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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2007.123406

Hippocampal deformation mapping in MRI-negative PET-positive temporal lobe epilepsy

  1. R. Edward Hogan (hogane{at}neuro.wustl.edu)
  1. Washington University in St. Louis, United States
    1. Ross P. Carne (ross.carne{at}svhm.org.au)
    1. St. Vincent's Hospital, Melbourne University, Australia
      1. Christine J. Kilpatrick (christine.kilpatrick{at}mh.org.au)
      1. The Royal Melbourne Hospital, Melbourne University, Australia
        1. Mark J. Cook (mark.cook{at}svhm.org.au)
        1. St. Vincent's Hospital, Melbourne University, Australia
          1. Abhishek Patel (mahadobo{at}gmail.com)
          1. Saint Louis University, United States
            1. Lauren King (mahadobo{at}gmail.com)
            1. Saint Louis University, United States
              1. Terence J. O'Brien (obrientj{at}unimelb.edu.au)
              1. Dept. of Medicine, Melbourne University, Australia
                • Published Online First 10 October 2007

                Abstract

                Objectives: To compare hippocampal surface structure, using large deformation high dimensional mapping (HDM-LD), of temporal lobe epilepsy (TLE) subjects with hippocampal sclerosis (HS+ve) and without hippocampal sclerosis (HS-ve).

                Methods: The study included 30 HS-ve subjects matched with 30 HS+ve subjects from the previously reported epilepsy patient cohort. To control for normal right-left asymmetries of hippocampal surface structure, subjects were regrouped based on laterality of onset of epileptic seizures and presence of HS. The gender ratio, age, duration of epilepsy, and seizure frequency were calculated for each of the four groups. Final HDM-LD surface maps of the right and left TLE groups were compared to define differences in subregional hippocampal involvement within the groups.

                Results: There were no significant differences in comparisons of the left TLE (left HS-ve compared to HS+ve) or right TLE (right HS-ve compared to HS+ve) groups with respect to age, duration of epilepsy, or seizure severity scores. HDM-LD maps showed accentuated surface changes over the lateral hippocampal surface, in the region of Sommer sector, in the hippocampi affected by HS. However, HS-ve hippocampi showed maximal surface changes in a different pattern, and did not involve the region of Sommer sector.

                Conclusion: We conclude that differences in segmental volume loss between the HS-ve and HS+ve groups are suggestive that the underlying pathophysiology of hippocampal changes in the two groups is different, and not related to chronic seizure duration or severity.

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