title: Neocortical thinning in "benign" mesial temporal lobe epilepsy.
abstract: OBJECTIVE
  In refractory mesial temporal lobe epilepsy (MTLE) extrahippocampal and neocortical abnormalities have been described in patients with or without mesial temporal sclerosis (MTS). Recently we observed gray matter reductions in regions outside the hippocampus in benign MTLE with or without MTS. Cortical thickness has been proposed as a viable methodologic alternative for assessment of neuropathologic changes in extratemporal regions. Herein, we aimed to use this technique to describe cortical abnormalities in patients with benign TLE.
  
  
  METHODS
  Whole-brain cortical thickness analysis (FreeSurfer) was performed in 32 unrelated patients with benign TLE [16 patients with signs of MTS on magnetic resonance imaging (MRI), pMTLE; 16 without, nMTLE] and 44 healthy controls.
  
  
  RESULTS
  In the pMTLE group, the most significant thinning was found in the sensorimotor cortex bilaterally but was more extensive in the left hemisphere (false discovery rate, p < 0.05). Other areas were localized in the occipital cortex, left supramarginal gyrus, left superior parietal gyrus, left paracentral sulcus, left inferior/middle/superior frontal gyrus, left inferior frontal sulcus, right cingulate cortex, right superior frontal gyrus, right inferior parietal gyrus, right fusiform gyrus, and cuneus/precuneus. In the nMTLE, a similar neurodegenerative pattern was detected, although not surviving correction for multiple comparisons. Direct comparison between pMTLE and nMTLE did not reveal significant changes.
  
  
  CONCLUSIONS
  Patients with either benign pMTLE or nMTLE showed comparable cortical thinning, mainly confined to the sensorimotor cortex. This finding that is not appreciated on routine MRI supports the hypothesis that similar to refractory MTLE, even in benign MTLE, pathology in neocortical regions maybe implicated in the pathophysiology of this syndrome.
authors: Institute of Neurology University Magna Graecia, Catanzaro, Italy. labate@unicz.it
authors: Angelo
authors: A
authors: Labate
authors: Antonio
authors: A
authors: Cerasa
authors: Umberto
authors: U
authors: Aguglia
authors: Laura
authors: L
authors: Mumoli
authors: Aldo
authors: A
authors: Quattrone
authors: Antonio
authors: A
authors: Gambardella
mesh_terms: D000328:Adult; D001284:Atrophy; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019579:Neocortex / Q000002:abnormalities / Q000473:pathology*; D055815:Young Adult