PT  - JOURNAL ARTICLE
AU  - E. Widjaja
AU  - S. Geibprasert
AU  - H. Otsubo
AU  - O.C. Snead III
AU  - S.Z. Mahmoodabadi
TI  - Diffusion Tensor Imaging Assessment of the Epileptogenic Zone in Children with Localization-Related Epilepsy
AID  - 10.3174/ajnr.A2801
DP  - 2011 Nov 01
TA  - American Journal of Neuroradiology
PG  - 1789--1794
VI  - 32
IP  - 10
4099  - http://www.ajnr.org/content/32/10/1789.short
4100  - http://www.ajnr.org/content/32/10/1789.full
SO  - Am. J. Neuroradiol.2011 Nov 01; 32
AB  - BACKGROUND AND PURPOSE: Patients with MR imaging-negative epilepsy could have subtle FCD. Our aim was to determine if structural changes could be identified by using DTI in children with intractable epilepsy, from MR imaging-visible FCD and MR imaging-negative localization-related epilepsy, that were concordant with the epileptogenic zone as defined by using the MEG dipole cluster. MATERIALS AND METHODS: Eight children with MR imaging-visible FCD and 16 with MR imaging-negative epilepsy underwent DTI and MEG. Twenty-six age-matched healthy children underwent DTI. Analysis was performed on controls across individual patients. Agreement between the location of DTI abnormalities and FCD and MEG dipole clusters was assessed. RESULTS: In patients with MR imaging-visible FCD, abnormal FA, MD, λ1, λ2, and λ3 were lobar concordant with the MEG dipole cluster in 4/8 (50.0%), 5/8 (62.5%), 3/8 (37.5%), 6/8 (75.0%), and 5/8 (62.5%), respectively. In patients with MR imaging-visible FCD, abnormal FA, MD, λ1, λ2, and λ3 overlapped the x-, y-, and z-axes of the MEG dipole cluster in 1/8 (12.5%), 4/8 (50%), 4/8 (50%), 6/8 (75%), and 4/8 (50%), respectively, and with FCD in 1/8 (12.5%), 3/8 (37.5%), 0/8 (0%), 3/8 (37.5%), and 1/8 (12.5%), respectively. In patients with MR imaging-negative epilepsy, abnormal FA, MD, λ1, λ2, and λ3 were lobar-concordant with the MEG dipole cluster in 11/16 (68.8%), 11/16 (68.8%), 8/16 (50.0%), 10/16 (62.5%), and 10/16 (62.5%), respectively, and overlapped the x-, y-, and z-axes of the MEG dipole cluster in 9/16 (56.3%), 10/16 (62.5%), 8/16 (50%), 8/16 (50%), and 8/16 (50%), respectively. There was no significant difference between abnormal DTI lobar concordance with the MEG dipole cluster in patients with MR imaging-visible FCD and MR imaging-negative epilepsy. CONCLUSIONS: White matter changes can be detected with DTI in children with MR imaging-visible FCD and MR imaging-negative epilepsy, which were concordant with the epileptogenic zone in more than half of the patients. EEGelectroencephalographyFAfractional anisotropyFCDfocal cortical dysplasiaFLEfrontal lobe epilepsyFMRIBFunctional MR Imaging of the Brain Libraryλ1, λ2, and λ3eigenvaluesMDmean diffusivityMEGmagnetoencephalographyMNIMontreal Neurological InstituteSPMstatistical parametric mappingTBSStract-based spatial statisticsTLEtemporal lobe epilepsyVBMvoxel-based morphometry