Auras and clinical features in temporal lobe epilepsy: A new approach on the basis of voxel-based morphometry

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dc.contributor.authorCastilho Garcia Santana, Maria Teresa [UNIFESP]
dc.contributor.authorJackowski, Andrea Parolin [UNIFESP]
dc.contributor.authorSilva, Henrique Hattori da [UNIFESP]
dc.contributor.authorSales Ferreira Caboclo, Luis Otavio [UNIFESP]
dc.contributor.authorCenteno, Ricardo Silva [UNIFESP]
dc.contributor.authorBressan, Rodrigo A. [UNIFESP]
dc.contributor.authorCarrete, Henrique [UNIFESP]
dc.contributor.authorTargas Yacubian, Elza Marcia [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:59:38Z
dc.date.available2016-01-24T13:59:38Z
dc.date.issued2010-05-01
dc.description.abstractMRI investigations in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) have demonstrated structural abnormalities extending beyond ipsilateral hippocampus which may be studied through voxel-based morphometry (VBM). We investigated brain morphology related to clinical features in patients with refractory TLE with MIS using VBM. One hundred patients with unilateral TLE with MTS (59 left) and 30 controls were enrolled. VBM5 was employed to analyze (1) hemispheric damage, (2) influence of initial precipitating injury (IPI): 23 patients with febrile seizures and 19 with status epilepticus, and (3) types of auras classified as: mesial, including psychic auras (19 patients); anterior mesio-lateral, as autonomic symptoms, specially epigastric auras (27 patients) and neocortical, which included auditory, vertiginous, somatosensory and visual auras (16 patients). (1) Left TLE patients presented more widespread gray matter volume (GMV) reductions affecting ipsilateral hippocampus, temporal neocortex, insula and also left uncus, precentral gyrus, thalamus, parietal lobule, cuneus and bilateral cingulum. (2) Febrile seizures group presented ipsilateral GMV reductions in hippocampus, neocortical temporal, frontal and occipital cortices, insula and cingulum. Status epilepticus group presented more widespread GMV reductions involving temporal and amygdala, particularly right TLE group, who presented greater extension of GMV reduction in the entorhinal cortex. Significant reductions in hippocampus, amygdala and insula were seen in patients with anterior mesio-lateral auras. This study evaluated a large number of TLE-MTS patients showing structural damage extending beyond hippocampus, and different types of IPI associated with the extension of brain damage. Subtypes of auras are related to different clusters of areas of GMV reductions in VBM. for the first time, we have demonstrated GMV reductions anatomically correspondent to psychic (mesial areas) and autonomic auras (mesial and insular areas) reproducing previous cortical stimulation studies. (C) 2010 Elsevier B.V. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, UNIPETE, Dept Neurol & Neurosurg, BR-04024002 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, LiNC, Dept Psychiat, BR-04024002 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Radiol, BR-04024002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, UNIPETE, Dept Neurol & Neurosurg, BR-04024002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, LiNC, Dept Psychiat, BR-04024002 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Radiol, BR-04024002 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipBrazilian Ministry of Education
dc.description.sponsorshipIDBrazilian Ministry of Education: 0151/08-4
dc.format.extent327-338
dc.identifierhttp://dx.doi.org/10.1016/j.eplepsyres.2010.02.006
dc.identifier.citationEpilepsy Research. Amsterdam: Elsevier B.V., v. 89, n. 2-3, p. 327-338, 2010.
dc.identifier.doi10.1016/j.eplepsyres.2010.02.006
dc.identifier.issn0920-1211
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32511
dc.identifier.wosWOS:000277872900020
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofEpilepsy Research
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectAurasen
dc.subjectInitial precipitating injuryen
dc.subjectMagnetic resonance imagingen
dc.subjectMesial temporal sclerosisen
dc.subjectTemporal lobe epilepsyen
dc.subjectVoxel-based morphometryen
dc.titleAuras and clinical features in temporal lobe epilepsy: A new approach on the basis of voxel-based morphometryen
dc.typeinfo:eu-repo/semantics/article
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