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MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

  • Diagnostic Neuroradiology
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An Erratum to this article was published on 19 July 2015

Abstract

Introduction

The paucity of morphometric markers for hemispheric asymmetries and gender variations in hippocampi and amygdalae in temporal lobe epilepsy (TLE) calls for better characterization of TLE by finding more useful prognostic MRI parameter(s).

Methods

T1-weighted MRI (3 T) morphometry using multiple parameters of hippocampus-parahippocampus (angular and linear measures, volumetry) and amygdalae (volumetry) including their hemispheric asymmetry indices (AI) were evaluated in both genders. The cutoff values of parameters were statistically estimated from measurements of healthy subjects to characterize TLE (57 patients, 55 % male) alterations.

Results

TLE had differential categories with hippocampal atrophy, parahippocampal angle (PHA) acuteness, and several other parametric changes. Bilateral TLE categories were much more prevalent compared to unilateral TLE categories. Female patients were considerably more disposed to bilateral TLE categories than male patients. Male patients displayed diverse categories of unilateral abnormalities. Few patients (both genders) had combined bilateral appearances of hippocampal atrophy, amygdala atrophy, PHA acuteness, and increase in hippocampal angle (HA) where medial distance ratio (MDR) varied among genders. TLE had gender-specific and hemispheric dominant alterations in AI of parameters. Maximum magnitude of parametric changes in TLE includes (a) AI increase in HA of both genders, (b) HA increase (bilateral) in female patients, and (c) increase in ratio of amygdale/hippocampal volume (unilateral, right hemispheric), and AI decrease in MDR, in male patients.

Conclusion

Multiparametric MRI studies of hippocampus and amygdalae, including their hemispheric asymmetry, underscore better characterization of TLE. Rapidly measurable single-slice parameters (HA, PHA, MDR) can readily delineate TLE in a time-constrained clinical setting, which contrasts with customary three-dimensional hippocampal volumetry that requires many slice computation.

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Acknowledgments

We are specifically thankful to Prof. Pradip Kumar Mitra, Director, Institute of Postgraduate Medical Education and Research (IPGME&R), SSKM Hospital under State Govt. of West Bengal, Kolkata, India; Prof. Subrata Sinha, Director, National Brain Research Centre (NBRC) under Govt. of India; and Dr. Samiran Samanta, Radiologist, IPGME&R, for providing necessary cooperation. We are grateful to Prof. Alan Evans and Mr. Samir Das (Montreal Neurological Institute, Canada) for their facilitation in the inter-institutional imaging grid infrastructure. We are grateful to Prof. Suranjan Das (Vice-Chancellor), Prof. Dhrubajyoti Chattopadhyay (Pro Vice-Chancellor, Academy), and Prof. Pritha Mukhopadhyay (Coordinator, UGC-CPEPA scheme) of the University of Calcutta, Kolkata, India, for their kind cooperation to execute the study under UGC-CPEPA scheme (Govt. of India).

The MRI acquisition of healthy subjects was funded by the grants [BI 92(7)] of the University of Calcutta and supported by University Grant Commission (UGC, Govt. of India) under the Centre with Potential for Excellence in Particular Area (CPEPA) scheme (F. No. 8-2/2008 (NS/PE), dt 14/12/2011), granted to the University of Calcutta.

Appreciation is extended to Office of Principal Scientific Officer, Government of India, for sponsoring the India Brain Grid initiative, which enabled the collaboration of this study. Sai Krishna Mulpuru is supported by Ministry of Information Technology, Govt. of India. Support for the logistics of the work of Prasun Kumar Roy is from Tata Innovation Program, Dept. of Biotechnology, Govt. of India.

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Human Ethics Committee at IPGME&R, SSKM Hospital (Memo No. Inst/IEC/552, dated 16.01.2014), under State Govt. of West Bengal, Kolkata, India, and the Department of Physiology (Reference No. IHEC/PHY/CU/H-P 28/13 dated 05.04.2013), University of Calcutta, Kolkata, India, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Physiology and UGC-CPEPA Centre for “Electro-physiological and Neuro-imaging studies including Mathematical Modelling”, University of Calcutta, 92 APC Road, Kolkata, 700009, India

    Siddhartha Datta & Nilkanta Chakrabarti

  2. Department of Radiodiagnosis, IPGME&R, SSKM Hospital, Kolkata, India

    Sudipta Sarkar, Sumit Chakraborty & Swadhapriya Basu

  3. National Neuro-Imaging Facility, National Brain Research Centre, Manesar, India

    Sai Krishna Mulpuru

  4. Centre for Bioinformatics, School of Life Sciences, Pondicherry University, Pondicherry, India

    Basant K. Tiwary

  5. Computational Neuroimaging Division, National Brain Research Centre, Manesar, India

    Prasun Kumar Roy

  6. Clinical Neuroscience Unit, National Brain Research Centre, General Hospital Campus, Gurgaon, India

    Prasun Kumar Roy

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  1. Siddhartha Datta
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Correspondence to Nilkanta Chakrabarti.

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Datta, S., Sarkar, S., Chakraborty, S. et al. MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features. Neuroradiology 57, 873–886 (2015). https://doi.org/10.1007/s00234-015-1540-6

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