Neocortical gliosis in temporal lobe epilepsy: gender-based differences.
OBJECTIVE
Sex hormones can influence the timing and frequency of seizure activity. In addition, gender may influence the age of epilepsy onset and hemispheric location of focal epilepsy. Whether gender alters temporal lobe pathologies differentially is not clear. In this study, we assess if neocortical or hippocampal pathologies from patients who underwent en bloc anteriomedial temporal lobectomy (AMTR) for medically refractory epilepsy differ by gender.


METHODS
Consecutive en bloc AMTR resections (n = 128), including hippocampal tissues, were systematically studied. Cortical and intracortical gliosis from a standardized location, 1.5 cm from the temporal lobe tip, was assessed for quantifiable gliotic change. Corresponding hippocampal sections were characterized according to Watson grade. These outcomes were then compared by gender. Other correlates such as age of epilepsy onset, age of risk exposure, and duration of epilepsy were similarly compared.


RESULTS
Subpial and intracortical gliosis was more pronounced in women (p = 0.02, p < 0.01). Cortical thickness was reduced in women compared to men (p < 0.05). No similar gender effects were seen in Watson grade of hippocampal sclerosis or CA1-4 neuronal dropout.


CONCLUSIONS
Gender may differentially influence neocortical pathologies in patients with refractory temporal lobe epilepsy. No gender effect was seen when studying hippocampal pathologies.
Doherty
Michael J
MJ
Swedish Epilepsy Center, 801 Broadway, Seattle, WA 98122, USA. Michael.Doherty@swedish.org
Rostad
Steven W
SW
Kraemer
Diana L Abson
DL
Vossler
David G
DG
Haltiner
Alan M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D038481:Anterior Temporal Lobectomy; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000601:surgery; D005260:Female; D005911:Gliosis / Q000473:pathology*; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019579:Neocortex / Q000473:pathology*; D012737:Sex Factors