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Title: Interictal epileptogenic networks and endophenotypes in mesial temporal lobe epilepsy
Author: Yaakub, Siti Nurbaya
ISNI:       0000 0004 6498 0693
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2017
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Mesial temporal lobe epilepsy (MTLE) is the most common adult focal epilepsy and is traditionally thought to involve focal-onset seizures arising from the affected hippocampus. Recent neuroimaging studies however have shown widespread bilateral structural and functional abnormalities in MTLE, providing evidence for MTLE as a network disorder. There has also been some evidence that neuroimaging-derived traits could be potential endophenotypes for MTLE. This thesis aimed to identify abnormalities in MTLE and to investigate the suitability of these traits as potential endophenotypes through magnetic resonance imaging- (MRI) and electroencephalography- (EEG) based investigations in MTLE patients, their first-degree unaffected relatives and healthy control participants. Temporal lobe morphology alterations were detected in MTLE patients and unaffected relatives using structural MRI morphometry. Diffusion MRI tractography of the fornix identified alterations in MTLE patients but not their relatives, although tract indices were correlated with hippocampal volumes in both groups but not in healthy controls. A reduction in the peak alpha frequency (PAF) of the EEG data was observed in MTLE patients, with a trend toward decreased PAF in unaffected relatives. The anterior insular and frontal opercular regions were implicated in a network associated with the occipital alpha rhythm in MTLE patients from EEG-correlated MRI and fMRI. Finally, there was a trend toward network reorganisation at the whole-brain level and in hippocampal sub-networks, and evidence for altered hubs in MTLE patients. This thesis presents evidence indicating structural and functional abnormalities in MTLE extend beyond the affected hippocampus and that some subtle alterations may be present in unaffected relatives. This suggests possible candidate MRI- and EEG-based endophenotypes for MTLE for further investigation.
Supervisor: Richardson, Mark Philip ; Barker, Gareth John Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available