Voxel-based diffusion tensor imaging in patients with mesial temporal lobe epilepsy and hippocampal sclerosis

Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

“…Similar to previous studies, 3,5,9,18 our analyses revealed FA reduction and MD elevation in the temporal and extratemporal WM, more prominent ipsilateral to the HS regardless of patient sex and lateralization of the HS. However, these studies compared DTI changes in patients with TLE with or without HS, 3 searched for a correlation between DTI findings and surgical outcome, 9 and considered the effect of the age of seizure onset and the duration of epilepsy but did not consider the sex of the patients.…”

“…In our study, the severity or extent of diffusion changes could not be solely attributed to the lateralization of HS, as more prominent WM diffusion changes were associated with different-sided HS between men and women. The previous finding 18 of limited WM involvement in right HS compared with left HS might have partly resulted from the outweighing proportion of men in the patient group. On the contrary, in left HS, men showed more extensive alterations of anisotropy compared with women.…”

“…7 Changes in diffusion measures were commonly observed in the cingulum, fornix, superior longitudinal and inferior longitudinal fasciculi, corpus callosum, uncinate fasciculus, and the external and internal capsules in patients with TLE with HS. 9,18,19 These changes may represent an underlying predisposing abnormality in production of TLE, abnormal networks in seizure propagation, reorganization of WM networks or solely damage caused by the seizures themselves, and use of antiepileptic drugs.…”

In VivoDiffusion Tensor Imaging and Histopathology of the Fimbria-Fornix in Temporal Lobe Epilepsy

“…While mesial temporal sclerosis (MTS) is the most commonly observed pathology in TLE, DTI studies have shown white matter abnormalities in several bundles not necessarily limited to the temporal lobe nor the hemisphere ipsilateral to seizure focus (Arfanakis et al, 2002;Gross et al, 2006;Rodrigo et al, 2007;Focke et al, 2008;McDonald et al, 2008;Nilsson et al, 2008;Yogarajah et al, 2008;Schoene-Bake et al, 2009). We have previously demonstrated that TLE patients with unilateral MTS (TLEϩuMTS) have DTI abnormalities of the fimbria-fornix (Concha et al, 2005b) that are not observed in TLE patients who do not have MTS (TLEϪMTS) (Concha et al, 2009).…”

Diffusion Tensor Imaging Assessment of the Epileptogenic Zone in Children with Localization-Related Epilepsy

“…Second, smoothing is not required in TBSS, thereby reducing partial volume effects and cross-contamination of different tissues. Focke et al 35 evaluated patients with mesial TLE and found that TBSS was more sensitive than SPM and demonstrated more widespread FA and MD abnormalities both in the ipsilateral and contralateral temporal and extratemporal white matter.…”