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A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology
Published on: March 17, 2016
Histological and MRI markers of white matter damage in focal epilepsy
Francesco Deleo1, Maria Thom2, Luis Concha3
1NeuroImaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Canada.
Abstract:
Growing evidence highlights the importance of white matter in the pathogenesis of focal epilepsy. Ex vivo and post-mortem studies show pathological changes in epileptic patients in white matter myelination, axonal integrity, and cellular composition. Diffusion-weighted MRI and its analytical extensions, particularly diffusion tensor imaging (DTI), have been the most widely used technique to image the white matter in vivo for the last two decades, and have shown microstructural alterations in multiple tracts both in the vicinity and at distance from the epileptogenic focus. These techniques have also shown promising ability to predict cognitive status and response to pharmacological or surgical treatments. More recently, the hypothesis that focal epilepsy may be more adequately described as a system-level disorder has motivated a shift towards the study of macroscale brain connectivity. This review will cover emerging findings contributing to our understanding of white matter alterations in focal epilepsy, studied by means of histological and ultrastructural analyses, diffusion MRI, and large-scale network analysis. Focus is put on temporal lobe epilepsy and focal cortical dysplasia. This topic was addressed in a special interest group on neuroimaging at the 70th annual meeting of the American Epilepsy Society, held in Houston December 2-6, 2016.
Insights
White matter changes are crucial in focal epilepsy. Advanced imaging like diffusion tensor imaging (DTI) reveals microstructural alterations and aids in predicting treatment response.
Area of Science:
- Neuroscience
- Neurology
- Epileptology
Background:
- Growing evidence implicates white matter abnormalities in focal epilepsy pathogenesis.
- Histopathological studies reveal changes in myelination, axonal integrity, and cellular composition in epileptic white matter.
- Focal epilepsy is increasingly viewed as a system-level disorder affecting brain connectivity.
Purpose of the Study:
- To review emerging findings on white matter alterations in focal epilepsy.
- To highlight the role of neuroimaging techniques in understanding these changes.
- To focus on temporal lobe epilepsy and focal cortical dysplasia.
Main Methods:
- Histological and ultrastructural analyses of white matter.
- Diffusion MRI techniques, including diffusion tensor imaging (DTI), for in vivo imaging.
- Large-scale network analysis to study macroscale brain connectivity.
Main Results:
- Diffusion MRI (including DTI) has identified microstructural alterations in white matter tracts near and far from the epileptic focus.
- These imaging techniques show potential in predicting cognitive status and treatment outcomes.
- Emerging research explores system-level network disruptions in focal epilepsy.
Conclusions:
- White matter integrity is significantly affected in focal epilepsy.
- Advanced neuroimaging techniques like DTI are vital for characterizing these alterations.
- Understanding white matter changes is key to comprehending epilepsy as a network disorder and improving patient outcomes.
