Brain microstructural abnormalities assessed by diffusion kurtosis MRI in patients with focal temporal lobe epilepsy

Dolgushin MB, Nadelyaev RV, Martynov MYu, et al. Brain microstructural abnormalities assessed by diffusion kurtosis MRI in patients with focal temporal lobe epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(11):171‑177. (In Russ.)
https://doi.org/10.17116/jnevro2024124111171

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)

Использование инфографики авторами научных работ

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OBJECTIVE

To study microstructural abnormalities in epileptogenic focus and in mirror region by diffusion kurtosis (DK) MRI in patients with focal temporal lobe epilepsy.

MATERIAL AND METHODS

The main group included 12 patients (mean age 35 [30.5; 39.0] years, 5 women) with a diagnosis of focal epilepsy in the right temporal lobe (r-TL). The control group consisted of 15 healthy volunteers (mean age 33 [29.0; 39.0] years, 5 women). In both groups all participants underwent clinical and neurologic assessments, EEG and video EEG monitoring, and MRI, including DK MRI.

Evaluation of microstructural changes in the temporal lobes included the study of 10 DK parameters.

RESULTS

In the main group, focal motor/nonmotor or bilateral tonic-clonic seizures were observed in 9 and 11 patients. Ten (83%) patients had focal epileptic activity on routine EEG in the r-TL and 9 (75%) patients had MRI focal changes in the same lobe. There was a significant decrease in fractional (FA) and kurtosis anisotropy (KA), mean (MK), radial (RK), and axial kurtosis (AK), as well as in axonal water fraction (AWF) in the r-TL of patients with epilepsy compared to the control group. Besides, FA, KA, MK, RK, AK, and AWF parameters in the l-TL in the main group were significantly reduced compared to the l-TL in the controls. There was a significant association between the duration of epilepsy, axial and radial extra axonal diffusion as well as axonal diffusivity in the l-TL. No association was observed in the r-TL. In the control group, MK, AK, RK, and AWF positively correlated with age. No correlation between age and MK, AK, RK, and AWF was found in the main group.

CONCLUSION

In patients with an epileptic focus in the r-TL, microstructural changes are observed not only in the area of the epileptic focus, but also in the affected temporal lobe as a whole, and also mirrored in the conditionally healthy temporal lobe. Altered microstructure in the mirror region may reflect changes secondary to bilateral tonic-clonic seizures or evolution to secondary epileptogenic zone. Assessment of DK MRI parameters may provide additional information about the epileptogenic focus and the extent of microstructural abnormalities.

Keywords:

epilepsy

epileptogenic focus

focal epilepsy

temporal lobe epilepsy

EEG

video EEG

MRI

diffusion kurtosis MRI

kurtosis

Authors:

Dolgushin M.B.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0000-0003-3930-5998

Nadelyaev R.V.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0009-0005-7367-9311

Martynov M.Yu.

Federal Center of Brain Research and Neurotechnologies;
Pirogov Russian National Research Medical University (Pirogovsky University)

SPIN RSCI: 8010-8340
Scopus AuthorID: 7004761286
ResearcherID: K-8390-2018
ORCID: 0000-0003-2797-7877

Rubleva Yu.V.

Federal Center of Brain Research and Neurotechnologies;
Pirogov Russian National Research Medical University (Pirogovsky University)

ORCID: 0000-0002-3746-1797

Dvoryanchikov A.V.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0009-0009-0678-7821

Burd S.G.

Federal Center of Brain Research and Neurotechnologies;
Pirogov Russian National Research Medical University (Pirogovsky University)

ORCID: 0000-0003-0804-7076

Senko I.V.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0000-0002-5743-8279

Garanina N.V.

Federal Center of Brain Research and Neurotechnologies

ORCID: 0000-0002-3036-2753

Received:

30.06.2024

Accepted:

04.07.2024

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