Asymmetrical hippocampal connectivity in mesial temporal lobe epilepsy: evidence from resting state fMRI.
BACKGROUND
Mesial temporal lobe epilepsy (MTLE), the most common type of focal epilepsy in adults, is often caused by hippocampal sclerosis (HS). Patients with HS usually present memory dysfunction, which is material-specific according to the hemisphere involved and has been correlated to the degree of HS as measured by postoperative histopathology as well as by the degree of hippocampal atrophy on magnetic resonance imaging (MRI). Verbal memory is mostly affected by left-sided HS, whereas visuo-spatial memory is more affected by right HS. Some of these impairments may be related to abnormalities of the network in which individual hippocampus takes part. Functional connectivity can play an important role to understand how the hippocampi interact with other brain areas. It can be estimated via functional Magnetic Resonance Imaging (fMRI) resting state experiments by evaluating patterns of functional networks. In this study, we investigated the functional connectivity patterns of 9 control subjects, 9 patients with right MTLE and 9 patients with left MTLE.


RESULTS
We detected differences in functional connectivity within and between hippocampi in patients with unilateral MTLE associated with ipsilateral HS by resting state fMRI. Functional connectivity resulted to be more impaired ipsilateral to the seizure focus in both patient groups when compared to control subjects. This effect was even more pronounced for the left MTLE group.


CONCLUSIONS
The findings presented here suggest that left HS causes more reduction of functional connectivity than right HS in subjects with left hemisphere dominance for language.
Neuroimaging Laboratory, Department of Neurology, University of Campinas - UNICAMP, Cidade Universitária, Campinas, SP, Brazil.
Fabrício R S
FR
Pereira
Andréa
A
Alessio
Maurício S
MS
Sercheli
Tatiane
T
Pedro
Elizabeth
E
Bilevicius
Jane M
JM
Rondina
Helka F B
HF
Ozelo
Gabriela
G
Castellano
Roberto J M
RJ
Covolan
Benito P
BP
Damasceno
Fernando
F
Cendes
D000328:Adult; D001931:Brain Mapping; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D009483:Neuropsychological Tests