MORPHOMETRIC ANALYSIS OF THE TEMPORAL-LOBE IN TEMPORAL-LOBE EPILEPSY

Purpose: Using high-resolution magnetic resonance imaging (MRI), we ex amined the temporal neocortex and the underlying white matter in patie nts with unilateral temporal lobe epilepsy (TLE) and in control subjec ts. Methods: The images of 27 patients and 42 control subjects were re gistered into stereotaxic space, corrected for image intensity inhomog eneity, and automatically segmented into gay matter, white matter, and cerebrospinal fluid (CSF) over a predetermined extent of the temporal lobe. The surface between the gray matter and CSF was extracted, indi ces of curvature (IOC) of the surface were calculated, and a frequency histogam of the IOC was obtained. Results: There was significant bila teral reduction in the total volume of the temporal lobe and in the vo lume of gay matter. White matter volume was significantly reduced only in the temporal lobe ipsilateral to the seizure focus. There were sig nificant changes in the position and amplitude of peaks in the frequen cy histogram of the IOC. Conclusions: The volume of gray matter was ne gatively correlated with duration of epilepsy, suggesting that neocort ical changes may be a consequence of seizures. Changes in the frequenc y histogram of the IOC suggested an additional alteration in the surfa ce morphology of the temporal lobe in TLE, possibly related to sulcal widening.