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Diffusion tensor imaging in patients with epilepsy and malformations of cortical development
S H Eriksson1, F J Rugg-Gunn, M R Symms
1The MRI Unit, National Society for Epilepsy and Epilepsy Research Group, National Hospital for Neurology and Neurosurgery, Chalfont St. Peter, Gerrards Cross, Bucks SL9 0RJ, UK.
Brain : a Journal of Neurology
|February 27, 2001
Summary
Malformations of cortical development (MCD) cause epilepsy. Diffusion tensor imaging revealed widespread tissue abnormalities beyond visible lesions in MCD patients, impacting surgical planning.
Area of Science:
- Neuroimaging
- Epileptology
- Neuropathology
Background:
- Malformations of cortical development (MCD) are a significant cause of epilepsy.
- Conventional MRI and PET studies indicate widespread changes in MCD patients, extending beyond visible lesions.
- The extent and nature of diffusion abnormalities in MCD remain incompletely understood.
Purpose of the Study:
- To investigate interictal diffusion changes in patients with Malformations of Cortical Development (MCD).
- To test the hypothesis that MCD is associated with widespread diffusion abnormalities.
- To objectively assess tissue organization using diffusion tensor imaging (DTI).
Main Methods:
- Diffusion Tensor Imaging (DTI) was used to acquire whole-brain data.
- Statistical Parametric Mapping (SPM) was employed for objective comparison of tissue organization.
- 22 patients with partial seizures and MCD were compared with 30 healthy control subjects.
Main Results:
- Reduced anisotropy was observed in 17 patients, while 10 showed increased diffusivity.
- Increased diffusivity areas were generally more extensive than reduced anisotropy areas.
- Diffusion abnormalities extended beyond visually identified lesions in multiple patients, providing additional information to conventional MRI.
Conclusions:
- Malformations of Cortical Development (MCD) are associated with widespread diffusion abnormalities.
- These widespread changes, detectable by DTI, extend beyond the visible lesions.
- The extensive nature of these abnormalities is a crucial consideration for surgical treatment planning in MCD patients.