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AJNR - American Journal of Neuroradiology

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Correlation of Apparent Diffusion Coefficient with Neuropsychological Testing in Temporal Lobe Epilepsy

Yvonne W. Lui^a, Annette O. Nusbaum^a, William B. Barr^b, Glyn Johnson^a, James S. Babb^a, Darren Orbach^a, Alice Kim^a, Georgia Laliotis^c and Orrin Devinsky^c

^a Department of Radiology, NYU Medical Center, 530 First Avenue, New York, NY 10016
^b Department of Neuropsychology, NYU Medical Center, 530 First Avenue, New York, NY 10016
^c Department of Neurology, NYU Medical Center, 530 First Avenue, New York, NY 10016

View larger version (122K): [in a new window]   FIG 1. Axial diffusion-weighted image with b = 0 seconds mm–2 obtained in a 30-year-old patient through the mesial temporal lobe structures. Placement of oval and round regions of interest is demonstrated in the hippocampi and parahippocampal gyri bilaterally.

View larger version (18K): [in a new window]   FIG 2. Bar graph shows that patients with temporal lobe epilepsy demonstrate higher apparent diffusion coefficient (ADC) values compared with controls over the whole brain, in the hippocampi, and in the parahippocampal gyri. The differences were statistically significant (P < .05). There were no significant differences comparing right- and left-sided diffusivity measures; therefore, the right and left regional measures are depicted together.

View larger version (16K): [in a new window]   FIG 3. Bar graph shows that in patients with temporal lobe epilepsy, mean diffusivity is higher in the hippocampus and parahippocampal gyrus ipsilateral to the seizure focus compared with the contralateral side. These differences are statistically significant (P < .05).

View larger version (23K): [in a new window]   FIG 4. Scatterplots demonstrate negative correlations between mean diffusivity measures in the hippocampus of patients with mesial temporal sclerosis and multiple neuropsychological tests assessing verbal memory (delayed recall [DR] and new word [REC]) and visuospatial memory (RD). Each data point corresponds to the average apparent diffusion coefficient (ADC) measure in the specified region for a single patient. Error bars indicate ±1 standard deviation derived from multiple readings and multiple readers. Correlation coefficients are calculated using a mixed-model analysis. Solid lines and solid data points indicate statistically significant findings (P < .05) using non-Bonferroni adjusted significance levels. Dotted line and hollow data points indicate that the relationship does not reach statistical significance. A. Left hippocampal ADC correlation with DR. B. Left hippocampal ADC correlation with REC. C. Left hippocampal ADC correlation with RD. D. Right hippocampal ADC correlation with REC. E. Right hippocampal ADC correlation with RD (P = .08).

View larger version (15K): [in a new window]   FIG 5. Scatterplot demonstrates a positive correlation between right parahippocampal apparent diffusion coefficient (ADC) measures and visuospatial memory test scores. Data points and error bars represent average ADC and standard deviation based on multiple readers and multiple readings. The correlation coefficient is calculated by using mixed-model analysis. Non-Bonferroni adjusted statistically significant positive correlation (P < .05) is seen between right parahippocampal ADC and BV2 (measure of delayed recall at 30 minutes). The relationship between right parahippocampal ADC and BV1 (measure of immediate recall) does not reach statistical significance (P = .09).