Glymphatic system dysfunction in temporal lobe epilepsy patients with hippocampal sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Epilepsy Research

Background:

• Temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) is a common form of epilepsy.
• Glymphatic system dysfunction has been implicated in various neurological disorders.
• The role of glymphatic system impairment in TLE with HS requires further investigation.

Purpose of the Study:

• To evaluate glymphatic system function in TLE patients with HS using Diffusion Tensor Imaging-Analysis along the Perivascular Space (DTI-ALPS).
• To compare glymphatic system function between TLE patients with HS and healthy controls.
• To explore the correlation between glymphatic system function and clinical characteristics of epilepsy.

Main Methods:

• Retrospective enrollment of 25 TLE patients with HS and 26 healthy controls.
• Diffusion Tensor Imaging (DTI) acquisition using a 3T MRI scanner.
• Calculation of the DTI-ALPS index to assess glymphatic system function.

Main Results:

• A significantly lower DTI-ALPS index was observed in TLE patients with HS compared to healthy controls (1.497 vs. 1.668, P = .015).
• No significant difference in DTI-ALPS index was found between newly diagnosed and chronic TLE patients with HS.
• The DTI-ALPS index showed a negative correlation with patient age (r = -0.420, P = .036).

Conclusions:

• Glymphatic system dysfunction is present in TLE patients with HS, as evidenced by reduced DTI-ALPS index.
• The DTI-ALPS method shows potential utility in assessing glymphatic system function in epilepsy.
• Further research is warranted to elucidate the precise mechanisms and clinical implications of glymphatic dysfunction in TLE.