PT  - JOURNAL ARTICLE
AU  - N.K. Focke
AU  - K. Kallenberg
AU  - A. Mohr
AU  - M. Djukic
AU  - R. Nau
AU  - H. Schmidt
TI  - Distributed, Limbic Gray Matter Atrophy in Patients after Bacterial Meningitis
AID  - 10.3174/ajnr.A3351
DP  - 2012 Nov 29
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2012/11/29/ajnr.A3351.short
4100  - http://www.ajnr.org/content/early/2012/11/29/ajnr.A3351.full
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. Abbreviations BMbacterial meningitismTLEmesial temporal lobe epilepsyTIVtotal intracranial volumeVBMvoxel-based morphometry