title: Selective medial temporal volume reduction in the hippocampus of patients with idiopathic generalized tonic-clonic seizures.
abstract: BACKGROUND
  Different subtypes of idiopathic generalized epilepsy may indicate different mechanisms and outcomes, suggesting that it is necessary to use a 'pure sample' of a single subtype.
  
  
  METHODS
  A volumetric study, in conjunction with cognition assessments, was performed in a pure sample of patients with idiopathic generalized tonic-clonic seizures (IGE-GTCS; 15 males and 15 females) matched with normal control subjects (15 males and 17 females). The volumetric measurements were focused on the hippocampus and its surrounding structures, including the amygdala, the parahippocampal gyrus, the entorhinal cortex and the perirhinal cortex. The Wechsler Adult Intelligence Scale-Revised in China was administered to assess cognitive status.
  
  
  RESULTS
  A volume reduction was found only in the hippocampus, with a more severe effect on the left side than the right side. The total number and frequency of seizures had significant negative correlations with multiple cognitive measures. Furthermore, the hippocampal volume reduction was significantly correlated with some aspects of cognitive impairment.
  
  
  CONCLUSIONS
  These findings suggest that compared with the other medial temporal structures, the hippocampus may be more vulnerable to the neuropathology of IGE-GTCS. The observation that cognitive deterioration was correlated with an increased frequency and total number of seizures highlights the critical importance of preventing seizures from recurrence.
authors.affiliation: Department of Psychology, Dalian Medical University, Dalian, China. Electronic address: zhoushiyu@dlmedu.edu.cn.
authors.forename: Shi-Yu
authors.initials: SY
authors.lastname: Zhou
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, No. 222 of ZhongShan Road, 116011 Dalian, China; Department of Neurology, Yantai Municipal Hospital, Yantai, China. Electronic address: sdzy006@163.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Tong
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, No. 222 of ZhongShan Road, 116011 Dalian, China. Electronic address: songfandalian@yahoo.com.cn.
authors.forename: Fan
authors.initials: F
authors.lastname: Song
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, No. 222 of ZhongShan Road, 116011 Dalian, China. Electronic address: chinalpha@163.com.
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Hong
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, No. 222 of ZhongShan Road, 116011 Dalian, China. Electronic address: shf2006317@sohu.com.
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Sun
authors.affiliation: Department of Neurology, The Third People's Hospital of Dalian, Dalian, China. Electronic address: ada.learnworld@163.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Neurology, The Third People's Hospital of Dalian, Dalian, China. Electronic address: 53381626@qq.com.
authors.forename: Hui-Juan
authors.initials: HJ
authors.lastname: Xing
authors.affiliation: Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China. Electronic address: zjy_lzy@126.com.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Li
authors.affiliation: Department of Neurology, First Affiliated Hospital of Dalian Medical University, No. 222 of ZhongShan Road, 116011 Dalian, China. Electronic address: chunbodong@dlmedu.edu.cn.
authors.forename: Chun-Bo
authors.initials: CB
authors.lastname: Dong
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology; D003072:Cognition Disorders / Q000473:pathology / Q000503:physiopathology; D018728:Entorhinal Cortex / Q000473:pathology; D004829:Epilepsy, Generalized / Q000473:pathology* / Q000503:physiopathology; D004830:Epilepsy, Tonic-Clonic / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D020534:Parahippocampal Gyrus / Q000473:pathology; D012640:Seizures / Q000473:pathology* / Q000503:physiopathology
keywords: Brain volume; Cognition; Generalized tonic–clonic seizure; Hippocampus; Idiopathic generalized epilepsy; Medial temporal lobe