 Lin JJ, Salamon N, Lee AD. et al. Reduced neocortical thickness and complexity mapped in mesial temporal lobe epilepsy with hippocampal sclerosis. Cereb Cortex 17 2007; 2007-2018
    CrossrefPubMedGoogle Scholar
  • 7 Lin JJ, Salamon N, Dutton RA. et al. Three-dimensional preoperative maps of hippocampal atrophy predict surgical outcomes in temporal lobe epilepsy. Neurology 65 2005; 1094-1097
    CrossrefPubMedGoogle Scholar
  • 8 Jackson GD, Berkovic SF, Duncan JS, Connelly A. Optimizing the diagnosis of hippocampal sclerosis using MR imaging. AJNR Am J Neuroradiol 14 1993; 753-762
    PubMedGoogle Scholar
  • 9 Mitchell LA, Jackson GD, Kalnins RM. et al. Anterior temporal abnormality in temporal lobe epilepsy: a quantitative MRI and histopathologic study. Neurology 52 1999; 327-336
    CrossrefPubMedGoogle Scholar
  • 10 Mori S, Zhang J. Principles of diffusion tensor imaging and its applications to basic neuroscience research. Neuron 51 2006; 527-539
    CrossrefPubMedGoogle Scholar
  • 11 Knake S, Salat DH, Halgren E. et al. Changes in white matter microstructure in patients with TLE and hippocampal sclerosis. Epileptic Disord 11 2009; 244-250
    PubMedGoogle Scholar
  • 12 Shon Y-M, Kim YI, Koo BB. et al. Group-specific regional white matter abnormality revealed in diffusion tensor imaging of medial temporal lobe epilepsy without hippocampal sclerosis. Epilepsia 51 2010; 529-535
    CrossrefPubMedGoogle Scholar
  • 13 Kim CH, Koo BB, Chung CK, Lee JM, Kim JS, Lee SK. Thalamic changes in temporal lobe epilepsy with and without hippocampal sclerosis: a diffusion tensor imaging study. Epilepsy Res 90 2010; 21-27
    CrossrefPubMedGoogle Scholar
  • 14 Moran NF, Lemieux L, Kitchen ND, Fish DR, Shorvon SD. Extrahippocampal temporal lobe atrophy in temporal lobe epilepsy and mesial temporal sclerosis. Brain 124 2001; 167-175
    CrossrefPubMedGoogle Scholar
  • 15 Mitchell LA, Harvey AS, Coleman LT, Mandelstam SA, Jackson GD. Anterior temporal changes on MR images of children with hippocampal sclerosis: an effect of seizures on the immature brain?. AJNR Am J Neuroradiol 24 2003; 1670-1677
    PubMedGoogle Scholar
  • 16 Thom M, Eriksson S, Martinian L. et al. Temporal lobe sclerosis associated with hippocampal sclerosis in temporal lobe epilepsy: neuropathological features. J Neuropathol Exp Neurol 68 2009; 928-938
    CrossrefPubMedGoogle Scholar
  • 17 Meiners LC, Witkamp TD, de Kort GA. et al. Relevance of temporal lobe white matter changes in hippocampal sclerosis. Magnetic resonance imaging and histology. Invest Radiol 34 1999; 38-45
    CrossrefPubMedGoogle Scholar
  • 18 Diehl B, Busch RM, Duncan JS, Piao Z, Tkach J, Lüders HO. Abnormalities in diffusion tensor imaging of the uncinate fasciculus relate to reduced memory in temporal lobe epilepsy. Epilepsia 49 2008; 1409-1418
    CrossrefPubMedGoogle Scholar
  • 19 McDonald CR, Ahmadi ME, Hagler DJ. et al. Diffusion tensor imaging correlates of memory and language impairments in temporal lobe epilepsy. Neurology 71 2008; 1869-1876
    CrossrefPubMedGoogle Scholar
  • 20 Jiang H, van Zijl PCM, Kim J, Pearlson GD, Mori S. DtiStudio: resource program for diffusion tensor computation and fiber bundle tracking. Comput Methods Programs Biomed 81 2006; 106-116
    CrossrefPubMedGoogle Scholar
  • 21 Wakana S, Caprihan A, Panzenboeck MM. et al. Reproducibility of quantitative tractography methods applied to cerebral white matter. Neuroimage 36 2007; 630-644
    CrossrefPubMedGoogle Scholar
  • 22 Ahmadi ME, Hagler Jr DJ, McDonald CR. et al. Side matters: diffusion tensor imaging tractography in left and right temporal lobe epilepsy. AJNR Am J Neuroradiol 30 2009; 1740-1747
    CrossrefPubMedGoogle Scholar
  • 23 Rodrigo S, Oppenheim C, Chassoux F. et al. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings. Eur Radiol 17 2007; 1663-1668
    CrossrefPubMedGoogle Scholar
  • 24 Govindan RM, Makki MI, Sundaram SK, Juhász C, Chugani HT. Diffusion tensor analysis of temporal and extra-temporal lobe tracts in temporal lobe epilepsy. Epilepsy Res 80 2008; 30-41
    CrossrefPubMedGoogle Scholar
  • 25 Concha L, Beaulieu C, Gross DW. Bilateral limbic diffusion abnormalities in unilateral temporal lobe epilepsy. Ann Neurol 57 2005; 188-196
    CrossrefPubMedGoogle Scholar
  • 26 Concha L, Gross DW, Beaulieu C. Diffusion tensor tractography of the limbic system. AJNR Am J Neuroradiol 26 2005; 2267-2274
    PubMedGoogle Scholar
  • 27 Powell HWR, Parker GJ, Alexander DC. et al. Abnormalities of language networks in temporal lobe epilepsy. Neuroimage 36 2007; 209-221
    CrossrefPubMedGoogle Scholar
  • 28 Catani M, Jones DK, Donato R, Ffytche DH. Occipito-temporal connections in the human brain. Brain 126 2003; 2093-2107
    CrossrefPubMedGoogle Scholar
  • 29 Babb TL, Brown WJ. Pathological findings in epilepsy. Engel Jr J. Surgical Treatment of the Epilepsies. 1987. Raven; NY: 511-540
    Google Scholar
  • 30 Mori S, Wakana S, Nagae-Poetscher L, van Zijl P. MRI Atlas of Human White Matter. 2005. Elsevier Science; San Francisco, CA:
    Google Scholar
  • 31 Mathern G, Wilson C, Beck H. Hippocampal sclerosis. Engel Jr J, Pedley T. Epilepsy: A Comprehensive Textbook. 2nd ed.. 2008. Lippincott Williams & Wilkins; Philadelphia, PA: 121-136
    Google Scholar