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Extratemporal white matter abnormalities in mesial temporal lobe epilepsy demonstrated with diffusion tensor imaging
Donald W Gross1, Luis Concha, Christian Beaulieu
1Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. donald.gross@ualberta.ca
Epilepsia
|August 23, 2006
Summary
Temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) shows extratemporal white matter abnormalities. These diffusion tensor imaging (DTI) findings in TLE patients do not predict worse surgical outcomes.
Area of Science:
- Neuroimaging
- Epilepsy Research
- White Matter Integrity
Background:
- Temporal lobe epilepsy (TLE) with unilateral mesial temporal sclerosis (MTS) is often associated with bilateral white matter abnormalities.
- Understanding extratemporal white matter involvement is crucial for predicting surgical outcomes.
Purpose of the Study:
- To investigate water diffusion abnormalities in extratemporal white matter of TLE patients with confirmed MTS.
- To correlate these diffusion findings with surgical outcomes.
Main Methods:
- Diffusion tensor imaging (DTI) and T2 relaxometry were used in 11 TLE patients and 14 controls.
- Surgical specimens confirmed unilateral MTS in all TLE patients.
Main Results:
- Elevated hippocampal T2 signal was observed ipsilateral and contralateral to MTS.
- Reduced fractional anisotropy and elevated mean diffusivity were found in the genu of the corpus callosum and external capsule.
- Perpendicular diffusion was elevated in the genu and external capsule, but parallel diffusion was not significantly different from controls.
Conclusions:
- TLE patients with MTS exhibit extensive bilateral and extratemporal white matter pathology.
- These extratemporal abnormalities do not appear to be associated with poorer surgical outcomes.