Journal of Neurology

, Volume 260, Issue 6, pp 1601–1610 | Cite as

Widespread grey matter changes and hemodynamic correlates to interictal epileptiform discharges in pharmacoresistant mesial temporal epilepsy

  • Roland WiestEmail author
  • Lea Estermann
  • Olivier Scheidegger
  • Christian Rummel
  • Kay Jann
  • Margitta Seeck
  • Kaspar Schindler
  • Martinus Hauf
Original Communication


Focal onset epilepsies most often occur in the temporal lobes. To improve diagnosis and therapy of patients suffering from pharmacoresistant temporal lobe epilepsy it is highly important to better understand the underlying functional and structural networks. In mesial temporal lobe epilepsy (MTLE) widespread functional networks are involved in seizure generation and propagation. In this study we have analyzed the spatial distribution of hemodynamic correlates (HC) to interictal epileptiform discharges on simultaneous EEG/fMRI recordings and relative grey matter volume (rGMV) reductions in 10 patients with MTLE. HC occurred beyond the seizure onset zone in the hippocampus, in the ipsilateral insular/operculum, temporo-polar and lateral neocortex, cerebellum, along the central sulcus and bilaterally in the cingulate gyrus. rGMV reductions were detected in the middle temporal gyrus, inferior temporal gyrus and uncus to the hippocampus, the insula, the posterior cingulate and the anterior lobe of the cerebellum. Overlaps between HC and decreased rGMV were detected along the mesolimbic network ipsilateral to the seizure onset zone. We conclude that interictal epileptic activity in MTLE induces widespread metabolic changes in functional networks involved in MTLE seizure activity. These functional networks are spatially overlapping with areas that show a reduction in relative grey matter volumes.


Mesial temporal lobe epilepsy EEG/fMRI Network analysis Voxel based morphometry 



We are grateful to M. Fuchs for his support in data collection.

Conflicts of interest

This project was funded by the Swiss National Science Foundation grants [320000-108321/1], [33CM30-140332] and [33CM30-124089]. No additional conflict of interest relevant to this article was reported.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Roland Wiest
    • 1
    Email author
  • Lea Estermann
    • 1
  • Olivier Scheidegger
    • 1
  • Christian Rummel
    • 1
  • Kay Jann
    • 2
  • Margitta Seeck
    • 3
  • Kaspar Schindler
    • 4
  • Martinus Hauf
    • 1
    • 5
  1. 1.Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, InselpitalUniversity of BernBernSwitzerland
  2. 2.Department of Psychiatric Neurophysiology, University Hospital of PsychiatryUniversity of BernBernSwitzerland
  3. 3.Epilepsy Unit, Department of NeurologyUniversity of GenevaGenevaSwitzerland
  4. 4.Epilepsy Unit, Department of NeurologyUniversity of BernBernSwitzerland
  5. 5.Bethesda Epilepsy ClinicTschuggSwitzerland

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