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Abnormal white matter on diffusion tensor imaging in children with new-onset seizures
1Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada. Elysa.Widjaja@sickkids.ca
Insights
Diffusion tensor imaging reveals white matter (WM) integrity impairments in children with new-onset seizures. These findings suggest abnormalities in myelin and axons are present in pediatric epilepsy.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- White Matter Disorders
Background:
- New-onset seizures in children can indicate underlying neurological conditions.
- White matter integrity is crucial for normal brain development and function.
- Diffusion Tensor Imaging (DTI) is a sensitive tool for assessing white matter microstructure.
Purpose of the Study:
- To investigate white matter (WM) integrity using whole-brain quantitative analysis in children with new-onset seizures.
- To identify specific patterns of WM alterations in relation to seizure types (partial vs. generalized).
- To correlate DTI findings with potential myelin and axonal damage.
Main Methods:
- Recruited 35 children with new-onset seizures (normal MRI) and 31 healthy controls.
- Performed whole-brain quantitative analysis of DTI metrics: fractional anisotropy (FA), apparent diffusion coefficient (ADC), radial diffusivity (RD), and axial diffusivity (AD).
- Compared DTI maps between patients and controls, with corrections for multiple comparisons.
Main Results:
- Significantly reduced FA in the left postcentral region was observed in patients.
- Elevated RD in the left posterior cingulum and right external capsule.
- Elevated AD in the left middle temporal WM and left thalamus; reduced AD in left anterior cingulum, left temporal, and right supramarginal WM.
- Specific WM alterations were noted for partial and generalized epilepsy subtypes.
Conclusions:
- Children with new-onset seizures exhibit impaired white matter integrity.
- Abnormalities in myelin and axons are suggested by the DTI findings.
- DTI can detect subtle white matter changes in pediatric epilepsy even with normal conventional MRI.
Abstract:
The aim of this study was to use whole brain quantitative analysis to identify impaired white matter (WM) integrity using diffusion tensor imaging (DTI) in children with new-onset seizures. Thirty-five children with new-onset seizures and normal MRI were recruited. Twelve patients had generalized seizures, and 23 had partial seizures. Thirty-one healthy controls were also recruited. Whole brain fractional anisotropy (FA), apparent diffusion coefficient (ADC), radial diffusivity (RD) and axial diffusivity (AD) maps of patients were compared to controls, corrected for multiple comparisons. There was significantly reduced FA in left postcentral, elevated RD in left posterior cingulum and right external capsule, elevated AD in left middle temporal WM and left thalamus, and reduced AD in left anterior cingulum, left temporal, and right supramarginal WM in patients relative to controls. Patients with partial epilepsy showed elevated RD in bilateral posterior cingulum, increased AD in left middle frontal, reduced AD in left temporal, right parietal and right supramarginal WM. Patients with generalized epilepsy showed increased AD in right cerebellum, and reduced AD in left anterior cingulum and left middle temporal WM. The findings indicate that impaired WM integrity with abnormal myelin and axons is present in children with new-onset seizures.
