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Investigation of altered microstructure in patients with drug refractory epilepsy using diffusion tensor imaging

  • Functional Neuroradiology
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Abstract

Purpose

The risk of refractory epilepsy can be more dangerous than the adverse effect caused by medical treatment. In this study, we employed voxel-wise analysis (VWA) and tract-based spatial statistics (TBSS) methods to measure microstructural changes using diffusion tensor imaging (DTI) in patients of drug refractory epilepsy (DRE) who had been epileptic for more than 10 years.

Methods

To examine the specific microstructural abnormalities in DRE patients and its difference from medically controlled epilepsy (MCE), we acquired DTI data of 7 DRE patients, 37 MCE patients, and 31 healthy controls (HCs) using a 3 T MRI scanner. Comparisons between epileptic patients and HCs between MCE and DRE patients were performed based on calculated diffusion anisotropic indices data using VWA and TBSS.

Results

Compared to HCs, epileptic patients (including MCE and DRE) showed significant DTI changes in the common affected regions based on VWA, whereas TBSS found that widespread DTI changes in parts of microstructures of bilateral hemispheres were more obvious in the DRE patients than that in the MCE patients when compared with HCs. In contrast, significant reduction of fractional anisotropy values of thalamo-cortical fibers, including left superior temporal gyrus, insular cortex, pre-/post-central gyri, and thalamus, were further found in DRE patients compared with MCE.

Conclusion

The results of multiple diffusion anisotropic indices data provide complementary information to understand the dysfunction of thalamo-cortical pathway in DRE patients, which may be contributors to disorder of language and motor functions. Our current study may shed light on the pathophysiology of DRE.

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Authors and Affiliations

  1. Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, People’s Republic of China

    Yuwei Jiang, Xu Yan & Mingxia Fan

  2. Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China

    Lingyan Mao, Xin Wang & Jing Ding

  3. MRI Unit/Epidemiology Division, Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY, 10032, USA

    Dongrong Xu

Authors
  1. Yuwei Jiang
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  2. Lingyan Mao
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  3. Xu Yan
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  4. Mingxia Fan
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  5. Xin Wang
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  7. Dongrong Xu
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Corresponding author

Correspondence to Dongrong Xu.

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Funding

This study was funded in part by grants from the China National Natural Science Foundation (Nos. 81471734 and 31271188), a grant from the China National 13th Five-Year Program and a grant from the Shanghai Municipal Committee of Science and Technology (No. 13DJ1400300).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Zhongshan Hospital affiliated with Fudan University Internal Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. 

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Jiang, Y., Mao, L., Yan, X. et al. Investigation of altered microstructure in patients with drug refractory epilepsy using diffusion tensor imaging. Neuroradiology 59, 597–608 (2017). https://doi.org/10.1007/s00234-017-1835-x

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  • DOI: https://doi.org/10.1007/s00234-017-1835-x

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