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Open Access Research article

MRI segmentation analysis in temporal lobe and idiopathic generalized epilepsy

Hila Goldberg12, Arie Weinstock137*, Niels Bergsland4, Michael G Dwyer4, Osman Farooq13, Mona Sazgar5, Guy Poloni4, Cierra Treu3, Bianca Weinstock-Guttman3, Murali Ramanathan6 and Robert Zivadinov34

Author Affiliations

1 Comprehensive Epilepsy Program, State University of New York, Buffalo, NY, USA

2 Bar-Ilan’s Faculty of Medicine in the Galilee, Safed, Israel

3 Department of Neurology, State University of New York, Buffalo, NY, USA

4 Buffalo Neuroimaging Analysis Center, The Jacobs Neurological Institute, State University of New York, Buffalo, NY, USA

5 Department of Neurology, University of California, Orange, Irvine, CA, USA

6 Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA

7 Department of Neurology, Comprehensive Epilepsy Program, Women and Children’s Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222, USA

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BMC Neurology 2014, 14:131  doi:10.1186/1471-2377-14-131

Published: 17 June 2014

Abstract

Background

Temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) patients have each been associated with extensive brain atrophy findings, yet to date there are no reports of head to head comparison of both patient groups. Our aim was to assess and compare between tissue-specific and structural brain atrophy findings in TLE to IGE patients and to healthy controls (HC).

Methods

TLE patients were classified in TLE lesional (L-TLE) or non-lesional (NL-TLE) based on presence or absence of MRI temporal structural abnormalities. High resolution 3 T MRI with automated segmentation by SIENAX and FIRST tools were performed in a group of patients with temporal lobe epilepsy (11 L-TLE and 15 NL-TLE) and in15 IGE as well as in 26 HC. Normal brain volume (NBV), normal grey matter volume (NGMV), normal white matter volume (NWMV), and volumes of subcortical deep grey matter structures were quantified. Using regression analyses, differences between the groups in both volume and left/right asymmetry were evaluated. Additionally, laterality of results was also evaluated to separately quantify ipsilateral and contralateral effects in the TLE group.

Results

All epilepsy groups had significantly lower NBV and NWMV compared to HC (p < 0.001). L-TLE had lower hippocampal volume than HC and IGE (p = 0.001), and all epilepsy groups had significantly lower amygdala volume than HC (p < = 0.004). In L-TLE, there was evidence of atrophy in both ipsilateral and contralateral structures.

Conclusions

Our study revealed that TLE and IGE patients demonstrated similar overall tissue-specific brain atrophy, although specific structures differences were appreciated. L-TLE also appeared to behave differently than NL-TLE, with atrophy not limited to the ipsilateral side.

Keywords:
Temporal lobe epilepsy; Idiopathic generalized epilepsy; MRI segmentation; Brain atrophy