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Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis

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Abstract

Temporal lobe epilepsy with (TLE-mts) and without (TLE-no) mesial temporal sclerosis display different patterns of cortical neuronal loss, suggesting that the distribution of white matter damage may also differ between the sub-groups. The purpose of this study was to examine patterns of white matter damage in TLE-mts and TLE-no and to determine if identified changes are related to neuronal loss at the presumed seizure focus. The 4 T diffusion tensor imaging (DTI) and T1-weighted data were acquired for 22 TLE-mts, 21 TLE-no and 31 healthy controls. Tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA) maps and voxel-based morphometry (VBM) was used to identify grey matter (GM) volume atrophy. Correlation analysis was conducted between the FA maps and neuronal loss at the presumed seizure focus. In TLE-mts, reduced FA was identified in the genu, body and splenium of the corpus callosum, bilateral corona radiata, cingulum, external capsule, ipsilateral internal capsule and uncinate fasciculus. In TLE-no, FA decreases were identified in the genu, the body of the corpus callosum and ipsilateral anterior corona radiata. The FA positively correlated with ipsilateral hippocampal volume. Widespread extra-focal GM atrophy was associated with both sub-groups. Despite widespread and extensive GM atrophy displaying different anatomical patterns in both sub-groups, TLE-mts demonstrated more extensive FA abnormalities than TLE-no. The microstructural organization in the corpus callosum was related to hippocampal volume in both patients and healthy subjects demonstrating the association of these distal regions.

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Acknowledgments

We would like to thank Dr. Tom Fletcher, Assistant Professor at the Scientific Computing and Imaging Institute, University of Utah, for his help with the DTI processing and software. This work was supported by a NIH grant R01NS0311966 to K.D.L.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Imaging of Neurodegenerative Diseases and Department of Radiology, University of California, San Francisco, CA, USA

    Cathy Scanlon, Susanne G. Mueller, Ian Cheong, Miriam Hartig & Michael W. Weiner

  2. Department of Psychiatry, Clinical Neuroimaging Laboratory, National University of Ireland, Galway, Ireland

    Cathy Scanlon

  3. Pacific Epilepsy Program, California Pacific Medical Center, San Francisco, CA, USA

    Kenneth D. Laxer

Authors
  1. Cathy Scanlon
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  2. Susanne G. Mueller
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  3. Ian Cheong
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  4. Miriam Hartig
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  5. Michael W. Weiner
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  6. Kenneth D. Laxer
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Correspondence to Kenneth D. Laxer.

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Scanlon, C., Mueller, S.G., Cheong, I. et al. Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis. J Neurol 260, 2320–2329 (2013). https://doi.org/10.1007/s00415-013-6974-3

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  • DOI: https://doi.org/10.1007/s00415-013-6974-3

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