Article
Mossy fiber sprouting and granule cell dispersion correlates with the selective neuronal death in hippocampi of patients with temporal lobe epilepsy
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Authors
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Barbara Schmeiser
- Klinik für Neurochirurgie, Universitätsklinikum, Albert-Ludwigs-Universität, Freiburg im Breisgau, Germany
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Josef Zentner
- Klinik für Neurochirurgie, Universitätsklinikum, Albert-Ludwigs-Universität, Freiburg im Breisgau, Germany
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Thomas M. Freiman
- Klinik für Neurochirurgie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main, Germany
| Published: | June 8, 2016 |
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Outline
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Objective: The most frequent findings in temporal lobe epilepsy is hippocampal sclerosis, which is characterised by selective cell loss in CA1 and hilus (CA4). Other subregions as CA2, CA3 and the granule cell layer are less affected. Granule cells show sprouting of its axons (mossy fibers) and a dispersion of its cell layer. This is the first study of large number of human specimens addressing mossy fiber sprouting and granule cell dispersion in relationship to neuronal death.
Method: We examined 323 human hippocampal specimens, which were collected in a 10-years period. Patient data consisted of the complete seizure history, electroencephalographic results, magnetic resonance imaging, Engel outcome score. Hippocampal specimens were stained for neuronal loss, granular cell dispersion (Wyler scale, Neu-N, HE) and mossy fiber sprouting (Synaptoporin-Immunohistochemistry).
Results: We could show, that mossy fiber sprouting is significantly correlated with the selective neuronal cell loss in CA4 and CA3 in Wyler III-IV. Further regular directed mossy fibers in CA3 and CA4 dismiss in these patients. In addition we could show that granule cell dispersion correlates with the extent of supragranular mossy fiber sprouting and the cell loss in CA3 and CA4. A beneficial outcome following hippocampectomy was achieved in 87% (Engel I-II).
Conclusions: The reorganisation of the mossy fiber system represents most likely a reaction of the denervating injury of the degraded CA3 pyramidal neurons and of hilar mossy cells (CA4).
