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Title: A Feasibility Study of Quantifying Longitudinal Brain Changes in Herpes Simplex Virus (HSV) Encephalitis Using Magnetic Resonance Imaging (MRI) and Stereology.
Austin Authors: Defres, Sylviane;Keller, Simon S;Das, Kumar;Vidyasagar, Rishma;Parkes, Laura M;Burnside, Girvan;Griffiths, Michael;Kopelman, Michael;Roberts, Neil;Solomon, Tom
Affiliation: Clinical Infection, microbiology and immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
Tropical and Infectious diseases Unit, Liverpool and Broadgreen University Hospital Trust, Liverpool, United Kingdom
NIHR HPRU in Emerging and Zoonotic Infections, University of Liverpool, Institute of infection and Global Health, Waterhouse Building, Liverpool, United Kingdom
The Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
The Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, Liverpool, United Kingdom
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Department of Anatomy and Neuroscience, University of Melbourne, Victoria, Australia
Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
The department of Biostatistics, Institute of translational medicine, University of Liverpool, Liverpool, United Kingdom
Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
Institute of Psychiatry, Kings College London, London, United Kingdom
Medical Physics and Imaging Science, University of Edinburgh, Edinburgh, United Kingdom
Issue Date: 26-Jan-2017 2017
Publication information: PLoS One 2017; 12(1): e0170215
Abstract: To assess whether it is feasible to quantify acute change in temporal lobe volume and total oedema volumes in herpes simplex virus (HSV) encephalitis as a preliminary to a trial of corticosteroid therapy. The study analysed serially acquired magnetic resonance images (MRI), of patients with acute HSV encephalitis who had neuroimaging repeated within four weeks of the first scan. We performed volumetric measurements of the left and right temporal lobes and of cerebral oedema visible on T2 weighted Fluid Attenuated Inversion Recovery (FLAIR) images using stereology in conjunction with point counting. Temporal lobe volumes increased on average by 1.6% (standard deviation (SD 11%) in five patients who had not received corticosteroid therapy and decreased in two patients who had received corticosteroids by 8.5%. FLAIR hyperintensity volumes increased by 9% in patients not receiving treatment with corticosteroids and decreased by 29% in the two patients that had received corticosteroids. This study has shown it is feasible to quantify acute change in temporal lobe and total oedema volumes in HSV encephalitis and suggests a potential resolution of swelling in response to corticosteroid therapy. These techniques could be used as part of a randomized control trial to investigate the efficacy of corticosteroids for treating HSV encephalitis in conjunction with assessing clinical outcomes and could be of potential value in helping to predict the clinical outcomes of patients with HSV encephalitis.
DOI: 10.1371/journal.pone.0170215
ORCID: 0000-0002-4729-7505
PubMed URL: 28125598
Type: Journal Article
Appears in Collections:Journal articles

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