title: Septal nuclei enlargement in human temporal lobe epilepsy without mesial temporal sclerosis.
abstract: OBJECTIVE
  To measure the volume of basal forebrain septal nuclei in patients with temporal lobe epilepsy (TLE) as compared to patients with extratemporal epilepsy and controls. In animal models of TLE, septal lesions facilitate epileptogenesis, while septal stimulation is antiepileptic.
  
  
  METHODS
  Subjects were recruited from 2 sites and consisted of patients with pharmacoresistant focal epilepsy (20 with TLE and mesial temporal sclerosis [MTS], 24 with TLE without MTS, 23 with extratemporal epilepsy) and 114 controls. Septal volume was measured using high-resolution MRI in association with newly developed probabilistic septal nuclei maps. Septal volume was compared between subject groups while controlling for relevant factors.
  
  
  RESULTS
  Patients with TLE without MTS had significantly larger septal nuclei than patients with extratemporal epilepsy and controls. This was not true for patients with MTS. These results are interpreted with reference to prior studies demonstrating expansion of the septo-hippocampal cholinergic system in animal models of TLE and human TLE surgical specimens.
  
  
  CONCLUSIONS
  Septal nuclei are enlarged in patients with TLE without MTS. Further investigation of septal nuclei and antiepileptic septo-hippocampal neurocircuitry could be relevant to development of new therapeutic interventions such as septal stimulation for refractory TLE.
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, New York University Medical Center, New York, USA. Tracy.butler@nyumc.org
authors.forename: Tracy
authors.initials: T
authors.lastname: Butler
authors.forename: Laszlo
authors.initials: L
authors.lastname: Zaborszky
authors.forename: Xiuyuan
authors.initials: X
authors.lastname: Wang
authors.forename: Carrie R
authors.initials: CR
authors.lastname: McDonald
authors.forename: Karen
authors.initials: K
authors.lastname: Blackmon
authors.forename: Brian T
authors.initials: BT
authors.lastname: Quinn
authors.forename: Jonathan
authors.initials: J
authors.lastname: DuBois
authors.forename: Chad
authors.initials: C
authors.lastname: Carlson
authors.forename: William B
authors.initials: WB
authors.lastname: Barr
authors.forename: Jacqueline
authors.initials: J
authors.lastname: French
authors.forename: Ruben
authors.initials: R
authors.lastname: Kuzniecky
authors.forename: Eric
authors.initials: E
authors.lastname: Halgren
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.forename: Thomas
authors.initials: T
authors.lastname: Thesen
mesh_terms: D000293:Adolescent; D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012598:Sclerosis / Q000473:pathology; D012686:Septal Nuclei / Q000473:pathology*; D013223:Statistics as Topic; D013702:Temporal Lobe / Q000473:pathology; D055815:Young Adult