RT Journal Article SR Electronic T1 Distributed, Limbic Gray Matter Atrophy in Patients after Bacterial Meningitis JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 1164 OP 1167 DO 10.3174/ajnr.A3351 VO 34 IS 6 A1 N.K. Focke A1 K. Kallenberg A1 A. Mohr A1 M. Djukic A1 R. Nau A1 H. Schmidt YR 2013 UL http://www.ajnr.org/content/34/6/1164.abstract AB BACKGROUND AND PURPOSE: The structural basis of cognitive sequelae after bacterial meningitis in humans is still poorly understood. In animal models and human autopsy cases, neuronal apoptosis of the hippocampal formation in particular seems to play an important role. Here, we aimed to analyze if BM entails MR imaging structural consequences in humans in vivo. MATERIALS AND METHODS: We applied voxel-based morphometry in a cohort of BM survivors with normal conventional MR imaging after resolution of the acute inflammation to assess morphologic differences. RESULTS: We found clear gray matter volume loss in the limbic system including the hippocampal formation, thalamus, and cingulate gyri bilaterally as well as in the temporal lobe. These results were corroborated by an alternative atlas-based method. CONCLUSIONS: Even in patients with normal routine MR imaging results, clear-cut gray matter atrophy with a mesial temporal/limbic pattern was evident. The anatomic distribution is compatible with the neuropsychological deficit commonly observed in patients after BM. The similarity of the observed atrophy may point to causal link between BM and mesial temporal epilepsy. BMbacterial meningitismTLEmesial temporal lobe epilepsyTIVtotal intracranial volumeVBMvoxel-based morphometry