Diffusion tensor MRI in temporal lobe epilepsy.

The purpose of this study was to investigate the diffusion characteristics of white matter in patients with focal temporal lobe epilepsy (TLE). Diffusion tensor imaging (DTI) was applied to patients and normal controls. Rotationally invariant mean diffusivity and diffusion anisotropy maps were calculated for all subjects. Comparisons between the two groups were performed for several white matter structures. Mean diffusivity and diffusion anisotropy of each selected structure were tested for correlations with age at onset and duration of epilepsy. Significantly lower diffusion anisotropy, and higher diffusivity in directions perpendicular to the axons, was detected in several white matter structures of the patients when compared to the controls. These structures were not located in the temporal lobes. No significant difference in mean diffusivity was detected between the selected structures from the two groups. Diffusion anisotropy was significantly correlated with age at onset of epilepsy in the posterior corpus callosum. Duration of epilepsy was not significantly correlated with the diffusion indices from any of the selected structures. The results of this study suggest that diffusion anisotropy may reveal abnormalities in patients with focal TLE. In addition, these abnormal changes are not necessarily restricted to the temporal lobes but might extend in other brain regions as well. Furthermore, the age at onset of epilepsy may be an important factor in determining the extent of the effect of epilepsy on white matter.