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Objective: To evaluate whether diffusion tensor imaging (DTI) can predict epileptogenic tubers by measuring apparent diffusion coefficient (ADC), fractional anisotropy, axial diffusivity, and radial diffusivity in both tubers and perituberal tissue in pediatric patients with tuberous sclerosis complex (TSC) undergoing epilepsy surgery.Methods: We retrospectively selected 23 consecutive patients (aged 0.4-19.6 years, mean age of 5.2; 13 female, 10 male) who underwent presurgical DTI and subsequent surgical resection between 2004 and 2013 from the University of California-Los Angeles TSC Clinic. We evaluated presurgical examinations including video-EEG, brain MRI, 18 F-fluorodeoxyglucose-PET, magnetic source imaging, and intraoperative electrocorticography for determining epileptogenic tubers. A total of 545 tubers, 33 epileptogenic and 512 nonepileptogenic, were identified. Two observers generated the regions of interest (ROIs) of tubers (ROI tuber ), the 4-mm-thick ring-shaped ROIs surrounding the tubers (ROI perituber ), and the combined ROIs (ROI tuber1perituber ) in consensus and calculated maximum, minimum, mean, and median values of each DTI measure in each ROI for all tubers.Results: The Mann-Whitney U test demonstrated that the epileptogenic group showed higher maximum ADC and radial diffusivity values in all ROIs, and that maximum ADC in ROI tuber1perituber showed the strongest difference (p 5 0.001). Receiver operating characteristic analysis demonstrated that maximum ADC measurements in ROI tuber1perituber (area under curve 5 0.68 6 0.05, p , 0.001) had 81% sensitivity and 44% specificity for correctly identifying epileptogenic tubers with a cutoff value of 1.32 mm 2 /ms.Conclusions: DTI analysis of tubers and perituberal tissue may help to identify epileptogenic tubers in presurgical patients with TSC more easily and effectively than current invasive methods. Neurology ® 2015;85:2011-2015 GLOSSARY AD 5 axial diffusivity; ADC 5 apparent diffusion coefficient; DTI 5 diffusion tensor imaging; FA 5 fractional anisotropy; FDG-PET 5 18 F-fluorodeoxyglucose-PET; RD 5 radial diffusivity; ROC 5 receiver operating characteristic; ROI 5 region of interest; TSC 5 tuberous sclerosis complex; UCLA 5 University of California-Los Angeles.The presurgical identification of epileptogenic tubers in patients with tuberous sclerosis complex (TSC) remains challenging.1 Many patients with TSC either require invasive intracranial recording to pinpoint the epileptogenic zone or are denied surgery altogether.Recent neurophysiologic studies have revealed that not only the tuber themselves but also the adjacent perituberal tissue can impair brain function and is therefore considered part of the ictal onset zone. 2,3 We hypothesized that microstructural changes in perituberal tissue may be measurable using diffusion tensor imaging (DTI), an MRI technique sensitive to subvoxel microstructural orientation and density. To test this hypothesis, we measured DTI characteristics, including apparent diffusion coefficient (ADC), fr...

Tuberous sclerosis complex is a multisystem genetic syndrome often affecting the central nervous system. The purpose of the current study was to identify topographical patterns in the distribution specific to epileptogenic (n = 37) and nonepileptogenic (n = 544) tubers throughout the brain for a cohort of 23 tuberous sclerosis complex patients with a history of seizures. Tubers localized to the inferior parietal lobes, middle frontal lobes, middle temporal lobes, or central sulcus regions were associated with a high frequency of epileptogenic tubers. Epileptogenic tubers occurred statistically more frequently within the inferior parietal lobe and within the central sulcus region in children younger than 1 or between 1 and 3 years old, respectively. Results imply seizure activity in tuberous sclerosis complex patients can be associated with the location of cortical tubers.

The article deals with scientific and methodological substantiation and description of the competency model of a modern leader and manager in scientific and technological sphere. This model has been developed by the authors on the initiative of the Coordinating Council for Youth Affairs in Scientific and Educational Spheres of the Presidential Council for Science and Education in the framework of the managers’ contest “Leaders of Russia” (specialization “Science”, season 2019– 2020). The competency model is aimed at improving the efficiency of solving the problems of scientific and technological development of Russia by overcoming the lack of personnel which is ready not only to conduct research at the world level, but also to take responsibility for the formation of priorities for scientific and technological development that meet the interests of Russia, as well as for their implementation. The proposed model is the first of its kind developed and tested system of competencies for improving leadership and management potential of Russian science.