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Related Experiment Videos

Diffusion tensor imaging of cryptogenic and acquired partial epilepsies.

F J Rugg-Gunn1, S H Eriksson, 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
PubMed
Summary

Diffusion tensor imaging (DTI) detects subtle brain abnormalities in patients with partial seizures, even when conventional MRI appears normal. This advanced imaging aids in identifying the causes of seizures for pre-surgical evaluation.

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Area of Science:

  • Neuroimaging
  • Epileptology
  • Radiology

Background:

  • Optimal MRI identifies structural abnormalities in up to 80% of refractory partial seizure patients.
  • Identifying structural lesions is crucial for pre-surgical evaluation in epilepsy.
  • Conventional MRI may miss subtle abnormalities in some epilepsy cases.

Purpose of the Study:

  • To objectively examine cerebral tissue's diffusion properties using diffusion tensor imaging (DTI) and statistical parametric mapping (SPM).
  • To assess DTI's sensitivity in detecting structural disorganization in patients with partial seizures, including those with normal conventional MRI.
  • To evaluate DTI's contribution to pre-surgical evaluation for refractory partial epilepsy.

Main Methods:

  • Diffusion tensor imaging (DTI) and statistical parametric mapping (SPM) were used to analyze diffusion properties.

Related Experiment Videos

  • Fractional anisotropy and mean diffusivity maps were calculated for 10 patients with acquired lesions and 30 with normal MRI.
  • Individual and group analyses compared patients to 30 control subjects using voxel-by-voxel statistical comparisons.

    • Main Results:

    • DTI identified significant increases in diffusivity and reductions in anisotropy in patients with acquired lesions.
    • DTI detected abnormalities in 10 areas that appeared normal on conventional MRI.
    • In MRI-negative patients, DTI revealed significant diffusivity increases in 8 subjects and anisotropy differences in 2, correlating with epileptiform EEG activity or seizure localization.

    Conclusions:

    • DTI analyzed with SPM is sensitive in detecting acquired cerebral damage and subtle structural disorganization in occult epileptogenic lesions.
    • DTI offers a promising, non-invasive method for identifying the causes of partial seizures.
    • These advanced imaging techniques can significantly contribute to the pre-surgical evaluation of epilepsy patients.