White matter microstructural differences between right and left mesial temporal lobe epilepsy
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ORIGINAL ARTICLE
White matter microstructural differences between right and left mesial temporal lobe epilepsy Hossein Sanjari Moghaddam1 · Farzaneh Rahmani2,3 · Mohammad Hadi Aarabi1 · Mohammad‑Reza Nazem‑Zadeh4 · Esmaeil Davoodi‑Bojd6 · Hamid Soltanian‑Zadeh5,6 Received: 25 October 2018 / Accepted: 5 January 2019 © Belgian Neurological Society 2019
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. Keywords Temporal lobe epilepsy · Diffusion magnetic resonance imaging (DMRI) · Connectometry
Introduction
Hossein Sanjari Moghaddam, Farzaneh Rahmani and Mohammad Hadi Aarabi have equal contributions to this work. * Hamid Soltanian‑Zadeh [email protected]; [email protected] 1
Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2
NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
3
Student’s Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
4
Research Center for Science and Technology in Medicine (RCSTIM), Tehran University of Medical Sciences, Tehran, Iran
Mesial temporal lobe epilepsy (mTLE) is the most common form of localization-related epilepsy. mTLE is characterized by focal seizures arising from the inner aspect of the 5
Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, Colleg
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