7T MRI features in control human hippocampus and hippocampal sclerosis: An ex vivo study with histologic correlations
Roland Coras
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorGloria Milesi
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorIleana Zucca
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAlfonso Mastropietro
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAlessandro Scotti
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorMatteo Figini
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAngelika Mühlebner
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorAndreas Hess
Department of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen-Nuremberg, Erlangen, Germany
Search for more papers by this authorWolfgang Graf
Department of Neurology, Epilepsy Centre, University Hospital Erlangen, Germany
Search for more papers by this authorGiovanni Tringali
Department of Neurosurgery, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorIngmar Blümcke
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorFlavio Villani
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorGiuseppe Didato
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorCarolina Frassoni
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorRoberto Spreafico
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorCorresponding Author
Rita Garbelli
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Address correspondence to Rita Garbelli, Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,” Via Amadeo, 42 20133 Milan, Italy. E-mail: [email protected]Search for more papers by this authorRoland Coras
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorGloria Milesi
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorIleana Zucca
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAlfonso Mastropietro
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAlessandro Scotti
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorMatteo Figini
Scientific IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorAngelika Mühlebner
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorAndreas Hess
Department of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen-Nuremberg, Erlangen, Germany
Search for more papers by this authorWolfgang Graf
Department of Neurology, Epilepsy Centre, University Hospital Erlangen, Germany
Search for more papers by this authorGiovanni Tringali
Department of Neurosurgery, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorIngmar Blümcke
Department of Neuropathology, University Hospital Erlangen, Germany
Search for more papers by this authorFlavio Villani
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorGiuseppe Didato
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorCarolina Frassoni
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorRoberto Spreafico
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Search for more papers by this authorCorresponding Author
Rita Garbelli
Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,”, Milan, Italy
Address correspondence to Rita Garbelli, Clinical Epileptology and Experimental Neurophysiology Unit, IRCCS Foundation Neurological Institute “C. Besta,” Via Amadeo, 42 20133 Milan, Italy. E-mail: [email protected]Search for more papers by this authorSummary
Objective
Hippocampal sclerosis (HS) is the major structural brain lesion in patients with temporal lobe epilepsy (TLE). However, its internal anatomic structure remains difficult to recognize at 1.5 or 3 Tesla (T) magnetic resonance imaging (MRI), which allows neither identification of specific pathology patterns nor their proposed value to predict postsurgical outcome, cognitive impairment, or underlying etiologies. We aimed to identify specific HS subtypes in resected surgical TLE samples on 7T MRI by juxtaposition with corresponding histologic sections.
Methods
Fifteen nonsclerotic and 18 sclerotic hippocampi were studied ex vivo using an experimental 7T MRI scanner. T2-weighted images (T2wi) and diffusion tensor imaging (DTI) data were acquired and validated using a systematic histologic analysis of same specimens along the anterior-posterior axis of the hippocampus.
Results
In nonsclerotic hippocampi, differences in MR intensity could be assigned to seven clearly recognizable layers and anatomic boundaries as confirmed by histology. All hippocampal subfields could be visualized also in the hippocampal head with three-dimensional imaging and angulated coronal planes. Only four discernible layers were identified in specimens with histopathologically confirmed HS. All sclerotic hippocampi showed a significant atrophy and increased signal intensity along the pyramidal cell layer. Changes in DTI parameters such as an increased mean diffusivity, allowed to distinguish International League Against Epilepsy (ILAE) HS type 1 from type 2. Whereas the increase in T2wi signal intensities could not be attributed to a distinct specific histopathologic substrate, that is, decreased neuronal or increased glial cell densities, intrahippocampal projections and fiber tracts were distorted in HS specimens suggesting a complex disorganization of the cellular composition, fiber networks, as well as its extracellular matrix.
Significance
Our data further advocate high-resolution MRI as a helpful and promising diagnostic tool for the investigation of hippocampal pathology along the anterior-posterior extent in TLE, as well as in other neurologic and neurodegenerative disorders.
Supporting Information
| Filename | Description |
|---|---|
| epi12828-sup-0001-TableS1.docWord document, 130 KB | Table S1. Clinical and neuropathologic findings. |
| epi12828-sup-0002-TableS2.docWord document, 31 KB | Table S2. MRI acquisition parameters. |
| epi12828-sup-0003-TableS3.docWord document, 58.5 KB | Table S3. 7T MRI and histologic measurements in the hippocampal subfields. |
| epi12828-sup-0004-FigS1.tifimage/tif, 42.3 MB | Figure S1. Comparison of MRI and histologic images along the anterior-posterior axis in HS. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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