Evaluation of the microstructural integrity of the uncinate tract in patients with temporal lobe epilepsy and its relation to pharmacological treatment response: a study of diffusion tensor images of magnetic resonance

• Grant number: 13/07856-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): July 01, 2013
• Effective date (End): June 30, 2014
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Cendes
• Grantee: Amanda Dantas Silva
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Recent studies showed that patients with mesial temporal lobe epilepsy (MTLE) had reduced anisotropy in the uncinate fasciculus, both ipsilateral and contralateral to the epileptic focus, and in addition, there is a significant correlation between changes of diffusivity and duration of epilepsy. Probably the uncinate fasciculus plays a fundamental role in the propagation of temporal lobe epileptic activity to the frontal lobe. The objective of this study is to evaluate whether there is a relationship between temporal lobe epilepsy with and without hippocampal sclerosis, and fiber changes in the uncinate fasciculus, and response to treatment with antiepileptic drugs (AEDs), using the technique of diffusion tensor image (DTI). We will include patients with clinical and electroencephalographic criteria of MTLE. We will include 4 groups of patients with MTLE: MTLE with HS and good response to AEDs; MTLE with HS and refractory to AEDs; MTLE without HS with good response to AEDs and MTLE without HS refractory to AEDs; and a group of normal controls. The fractional anisotropy (FA) and mean diffusivity (MD) will be determined from DTI sequences. The calculation of MD and FA maps result in parametric maps dependent on these factors for each individual. After obtaining the MD and FA maps for all individuals, the uncinate tracts will be drawn by placing a seed in the region of origin of the uncinate fasciculus, in an intermediate zone, and in the path of the target area of this tract. We will evaluate if the FA and MD values are related to the clinical variables defined above. (AU)