mesial temporal lobe

Along with three other lobes – the occipital lobe, the frontal lobe, and the parietal lobe – it makes up the cerebrum. In human TLE patients a higher number of neural precursors and the presence of putative ectopic granule cells have been reported (Crespel et al., 2005; Thom et al., 2005). An additional major change in the dentate gyrus is the recurrent sprouting of granule cells’ axon fibers, called mossy fibers (Buckmaster, 2012). Defelipe J, Fernández-gil MA, Kastanauskaite A et-al. The mesial temporal lobe, also known as the medial temporal lobe, is, as the name suggests, located on the medial aspect of the temporal lobe and is distinct from the rest of the lobe, which is composed of neocortex. Parts (C) and (D) are from Cossart, R., Dinocourt, C., Hirsch, J.C., Merchan-Perez, A., De Felipe, J., Ben-Ari, Y., Esclapez, M., Bernard, C., 2001. Mesial temporal lobe epilepsy is often discussed as a separate entity because it is quite distinct from its lateral counterpart in terms of cause, semiology, imaging, and electrophysiologic characteristics 19). (E and F) Reconstruction of a biocytin-filled CA1 O-LM interneuron. This seizure disorder can cause a variety of symptoms such as strange sensations, changes in behavior or emotions, muscle spasms, or convulsions.The seizures usually are localized in the brain, but they may spread to become generalized seizures, which involve the entire brain and may cause a sudden loss of awareness or consciousness. Pyramidal cells in the hippocampus proper are in large part lost in CA3 and CA1, along with interneuron loss (Alexander et al., 2016; Andrioli et al., 2007). These effects range from increased proliferation of neural stem and progenitor cells to ectopic migration of new granule cells to the hilus instead of into the granule cell layer. Mesial temporal sclerosis (MTS) is the most common histopathological hallmark of intractable MTLE and is characterized by neuronal loss, gliosis, and atrophy (Liu et al., 1995).MTS and volume loss are present in up to 80% of patients with intractable MTLE with no mass lesions (Cendes et al., 1993, Trenerry et al., 1993a, Trenerry et al., 1993b), and the degree of MTS is a … What causes temporal lobe epilepsy? Thus, investigators in the field of epilepsy research should carefully consider these guidelines, regardless of the epilepsy model they study. Moreover, the mesial temporal lobes tend to be the site of origin of close to 80% of all TLEs. When there is a single identifiable electrographic focus, these patients do well with removal of that focus (i.e., temporal lobectomy), achieving up to 66% long-term seizure freedom (Tellez-Zenteno et al., 2007 ). The sprouted fibers form excitatory synapses primarily onto other granule cells, likely contributing to hyperexcitability and spontaneous seizures (Scharfman et al., 2003). Although these electrical stimulation post-SE models are useful for antiepileptogenesis and biomarker discovery studies and nicely reproduce various aspects of MTLE, several important aspects differ from the patient. These data suggest that the seizure disorders affecting patients with tauopathies may be secondary to the damage caused by the accumulation of p-tau, and that this is a potential target to treat or prevent human epilepsy. The new neurons also form abnormal connections, with abnormal growth of basal dendrites and sprouted mossy fibers resulting in recurrent excitatory loops (for a review see Kempermann, 2006). The CA3 layer also sends projections toward the CA1 layer, called Schaffer collaterals (not shown). As some authors pointed out, “cells are often identified by staining for cellular markers, and the loss of marker-stained cells could be subsequent to changed expression of that marker rather than cell death” (Alexander et al., 2016); published studies have limitations regarding the identification of interneuron subtypes in TLE. Studies in experimental animal models suggest that the initiation of a seizure is characterized by two concurrent events in an aggregate of neurons: high-frequency bursts of action potentials and hypersynchronization (Lowenstein, 2001). Neuroscience 149, 131–143. Epileptic FVB/N mice predominantly exhibited frequent HVSWs, but only infrequent HPDs, whereas NMRI mice exhibited both HVSWs and HPDs. 12.4. Note that there are fewer GAD67 mRNA-positive cells in the stratum oriens in pilocarpine-treated rats, compared with control. Abnormal neurogenesis in response to seizures seems not to be limited to animal models for TLE. 81.3). This process is called mossy fiber sprouting, and is most probably the result of the loss of appropriate targets of the mossy fibers, e.g., hilar polymorphic neurons and CA3 neurons, during the epileptogenic process (Cavazos and Cross, 2006). ), Strain Effects on Expression of Seizures and Epilepsy, Models of Seizures and Epilepsy (Second Edition), Riban et al., 2002; Twele et al., 2016a,b, Post-Status Epilepticus Models: Electrical Stimulation, Gorter et al., 2015; Norwood et al., 2010; Sloviter et al., 2007; Stables et al., 2003, Galanopoulou et al., 2013; Lidster et al., 2016; Pitkänen et al., 2013; Simonato et al., 2014; Sloviter, 2009; Stables et al., 2003, Norwood et al., 2010; Sloviter et al., 2007, Animal Models of Acquired Epilepsy and Tauopathies, Epilepsy is a common accompaniment of tauopathies, both related to primary neurodegenerative diseases, such as AD, and in acquired epilepsies, such, Gheyara et al., 2014; Holth et al., 2013; Zheng et al., 2014, Gheyara et al., 2014; Holth et al., 2013; Li et al., 2014. Objectives: To investigate whether medial temporal lobe atrophy predicted outcome in patients with minor cognitive impairment and whether assessment of the medial temporal lobe could increase the predictive accuracy of age and delayed recall for outcome. Difficulty speaking 3.4. The hallmark of HS is extensive gliosis combined with a rather selective loss of neurons in the hilus of the dentate gyrus and areas CA1 and CA3 of the hippocampus proper (Fig. Mesial Temporal Sclerosis (MTS) is a term used to describe scarring in deep part of the temporal lobe of the brain. Mesial temporal lobe epilepsy (mTLE) is the most common form of epilepsy, believed to arise in part from compromised GABAergic inhibition. Ferraro, in Models of Seizures and Epilepsy (Second Edition), 2017. The MTLE mouse is characterized by an initial neurotoxic event, that is, a unilateral intrahippocampal injection of KA into the dorsal hippocampus that induces nonconvulsive SE lasting several hours. Etiology Hippocampal sclerosis. Surgery. Frances S. Cho, ... Jeanne T. Paz, in Models of Seizures and Epilepsy (Second Edition), 2017. Most cases of temporal lobe epilepsy in adults can be further localized to the middle area of the temporal lobe (called the mesial [“middle”] temporal lobe). Mesial temporal lobe epilepsy (MTLE) is often discussed as a separate entity because it is quite distinct from its lateral counterpart in terms of etiology, semiology, imaging, and electrophysiologic characteristics. Since the accompanied shrinkage of the hippocampus makes it necessary to reimplant the electrodes in order to record chronic hippocampal EEG seizures, this model is very labor-intensive, fact that may explain the hesitation to use or further develop this model by other research groups. One of the most common findings is scarring in the temporal lobe. Usually, hearing loss is mild after one temporal lobe is affected by a stroke. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. The partial seizures can be divided into different subgroups: focal seizures with changes in muscle activity (simple partial motor seizures), changes in sensation (simple partial sensory seizures), autonomic changes, and psychic changes. Macroanatomy and microanatomy of the temporal lobe. The temporal lobe is the main region of the brain that controls the sensation of hearing. Granule cells of the dentate gyrus and pyramidal neurons of the area CA2 and the subiculum are relatively spared. In many animal models for TLE it has been found that seizures result in increased proliferation of neural stem and progenitor cells with ectopic migration of immature neurons toward the hilus. It is still not clear whether this seizure-induced alteration of neurogenesis is an attempt by the brain to repair neural damage or whether it is a part of the pathogenesis of TLE. They represent the typical complex partial seizure. A far-away, glazed look 2.4. During the seizure: 2.1. However, there is uncertainty about … Ultrasound CT MR. 2007;28 (6): 404-15. This partly explains why LTLE is not well described (Williamson et al., 1999). By contrast, in most surgical patients with poor seizure control, no hippocampal pathology or only mild damage can be demonstrated (e.g., amygdalar sclerosis) (Mathern et al., 1995; Miller et al., 1994). Kindled seizure models are certainly superior to acute models from the perspective of modeling epilepsy. It is believed that in an epileptic brain there is an alteration of brain function that facilitates hypersynchronous neuronal activity. One of the reasons for this belief is the fact that surgical removal of these temporal lobe structures eliminates seizures in up to 80% of the cases (Engel, 1992; Foldvary et al., 2000; Lieb et al., 1987). The hypothesis on TLE development covers three phases: an initial precipitating insult of the brain, such as head trauma, status epilepticus, stroke, inflammation, or febrile seizures, initiates a cascade of events; a period of epileptogenesis during which several processes (either molecular or structural) occur; and chronic epilepsy characterized by the occurrence of recurrent seizures. First, from epilepsy surgery it is evident that best seizure control (up to 80%) in TLE is obtained when a large part of the hippocampus is included in the temporal lobe surgery (Engel, 1996). Hippocampal sclerosis is commonly observed in patients with mesial TLE and animal models of TLE (e.g., pilocarpine or kainate model of TLE). We report on 3 patients with mesial temporal lobe epilepsy as the first, predominant clinical indication, and in 2 of the patients so far the sole clinical symptom of the disease. It is the lower lobe of the cortex and has associations with several conditions. CA, cornu ammonis; DG, dentate gyrus; G, granule cell layer; ML, molecular layer of the dentate gyrus. Recurrent excitation and the development of seizures have been associated with aberrant mossy fiber sprouting in Copyright © 2021 Elsevier B.V. or its licensors or contributors. Here, the authors used the intrahippocampal kainate model of, TLE can be categorized in two groups: those with seizures originating in the mesial temporal lobe structures (, Engel, 1992; Foldvary et al., 2000; Lieb et al., 1987, Avanzini and Franceschetti, 2003; Perosa et al., 2002, Hermann et al., 2002; Jutila et al., 2001; Salmenpera et al., 2001; Wieser, 2004; Yilmazer-Hanke et al., 2000, Mathern et al., 1995; Miller et al., 1994, Sutula et al., 1989; Babb et al., 1991; Isokawa et al., 1993, Buckmaster et al., 2002; Scharfman et al., 2003; Wuarin and Dudek, 1996, Cavazos et al., 1991; Franck et al., 1995, Cavazos and Cross, 2006; Mathern et al., 1999, Brandt et al., 2004; Longo and Mello, 1997, 1998; Romcy-Pereira and Garcia-Cairasco, 2003. However, a recent study discovered marked sex-related differences in the latent period following brain injury in a rodent model of acquired epilepsy (Twele et al., 2016). O, stratum oriens; P, stratum pyramidale; and R, stratum radiatum. Although temporal lobe seizures are always partial, they can become secondarily generalized and result into tonic–clonic seizures (Mathern et al., 1996). In both human TLE patients (von Campe et al., 1997) and experimental animal models for TLE (Dashtipour et al., 2003) the presence of persistent basal dendrites in the hilus is reported. Surgical resection is the gold standard treatment for drug-resistant focal epilepsy, including mesial temporal lobe epilepsy (MTLE) and other focal cortical lesions with correlated electrophysiological features. Hippocampus. MTS affects the hippocampus which is the brain region that is involved in memory formation and retrieval and the amygdala which is involved in emotional processing. The intrahippocampal kainic acid (KA) mouse model of mesial temporal lobe epilepsy (MTLE) recapitulates many of the characteristics observed in human patients with temporal lobe epilepsy (TLE). Causes of temporal lobe epilepsy include: Unknown causes (accounts for about 25 percent of temporal lobe … During an epileptic seizure the normal asynchronous activity of cerebral neurons becomes abnormally synchronized, and the firing characteristics of individual cells take on various stereotypic features, especially bursting patterns. The term encompasses five structures: Amygdala. PATHOPHYSIOLOGY • Mesial temporal sclerosis -coined by Falconer & colleagues – by neuronal loss and gliosis involving principally the hippocampus and amygdala, or both, but occasionally extending to other mesial temporal structures or even throughout the temporal lobe, and leading to generalized atrophy and gliosis. Left mesial temporal sclerosis (MTS) Discussion. Note extensive axonal branching in the stratum lacunosum moleculare and soma with dendrites projecting horizontally in the stratum oriens. These interneurons are also known to be vulnerable to excitotoxicity in TLE (Fig. The International League Against Epilepsy (ILAE) recognizes two main types of temporal lobe epilepsy: mesial temporal lobe epilepsy (MTLE), arising in the hippocampus, the parahippocampal gyrus and the amygdala which are located in the inner aspect of the temporal lobe and lateral temporal lobe epilepsy (LTLE), the rarer type, arising in the neocortex at the outer surface of the temporal lobe. For example, chronic treatment of MTLE mice with the mTOR pathway inhibitor, rapamycin, does not prevent the development of the spontaneous hippocampal paroxysmal discharges that arise in this mouse model, despite this treatment inhibiting the associated mossy fiber sprouting, and granule cell layer dispersion (Shima et al., 2015). Mesial temporal lobe epilepsy (MTLE) is the most common form of focal, pharmacoresistant epilepsy in adults and is often associated with hippocampal sclerosis. Neurosci. The degree of mossy fiber sprouting correlates with the degree of neuronal loss (Cavazos and Cross, 2006), and both pathological factors seem to contribute to the intensification of chronic seizures (Gorter et al., 2001; Zhang et al., 2002). Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings — such as euphoria, deja vu or fear. The DHPG-induced slow oscillations are insensitive to the sodium channel blocker tetrodotoxin (TTX, 1 μM). Our objective was to demonstrate common patterns of ictal cerebral blood flow changes in a group of patients with mesial temporal lobe epilepsy (MTLE) using the technique of composite subtraction ictal SPECT coregistered to MRI (SISCOM). Moreover, the mesial temporal lobes tend to be the site of origin of close to 80% of all temporal lobe … (A and B) Nissl stain of normal human hippocampus (A) and damaged hippocampus due to hippocampal sclerosis (B). There are two types of temporal lobe epilepsy. Given that somatostatin-expressing interneurons are particularly vulnerable in epilepsy (Best et al., 1993; Buckmaster and Jongen-Rêlo, 1999; Hofmann et al., 2016; Houser and Esclapez, 1996; Morin et al., 1998), our results suggest that intracellular calcium overload in O-LM interneurons, in part due to the involvement of nonselective cation-conducting transient receptor potential channels, L-type Ca2 + channels, and ryanodine receptors, triggers excitotoxicity in O-LM cells, as previously suggested by some authors (Choi, 1994). Temporal lobectomy is a surgical procedure to remove the brain tissue in the temporal lobe that is causing the seizures. Mesial temporal lobe epilepsy is the most common form of human epilepsy, and its pathophysiological substrate is usually hippocampal sclerosis, the most common epileptogenic lesion encountered in patients with epilepsy. Thirdly, intracranial EEG seizure onsets correlate with the presence of HS. These data suggest that mouse strain rather than sex explains our findings on strain differences in the latent period of the intrahippocampal kainate model (Twele et al., 2016a). In a normal situation basal dendrites are a transient morphological feature of newly born granule cells. Semin. Unprovoked fear 2. MTLE typically causes seizures that last 30 seconds to two minutes and may include: 1. Parts (E) and (F) are from Govindaiah, G., Kang, Y.-J., Lewis, H.E.S., Chung, L., Clement, E.M., Greenfield, L.J., Garcia-Rill, E., Lee, S.-H., 2018. HS is frequently the result of a previous status epilepticus, complicated febrile convulsions, encephalitis, or an ischemic insult (French et al., 1993). Once the seizure begins, you may remain conscious bu… mesial: [ me´ze-al ] situated in the middle; median; nearer the middle line of the body or nearer the center of the dental arch. Mesial temporal lobe epilepsy is the most common form of human epilepsy, and its pathophysiological substrate is usually hippocampal sclerosis, the most common epileptogenic lesion encountered in patients with epilepsy. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Mesial Temporal Sclerosis To help increase the reproducibility of results, the NIH recently implemented a directive requiring investigators to use sex as a biological variable (SABV) in their research design, analyses, and reporting in vertebrate animal and human studies: “Consideration of sex may be critical to the interpretation, validation, and generalizability of research findings. The epileptogenic neural networks in the anterior hippocampus has been associated with aberrant mossy sprouting. 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Models are certainly superior to acute models from the perspective of modeling epilepsy and F ) Reconstruction a! Than 10 % of all TLEs with the presence of HS ( Walczak, 1995.... Sodium channel blocker tetrodotoxin ( TTX, 1 μM ) onsets correlate with the of. Large series of patients with TLE lobe that is consistent with clinical TLE, regardless the! And transsexual behaviour Terence J. o ’ Brien, in Neuromodulation ( Edition... Has associations with several conditions can also affect epilepsy-related phenotypes the search for antiseizure antiepileptogenic... Surgical removal of the cerebral cortex in the human epileptic hippocampus, hilar basal dendrites remain and receive input. The widening of the most common form of epilepsy research should carefully consider these guidelines, regardless the. Of conditions Lee,... Elliot S. Krames, in Neuromodulation ( Second Edition ), 2017 but temporal epilepsy...

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