Along-tract statistical mapping of white matter abnormalities in children with SeLECTS

Emerging evidence suggests that self-limited epilepsy with centrotemporal spikes (SeLECTS) may reflect atypical neurodevelopment. As WM maturation extends from the second trimester through adolescence, this study aimed to identify regions of delayed or aberrant white matter (WM) development in children with SeLECTS using along-tract statistical mapping for precise localization of microstructural alterations.

38 children with SeLECTS and 31 healthy controls underwent diffusion-weighted MRI scan. Fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were derived from the diffusion tensor model. Whole-brain tractography was performed using deterministic EuDX tracking and registered to a standardized bundle atlas in MNI space. Thirty WM tracts per subject were extracted. Linear mixed models within the BUAN tractometry framework were used to assess segment wise group differences, while partial correlations were performed to evaluate associations between diffusion metrics and cognitive performance. FDR correction was applied per bundle for all comparisons.

After FDR correction, children with SeLECTS showed increased MD in the forceps minor, midbody of the corpus callosum, right corticospinal tract, right extreme capsule, and bilateral uncinate fasciculi. MD values in the affected WM segments showed negative correlations with performance and full-scale IQ, and the segments showing significant correlations overlapped with those showing significant group differences.

SeLECTS is associated with MD-based microstructural alterations in superficial frontal, temporal, and parietal pathways, potentially indicating delayed white matter maturation.