Background: Patients with chronic focal epilepsy may have atrophy of brain structures important for the generation and maintenance of seizures. However, little research has been conducted in patients with newly diagnosed focal epilepsy (NDfE), despite it being a crucial point in time for understanding the underlying biology of the disorder. We aimed to determine whether patients with NDfE show evidence of volumetric abnormalities of subcortical structures. Methods: Eighty-two patients with NDfE and 40 healthy controls underwent MRI scanning using a standard clinical protocol. Volume estimation of the left and right hippocampus, thalamus, caudate nucleus, putamen and cerebral hemisphere was performed for all participants and normalised to whole brain volume. Volumes lower than two standard deviations below the control mean were considered abnormal. Volumes were analysed with respect to patient clinical characteristics, including treatment outcome 12 months after diagnosis. Results: Volume of the left hippocampus (P_(FDR-corr) = 0.04) and left (P_(FDR-corr) = 0.002) and right (P_(FDR-corr) = 0.04) thalamus were significantly smaller in patients relative to controls. Relative to the normal volume limits in controls, 11% individual patients had left hippocampal atrophy, 17% had left thalamic atrophy and 9% had right thalamic atrophy. We did not find evidence of a relationship between volumes and future seizure control or with other clinical characteristics of epilepsy. Conclusions: Volumetric abnormalities of structures known to be important for the generation and maintenance of focal seizures are established at the time of epilepsy diagnosis and are not necessarily a result of the chronicity of the disorder.

中文翻译：

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诊断时病因不明的局灶性癫痫的丘脑海马萎缩

背景：患有慢性局灶性癫痫的患者可能具有大脑结构萎缩，这对于癫痫发作的产​​生和维持很重要。然而，尽管对于了解新的局灶性癫痫（NDfE）是了解该疾病潜在生物学的关键时间点，但几乎没有进行任何研究。我们旨在确定NDfE患者是否显示皮质下结构体积异常的证据。方法：使用标准临床方案对82例NDfE患者和40名健康对照进行MRI扫描。对所有参与者进行左右海马，丘脑，尾状核，壳状核和脑半球的体积估计，并将其标准化为全脑体积。低于控制平均值以下两个标准偏差的体积被认为是异常的。针对患者的临床特征（包括诊断后12个月的治疗结果）分析了体积。结果：左海马体体积（与对照组相比，患者的丘脑P _{（FDR-corr）} = 0.04）和左（P _{（FDR-corr）} = 0.002）和右（P _{（FDR-corr）} = 0.04）。相对于对照组的正常容量限制，11％的患者左海马萎缩，17％的左丘脑萎缩，9％的右丘脑萎缩。我们没有发现数量与未来癫痫发作控制之间或与癫痫的其他临床特征之间存在关系的证据。结论：在癫痫诊断时已经确定了对局灶性癫痫发作的产​​生和维持很重要的结构的体积异常，但这不一定是该疾病的慢性病的结果。