Bilateral white matter abnormality in children with frontal lobe epilepsy

In frontal lobe epilepsy (FLE), interictal discharges and seizures are more likely to spread to contralateral hemisphere and become secondarily generalized. The aim of this study was to assess white matter (WM) integrity in children with FLE using diffusion tensor imaging (DTI). Children with FLE and normal MRI, and healthy controls with no neurological or psychiatric disorders underwent DTI on 3T MRI. Whole brain fractional anisotropy (FA) and mean diffusivity (MD) maps were compared between right and left FLE with controls. 43 children with FLE, consisting of 28 left and 15 right FLE, and 44 healthy controls were recruited. Patients with left FLE had significant FA reductions in left (p=0.002) and right (p=0.003 and p=0.034) superior longitudinal fasciculi (SLF), genu/body (p=0.0002) and splenium (p=0.011) of corpus callosum. Patients with right FLE had significant FA reductions in left (p=0.016) and right (p=0.033) SLF, genu (p=0.001) and body of corpus callosum (p=0.001 and p=0.008), and significant MD elevation in right thalamus (p=0.032). There was no significant association between FA or MD and clinical seizure parameters. The abnormal WM both ipsilateral and contralateral to seizure focus may be due to seizure activity or abnormal brain development.