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Entorhinal cortex in temporal lobe epilepsy: a quantitative MRI study.

N Bernasconi1, A Bernasconi, F Andermann

  • 1Department of Neurology and Neurosurgery, McGill University, and Montreal Neurological Institute and Hospital, Quebec, Canada.

Neurology
|June 17, 1999
PubMed
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Temporal lobe epilepsy (TLE) patients exhibit reduced entorhinal cortex (EC) volume bilaterally. This volume reduction is more pronounced on the side of the epileptic focus, impacting associated brain structures.

Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Neuroanatomy

Background:

  • The entorhinal cortex (EC) is crucial for seizure generation in temporal lobe epilepsy (TLE).
  • Cell loss in the EC is a known characteristic of TLE in resected brain tissue.

Purpose of the Study:

  • To establish a standardized high-resolution MRI protocol for defining EC boundaries.
  • To investigate morphologic changes, specifically volume, of the EC in TLE patients.

Main Methods:

  • T1-weighted MRI scans were acquired from 20 TLE patients and 18 healthy controls.
  • Standardized MRI protocol was used to measure volumes of the EC, hippocampus, and amygdala.
  • Analysis of variance (ANOVA) assessed effects of seizure lateralization and hemisphere on volumes.

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Main Results:

  • TLE patients showed a bilateral reduction in EC volume compared to controls.
  • The reduction in EC volume was significantly greater ipsilateral to the epileptic focus.
  • Hippocampus and amygdala volumes were reduced ipsilaterally in TLE patients.

Conclusions:

  • A standardized MRI protocol enables quantitative assessment of the EC.
  • Unilateral TLE is associated with bilateral EC volume reduction, more severe on the seizure side.
  • Associated structures like the hippocampus and amygdala also show ipsilateral volume reduction in TLE.