Characterising subtypes of hippocampal sclerosis and reorganization: correlation with pre and postoperative memory deficit

Characterising subtypes of hippocampal sclerosis and reorganization: correlation with pre and postoperative memory deficit

Author Jardim, Anaclara Prada Autor UNIFESP Google Scholar
Liu, Joan Google Scholar
Baber, Jack Google Scholar
Michalak, Zuzanna Google Scholar
Reeves, Cheryl Google Scholar
Ellis, Matthew Google Scholar
Novy, Jan Google Scholar
de Tisi, Jane Google Scholar
McEvoy, Andrew Google Scholar
Miserocchi, Anna Google Scholar
Yacubian, Elza Marcia Targas Autor UNIFESP Google Scholar
Sisodiya, Sanjay Google Scholar
Thompson, Pamela Google Scholar
Thom, Maria Google Scholar
Abstract Neuropathological subtypes of hippocampal sclerosis (HS) in temporal lobe epilepsy (The2013 International League Against Epilepsy classification) are based on the qualitativeassessment of patterns of neuronal loss with NeuN. In practice, some cases appear indeterminate between type 1 (CA1 and CA4 loss) and type 2 HS (CA1 loss) and we predicted that MAP2 would enable a more stringent classification. HS subtypes, as well asthe accompanying alteration of axonal networks, regenerative capacity and neurodegeneration have been previously correlated with outcome and memory deficits and may provide prognostic clinical information. We selected 92 cases: 52 type 1 HS, 15 type 2 HS, 18 indeterminate-HS and 7 no-HS. Quantitative analysis was carried out on NeuN and MAP2 stained sections and a labeling index (LI) calculated for six hippocampal subfields. We also evaluated hippocampal regenerative activity (MCM2, nestin, olig2, calbindin), degeneration (AT8/phosphorylated tau) and mossy-fiber pathway re-organization (ZnT3). Pathology measures were correlated with clinical epilepsy history, memory and naming test scores and postoperative outcomes, at 1 year following surgery. MAP2 LI in indeterminate-HS was statistically similar to type 2 HS but this clustering was not shown with NeuN. Moderate verbal and visual memory deficits were noted in all HS types, including 54% and 69% of type 2 HS. Memory deficits correlated with several pathology factors including lower NeuN or MAP2 LI in CA4, CA1, dentate gyrus (DG) and subiculum and poor preservation of the mossy fiber pathway. Decline in memory at 1 year associated with AT8 labeling in the subiculum and DG but not HS type. We conclude that MAP2 is a helpful addition in the classification of HS in some cases. Classification of HS subtype, however, did not significantly correlate with outcome or pre- or postoperative memory dysfunction, which was associated with multiple pathology factors including hippocampal axonal pathways, regenerative capacity and degenerative changes.
Keywords hippocampal sclerosis
memory
mossy fiber sprouting
temporal lobe epilepsy
xmlui.dri2xhtml.METS-1.0.item-coverage Hoboken
Language English
Sponsor European Union
CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)
Medical Research Council
Department of Health's NIHR Biomedical Research Centres funding scheme
Epilepsy Society
Grant number EU: 602102
MRC: MR/JO127OX/1
Date 2018
Published in Brain Pathology. Hoboken, v. 28, n. 2, p. 143-154, 2018.
ISSN 1015-6305 (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 143-154
Origin http://dx.doi.org/10.1111/bpa.12514
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000426841200001
URI https://repositorio.unifesp.br/handle/11600/55922

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