title: Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic-clonic seizure: a voxel-based diffusional kurtosis imaging study.
abstract: OBJECTIVE
  To investigate the diffusion abnormalities in the brain of children with idiopathic generalized epilepsy (IGE) with generalized tonic-clonic seizure (GTCS) by using diffusion kurtosis imaging (DKI).
  
  
  METHODS
  Twenty-one IGE children with GTCS and 16 controls were recruited. DKI was performed and maps of radial diffusivity (λ⊥ ), axial diffusivity (λ// ), mean diffusivity (MD), fractional anisotropy (FA), radial kurtosis (K⊥ ), axial kurtosis (K// ) and mean kurtosis (MK) were calculated. Voxel-based analyses were employed to compare diffusion metrics in epilepsy versus the controls.
  
  
  RESULTS
  In the case group, MD was found significantly higher in the right temporal lobe, the right occipital lobe, hippocampus, and some subcortical regions, while FA increased in bilateral supplementary motor area and the left superior frontal lobe (false discovery rate corrected P < 0.05). Analysis of λ⊥ and λ// showed that the increased MD was mainly due to the elevated λ// . Significantly decreased MK was also detected in bilateral temporo-occipital regions, the right hippocampus, the left insula, the left post-central area, and some subcortical regions (false discovery rate corrected P < 0.05). In most regions the changed MK were due to the decreased K// .
  
  
  CONCLUSIONS
  The kurtosis parameters (K⊥ , K// , and MK) reflect different microstructural information in the IGE children with GTCS, and this support the value of DKI in studying children GTCS.
authors.affiliation: Department of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: Junling
authors.initials: J
authors.lastname: Gao
authors.forename: Shi-Ting
authors.initials: ST
authors.lastname: Feng
authors.forename: Bangxian
authors.initials: B
authors.lastname: Wu
authors.forename: Nanjie
authors.initials: N
authors.lastname: Gong
authors.forename: Minhua
authors.initials: M
authors.lastname: Lu
authors.forename: Po-Man
authors.initials: PM
authors.lastname: Wu
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.forename: Xiaoming
authors.initials: X
authors.lastname: He
authors.forename: Bingsheng
authors.initials: B
authors.lastname: Huang
mesh_terms: D001921:Brain / Q000473:pathology*; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004829:Epilepsy, Generalized / Q000473:pathology*; D004830:Epilepsy, Tonic-Clonic / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male
keywords: children; diffusional kurtosis imaging; generalized tonic-clonic seizure; voxel-based analysis