Postma, TS;
Cury, C;
Baxendale, S;
Thompson, PJ;
Cano-López, I;
de Tisi, J;
Burdett, JL;
... Galovic, M; + view all
(2020)
Hippocampal shape is associated with memory deficits in temporal lobe epilepsy.
Annals of Neurology
, 88
(1)
pp. 170-182.
10.1002/ana.25762.
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Abstract
OBJECTIVES: Cognitive problems, especially disturbances in episodic memory, and hippocampal sclerosis are common in temporal lobe epilepsy (TLE) but little is known about the relationship of hippocampal morphology with memory. We aimed to relate hippocampal surface-shape patterns to verbal and visual learning. METHODS: We analysed hippocampal surface shapes on high-resolution MRI images and the Adult Memory and Information Processing Battery in 145 unilateral refractory TLE patients undergoing epilepsy surgery, a validation set of 55 unilateral refractory TLE patients and 39 age- and sex-matched healthy volunteers. RESULTS: Both left (LTLE) and right (RTLE) TLE patients had lower verbal (LTLE 44 ± 11; RTLE 45 ± 10) and visual learning (LTLE 34 ± 8; RTLE 30 ± 8) scores than healthy controls (verbal 58 ± 8; visual 39 ± 6; p<0.001). Verbal learning was more impaired the greater the atrophy of the left superolateral hippocampal head. In contrast, visual memory was worse with greater bilateral inferiomedial hippocampal atrophy. Postsurgical verbal memory decline was more common in LTLE than in RTLE (reliable change index in LTLE 27% vs. RTLE 7%, p=0.006), whereas there were no differences in postsurgical visual memory decline between those groups. Preoperative atrophy of the left hippocampal tail predicted postsurgical verbal memory decline. INTERPRETATION: Memory deficits in TLE are associated with specific morphological alterations of the hippocampus, which could help stratify TLE patients into those at high vs. low risk of presurgical or postsurgical memory deficits. This knowledge could improve planning and prognosis of selective epilepsy surgery and neuropsychological counselling in TLE. This article is protected by copyright. All rights reserved.
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