Granule cell dispersion is associated with hippocampal neuronal cell loss, initial precipitating injury, and other clinical features in mesial temporal lobe epilepsy and hippocampal sclerosis.

Autor: Jardim AP; Unidade de Pesquisa e Tratamento das Epilepsias, Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil. Electronic address: anaclarapjardim@gmail.com., Duarte JTC; Unidade de Pesquisa e Tratamento das Epilepsias, Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil., Lancellotti CLP; Department of Pathological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, Brazil., Carrete H Jr; Diagnostic Imaging Sector, Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Brazil., Centeno RS; Neurosurgery Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil., Scorza CA; Neuroscience Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil., Cavalheiro EA; Neuroscience Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil., Guaranha MSB; Unidade de Pesquisa e Tratamento das Epilepsias, Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil., Yacubian EMT; Unidade de Pesquisa e Tratamento das Epilepsias, Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Brazil.
Jazyk: angličtina
Zdroj: Seizure [Seizure] 2021 Aug; Vol. 90, pp. 60-66. Date of Electronic Publication: 2021 May 31.
DOI: 10.1016/j.seizure.2021.05.024
Abstrakt: Purpose: To characterize a 10-year series of patients with mesial temporal lobe epilepsy (MTLE) and unilateral hippocampal sclerosis (HS) and determine the histopathological characteristic of the association between granule cell dispersion (GCD) and hippocampal neuronal loss.
Methods: The study included 108 MTLE/HS patients. Histopathological analyses were performed in NeuN-stained hippocampal sections for HS pattern, neuronal density, dentate gyrus (DG) pathology, and granule cell layer width. Statistical tests investigated the association between DG pathologies and HS patterns, as well as the correlation of DG width with total hippocampal and subfield-specific neuronal densities.
Results: Fifty-six patients (51.9%) presented right HS. All the four ILAE HS patterns were represented (90 Type 1, 11 Type 2, 2 Type 3, and 5 no-HS). Sixty-seven patients (62.0%) presented GCD, 39 (36.1%) normal DG, and 2 (1.9%) narrow DG. GCD was associated with initial precipitating injury, higher numbers of monthly focal seizures and lifetime bilateral tonic-clonic seizures, longer epilepsy duration, and older age at surgery. GCD was prevalent in all HS patterns, except for Type 2 (81.8% normal versus 18.2% GCD, p = 0.005). GCD was associated with total hippocampal and subfield-specific neuronal loss, except for CA1. DG width correlated with total hippocampal (r = -0.201, p = 0.037) and CA4 neuronal densities (r = -0.299, p = 0.002). Patients with HS Type 1 had better surgical outcomes, with 51 (61.4%) seizure-free in the first year post-surgery.
Conclusions: This study confirmed that seizure control in MTLE/HS patients submitted to surgical treatment is comparable worldwide. Moreover, histopathological analyses showed an association between GCD and hippocampal neuronal loss, especially in the CA4 subfield.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
Externí odkaz: