Evaluation of subcortical grey matter abnormalities in patients with MRI-negative cortical epilepsy determined through structural and tensor magnetic resonance imaging

Syu Jyun Peng, Tomor Harnod, Jang Zern Tsai, Ming Dou Ker, Jun Chern Chiou, Herming Chiueh, Chung Yu Wu, Yue Loong Hsin

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Although many studies have found abnormalities in subcortical grey matter (GM) in patients with temporal lobe epilepsy or generalised epilepsies, few studies have examined subcortical GM in focal neocortical seizures. Using structural and tensor magnetic resonance imaging (MRI), we evaluated subcortical GM from patients with extratemporal lobe epilepsy without visible lesion on MRI. Our aims were to determine whether there are structural abnormalities in these patients and to correlate the extent of any observed structural changes with clinical characteristics of disease in these patients.Methods: Twenty-four people with epilepsy and 29 age-matched normal subjects were imaged with high-resolution structural and diffusion tensor MR scans. The patients were characterised clinically by normal brain MRI scans and seizures that originated in the neocortex and evolved to secondarily generalised convulsions. We first used whole brain voxel-based morphometry (VBM) to detect density changes in subcortical GM. Volumetric data, values of mean diffusivity (MD) and fractional anisotropy (FA) for seven subcortical GM structures (hippocampus, caudate nucleus, putamen, globus pallidus, nucleus accumbens, thalamus and amygdala) were obtained using a model-based segmentation and registration tool. Differences in the volumes and diffusion parameters between patients and controls and correlations with the early onset and progression of epilepsy were estimated.Results: Reduced volumes and altered diffusion parameters of subcortical GM were universally observed in patients in the subcortical regions studied. In the patient-control group comparison of VBM, the right putamen, bilateral nucleus accumbens and right caudate nucleus of epileptic patients exhibited a significantly decreased density Segregated volumetry and diffusion assessment of subcortical GM showed apparent atrophy of the left caudate nucleus, left amygdala and right putamen; reduced FA values for the bilateral nucleus accumbens; and elevated MD values for the left thalamus, right hippocampus and right globus pallidus A decreased volume of the nucleus accumbens consistently related to an early onset of disease. The duration of disease contributed to the shrinkage of the left thalamus.Conclusions: Patients with neocortical seizures and secondary generalisation had smaller volumes and microstructural anomalies in subcortical GM regions. Subcortical GM atrophy is relevant to the early onset and progression of epilepsy.

Original languageEnglish
Article number104
JournalBMC Neurology
Volume14
Issue number1
DOIs
Publication statusPublished - May 14 2014
Externally publishedYes

Fingerprint

Epilepsy
Magnetic Resonance Imaging
Nucleus Accumbens
Caudate Nucleus
Putamen
Seizures
Thalamus
Globus Pallidus
Anisotropy
Amygdala
Atrophy
Hippocampus
Gray Matter
Generalized Epilepsy
Temporal Lobe Epilepsy
Neocortex
Brain
Control Groups

Keywords

  • Diffusion tensor imaging
  • Neocortical epilepsy
  • Subcortical grey matter
  • Volumetry

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Evaluation of subcortical grey matter abnormalities in patients with MRI-negative cortical epilepsy determined through structural and tensor magnetic resonance imaging. / Peng, Syu Jyun; Harnod, Tomor; Tsai, Jang Zern; Ker, Ming Dou; Chiou, Jun Chern; Chiueh, Herming; Wu, Chung Yu; Hsin, Yue Loong.

In: BMC Neurology, Vol. 14, No. 1, 104, 14.05.2014.

Research output: Contribution to journalArticle

Peng, Syu Jyun ; Harnod, Tomor ; Tsai, Jang Zern ; Ker, Ming Dou ; Chiou, Jun Chern ; Chiueh, Herming ; Wu, Chung Yu ; Hsin, Yue Loong. / Evaluation of subcortical grey matter abnormalities in patients with MRI-negative cortical epilepsy determined through structural and tensor magnetic resonance imaging. In: BMC Neurology. 2014 ; Vol. 14, No. 1.
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AU - Harnod, Tomor

AU - Tsai, Jang Zern

AU - Ker, Ming Dou

AU - Chiou, Jun Chern

AU - Chiueh, Herming

AU - Wu, Chung Yu

AU - Hsin, Yue Loong

PY - 2014/5/14

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N2 - Background: Although many studies have found abnormalities in subcortical grey matter (GM) in patients with temporal lobe epilepsy or generalised epilepsies, few studies have examined subcortical GM in focal neocortical seizures. Using structural and tensor magnetic resonance imaging (MRI), we evaluated subcortical GM from patients with extratemporal lobe epilepsy without visible lesion on MRI. Our aims were to determine whether there are structural abnormalities in these patients and to correlate the extent of any observed structural changes with clinical characteristics of disease in these patients.Methods: Twenty-four people with epilepsy and 29 age-matched normal subjects were imaged with high-resolution structural and diffusion tensor MR scans. The patients were characterised clinically by normal brain MRI scans and seizures that originated in the neocortex and evolved to secondarily generalised convulsions. We first used whole brain voxel-based morphometry (VBM) to detect density changes in subcortical GM. Volumetric data, values of mean diffusivity (MD) and fractional anisotropy (FA) for seven subcortical GM structures (hippocampus, caudate nucleus, putamen, globus pallidus, nucleus accumbens, thalamus and amygdala) were obtained using a model-based segmentation and registration tool. Differences in the volumes and diffusion parameters between patients and controls and correlations with the early onset and progression of epilepsy were estimated.Results: Reduced volumes and altered diffusion parameters of subcortical GM were universally observed in patients in the subcortical regions studied. In the patient-control group comparison of VBM, the right putamen, bilateral nucleus accumbens and right caudate nucleus of epileptic patients exhibited a significantly decreased density Segregated volumetry and diffusion assessment of subcortical GM showed apparent atrophy of the left caudate nucleus, left amygdala and right putamen; reduced FA values for the bilateral nucleus accumbens; and elevated MD values for the left thalamus, right hippocampus and right globus pallidus A decreased volume of the nucleus accumbens consistently related to an early onset of disease. The duration of disease contributed to the shrinkage of the left thalamus.Conclusions: Patients with neocortical seizures and secondary generalisation had smaller volumes and microstructural anomalies in subcortical GM regions. Subcortical GM atrophy is relevant to the early onset and progression of epilepsy.

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