Brain Volume Loss After Stereotactic Laser Interstitial Thermal Therapy in Patients With Temporal Lobe Epilepsy

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-04-08 DOI:10.1111/jon.70039

Sebastian Johannes Müller, Eya Khadhraoui, Olga Kukhlenko, Johannes Schwarzer, Jürgen Voges, I. Erol Sandalcioglu, Daniel Behme, Friedhelm Schmitt, Lars Büntjen

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Abstract

Background and Purpose

Temporal lobe epilepsy is the most common form of focal epilepsy. MR-guided laser interstitial thermal therapy (LITT) of the amygdalohippocampal complex has become an established therapy option in case of drug resistance. Long-term anatomic network effects on the brain due to deafferentiation have not yet been evaluated.

Methods

We analyzed brain volumes of 11 patients with temporal lobe epilepsy before and 1-year after hippocampal LITT with FastSurfer segmenting T1-weighted data. Additionally, we performed visual ratings and measurements.

Results

A total of 11 patients with temporal lobe epilepsy (7 left-sided, 4 right-sided) were included (5 females); the mean age years (±standard deviation) at surgery was 41.5 (±18.4) years. The mean postoperative defect size was 1427 (±517) mm³. Volumetry as well as visual ratings found a progressive volume loss after left-sided surgery in the ipsilateral temporal lobe, the contralateral (right) part of the thalamus, and especially contralateral (right) fusiform cortex. These changes could not be detected for right-sided surgery.

Conclusion

A (partial) ablation of the left (dominant) hippocampus appears to exert long-term effects on the right thalamus and right-sided temporal cortices. However, we could not observe this effect in the reverse direction. Volumetric studies for larger cohorts should be conducted to investigate these findings.

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立体定向激光间质热治疗颞叶癫痫后脑容量减少

背景与目的颞叶癫痫是局灶性癫痫最常见的形式。核磁共振引导下的杏仁海马体激光间质热治疗（LITT）已成为一种成熟的治疗方案，以应对耐药性。由于去分化对大脑的长期解剖网络效应尚未得到评估。方法应用FastSurfer分割t1加权数据对11例颞叶癫痫患者海马LITT前后1年的脑容量进行分析。此外，我们进行了视觉评分和测量。结果共纳入11例颞叶癫痫患者（左侧7例，右侧4例），其中女性5例；手术时的平均年龄（±标准差）为41.5（±18.4）岁。术后平均缺损大小为1427（±517）mm3。体积测量和视觉评分发现，左侧手术后同侧颞叶、丘脑对侧（右）部分，尤其是对侧（右）梭状皮质的体积逐渐减少。右侧手术无法检测到这些变化。结论：左侧（显性）海马（部分）消融对右侧丘脑和右侧颞叶皮质有长期影响。然而，我们不能在相反的方向上观察到这种效应。应该对更大的队列进行容量研究来调查这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!