Quantitative relaxometry and diffusion MRI for lateralization in MTS and non-MTS temporal lobe epilepsy

Area of Science:

• Neuroimaging
• Epilepsy Research
• Quantitative MRI

Background:

• Temporal lobe epilepsy (TLE) diagnosis relies on accurate seizure onset localization.
• Quantitative MRI techniques offer potential for improved lateralization in TLE.

Purpose of the Study:

• To investigate quantitative relaxometry (T1, T2) and diffusion tensor imaging (DTI) for lateralizing TLE.
• To compare MRI metrics between patients with mesial temporal sclerosis (MTS), non-MTS TLE, and healthy controls.

Main Methods:

• Voxel-based analysis of anterior temporal lobes in TLE patients and controls.
• Computation of laterality indices for T1, T2, and DTI metrics (FA, MD, AD, RD).
• Development of patient-specific multi-modal laterality indices.

Main Results:

• Diffusivity metrics (FA, MD, AD, RD) were most effective for lateralizing both MTS and non-MTS TLE.
• Multi-modal laterality indices accurately separated left-onset and right-onset TLE.
• Left-onset TLE patients showed stronger laterality indices.
• Neocortical abnormalities were more prevalent in non-MTS TLE patients.

Conclusions:

• Quantitative MRI and multi-modal analysis show promise for clinical seizure onset determination in TLE.
• Neocortical abnormalities in non-MTS TLE warrant further investigation for their role in seizure onset/propagation.