PO047 Diffusion abnormalities in non-lesional temporal lobe epilepsy

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Temporal lobe epilepsy (TLE) is a network disorder affecting grey and white matter ipsilateral and contralateral to the epileptogenic zone. Temporal lobe white matter fibre bundles are reported to be abnormal in diffusion tensor imaging (DTI) studies of patients with TLE and associated hippocampal sclerosis (HS). In this study, we sought to assess the diffusion characteristics of two important white matter tract bundles, the uncinate fasciculus (UF) and parahippocampal white matter bundle (PWMB), in patients with TLE recruited as non-lesional cases. 3D T1-weighted and DTI MRI sequences for 40 neurologically healthy controls and 24 patients with TLE (16 left TLE, 8 right TLE) were acquired. Mean fractional anisotropy (FA) and mean diffusivity (MD) values were obtained for each bundle in each hemisphere and were correlated with clinical data. Significantly increased MD in the left UF (p=0.01), right UF (p=0.003) and right PWMB (p=0.02) in patients with left TLE relative to controls was observed. The UF is particularly vulnerable to pathological alterations in patients with non-lesional TLE. An earlier age of onset, a longer duration of epilepsy, and an increased epilepsy burden compound these alterations. This data indicate the abnormality is present regardless of the presence of HS.

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