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Diffusion Abnormality in Temporal Lobe Epilepsy Patients With Sleep Disorders: A Diffusion Kurtosis Imaging Study
Min Guo1, Boxing Shen1, Jinhong Li1
1Department of Radiology, Yanan University Affiliated Hospital, Yanan, China.
Frontiers in Psychiatry
|June 13, 2022
Summary
Temporal lobe epilepsy (TLE) patients often experience poor sleep quality. Diffusion kurtosis imaging (DKI) revealed white matter abnormalities in TLE patients with sleep disorders, with mean kurtosis (MK) being a sensitive indicator.
Area of Science:
- Neuroscience
- Medical Imaging
- Sleep Medicine
Background:
- Temporal lobe epilepsy (TLE) is frequently associated with poor sleep quality, a symptom often overlooked by clinicians.
- Standard sleep assessment tools include the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Athens Insomnia Scale (AIS).
- Diffusion Kurtosis Imaging (DKI) is a technique used to examine white matter microstructure abnormalities.
Purpose of the Study:
- To assess sleep status in TLE patients using standard questionnaires.
- To investigate white matter microstructure abnormalities in TLE patients with sleep disorders using DKI.
- To compare DKI parameters between TLE patients with and without sleep disorders and healthy controls.
Main Methods:
- Recruited 51 TLE patients and 30 healthy controls diagnosed between October 2020 and August 2021.
- Administered sleep evaluation questionnaires (ESS, PSQI, AIS) and conducted DKI examinations.
- Employed statistical analyses including independent sample t-test, ANOVA, and Mann-Whitney U test for group comparisons.
Main Results:
- A significant proportion of TLE patients (58.82%) reported long-term sleep difficulties.
- Statistically significant differences in AIS, ESS, and PSQI scores were observed between TLE patients with sleep disorders and controls.
- Decreased mean kurtosis (MK) was observed in TLE patients with sleep disorders, particularly in the affected hemisphere, indicating white matter abnormalities. Tensor parameters (MD, FA) showed less significant differences.
Conclusions:
- TLE patients with sleep disorders exhibit distinct DKI parameters compared to those without sleep issues.
- Mean kurtosis (MK) is more sensitive than diffusion tensor imaging (DTI) parameters (MD, FA) in detecting aberrant white matter diffusion in TLE patients.
- DKI is a valuable tool for in vivo investigation of anomalous craniocerebral water diffusion in TLE.
