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Epileptic children with hemispheres' asymmetry. Quantitative brain magnetic resonance-based analysis of apparently
Rosalinda Calandrelli1, Fabio Pilato2, Domenica Battaglia3
1Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma-UOC Radiologia e Neuroradiologia, Polo Diagnostica Per Immagini, Radioterapia, Oncologia ed Ematologia, Area Diagnostica Per Immagini, 00168, Rome, Italy.
Insights
Epileptic children with hemispheric asymmetry show subtle volumetric changes in the unaffected hemisphere. These brain volume alterations, detected by MRI, vary based on malformation type and epilepsy patterns.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Epileptology
Background:
- Hemispheric asymmetry in children can result from unilateral dysplastic malformations.
- Understanding volumetric changes in the contralateral hemisphere is crucial for assessing the impact of these conditions.
Purpose of the Study:
- To quantitatively analyze subtle volumetric changes in the contralateral hemisphere of epileptic children with hemispheric asymmetry.
- To correlate these changes with specific types of dysplastic malformations and epilepsy patterns.
Main Methods:
- Involved 13 children with Hemimegalencephaly (HME) and 20 with Hemimicrencephaly (Hme), categorized into subgroups.
- Utilized 3D FSPGR T1-weighted MRI to assess white and grey matter volumes of both hemispheres.
- Compared volumetric parameters against an age-matched healthy control group.
Main Results:
- In HME subgroups, the affected hemisphere volume increased, while the contralateral hemisphere showed white matter reduction; grey matter reduction was more pronounced in multifocal epilepsy.
- In Hme subgroups, the affected hemisphere volume decreased. The contralateral hemisphere volume significantly increased in polymicrogyria and giant subcortical nodular heterotopia with multifocal epilepsy subgroups.
Conclusions:
- Quantitative MRI provides objective assessment of brain structures in patients with hemispheric asymmetry.
- Dysplastic malformation type, epilepsy onset age, and pattern influence contralateral hemisphere volume changes.
- Early identification of these volumetric changes may aid in planning antiepileptic treatments.
Objective:
We performed a quantitative hemispheres analysis in epileptic children with hemispheres' asymmetry -due to unilateral dysplastic malformation- in order to recognize subtle volumetric changes of the contralateral and apparently unaffected hemisphere.
Methods:
13 children with Hemimegalencephaly (HME) and 20 with Hemimicrencephaly (Hme) were clustered in subgroups according to underlying hemispheric cortical dysplastic malformation and epilepsy pattern. 3D FSPGR T1weighted images were used to assess white and grey matter volumes for both hemispheres. Each volumetric parameter was compared with the average of an age-matched healthy control group.
Results:
HME subgroups: HME with pachygyria and focal (HME-PG-F; n 6) or multifocal epilepsy (HME-PG-MF; n.7). In both subgroups affected hemisphere (AH) volume was increased and contralateral hemisphere (CH) showed white matter volume reduction; in HME-PG-MF grey matter volume of CH was more reduced than HME-PG-F. Hme subgroups: Hme with polimicrogyria and focal epilepsy (Hme-PMG-F; n.8), Hme with giant subcortical nodular heterotopia and focal (Hme-SCH-F; n.6) or multifocal epilepsy (Hme-SCH-MF; n.6). In all subgroups AH volume was reduced; the volume of CH was significantly increased in Hme-PMG-F and Hme-SCH-MF while it was not significantly increased in Hme-SCH-F compared to affected hemisphere.
Conclusions:
In patients with hemispheres' asymmetry, quantitative high-resolution MRI offers a more objective assessment of brain structures volume. The type of hemispheric dysplastic malformation together with the age of epilepsy onset and epileptic pattern may contribute to changes in contralateral and apparently unaffected hemisphere. Future studies are warranted to evaluate whether the early identification of these changes might help in planning future antiepileptic treatments.
