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Three-dimensional preoperative maps of hippocampal atrophy predict surgical outcomes in temporal lobe epilepsy

From the Department of Neurology (Drs. Lin and Engel), Laboratory of Neuro Imaging, Brain Mapping Division (Ms. Dutton, Ms. Lee, Ms. Geaga, Ms. Hayashi, and Drs. Toga and Thompson), Department of Radiology (Dr. Salamon), Department of Neurobiology (Dr. Engel), and the Brain Research Institute (Dr. Engel), David Geffen School of Medicine at UCLA, Los Angeles, CA.

Address correspondence and reprint requests to Dr. Jack J. Lin, Department of Neurology, University of California, Irvine, 101 The City Dr. South, Bldg. 22C, 2nd Floor, Rt. 13, Orange, CA 92868; e-mail: linjj{at}uci.edu

The authors used surface-based anatomic mapping to detect features of hippocampal anatomy that correlated with surgical outcomes in patients undergoing surgery for mesial temporal lobe epilepsy with hippocampal sclerosis. Compared with a seizure-free group, hippocampal profiles for the non–seizure-free group had greater diffuse ipsilateral atrophy and more region-specific contralateral atrophy in the anterior, lateral hippocampus. These atrophic regions may indicate areas of increased epileptogenicity, contributing to poorer surgical outcomes.

Commentary, see page 975

See also page 1026

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 11 issue to find the title link for this article.

Supported by grants from the Epilepsy Foundation Clinical Research Training Fellowship, National EpiFellows Foundation Fritz E. Dreifuss Award (to J.J.L. and J.E.), National Institute for Biomedical Imaging and Bioengineering, the National Center for Research Resources, and the National Institute on Aging (to P.M.T.: R21 EB01651, R21 RR019771, P50 AG016570; to A.W.T.: P41 RR13642 and M01 RR00865 [GCRC]).

Disclosure: The authors report no conflicts of interest.

Received December 22, 2004. Accepted in final form July 8, 2005.

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