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  Patterns of subregional mesiotemporal disease progression in temporal lobe epilepsy

Bernhardt, B. C., Kim, H., & Bernasconi, N. (2013). Patterns of subregional mesiotemporal disease progression in temporal lobe epilepsy. Neurology, 81(21), 1840-1847. doi:10.1212/01.wnl.0000436069.20513.92.

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 Creators:
Bernhardt, Boris C.1, Author              
Kim, Hosung1, Author
Bernasconi, Neda1, Author
Affiliations:
1Neuroimaging of Epilepsy Laboratory, Montréal Neurological Institute and Hospital, McGill University, Montréal, QC, Canada, ou_persistent22              

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 Abstract: Objective: Evidence for disease progression in the mesiotemporal lobe is mainly derived from global volumetry of the hippocampus. In this study, we tracked progressive structural changes in the hippocampus, amygdala, and entorhinal cortex in drug-resistant temporal lobe epilepsy at a subregional level. Furthermore, we evaluated the relation between disease progression and surgical outcome. Methods: We combined cross-sectional modeling of disease duration in a large cohort of patients (n = 134) and longitudinal analysis in a subset that delayed surgery (n = 31). To track subregional pathology, we applied surface-shape analysis techniques on manual mesiotemporal labels. Results: Longitudinal and cross-sectional designs showed consistent patterns of progressive atrophy in hippocampal CA1, anterolateral entorhinal, and the amygdalar laterobasal group bilaterally. These regions also exhibited more marked age-related volume loss in patients compared with controls. We found a faster progression of hippocampal atrophy in patients with a seizure frequency ≥6 per month. High rates of contralateral entorhinal cortex atrophy predicted postsurgical seizure relapse. Conclusion: We observed progressive atrophy in hippocampal, amygdalar, and entorhinal subregions that frequently display neuronal loss on histology. The bilateral character of cumulative atrophy highlights the importance of early surgery. In patients who nevertheless delay this procedure, serial scanning may provide markers of surgical outcome.

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Language(s): eng - English
 Dates: 2013-05-012013-08-212013-10-182013-11-19
 Publication Status: Published in print
 Pages: -
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 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1212/01.wnl.0000436069.20513.92
PMID: 24142475
PMC: PMC3821710
Other: Epub 2013
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Title: Neurology
Source Genre: Journal
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Pages: - Volume / Issue: 81 (21) Sequence Number: - Start / End Page: 1840 - 1847 Identifier: ISSN: 0028-3878
CoNE: https://pure.mpg.de/cone/journals/resource/954925246073