Distribution of regional gray matter abnormalities in a pediatric population with temporal lobe epilepsy and correlation with neuropsychological performance |
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| Institution: | 1. IBE Commission on e-Solutions and Neuroscience Research Laboratory, Marrakesh Medical School and Neurology Department, University Teaching Hospital Mohammed VI, Morocco;2. President, International Bureau for Epilepsy Director, Epilepsy Unit, Scottish Epilepsy Initiative 11 Somerset Place, Glasgow G3 7JT; Scotland (UK);3. Department of Neurology, University, Teaching Hospital Yalgado Ouédraogo, Ouagadougou, Burkina Faso;4. UCLA Seizure Disorder Center, UCLA Department of Neurology, Los Angeles, USA;5. ?nternational University of Cerrahpa?a T?p Fakültesi, Nöroloji ABD, Klinik Elektrofizyoloji BD; ?stanbul (Turkey);6. University College London, UK;7. IBE Western Pacific Regional Committee;8. Epilepsy Association of Pakistan, Pakistan;9. Epilepsy Namibia, Namibia;1. University of Washington Neurology Vocational Services Unit/Epilepsy Center, Department of Rehabilitation Medicine, Seattle, WA, United States;2. Surgical Epilepsy Program, California Pacific Medical Center, San Francisco, CA, United States;3. University of California, San Francisco, United States;4. Epilepsy Program, California Pacific Medical Center, San Francisco, CA, United States;5. PEP Jobs Program, California Pacific Medical Center, San Francisco, CA, United States;1. Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 South 33rd Street, Philadelphia, PA 19104-6321, USA;2. Department of Radiology, Hospital of the University of Pennsylvania, Richards - 6th Floor, 3700 Hamilton Walk, Philadelphia, PA 19104-6116, USA;3. Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 3 West Gates Bldg., Philadelphia, PA 19104, USA |
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| Abstract: | ObjectiveThe goals of the work described here were to determine if hippocampal and extrahippocampal atrophy in children with temporal lobe epilepsy (TLE) follows a pattern similar to that in adult patients, and to assess the clinical and neuropsychological relevance of regional brain atrophy in pediatric TLE.MethodsChildren with symptomatic TLE (n = 14: 9 with mesial TLE due to hippocampal atrophy and 5 with TLE due to neocortical lesions), healthy children (n = 14), and 9 adults with mesial temporal lobe epilepsy (MTLE) were compared using voxel-based morphometry (VBM) of brain magnetic resonance imaging (MRI). The children underwent a comprehensive neuropsychological battery.ResultsChildren with MTLE with unilateral hippocampal atrophy (n = 9) exhibited a significant reduction in gray matter in the hippocampus ipsilateral to the seizure origin and significant atrophy in the ipsilateral cingulate gyrus and contralateral middle frontal lobe. Children with TLE (n = 14) exhibited a significant reduction in the gray matter of the ipsilateral hippocampus and parahippocampal gyrus. There was a correlation between gray matter volume in children with TLE and scores on several neuropsychological tests. Atrophy in pediatric patients with MTLE was less extensive than that in adults, and involved the hippocampi and the frontal cortex.ConclusionsSimilar to adult MTLE, pediatric MTLE is associated with hippocampal and extrahippocampal cell loss. However, children display less intense quantifiable gray matter atrophy, which affects predominantly frontal lobe areas. There was a significant association between volume of gray matter in medial temporal and frontal regions and scores on neuropsychological tests. In childhood, TLE and the concomitant cognitive/behavior disturbances are the result of a damaged neural network. |
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