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Abstract
Objective: To measure the volume of basal forebrain septal nuclei in patients with temporal lobe epilepsy (TLE) as compared to patients with extratemporal epilepsy and controls. In animal models of TLE, septal lesions facilitate epileptogenesis, while septal stimulation is antiepileptic.
Method: Subjects were recruited from 2 sites and consisted of patients with pharmacoresistant focal epilepsy (20 with TLE and mesial temporal sclerosis [MTS], 24 with TLE without MTS, 23 with extratemporal epilepsy) and 114 controls. Septal volume was measured using high-resolution MRI in association with newly developed probabilistic septal nuclei maps. Septal volume was compared between subject groups while controlling for relevant factors.
Results: Patients with TLE without MTS had significantly larger septal nuclei than patients with extratemporal epilepsy and controls. This was not true for patients with MTS. These results are interpreted with reference to prior studies demonstrating expansion of the septo-hippocampal cholinergic system in animal models of TLE and human TLE surgical specimens.
Conclusion: Septal nuclei are enlarged in patients with TLE without MTS. Further investigation of septal nuclei and antiepileptic septo-hippocampal neurocircuitry could be relevant to development of new therapeutic interventions such as septal stimulation for refractory TLE.
GLOSSARY
- ETE=
- extratemporal epilepsy;
- FCD=
- focal cortical dysplasia;
- FOV=
- field of view;
- icEEG=
- intracranial EEG;
- MNI=
- Montreal Neurological Institute;
- MTS=
- mesial temporal sclerosis;
- NGF=
- nerve growth factor;
- NYU=
- New York University;
- TE=
- echo time;
- TI=
- inversion time;
- TICV=
- total intracranial volume;
- TLE=
- temporal lobe epilepsy;
- TLE-NL=
- patients with temporal lobe epilepsy without mesial temporal sclerosis;
- TLVV=
- total lateral ventricle volume;
- TR=
- repetition time;
- UCSD=
- University of California, San Diego
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received April 2, 2012.
- Accepted September 24, 2012.
- © 2013 American Academy of Neurology
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