Through Diffusion Tensor Magnetic Resonance Imaging to Evaluate the Original Properties of Neural Pathways of Patients with Partial Seizures and Secondary Generalization by Individual Anatomic Reference Atlas

Abstract

To investigate white matter (WM) abnormalities in neocortical epilepsy, we extract supratentorial WM parameters from raw tensor magnetic resonance images (MRI) with automated region-of-interest (ROI) registrations. Sixteen patients having neocortical seizures with secondarily generalised convulsions and 16 age-matched normal subjects were imaged with high-resolution and diffusion tensor MRIs. Automated demarcation of supratentorial fibers was accomplished with personalized fiber-labeled atlases. From the individual atlases, we observed significant elevation of mean diffusivity (MD) in fornix (cres)/stria terminalis (FX/ST) and sagittal stratum (SS) and a significant difference in fractional anisotropy (FA) among FX/ST, SS, posterior limb of the internal capsule (PLIC), and posterior thalamic radiation (PTR). For patients with early-onset epilepsy, the diffusivities of the SS and the retrolenticular part of the internal capsule were significantly elevated, and the anisotropies of the FX/ST and SS were significantly decreased. In the drug-resistant subgroup, the MDs of SS and PTR and the FAs of SS and PLIC were significantly different. Onset age was positively correlated with increases in FAs of the genu of the corpus callosum. Patients with neocortical seizures and secondary generalisation had microstructural anomalies in WM. The changes in WM are relevant to early onset, progression, and severity of epilepsy.

White matter abnormalities at a regional and voxel level in focal and generalized epilepsy: A systematic review and meta-analysis

“…The total number of people with epilepsy and controls was 1027 and 1122, respectively. Sixteen voxel-based studies were included, with 312 patients and 500 controls (Amarreh et al, 2014, Bonilha et al, 2015, Concha et al, 2012, Focke et al, 2014, Keller et al, 2013, Kim et al, 2012, Kim et al, 2014, Li et al, 2010, Liu et al, 2015, O'Muircheartaigh et al, 2011, Peng et al, 2014, Riley et al, 2010, Rugg-Gunn et al, 2001, Wang et al, 2011, Whelan et al, 2015, Yang et al, 2012). One of these studies was also included in the meta-analysis (Li et al, 2010).…”

Reappraisal of corpus callosotomy

“…There was a significant decrease of the fractional anisotropy values in the first DTI, which was no longer seen 1 year postoperatively in the patients with seizure recurrence [9]. However, the groups were small, and the possibility that recurrent seizures might affect the fractional anisotropy values [11,12] was not discussed [9]. A possible reorganization of sectioned axons was suggested as an explanation [9] that seems very unlikely.…”

Diffusion MRI and its Role in Neuropsychology

“…TBSS is a more sophisticated approach than traditional VBM allowing more precise spatial comparison across subjects, preventing partial volume effects and preventing cross-contamination of different tissues (Peng et al 2014). However, TBSS has some disadvantages.…”