Whelan, Christopher D Altmann, Andre Botía, Juan A. Jahanshad, Neda Hibar, Derrek P. Absil, Julie Alhusaini, Saud Alvim, Marina KM Auvinen, Pia Bartolini, Emanuele Bergo, Felipe PG Bernardes, Tauana Blackmon, Karen Braga, Barbara Caligiuri, Maria Eugenia Calvo, Anna Carr, Sarah J. Chen, Shuai Cherubini, Andrea David, Philippe Domin, Martin Foley, Sonya França, Wendy Haaker, Gerrit Isaev, Dmitry Keller, Simon S. Kotikalapudi, Raviteja Kowalczyk, Magdalena A. Kuzniecky, Ruben Langner, Soenke Lenge, Matteo Leyden, Kelly M. Liu, Min Loi, Richard Q. Martin, Pascal Mascalchi, Mario Morita, Marcia E. Pariente, Jose C. Rodríguez-Cruces, Raul Rummel, Christian Saavalainen, Taavi Semmelroch, Mira K. Severino, Mariasavina Thomas, Rhys H. Tondelli, Manuela Tortora, Domenico Vaudano, Anna Elisabetta Vivash, Lucy von Podewils, Felix Wagner, Jan Weber, Bernd Yao, Yi Yasuda, Clarissa L. Zhang, Guohao Bargalló, Nuria Bender, Benjamin Bernasconi, Neda Bernasconi, Andrea Bernhardt, Boris C. Blümcke, Ingmar Carlson, Chad Cavalleri, Gianpiero L. Cendes, Fernando Concha, Luis Delanty, Norman Depondt, Chantal Devinsky, Orrin Doherty, Colin P. Focke, Niels K. Gambardella, Antonio Guerrini, Renzo Hamandi, Khalid Jackson, Graeme D. Kälviäinen, Reetta Kochunov, Peter Kwan, Patrick Labate, Angelo McDonald, Carrie R. Meletti, Stefano O'Brien, Terence J. Ourselin, Sebastien Richardson, Mark P. Striano, Pasquale Thesen, Thomas Wiest, Roland Zhang, Junsong Vezzani, Annamaria Ryten, Mina Thompson, Paul M. Sisodiya, Sanjay M. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. <p>Progressive functional decline in the epilepsies is largely unexplained. We formed the ENIGMA-Epilepsy consortium to understand factors that influence brain measures in epilepsy, pooling data from 24 research centres in 14 countries across Europe, North and South America, Asia, and Australia. Structural brain measures were extracted from MRI brain scans across 2149 individuals with epilepsy, divided into four epilepsy subgroups including idiopathic generalized epilepsies (n =367), mesial temporal lobe epilepsies with hippocampal sclerosis (MTLE; left, n = 415; right, n = 339), and all other epilepsies in aggregate (n = 1026), and compared to 1727 matched healthy controls. We ranked brain structures in order of greatest differences between patients and controls, by meta-analysing effect sizes across 16 subcortical and 68 cortical brain regions. We also tested effects of duration of disease, age at onset, and age-by-diagnosis interactions on structural measures. We observed widespread patterns of altered subcortical volume and reduced cortical grey matter thickness. Compared to controls, all epilepsy groups showed lower volume in the right thalamus (Cohen's d = -0.24 to -0.73; P < 1.49 × 10-4), and lower thickness in the precentral gyri bilaterally (d = -0.34 to -0.52; P < 4.31 × 10-6). Both MTLE subgroups showed profound volume reduction in the ipsilateral hippocampus (d = -1.73 to -1.91, P < 1.4 × 10-19), and lower thickness in extrahippocampal cortical regions, including the precentral and paracentral gyri, compared to controls (d = -0.36 to -0.52; P < 1.49 × 10-4). Thickness differences of the ipsilateral temporopolar, parahippocampal, entorhinal, and fusiform gyri, contralateral pars triangularis, and bilateral precuneus, superior frontal and caudal middle frontal gyri were observed in left, but not right, MTLE (d = -0.29 to -0.54; P < 1.49 × 10-4). Contrastingly, thickness differences of the ipsilateral pars opercularis, and contralateral transverse temporal gyrus, were observed in right, but not left, MTLE (d = -0.27 to -0.51; P < 1.49 × 10-4). Lower subcortical volume and cortical thickness associated with a longer duration of epilepsy in the all-epilepsies, all-other-epilepsies, and right MTLE groups (beta, b < -0.0018; P < 1.49 × 10-4). In the largest neuroimaging study of epilepsy to date, we provide information on the common epilepsies that could not be realistically acquired in any other way. Our study provides a robust ranking of brain measures that can be further targeted for study in genetic and neuropathological studies. This worldwide initiative identifies patterns of shared grey matter reduction across epilepsy syndromes, and distinctive abnormalities between epilepsy syndromes, which inform our understanding of epilepsy as a network disorder, and indicate that certain epilepsy syndromes involve more widespread structural compromise than previously assumed.</p> MRI;Epilepsy;Precentral Gyrus;Thalamus;Clinical Pharmacology and Therapeutics 2019-11-22
    https://repository.rcsi.com/articles/journal_contribution/Structural_brain_abnormalities_in_the_common_epilepsies_assessed_in_a_worldwide_ENIGMA_study_/10781555