Epilepsy in multiple sclerosis: The role of temporal lobe damage.
BACKGROUND
Although temporal lobe pathology may explain some of the symptoms of multiple sclerosis (MS), its role in the pathogenesis of seizures has not been clarified yet.


OBJECTIVE
To investigate the role of temporal lobe damage in MS patients suffering from epilepsy, by the application of advanced multimodal 3T magnetic resonance imaging (MRI) analysis.


METHODS
A total of 23 relapsing remitting MS patients who had epileptic seizures (RRMS/E) and 23 disease duration matched RRMS patients without any history of seizures were enrolled. Each patient underwent advanced 3T MRI protocol specifically conceived to evaluate grey matter (GM) damage. This includes grey matter lesions (GMLs) identification, evaluation of regional cortical thickness and indices derived from the Neurite Orientation Dispersion and Density Imaging model.


RESULTS
Regional analysis revealed that in RRMS/E, the regions most affected by GMLs were the hippocampus (14.2%), the lateral temporal lobe (13.5%), the cingulate (10.0%) and the insula (8.4%). Cortical thinning and alteration of diffusion metrics were observed in several regions of temporal lobe, in insular cortex and in cingulate gyrus of RRMS/E compared to RRMS ( p< 0.05 for all comparisons).


CONCLUSIONS
Compared to RRMS, RRMS/E showed more severe damage of temporal lobe, which exceeds what would be expected on the basis of the global GM damage observed.
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Calabrese
Department of Information Engineering, University of Padova, Padova, Italy.
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Castellaro
Department of Information Engineering, University of Padova, Padova, Italy.
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Bertoldo
Department of Information Engineering, University of Padova, Padova, Italy/Scientific Institute, IRCCS "Eugenio Medea", Neuroimaging Lab, Bosisio Parini, LC, Italy.
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De Luca
Neuroradiology and Radiology Units, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Pizzini
Neuroradiology and Radiology Units, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Ricciardi
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Pitteri
Neuroradiology and Radiology Units, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Zimatore
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy/Division of Brain Sciences, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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Magliozzi
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Benedetti
Neurology Section, University Hospital of Trieste, Trieste, Italy.
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Manganotti
Neuroradiology and Radiology Units, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
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Montemezzi
Division of Brain Sciences, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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Reynolds
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Gajofatto
Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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Monaco
D000328:Adult; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D013702:Temporal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology*
Multiple sclerosis; epilepsy; grey matter; neuroimaging; temporal lobe