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Articles
September 14, 2009

Seizure frequency and lateralization affect progression of atrophy in temporal lobe epilepsy

September 15, 2009 issue
73 (11) 834-842

Abstract

Background: It is unclear which factors lead to progressive neuronal damage in mesial temporal lobe epilepsy (MTLE). The objective of this study was to evaluate whether progressive hippocampal and extrahippocampal atrophy occur in patients with MTLE and whether this atrophy is related to seizures.
Method: We performed 2 MRI scans in 33 patients with clinical and electroencephalographic diagnosis of MTLE and in 24 healthy controls. MRI was performed in a 2-T scanner, and a T1-weighted gradient-echo sequence with 1 mm thickness was used for voxel-based morphometry analysis. Follow-up images were obtained at least 7 months after the first baseline MRI. Comparisons between the patient’s follow-up and baseline MRIs, and between patients and controls, were performed. A corrected p value of 0.05 was set as the threshold for the statistical analysis.
Results: Follow-up MRI was performed after a median interval of 39 months (range 7–85 months). Three patients were seizure-free between the first and second MRIs. We observed progressive white and gray matter atrophy (p < 0.05) in patients with MTLE. This progression was more intense in patients with left MTLE compared with right MTLE. A higher frequency of seizures and a longer duration of epilepsy were associated with progression of gray and white matter atrophy in patients with MTLE.
Conclusion: The progression of white and gray matter atrophy in patients with mesial temporal lobe epilepsy (MTLE) was more intense in patients with left MTLE and was associated with poorer seizure control and a longer duration of epilepsy.

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Published In

Neurology®
Volume 73Number 11September 15, 2009
Pages: 834-842
PubMed: 19752449

Publication History

Published online: September 14, 2009
Published in print: September 15, 2009

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Authors

Affiliations & Disclosures

A. C. Coan, MD
From the Department of Neurology, University of Campinas–UNICAMP, SP, Brazil, ClnAPCe Program, MRC-UNICAMP, SP, Brazil. Dr. Bonilha is currently with the Department of Neuropsychiatry, Arnold School of Public Health, University of South Carolina, Columbia, SC.
S. Appenzeller, MD, PhD
From the Department of Neurology, University of Campinas–UNICAMP, SP, Brazil, ClnAPCe Program, MRC-UNICAMP, SP, Brazil. Dr. Bonilha is currently with the Department of Neuropsychiatry, Arnold School of Public Health, University of South Carolina, Columbia, SC.
L. Bonilha, MD, PhD
From the Department of Neurology, University of Campinas–UNICAMP, SP, Brazil, ClnAPCe Program, MRC-UNICAMP, SP, Brazil. Dr. Bonilha is currently with the Department of Neuropsychiatry, Arnold School of Public Health, University of South Carolina, Columbia, SC.
L. M. Li, MD, PhD
From the Department of Neurology, University of Campinas–UNICAMP, SP, Brazil, ClnAPCe Program, MRC-UNICAMP, SP, Brazil. Dr. Bonilha is currently with the Department of Neuropsychiatry, Arnold School of Public Health, University of South Carolina, Columbia, SC.
F. Cendes, MD, PhD
From the Department of Neurology, University of Campinas–UNICAMP, SP, Brazil, ClnAPCe Program, MRC-UNICAMP, SP, Brazil. Dr. Bonilha is currently with the Department of Neuropsychiatry, Arnold School of Public Health, University of South Carolina, Columbia, SC.

Notes

Address correspondence and reprint requests to Dr. Fernando Cendes, Department of Neurology, FCM-UNICAMP, Cidade Universitária Zeferino Vaz, Campinas SP, Brazil, CEP 13083-970 [email protected]

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