SIG | Temporal Lobe Club: The Network in Mesial Temporal Lobe Epilepsy
Saturday, December 4, 2021
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OVERVIEW:
Presenters focus on key factors in the network underpinning mTLE. The session begins with a focus on imaging studies using high resolution MRI have shown extensive areas of cortical thinning in multiple lobes of the brain, white matter tract abnormalities, and structural changes in basal ganglia, thalamus, and brainstem. These anatomic derangements help define the substrate for the network of mTLE.
Second, functional MRI research has shown pathological networks associated with some of these anatomic findings, with enhanced connectivity between specific regions, subcortical-cortical and cortical-cortical interactions that are related to the clinical expression of temporal lobe seizures and outcome after surgery. For example, recent research has shown that thalamocortical and thalamobasal ganglia network interactions assessed with fMRI are associated with propensity for mesial temporal lobe seizures to generalize, which reflects recruitment of a wider network in the expression of seizures.
Third,, electrophysiological techniques have also demonstrated enhanced connectivity between various cortical regions extending well behond the mesial temporal lobe, which may relate to the propensity for seizure development, seizure spread, and response to treatment.
The relevance of these mTLE networks is a critical discussion point, with a view to developing new ideas for research and advancing therapeutics.
Learning Objectives:
Following participation in this activity, participants will be able to:
- Describe the anatomic features of mesial temporal lobe epilepsy networks and relate these to abnormal functional connections
- Describe the functional derangements of the network in mTLE and relate these to seizure expression, seizure propagation, and treatment efficacy
- Describe new approaches to defining abnormal network interactions and new strategies for modifying these abnormal networks to improve treatment of this condition
Program:
SIG Coordinators: Michael Sperling, MD and Julia Jacobs, MD
Chair: Michael Sperling, MD
Anatomic Abnormalities in the Mesial Temporal Lobe Epilepsy Network | Boris Bernhardt, PhD
Use of fMRI to Define Networks in Temporal Lobe Epilepsy | Lorenzo Caciagli, MD, PhD
The Electrophysiology of the Mesial Temporal Lobe Epilepsy Network | Julia Jacobs, MD
Education Credit:
1.5 Nursing Contact Hours
1.5 Pharmacy Contact Hours
1.5 CME