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Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA‐Epilepsy study.

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Title: Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA‐Epilepsy study.
Authors: Kerestes, Rebecca (AUTHOR), Perry, Andrew (AUTHOR), Vivash, Lucy (AUTHOR), O'Brien, Terence J. (AUTHOR), Alvim, Marina K. M. (AUTHOR), Arienzo, Donatello (AUTHOR), Aventurato, Ítalo K. (AUTHOR), Ballerini, Alice (AUTHOR), Baltazar, Gabriel F. (AUTHOR), Bargalló, Núria (AUTHOR), Bender, Benjamin (AUTHOR), Brioschi, Ricardo (AUTHOR), Bürkle, Eva (AUTHOR), Caligiuri, Maria Eugenia (AUTHOR), Cendes, Fernando (AUTHOR), de Tisi, Jane (AUTHOR), Duncan, John S. (AUTHOR), Engel, Jerome P. (AUTHOR), Foley, Sonya (AUTHOR), Fortunato, Francesco (AUTHOR)
Source: Epilepsia (Series 4). Apr2024, Vol. 65 Issue 4, p1072-1091. 20p.
Subjects: Epilepsy, Cerebral cortical thinning, Temporal lobe epilepsy, Hippocampal sclerosis, Partial epilepsy, Magnetic resonance imaging
Abstract: Objective: The intricate neuroanatomical structure of the cerebellum is of longstanding interest in epilepsy, but has been poorly characterized within the current corticocentric models of this disease. We quantified cross‐sectional regional cerebellar lobule volumes using structural magnetic resonance imaging in 1602 adults with epilepsy and 1022 healthy controls across 22 sites from the global ENIGMA‐Epilepsy working group. Methods: A state‐of‐the‐art deep learning‐based approach was employed that parcellates the cerebellum into 28 neuroanatomical subregions. Linear mixed models compared total and regional cerebellar volume in (1) all epilepsies, (2) temporal lobe epilepsy with hippocampal sclerosis (TLE‐HS), (3) nonlesional temporal lobe epilepsy, (4) genetic generalized epilepsy, and (5) extratemporal focal epilepsy (ETLE). Relationships were examined for cerebellar volume versus age at seizure onset, duration of epilepsy, phenytoin treatment, and cerebral cortical thickness. Results: Across all epilepsies, reduced total cerebellar volume was observed (d =.42). Maximum volume loss was observed in the corpus medullare (dmax =.49) and posterior lobe gray matter regions, including bilateral lobules VIIB (dmax =.47), crus I/II (dmax =.39), VIIIA (dmax =.45), and VIIIB (dmax =.40). Earlier age at seizure onset (ηρmax2 =.05) and longer epilepsy duration (ηρmax2 =.06) correlated with reduced volume in these regions. Findings were most pronounced in TLE‐HS and ETLE, with distinct neuroanatomical profiles observed in the posterior lobe. Phenytoin treatment was associated with reduced posterior lobe volume. Cerebellum volume correlated with cerebral cortical thinning more strongly in the epilepsy cohort than in controls. Significance: We provide robust evidence of deep cerebellar and posterior lobe subregional gray matter volume loss in patients with chronic epilepsy. Volume loss was maximal for posterior subregions implicated in nonmotor functions, relative to motor regions of both the anterior and posterior lobe. Associations between cerebral and cerebellar changes, and variability of neuroanatomical profiles across epilepsy syndromes argue for more precise incorporation of cerebellar subregional damage into neurobiological models of epilepsy. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA‐Epilepsy study.
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  Data: <searchLink fieldCode="AR" term="%22Kerestes%2C+Rebecca%22">Kerestes, Rebecca</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Perry%2C+Andrew%22">Perry, Andrew</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vivash%2C+Lucy%22">Vivash, Lucy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22O'Brien%2C+Terence+J%2E%22">O'Brien, Terence J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Alvim%2C+Marina+K%2E+M%2E%22">Alvim, Marina K. M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Arienzo%2C+Donatello%22">Arienzo, Donatello</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aventurato%2C+Ítalo+K%2E%22">Aventurato, Ítalo K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ballerini%2C+Alice%22">Ballerini, Alice</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Baltazar%2C+Gabriel+F%2E%22">Baltazar, Gabriel F.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bargalló%2C+Núria%22">Bargalló, Núria</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bender%2C+Benjamin%22">Bender, Benjamin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brioschi%2C+Ricardo%22">Brioschi, Ricardo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bürkle%2C+Eva%22">Bürkle, Eva</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Caligiuri%2C+Maria+Eugenia%22">Caligiuri, Maria Eugenia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cendes%2C+Fernando%22">Cendes, Fernando</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22de+Tisi%2C+Jane%22">de Tisi, Jane</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Duncan%2C+John+S%2E%22">Duncan, John S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Engel%2C+Jerome+P%2E%22">Engel, Jerome P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Foley%2C+Sonya%22">Foley, Sonya</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fortunato%2C+Francesco%22">Fortunato, Francesco</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Apr2024, Vol. 65 Issue 4, p1072-1091. 20p.
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  Data: <searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebral+cortical+thinning%22">Cerebral cortical thinning</searchLink><br /><searchLink fieldCode="DE" term="%22Temporal+lobe+epilepsy%22">Temporal lobe epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Hippocampal+sclerosis%22">Hippocampal sclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Partial+epilepsy%22">Partial epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: The intricate neuroanatomical structure of the cerebellum is of longstanding interest in epilepsy, but has been poorly characterized within the current corticocentric models of this disease. We quantified cross‐sectional regional cerebellar lobule volumes using structural magnetic resonance imaging in 1602 adults with epilepsy and 1022 healthy controls across 22 sites from the global ENIGMA‐Epilepsy working group. Methods: A state‐of‐the‐art deep learning‐based approach was employed that parcellates the cerebellum into 28 neuroanatomical subregions. Linear mixed models compared total and regional cerebellar volume in (1) all epilepsies, (2) temporal lobe epilepsy with hippocampal sclerosis (TLE‐HS), (3) nonlesional temporal lobe epilepsy, (4) genetic generalized epilepsy, and (5) extratemporal focal epilepsy (ETLE). Relationships were examined for cerebellar volume versus age at seizure onset, duration of epilepsy, phenytoin treatment, and cerebral cortical thickness. Results: Across all epilepsies, reduced total cerebellar volume was observed (d =.42). Maximum volume loss was observed in the corpus medullare (dmax =.49) and posterior lobe gray matter regions, including bilateral lobules VIIB (dmax =.47), crus I/II (dmax =.39), VIIIA (dmax =.45), and VIIIB (dmax =.40). Earlier age at seizure onset (ηρmax2 =.05) and longer epilepsy duration (ηρmax2 =.06) correlated with reduced volume in these regions. Findings were most pronounced in TLE‐HS and ETLE, with distinct neuroanatomical profiles observed in the posterior lobe. Phenytoin treatment was associated with reduced posterior lobe volume. Cerebellum volume correlated with cerebral cortical thinning more strongly in the epilepsy cohort than in controls. Significance: We provide robust evidence of deep cerebellar and posterior lobe subregional gray matter volume loss in patients with chronic epilepsy. Volume loss was maximal for posterior subregions implicated in nonmotor functions, relative to motor regions of both the anterior and posterior lobe. Associations between cerebral and cerebellar changes, and variability of neuroanatomical profiles across epilepsy syndromes argue for more precise incorporation of cerebellar subregional damage into neurobiological models of epilepsy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/epi.17881
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        Text: English
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