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Postoperative recovery of hippocampal contralateral diffusivity in medial temporal lobe epilepsy
Authors:Thivard Lionel  Tanguy Marie-Laure  Adam Claude  Clémenceau Stéphane  Dezamis Edouard  Lehéricy Stéphane  Dormont Didier  Chiras Jacques  Baulac Michel  Dupont Sophie
Affiliation:Epileptology Unit, H?pital de la Salpêtrière, Paris, France. lionel.thivard@psl.ap-hop-paris.fr
Abstract:PURPOSE: To search for a recovery after surgery of mean diffusivity (MD) values in the contralateral nonsclerotic hippocampus of patients with medial temporal lobe epilepsy (MTLE) and hippocampal sclerosis (HS). METHODS: Twenty-four MTLE patients (12 right-sided and 12 left-sided MTLE) and 36 healthy volunteers were investigated using diffusion tensor imaging. A region-of-interest approach was used to measure pre- and postoperative interictal hippocampal MD values in patients. RESULTS: Diffusion abnormalities in contralateral nonsclerotic hippocampus recovered after surgery (p<0.0001). A subgroup of 14 patients exhibited a clear increase in MD values whereas the remaining 10 patients were stable. No significant difference was found between the two subgroups for each of the electroclinical data studied including early postoperative outcome, all patients being either seizure free or with rare persistent auras. CONCLUSIONS: This finding suggests that diffusion abnormalities in contralateral hippocampus may represent a functional mechanism linked to the active epileptic process.
Keywords:Diffusion tensor imaging  Medial temporal lobe epilepsy  Hippocampal sclerosis  Epilepsy surgery  Recovery
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