Correlation Between White Matter Microstructural Lesions By Diffusion Tensor Imaging And Clinical Profiles In Patients With Temporal Lobe Epilepsy And Hippocampal Sclerosis

[Objective]:Diffusion tensor imaging（DTI）is a new imaging method thatdeveloped in recent years to measure water molecular diffusion rate in biologicaltissue structure. This paper aims to study the characteristics of the whole brainwhite matter microstructure damage in patients with temporal lobe epilepsy andhippocampal sclerosis by DTI technology. Then we investigated the influence ofthe age of epilepsy onset and the course on white matter changes.[Materials and Methods]: DTI data were obtained in30TLE patients withHS collected from2009to2012in our hospital and23age and sex-matchedhealthy volunteers served as controls. Thirteen patients had left hippocampalsclerosis and seventeen had right hippocampal sclerosis. All the subjectsunderwent MRI scans for the whole brain DTI. And the DTI data processing software package is provided by FMRIB software library. Comparisons amonggroups of the brain white matter fractional anisotropy (FA) were carried out byemploying track-based spatial statistics (TBSS) methods. In addition, FA inregions of interest (ROI) where white matter lesions had statistically significantdifference was correlated with the age of epilepsy onset and the course. Allstatistical analyzes were using SPSS16.0, when P<0.05was consideredstatistically significant.[Results]:1. Compared with the healthy controls, Subjects in the LHS groupdemonstrated these clusters of reduced FA: bilateral corona radiata, the left genuof corpus callosum, the right body and splenium of corpus callosum, the rightposterior thalamic radiation, external capsule and superior longitudinalfasciculus. There is no brain white matter with higher FA value;2. White thesubjects in the RHS group, the clusters of reduced FA are involving bilateralcorpus callosum, corona radiata, posterior thalamic radiation, cingulum, superiorlongitudinal fasciculus, and the right anterior limb of internal capsule, the rightretrolenticular part of internal capsule and external capsule. Haven’t found anycerebral white matter with higher FA values;3. In LHS group, the FA of the leftgenu of corpus callosum was negatively correlated with the course, and the FAof the right anterior corona radiata was positively correlated with the age ofonset. In RHS group, the FA of the bilateral superior corona radiata waspositively correlated with the course.[Conclusions]:1. Extensive white matter microstructure abnormalities wasseen in temporal lobe epilepsy patients with hippocampal sclerosis, which cannot be seen on conventional MRI, but sensitive to DTI.2. Diffusionabnormalities are not restricted to pathological hippocampus and involve a larger network.3. The age of epilepsy onset in LHS was correlated with thechanges of anterior corona radiata. This area may be susceptible to early seizuresdamage, or under the influence of epileptic induced factors.4. The course ofepilepsy and the white matter change were linked to each other.