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Ipsilateral subcortical atrophy associated with temporal lobectomy

K J Shedlack1, E K Lee, R A Radtke

  • 1Department of Psychiatry, State University of New York, Stony Brook 11794-8101, USA.

Psychiatry Research
|December 1, 1994
PubMed
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Temporal lobectomy in epilepsy patients may lead to progressive degeneration in connected brain regions. Post-surgery, the putamen showed reduced volume, suggesting extratemporal changes over time.

Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Neuroanatomy

Background:

  • Complex partial epilepsy of temporal lobe origin is associated with hippocampal atrophy and altered metabolism in temporal and extratemporal regions.
  • The temporal cortex and limbic system nuclei have reciprocal connections with striatal projection fields, including the putamen.

Purpose of the Study:

  • To investigate extratemporal volume asymmetry in the putamen nuclei of patients before and after temporal lobectomy for epilepsy.
  • To determine if temporal lobectomy is associated with progressive degeneration of extratemporal projections.

Main Methods:

  • Stereologic methods using in vivo magnetic resonance imaging (MRI) to determine cerebral structure volumes.
  • Volumetric analysis of the putamen nuclei in patients pre- and post-temporal lobectomy.

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Main Results:

  • No evidence of preoperative putamen volume asymmetry was found.
  • A significant postoperative decrement in ipsilateral putamen volume was observed.
  • The degree of postsurgical putamen volume asymmetry correlated with the time elapsed since resection.

Conclusions:

  • Temporal lobectomy may be associated with progressive degeneration of extratemporal projections originating from the temporal lobe.
  • These findings suggest that epilepsy surgery can impact connected brain structures beyond the resection site.