Remote effects of temporal lobe epilepsy surgery: Long-term morphological changes after surgical resection.
brain atrophy
cortical thickness
cortical thinning
neurosurgery
seizure
virtual resection
Journal
Epilepsia open
ISSN: 2470-9239
Titre abrégé: Epilepsia Open
Pays: United States
ID NLM: 101692036
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
26
07
2022
accepted:
16
03
2023
medline:
5
6
2023
pubmed:
22
3
2023
entrez:
21
3
2023
Statut:
ppublish
Résumé
Epilepsy surgery is an effective treatment for drug-resistant patients. However, how different surgical approaches affect long-term brain structure remains poorly characterized. Here, we present a semiautomated method for quantifying structural changes after epilepsy surgery and compare the remote structural effects of two approaches, anterior temporal lobectomy (ATL), and selective amygdalohippocampectomy (SAH). We studied 36 temporal lobe epilepsy patients who underwent resective surgery (ATL = 22, SAH = 14). All patients received same-scanner MR imaging preoperatively and postoperatively (mean 2 years). To analyze postoperative structural changes, we segmented the resection zone and modified the Advanced Normalization Tools (ANTs) longitudinal cortical pipeline to account for resections. We compared global and regional annualized cortical thinning between surgical treatments. Across procedures, there was significant cortical thinning in the ipsilateral insula, fusiform, pericalcarine, and several temporal lobe regions outside the resection zone as well as the contralateral hippocampus. Additionally, increased postoperative cortical thickness was seen in the supramarginal gyrus. Patients treated with ATL exhibited greater annualized cortical thinning compared with SAH cases (ATL: -0.08 ± 0.11 mm per year, SAH: -0.01 ± 0.02 mm per year, t = 2.99, P = 0.006). There were focal postoperative differences between the two treatment groups in the ipsilateral insula (P = 0.039, corrected). Annualized cortical thinning rates correlated with preoperative cortical thickness (r = 0.60, P < 0.001) and had weaker associations with age at surgery (r = -0.33, P = 0.051) and disease duration (r = -0.42, P = 0.058). Our evidence suggests that selective procedures are associated with less cortical thinning and that earlier surgical intervention may reduce long-term impacts on brain structure.
Identifiants
pubmed: 36944585
doi: 10.1002/epi4.12733
pmc: PMC10235552
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
559-570Subventions
Organisme : NINDS NIH HHS
ID : DP1 NS122038
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS075270
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS110130
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS112252
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS116504
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS099348
Pays : United States
Organisme : NINDS NIH HHS
ID : R00 NS097618
Pays : United States
Organisme : NINDS NIH HHS
ID : T32 NS091006
Pays : United States
Organisme : NIBIB NIH HHS
ID : T32 EB009384
Pays : United States
Organisme : NINDS NIH HHS
ID : K23 NS073806
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS108445
Pays : United States
Informations de copyright
© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
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