The role of amygdala volume index in surgical evaluation in patients with meisal temporal lobe epilepsy_Journal of Epilepsy

Authors：

ZHENG Yang , ZJHANG Yinxi , CAI Mengting ,  DING Meiping

Neurology Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China;

Corresponding author：

DING Meiping, Email: meipingd@163.com

Keywords：

Temporal lobe epilepsy; Amygdala Volume index; Magnetic resonance imaging; Outcome

DOI：

10.7507/2096-0247.20170043

Video：

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Objective To investigate the role of amygdala volume index(AVI) in surgcial evaluation in patients with mesial temporal lobe epilepsy (mTLE), including clinical features, etiologies and surgical outcome. Methods Thirty six patients were diagnosed as mTLE after surgical evaluation including clinical manifestations, video-electroencephalogram (VEEG) and magnetic resonance imaging (MRI) at the Second Affiliated Hospital of Zhejiang University between March 2013 and March 2016. Bilateral amygdala AVI was then calculated from amygdala volumes on MRI, which were measured with region of interest (ROI) analysis. All patients were treated surgically. Etiologies of mTLE were further confirmed by the histopathology of the resected tissue. Results Among the 35 patients, there is a strong correlation between AVI on the lesion side and age of onset (R =-0.389, P = 0.019) as well as age of surgery (R =-0.357, P = 0.032). No obvious relation can be seen between AVI and gender, history of febrile convulsion, duration of epilepsy, secondary generalized seizure, side of lesion, presurgical seizure frequency and electrode implantation. There is no significant difference in AVI among the five etiologies. At follow-up, thirty patients (80.5%) reached seizure-free, AVI on the lesion side is nota predictor of surgical failure (P > 0.05). Conclusion AVI plays a role in etiology evaluation in patients with mesial temporal lobe epilepsy. Moreover, a larger AVI on the lesion side is correlated with an earlier age of onset. There is limited value of amygdala volume insurgical outcome prediction of patients with mTLE.

Citation： ZHENG Yang, ZJHANG Yinxi, CAI Mengting, DING Meiping. The role of amygdala volume index in surgical evaluation in patients with meisal temporal lobe epilepsy. Journal of Epilepsy, 2017, 3(4): 292-297. doi: 10.7507/2096-0247.20170043 Copy

1.	Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. Lancet Neurol, 2008, 7(6): 525-537.
2.	Spencer SS, Berg AT, Vickrey BG, et al. Predicting long-term seizure outcome after resective epilepsy surgery: the multicenter study. Neurology, 2005, 65(6): 912-918.
3.	Kullmann DM. What's wrong with the amygdala in temporal lobe epilepsy. Brain, 2011, 134(Pt 10): 2800-2801.
4.	Mitsueda-Ono T, Ikeda A, Inouchi M, et al. Amygdalar enlargement in patients with temporal lobe epilepsy. J Neurol Neurosurg Psychiatry, 2011, 82(6): 652-657.
5.	Thom M, Mathern GW, Cross JH, et al. Mesial temporal lobe epilepsy: how do we improve surgical outcome. Ann Neurol, 2010, 68(4): 424-434.
6.	Lambert MV, Brierley B, Al-Sarraj S, et al. Quantitative magnetic resonance imaging of the amygdala in temporal lobe epilepsy-clinico-pathological correlations (a pilot study). Epilepsy Res, 2003, 53(1-2): 39-46.
7.	Cendes F, Andermann F, Gloor P, et al. MRI volumetric measurement of amygdala and hippocampus in temporal lobe epilepsy. Neurology, 1993, 43(4): 719-725.
8.	Fischl B, Salat DH, Busa E, et al. Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain. Neuron, 2002, 33(3): 341-355.
9.	Morey RA, Petty CM, Xu Y, et al. A comparison of automated segmentation and manual tracing for quantifying hippocampal and amygdala volumes. Neuroimage, 2009, 45(3): 855-866.
10.	Keller SS, Roberts N. Voxel-based morphometry of temporal lobe epilepsy: An introduction and review of the literature. Epilepsia, 2008, 49(5): 741-757.
11.	Peng B, Wu L, Zhang L, et al. Volumetric changes in amygdala and entorhinal cortex and their relation to memory impairment in patients with medial temporal lobe epilepsy with visually normal MR imaging findings. Epilepsy Res, 2015, 114(3): 66-72.
12.	Watson C, Andermann F, Gloor P, et al. Anatomic basis of amygdaloid and hippocampal volume measurement by magnetic resonance imaging. Neurology, 1992, 42(9): 1743-1750.
13.	Wieser HG, Blume WT, Fish D, et al. ILAE Commission report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia, 2001, 42(2): 282-286.
14.	Beh SM, Cook MJ, D'Souza WJ. Isolated amygdala enlargement in temporal lobe epilepsy: a systematic review. Epilepsy Behav, 2016, 60(7): 33-41.
15.	Lv RJ, Sun ZR, Cui T, et al. Temporal lobe epilepsy with amygdala enlargement: asubtype of temporal lobe epilepsy. BMC Neurol, 2014, 14(1): 194.
16.	Kimura Y, Sato N, Saito Y, et al. Temporal lobe epilepsy with unilateral amygdala enlargement: morphometric MR analysis with clinical and pathological study. J Neuroimaging, 2015, 25(2): 175-183.
17.	潘克梫, 陈楠, 王星, 等. 1 000名中国正常成人杏仁核体积高分辨力MRI测量.中国医学影像技术, 2010, 26(9): 1615-1619.
18.	Gloor P, Olivier A, Quesney LF, et al. The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Ann Neurol, 1982, 12(2): 129-144.
19.	Wieshmann UC, Larkin D, Varma T, et al. Predictors of outcome after temporal lobectomy for refractory temporal lobe epilepsy. Acta Neurol Scand, 2008, 118(5): 306-312.
20.	Mueller CA, Scorzin J, von Lehe M, et al. Seizure outcome 1 year after temporal lobe epilepsy: an analysis of MR volumetric and clinical parameters. Acta Neurochir (Wien), 2012, 154(8): 1327-1336.
21.	Bonilha L, Jensen JH, Baker N, et al. The brain connectome as a personalized biomarker of seizure outcomes after temporal lobectomy. Neurology, 2015, 84(18): 1846-1853.

1. Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. Lancet Neurol, 2008, 7(6): 525-537.
2. Spencer SS, Berg AT, Vickrey BG, et al. Predicting long-term seizure outcome after resective epilepsy surgery: the multicenter study. Neurology, 2005, 65(6): 912-918.
3. Kullmann DM. What's wrong with the amygdala in temporal lobe epilepsy. Brain, 2011, 134(Pt 10): 2800-2801.
4. Mitsueda-Ono T, Ikeda A, Inouchi M, et al. Amygdalar enlargement in patients with temporal lobe epilepsy. J Neurol Neurosurg Psychiatry, 2011, 82(6): 652-657.
5. Thom M, Mathern GW, Cross JH, et al. Mesial temporal lobe epilepsy: how do we improve surgical outcome. Ann Neurol, 2010, 68(4): 424-434.
6. Lambert MV, Brierley B, Al-Sarraj S, et al. Quantitative magnetic resonance imaging of the amygdala in temporal lobe epilepsy-clinico-pathological correlations (a pilot study). Epilepsy Res, 2003, 53(1-2): 39-46.
7. Cendes F, Andermann F, Gloor P, et al. MRI volumetric measurement of amygdala and hippocampus in temporal lobe epilepsy. Neurology, 1993, 43(4): 719-725.
8. Fischl B, Salat DH, Busa E, et al. Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain. Neuron, 2002, 33(3): 341-355.
9. Morey RA, Petty CM, Xu Y, et al. A comparison of automated segmentation and manual tracing for quantifying hippocampal and amygdala volumes. Neuroimage, 2009, 45(3): 855-866.
10. Keller SS, Roberts N. Voxel-based morphometry of temporal lobe epilepsy: An introduction and review of the literature. Epilepsia, 2008, 49(5): 741-757.
11. Peng B, Wu L, Zhang L, et al. Volumetric changes in amygdala and entorhinal cortex and their relation to memory impairment in patients with medial temporal lobe epilepsy with visually normal MR imaging findings. Epilepsy Res, 2015, 114(3): 66-72.
12. Watson C, Andermann F, Gloor P, et al. Anatomic basis of amygdaloid and hippocampal volume measurement by magnetic resonance imaging. Neurology, 1992, 42(9): 1743-1750.
13. Wieser HG, Blume WT, Fish D, et al. ILAE Commission report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia, 2001, 42(2): 282-286.
14. Beh SM, Cook MJ, D'Souza WJ. Isolated amygdala enlargement in temporal lobe epilepsy: a systematic review. Epilepsy Behav, 2016, 60(7): 33-41.
15. Lv RJ, Sun ZR, Cui T, et al. Temporal lobe epilepsy with amygdala enlargement: asubtype of temporal lobe epilepsy. BMC Neurol, 2014, 14(1): 194.
16. Kimura Y, Sato N, Saito Y, et al. Temporal lobe epilepsy with unilateral amygdala enlargement: morphometric MR analysis with clinical and pathological study. J Neuroimaging, 2015, 25(2): 175-183.
17. 潘克梫, 陈楠, 王星, 等. 1 000名中国正常成人杏仁核体积高分辨力MRI测量.中国医学影像技术, 2010, 26(9): 1615-1619.
18. Gloor P, Olivier A, Quesney LF, et al. The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Ann Neurol, 1982, 12(2): 129-144.
19. Wieshmann UC, Larkin D, Varma T, et al. Predictors of outcome after temporal lobectomy for refractory temporal lobe epilepsy. Acta Neurol Scand, 2008, 118(5): 306-312.
20. Mueller CA, Scorzin J, von Lehe M, et al. Seizure outcome 1 year after temporal lobe epilepsy: an analysis of MR volumetric and clinical parameters. Acta Neurochir (Wien), 2012, 154(8): 1327-1336.
21. Bonilha L, Jensen JH, Baker N, et al. The brain connectome as a personalized biomarker of seizure outcomes after temporal lobectomy. Neurology, 2015, 84(18): 1846-1853.

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