White Matter Abnormalities in Patients with Treatment-Resistant Genetic Generalized Epilepsies.
BACKGROUND Genetic generalized epilepsies (GGEs) are associated with microstructural brain abnormalities that can be evaluated with diffusion tensor imaging (DTI). Available studies on GGEs have conflicting results. Our primary goal was to compare the white matter structure in a cohort of patients with video/EEG-confirmed GGEs to healthy controls (HCs). Our secondary goal was to assess the potential effect of age at GGE onset on the white matter structure. MATERIAL AND METHODS A convenience sample of 23 patients with well-characterized treatment-resistant GGEs (13 female) was compared to 23 HCs. All participants received MRI at 3T. DTI indices, including fractional anisotropy (FA) and mean diffusivity (MD), were compared between groups using Tract-Based Spatial Statistics (TBSS). RESULTS After controlling for differences between groups, abnormalities in DTI parameters were observed in patients with GGEs, including decreases in functional anisotropy (FA) in the hemispheric (left>right) and brain stem white matter. The examination of the effect of age at GGE onset on the white matter integrity revealed a significant negative correlation in the left parietal white matter region FA (R=-0.504; p=0.017); similar trends were observed in the white matter underlying left motor cortex (R=-0.357; p=0.103) and left posterior limb of the internal capsule (R=-0.319; p=0.148). CONCLUSIONS Our study confirms the presence of widespread white matter abnormalities in patients with GGEs and provides evidence that the age at GGE onset may have an important effect on white matter integrity.
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Jerzy P
JP
Szaflarski
Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA.
Seongtaek
S
Lee
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Jane B
JB
Allendorfer
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Tyler E
TE
Gaston
Department of Neurology, University of California at San Francisco, San Francisco, CA, USA.
Robert C
RC
Knowlton
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Sandipan
S
Pati
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Lawrence W
LW
Ver Hoef
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Georg
G
Deutsch
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000502:physiology; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D004829:Epilepsy, Generalized / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*