Altered white matter integrity in temporal lobe epilepsy: association with cognitive and clinical profiles.
OBJECTIVE
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.


CONCLUSIONS
TLE is associated with widespread disturbances in white matter tracts and these changes have important cognitive and clinical consequences.
Riley
Jeffrey D
JD
Department of Neurology, University of California, Irvine, CA 92868, USA.
Franklin
David L
DL
Choi
Vicky
V
Kim
Ronald C
RC
Binder
Devin K
DK
Cramer
Steven C
SC
Lin
Jack J
JJ
D000328:Adult; D017668:Age of Onset; D002531:Cerebellum / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D003337:Corpus Callosum / Q000473:pathology / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004292:Dominance, Cerebral / Q000502:physiology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology / Q000502:physiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D011594:Psychometrics; D012153:Retention, Psychology / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology