Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.

Anterior temporal lobectomy (ATL) is commonly adopted to control medically intractable temporal lobe epilepsy (TLE). Depending on the side of resection, the degree to which Wallerian degeneration and adaptive plasticity occur after ATL has important implications for understanding cognitive and clini...

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Autores principales:	Dorian Pustina, Gaelle Doucet, James Evans, Ashwini Sharan, Michael Sperling, Christopher Skidmore, Joseph Tracy
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/79d2da138b514da090bf97ac8d80ab33
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spelling	oai:doaj.org-article:79d2da138b514da090bf97ac8d80ab332021-11-25T06:06:06ZDistinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.1932-620310.1371/journal.pone.0104211https://doaj.org/article/79d2da138b514da090bf97ac8d80ab332014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25089698/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203Anterior temporal lobectomy (ATL) is commonly adopted to control medically intractable temporal lobe epilepsy (TLE). Depending on the side of resection, the degree to which Wallerian degeneration and adaptive plasticity occur after ATL has important implications for understanding cognitive and clinical outcome. We obtained diffusion tensor imaging from 24 TLE patients (12 left) before and after surgery, and 12 matched controls at comparable time intervals. Voxel-based analyses were performed on fractional anisotropy (FA) before and after surgery. Areas with postoperative FA increase were further investigated to distinguish between genuine plasticity and processes related to the degeneration of crossing fibers. Before surgery, both patient groups showed bilateral reduced FA in numerous tracts, but left TLE patients showed more extensive effects, including language tracts in the contralateral hemisphere (superior longitudinal fasciculus and uncinate). After surgery, FA decreased ipsilaterally in both ATL groups, affecting the fornix, uncinate, stria terminalis, and corpus callosum. FA increased ipsilaterally along the superior corona radiata in both left and right ATL groups, exceeding normal FA values. In these clusters, the mode of anisotropy increased as well, confirming fiber degeneration in an area with crossing fibers. In left ATL patients, pre-existing low FA values in right superior longitudinal and uncinate fasciculi normalized after surgery, while MO values did not change. Preoperative verbal fluency correlated with FA values in all areas that later increased FA in left TLE patients, but postoperative verbal fluency correlated only with FA of the right superior longitudinal fasciculus. Our results demonstrate that genuine reorganization occurs in non-dominant language tracts after dominant hemisphere resection, a process that may help implement the inter-hemispheric shift of language activation found in fMRI studies. The results indicate that left TLE patients, despite showing more initial white matter damage, have the potential for greater adaptive changes postoperatively than right TLE patients.Dorian PustinaGaelle DoucetJames EvansAshwini SharanMichael SperlingChristopher SkidmoreJoseph TracyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e104211 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dorian Pustina Gaelle Doucet James Evans Ashwini Sharan Michael Sperling Christopher Skidmore Joseph Tracy Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
description	Anterior temporal lobectomy (ATL) is commonly adopted to control medically intractable temporal lobe epilepsy (TLE). Depending on the side of resection, the degree to which Wallerian degeneration and adaptive plasticity occur after ATL has important implications for understanding cognitive and clinical outcome. We obtained diffusion tensor imaging from 24 TLE patients (12 left) before and after surgery, and 12 matched controls at comparable time intervals. Voxel-based analyses were performed on fractional anisotropy (FA) before and after surgery. Areas with postoperative FA increase were further investigated to distinguish between genuine plasticity and processes related to the degeneration of crossing fibers. Before surgery, both patient groups showed bilateral reduced FA in numerous tracts, but left TLE patients showed more extensive effects, including language tracts in the contralateral hemisphere (superior longitudinal fasciculus and uncinate). After surgery, FA decreased ipsilaterally in both ATL groups, affecting the fornix, uncinate, stria terminalis, and corpus callosum. FA increased ipsilaterally along the superior corona radiata in both left and right ATL groups, exceeding normal FA values. In these clusters, the mode of anisotropy increased as well, confirming fiber degeneration in an area with crossing fibers. In left ATL patients, pre-existing low FA values in right superior longitudinal and uncinate fasciculi normalized after surgery, while MO values did not change. Preoperative verbal fluency correlated with FA values in all areas that later increased FA in left TLE patients, but postoperative verbal fluency correlated only with FA of the right superior longitudinal fasciculus. Our results demonstrate that genuine reorganization occurs in non-dominant language tracts after dominant hemisphere resection, a process that may help implement the inter-hemispheric shift of language activation found in fMRI studies. The results indicate that left TLE patients, despite showing more initial white matter damage, have the potential for greater adaptive changes postoperatively than right TLE patients.
format	article
author	Dorian Pustina Gaelle Doucet James Evans Ashwini Sharan Michael Sperling Christopher Skidmore Joseph Tracy
author_facet	Dorian Pustina Gaelle Doucet James Evans Ashwini Sharan Michael Sperling Christopher Skidmore Joseph Tracy
author_sort	Dorian Pustina
title	Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
title_short	Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
title_full	Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
title_fullStr	Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
title_full_unstemmed	Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
title_sort	distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/79d2da138b514da090bf97ac8d80ab33
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Distinct types of white matter changes are observed after anterior temporal lobectomy in epilepsy.

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