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Related Experiment Videos

Diffusion mapping applied to mesial temporal lobe epilepsy: preliminary observations.

J W Hugg1, E J Butterworth, R I Kuzniecky

  • 1UAB Epilepsy Center and Center for Nuclear Imaging Research, Department of Neurology, University of Alabama at Birmingham, 35294-0021, USA.

Neurology
|July 17, 1999
PubMed
Summary

Diffusion mapping can identify the seizure focus in patients with mesial temporal lobe epilepsy (MTLE). Elevated apparent diffusion coefficient of water (ADCw) in the hippocampus suggests an epileptogenic region, aiding in seizure lateralization.

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Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Diffusion MRI

Background:

  • Animal models indicate altered water diffusion post-seizure.
  • Apparent diffusion coefficient of water (ADCw) changes acutely, normalizes, then elevates chronically.
  • Interictal elevation of ADCw is observed in chronic seizure models.

Purpose of the Study:

  • To determine if diffusion mapping can lateralize intractable seizures in mesial temporal lobe epilepsy (MTLE) patients.
  • To investigate the utility of apparent diffusion coefficient of water (ADCw) mapping for seizure focus identification.

Main Methods:

  • Utilized diffusion mapping with five diffusion weightings along each axis.
  • Generated isotropic ADCw maps by averaging three orthogonal ADCw maps.
  • Corroborated seizure focus lateralization with electrography and volumetric MRI.

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Main Results:

  • Interictal elevation of ADCw (mean 10+/-3%, p<0.01) was observed in the ipsilateral hippocampus of all eight MTLE patients.
  • ADCw values in phantoms and normal brains aligned with published data.
  • Demonstrated a statistically significant increase in ADCw in the epileptic hippocampus.

Conclusions:

  • Interictally increased ADCw may indicate an epileptogenic zone characterized by neuronal loss and gliosis (hippocampal sclerosis).
  • Diffusion mapping shows promise in confirming seizure lateralization in MTLE.
  • This technique could improve the localization of seizure foci for surgical planning.