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Published on: August 11, 2019
Duration-dependent hippocampal structural changes in focal epilepsy: multicenter neuroimaging evidence
Yuxin Wu1,2, Zaiyu Zhang1,2, Baohui Yang1,2
1Department of Neurosurgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400010, China.
Epilepsy duration is linked to hippocampal changes, with longer disease duration correlating with reduced hippocampal volume and thickness. These findings suggest disease progression significantly impacts brain structure, aiding clinical monitoring.
Area of Science:
- Neuroimaging
- Epilepsy Pathophysiology
- Structural Brain Changes
Background:
- Hippocampal sclerosis (HS) is more prevalent in adult epilepsy surgery cases than pediatric.
- Epilepsy-related hippocampal abnormalities may evolve with disease duration.
- A duration-dependent hypothesis for hippocampal changes in epilepsy was proposed.
Purpose of the Study:
- To investigate the association between epilepsy duration and hippocampal morphological features.
- To test the hypothesis that hippocampal structural changes in epilepsy are duration-dependent.
- To utilize advanced neuroimaging in a large multicenter cohort.
Main Methods:
- Included 705 epilepsy patients and 424 controls from three Chinese centers.
- Extracted global and subfield hippocampal features using HippUnfold and AID-HS.
- Assessed associations using Spearman correlations and longitudinal analysis via linear mixed-effects models.
Main Results:
- Epilepsy patients showed bilateral hippocampal abnormalities, more severe ipsilaterally.
- Disease duration correlated negatively with ipsilateral hippocampal volume, thickness, and gyrification.
- Longitudinal analysis revealed a significant annual decline in ipsilateral hippocampal volume.
Conclusions:
- Novel neuroimaging evidence supports the duration-related structural alteration hypothesis in focal epilepsy.
- Findings may explain higher HS rates in adult vs. pediatric surgical cohorts.
- Disease duration is a significant indicator for monitoring and therapeutic decisions in epilepsy.
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