ArticleFrontiers in neuroscience2026
Voxel-based morphometry in mesial temporal lobe epilepsy surgery: an exploratory Moroccan pilot study.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Mesial temporal lobe epilepsy (MTLE) is a common focal epilepsy syndrome that may require surgery when seizures persist despite appropriate antiseizure medications. Although widespread gray matter (GM) abnormalities have been reported in MTLE, quantitative neuroimaging has not yet been implemented in the newly established epilepsy surgery programme in Fez, Morocco. This prospective observational exploratory pilot study evaluated the feasibility of implementing a whole-brain voxel-based morphometry (VBM) workflow using the Computational Anatomy Toolbox (CAT12), Statistical Parametric Mapping (SPM12), and ResectVol, and descriptively characterized GM differences before and after unilateral temporal lobectomy. Methods: Four patients with unilateral drug-resistant MTLE and eight age- and sex-matched healthy controls were prospectively recruited. Patients underwent preoperative and postoperative magnetic resonance imaging (MRI), whereas controls underwent one research MRI examination. Right-sided patient images were left-right flipped before tissue segmentation so that the epileptogenic and operated hemisphere corresponded to the left side in all patients. Exploratory whole-brain VBM maps were generated using general linear models for the contrasts controls > presurgical patients and presurgical > postsurgical patients; age, sex, and total intracranial volume (TIV) were entered as covariates in each model (voxel-level Results: The exploratory controls > presurgical contrast showed clusters in bilateral temporal, occipital, parietal, frontal, and sensorimotor regions. The exploratory presurgical > postsurgical contrast showed clusters predominantly in the ipsilateral temporal region. Conclusion: Implementing this VBM workflow was feasible within a newly established Moroccan epilepsy surgery programme. The findings are preliminary, descriptive, and hypothesis-generating; they do not establish disease mechanisms or postoperative reorganization. Larger, adequately powered longitudinal studies using dedicated repeated-measures models and multimodal quantitative MRI are required.
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