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Updated: Apr 1, 2026
High-resolution In Vivo Manual Segmentation Protocol for Human Hippocampal Subfields Using 3T Magnetic Resonance Imaging
Published on: November 10, 2015
Volumetric and shape analysis of hippocampal subfields in unilateral mesial temporal lobe epilepsy with hippocampal
Jung Bin Kim1, Sang-Il Suh2, Ji Hyun Kim1
1Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
Objective:
The hippocampus consists of several functionally and histologically different subfields that are known to be differentially affected in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE). Using automated MRI analyses, we aimed to investigate atrophy patterns of hippocampal subfields and their relationships with clinical characteristics in a homogenous group of unilateral MTLE.
Methods:
Twenty-four left MTLE patients, 23 right MTLE patients, and 41 control subjects were scanned on a 3T MR scanner. Automated volumetry and shape analysis were used to assess volume and shape changes of hippocampal subfields in MTLE patients relative to controls. Within-group correlations were performed between subfield volumes and clinical variables in patients.
Results:
Compared to controls, left and right MTLE patients exhibited significant volume reductions in ipsilateral whole hippocampus and subfields including CA1, CA2-3, CA4-DG, presubiculum, and subiculum (corrected p<0.05). Regional inward shape deformation mainly localized to ipsilateral CA1 and adjacent subiculum was found in left and right MTLE patients relative to controls (corrected p<0.05). Longer disease duration was related to smaller volumes of left CA1, presubiculum, and subiculum in left MTLE, and right CA1 in right MTLE.
Conclusion:
We found overall volume reductions in ipsilateral hippocampal subfields in patients with unilateral MTLE, in accordance with known pathologic findings. Our findings of regional atrophy in ipsilateral CA1 and subiculum on shape analysis and an inverse relationship between disease duration and ipsilateral CA1 volume implicate an important role of CA1 and subiculum in the pathogenesis underlying MTLE.
Insights
Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE) causes atrophy in specific hippocampal subfields, particularly CA1 and subiculum. Longer disease duration correlates with reduced volumes in these areas, suggesting their role in MTLE pathogenesis.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Human Anatomy
Background:
- The hippocampus has distinct subfields vulnerable in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE).
- Understanding atrophy patterns in MTLE is crucial for elucidating disease mechanisms.
Purpose of the Study:
- To investigate hippocampal subfield atrophy patterns in unilateral MTLE using automated MRI.
- To explore relationships between subfield atrophy and clinical characteristics in MTLE patients.
Main Methods:
- Automated MRI volumetry and shape analysis were employed on 24 left MTLE, 23 right MTLE patients, and 41 controls.
- Volume and shape changes in hippocampal subfields were assessed.
- Correlations between subfield volumes and clinical variables were analyzed.
Main Results:
- MTLE patients showed significant ipsilateral hippocampal and subfield volume reductions (CA1, CA2-3, CA4-DG, presubiculum, subiculum).
- Inward shape deformation was observed in ipsilateral CA1 and subiculum.
- Longer disease duration correlated with smaller volumes in CA1, presubiculum, and subiculum.
Conclusions:
- Unilateral MTLE is associated with widespread ipsilateral hippocampal subfield atrophy.
- Shape analysis revealed regional atrophy in CA1 and subiculum.
- CA1 and subiculum play a significant role in MTLE pathogenesis, with disease duration influencing atrophy.
