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MRI analysis in temporal lobe epilepsy: Cortical thinning and white matter disruptions are related to side of seizure onset

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Bernhardt,  Boris C.
Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montréal, QC, Canada;
Department Social Neuroscience, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Citation

Kemmotsu, N., Girard, H. M., Bernhardt, B. C., Bonilha, L., Lin, J. J., Tecoma, E. S., et al. (2011). MRI analysis in temporal lobe epilepsy: Cortical thinning and white matter disruptions are related to side of seizure onset. Epilepsia, 52(12), 2257-2266. doi:10.1111/j.1528-1167.2011.03278.x.


Cite as: http://hdl.handle.net/11858/00-001M-0000-0012-14E7-B
Abstract
Purpose: Past studies have reported more widespread structural brain abnormalities in patients with left compared to right temporal lobe epilepsy (TLE), but the profile of these differences remain unknown. This study investigated the relationship between cortical thinning, white matter compromise, epilepsy variables and the side of seizure onset, in patients with TLE. Methods: We performed diffusion tensor imaging tractography and cortical thickness analyses of 18 patients with left TLE (LTLE), 18 patients with right TLE (RTLE), and 36 controls. We investigated the relationship between brain structural abnormalities, side of seizure onset, age of seizure onset, and disease duration. Key findings: TLE groups displayed cortical thinning and white matter compromise, predominately on the side ipsilateral to the seizure onset. Relative to RTLE, patients with LTLE showed more widespread abnormalities, particularly in white matter fiber tracts. Greater compromise in white matter integrity was associated with earlier age of seizure onset, while cortical thinning was marginally associated with disease duration. Significance: These data support previous findings of LTLE showing greater structural compromise than RTLE, and suggest that mechanisms may not be uniform for gray and white matter compromise in patients with LTLE and RTLE. These results may indicate that LTLE is different than RTLE, possibly due to greater vulnerability of the left hemisphere to early injury and the progressive effects of seizures.