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Altered white matter integrity in temporal lobe epilepsy: Association with cognitive and clinical profiles
Authors:Jeffrey D Riley  David L Franklin  Vicky Choi  Ronald C Kim  Devin K Binder  Steven C Cramer  Jack J Lin
Institution:1. Department of Neurology, University of California, Irvine, California, U.S.A.;2. Department of Psychiatry and Human Behavior, University of California, Irvine, California, U.S.A.;3. Department of Pathology, University of California, Irvine, California, U.S.A.;4. Department of Neurological Surgery, University of California, Irvine, California, U.S.A.;5. Department of Anatomy & Neurobiology, University of California, Irvine, California, U.S.A.
Abstract:Purpose: Diffusion tensor imaging (DTI) studies have reported substantial white matter abnormalities in patients with temporal lobe epilepsy (TLE). However, limited data exist regarding the extent of white matter tract abnormalities, cognitive effects of these abnormalities, and relationship to clinical factors. The current study examined these issues in subjects with chronic TLE. Methods: DTI data were obtained in 12 TLE subjects and 10 age‐matched healthy controls. Voxel‐wise statistical analysis of fractional anisotropy (FA) was carried out using tract‐based spatial statistics (TBSS). White matter integrity was correlated with cognitive performance and epilepsy‐related clinical parameters. Results: Subjects with TLE, as compared to healthy controls, demonstrated four clusters of reduced FA, in anterior temporal lobe, mesial temporal lobe, and cerebellum ipsilateral, as well as frontoparietal lobe contralateral to the side of seizure onset. Mean FA was positively correlated with delayed memory, in anterior temporal lobe; and immediate memory, in mesial temporal lobe. Lower FA values in the posterior region of corpus callosum were related to earlier age of seizure onset. Conclusion: TLE is associated with widespread disturbances in white matter tracts and these changes have important cognitive and clinical consequences.
Keywords:Temporal lobe epilepsy  Diffusion tensor imaging  Cognition  Age of seizure onset
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