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Extratemporal quantitative MR volumetrics and neuropsychological status in temporal lobe epilepsy

Published online by Cambridge University Press:  02 March 2020

Hermann Bruce
Affiliation:
Department of Neurology, University of Wisconsin, Madison
Seidenberg Michael
Affiliation:
Department of Psychology, Chicago Medical School, North Chicago
Bell Brian
Affiliation:
Department of Neurology, University of Wisconsin, Madison
Rutecki Paul
Affiliation:
Department of Neurology, University of Wisconsin, Madison Middleton VA Medical Center, Madison
Sheth Raj D.
Affiliation:
Department of Neurology, University of Wisconsin, Madison
Wendt Gary
Affiliation:
Department of Radiology, University of Wisconsin, Madison
O'Leary Daniel
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City
Magnotta Vince
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City
Corresponding

Abstract

Neuropsychological studies of temporal lobe epilepsy have focused heavily on the nature and extent of memory dysfunction and its relationship to the neuropathological status of the hippocampus and related mesial temporal lobe structures. In this study, we examined whole brain and lobar quantitative MRI volumes and comprehensive neuropsychological performance in 58 patients with temporal lobe epilepsy and 62 healthy controls in order to determine (1) the nature and degree of extratemporal structural abnormalities in localization-related temporal lobe epilepsy; (2) the nature and degree of cognitive abnormalities outside of anterograde memory function; and (3) the relationship of volumetric abnormalities to neuropsychological status. Temporal lobe epilepsy patients exhibited significant reduction in the volume of adjusted (age, gender, height) total cerebral tissue (−5.8%), more evident in white (−9.8%) compared to gray matter (−3.0%) tissue volumes. Significant volumetric reductions were evident across frontal, temporal and parietal but not occipital lobe regions. Subarachnoid but not total ventricular CSF was significantly increased in epilepsy patients. Neuropsychological abnormality was generalized in nature, consistent with the generalized nature of the morphometric abnormalities, and reductions in cerebral tissue volumes were directly associated with poorer cognitive performance. In summary, patients with temporal lobe epilepsy exhibited clinically significant structural and functional abnormalities that extended outside the epileptogenic temporal lobe. The degree to which these structural and cognitive abnormalities are due to factors that cause the epilepsy, as opposed to reflecting the consequences of chronic epilepsy (e.g., duration and severity of epilepsy), remain to be determined. (JINS, 2003, 9, 353–362.)

Type
Research Article
Copyright
Copyright © The International Neuropsychological Society 2003

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