MRI and pathology correlations in the medulla in sudden unexpected death in epilepsy (SUDEP): a postmortem study
S Patodia, M Tachrount, A Somani, I Scheffer, T Yousry, X Golay, SM Sisodiya, M Thom
Neuropathology and Applied Neurobiology | WILEY | Published : 2020
AIMS: Sudden unexpected death in epilepsy (SUDEP) likely arises as a result of autonomic dysfunction around the time of a seizure. In vivo MRI studies report volume reduction in the medulla and other brainstem autonomic regions. Our aim, in a pathology series, is to correlate regional quantitative features on 9.4T MRI with pathology measures in medullary regions. METHODS: Forty-seven medullae from 18 SUDEP, 18 nonepilepsy controls and 11 epilepsy controls were studied. In 16 cases, representing all three groups, ex vivo 9.4T MRI of the brainstem was carried out. Five regions of interest (ROI) were delineated, including the reticular formation zone (RtZ), and actual and relative volumes (RV),..View full abstract
Awarded by National Institute of Neurological Disorders and Stroke of the National Institutes of Health
UCL is part of the Center for SUDEP Research (CSR) and supported through the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (Award Numbers neuropathology of SUDEP: 5U01NS090415 and SUDEP admin core grant: U01-NS090405). Epilepsy Society supports SMS, and through the Katy Baggott Foundation, supports the UCL Epilepsy Society Brain and Tissue Bank (ESBTB). The Horne Foundation Trust supported infrastructure in the ESBTB that enabled this work. This work was undertaken at UCLH/UCL who received a proportion of funding from the Department of Health's NIHR Biomedical Research Centres funding scheme. We are very grateful for provision of additional SUDEP and control material for this study from the following resources: The MRC Sudden Death Brain Bank in Edinburgh (cases detailed Table S1). Tissue samples were also obtained from David Hilton at Derriford Hospital as part of the UK Brain Archive Information Network (BRAIN UK) which is funded by the Medical Research Council and Brain Tumour Research. We are grateful to the help of Derek Marsden in the neuropathology laboratory for his technical expertise.