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Tractography of the parahippocampal gyrus and material specific memory impairment in unilateral temporal lobe epilepsy
Yogarajah, M., Powell, H.W. Robert, Parker, GJM, Alexander, Daniel C., Thompson, P., Symms, Mark R., Boulby, Philip A., Wheeler-Kingshott, Claudia A.M., Barker, Gareth J., Koepp, Matthias J., Duncan, John S
Neuroimage. 2008;40:1755-1764.
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Abstract
Introduction: Temporal lobe epilepsy (TLE) is associated withdisrupted memory function. The structural changes underlying thismemory impairment have not been demonstrated previously withtractography.Methods: We performed a tractography analysis of diffusion magneticresonance imaging scans in 18 patients with unilateral TLE undergoingpresurgical evaluation, and in 10 healthy controls. A seed region in theanterior parahippocampal gyrus was selected from which to trace thewhite matter connections of the medial temporal lobe. A correlationanalysis was carried out between volume and mean fractionalanisotropy (FA) of the connections, and pre-operative material specificmemory performance.Results: There was no significant difference between the left and rightsided connections in controls. In the left TLE patients, the connectedregions ipsilateral to the epileptogenic region were found to besignificantly reduced in volume and mean FA compared with thecontralateral region, and left-sided connections in control subjects.Significant correlations were found in left TLE patients between leftand right FA, and verbal and non-verbal memory respectively.Conclusion: Tractography demonstrated the alteration of whitematter pathways that may underlie impaired memory function inTLE. A detailed knowledge of the integrity of these connections may beuseful in predicting memory decline in chronic temporal lobe epilepsy.