Cerebellum Abnormalities in Idiopathic Generalized Epilepsy with Generalized Tonic-Clonic Seizures Revealed by Diffusion Tensor Imaging

Abstract

Although there is increasing evidence suggesting that there may be subtle abnormalities in idiopathic generalized epilepsy (IGE) patients using modern neuroimaging techniques, most of these previous studies focused on the brain grey matter, leaving the underlying white matter abnormalities in IGE largely unknown, which baffles the treatment as well as the understanding of IGE. In this work, we adopted multiple methods from different levels based on diffusion tensor imaging (DTI) to analyze the white matter abnormalities in 14 young male IGE patients with generalized tonic-clonic seizures (GTCS) only, comparing with 29 age-matched male healthy controls. First, we performed a voxel-based analysis (VBA) of the fractional anisotropy (FA) images derived from DTI. Second, we used a tract-based spatial statistics (TBSS) method to explore the alterations within the white matter skeleton of the patients. Third, we adopted region-of-interest (ROI) analyses based on the findings of VBA and TBSS to further confirm abnormal brain regions in the patients. At last, considering the convergent evidences we found by VBA, TBSS and ROI analyses, a subsequent probabilistic fiber tractography study was performed to investigate the abnormal white matter connectivity in the patients. Significantly decreased FA values were consistently observed in the cerebellum of patients, providing fresh evidence and new clues for the important role of cerebellum in IGE with GTCS.

Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic‐clonic seizure: A voxel‐based diffusional kurtosis imaging study

“…Untreated patients with childhood absence epilepsy showed significantly higher FA in the bilateral thalamus, anterior corpus callosum, and upper brainstem (32). For children with GTCS, reduced FA was reported by Li et al (33), while normal FA was reported by Widjaja et al (34). These findings may indicate the variety of white matter characteristics in different periods of childhood with seizures of various types.…”

Cingulum bundle alterations underlie subjective fatigue in multiple sclerosis

“…16 Pattern of connectivity change evaluation Firstly, we used the JHU white matter atlas included in FSL 14 to identify if any of the included tracts presented with a significant overlap with the clusters identified in the voxel-wise analysis of diffusion data.…”

White matter abnormalities correlate with neurocognitive performance in patients with HBV-related cirrhosis

“…In addition, VBM has also been applied to investigate abnormal FA values that are computed from DTI data. Currently, voxel-based DTI analysis is a popular method for comparing DTI data across subjects [12,[16][17][18]; however, it has been proposed that voxel-based DTI has a low replication rate [19]. Thus, more relevant studies may be needed to accurately ascertain the WM abnormalities detected by voxel-based DTI due to the low number of voxel-based DTI analyses conducted in cirrhotic patients.…”