European journal of neurology · 2025
Decreased Structural Connectivity Between Thalamic Nuclei and Hippocampus in Temporal Lobe Epilepsy-A Diffusion Tensor Imaging-Based Study.
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Yildirim Mehmet S, Stepponat Radheshyam, Fischmeister Florian Ph S, Tomschik Matthias, Schmidbauer Victor, Khalaveh Farjad, Koren Johannes, Baumgartner Christoph, Pataraia Ekaterina, Bonelli Silvia, Rössler Karl, Kasprian Gregor, Dorfer Christian
Аннотация
BACKGROUND: Temporal lobe epilepsy (TLE) can lead to structural brain abnormalities, with thalamus atrophy being the most common extratemporal alteration. This study used probabilistic tractography to investigate the structural connectivity between individual thalamic nuclei and the hippocampus in TLE.
METHODS: Thirty-six TLE patients who underwent pre-surgical 3 Tesla magnetic resonance imaging (MRI) and 18 healthy controls were enrolled in this study. Patients were subdivided into TLE with HS (TLE-HS) and MRI-negative TLE (TLE-MRneg). Tractography and whole brain segmentation, including thalamus parcellation, were performed to determine the number of streamlines per mm3 between the thalamic nuclei and hippocampus. Connectivity strength and volume of regions were correlated with clinical data.
RESULTS: The volume of the entire thalamus ipsilateral to seizure onset was significantly decreased in TLE-HS compared to controls (Mann-Whitney-U test: pFDR < 0.01) with the anterior thalamic nuclei (ANT) as important contributor. Furthermore, decreased ipsilateral connectivity strength between the hippocampus and ANT was detected in TLE-HS (pFDR < 0.01) compared to TLE-MRneg and controls which correlated negatively with the duration of epilepsy (ρ = -0.512, p = 0.025) and positively with seizure frequency (ρ = 0.603, p = 0.006). Moreover, ANT volume correlated negatively with epilepsy duration in TLE-HS (ρ = -0.471, p = 0.042).
CONCLUSIONS: ANT showed atrophy and decreased connectivity in TLE-HS, which correlated with epilepsy duration and seizure frequency. Understanding the dynamics of epileptogenic networks has the potential to shed light on surgery-resistant epilepsy and refine the selection process for ideal neurosurgical candidates, consequently enhancing post-surgical outcomes.
METHODS: Thirty-six TLE patients who underwent pre-surgical 3 Tesla magnetic resonance imaging (MRI) and 18 healthy controls were enrolled in this study. Patients were subdivided into TLE with HS (TLE-HS) and MRI-negative TLE (TLE-MRneg). Tractography and whole brain segmentation, including thalamus parcellation, were performed to determine the number of streamlines per mm3 between the thalamic nuclei and hippocampus. Connectivity strength and volume of regions were correlated with clinical data.
RESULTS: The volume of the entire thalamus ipsilateral to seizure onset was significantly decreased in TLE-HS compared to controls (Mann-Whitney-U test: pFDR < 0.01) with the anterior thalamic nuclei (ANT) as important contributor. Furthermore, decreased ipsilateral connectivity strength between the hippocampus and ANT was detected in TLE-HS (pFDR < 0.01) compared to TLE-MRneg and controls which correlated negatively with the duration of epilepsy (ρ = -0.512, p = 0.025) and positively with seizure frequency (ρ = 0.603, p = 0.006). Moreover, ANT volume correlated negatively with epilepsy duration in TLE-HS (ρ = -0.471, p = 0.042).
CONCLUSIONS: ANT showed atrophy and decreased connectivity in TLE-HS, which correlated with epilepsy duration and seizure frequency. Understanding the dynamics of epileptogenic networks has the potential to shed light on surgery-resistant epilepsy and refine the selection process for ideal neurosurgical candidates, consequently enhancing post-surgical outcomes.