Successful epilepsy surgery prevents the progressive cortical atrophy observed in patients with temporal lobe epilepsy and is potentially neuroprotective

neurodiem-image

Abstract

Focal epilepsy in adults is associated with progressive atrophy of the cortex at a rate more than double that of normal ageing. We aimed to determine whether successful epilepsy surgery interrupts progressive cortical thinning. In this longitudinal case-control neuroimaging study, we included subjects with unilateral temporal lobe epilepsy (TLE) before (n = 29) or after (n = 56) anterior temporal lobe resection and healthy volunteers (n = 124) comparable regarding age and sex. We measured cortical thickness on paired structural MRI scans in all participants and compared progressive thinning between groups using linear mixed effects models. Compared to ageing-related cortical thinning in healthy subjects, we found progressive cortical atrophy on vertex-wise analysis in TLE before surgery that was bilateral and localized beyond the ipsilateral temporal lobe. In these regions, we observed accelerated annualized thinning in left (left TLE 0.0192 ± 0.0014 versus healthy volunteers 0.0032 ± 0.0013 mm/year, P < 0.0001) and right (right TLE 0.0198 ± 0.0016 versus healthy volunteers 0.0037 ± 0.0016 mm/year, P < 0.0001) presurgical TLE cases. Cortical thinning in these areas was reduced after surgical resection of the left (0.0074 ± 0.0016 mm/year, P = 0.0006) or right (0.0052 ± 0.0020 mm/year, P = 0.0006) anterior temporal lobe.

https://academic.oup.com/brain/article/143/11/3262/5975183 © 2020 Guarantors of Brain. Published by Oxford University Press on behalf of the Guarantors of Brain.
Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries. Published in the United States by Oxford University Press USA, New York. This article is published with permission from Oxford University Press.
All rights reserved. No part of this article may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under
terms agreed with the appropriate reprographics rights organization.

Enquiries concerning reproduction outside the scope of the above should be sent to the Academic Rights Department, Oxford University Press, Oxford, UK.
Oxford University Press makes no representation, express or implied, that the drug dosages in this article are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.
The ultimate responsibility for the use and dosage of drugs mentioned in this article, and in interpretation of published material, lies with the medical practitioner. Please inform Biogen MA Inc of any actual or suspected errors contained in this article.
The mention of trade names, commercial products or organizations, and/or the inclusion of advertisements in this Translation does not imply a guarantee, recommendation or endorsement of any kind by Oxford University Press or its authors or editors.