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Quantitative MRI evidence for altered structural remodelling of the temporal lobe in cryptogenic West syndrome

Clark, CA; Fosi, T; Chu, C; Chong, W; Scott, R; Boyd, S; Neville, B; (2015) Quantitative MRI evidence for altered structural remodelling of the temporal lobe in cryptogenic West syndrome. Epilsepsia , 56 (4) pp. 608-616. 10.1111/epi.12907. Green open access

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Abstract

Objective: To explore the structure-function relation of the temporal lobe in newly diagnosed West syndrome of unknown cause (uWS). / Methods: Quantitative magnetic resonance imaging (3D structural MRI and diffusion tensor imaging, DTI) was analysed by voxel-based morphometry (VBM) and tractbased spatial statistics (TBSS) in 22 patients and healthy age-matched controls. The electrophysiological responsiveness of the temporal lobe was measured using the N100 auditory event-related potential (ERP) to a repeated 1000Hz tone. Neurocognitive function was assessed using the Bayley scales of infant development II (BSID-II). Tests followed first-line treatment with Vigabatrin (17) or high dose oral prednisolone (5). / Results: Total temporal lobe volume was similar in patients and controls. Patients had a smaller temporal stem (TS) [p < 0.0001] and planum temporale (PT) [p = 0.029] bilaterally. TS width asymmetry with a larger right-sided width in controls, was absent in patients [p = 0.033]. PT asymmetry was present in both groups, being larger on the right [p = 0.048]. VBM grey matter volume was increased at the left temporal lobe (superior and middle temporal gyri, the perirhinal cortex and medial temporal lobe) [p<0.005, family wise error-corrected]. VBM grey matter volume correlated with the duration of infantile spasms. [Pearson’s R = - 0.630, p = 0.009] DTI metrics did not differ between patients and controls on TBSS. Patients’ mean BSID-II scores were lower [p<0.001] and their auditory N100 ERP attenuated less than controls’ [p = 0.002]. / Significance: The functional networking and white matter development of the temporal lobe are impaired following infantile spasms. Treatment may promote structural plasticity within the temporal lobe following infantile spasms, manifest as increased grey matter volume on VBM. It remains to be investigated further whether this predicts patients’ longterm cognitive difficulties.

Type: Article
Title: Quantitative MRI evidence for altered structural remodelling of the temporal lobe in cryptogenic West syndrome
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/epi.12907
Publisher version: http://dx.doi.org/10.1111/epi.12907
Language: English
Additional information: © 2015 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: West syndrome, Temporal lobe, Quantitative MRI, Auditory event-related potential, Structural plasticity
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1458550
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