Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA.
Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.
J Neurol Neurosurg Psychiatry. 2016 Sep;87(9):930-6. doi: 10.1136/jnnp-2015-312980. Epub 2016 Apr 13.
Temporal lobe epilepsy (TLE) is one of the most common forms of epilepsy. Unfortunately, the clinical outcomes of TLE cannot be determined based only on current diagnostic modalities. A better understanding of white matter (WM) connectivity changes in TLE may aid the identification of network abnormalities associated with TLE and the phenotypic characterisation of the disease.
We implemented a novel approach for characterising microstructural changes along WM pathways using diffusional kurtosis imaging (DKI). Along-the-tract measures were compared for 32 subjects with left TLE and 36 age-matched and gender-matched controls along the left and right fimbria-fornix (FF), parahippocampal WM bundle (PWMB), arcuate fasciculus (AF), inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF) and cingulum bundle (CB). Limbic pathways were investigated in relation to seizure burden and control with antiepileptic drugs.
By evaluating measures along each tract, it was possible to identify abnormalities localised to specific tract subregions. Compared with healthy controls, subjects with TLE demonstrated pathological changes in circumscribed regions of the FF, PWMB, UF, AF and ILF. Several of these abnormalities were detected only by kurtosis-based and not by diffusivity-based measures. Structural WM changes correlated with seizure burden in the bilateral PWMB and cingulum.
DKI improves the characterisation of network abnormalities associated with TLE by revealing connectivity abnormalities that are not disclosed by other modalities. Since TLE is a neuronal network disorder, DKI may be well suited to fully assess structural network abnormalities related to epilepsy and thus serve as a tool for phenotypic characterisation of epilepsy.
颞叶癫痫（TLE）是最常见的癫痫类型之一。不幸的是，仅基于当前的诊断方式无法确定 TLE 的临床结果。更好地了解 TLE 中的白质（WM）连接变化可能有助于识别与 TLE 相关的网络异常，并对该疾病进行表型特征描述。
我们使用弥散峰度成像（DKI）实施了一种新的方法来描述 WM 通路中的微观结构变化。比较了 32 例左侧 TLE 患者和 36 名年龄和性别匹配的对照者在左侧和右侧穹窿伞（FF）、海马旁 WM 束（PWMB）、弓状束（AF）、下纵束（ILF）、钩束（UF）和扣带回束（CB）上的沿束测量值。研究了边缘通路与癫痫发作负担和抗癫痫药物控制之间的关系。
通过评估每条束路上的测量值，可以识别出定位于特定束区的异常。与健康对照组相比，TLE 患者在 FF、PWMB、UF、AF 和 ILF 的特定区域显示出病理性变化。这些异常中的一些仅通过基于峰度的测量而不是基于扩散的测量才能检测到。WM 结构变化与双侧 PWMB 和扣带回的癫痫发作负担相关。
DKI 通过揭示其他方式无法揭示的连接异常，改善了与 TLE 相关的网络异常的特征描述。由于 TLE 是一种神经元网络障碍，DKI 可能非常适合全面评估与癫痫相关的结构网络异常，从而成为癫痫表型特征描述的工具。
