2015•UCL Discovery (University College London)Requires access
Quantitative MRI evidence for altered structural remodelling of the temporal lobe in cryptogenic West syndrome
CA Clark, Tangunu Fosi, Chin‐Chen Chu, W.K. Chong, Rod C. Scott, Stewart Boyd, Bgr Neville
Open publisher page 2 citations
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.