A comparative evaluation of bilateral hippocampus and amygdala volumes with ADC values in pediatric primary idiopathic partial epilepsy patients

Yıl 2019, , 740 - 745, 01.10.2019

İsmail Taşkent , Gürkan Danışan , Hanefi Yıldırım

https://doi.org/10.28982/josam.630645

Öz

Aim: Approximately 70% of temporal seizures are hippocampal seizures, which are often concomitant with amygdala seizures. Seizures occurring in this region are usually complex partial. The aim of this study was to determine whether there was a significant change in hippocampus and amygdala volumes in idiopathic partial epilepsy patients without pathology on routine cranial MRI and to compare the hippocampus and amygdala ADC values with the control group.

Methods: In this case-control study, 27 patients aged between 1-18 years, who were admitted to our hospital between the years of 2014 and 2017 and diagnosed with idiopathic partial epilepsy based on EEG and clinical findings were compared with 20 children in the control group, which consisted of twenty children of similar ages who were referred to our hospital with nonspecific complaints such as headache and dizziness and who underwent cranial MRI. Children with histories of any congenital diseases, acquired neurodegenerative diseases, intracranial infections, intracranial masses, and those who were perinatally affected were not included in the study. Drawings, volumetric measurements, and ADC calculations were performed by two separate evaluators (one neuroradiology and one radiology research assistant).

Results: Hippocampus and amygdala volumes of the study group were decreased compared to the control group, but the results were significant only for the left hippocampus. Although ADC values of the study group were increased, the findings were statistically significant only for the left amygdala.

Conclusion: In our study, we found that the hippocampus and amygdala volumes of patients diagnosed with idiopathic partial epilepsy were decreased ipsilateral to the seizure focus, and the ADC values of the ipsilateral amygdala were increased.

Anahtar Kelimeler

Idiopathic partial epilepsy, Hippocampus, Amygdala, Pediatric, ADC

Pediatrik yaş grubu primer idiyopatik parsiyel epilepsi hastalarında bilateral hipokampus ve amigdala volümlerinin ADC değerleri ile karşılaştırmalı değerlendirilmesi

Öz

Amaç: Temporal nöbetlerin yaklaşık %70'i hipokampal nöbetlerdir ve genellikle amigdala nöbetleri ile birliktedir. Bu bölgede meydana gelen nöbetler genellikle kompleks parsiyel nöbetlerdir.Çalışmamızın amacı, rutin kraniyal MRG'de patolojisi olmayan 0-18 yaş arasındaki idiyopatik parsiyel epilepsi hastalarında hipokampus ve amigdala hacminde anlamlı bir değişiklik olup olmadığını belirlemek ve hastaların hipokampüs ile amigdala ADC değerlerini kontrol grubu ile karşılaştımalı olarak değerlendirmektir.

Yöntemler: Yapılan olgu-kontrol çalışmasında 2014 ve 2017 yılları arasında hastanemize başvuran, 1-18 yaş arasında olup, EEG ve klinik bulgularıyla idiyopatik parsiyel epilepsi tanısı alan 27 hasta ile 20 kontrol grubu karşılaştırıldı. Kontrol grubu olarak, benzer yaşlarda olup hastanemize baş ağrısı ve baş dönmesi gibi nonspesifik şikâyetlerle başvuran ve kraniyal MRG çekilen 20 çocuk değerlendirildi. Çalışma ve kontrol grubunda bilinen konjenital hastalık öyküsü olan, edinsel nörodejeneratif hastalık geçiren, intrakraniyal enfeksiyon ya da perinatal etkilenme öyküsü bulunan ve intrakraniyal kitlesi olan çocuklar çalışmaya dâhil edilmemiştir Çizimler, volümetrik ölçümler ve ADC ölçümleri iki ayrı değerlendirici tarafından yapıldılar (Biri nöroradyolog, diğeri radyoloji araştırma görevlisi).

Bulgular: Kontrol grubu ile karşılaştırıldığında, çalışma grubunda hipokampüs ve amigdala volümlerinde azalma izlenmekle beraber sonuçlar sadece sol hipokampüs için anlamlıydı. ADC değerlerinin karşılaştırılımasında çalışma grubunun ADC değerleri kontrol grubuna kıyasla artmış olmakla birlikte bulgular sadece sol amigdala için istatistiksel olarak anlamlıydı.

Sonuç: Çalışmamızda, idiyopatik parsiyel epilepsi tanısı alanlarda, hipokampus ve amigdala volümlerinin, nöbet odağına bağlı olarak ipsilateral azalmış olduğunu bulduk. Aynı zamanda, ipsilateral amigdalada ADC değerlerinde artış olduğunu bulduk.

Anahtar Kelimeler

İdiyopatik Parsiyel Epilepsi, Hipokampüs, Amigdala, Pediyatrik, ADC

Kaynakça

• 1. Beaumanoir A, Nahory A. Benign partial epilepsies: 11 cases of frontal partial epilepsy with favorable prognosis. Rev Electroencephalogr Neurophysiol Clin. 1983;13:207-11.
• 2. Mega MS, Cummings JL. Frontal-subcortical circuits and neuropsychiatric disorders. J Neuropsychiatry Clin Neurosci. 1994;6:358-70.
• 3. Wieser HG. ILAE Commission Report. Mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia. 2004;45:695-14.
• 4. Cendes F, Andermann F, Gloor P. Relationship between atrophy of the amygdala and ictal fear in temporal lobe epilepsy. Brain. 1994;4:739-46.
• 5. McLachlan RS, Blume WT. Isolated fear in complex partial status epilepticus. Ann Neurol. 1980;8:639-41.
• 6. Fedio P, Martin A. Ideative-emotive behavioral characteristics of patients following left or right temporal lobectomy. Epilepsia. 1983;24:117-30.
• 7. Watson C, Andermann F, Gloor P, Gotman M. Anatomic basis of amygdaloid and hippocampal volume measurement by magnetic resonance imaging. Neurology. 1992;42:1743-50.
• 8. Atmaca M, Yildirim H, Ozdemir H, Ozler S, Kara B, Ozler Z, et al. Hippocampus and amygdala volumes in patients with refractory obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:1283-6.
• 9. Stejskal EO, Tanner JE. Spin diffusion measurements: spin echo in presence of a time dependent field gradient. J Chem Phys. 1965;42:288–92.
• 10. Hakyemez B, Erdoğan C, Yıldız H, Ercan I, Parlak M. Apparent diffusion coefficient measurements in the hippocampus and amygdala of patients with temporal lobe seizures and in healthy volunteers. Epilepsy Behav. 2005;6:250–6.
• 11. Herzog AG, Kemper TL. Amygdaloid changes in aging and dementia. Archives of Neurology. 1980;37:625-9.
• 12. Atlas SW, Zimmerman RA, Bilaniuk LT, Rorke L, Hackney DB, Goldberg HI, et al. Corpus callosum and limbic system: Neuroanatomic MR evaluation of developmental anomalies. Radiology. 1986;160:355–62.
• 13. Brick J, Erickson CK (eds). Drugs, the brain, and behavior. The Pharmacology of Abuse and Dependence. New York: The Haworth Medical Pres. 1998;119-31.
• 14. Rosso IM. Amygdala and hippocampus volumes in pediatric major depression. Biol Psychiatry. 2005;57:21-6.
• 15. Szeszko PR. Amygdala volume reductions in pediatric patients with obsessive compulsive disorder treated with paroxetine: preliminary findings. Neuropsychopharmacology. 2004;29:826-32.
• 16. Chang K, Karchemskiy A, Barnea-Goraly N. Reduced amygdalar gray matter volume in familial pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005;44:565-73.
• 17. Keller SS, Wieshmann UC, Mackay CE, Denby CE, Webb J, Roberts N. Voxel based orphometry of grey matter abnormalities in patients with medically intractable temporal lobe epilepsy: effects of side of seizure onset and epilepsy duration. J Neurol Neurosurg Psychiatry. 2002;73:648–56.
• 18. Achten E, Boon P, De Kerckhove TV. Value of single-voxel proton MR spectroscopy in temporal lobe epilepsy. Am J Neuroradiol. 1997;18:1131-9.
• 19. Cendes F, Leproux F, Melanson D, Ethier R, Evans A, Peters T. MRI of amygdala and hippocampus in temporal lobe epilepsy. J Comput Asist Tomog. 1993;17:206-10.
• 20. Hakyemez B, Yücel K, Yıldırım N, Erdoğan C, Bora I, Parlak M. Morphologic and volumetric analysis of amygdala, hippocampus, fornix and mamillary body with MRI in patients with temporal lobe epilepsy. Neuroradiol J. 2006;19:289-96.
• 21. Scott SK, Young AW, Calder AJ, Hellawell DJ, Aggleton JP, Johnson M. Impaired auditory recognition of fear and anger following bilateral amygdala lesions. Nature. 1997;385:254-7.
• 22. Glaser G. Historical perspectives and future directions. Wylie E (eds). The treatment of epilepsy: Principles and practise. Philedelphia: Febiger Press. 1993;3-9.
• 23. Sander JW, Hart YM. Epilepsy. In: Jack MA (eds). Florida: Merit Publishing International. 1998;12-29.
• 24. Berkovich SF, Andermann F, Oliver AA. Hippocampal sclerosis in temporal lobe epilepsy demonstrated by magnetic resonance imaging. Ann Neurol. 1991;29:175-82.
• 25. Bonilha L, Kobayashi E, Cendes F, Li LM. The importance of accurate anatomic assessment for the volumetric analysis of the amygdala. Braz J Med Biol Res. 2005;38:409-18.
• 26. Brandt C, Glien M, Potsckha H, Volk H, Loscher W. Epileptogenesis and neuropathology after different types of status epilepticus induced by prolonged electrical stimulation of the basolateral amygdala in rats. Epilepsy Res. 2010;55:83-103.
• 27. Kalviainen R, Salmenpera T, Partanen K, Vainio P, Riekkinen P, Pitkanen A. MRI volumetry and T2 relaxometry of the amygdala in newly diagnosed and chronic temporal lobe epilepsy. Epilepsy Res. 1997;28:39–50.
• 28. Qiwen M, Jingxia X, Zongyao W, Yaqin W, Zhang S. A Quantitative MR Study of the Hippocampal Formation, the Amygdala, and the Temporal Horn of the Lateral Ventricle in Healthy Subjects 40 to 90 Years of Age. AJNR Am J Neuroradiol. 1999;20:207–11.
• 29. Geuze E, Vermetten E, Bremner JD. MR-based in vivo hippocampal volumetrics: 1. Review of methodologies currently employed. Mol Psychiatry. 2005;10:147–59.
• 30. Jackson GD, Berkovic SF, Duncan JS, Connelly A. Optimizing the diagnosis of hippocampal sclerosis with MR imaging. AJNR. 1993;14:753-62.
• 31. Cendes F, Leproux F, Melanson D, Ethier R, Evans A, Peters T. MRI of amygdala and hippocampus in temporal lobe epilepsy. J Comput Asist Tomog. 1993;17:206-10.
• 32. Reutens D, Cook M, Kingsley D. Volumetric MRI is essential for reliable detection of hippocampal asymetry. Epilepsia. 1993;34:138-40.
• 33. Jackson GD, Berkovic SF, Tress BM, Kalnins RM, Fabinyi GC, Bladin PF. Hippocampal sclerosis can be reliably detected by magnetic resonance imaging. Neurology. 1990;40:1869–75.
• 34. Jack CR, Sharbrough FW, Twomey CK. Temporal lobe seizures: lateralization with MR volume measurements of the hippocampal formation. Radiology. 1990;175:423–9.
• 35. Berkovic SF, Andermann F, Olivier A. Hippocampal sclerosis in temporal lobe epilepsy demonstrated by magnetic resonance imaging. Ann Neurol. 1991;129:175–82.
• 36. Bronen RA, Fulbright RK, Kim JH, Spencer SS, Spencer DD, Al-Rodhan NR. Regional distribution of MR findings in hippocampal sclerosis. AJNR Am J Neuroradiol. 1995;16:1193–200.
• 37. Jack CR, Rydberg CH, Krecke KN. Mesial temporal sclerosis: diagnosis with fluid-attenuated inversion-recovery versus spin-echo MR imaging. Radiology. 1996;199:367–73.
• 38. Margerison JH, Corsellis JA. Epilepsy and the temporal lobes: a clinical, electroencephalographic and neuropathological study of the brain in epilepsy, with particular reference to the temporal lobes. Brain. 1966;89:499–530.
• 39. Dam AM. Epilepsy and neuron loss in the hippocampus. Epilepsia. 1980;21:617–29.
• 40. Babb T, Brown W. Pathological findings in epilepsy. Engel J (ed). Surgical Treatment of the Epilepsies. New York: Raven. 1987;511–40.
• 41. Jackson GD, Connelly A, Duncan JS, Grunewald RA, Gadian DG. Detection of hippocampal pathology in intractable partial epilepsy: increased sensitivity with quantitative magnetic resonance T2 relaxometry. Neurology. 1993;43:1793–9.
• 42. Tien RD, Felsberg GJ, Campi de Castro C. Complex partial seizures and mesial temporal sclerosis: evaluation with fast spin-echo MR imaging. Radiology. 1993;189:835–42.
• 43. Cendes F, Andermann F, Gloor P. MRI volumetric measurement of amygdala and hippocampus in temporal lobe epilepsy. Neurology. 1993;43:719–25.
• 44. Kim JH, Tien RD, Felsberg GJ, Osumi AK, Lee N, Friedman AH. Fast spin-echo MR in hippocampal sclerosis: correlation with pathology and surgery. AJNR Am J Neuroradiol. 1995;16:627–36.
• 45. Cheon JE, Chang KH, Kim HD. MR of hippocampal sclerosis: comparison of qualitative and quantitative assessments. AJNR Am J Neuroradiol. 1998;19:465–8.