HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Baxendale, S. A. Articles by Shorvon, S. D. Search for Related Content PubMed PubMed Citation Articles by Baxendale, S. A. Articles by Shorvon, S. D.

Disproportion in the distribution of gray and white matter

Neuropsychological correlates

From the Epilepsy Research Group (Drs. Baxendale, Sisodiya, Thompson, Free, Kitchen, Stevens, Fish, and Shorvon), Department of Clinical Neurology, Department of Neurosurgery (Drs. Kitchen and Harkness), and Department of Neuroradiology (Dr. Stevens), National Hospital for Neurology & Neurosurgery, London, UK.

Address correspondence and reprint requests to Dr. Sallie A. Baxendale, Department of Neuropsychology, National Society for Epilepsy, Chalfont St. Peter, Gerrards Cross, Buckinghamshire, UK SL9 0RJ.

OBJECTIVE: To examine the relationship between measures of disproportion in the regional distribution of gray and white matter and preoperative neuropsychological function in temporal lobe epilepsy patients with proved hippocampal sclerosis (HS).

BACKGROUND: Subtle cerebral structural disruption, not evident on routine inspection of high-resolution MRI, is associated with poor surgical outcome in patients with histologically proved HS. Preoperative global memory dysfunction is also associated with poor postoperative seizure control. The authors hypothesize that patients with HS and abnormal regional distributions of gray and white matter would show more diffuse neuropsychological deficits preoperatively than patients with isolated HS alone.

METHODS: A total of 28 adults with lateralized temporal lobe epilepsy and hippocampal volume loss measured on MRI were assessed preoperatively on neuropsychological tests of general intellect and the learning and recall of both verbal and nonverbal material. Quantitative MRI analysis of the regional distribution of gray and white matter was performed. Chi-square analyses were used to examine the relation between the presence or absence of cerebral abnormalities and preoperative performance on the neuropsychological tests.

RESULTS: A total of 15 of 28 patients had extrahippocampal abnormalities on quantitative MRI analysis. Thirteen patients had global memory impairment. Bilateral memory deficits were significantly associated with both the presence of cerebral abnormalities (p < 0.02) and poor postoperative seizure control (p < 0.05).

CONCLUSIONS: Disproportion in the regional distribution of gray and white matter in patients with HS may form the structural basis of global memory disturbance in a distinct group of patients with temporal lobe epilepsy.

This article has been cited by other articles:

				S. A. Baxendale, P. J. Thompson, and J. S. Duncan Evidence-Based Practice: A Reevaluation of the Intracarotid Amobarbital Procedure (Wada Test) Arch Neurol, June 1, 2008; 65(6): 841 - 845. [Full Text] [PDF]

				J. J. Lin, N. Salamon, A. D. Lee, R. A. Dutton, J. A. Geaga, K. M. Hayashi, E. Luders, A. W. Toga, J. Engel Jr, and P. M. Thompson Reduced Neocortical Thickness and Complexity Mapped in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis Cereb Cortex, September 1, 2007; 17(9): 2007 - 2018. [Abstract] [Full Text] [PDF]

				B. Hermann, J. Jones, R. Sheth, C. Dow, M. Koehn, and M. Seidenberg Children with new-onset epilepsy: neuropsychological status and brain structure Brain, October 1, 2006; 129(10): 2609 - 2619. [Abstract] [Full Text] [PDF]

				F Zubler, M Seeck, T Landis, F Henry, and F Lazeyras Contralateral medial temporal lobe damage in right but not left temporal lobe epilepsy: a 1H magnetic resonance spectroscopy study J. Neurol. Neurosurg. Psychiatry, September 1, 2003; 74(9): 1240 - 1244. [Abstract] [Full Text] [PDF]

				S. M. Sisodiya Surgery for malformations of cortical development causing epilepsy Brain, June 1, 2000; 123(6): 1075 - 1091. [Abstract] [Full Text] [PDF]

				F. G Woermann, L. T. van Elst, M. J Koepp, S. L Free, P. J Thompson, M. R Trimble, and J. S Duncan Reduction of frontal neocortical grey matter associated with affective aggression in patients with temporal lobe epilepsy: an objective voxel by voxel analysis of automatically segmented MRI J. Neurol. Neurosurg. Psychiatry, February 1, 2000; 68(2): 162 - 169. [Abstract] [Full Text] [PDF]