White matter correlates of disease duration in patients with temporal lobe epilepsy: updated review of literature
Medial temporal lobe epilepsy (mTLE) has been associated with widespread white mater (WM) alternations in addition to mesial temporal sclerosis (MTS). Herein, we aimed to investigate the correlation between disease duration and WM structural abnormalities in mTLE using diffusion MRI (DMRI) connectometry approach.
DMRI connectometry was conducted on 24 patients with mTLE. A multiple regression model was used to investigate white matter tracts with microstructural correlates to disease duration, controlling for age and sex. DMRI data were processed in the MNI space using q-space diffeomorphic reconstruction to obtain the spin distribution function (SDF). The SDF values were converted to quantitative anisotropy (QA) and used in further analyses.
Connectometry analysis identified impaired white matter QA of the following fibers to be correlated with disease duration: bilateral retrosplenial cingulum, bilateral fornix, right inferior longitudinal fasciculus (ILF), and genu of corpus callosum (CC) (FDR = 0.009).
Our results were obtained from DMRI connectometry, which indicates the connectivity and the level of diffusion in nerve fibers rather just the direction of diffusion. Compared to previous studies investigating the correlation between duration of epilepsy and white matter integrity in mTLE patients, we detected broader and somewhat different associations in midline structures and component of limbic system. However, further studies with larger sample sizes are required to elucidate previous and current results.
KeywordsTemporal lobe epilepsy Diffusion MRI Connectometry Disease duration Spin distribution function
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval was provided by Henry Ford Health System Institutional Review Board, Detroit, Michigan, USA.
De-identified retrospective data was used in this research.
Glossary (adopted from: F.C Yeh; NeuroImage: Clinical 2 (2013): 912–921)
A magnetic resonance imaging method that generates images related to the density, direction, or velocity of water diffusion in the tissue.
A model to quantify local anatomical integration of brain voxels as nodes of a network using graph theory methods. The model generates a connectivity matrix.
A model free method to analyze diffusion MRI connectomics using permutation test to find the association of white matter pathways with a study factor. Connectometry essentially uses the “tracking the difference” paradigm.
A reconstruction method that calculates the density of diffusing water along the major fiber bundles from the diffusion MRI data. Local connectome finger print is found to be highly unique for each individual.
The quantity/density of the water diffusion in each direction of a given voxel/node of the connectivity matrix.
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