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Widespread grey matter changes and hemodynamic correlates to interictal epileptiform discharges in pharmacoresistant mesial temporal epilepsy

Wiest, Roland ; Estermann, Lea ; Scheidegger, Olivier ; Rummel, Christian ; Jann, Kay ; Seeck, Margitta ; Schindler, Kaspar ; Hauf, Martinus

In: Journal of Neurology, 2013, vol. 260, no. 6, p. 1601-1610

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    Titre
    • Widespread grey matter changes and hemodynamic correlates to interictal epileptiform discharges in pharmacoresistant mesial temporal epilepsy
    Auteur
    • Wiest, Roland. Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselpital, University of Bern, 3010, Bern, Switzerland
    • Estermann, Lea. Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselpital, University of Bern, 3010, Bern, Switzerland
    • Scheidegger, Olivier. Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselpital, University of Bern, 3010, Bern, Switzerland
    • Rummel, Christian. Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselpital, University of Bern, 3010, Bern, Switzerland
    • Jann, Kay. Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
    • Seeck, Margitta. Epilepsy Unit, Department of Neurology, University of Geneva, Geneva, Switzerland
    • Schindler, Kaspar. Epilepsy Unit, Department of Neurology, University of Bern, Bern, Switzerland
    • Hauf, Martinus. Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselpital, University of Bern, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320301
    Summary
    Focal onset epilepsies most often occur in the temporal lobes. To improve diagnosis and therapy of patients suffering from pharmacoresistant temporal lobe epilepsy it is highly important to better understand the underlying functional and structural networks. In mesial temporal lobe epilepsy (MTLE) widespread functional networks are involved in seizure generation and propagation. In this study we have analyzed the spatial distribution of hemodynamic correlates (HC) to interictal epileptiform discharges on simultaneous EEG/fMRI recordings and relative grey matter volume (rGMV) reductions in 10 patients with MTLE. HC occurred beyond the seizure onset zone in the hippocampus, in the ipsilateral insular/operculum, temporo-polar and lateral neocortex, cerebellum, along the central sulcus and bilaterally in the cingulate gyrus. rGMV reductions were detected in the middle temporal gyrus, inferior temporal gyrus and uncus to the hippocampus, the insula, the posterior cingulate and the anterior lobe of the cerebellum. Overlaps between HC and decreased rGMV were detected along the mesolimbic network ipsilateral to the seizure onset zone. We conclude that interictal epileptic activity in MTLE induces widespread metabolic changes in functional networks involved in MTLE seizure activity. These functional networks are spatially overlapping with areas that show a reduction in relative grey matter volumes