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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Neocortical thinning in "benign" mesial temporal lobe epilepsy
Angelo Labate1, Antonio Cerasa, Umberto Aguglia
1Institute of Neurology University Magna Graecia, Catanzaro, Italy. labate@unicz.it
Epilepsia
|April 2, 2011
Summary
Benign mesial temporal lobe epilepsy (MTLE) involves cortical thinning, particularly in the sensorimotor cortex, even without mesial temporal sclerosis (MTS). This suggests neocortical involvement in benign MTLE pathophysiology.
Area of Science:
- Neurology
- Neuroimaging
- Epilepsy Research
Background:
- Refractory mesial temporal lobe epilepsy (MTLE) is associated with extrahippocampal and neocortical abnormalities.
- Gray matter reductions outside the hippocampus have been observed in benign MTLE, with or without mesial temporal sclerosis (MTS).
- Cortical thickness analysis offers a method for assessing neuropathologic changes in extratemporal regions.
Purpose of the Study:
- To investigate cortical abnormalities in benign MTLE using cortical thickness analysis.
- To describe the pattern of cortical thinning in patients with benign MTLE, differentiating between those with (pMTLE) and without (nMTLE) signs of MTS.
Main Methods:
- Whole-brain cortical thickness analysis was performed using FreeSurfer software.
- The study included 32 unrelated patients with benign MTLE (16 pMTLE, 16 nMTLE) and 44 healthy controls.
Main Results:
- Significant cortical thinning was observed bilaterally in the sensorimotor cortex in the pMTLE group, more pronounced in the left hemisphere.
- Additional areas of thinning in pMTLE included the occipital cortex, left supramarginal and superior parietal gyri, left frontal regions, right cingulate and superior frontal gyri, right inferior parietal gyrus, right fusiform gyrus, and cuneus/precuneus.
- A similar pattern of neurodegeneration was noted in the nMTLE group, though not statistically significant after multiple comparison correction. No significant differences were found between pMTLE and nMTLE groups.
Conclusions:
- Patients with benign MTLE, regardless of MTS presence, exhibit comparable cortical thinning, primarily in the sensorimotor cortex.
- These findings, not apparent on routine MRI, support the hypothesis of neocortical involvement in the pathophysiology of benign MTLE, similar to refractory MTLE.
