Navegando por Palavras-chave "Hippocampal atrophy"
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- ItemSomente MetadadadosHippocampal atrophy and memory dysfunction in patients with juvenile myoclonic epilepsy(Elsevier B.V., 2013-10-01) Lin, Katia [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Pascalicchio, Tatiana Frascareli [UNIFESP]; Silva, Ivaldo [UNIFESP]; Silva Tudesco, Ivanda Souza [UNIFESP]; Bittar Guaranha, Mirian Salvadori [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); HGCR; Universidade de São Paulo (USP)Juvenile myoclonic epilepsy (JME) is a well-defined idiopathic generalized epilepsy (IGE) syndrome, being the most common IGE in adults and accounting for 5-11% of patients with epilepsy. While neuropsychological and neuroimaging studies have discussed the thalamofrontal dysfunction as the major pathophysiologic mechanism of JME, investigation on memory is scarce in patients with JME, with lack of objective assessments addressing common complaints and daily difficulties such as recalling telephone numbers, messages to pass on, and taking antiepileptic drugs regularly. the aim of this study was to objectively assess memory deficits in a group of patients with JME using neuropsychological examination combined with structural MRI of the hippocampi. After informed consent, a cohort of 56 consecutive patients with JME (29 males; mean age +/- SD = 26.5 +/- 9.01 years; range = 14.0-55.0 years) was included. the control group consisted of 42 healthy volunteers (18 males; mean age +/- SD = 31.0 +/- 8.54 years; range = 20.0-56.0 years) without a family history of neuropsychiatric disorders. Patients and controls were submitted to a MRI and to a neuropsychological assessment, and comparisons between groups were performed, as well as a correlation study between hippocampal atrophy and neuropsychological performance in a group of patients with JME. the level of statistical significance was set at p < 0.05. Significant hippocampal atrophy among patients with JME was observed, which was correlated with memory dysfunctions. the present findings reinforce the existence of functional-anatomic ictogenic networks that are not limited to frontal lobes, providing further support towards the concept of 'system epilepsies' in JME. (C) 2013 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosHippocampal atrophy on MRI is predictive of histopathological patterns and surgical prognosis in mesial temporal lobe epilepsy with hippocampal sclerosis(Elsevier Science Bv, 2016) Jardim, Anaclara Prada [UNIFESP]; Corso, Jeana Torres [UNIFESP]; Garcia, Maria Teresa Fernandes Castilho [UNIFESP]; Gaca, Larissa Botelho [UNIFESP]; Comper, Sandra Mara [UNIFESP]; Penteado Lancellotti, Carmen Lucia; Centeno, Ricardo Silva [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Cavalheiro, Esper Abrão [UNIFESP]; Scorza, Carla Alessandra [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]Purpose: To correlate hippocampal volumes obtained from brain structural imaging with histopathological patterns of hippocampal sclerosis (HS), in order to predict surgical outcome. Methods: Patients with mesial temporal lobe epilepsy (MTLE) with HS were selected. Clinical data were assessed pre-operatively and surgical outcome in the first year post surgery. One block of mid hippocampal body was selected for HS classification according to ILAE criteria. NeuN-immunoreactive cell bodies were counted within hippocampal subfields, in four randomly visual fields, and cell densities were transformed into z-score values. FreeSurfer processing of 1.5 T brain structural images was used for subcortical and cortical volumetric estimation of the ipsilateral hippocampus. Univariate analysis of variance and Pearson's correlation test were applied for statistical analyses. Results: Sixty-two cases (31 female, 32 right HS) were included. ILAE type 1 HS was identified in 48 patients, type 2 in eight, type 3 in two, and four had no-HS. Better results regarding seizure control, i.e. ILAE 1, were achieved by patients with type 1 HS (58.3%). Patients with types 1 and 2 had smaller hippocampal volumes compared to those with no-HS (p<0.001 and p=0.004, respectively). Positive correlation was encountered between hippocampal volumes and CA1, CA3, CA4, and total estimated neuronal densities. CA2 was the only sector which did not correlate its neuronal density with hippocampal volume (p = 0.390). Conclusion: This is the first study correlating hippocampal volume on MRI submitted to FreeSurfer processing with ILAE patterns of HS and neuronal loss within each hippocampal subfield, a fundamental finding to anticipate surgical prognosis for patients with drug-resistant MTLE and HS. (C) 2016 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosMemory impairment is not necessarily related to seizure frequency in mesial temporal lobe epilepsy with hippocampal sclerosis(Wiley-Blackwell, 2014-08-01) Pacagnella, Denise; Lopes, Tatila M.; Morita, Marcia E.; Yasuda, Clarissa L.; Cappabianco, Fabio A. M. [UNIFESP]; Bergo, Felipe; Balthazar, Marcio L. F.; Coan, Ana C.; Cendes, Fernando; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)Objective: To investigate the effect of seizure frequency on memory, we performed a cross sectional study comparing mesial temporal lobe epilepsy (MTLE) patients with frequent and infrequent seizures.Methods: We performed magnetic resonance imaging (MRI) hippocampal volume (HV) measurements and neuropsychological assessment in 22 patients with frequent seizures (at least one dyscognitive seizure [DS] per month) that were refractory to antiepileptic drugs and 20 patients with infrequent seizures (three or less DS per year and no event evolving to a bilateral convulsive seizure), all with MRI signs of hippocampal sclerosis (HS) on visual analysis. We also included 29 controls for comparison of volumetric data.Results: There was no difference in memory performance between patients with frequent seizures and infrequent seizures. We observed a significant bilateral reduction of HV in patients with MTLE when compared to controls (p < 0.001). the degree of hippocampal atrophy (HA) between patients with frequent and infrequent seizures was not different. There was a negative correlation between seizure frequency and HV, with r = -0.3 for the HV ipsilateral to the HS and r = -0.55 for the contralateral side, thus, explaining only 9% and 30% of the HV loss. There was a positive correlation between age of onset and degree of HA (r = 0.37).Significance: Our data suggest that seizure frequency does not explain most of the HV loss or memory impairment in MTLE. Memory impairment appears to be more influenced by hippocampal damage than by seizure frequency. Further studies are necessary to identify the factors that influence memory decline in patients with MTLE.