Septal nuclei enlargement in human temporal lobe epilepsy without mesial temporal sclerosis.

Publication Type	Academic Article
Authors	Butler T, Zaborszky L, Wang X, McDonald C, Blackmon K, Quinn B, DuBois J, Carlson C, Barr W, French J, Kuzniecky R, Halgren E, Devinsky O, Thesen T
Journal	Neurology
Volume	80
Issue	5
Pagination	487-91
Date Published	01/09/2013
ISSN	1526-632X
Keywords	Epilepsy, Temporal Lobe, Septal Nuclei
Abstract	OBJECTIVE: To measure the volume of basal forebrain septal nuclei in patients with temporal lobe epilepsy (TLE) as compared to patients with extratemporal epilepsy and controls. In animal models of TLE, septal lesions facilitate epileptogenesis, while septal stimulation is antiepileptic. METHOD: Subjects were recruited from 2 sites and consisted of patients with pharmacoresistant focal epilepsy (20 with TLE and mesial temporal sclerosis [MTS], 24 with TLE without MTS, 23 with extratemporal epilepsy) and 114 controls. Septal volume was measured using high-resolution MRI in association with newly developed probabilistic septal nuclei maps. Septal volume was compared between subject groups while controlling for relevant factors. RESULTS: Patients with TLE without MTS had significantly larger septal nuclei than patients with extratemporal epilepsy and controls. This was not true for patients with MTS. These results are interpreted with reference to prior studies demonstrating expansion of the septo-hippocampal cholinergic system in animal models of TLE and human TLE surgical specimens. CONCLUSION: Septal nuclei are enlarged in patients with TLE without MTS. Further investigation of septal nuclei and antiepileptic septo-hippocampal neurocircuitry could be relevant to development of new therapeutic interventions such as septal stimulation for refractory TLE.
DOI	10.1212/WNL.0b013e31827f0ed7
PubMed ID	23303846
PubMed Central ID	PMC3590047