Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy
Abstract Bilateral Temporal lobe epilepsy (BTLE) cases may result in poor surgical outcomes due to the difficulty in determining/localizing the epileptogenic zone. In this study, we investigated whether hippocampal volume (HV) would be useful for the determination of the best resection side in BTLE....
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-02-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-30151-8 |
| _version_ | 1797864861695213568 |
|---|---|
| author | Go Seyama Koji Iida Kota Kagawa Masaya Katagiri Akitake Okamura Hiromi Morioka Nobutaka Horie |
| author_facet | Go Seyama Koji Iida Kota Kagawa Masaya Katagiri Akitake Okamura Hiromi Morioka Nobutaka Horie |
| author_sort | Go Seyama |
| collection | DOAJ |
| description | Abstract Bilateral Temporal lobe epilepsy (BTLE) cases may result in poor surgical outcomes due to the difficulty in determining/localizing the epileptogenic zone. In this study, we investigated whether hippocampal volume (HV) would be useful for the determination of the best resection side in BTLE. Eighteen cases of BTLE determined by a scalp video electroencephalogram (SVEEG) underwent resection via intracranial electroencephalography (IVEEG). Patients with lesions or semiologically determined focus lateralization were excluded. In addition to SVEEG, an epilepsy protocol magnetic resonance imaging (MRI) including hippocampus fluid-attenuated inversion recovery (FLAIR) and HV, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), single-photon emission computed tomography with 123I-iomazenil (IMZ-SPECT), and magnetoencephalography (MEG) were performed for the preoperative evaluation of the lateralization. The resection side was determined based on the IVEEG results, and the seizure outcome at two years postoperatively was classified as either a well-controlled seizure outcome (Engel class I), or residual (classes II–V). We used a Fisher's exact test to compare the concordance between the determination of the epileptic focus by each modality and the resected side where patients achieved a well-controlled seizure outcome. Seizures were well controlled in 9/18 patients after surgery. Eight out of 11 patients (72.7%), in whom the HV results (strongly atrophic side) and the resection side were matched, had well-controlled seizure outcomes (P = 0.0498). The concordance of other presurgical evaluations with the resection side was not significantly related to a well-controlled seizure outcome. HV may be a useful method to determine the optimal resection side of the epileptic focus/foci in cases of suspected BTLE. |
| first_indexed | 2024-04-09T22:58:49Z |
| format | Article |
| id | doaj.art-ccd994f2426649ca9861839f3bb1a760 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:58:49Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ccd994f2426649ca9861839f3bb1a7602023-03-22T11:07:19ZengNature PortfolioScientific Reports2045-23222023-02-011311910.1038/s41598-023-30151-8Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsyGo Seyama0Koji Iida1Kota Kagawa2Masaya Katagiri3Akitake Okamura4Hiromi Morioka5Nobutaka Horie6Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima UniversityEpilepsy Center, Hiroshima University HospitalDepartment of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima UniversityDepartment of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima UniversityDepartment of Neurosurgery, Takanobashi Central HospitalDepartment of Neurosurgery, Mazda HospitalDepartment of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima UniversityAbstract Bilateral Temporal lobe epilepsy (BTLE) cases may result in poor surgical outcomes due to the difficulty in determining/localizing the epileptogenic zone. In this study, we investigated whether hippocampal volume (HV) would be useful for the determination of the best resection side in BTLE. Eighteen cases of BTLE determined by a scalp video electroencephalogram (SVEEG) underwent resection via intracranial electroencephalography (IVEEG). Patients with lesions or semiologically determined focus lateralization were excluded. In addition to SVEEG, an epilepsy protocol magnetic resonance imaging (MRI) including hippocampus fluid-attenuated inversion recovery (FLAIR) and HV, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), single-photon emission computed tomography with 123I-iomazenil (IMZ-SPECT), and magnetoencephalography (MEG) were performed for the preoperative evaluation of the lateralization. The resection side was determined based on the IVEEG results, and the seizure outcome at two years postoperatively was classified as either a well-controlled seizure outcome (Engel class I), or residual (classes II–V). We used a Fisher's exact test to compare the concordance between the determination of the epileptic focus by each modality and the resected side where patients achieved a well-controlled seizure outcome. Seizures were well controlled in 9/18 patients after surgery. Eight out of 11 patients (72.7%), in whom the HV results (strongly atrophic side) and the resection side were matched, had well-controlled seizure outcomes (P = 0.0498). The concordance of other presurgical evaluations with the resection side was not significantly related to a well-controlled seizure outcome. HV may be a useful method to determine the optimal resection side of the epileptic focus/foci in cases of suspected BTLE.https://doi.org/10.1038/s41598-023-30151-8 |
| spellingShingle | Go Seyama Koji Iida Kota Kagawa Masaya Katagiri Akitake Okamura Hiromi Morioka Nobutaka Horie Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy Scientific Reports |
| title | Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy |
| title_full | Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy |
| title_fullStr | Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy |
| title_full_unstemmed | Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy |
| title_short | Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy |
| title_sort | hippocampal volumetry to determine the resection side in patients with intractable non lesional bilateral temporal lobe epilepsy |
| url | https://doi.org/10.1038/s41598-023-30151-8 |
| work_keys_str_mv | AT goseyama hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT kojiiida hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT kotakagawa hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT masayakatagiri hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT akitakeokamura hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT hiromimorioka hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy AT nobutakahorie hippocampalvolumetrytodeterminetheresectionsideinpatientswithintractablenonlesionalbilateraltemporallobeepilepsy |