title: Sulcus-based MR analysis of focal cortical dysplasia located in the central region.
abstract: OBJECTIVE
  Focal cortical dysplasias (FCDs) are mainly located in the frontal region, with a particular tropism for the central sulcus. Up to 30% of lesions are undetected (magnetic resonance [MR]-negative FCD patients) or belatedly diagnosed by visual analysis of MR images. We propose an automated sulcus-based method to analyze abnormal sulcal patterns associated with central FCD, taking into account the normal interindividual sulcal variability.
  
  
  METHODS
  We retrospectively studied 29 right-handed patients with FCD in the central region (including 12 MR negative histologically-confirmed cases) and 29 right-handed controls. The analysis of sulcal abnormalities from T1-weighted MR imaging (MRI) was performed using a graph-based representation of the cortical folds and an automated sulci recognition system, providing a new quantitative criterion to describe sulcal patterns, termed sulcus energy.
  
  
  RESULTS
  Group analysis showed that the central sulcus in the hemisphere ipsilateral to the FCD exhibited an abnormal sulcal pattern compared with controls (p = 0.032). FCDs were associated with abnormal patterns of the central sulci compared with controls (p = 0.006), a result that remained significant when MR-negative and MR-positive patients were considered separately, while the effects of sex, age and MR-field were not significant. At the individual level, sulcus energy alone failed to detect the FCD lesion. We found, however, a significant association between maximum z-scores and the site of FCD (p = 0.0046) which remained significant in MR-negative (p = 0.024) but not in MR-positive patients (p = 0.058). The maximum z-score pointed to an FCD sulcus in four MR-negative and five MR-positive patients.
  
  
  CONCLUSIONS
  We identified abnormal sulcal patterns in patients with FCD of the central region compared with healthy controls. The abnormal sulcal patterns ipsilateral to the FCD and the link between sulcus energy and the FCD location strengthen the interest of sulcal abnormalities in FCD patients.
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Roca
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Mellerio
authors.affiliation: Department of Neurosurgery, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Paris, France.
authors.forename: Francine
authors.initials: F
authors.lastname: Chassoux
authors.affiliation: UNATI, Neurospin, CEA, Saclay, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Rivière
authors.affiliation: Center for Psychiatry & Neurosciences, Sainte-Anne Hospital Center, UMR 894 INSERM/Université Paris Descartes & Laboratory for the Psychology of Child Development and Education, UMR 8240 CNRS/Université Paris Descartes Sorbonne Paris Cité, Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Cachia
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Charron
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Lion
authors.affiliation: UNATI, Neurospin, CEA, Saclay, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Mangin
authors.affiliation: Department of Neurosurgery, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Devaux
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Meder
authors.affiliation: Department of Neuroimaging, Sainte-Anne Hospital Center, Université Paris Descartes Sorbonne Paris Cité, Center for Psychiatry & Neurosciences, UMR 894 INSERM, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Oppenheim
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054220:Malformations of Cortical Development / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
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