Gender and hemispheric differences in temporal lobe epilepsy: a VBM study.
OBJECTIVE
Gender differences are recognized in the functional and anatomical organization of the human brain. Differences between genders are probably expressed early in life, when differential rates of cerebral maturation occur. Sexual dimorphism has been described in temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS). Several voxel-based morphometry (VBM) studies have shown that TLE-MTS extends beyond mesial temporal structures, and that there are differences in the extent of anatomical damage between hemispheres, although none have approached gender differences. Our aim was to investigate gender differences and anatomical abnormalities in TLE-MTS.


METHODS
VBM5 was employed to analyze gender and hemispheric differences in 120 patients with TLE-MTS and 50 controls.


RESULTS
VBM abnormalities were more widespread in left-TLE; while in women changes were mostly seen in temporal areas, frontal regions were more affected in men.


CONCLUSIONS
Our study confirmed that gender and laterality are important factors determining the nature and severity of brain damage in TLE-MTS. Differential rates of maturation between gender and hemispheres may explain the distinct areas of anatomical damage in men and women.
Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: teresacgsantana@hotmail.com.
Maria Teresa Castilho Garcia
MT
Santana
Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
Andrea Parolin
AP
Jackowski
Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Fernanda Dos Santos
Fdos S
Britto
Departamento de Diagnóstico por Imagem, Universidade Federal de São Paulo, São Paulo, Brazil.
Gabriel Barbosa
GB
Sandim
Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Luís Otávio Sales Ferreira
LO
Caboclo
Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Ricardo Silva
RS
Centeno
Departamento de Diagnóstico por Imagem, Universidade Federal de São Paulo, São Paulo, Brazil.
Henrique
H
Carrete
Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Elza Márcia Targas
EM
Yacubian
D000328:Adult; D003627:Data Interpretation, Statistical; D004833:Epilepsy, Temporal Lobe / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012598:Sclerosis / Q000473:pathology; D012727:Sex Characteristics; D055815:Young Adult
Gender; Mesial temporal sclerosis; Temporal lobe epilepsy; Voxel-based morphometry