دورية أكاديمية
Amygdala enlargement in temporal lobe epilepsy: Histopathology and surgical outcomes.
| العنوان: | Amygdala enlargement in temporal lobe epilepsy: Histopathology and surgical outcomes. |
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| المؤلفون: | Shakhatreh L; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.; Department of Neurology, Alfred Health, Melbourne, Australia.; Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia., Sinclair B; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia., McLean C; Department of Anatomical Pathology, The Alfred Hospital, Melbourne, Australia., Lui E; Department of Radiology, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia., Morokoff AP; Department of Surgery, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia., King JA; Department of Surgery, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia., Chen Z; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Perucca P; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.; Department of Neurology, Alfred Health, Melbourne, Australia.; Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, Australia.; Epilepsy Research Centre, Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia., O'Brien TJ; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.; Department of Neurology, Alfred Health, Melbourne, Australia.; Department of Medicine, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia., Kwan P; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia.; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia.; Department of Neurology, Alfred Health, Melbourne, Australia.; Department of Medicine, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia. |
| المصدر: | Epilepsia [Epilepsia] 2024 Jun; Vol. 65 (6), pp. 1709-1719. Date of Electronic Publication: 2024 Mar 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malden, MA : Blackwell Science Original Publication: Copenhagen : Munskgaard |
| مواضيع طبية MeSH: | Amygdala*/surgery , Amygdala*/pathology , Amygdala*/diagnostic imaging , Epilepsy, Temporal Lobe*/surgery , Epilepsy, Temporal Lobe*/diagnostic imaging , Epilepsy, Temporal Lobe*/pathology , Magnetic Resonance Imaging*, Humans ; Male ; Female ; Adult ; Case-Control Studies ; Treatment Outcome ; Young Adult ; Middle Aged ; Anterior Temporal Lobectomy/methods ; Drug Resistant Epilepsy/surgery ; Drug Resistant Epilepsy/diagnostic imaging ; Drug Resistant Epilepsy/pathology ; Hippocampus/pathology ; Hippocampus/diagnostic imaging ; Hippocampus/surgery ; Adolescent |
| مستخلص: | Objectives: Amygdala enlargement is detected on magnetic resonance imaging (MRI) in some patients with drug-resistant temporal lobe epilepsy (TLE), but its clinical significance remains uncertain We aimed to assess if the presence of amygdala enlargement (1) predicted seizure outcome following anterior temporal lobectomy with amygdalohippocampectomy (ATL-AH) and (2) was associated with specific histopathological changes. Methods: This was a case-control study. We included patients with drug-resistant TLE who underwent ATL-AH with and without amygdala enlargement detected on pre-operative MRI. Amygdala volumetry was done using FreeSurfer for patients who had high-resolution T1-weighted images. Mann-Whitney U test was used to compare pre-operative clinical characteristics between the two groups. The amygdala volume on the epileptogenic side was compared to the amygdala volume on the contralateral side among cases and controls. Then, we used a two-sample, independent t test to compare the means of amygdala volume differences between cases and controls. The chi-square test was used to assess the correlation of amygdala enlargement with (1) post-surgical seizure outcomes and (2) histopathological changes. Results: Nineteen patients with and 19 patients without amygdala enlargement were studied. Their median age at surgery was 38 years for cases and 39 years for controls, and 52.6% were male. There were no statistically significant differences between the two groups in their pre-operative clinical characteristics. There were significant differences in the means of volume difference between cases and controls (Diff = 457.2 mm 3 , 95% confidence interval [CI] 289.6-624.8; p < .001) and in the means of percentage difference (p < .001). However, there was no significant association between amygdala enlargement and surgical outcome (p = .72) or histopathological changes (p = .63). Significance: The presence of amygdala enlargement on the pre-operative brain MRI in patients with TLE does not affect the surgical outcome following ATL-AH, and it does not necessarily suggest abnormal histopathology. These findings suggest that amygdala enlargement might reflect a secondary reactive process to seizures in the epileptogenic temporal lobe. (© 2024 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.) |
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| فهرسة مساهمة: | Keywords: amygdala enlargement; histopathology; surgical outcome; temporal lobe epilepsy |
| تواريخ الأحداث: | Date Created: 20240328 Date Completed: 20240611 Latest Revision: 20240611 |
| رمز التحديث: | 20240612 |
| DOI: | 10.1111/epi.17968 |
| PMID: | 38546705 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1528-1167 |
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| DOI: | 10.1111/epi.17968 |