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High b-value diffusion tractography: Abnormal axonal network organization associated with medication-refractory

Ezequiel Gleichgerrcht1, Simon S Keller2, Lorna Bryant3

  • 1Department of Neurology, Medical University of South Carolina, Charleston, SC, USA.

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|January 2, 2022
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Summary

Fiber Ball Imaging (FBI) tractography improves brain network analysis in epilepsy. Drug-resistant epilepsy shows increased network segregation, suggesting FBI

Keywords:
DiffusionFiber ball imagingFocal epilepsyMagnetic resonance imagingTractography

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Area of Science:

  • Neuroimaging
  • Epilepsy research
  • White matter tractography

Background:

  • Diffusion magnetic resonance imaging (dMRI) tractography is crucial for understanding epilepsy-related brain network changes.
  • Traditional dMRI accuracy is limited by complex white matter biophysical properties.
  • High b-value diffusion imaging offers improved axonal pathway isolation.

Purpose of the Study:

  • To introduce Fiber Ball Imaging (FBI) tractography for identifying atypical neuronal networks in epilepsy patients.
  • To compare network properties from diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), and FBI.
  • To assess the pathophysiological relevance of network rearrangement in medication-responsive versus medication-refractory focal epilepsy.

Main Methods:

  • Utilized high b-value diffusion imaging with Fiber Ball Imaging (FBI) to exclude non-axonal signals.
  • Compared tractography-derived network properties using DTI, DKI, and FBI.
  • Analyzed network topology in adult focal epilepsy patients, differentiating between medication-responsive and refractory groups.

Main Results:

  • Fiber Ball Imaging (FBI) tractography successfully identified atypical neuronal networks.
  • Drug-resistant epilepsy was associated with increased global network segregation when analyzed with FBI.
  • FBI-based tractography revealed distinct network topological changes compared to DTI and DKI.

Conclusions:

  • FBI tractography offers a more accurate method for analyzing brain networks in epilepsy by isolating axonal pathways.
  • Increased global network segregation detected by FBI is a potential biomarker for drug-resistant epilepsy.
  • FBI is a clinically feasible tool for quantifying topological brain changes, aiding disease tracking and outcome prediction.