| Autor: |
Tuleasca, Constantin, Hamdi, Hussein, Patrick, Chauvel, Anne, Lepine, Fabrice, Bartolomei, Régis, Jean |
| Předmět: |
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| Zdroj: |
Journal of Radiosurgery & SBRT; 2022 Supplement, Vol. 8, p45-46, 2p |
| Abstrakt: |
Objective: Hypothalamic hamartomas (HH) are disabling congenital lesions, responsible for gelastic seizures frequently associated with catastrophic epilepsies, epileptogenic encephalopathy, cognitive and psychiatric severe comorbidities. Stereotactic radiosurgery is wellestablished minimally invasive therapeutic approach. Methods: Here, we used voxel-based morphometry (VBM), as depicted on pretherapeutic standard structural magnetic resonance neuroimaging. We assessed whether gray matter density (GMD) correlates with seizure outcome. Were examined 24 patients (10 males, 14 females; mean age 12.7 years, median 9, range 5.9-50), treated in Marseille University Hospital, France, between May 2001 and August 2018. Results: Most relevant anatomical area predicting postoperative Engel class I and II versus III and IV was mesencephalic tegmentum. Higher pretherapeutic GMD in this area was associated with better outcome in terms of seizure cessation. The only other statistically significant clusters were right cerebellar lobule VIIIb and VIIIa. Lower pretherapeutic GMD in both clusters correlated with better Engel class outcome. Grey matter density decreased with age in the left medio-dorsal thalamus. Conclusions: Seizure cessation was associated with higher GMD in mesencephalic tegmental area, acknowledged to be involved in the neural control of explosive vocal behavior in animals. This area is connected by the mamillo-tegmental bundle to the lateral tuberal nucleus area of the hypothalamus, where HH are known to rise. In the future, the detection of more gray matter in this “laugh” tegmental area, based on pretherapeutic routine structural neuroimaging might help in patient selection for minimally invasive radiosurgery for HH. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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