TY - JOUR T1 - Altered Microstructure in Temporal Lobe Epilepsy: A Diffusional Kurtosis Imaging Study JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 719 LP - 724 DO - 10.3174/ajnr.A4185 VL - 36 IS - 4 AU - L. Bonilha AU - C.-Y. Lee AU - J.H. Jensen AU - A. Tabesh AU - M.V. Spampinato AU - J.C. Edwards AU - J. Breedlove AU - J.A. Helpern Y1 - 2015/04/01 UR - http://www.ajnr.org/content/36/4/719.abstract N2 - BACKGROUND AND PURPOSE: Temporal lobe epilepsy is associated with regional abnormalities in tissue microstructure, as demonstrated by DTI. However, the full extent of these abnormalities has not yet been defined because DTI conveys only a fraction of the information potentially accessible with diffusion MR imaging. In this study, we assessed the added value of diffusional kurtosis imaging, an extension of DTI, to evaluate microstructural abnormalities in patients with temporal lobe epilepsy. MATERIALS AND METHODS: Thirty-two patients with left temporal lobe epilepsy and 36 matched healthy subjects underwent diffusion MR imaging. To evaluate abnormalities in patients, we performed voxelwise analyses, assessing DTI-derived mean diffusivity, fractional anisotropy, and diffusional kurtosis imaging–derived mean diffusional kurtosis, as well as diffusional kurtosis imaging and DTI-derived axial and radial components, comparing patients with controls. RESULTS: We replicated findings from previous studies demonstrating a reduction in fractional anisotropy and an increase in mean diffusivity preferentially affecting, but not restricted to, the temporal lobe ipsilateral to seizure onset. We also noted a pronounced pattern of diffusional kurtosis imaging abnormalities in gray and white matter tissues, often extending into regions that were not detected as abnormal by DTI measures. CONCLUSIONS: Diffusional kurtosis is a sensitive and complementary measure of microstructural compromise in patients with temporal lobe epilepsy. It provides additional information regarding the anatomic distribution and degree of damage in this condition. Diffusional kurtosis imaging may be used as a biomarker for disease severity, clinical phenotypes, and treatment monitoring in epilepsy. DKIdiffusional kurtosis imagingFAfractional anisotropyMDmean diffusivityTLEtemporal lobe epilepsy ER -