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Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
Published on: August 5, 2014
Temporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a
Henrique Carrete1, Nitamar Abdala, Kátia Lin
1Departamento de Diagnóstico por Imagem, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Objective:
To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history.
Method:
Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation.
Results:
Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy.
Conclusion:
Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.
Insights
Temporal pole signal abnormality (TPA) is common in hippocampal sclerosis (HS), often affecting the anteromedial region. This finding is more prevalent when left hippocampal sclerosis is present.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Hippocampal sclerosis (HS) is a common cause of epilepsy.
- Temporal pole signal abnormality (TPA) is a potential imaging marker in neurological conditions.
Purpose of the Study:
- To investigate the frequency and location of TPA in patients with HS.
- To correlate TPA with patient history, specifically age at seizure onset and epilepsy duration.
Main Methods:
- Coronal fluid-attenuated inversion-recovery (FLAIR) MR images were analyzed.
- 120 patients with HS and 30 healthy controls were included.
- Assessment focused on gray-white matter demarcation in the temporal pole.
Main Results:
- TPA was observed in 75% of patients with HS.
- TPA showed a left-sided prevalence (p=0.04).
- The anteromedial temporal pole was affected in 30% of cases, with the lateral zone also involved in 70% of those with TPA. Patients with TPA had a younger age at seizure onset (p=0.018).
Conclusions:
- FLAIR imaging reveals TPA in a majority of HS patients.
- TPA is frequently located in the anteromedial temporal pole.
- Left-sided HS is associated with a higher prevalence of TPA.
