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Analysis of temporal structures using MRI, VBM and their histological correlation in patients with surgical resistant temporal epilepsy.

Ernesto Gonzalez Stivala

  • CABA Buenos Aires,
  • Argentina
  • Ernesto Gonzalez Stivala ¹
  • , Hernán Kulsgaard ⁴
  • , Micaela Sanzo ¹
  • , Mariana Bendersky ³
  • , Juan Pablo Princich ²
  • , Lucía Alba Ferrara ³
  • , Ignacio Larrabide ⁴
  • , Silvia Kochen ³
  • , Fabián Loidl ¹
  • , Luciana D'Alessio ¹
  • 1 IBCN-CONICET, Facultad de Medicina, UBA.
  • 2 Hospital El Cruce, Buenos Aires.
  • 3 ENyS-CONICET, Buenos Aires
  • 4 Universidad Nacional del Centro, Buenos Aires

Objective: To determine the neuronal and glial density in the resected temporal pole (TP) cortex of patients with resistant temporal lobe epilepsy (RTLE). These findings were related to brain neuroimaging (MRI) and voxel-based morphometry (VBM).
Methods: Patients with RTLE were included. Surgical piece was fixed to perform morphological analysis and qualitative analysis of the tissue. 3T MRI images and VBM were used to calculate TP volume. The patients were divided in 2 groups based on volume reduction.
Results: 21 patients (10 women) with RTLE were included. According to the MRI, 19 patients had hippocampal sclerosis. Five patients presented focal cortical dysplasia. We found higher neuronal density in layer III in patients with volume reduction. Furthermore, a positive correlation between neuronal density in layer III and volume reduction was found by adding both poles. Dysplasia patients presented a tendence towards a higher neuron/glia ratio. In contrast, a greater amount of glia was found in patients with changes in the pole signal on MRI, although not statistically significant (p=0.012)
Conclusions: In this exploratory study, patients with the greater extension of volume reduction showed a higher neuronal density. An increase in neuronal density has previously been observed in patients with dysplasia.