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White matter microstructural differences between right and left mesial temporal lobe epilepsy

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Abstract

Purpose

Mesial temporal lobe epilepsy (mTLE) is a chronic focal epileptic disorder characterized by recalcitrant seizures often necessitating surgical intervention. Identifying the laterality of seizure focus is crucial for pre-surgical planning. We implemented diffusion MRI (DMRI) connectometry to identify differences in white matter connectivity in patients with left and right mTLE relative to healthy control subjects.

Method

We enrolled 12 patients with right mTLE, 12 patients with left mTLE, and 12 age/sex matched healthy controls (HCs). We used DMRI connectometry to identify local connectivity patterns of white matter tracts, based on quantitative anisotropy (QA). We compared QA of white matter to reconstruct tracts with significant difference in connectivity between patients and HCs and then between patients with left and right mTLE.

Results

Right mTLE patients show higher anisotropy in left inferior longitudinal fasciculus (ILF) and forceps minor and lower QA in genu of corpus callosum (CC), bilateral corticospinal tracts (CSTs), and bilateral middle cerebellar peduncles (MCPs) compared to HCs. Left mTLE patients show higher anisotropy in genu of CC, bilateral CSTs, and right MCP and decreased anisotropy in forceps minor compared to HCs. Compared to patients with right mTLE, left mTLE patients showed increased and decreased connectivity in some major tracts.

Conclusions

Our study showed the pattern of microstructural disintegrity in mTLE patients relative to HCs. We demonstrated that left and right mTLE patients have discrepant alternations in their white matter microstructure. These results may indicate that left and right mTLE have different underlying pathologic mechanisms.

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Acknowledgement

This study was supported in part by NIH grant R01EB013227.

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Authors and Affiliations

  1. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Hossein Sanjari Moghaddam & Mohammad Hadi Aarabi

  2. NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Farzaneh Rahmani

  3. Student’s Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran

    Farzaneh Rahmani

  4. Research Center for Science and Technology in Medicine (RCSTIM), Tehran University of Medical Sciences, Tehran, Iran

    Mohammad-Reza Nazem-Zadeh

  5. Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, North Kargar Ave., Tehran, Iran

    Hamid Soltanian-Zadeh

  6. Image Analysis Laboratory, Departments of Radiology and Research Administration, Henry Ford Health System, One Ford Place, 2F, Detroit, MI, 48202, USA

    Esmaeil Davoodi-Bojd & Hamid Soltanian-Zadeh

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  1. Hossein Sanjari Moghaddam
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  2. Farzaneh Rahmani
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Correspondence to Hamid Soltanian-Zadeh.

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Ethical approval of the study was granted by the Institutional Review Board at Henry Ford Health System, Detroit, MI, USA.

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Hossein Sanjari Moghaddam, Farzaneh Rahmani and Mohammad Hadi Aarabi have equal contributions to this work.

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Sanjari Moghaddam, H., Rahmani, F., Aarabi, M. et al. White matter microstructural differences between right and left mesial temporal lobe epilepsy. Acta Neurol Belg 120, 1323–1331 (2020). https://doi.org/10.1007/s13760-019-01074-x

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