Abstract Details

Title Sub-cortical Patho-connectivity in Medial Temporal Lobe Epilepsy: A VBM Meta-analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S25 - Epilepsy/Clinical Neurophysiology (EEG) 2 (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Objective

To identify zones of remote atrophy in Medial Temporal Lobe Epilepsy (MTLE) in addition to medial dorsal nucleus (MDN) thalamus.

Background

In MTLE, remote structural alterations presumably reflect network-based propagation of pathological discharges or patho-connectivity. In prior work, we demonstrated that: 1) MDN of the thalamus exhibits reliable atrophy in MTLE (Barron et al., 2013); and, 2) resting-state fMRI functional connectivity (FC) between MTL and MDN predicts seizure-onset laterality in MTLE (Barron et al., 2015).

Design/Methods A literature search was performed and filtered for compliance with coordinate-based meta-analysis (CBMA) methods standards, namely: 1) peer-reviewed report; 2) contrasts MTLE patients to healthy controls (HC) in a whole-brain voxel-wise manner; 3) analyzed & reported in 3-D standard space. This yielded 29 reports containing 46 experimental contrasts collectivity representing 1392 MTLE and 1334 HC subjects. Data were coded using Scribe 3.6 and submitted to the BrainMap meta-analysis environment (). An MTLE workspace was created using Sleuth 3.03. Activation-likelihood estimation (ALE) meta-analyses were performed using GingerALE 3.0.2 for R-MTLE, L-MTLE, and R/L rectified MTLE.

Results

As hoped, CBMA using an expanded dataset increased the number of brain regions identified as exhibiting reliable remote atrophy in MTLE. All locations are expressed as x;y;z in Talairach space.

R-MTLE ALE identified atrophy in: MDN (2;-18;10), caudate (8;6;10); pulvinar (16;-36;12).

L-MTLE ALE identified atrophy in: caudate (-10;12;8), putamen (-22;0;0), MDN (6;-16;6), pulvinar (-12;-8;10).

R/L-MTLE identified atrophy in: MDN (6;-18;10), pulvinar (4;-24;6), caudate (8;10;10), and putamen (26;10;8).

Conclusions

MTLE exhibits reliable remote atrophy with MDN thalamus, pulvinar, caudate, and putamen. This suggests that a network model of MTLE, including these regions as nodes, will be a more effective tool for identifying per-subject path-connectivity using FC analysis of resting-state fMRI.

Authors/Disclosures
Victor Lami, MD PRESENTER	Dr. Eslami has nothing to disclose.
	No disclosure on file
Heath Pardoe	No disclosure on file
Peter T. Fox, MD (Univ of TX Health Sci Center)	No disclosure on file

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