White matter abnormalities differentiate severe from benign temporal lobe epilepsy
Summary Objective Temporal and extratemporal white matter abnormalities have been identified frequently in patients with refractory mesial temporal lobe epilepsy ( rMTLE ). However, the identification of potential water diffusion abnormalities in patients with drug‐responsive, benign MTLE ( bMTLE )...
-д хадгалсан:
| Үндсэн зохиолчид: | , , , , , , , |
|---|---|
| Формат: | Artigo |
| Хэл сонгох: | англи |
| Хэвлэсэн: |
2015
|
| Онлайн хандалт: | https://doi.org/10.1111/epi.13027 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/epi.13027 |
| Шошгууд: |
Шошго нэмэх
Шошго байхгүй, Энэхүү баримтыг шошголох эхний хүн болох!
|
| Тойм: | Summary Objective Temporal and extratemporal white matter abnormalities have been identified frequently in patients with refractory mesial temporal lobe epilepsy ( rMTLE ). However, the identification of potential water diffusion abnormalities in patients with drug‐responsive, benign MTLE ( bMTLE ) is still missing. The aim of this study was to identify markers of refractoriness in MTLE. Methods The study group included 48 patients with bMTLE (mean age 42.8 + 13.5 years), 38 with rMTLE (mean age 41.7 + 14.1 years) and 54 healthy volunteers. Diffusion tensor imaging ( DTI ) was performed to measure mean diffusivity ( MD ) and fractional anisotropy ( FA ) in a regions‐of‐interest analysis comprising hippocampi and temporal lobe gray and white matter regions. The presence of hippocampal sclerosis ( Hs) was assessed using automated magnetic resonance imaging ( MRI ) evaluation. For statistics we used chi‐square test; two‐tailed, two‐sample t ‐test; and stratified linear regression. Results The significant demographic differences between the two patient groups were sex (p = 0.003), duration of epilepsy (p = 0.003) and complex febrile convulsions (p = 0.0001). In rMTLE , temporal white matter MD was higher and FA lower, as compared to bMTLE . The analysis of diagnostic accuracy (area under the receiver operator characteristic [ ROC ] curve [ AUC ]) showed that FA had an AUC for discriminating patients affected from those unaffected by refractory MTLE of 74.0% (p < 0.001), a value that was higher than that of temporal MD (64.0%), hippocampus volume (65.0%), and Hs (66.0%). Significance We performed DTI measurements in MTLE and found a significant reduction of FA along the white matter of the temporal lobes in rMTLE , suggesting it as a valuable measure of refractoriness in MTLE . |
|---|