Lee Dong Ah, Lee Ho-Joon, Kim Sung Eun, Park Kang Min
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Epilepsia. 2025 Feb;66(2):531-540. doi: 10.1111/epi.18205. Epub 2024 Dec 5.
White matter abnormalities in patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) are well known. Peak width of skeletonized mean diffusivity (PSMD) is a novel marker for quantifying white matter integrity that may reflect small vessel disease. In this study, we aimed to quantify the extent of white matter damage in patients with TLE and HS by using PSMD.
We enrolled 52 patients with TLE with HS and 54 age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was performed using a 3-T magnetic resonance imaging scanner. We measured PSMD using DTI findings and compared PSMD between patients with TLE with HS and healthy controls. We also evaluated the correlation between PSMD and clinical factors in patients with TLE and HS.
PSMD differed significantly between healthy controls and patients with TLE and HS, and it was higher in the patients (2.375 × 10 mm/s vs. 2.108 × 10 mm/s, p < .001). Furthermore, PSMD in the ipsilateral hemisphere of the HS was higher than in the contralateral hemisphere of the HS (2.472 × 10 mm/s vs. 2.258 × 10 mm/s, p = .040). PSMD was positively correlated with age (r = .512, p < .001) and age at seizure onset (r = .423, p = .002) in patients with TLE and HS.
Patients with TLE and HS had higher PSMD values than healthy controls, and PSMD was positively correlated with age. These findings provide evidence of white matter damage probably due to small vessel disease in patients with TLE and HS and support the feasibility of PSMD as a promising imaging marker for epileptic disorders.
颞叶癫痫（TLE）合并海马硬化（HS）患者的白质异常已为人所知。骨架化平均扩散率峰值宽度（PSMD）是一种用于量化白质完整性的新型标志物，可能反映小血管疾病。在本研究中，我们旨在使用PSMD来量化TLE合并HS患者的白质损伤程度。
我们招募了52例TLE合并HS患者和54例年龄及性别匹配的健康对照者。使用3-T磁共振成像扫描仪进行扩散张量成像（DTI）。我们根据DTI结果测量PSMD，并比较TLE合并HS患者与健康对照者之间的PSMD。我们还评估了TLE合并HS患者中PSMD与临床因素之间的相关性。
健康对照者与TLE合并HS患者之间的PSMD存在显著差异，患者的PSMD更高（2.375×10⁻³mm²/s对2.108×10⁻³mm²/s，p＜0.001）。此外，HS同侧半球的PSMD高于HS对侧半球（2.472×10⁻³mm²/s对2.258×10⁻³mm²/s，p = 0.040）。在TLE合并HS患者中，PSMD与年龄呈正相关（r = 0.512，p＜0.001）以及与癫痫发作起始年龄呈正相关（r = 0.423，p = 0.002）。
TLE合并HS患者的PSMD值高于健康对照者，且PSMD与年龄呈正相关。这些发现提供了证据，表明TLE合并HS患者的白质损伤可能归因于小血管疾病，并支持PSMD作为癫痫疾病一种有前景的成像标志物的可行性。
