Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy

Hana Malikova,1,2,* Lenka Kramska,3,* Zdenek Vojtech,4,5 Jan Sroubek,6 Jiri Lukavsky,7 Roman Liscak8 1Department of Radiology, Na Homolce Hospital, 2Institute of Anatomy, Second Medical Faculty, Charles University in Prague, 3Department of Clinical Psychology, Na Homolce Hospital, 4Department of Ne...

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Autores principales: Malikova H, Kramska L, Vojtech Z, Sroubek J, Lukavsky J, Liscak R
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Publicado: Dove Medical Press 2015
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spelling oai:doaj.org-article:57968d072c504bbaa424e51f7b6882212021-12-02T03:55:24ZRelationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy1178-2021https://doaj.org/article/57968d072c504bbaa424e51f7b6882212015-11-01T00:00:00Zhttps://www.dovepress.com/relationship-between-remnant-hippocampus-and-amygdala-and-memory-outco-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Hana Malikova,1,2,* Lenka Kramska,3,* Zdenek Vojtech,4,5 Jan Sroubek,6 Jiri Lukavsky,7 Roman Liscak8 1Department of Radiology, Na Homolce Hospital, 2Institute of Anatomy, Second Medical Faculty, Charles University in Prague, 3Department of Clinical Psychology, Na Homolce Hospital, 4Department of Neurology, Na Homolce Hospital, 5Department of Neurology, 3rd Medical Faculty, Charles University in Prague, 6Department of Neurosurgery, Na Homolce Hospital, 7Institute of Psychology, Academy of Sciences of the Czech Republic, 8Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic *These authors contributed equally to this work Background and purpose: Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE), seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE) is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE. The aim of the present study was to correlate the volume of the remnant hippocampus and amygdala in patients treated by SAHE with changes in memory parameters.Materials and methods: Thirty-seven MTLE patients treated by SAHE (ten right, 27 left) were included. Patients underwent magnetic resonance imaging examinations including hippocampal and amygdalar volumetry and neuropsychological evaluation preoperatively and 1 year after surgery.Results: Using Spearman correlation analyses, larger left-sided hippocampal reductions were associated with lower verbal memory performance (ρ=-0.46; P=0.02). On the contrary, improvement of global memory quotient (MQ) was positively correlated with larger right-sided hippocampal reduction (ρ=0.66; P=0.04). Similarly, positive correlations between the extent of right amygdalar reduction and verbal MQ (ρ=0.74; P=0.02) and global MQ change (ρ=0.69; P=0.03) were found. Thus, larger right hippocampal and amygdalar reduction was associated with higher global and verbal MQ change after SAHE.Conclusion: Larger left-sided hippocampal reductions were associated with lower verbal memory performance. This finding is in accordance with the material-specific model of human memory, which states that the dominant hemisphere is specialized for the learning and recall of verbal information. We hypothesize that larger right-sided ablations enable the left temporal lobe to support memory more effectively, perhaps as a consequence of epileptiform discharges spreading from remnants of right mesiotemporal structures to the left. Keywords: amygdalohippocampectomy, thermocoagulation, MRI, volumetry, neuro­psychologyMalikova HKramska LVojtech ZSroubek JLukavsky JLiscak RDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 2927-2933 (2015)
institution DOAJ
collection DOAJ
language EN
topic Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Malikova H
Kramska L
Vojtech Z
Sroubek J
Lukavsky J
Liscak R
Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
description Hana Malikova,1,2,* Lenka Kramska,3,* Zdenek Vojtech,4,5 Jan Sroubek,6 Jiri Lukavsky,7 Roman Liscak8 1Department of Radiology, Na Homolce Hospital, 2Institute of Anatomy, Second Medical Faculty, Charles University in Prague, 3Department of Clinical Psychology, Na Homolce Hospital, 4Department of Neurology, Na Homolce Hospital, 5Department of Neurology, 3rd Medical Faculty, Charles University in Prague, 6Department of Neurosurgery, Na Homolce Hospital, 7Institute of Psychology, Academy of Sciences of the Czech Republic, 8Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic *These authors contributed equally to this work Background and purpose: Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE), seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE) is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE. The aim of the present study was to correlate the volume of the remnant hippocampus and amygdala in patients treated by SAHE with changes in memory parameters.Materials and methods: Thirty-seven MTLE patients treated by SAHE (ten right, 27 left) were included. Patients underwent magnetic resonance imaging examinations including hippocampal and amygdalar volumetry and neuropsychological evaluation preoperatively and 1 year after surgery.Results: Using Spearman correlation analyses, larger left-sided hippocampal reductions were associated with lower verbal memory performance (ρ=-0.46; P=0.02). On the contrary, improvement of global memory quotient (MQ) was positively correlated with larger right-sided hippocampal reduction (ρ=0.66; P=0.04). Similarly, positive correlations between the extent of right amygdalar reduction and verbal MQ (ρ=0.74; P=0.02) and global MQ change (ρ=0.69; P=0.03) were found. Thus, larger right hippocampal and amygdalar reduction was associated with higher global and verbal MQ change after SAHE.Conclusion: Larger left-sided hippocampal reductions were associated with lower verbal memory performance. This finding is in accordance with the material-specific model of human memory, which states that the dominant hemisphere is specialized for the learning and recall of verbal information. We hypothesize that larger right-sided ablations enable the left temporal lobe to support memory more effectively, perhaps as a consequence of epileptiform discharges spreading from remnants of right mesiotemporal structures to the left. Keywords: amygdalohippocampectomy, thermocoagulation, MRI, volumetry, neuro­psychology
format article
author Malikova H
Kramska L
Vojtech Z
Sroubek J
Lukavsky J
Liscak R
author_facet Malikova H
Kramska L
Vojtech Z
Sroubek J
Lukavsky J
Liscak R
author_sort Malikova H
title Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
title_short Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
title_full Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
title_fullStr Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
title_full_unstemmed Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
title_sort relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/57968d072c504bbaa424e51f7b688221
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