White matter abnormalities associate with type and localization of focal epileptogenic lesions

Autor(es)

Campos, Brunno M. ^[1] ; Coan, Ana C. ^[1] ; Beltramini, Guilherme C. ^[2] ; Liu, Min ^[3] ; Yassuda, Clarissa L. ^[1] ; Ghizoni, Enrico ^[1] ; Beaulieu, Christian ^[3] ; Gross, Donald W. ^[4] ; Cendes, Fernando ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Neuroimaging Lab, Dept Neurol, Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Gleb Wataghin Phys Inst, Neurophys Grp, Campinas, SP - Brazil

^[3] Univ Alberta, Fac Med & Dent, Dept Biomed Engn, Edmonton, AB - Canada

^[4] Univ Alberta, Dept Med, Div Neurol, Fac Med & Dent, Edmonton, AB - Canada

• Tipo de documento: Artigo Científico
• Fonte: Epilepsia; v. 56, n. 1, p. 125-132, JAN 2015.
• Citações Web of Science: 20

Resumo

ObjectiveTo evaluate white matter (WM) integrity of distinct groups of patients with antiepileptic drug (AED)-resistant localization-related epilepsies. MethodsWe used diffusion tensor imaging (DTI) fiber-tractography and voxel-based morphometry (VBM) to investigate differences of WM micro- and macrostructural integrity in patients with different drug-resistant localization-related epilepsies: 17 with temporal lobe epilepsy with magnetic resonance imaging (MRI) signs of hippocampal sclerosis (TLE-HS), 17 with TLE and normal MRI (TLE-NL), 14 with frontal lobe epilepsy and subtle MRI signs of focal cortical dysplasia (FLE-FCD), and 112 healthy controls. We performed fiber-tractography using a semiautomatic deterministic method to yield average fractional anisotropy (FA), axial (AD), and radial (RD) diffusivity ipsilateral and contralateral to the epileptogenic zone of the following tracts based on their functional and anatomic relevance: body of fornix (BoF), body of cingulum (BoC), inferior frontal occipital (IFO), and uncinate fasciculi (UF). In addition, we performed VBM of the WM maps to assess macrostructural integrity differences among groups. ResultsTLE-HS had ipsilateral and contralateral decreased FA and increased RD for all tracts. VBM showed WM alterations mainly in the ipsilateral parahippocampal region and contralateral superior temporal gyrus. FLE-FCD showed bilateral FA decreases only in the BoC and ipsilateral RD increases also in the BoC. VBM showed WM reduction mainly in the ipsilateral precuneus and posterior and anterior cingulum. No significant WM alterations were found in the TLE-NL in DTI or VBM analysis. SignificanceWM abnormalities differ in distinct AED-resistant localization-related epilepsies. The diverse distribution of the WM damage in these patients suggests that the localization of the epileptic networks may play a role in the WM burden. However, the distinct degree of this damage, more accentuated in TLE-HS, also suggests that the underlying cause of the epilepsy is probably an additional factor to explain this WM damage. (AU)

• Processo FAPESP: 13/07559-3 - Instituto Brasileiro de Neurociência e Neurotecnologia - BRAINN
• Beneficiário: Fernando Cendes
• Modalidade de apoio: Auxílio à Pesquisa - Centros de Pesquisa, Inovação e Difusão - CEPIDs
• Processo FAPESP: 13/00099-7 - Aprimoramento da técnica de EEG-RMf na avaliação pré-operatória de pacientes com epilepsias focais refratárias
• Beneficiário: Ana Carolina Coan
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado