Cortical Gray-White Matter Blurring and Cognitive Morbidity in Focal Cortical Dysplasia.
Focal cortical dysplasia (FCD) is a malformation of cortical development that is associated with high rates of cognitive morbidity. However, the degree to which specific irregularities of dysplastic tissue directly impact cognition remains unknown. This study investigates the relationship between blurring of the cortical gray and white matter boundary on magnetic resonance imaging (MRI) and global cognitive abilities in FCD. Gray-white blurring (GWB) is quantified by sampling the non-normalized T1 image intensity contrast above and below the gray and white matter interface along the cortical mantle. Spherical averaging is used to compare resulting GWB for patients with histopathologically verified FCD with matched controls. Whole-brain correlational analyses are used to investigate the relationship between blurring and general cognitive abilities, controlling for epilepsy duration. Results show that cognitive performance is reduced in patients with FCD relative to controls. Patients show increased GWB in bilateral temporal, parietal, and frontal regions. Furthermore, increased GWB in these regions is linearly related to decreased cognition and mediates group differences in cognitive performance. These findings demonstrate that GWB is a marker of reduced cognitive efficiency in FCD that can potentially be used to probe general and domain-specific cognitive functions in other neurological disorders.
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
Karen
K
Blackmon
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
Ruben
R
Kuzniecky
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
William B
WB
Barr
Department of Pathology, New York University School of Medicine, New York 10016, USA.
Matija
M
Snuderl
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
Werner
W
Doyle
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
Orrin
O
Devinsky
Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York 10016, USA.
Thomas
T
Thesen
D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D054220:Malformations of Cortical Development / Q000145:classification / Q000150:complications* / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D066127:White Matter / Q000473:pathology*; D055815:Young Adult
cognition; epilepsy; focal cortical dysplasia; gray and white matter blurring; quantitative MRI