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amygdala volume and epilepsy

N Hansen, G Widman, J-A Witt, J Wagner, A J Becker, C E Elger, C Helmstaedter
OBJECTIVE: To determine the efficacy of immunotherapy in limbic encephalitis (LE) associated epilepsies with autoantibodies against intracellular antigens in the forms of paraneoplastic autoantibodies versus glutamic acid decarboxylase 65 (GAD)-autoantibodies. METHODS: Eleven paraneoplastic-antibodies+ and eleven age- and gender-matched GAD-antibodies+ patients with LE were compared regarding EEG, seizure frequency, MRI volumetry of the brain, and cognition. All patients received immunotherapy with corticosteroids add-on to antiepileptic therapy...
December 2016: Epilepsy & Behavior: E&B
Camille Garcia-Ramos, Jack J Lin, Leonardo Bonilha, Jana E Jones, Daren C Jackson, Vivek Prabhakaran, Bruce P Hermann
Anxiety disorders represent a prevalent psychiatric comorbidity in both adults and children with epilepsy for which the etiology remains controversial. Neurobiological contributions have been suggested, but only limited evidence suggests abnormal brain volumes particularly in children with epilepsy and anxiety. Since the brain develops in an organized fashion, covariance analyses between different brain regions can be investigated as a network and analyzed using graph theory methods. We examined 46 healthy children (HC) and youth with recent onset idiopathic epilepsies with (n = 24) and without (n = 62) anxiety disorders...
2016: NeuroImage: Clinical
Daichi Sone, Miho Ota, Norihide Maikusa, Yukio Kimura, Kaoru Sumida, Kota Yokoyama, Etsuko Imabayashi, Masako Watanabe, Yutaka Watanabe, Mitsutoshi Okazaki, Noriko Sato, Hiroshi Matsuda
PURPOSE: Cases of temporal lobe epilepsy (TLE) with ipsilateral amygdala enlargement (AE) have increasingly been reported. However, the white matter (WM) abnormalities of TLE patients with AE remain poorly investigated. Here we explored macrostructural and microstructural WM abnormalities in TLE patients with AE compared to normal controls and TLE patients with hippocampal sclerosis (HS). MATERIAL AND METHODS: We selected 17 patients with unilateral TLE with AE (TLE-AE) based on automated amygdala volumetry using FreeSurfer software, and 34 healthy controls and 35 patients with unilateral TLE with HS (TLE-HS) were also recruited...
September 11, 2016: Epilepsy Research
Michael P Malter, Guido Widman, Norbert Galldiks, Winfried Stoecker, Christoph Helmstaedter, Christian E Elger, Jan Wagner
OBJECTIVE: Recent reports define temporal lobe epilepsy with amygdala enlargement (TLE-AE) as a distinct electroclinical syndrome comparable to TLE with hippocampal sclerosis. In this retrospective observational study, we present the largest consecutive series of patients with new-onset TLE-AE to date and describe clinical characteristics and seizure outcome, and we aim to explore underlying autoimmune mechanisms within this syndrome. METHODS: We reviewed all consecutive patients between 2004 and 2014 at our tertiary epilepsy center at the University of Bonn, Germany, with new-onset (<5 years) TLE-AE, negative serum antibody (ab) test results, and with available follow-up data for at least 12 months...
September 2016: Epilepsia
Anny Reyes, Thomas Thesen, Xiuyuan Wang, Daniel Hahn, Daeil Yoo, Ruben Kuzniecky, Orrin Devinsky, Karen Blackmon
OBJECTIVE: We assessed whether presurgical resting state functional magnetic resonance imaging (fMRI) provides information for distinguishing temporal lobe epilepsy (TLE) with mesial temporal sclerosis (TLE-MTS) from TLE without MTS (TLE-noMTS). METHODS: Thirty-four patients with TLE and 34 sex-/age-matched controls consented to a research imaging protocol. MTS status was confirmed by histologic evaluation of surgical tissue (TLE-MTS = 16; TLE-noMTS = 18). The fractional amplitude of low-frequency fluctuations (fALFFs) in the blood oxygen level-dependent (BOLD) resting-state fMRI signal, a marker of local metabolic demand at rest, was averaged at five regions of interest (ROIs; hippocampus, amygdala, frontal, occipital, and temporal lobe), along with corresponding volume and cortical thickness estimates...
September 2016: Epilepsia
Paramdeep Singh, Rupinderjeet Kaur, Kavita Saggar, Gagandeep Singh, Simmi Aggarwal
BACKGROUND: It has been suggested that the pathophysiology of temporal lobe epilepsy may relate to abnormalities in various brain structures, including the amygdala. Patients with mesial temporal lobe epilepsy (MTLE) without MRI abnormalities (MTLE-NMRI) represent a challenge for diagnosis of the underlying abnormality and for presurgical evaluation. To date, however, only few studies have used quantitative structural Magnetic Resonance Imaging-based techniques to examine amygdalar pathology in these patients...
2016: Polish Journal of Radiology
S M Jessica Beh, Mark J Cook, Wendyl J D'Souza
OBJECTIVE: The objective of this study was to compare the seizure characteristics and treatment outcomes in patient groups with temporal lobe epilepsy (TLE) identified with isolated amygdala enlargement (AE) on magnetic resonance imaging studies. METHODS: PubMed, Embase, and the Cochrane Library were searched for relevant studies using the keywords 'amygdala enlargement', 'epilepsy', and 'seizures' in April 2015. Human studies, written in English, that investigated cohorts of patients with TLE and AE were included...
July 2016: Epilepsy & Behavior: E&B
B von Rhein, J Wagner, G Widman, M P Malter, C E Elger, C Helmstaedter
OBJECTIVES: Whether and when to immunologically treat epilepsy patients with suggested autoantibody (AB)-negative limbic encephalitis (LE) is clinically challenging. Therefore, we evaluated the clinical outcome and eventual outcome predictors of immunotherapy in a group of AB-negative patients with recent-onset temporal lobe epilepsy (TLE), magnetic resonance imaging (MRI) indicators of LE, subjective cognitive decline, and/or psychiatric symptoms. METHODS: This retrospective, observational, uncontrolled study monitored 28 TLE patients with suggested AB-negative LE along with methylprednisolone immunotherapy...
January 2017: Acta Neurologica Scandinavica
Stephen Monteith, John Snell, Mathew Eames, Neal F Kassell, Edward Kelly, Ryder Gwinn
OBJECTIVE In appropriate candidates, the treatment of medication-refractory mesial temporal lobe epilepsy (MTLE) is primarily surgical. Traditional anterior temporal lobectomy yields seizure-free rates of 60%-70% and possibly higher. The field of magnetic resonance-guided focused ultrasound (MRgFUS) is an evolving field in neurosurgery. There is potential to treat MTLE with MRgFUS; however, it has appeared that the temporal lobe structures were beyond the existing treatment envelope of currently available clinical systems...
December 2016: Journal of Neurosurgery
Joon Y Kang, Chengyuan Wu, Joseph Tracy, Matthew Lorenzo, James Evans, Maromi Nei, Christopher Skidmore, Scott Mintzer, Ashwini D Sharan, Michael R Sperling
OBJECTIVE: To describe mesial temporal lobe ablated volumes, verbal memory, and surgical outcomes in patients with medically intractable mesial temporal lobe epilepsy (mTLE) treated with magnetic resonance imaging (MRI)-guided stereotactic laser interstitial thermal therapy (LiTT). METHODS: We prospectively tracked seizure outcome in 20 patients at Thomas Jefferson University Hospital with drug-resistant mTLE who underwent MRI-guided LiTT from December 2011 to December 2014...
February 2016: Epilepsia
Erwin A van Vliet, Willem M Otte, Wytse J Wadman, Eleonora Aronica, Gijs Kooij, Helga E de Vries, Rick M Dijkhuizen, Jan A Gorter
OBJECTIVE: The mammalian target of rapamycin (mTOR) pathway has received increasing attention as a potential antiepileptogenic target. Treatment with the mTOR inhibitor rapamycin after status epilepticus reduces the development of epilepsy in a rat model. To study whether rapamycin mediates this effect via restoration of blood-brain barrier (BBB) dysfunction, contrast-enhanced magnetic resonance imaging (CE-MRI) was used to determine BBB permeability throughout epileptogenesis. METHODS: Imaging was repeatedly performed until 6 weeks after kainic acid-induced status epilepticus in rapamycin (6 mg/kg for 6 weeks starting 4 h after SE) and vehicle-treated rats, using gadobutrol as contrast agent...
January 2016: Epilepsia
Femke E Froklage, Andrey Postnov, Maqsood M Yaqub, Esther Bakker, Ronald Boellaard, N Harry Hendrikse, Emile Fi Comans, Robert C Schuit, Patrick Schober, Demetrios N Velis, Jack Zwemmer, Jan J Heimans, Adriaan A Lammertsma, Rob A Voskuyl, Jaap C Reijneveld
Studies in rodents suggest that flumazenil is a P-glycoprotein substrate at the blood-brain barrier. This study aimed to assess whether [(11)C]flumazenil is a P-glycoprotein substrate in humans and to what extent increased P-glycoprotein function in epilepsy may confound interpretation of clinical [(11)C]flumazenil studies used to assess gamma-aminobutyric acid A receptors. Nine drug-resistant patients with epilepsy and mesial temporal sclerosis were scanned twice using [(11)C]flumazenil before and after partial P-glycoprotein blockade with tariquidar...
January 2017: Journal of Cerebral Blood Flow and Metabolism
Hana Malikova, Lenka Kramska, Zdenek Vojtech, Jan Sroubek, Jiri Lukavsky, Roman Liscak
BACKGROUND AND PURPOSE: Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE), seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE) is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE...
2015: Neuropsychiatric Disease and Treatment
Nicola Pietrafusa, Luca de Palma, Alessandro De Benedictis, Marina Trivisano, Carlo Efisio Marras, Federico Vigevano, Nicola Specchio
Vomiting is uncommon in patients with epilepsy and has been reported in both idiopathic and symptomatic epilepsies. It is presumed to originate in the anterior part of the temporal lobe or insula. To date, 44 cases of nonidiopathic focal epilepsy and seizures associated with ictal vomiting have been reported. Of the 44 cases, eight were studied using invasive exploration (3 stereo-EEG/5 subdural grids). Here, we report a 4-year-and-7-month-old patient with a history of febrile convulsion in the second year of life and who developed episodes of vomiting and complex partial seizures at 3 years of age...
December 2015: Epilepsy & Behavior: E&B
Clarissa Lin Yasuda, Zhang Chen, Guilherme Coco Beltramini, Ana Carolina Coan, Marcia Elisabete Morita, Bruno Kubota, Felipe Bergo, Christian Beaulieu, Fernando Cendes, Donald William Gross
OBJECTIVE: Although altered large-scale brain network organization in patients with temporal lobe epilepsy (TLE) has been shown using morphologic measurements such as cortical thickness, these studies, have not included critical subcortical structures (such as hippocampus and amygdala) and have had relatively small sample sizes. Here, we investigated differences in topological organization of the brain volumetric networks between patients with right TLE (RTLE) and left TLE (LTLE) with unilateral hippocampal atrophy...
December 2015: Epilepsia
Deniz Yilmazer-Hanke, Elaine O'Loughlin, Kieran McDermott
The amygdala contributes to the generation and propagation of epileptiform activity in temporal lobe epilepsy (TLE). Ictal symptoms such as fear, dreamy states (déjà vu, memory flashbacks, experiential hallucinations), epigastric auras, or sympathetic outflow with cardiovascular changes are often linked to a seizure focus in the amygdala. However, the amygdala may also play a role in comorbid anxiety, depression, and other psychiatric symptoms experienced in the interictal phase, especially in pharmacoresistant TLE...
June 2016: Journal of Neuroscience Research
Jerzy Wegiel, Michael Flory, N Carolyn Schanen, Edwin H Cook, Krzysztof Nowicki, Izabela Kuchna, Humi Imaki, Shuang Yong Ma, Jarek Wegiel, Eric London, Manuel F Casanova, Thomas Wisniewski, W Ted Brown
INTRODUCTION: Autism is diagnosed in numerous genetic and genomic developmental disorders associated with an overlap in high-risk genes and loci that underlie intellectual disability (ID) and epilepsy. The aim of this stereological study of neuronal soma volume in 25 brain structures and their subdivisions in eight individuals 9 to 26 years of age who were diagnosed with chromosome 15q11.2-13.1 duplication syndrome [dup(15)], autism, ID and epilepsy; eight age-matched subjects diagnosed with autism of unknown etiology (idiopathic autism) and seven control individuals was to establish whether defects of neuronal soma growth are a common denominator of developmental pathology in idiopathic and syndromic autism and how genetic modifications alter the trajectory of neuronal soma growth in dup(15) autism...
October 13, 2015: Acta Neuropathologica Communications
Kang Min Park, Yong Hee Han, Tae Hyung Kim, Chi Woong Mun, Kyong Jin Shin, Sam Yeol Ha, JinSe Park, Yun Jung Hur, Hae Yu Kim, Si Hyung Park, Sung Eun Kim
OBJECTIVE: We hypothesize that pre-existing susceptible structures in the brain may be associated with the development of newly diagnosed partial epilepsy of unknown etiology. METHODS: Twenty-two patients with newly diagnosed partial epilepsy of unknown etiology and 36 healthy controls were enrolled in this study. In addition, we included 24 patients with chronic partial epilepsy of unknown etiology as a disease control group. We analyzed whole-brain T1-weighted MRIs using FreeSurfer 5...
November 2015: Clinical Neurology and Neurosurgery
Britta Wandschneider, Matthias Koepp, Catherine Scott, Caroline Micallef, Simona Balestrini, Sanjay M Sisodiya, Maria Thom, Ronald M Harper, Josemir W Sander, Sjoerd B Vos, John S Duncan, Samden Lhatoo, Beate Diehl
Sudden unexpected death in epilepsy is a major cause of premature death in people with epilepsy. We aimed to assess whether structural changes potentially attributable to sudden death pathogenesis were present on magnetic resonance imaging in people who subsequently died of sudden unexpected death in epilepsy. In a retrospective, voxel-based analysis of T1 volume scans, we compared grey matter volumes in 12 cases of sudden unexpected death in epilepsy (two definite, 10 probable; eight males), acquired 2 years [median, interquartile range (IQR) 2...
October 2015: Brain: a Journal of Neurology
Petra Ehling, Nico Melzer, Thomas Budde, Sven G Meuth
Autoimmune inflammation of the limbic gray matter structures of the human brain has recently been identified as major cause of mesial temporal lobe epilepsy with interictal temporal epileptiform activity and slowing of the electroencephalogram, progressive memory disturbances, as well as a variety of other behavioral, emotional, and cognitive changes. Magnetic resonance imaging exhibits volume and signal changes of the amygdala and hippocampus, and specific anti-neuronal antibodies binding to either intracellular or plasma membrane neuronal antigens can be detected in serum and cerebrospinal fluid...
2015: Frontiers in Neurology
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