Age at onset and seizure frequency affect white matter diffusion coefficient in patients with mesial temporal lobe epilepsy

Szilvia A. Nagy, Réka Horváth, Gábor Perlaki, Gergely Orsi, P. Barsi, Flóra John, Andrea Horváth, N. Kovács, P. Bogner, H. Ábrahám, Beáta Bóné, Csilla Gyimesi, T. Dóczi, J. Janszky

Research output: Article

5 Citations (Scopus)

Abstract

In mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), structural abnormalities are present not only in the hippocampus but also in the white matter with ipsilateral predominance. Although the timing of epilepsy onset is commonly associated with clinical and semiological dissimilarities, limited data exist regarding white matter diffusion changes with respect to age at epilepsy onset. The aim of this study was to investigate diffusion changes in the white matter of patients with unilateral MTLE-HS with respect to clinical parameters and to compare them with an age- and sex-matched healthy control group. Apparent diffusion coefficients (ADCs) were derived using monoexponential approaches from 22 (11 early and 11 late age at onset) patients with unilateral MTLE-HS and 22 age- and sex-matched control subjects after acquiring diffusion-weighted images on a 3T MRI system. Data were analyzed using two-tailed t-tests and multiple linear regression models. In the group with early onset MTLE-HS, ADC was significantly elevated in the ipsilateral hemispheric (p = 0.04) and temporal lobe white matter (p = 0.01) compared with that in controls. These differences were not detectable in late onset MTLE-HS patients. Apparent diffusion coefficient of the group with early onset MTLE-HS was negatively related to age at epilepsy onset in the ipsilateral hemispheric white matter (p = 0.03) and the uncinate fasciculus (p = 0.03), while in patients with late onset MTLE-HS, ADC was no longer dependent on age at epilepsy onset itself but rather on the seizure frequency in the ipsilateral uncinate fasciculus (p = 0.03). Such diffusivity pattern has been associated with chronic white matter degeneration, reflecting myelin loss and higher extracellular volume which are more pronounced in the frontotemporal regions and also depend on clinical features. In the group with early onset MTLE-HS, the timing of epilepsy seems to be the major cause of white matter abnormalities while in late onset disease, it has a secondary role in provoking diffusion changes.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalEpilepsy and Behavior
Volume61
DOIs
Publication statusPublished - aug. 1 2016

Fingerprint

Temporal Lobe Epilepsy
Sclerosis
Age of Onset
Seizures
Epilepsy
Linear Models
White Matter
Temporal Lobe
Myelin Sheath
Hippocampus
Control Groups

ASJC Scopus subject areas

  • Clinical Neurology
  • Behavioral Neuroscience
  • Neurology

Cite this

Age at onset and seizure frequency affect white matter diffusion coefficient in patients with mesial temporal lobe epilepsy. / Nagy, Szilvia A.; Horváth, Réka; Perlaki, Gábor; Orsi, Gergely; Barsi, P.; John, Flóra; Horváth, Andrea; Kovács, N.; Bogner, P.; Ábrahám, H.; Bóné, Beáta; Gyimesi, Csilla; Dóczi, T.; Janszky, J.

In: Epilepsy and Behavior, Vol. 61, 01.08.2016, p. 14-20.

Research output: Article

Nagy, Szilvia A. ; Horváth, Réka ; Perlaki, Gábor ; Orsi, Gergely ; Barsi, P. ; John, Flóra ; Horváth, Andrea ; Kovács, N. ; Bogner, P. ; Ábrahám, H. ; Bóné, Beáta ; Gyimesi, Csilla ; Dóczi, T. ; Janszky, J. / Age at onset and seizure frequency affect white matter diffusion coefficient in patients with mesial temporal lobe epilepsy. In: Epilepsy and Behavior. 2016 ; Vol. 61. pp. 14-20.
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abstract = "In mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), structural abnormalities are present not only in the hippocampus but also in the white matter with ipsilateral predominance. Although the timing of epilepsy onset is commonly associated with clinical and semiological dissimilarities, limited data exist regarding white matter diffusion changes with respect to age at epilepsy onset. The aim of this study was to investigate diffusion changes in the white matter of patients with unilateral MTLE-HS with respect to clinical parameters and to compare them with an age- and sex-matched healthy control group. Apparent diffusion coefficients (ADCs) were derived using monoexponential approaches from 22 (11 early and 11 late age at onset) patients with unilateral MTLE-HS and 22 age- and sex-matched control subjects after acquiring diffusion-weighted images on a 3T MRI system. Data were analyzed using two-tailed t-tests and multiple linear regression models. In the group with early onset MTLE-HS, ADC was significantly elevated in the ipsilateral hemispheric (p = 0.04) and temporal lobe white matter (p = 0.01) compared with that in controls. These differences were not detectable in late onset MTLE-HS patients. Apparent diffusion coefficient of the group with early onset MTLE-HS was negatively related to age at epilepsy onset in the ipsilateral hemispheric white matter (p = 0.03) and the uncinate fasciculus (p = 0.03), while in patients with late onset MTLE-HS, ADC was no longer dependent on age at epilepsy onset itself but rather on the seizure frequency in the ipsilateral uncinate fasciculus (p = 0.03). Such diffusivity pattern has been associated with chronic white matter degeneration, reflecting myelin loss and higher extracellular volume which are more pronounced in the frontotemporal regions and also depend on clinical features. In the group with early onset MTLE-HS, the timing of epilepsy seems to be the major cause of white matter abnormalities while in late onset disease, it has a secondary role in provoking diffusion changes.",
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AU - Nagy, Szilvia A.

AU - Horváth, Réka

AU - Perlaki, Gábor

AU - Orsi, Gergely

AU - Barsi, P.

AU - John, Flóra

AU - Horváth, Andrea

AU - Kovács, N.

AU - Bogner, P.

AU - Ábrahám, H.

AU - Bóné, Beáta

AU - Gyimesi, Csilla

AU - Dóczi, T.

AU - Janszky, J.

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N2 - In mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), structural abnormalities are present not only in the hippocampus but also in the white matter with ipsilateral predominance. Although the timing of epilepsy onset is commonly associated with clinical and semiological dissimilarities, limited data exist regarding white matter diffusion changes with respect to age at epilepsy onset. The aim of this study was to investigate diffusion changes in the white matter of patients with unilateral MTLE-HS with respect to clinical parameters and to compare them with an age- and sex-matched healthy control group. Apparent diffusion coefficients (ADCs) were derived using monoexponential approaches from 22 (11 early and 11 late age at onset) patients with unilateral MTLE-HS and 22 age- and sex-matched control subjects after acquiring diffusion-weighted images on a 3T MRI system. Data were analyzed using two-tailed t-tests and multiple linear regression models. In the group with early onset MTLE-HS, ADC was significantly elevated in the ipsilateral hemispheric (p = 0.04) and temporal lobe white matter (p = 0.01) compared with that in controls. These differences were not detectable in late onset MTLE-HS patients. Apparent diffusion coefficient of the group with early onset MTLE-HS was negatively related to age at epilepsy onset in the ipsilateral hemispheric white matter (p = 0.03) and the uncinate fasciculus (p = 0.03), while in patients with late onset MTLE-HS, ADC was no longer dependent on age at epilepsy onset itself but rather on the seizure frequency in the ipsilateral uncinate fasciculus (p = 0.03). Such diffusivity pattern has been associated with chronic white matter degeneration, reflecting myelin loss and higher extracellular volume which are more pronounced in the frontotemporal regions and also depend on clinical features. In the group with early onset MTLE-HS, the timing of epilepsy seems to be the major cause of white matter abnormalities while in late onset disease, it has a secondary role in provoking diffusion changes.

AB - In mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), structural abnormalities are present not only in the hippocampus but also in the white matter with ipsilateral predominance. Although the timing of epilepsy onset is commonly associated with clinical and semiological dissimilarities, limited data exist regarding white matter diffusion changes with respect to age at epilepsy onset. The aim of this study was to investigate diffusion changes in the white matter of patients with unilateral MTLE-HS with respect to clinical parameters and to compare them with an age- and sex-matched healthy control group. Apparent diffusion coefficients (ADCs) were derived using monoexponential approaches from 22 (11 early and 11 late age at onset) patients with unilateral MTLE-HS and 22 age- and sex-matched control subjects after acquiring diffusion-weighted images on a 3T MRI system. Data were analyzed using two-tailed t-tests and multiple linear regression models. In the group with early onset MTLE-HS, ADC was significantly elevated in the ipsilateral hemispheric (p = 0.04) and temporal lobe white matter (p = 0.01) compared with that in controls. These differences were not detectable in late onset MTLE-HS patients. Apparent diffusion coefficient of the group with early onset MTLE-HS was negatively related to age at epilepsy onset in the ipsilateral hemispheric white matter (p = 0.03) and the uncinate fasciculus (p = 0.03), while in patients with late onset MTLE-HS, ADC was no longer dependent on age at epilepsy onset itself but rather on the seizure frequency in the ipsilateral uncinate fasciculus (p = 0.03). Such diffusivity pattern has been associated with chronic white matter degeneration, reflecting myelin loss and higher extracellular volume which are more pronounced in the frontotemporal regions and also depend on clinical features. In the group with early onset MTLE-HS, the timing of epilepsy seems to be the major cause of white matter abnormalities while in late onset disease, it has a secondary role in provoking diffusion changes.

KW - Age at epilepsy onset

KW - Apparent diffusion coefficient

KW - Diffusion-weighted imaging

KW - Mesial temporal lobe epilepsy with hippocampal sclerosis

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