Dados do Trabalho

Título

SUBCORTICAL GRAY MATTER ATROPHY IN PATIENTS WITH FRONTAL EPILEPSY ASSOCIATED WITH FOCAL CORTICAL DYSPLASIA

Introdução

Cortical and subcortical gray matter volume (GMV) reduction have been reported in patients with epilepsies, in particular temporal lobe epilepsy (TLE), extending beyond the epileptogenic region. However, few studies have investigated GMV reduction in patients with frontal lobe epilepsies associated with focal cortical dysplasias (FLE-FCD).

Objetivo

To identify GMV reduction in patients with FLE-FCD using voxel-based morphometry (VBM).

Método

In this retrospective study, we analyzed high resolution volumetric T1-weighted images with VBM-12 from 36 patients older than 12 years with pharmacoresistant FLE-FCD, and 97 healthy controls matched in age and gender. There were 22 patients with right- and 14 with left-FLE-FCD. The findings of structural abnormalities were regressed in relation to the age at seizure onset, duration of epilepsy, frequency of seizures and number of antiseizure medications.

Resultados

Among the 14 patients with left-FLE-FCD, there was a decrease in the GMV in relation to healthy controls in the following regions: left thalamus, left caudate, left pallidum, left putamen, and left ventral diencephalon (P<0.001, false discovery rate (FDR) corrected). Among the 22 patients with right-FLE-FCD, the areas with reduced GMV did not survive the statistical threshold with FDR. There was no significant correlation between GMV alterations and age at onset of seizures, duration of the disease, frequency of seizures, or with the number of antiseizure medications.

Conclusão

Contrary of what have been demonstrated in TLE, patients with FLE-FCD had subcortical but not cortical GMV decrease. Although there were fewer patients with left-FLE-FCD than right-FLE-FCD, the decreased GMV were significant only in left-sided FCDs. Thus, suggesting that left-sided FCD lesions may be related to more widespread gray matter atrophy.

Palavras-chave

Frontal epilepsy, volumetric changes, gray matter.