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Temporal and extratemporal atrophic manifestation of temporal lobe epilepsy using voxel-based morphometry and corticometry: clinical application in lateralization of epileptogenic zone

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Abstract

Background

Advances in MRI acquisition and data processing have become important for revealing brain structural changes. Previous studies have reported widespread structural brain abnormalities and cortical thinning in patients with temporal lobe epilepsy (TLE), as the most common form of focal epilepsy.

Methods

In this research, healthy control cases (n = 20) and patients with left TLE (n = 19) and right TLE (n = 14) were recruited, all underwent 3.0 T MRI with magnetization-prepared rapid gradient echo sequence to acquire T1-weighted images. Morphometric alterations in gray matter were identified using voxel-based morphometry (VBM). Volumetric alterations in subcortical structures and cortical thinning were also determined.

Results

Patients with left TLE demonstrated more prevailing and widespread changes in subcortical volumes and cortical thickness than right TLE, mainly in the left hemisphere, compared to the healthy group. Both VBM analysis and subcortical volumetry detected significant hippocampal atrophy in ipsilateral compared to contralateral side in TLE group. In addition to hippocampus, subcortical volumetry found the thalamus and pallidum bilaterally vulnerable to the TLE. Furthermore, the TLE patients underwent cortical thinning beyond the temporal lobe, affecting gray matter cortices in frontal, parietal, and occipital lobes in the majority of patients, more prevalently for left TLE cases. Exploiting volume changes in individual patients in the hippocampus alone led to 63.6% sensitivity and 100% specificity for lateralization of TLE.

Conclusion

Alteration of gray matter volumes in subcortical regions and neocortical temporal structures and also cortical gray matter thickness were evidenced as common effects of epileptogenicity, as manifested by the majority of cases in this study.

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Acknowledgments

We must acknowledge the contribution of the Iranian National Brain Mapping Lab (NBNL), and their staffs for MRI data acquisition throughout conducting this project.

Funding

This work was partially funded and supported by Iran’s National Elites Foundation, National Institute for Medical Research Development (Grant No. 971683), and Cognitive Sciences & Technologies Council (Grant No. 6431), between 2017 and 2019.

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Authors and Affiliations

  1. Medical School, International Campus, Tehran University of Medical Sciences, Tehran, Iran

    Majdi Jber

  2. Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Jafar Mehvari Habibabadi

  3. Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran

    Roya Sharifpour, Milad Seyfi, Ahmedreza Keihani, Mohammadreza Ay & Mohammad-Reza Nazem-Zadeh

  4. Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran

    Roya Sharifpour, Masoud Hassanpour, Milad Seyfi, Neda Mohammadi Mobarakeh, Mohammadreza Ay & Mohammad-Reza Nazem-Zadeh

  5. Department of Biomedical Engineering, Amirkabir University of Technology (AUT), Tehran, Iran

    Hengameh Marzbani

  6. Pars Advanced Medical Research Center, Pars Hospital, Tehran, Iran

    Seyed Sohrab Hashemi-Fesharaki

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Jber, M., Habibabadi, J.M., Sharifpour, R. et al. Temporal and extratemporal atrophic manifestation of temporal lobe epilepsy using voxel-based morphometry and corticometry: clinical application in lateralization of epileptogenic zone. Neurol Sci 42, 3305–3325 (2021). https://doi.org/10.1007/s10072-020-05003-2

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