title: MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features.
abstract: BACKGROUND
  The paucity of morphometric markers for hemispheric asymmetries and gender variations in hippocampi and amygdalae in temporal lobe epilepsy (TLE) calls for better characterization of TLE by finding more useful prognostic MRI parameter(s).
  
  
  METHODS
  T1-weighted MRI (3 T) morphometry using multiple parameters of hippocampus-parahippocampus (angular and linear measures, volumetry) and amygdalae (volumetry) including their hemispheric asymmetry indices (AI) were evaluated in both genders. The cutoff values of parameters were statistically estimated from measurements of healthy subjects to characterize TLE (57 patients, 55% male) alterations.
  
  
  RESULTS
  TLE had differential categories with hippocampal atrophy, parahippocampal angle (PHA) acuteness, and several other parametric changes. Bilateral TLE categories were much more prevalent compared to unilateral TLE categories. Female patients were considerably more disposed to bilateral TLE categories than male patients. Male patients displayed diverse categories of unilateral abnormalities. Few patients (both genders) had combined bilateral appearances of hippocampal atrophy, amygdala atrophy, PHA acuteness, and increase in hippocampal angle (HA) where medial distance ratio (MDR) varied among genders. TLE had gender-specific and hemispheric dominant alterations in AI of parameters. Maximum magnitude of parametric changes in TLE includes (a) AI increase in HA of both genders, (b) HA increase (bilateral) in female patients, and (c) increase in ratio of amygdale/hippocampal volume (unilateral, right hemispheric), and AI decrease in MDR, in male patients.
  
  
  CONCLUSIONS
  Multiparametric MRI studies of hippocampus and amygdalae, including their hemispheric asymmetry, underscore better characterization of TLE. Rapidly measurable single-slice parameters (HA, PHA, MDR) can readily delineate TLE in a time-constrained clinical setting, which contrasts with customary three-dimensional hippocampal volumetry that requires many slice computation.
authors.affiliation: Department of Physiology and UGC-CPEPA Centre for "Electro-physiological and Neuro-imaging studies including Mathematical Modelling", University of Calcutta, 92 APC Road, Kolkata, 700009, India.
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Datta
authors.affiliation: Department of Radiodiagnosis, IPGME&R, SSKM Hospital, Kolkata, India.
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Radiodiagnosis, IPGME&R, SSKM Hospital, Kolkata, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: National Neuro-Imaging Facility, National Brain Research Centre, Manesar, India.
authors.forename: Sai Krishna
authors.initials: SK
authors.lastname: Mulpuru
authors.affiliation: Department of Radiodiagnosis, IPGME&R, SSKM Hospital, Kolkata, India.
authors.forename: Swadhapriya
authors.initials: S
authors.lastname: Basu
authors.affiliation: Centre for Bioinformatics, School of Life Sciences, Pondicherry University, Pondicherry, India.
authors.forename: Basant K
authors.initials: BK
authors.lastname: Tiwary
authors.affiliation: Department of Physiology and UGC-CPEPA Centre for "Electro-physiological and Neuro-imaging studies including Mathematical Modelling", University of Calcutta, 92 APC Road, Kolkata, 700009, India. ncphysiolcu@gmail.com.
authors.forename: Nilkanta
authors.initials: N
authors.lastname: Chakrabarti
authors.affiliation: Computational Neuroimaging Division, National Brain Research Centre, Manesar, India.|Clinical Neuroscience Unit, National Brain Research Centre, General Hospital Campus, Gurgaon, India.
authors.forename: Prasun Kumar
authors.initials: PK
authors.lastname: Roy
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology*; D001499:Bayes Theorem; D016022:Case-Control Studies; D004833:Epilepsy, Temporal Lobe / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012737:Sex Factors
keywords: Amygdala; Hemispheric asymmetry; Hippocampus; MRI morphometry; TLE