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Glial cell quantification, clinicopatological and historadiological correlations in refractory temporal lobe epilepsy associated with hippocampal sclerosis


Temporal Lobe Epilepsy (TLE) corresponds to 40% of all cases of epilepsy in adults, of which 70% are refractory to pharmacologic treatment. The successful identification of the epileptogenic lesion is an important goal in the treatment of patients with refractory epilepsy. Nevertheless, the histopathological basis for the MRI signal is still poorly understood and correlations between MRI findings and pathology are necessary. Reactive gliosis, one of the major histological changes associated with epilepsy, is characterized by an extensive proliferation of glial cells which occurs in regions with lesions or neuronal loss, constituting a marker for pathological tissue damage. The overall goal of this work is to study the relation between the amount of glial cells in brain tissue and certain clinical and magnetic resonance imaging parameters in hippocampi of patients with TLE. Our working hypothesis are the following: 1-The amount of glial cells in the tissue will be greater in TLE cases with a history of febrile convulsions and longer epilespy duration, 2-Intensity of glial proliferation will be correlated with MRI signal quantification using relaxometry, 3-Glial cell counts will be proportional to the quantification of immunohistochemical labeling with GFAP, 4-Different histopathological evaluation techniques will result in different degrees of correlation with clinical and neuroimaging variables. This proposal is a subproject of the thematic project 2009/53443-1 FAPESP. (AU)

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