Quantitative magnetic resonance imaging of the amygdala in temporal lobe epilepsy-clinico-pathological correlations (a pilot study).
OBJECTIVE
We carried out a pilot study of quantitative volumetric MRI of the amygdala in patients undergoing surgery for intractable temporal lobe epilepsy. We wished to explore whether amygdala volume correlated with pre-operative clinical variables and post-operative outcome.


METHODS
Ten patients had detailed volumetric measurements of their amygdala and hippocampus according to operationalised anatomical criteria from an optimised MRI imaging sequence. A ratio of volumes from the unoperated to operated side was calculated. Surgical specimens were examined histologically for astrocytosis.


RESULTS
The volumes of the amygdala and hippocampus on the operated side were significantly smaller than on the unoperated side. More severe astrocytosis appeared to go along with smaller volume ratios but the relationship was not significant. There were few significant correlations between volumes measures and clinical or outcome variables.


CONCLUSIONS
Reductions in amygdala volume in the to-be-operated temporal lobe in patients with medically intractable epilepsy can be reliably detected using volumetric MRI. Accurate amygdala volume measures do not appear to exert a significant effect on clinical presentation and outcome in the presence of hippocampal volumes reductions, but may be useful in confirming bilateral pathology. Larger studies examining clinico-pathological correlations are recommended.
Lambert
Michelle V
MV
Section of Cognitive Neuropsychiatry, Department of Psychological Medicine, Institute of Psychiatry, GKT School of Medicine, and King's College Hospital, DeCrespigny Park, SE5 8AF, London, UK.
Brierley
Barbara
B
Al-Sarraj
Safa
S
Shaw
Philip
P
Polkey
Charles E
CE
Chandler
Chris
C
Toone
Brian K
BK
David
Anthony S
AS
D000679:Amygdala / Q000473:pathology*; D038481:Anterior Temporal Lobectomy; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005334:Fever / Q000150:complications; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D010865:Pilot Projects; D012598:Sclerosis / Q000473:pathology; D016896:Treatment Outcome