title: Temporopolar changes in temporal lobe epilepsy: a quantitative MRI-based study.
abstract: OBJECTIVE
  To quantify the morphologic changes of temporopolar structures to better understand the pathophysiology of anterior temporal white matter increased T2 signal observed in temporal lobe epilepsy (TLE).
  
  
  METHODS
  MRI was performed in 30 patients with TLE and in 30 normal control subjects and independently assessed by visual analysis and quantitative measurements. Specifically, the temporal pole (TP) volume, as well as its gray and white matter components, was measured using three-dimensional T1 MR images and a semiautomatic protocol. The authors tested whether the presence of an increased T2-weighted signal in the anterior temporal white matter was associated with significant TP atrophy. The associations between the TP volume and MRI signs of hippocampal sclerosis, age at onset, seizure frequency, duration of illness, and a history of febrile convulsions were also studied.
  
  
  RESULTS
  Both right and left TLE populations demonstrated a reduction of the temporopolar white and gray matter volumes ipsilateral to seizure onset (p < 0.02 in right TLE; p < 0.0001 in left TLE). Twenty-two patients (72%) exhibited significantly abnormal TP volume measurements, which correctly lateralized the epileptogenic zone in all cases. The presence of an increased T2-weighted signal in the anterior temporal white matter (ISWM), but not that of hippocampal sclerosis, was associated with a greater TP volume asymmetry index (p < 0.05).
  
  
  CONCLUSIONS
  The temporal pole is frequently atrophic ipsilateral to seizure onset in refractory TLE. The association between TP atrophy and ISWM suggests that both abnormalities might derive from a common pathologic process.
authors.affiliation: Department of Functional Neurology and Epilepsy, Neurological Hospital, Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Coste
authors.forename: P
authors.initials: P
authors.lastname: Ryvlin
authors.forename: M
authors.initials: M
authors.lastname: Hermier
authors.forename: K
authors.initials: K
authors.lastname: Ostrowsky
authors.forename: P
authors.initials: P
authors.lastname: Adeleine
authors.forename: J C
authors.initials: JC
authors.lastname: Froment
authors.forename: F
authors.initials: F
authors.lastname: Mauguière
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology*