title: Quantitative MR and cognitive impairment in cryptogenic localisation-related epilepsy.
abstract: For patients with chronic cryptogenic localisation-related epilepsy (CLRE), conventional MRI does not provide measures to discern between patients with or without cognitive complaints. We investigated, in a preliminary study, whether it is possible to detect cerebral biomarkers of cognitive impairment in patients with CLRE using sensitive quantitative MRI techniques. Neuropsychological assessment and quantitative 3.0 T MRI, comprising T2 relaxometry, diffusion tensor imaging, and spectroscopic imaging, were applied to 35 patients with CLRE and 21 healthy controls. Analysis included the left and right hippocampi, and frontal and temporal lobes. Differences between the groups and correlations with cognitive and clinical characteristics were assessed. Patients with epilepsy scored significantly worse on cognitive tasks compared to healthy controls. Significantly larger CSF fractions in the hippocampi and left temporal lobe, a longer T2 relaxation time in the left hippocampus, and a significantly higher concentration of glutamate/glutamine in the left frontal lobe were observed in patients with epilepsy. Moreover, poor memory performance was significantly correlated with larger CSF fractions in the right hippocampus and left temporal lobe in patients. In the temporal lobe, an association between subtle changes in morphology (indicative of atrophy) and memory performance was found, consistent with previous literature. These results may help to explain the alterations in brain functioning in patients with epilepsy.
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, Maastricht, School for Mental Health and Neurosciences, Maastricht University, Maastricht.
authors.forename: Jacobus Fa
authors.initials: JF
authors.lastname: Jansen
authors.affiliation: School for Mental Health and Neurosciences, Maastricht University, Maastricht, Epilepsy Centre Kempenhaeghe, Heeze.
authors.forename: Sylvie Jm
authors.initials: SJ
authors.lastname: van der Kruijs
authors.affiliation: School for Mental Health and Neurosciences, Maastricht University, Maastricht, Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Mariëlle Cg
authors.initials: MC
authors.lastname: Vlooswijk
authors.affiliation: Epilepsy Centre Kempenhaeghe, Heeze, Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Hj Marian
authors.initials: HM
authors.lastname: Majoie
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, Maastricht, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Epilepsy Centre Kempenhaeghe, Heeze.
authors.forename: Paul Am
authors.initials: PA
authors.lastname: Hofman
authors.affiliation: School for Mental Health and Neurosciences, Maastricht University, Maastricht, Epilepsy Centre Kempenhaeghe, Heeze, Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, Maastricht, School for Mental Health and Neurosciences, Maastricht University, Maastricht.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
mesh_terms: D000328:Adult; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology* / Q000523:psychology; D056324:Diffusion Tensor Imaging; D004827:Epilepsy / Q000150:complications / Q000473:pathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
keywords: MR spectroscopy; MRI-negative; cognition; diffusion tensor imaging; localization-related epilepsy; memory