Regeneração de atrofia de substância branca após a cirurgia de epilesia: evidências estruturais através da morfometria baseada em voxel

Recovery of white matter atrophy after epilepsy surgery: structural evidences through voxel-based morphometry

dc.creatorYasuda, Clarissa Lin
dc.creatorValise, Clarissa
dc.creatorSaúde, André Vital
dc.creatorPereira, Fabrício Ramos
dc.creatorCosta, André Luiz Ferreira
dc.creatorMorita, Márcia Elizabete
dc.creatorBetting, Luis Eduardo
dc.creatorTedeschi, Helder
dc.creatorOliveira, Evandro de
dc.creatorCastelano, Gabriela
dc.creatorCendes, Fernando
dc.date2009-03-01
dc.date2014-12-23T13:16:55Z
dc.date2015-11-26T11:53:11Z
dc.date2014-12-23T13:16:55Z
dc.date2015-11-26T11:53:11Z
dc.date.accessioned2018-03-28T20:56:24Z
dc.date.available2018-03-28T20:56:24Z
dc.identifierJournal of Epilepsy and Clinical Neurophysiology. Liga Brasileira de Epilepsia (LBE), v. 15, n. 1, p. 07-11, 2009.
dc.identifier1676-2649
dc.identifierS1676-26492009000100003
dc.identifier10.1590/S1676-26492009000100003
dc.identifierhttp://dx.doi.org/10.1590/S1676-26492009000100003
dc.identifierhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1676-26492009000100003
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/44519
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/44519
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/44519
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1237725
dc.descriptionOBJECTIVES: To study pre and postoperative WMA in MTLE patients. METHODS: We performed Voxel-Based Morphometry (VBM) with volume of interest (VOI) in 69 controls (mean age, 34.3±11.1 years) and 67 operated patients (mean age, 34.1±10.4 years) with unilateral MTLE. 34 became seizure-free (SzFree-Group), 23 improved (Engel IB-IIA [Partial recovery-group]) and 10 did not improve (Engel III-IV [Failure-Group]). All had pre and postoperative MRIs (one year minimum). We flipped MRIs of right MTLE patients in order to avoid right-to-left analysis cancelation. VBM was performed on SPM2/MATLAB7.0 with individual masks for surgical lacunae and 1% false-discovery-rate to control for multiple comparisons. We used MARSbar <www.marsbar.sourceforge.net> routine to select ROIs and t-test for statistical analyses. RESULTS: Mean postoperative follow-up was 60.2 (±SD 30.7) months. On baseline MRI, SzFree-Group showed White Matter Atrophy (WMA) involving temporal lobes [TL], ipsilateral occipital, parietal and frontal regions, with areas of significant recovery of WMA on postoperative MRI. Partial recovery-Group presented a more restricted pattern of WMA, involving ipsilateral temporal lobe, contralateral superior temporal gyrus and few areas in bilateral cingulated and orbitofrontal areas. In this group we also identified areas with relative increase of WM after surgery. By contrast, Failure-Group showed more widespread bi-hemispheric areas of WMA on baseline MRI without postoperative improvement. CONCLUSIONS: Although we have identified some differences in baseline WMA, we were unable to correlate a more widespread pattern with a worse prognosis, as SzFree-Group, also presented a bilateral distribution of WMA. The recovery of WMA in SzFree-Group and Partial recovery-group is in agreement with previous MRS and PET studies and suggests that a network of neuronal dysfunction in MTLE can be, at least in part, reversible after successful postoperative seizure control.
dc.description07
dc.description11
dc.languagept
dc.publisherLiga Brasileira de Epilepsia (LBE)
dc.relationJournal of Epilepsy and Clinical Neurophysiology
dc.rightsaberto
dc.sourceSciELO
dc.subjectTemporal lobe epilepsy
dc.subjectwhite matter
dc.subjectsurgery
dc.subjectVBM
dc.subjectplasticity
dc.titleRegeneração de atrofia de substância branca após a cirurgia de epilesia: evidências estruturais através da morfometria baseada em voxel
dc.titleRecovery of white matter atrophy after epilepsy surgery: structural evidences through voxel-based morphometry
dc.typeArtículos de revistas


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