1. Volume 125, Pages 62-71 (September 2016)
Progressive contralateral hippocampal atrophy following surgery for medically refractory temporal lobe epilepsy 
Cameron A. Elliott, Donald W. Gross, B. Matt Wheatley, Christian Beaulieu, Tejas Sankar 
Epilepsy Research 
Volume 125, Pages (September 2016)
DOI: /j.eplepsyres
Copyright © 2016 Elsevier B.V. Terms and Conditions

2. Fig. 1
Mean contralateral hippocampal volume (mm3) pre- and post-operatively in the two scan group (n=16; ATL − 6; SAH − 10). There was statistically significant post-operative atrophy (mean of 5.4±3.2years after surgery) for (A) whole hippocampus (WHV) by 12%, (B) hippocampal body (HBV) by 28%, but not (C) hippocampal head (HHV) or (D) tail (HTV). * denotes p<0.05, **denotes p<0.01. Error bars denote SEM.
Epilepsy Research  , 62-71DOI: ( /j.eplepsyres )
Copyright © 2016 Elsevier B.V. Terms and Conditions

3. Fig. 2
Longitudinal normalized volume of the contralateral (non-resected) hippocampus in ten patients prior to (P1) and following (days, d; months, m and years, y) temporal lobe epilepsy surgery (ATL − 8; SAH − 2) for medically refractory epilepsy. Post-operative measures were normalized to each subject’s pre-operative baseline. The dashed red lines show the normal variation range defined from repeated measures of both hippocampi in three healthy controls using the same scanner, protocol and time period. (A) WHV loss occurred rapidly over the first week (-1.3%/day) such that all ten subjects had significant reductions from baseline by the end of the first post-operative week which subsequently recovered in two subjects but remained significantly depressed in all others at long-term follow up. (B) HBV loss accounted for the majority of hippocampal atrophy occurring drastically over the first post-operative week (-3.0%/day) in all subjects and remained significantly depressed in all subjects at long-term follow up. (C) HHV was more scattered and less severe although significant volume loss occurred over the first week in three subjects and ultimately in 7 subjects at delayed follow up. (D) HTV was considerably heterogeneous with long-term significant volume loss relative to baseline occurring in 5 subjects. SAH, selective amygdalohippocampectomy; ATL, anterior temporal lobectomy.
Epilepsy Research  , 62-71DOI: ( /j.eplepsyres )
Copyright © 2016 Elsevier B.V. Terms and Conditions

4. Fig. 3
Early (6–7days, 6–7d) and delayed (1–3years, 1–3y) post-operative contralateral hippocampal and sub-regional absolute volume (in mm3) changes following surgery for medically refractory TLE in the longitudinal group (n=10; ATL − 8; SAH − 2). Despite the factor of 2–3 variability in the absolute volumes across subjects, there is statistically significant and consistent early atrophy of the whole hippocampus (WHV, A) and the hippocampal body (HBV, B), followed by volumetric stabilization without any further atrophy or recovery at the group-wide level. The hippocampal head (HHV) and tail (HTV) do not undergo similar group-wide changes over the same time period. **denotes p<0.01 relative to baseline. Error bars denote SEM. Individual subject labels are the same as in Fig. 2.
Epilepsy Research  , 62-71DOI: ( /j.eplepsyres )
Copyright © 2016 Elsevier B.V. Terms and Conditions

5. Fig. 4
Time course of normalized hippocampal and sub-regional volume from three controls (C1, C2, C3) imaged longitudinally over a similar time span as the longitudinal surgical group. Measurements are normalized to each subject’s baseline for each structure. The normal variation range (two red dashed lines) was defined as twice the average absolute deviation from the initial scan baseline of the six hippocampi. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Epilepsy Research  , 62-71DOI: ( /j.eplepsyres )
Copyright © 2016 Elsevier B.V. Terms and Conditions

6. Fig. 5
Post-operative contralateral whole hippocampal (WHV) and hippocampal body (HBV) atrophy expressed as a percentage of baseline at most delayed time point (4.3±3.0years post-surgery) combined across both single-scan group and longitudinal group (n=26). There was a statistically significant difference between subjects who were seizure free (Engel I, n=20) versus those with continued post-operative seizures (Engel>I, n=6) who had a greater reduction of hippocampal volume. * denotes p<0.05. Error bars denote SEM.
Epilepsy Research  , 62-71DOI: ( /j.eplepsyres )
Copyright © 2016 Elsevier B.V. Terms and Conditions