Magnetic Resonance Elastography of the Hippocampus in Mesial Temporal Sclerosis: Initial Results

Clinical Research Poster



Magnetic Resonance Elastography of the Hippocampus in Mesial Temporal Sclerosis: Initial Results

Author/Presenter: Dr. Graham R. Huesmann M
Co-Author(s):  Hillary Schwarb, Aaron T. Anderson, Bradley P. Sutton, William C. Olivero MD, Tracey M. Wszalek, Curtis L. Johnson

Mesial temporal sclerosis (MTS) is the most common form of pharmacoresistant temporal lobe epilepsy. Surgical resection of the epileptogenic hippocampus is the most promising treatment for MTS; however, the lack of definitive imaging evidence often impedes the use of surgery. In this work we explore the use of a mechanical biomarker for mesial temporal sclerosis (MTS) based on the hypothesis that hippocampal stiffness will be altered ipsilateral to seizure onset, as measured by magnetic resonance elastography (MRE). Four patients with confirmed MTS each completed an MRI session that included MRE and an anatomical image for volumetric analysis. From the MRE protocol we obtained stiffness values for both the left (ipsilateral to seizure onset in all patients) and right (contralateral) hippocampi. We also calculated hippocampal volumes from anatomical images using FreeSurfer. We found that in our initial population, the hippocampus ipsilateral to seizure onset was 11.3% stiffer than contralateral. This result suggests that chronic seizure activity and extensive scarring may stiffen hippocampal tissue. In contrast, we found the ipsilateral hippocampus to be 5.1% smaller than contralateral. This result suggests that hippocampal stiffness may be a more sensitive measure in MTS than hippocampal volume. In conclusion, we have provided initial evidence that hippocampal stiffness is a sensitive marker for the lateralization of epileptogenesis in MTS. Future work will further explore its efficacy with the goal of establishing the technique as a reliable biomarker that can better enable surgical treatments for MTS.

Author/Presenter Bio: Dr. Huesmann is an epileptologist/neurologist at the Carle Foundation Hospital and Research Asst. Professor in the Department of Molecular and Integrative Physiology at the University of Illinois. Dr. Huesmann’s lab investigates mechanisms of both acquired and congenital adult onset epilepsy with both translational clinical studies and basic science. Additionally, the lab is interested in honing identification of seizure onset zones in patients with epilepsy who are potential surgical resection candidates. Dr. Huesmann is an alumnus of the MD/PhD program of the University of Illinois.

Aaron Anderson is a PhD candidate in Theoretical & Applied Mechanics at the University of Illinois.  Mr. Anderson’s thesis research is focused on increasing the specificity of magnetic resonance elastography (MRE) to aid in the diagnosis and staging of neurodegenerative diseases through the use of advanced material models. He is involved with multiple studies using MRE to investigate the potential mechanical biomarkers of brain tumors, epilepsy, hydrocephalus, and multiple sclerosis in collaboration with Carle Foundation Hospital and the Beckman Institute.

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Physician attendees will receive 0.75 CME credits.

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