Microstructural integrity of early- versus late-myelinating white matter tracts in medial temporal lobe epilepsy.

Abstract:

PURPOSE:Patients with medial temporal lobe epilepsy (MTLE) exhibit structural brain damage involving gray matter (GM) and white matter (WM). The mechanisms underlying tissue loss in MTLE are unclear and may be associated with a combination of seizure excitotoxicity and WM vulnerability. The goal of this study was to investigate whether late-myelinating WM tracts are more vulnerable to injury in MTLE compared with early myelinating tracts. METHODS:Diffusional kurtosis imaging scans were obtained from 25 patients with MTLE and from 36 matched healthy controls. Diffusion measures from regions of interest (ROIs) for both late- and early myelinating WM tracts were analyzed. Regional Z-scores were computed with respect to normal controls to compare WM in early myelinating tracts versus late-myelinating tracts. KEY FINDINGS:We observed that late-myelinating tracts exhibited a larger decrease in mean, axial, and radial kurtosis compared with early myelinating tracts. We also observed that the change in radial kurtosis was more pronounced in late-myelinating tracts ipsilateral to the side of seizure onset. SIGNIFICANCE:These results suggest a developmentally based preferential susceptibility of late-myelinating WM tracts to damage in MTLE. Brain injury in epilepsy may be due to the pathologic effects of seizures in combination with regional WM vulnerability.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Lee CY,Tabesh A,Benitez A,Helpern JA,Jensen JH,Bonilha L

doi

10.1111/epi.12353

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

1801-9

issue

10

eissn

0013-9580

issn

1528-1167

journal_volume

54

pub_type

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