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Distinct patterns of hippocampal subfield volume loss in left and right mesial temporal lobe epilepsy

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To investigate the pattern and severity of hippocampal subfield volume loss in patients with left and right mesial temporal lobe epilepsy (mTLE) using quantitative MRI volumetric analysis.


A total of 21 left and 14 right mTLE subjects, as well as 15 healthy controls, were enrolled in this cross-sectional study. A publically available magnetic resonance imaging (MRI) brain volumetry system (volBrain) was used for volumetric analysis of hippocampal subfields. The T1-weighted images were processed with a HIPS pipeline.


A distinct pattern of hippocampal subfield atrophy was found between left and right mTLE patients when compared with controls. Patients with left mTLE exhibited ipsilateral hippocampal atrophy and segmental volume depletion of the Cornu Ammonis (CA) 2/CA3, CA4/dentate gyrus (DG), and strata radiatum-lacunosum-moleculare (SR-SL-SM). Those with right mTLE exhibited similar ipsilateral hippocampal atrophy but with additional segmental CA1 volume depletion. More extensive bilateral subfield volume loss was apparent with right mTLE patients.


We demonstrate that left and right mTLE patients show a dissimilar pattern of hippocampal subfield atrophy, suggesting the pathophysiology of epileptogenesis in left and right mTLE to be different.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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The authors recognize and are grateful for the contributions of the Iranian National Brain Mapping Laboratory (NBML), Tehran, Iran, for their data acquisition service.


This work was partially funded and supported by Iran’s National Elites Foundation, National Institute for Medical Research Development, and Cognitive Sciences & Technologies Council, in 2017 to 2019.

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Correspondence to Mohammad-Reza Nazem-Zadeh.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Tehran University of Medical University.

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Informed consent was obtained from all individual participants included in the study.

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Moghaddam, H.S., Aarabi, M.H., Mehvari-Habibabadi, J. et al. Distinct patterns of hippocampal subfield volume loss in left and right mesial temporal lobe epilepsy. Neurol Sci 42, 1411–1421 (2021).

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