Exploring Cortical and Hippocampal Changes in Temporal Lobe Epilepsy Using Automated MRI Segmentation Techniques.

Background: To investigate the applicability of MR-based automated segmentation techniques in evaluating cortical and hippocampal changes in adults with temporal lobe epilepsy (TLE), specifically emphasizing the affected hemisphere.

Methods: A retrospective analysis involved 48 cases diagnosed with TLE based on clinical and EEG criteria. The cohort comprised 30 patients with hippocampal sclerosis (HS) and 18 with nonlesional temporal lobe epilepsy (TLE-NL) on MR. 30 healthy volunteers constituted the control group. FreeSurfer software facilitated the segmentation of cortical regions and hippocampal subfields, generating numerical values for cortical thickness and hippocampal subfield volumes on the left hemisphere. Independent sample Wilcoxon rank-sum tests enabled pairwise comparisons of cortical thickness and hippocampal subfield volumes between the control, TLE-NL, and HS groups.

Results: Significant differences emerged in hippocampal total volume and volumes of the head, body, and tail regions between the control and HS groups and the TLE-NL and HS groups. Cortical thickness of 6 regions exhibited statistical differences between the control and TLE-NL groups, while 15 regions showed distinctions between the control and HS groups. 2 regions displayed variations in cortical thickness between the TLE-NL and HS groups.

Conclusion: MRI-based automated segmentation techniques provide valuable insights into cortical and hippocampal structural variations in distinct TLE subtypes. This methodology effectively delineates changes in cortical regions and hippocampal subfields, augmenting clinical comprehension of TLE progression.