Defining Meyers looptemporal lobe resections, visual field deficits and diffusion tensor tractography

M. Yogarajah, N. K. Focke, S. Bonelli, M. Cercignani, J. Acheson, G. J M Parker, D. C. Alexander, A. W. McEvoy, M. R. Symms, M. J. Koepp, J. S. Duncan

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Anterior temporal lobe resection is often complicated by superior quadrantic visual field deficits (VFDs). In some cases this can be severe enough to prohibit driving, even if a patient is free of seizures. These deficits are caused by damage to Meyers loop of the optic radiation, which shows considerable heterogeneity in its anterior extent. This structure cannot be distinguished using clinical magnetic resonance imaging sequences. Diffusion tensor tractography is an advanced magnetic resonance imaging technique that enables the parcellation of white matter. Using seed voxels antero-lateral to the lateral geniculate nucleus, we applied this technique to 20 control subjects, and 21 postoperative patients. All patients had visual fields assessed with Goldmann perimetry at least three months after surgery. We measured the distance from the tip of Meyers loop to the temporal pole and horn in all subjects. In addition, we measured the size of temporal lobe resection using postoperative T1-weighted images, and quantified VFDs. Nine patients suffered VFDs ranging from 22 to 87 of the contralateral superior quadrant. In patients, the range of distance from the tip of Meyers loop to the temporal pole was 2443 mm (mean 34 mm), and the range of distance from the tip of Meyers loop to the temporal horn was -15 to 9 mm (mean 0 mm). In controls the range of distance from the tip of Meyers loop to the temporal pole was 2447 mm (mean 35 mm), and the range of distance from the tip of Meyers loop to the temporal horn was -11 to 9 mm (mean 0 mm). Both quantitative and qualitative results were in accord with recent dissections of cadaveric brains, and analysis of postoperative VFDs and resection volumes. By applying a linear regression analysis we showed that both distance from the tip of Meyers loop to the temporal pole and the size of resection were significant predictors of the postoperative VFDs. We conclude that there is considerable variation in the anterior extent of Meyers loop. In view of this, diffusion tensor tractography of the optic radiation is a potentially useful method to assess an individual patients risk of postoperative VFDs following anterior temporal lobe resection.

Original languageEnglish
Pages (from-to)1656-1668
Number of pages13
JournalBrain
Volume132
Issue number6
DOIs
Publication statusPublished - Jun 2009

Fingerprint

Diffusion Tensor Imaging
Visual Fields
Temporal Lobe
Magnetic Resonance Imaging
Radiation
Geniculate Bodies
Visual Field Tests
Dissection
Linear Models
Seeds
Seizures
Regression Analysis
Brain

Keywords

  • Anterior temporal lobe resection
  • Diffusion tensor tractography
  • Meyers loop
  • Optic radiation

ASJC Scopus subject areas

  • Clinical Neurology
  • Medicine(all)

Cite this

Yogarajah, M., Focke, N. K., Bonelli, S., Cercignani, M., Acheson, J., Parker, G. J. M., ... Duncan, J. S. (2009). Defining Meyers looptemporal lobe resections, visual field deficits and diffusion tensor tractography. Brain, 132(6), 1656-1668. https://doi.org/10.1093/brain/awp114

Defining Meyers looptemporal lobe resections, visual field deficits and diffusion tensor tractography. / Yogarajah, M.; Focke, N. K.; Bonelli, S.; Cercignani, M.; Acheson, J.; Parker, G. J M; Alexander, D. C.; McEvoy, A. W.; Symms, M. R.; Koepp, M. J.; Duncan, J. S.

In: Brain, Vol. 132, No. 6, 06.2009, p. 1656-1668.

Research output: Contribution to journalArticle

Yogarajah, M, Focke, NK, Bonelli, S, Cercignani, M, Acheson, J, Parker, GJM, Alexander, DC, McEvoy, AW, Symms, MR, Koepp, MJ & Duncan, JS 2009, 'Defining Meyers looptemporal lobe resections, visual field deficits and diffusion tensor tractography', Brain, vol. 132, no. 6, pp. 1656-1668. https://doi.org/10.1093/brain/awp114
Yogarajah, M. ; Focke, N. K. ; Bonelli, S. ; Cercignani, M. ; Acheson, J. ; Parker, G. J M ; Alexander, D. C. ; McEvoy, A. W. ; Symms, M. R. ; Koepp, M. J. ; Duncan, J. S. / Defining Meyers looptemporal lobe resections, visual field deficits and diffusion tensor tractography. In: Brain. 2009 ; Vol. 132, No. 6. pp. 1656-1668.
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