The role of the amygdala in ictal central apnea: insights from brain MRI morphometry
Abstract Objective Ictal central apnea (ICA) is a frequent correlate of focal seizures, particularly in temporal lobe epilepsy (TLE), and regarded as a potential electroclinical biomarker of sudden unexpected death in epilepsy (SUDEP). Aims of this study are to investigate morphometric changes of su...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
|
| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51938 |
| _version_ | 1797353814951460864 |
|---|---|
| author | Elisa Micalizzi Alice Ballerini Giada Giovannini Maria Cristina Cioclu Simona Scolastico Matteo Pugnaghi Niccolò Orlandi Marcella Malagoli Maurilio Genovese Alessandra Todeschini Leandra Giunta Flavio Villani Stefano Meletti Anna Elisabetta Vaudano |
| author_facet | Elisa Micalizzi Alice Ballerini Giada Giovannini Maria Cristina Cioclu Simona Scolastico Matteo Pugnaghi Niccolò Orlandi Marcella Malagoli Maurilio Genovese Alessandra Todeschini Leandra Giunta Flavio Villani Stefano Meletti Anna Elisabetta Vaudano |
| author_sort | Elisa Micalizzi |
| collection | DOAJ |
| description | Abstract Objective Ictal central apnea (ICA) is a frequent correlate of focal seizures, particularly in temporal lobe epilepsy (TLE), and regarded as a potential electroclinical biomarker of sudden unexpected death in epilepsy (SUDEP). Aims of this study are to investigate morphometric changes of subcortical structures in ICA patients and to find neuroimaging biomarkers of ICA in patients with focal epilepsy. Methods We prospectively recruited focal epilepsy patients with recorded seizures during a video‐EEG long‐term monitoring with cardiorespiratory polygraphic recordings from April 2020 to September 2022. Participants were accordingly subdivided into two groups: patients with focal seizures with ICA (ICA) and without (noICA). A pool of 30 controls matched by age and sex was collected. All the participants underwent MRI scans with volumetric high‐resolution T1‐weighted images. Post‐processing analyses included a whole‐brain VBM analysis and segmentation algorithms performed with FreeSurfer. Results Forty‐six patients were recruited (aged 15–60 years): 16 ICA and 30 noICA. The whole‐brain VBM analysis showed an increased gray matter volume of the amygdala ipsilateral to the epileptogenic zone (EZ) in the ICA group compared to the noICA patients. Amygdala sub‐segmentation analysis revealed an increased volume of the whole amygdala, ipsilateral to the EZ compared to controls [F(1, 76) = 5.383, pFDR = 0.042] and to noICA patients ([F(1, 76) = 5.383, pFDR = 0.038], specifically of the basolateral complex (respectively F(1, 76) = 6.160, pFDR = 0.037; F(1, 76) = 5.121, pFDR = 0.034). Interpretation Our findings, while confirming the key role of the amygdala in participating in ictal respiratory modifications, suggest that structural modifications of the amygdala and its subnuclei may be valuable morphological biomarkers of ICA. |
| first_indexed | 2024-03-08T13:35:30Z |
| format | Article |
| id | doaj.art-85186136f4cd4f65b9b8cd1f0f5f67e6 |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-03-08T13:35:30Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-85186136f4cd4f65b9b8cd1f0f5f67e62024-01-16T18:36:37ZengWileyAnnals of Clinical and Translational Neurology2328-95032024-01-0111112113210.1002/acn3.51938The role of the amygdala in ictal central apnea: insights from brain MRI morphometryElisa Micalizzi0Alice Ballerini1Giada Giovannini2Maria Cristina Cioclu3Simona Scolastico4Matteo Pugnaghi5Niccolò Orlandi6Marcella Malagoli7Maurilio Genovese8Alessandra Todeschini9Leandra Giunta10Flavio Villani11Stefano Meletti12Anna Elisabetta Vaudano13Department of Neuroscience IRCCS San Martino Hospital Genoa ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Radiology AOU Modena Modena ItalyDepartment of Radiology AOU Modena Modena ItalyDepartment of Radiology AOU Modena Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Neuroscience IRCCS San Martino Hospital Genoa ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyDepartment of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena ItalyAbstract Objective Ictal central apnea (ICA) is a frequent correlate of focal seizures, particularly in temporal lobe epilepsy (TLE), and regarded as a potential electroclinical biomarker of sudden unexpected death in epilepsy (SUDEP). Aims of this study are to investigate morphometric changes of subcortical structures in ICA patients and to find neuroimaging biomarkers of ICA in patients with focal epilepsy. Methods We prospectively recruited focal epilepsy patients with recorded seizures during a video‐EEG long‐term monitoring with cardiorespiratory polygraphic recordings from April 2020 to September 2022. Participants were accordingly subdivided into two groups: patients with focal seizures with ICA (ICA) and without (noICA). A pool of 30 controls matched by age and sex was collected. All the participants underwent MRI scans with volumetric high‐resolution T1‐weighted images. Post‐processing analyses included a whole‐brain VBM analysis and segmentation algorithms performed with FreeSurfer. Results Forty‐six patients were recruited (aged 15–60 years): 16 ICA and 30 noICA. The whole‐brain VBM analysis showed an increased gray matter volume of the amygdala ipsilateral to the epileptogenic zone (EZ) in the ICA group compared to the noICA patients. Amygdala sub‐segmentation analysis revealed an increased volume of the whole amygdala, ipsilateral to the EZ compared to controls [F(1, 76) = 5.383, pFDR = 0.042] and to noICA patients ([F(1, 76) = 5.383, pFDR = 0.038], specifically of the basolateral complex (respectively F(1, 76) = 6.160, pFDR = 0.037; F(1, 76) = 5.121, pFDR = 0.034). Interpretation Our findings, while confirming the key role of the amygdala in participating in ictal respiratory modifications, suggest that structural modifications of the amygdala and its subnuclei may be valuable morphological biomarkers of ICA.https://doi.org/10.1002/acn3.51938 |
| spellingShingle | Elisa Micalizzi Alice Ballerini Giada Giovannini Maria Cristina Cioclu Simona Scolastico Matteo Pugnaghi Niccolò Orlandi Marcella Malagoli Maurilio Genovese Alessandra Todeschini Leandra Giunta Flavio Villani Stefano Meletti Anna Elisabetta Vaudano The role of the amygdala in ictal central apnea: insights from brain MRI morphometry Annals of Clinical and Translational Neurology |
| title | The role of the amygdala in ictal central apnea: insights from brain MRI morphometry |
| title_full | The role of the amygdala in ictal central apnea: insights from brain MRI morphometry |
| title_fullStr | The role of the amygdala in ictal central apnea: insights from brain MRI morphometry |
| title_full_unstemmed | The role of the amygdala in ictal central apnea: insights from brain MRI morphometry |
| title_short | The role of the amygdala in ictal central apnea: insights from brain MRI morphometry |
| title_sort | role of the amygdala in ictal central apnea insights from brain mri morphometry |
| url | https://doi.org/10.1002/acn3.51938 |
| work_keys_str_mv | AT elisamicalizzi theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT aliceballerini theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT giadagiovannini theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT mariacristinacioclu theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT simonascolastico theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT matteopugnaghi theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT niccoloorlandi theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT marcellamalagoli theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT mauriliogenovese theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT alessandratodeschini theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT leandragiunta theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT flaviovillani theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT stefanomeletti theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT annaelisabettavaudano theroleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT elisamicalizzi roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT aliceballerini roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT giadagiovannini roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT mariacristinacioclu roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT simonascolastico roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT matteopugnaghi roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT niccoloorlandi roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT marcellamalagoli roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT mauriliogenovese roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT alessandratodeschini roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT leandragiunta roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT flaviovillani roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT stefanomeletti roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry AT annaelisabettavaudano roleoftheamygdalainictalcentralapneainsightsfrombrainmrimorphometry |