What is the significance of interictal water diffusion changes in frontal lobe epilepsies?

The aim of this study was to better understand the significance of interictal changes in water molecule diffusivity defined by diffusion-weighted imaging (DWI) in frontal lobe epilepsy (FLE), as well as to test the accuracy of interictal DWI in the definition of the epileptogenic zone (EZ). DWI was carried out in 14 patients with refractory FLE (9 negative-MRI) as well as in 25 controls. Statistical mapping analysis (SPM2) of diffusivity maps was used to detect, for each subject, significant diffusivity alterations. We then studied the relationships between diffusion and depth recorded electrical abnormalities. Clinical correlates of the extent of diffusivity changes were also tested. We found areas of significantly increased diffusivity (SID) in 13 patients. Eight had SID in the EZ, 9 within the irritative zone (IZ) and 12 outside, mainly in connected areas. We found a correlation between the extent of SID and the duration of epilepsy (p corrected=0.026, R=0.621). In addition, SID was significantly less widespread in negative-MRI patients (p=0.028). However, we found no significant differences concerning either seizure frequency (p=0.302), seizure generalization (p=0.841), history of status (p=0.396), or surgical outcome (p=0.606). We suggest that SID in normal appearing areas is not a specific signature of epileptogenicity in FLE, and is more likely to reflect multifactorial and potentially evolving neuro-glial injuries.

[1]  John S. Duncan,et al.  Postictal diffusion tensor imaging , 2005, Epilepsy Research.

[2]  Fabrice Wendling,et al.  Neural Networks Underlying Epileptic Humming , 2002, Epilepsia.

[3]  Karl J. Friston,et al.  Analysis of fMRI Time-Series Revisited , 1995, NeuroImage.

[4]  Karl J. Friston,et al.  Hemodynamic correlates of epileptiform discharges: An EEG-fMRI study of 63 patients with focal epilepsy , 2006, Brain Research.

[5]  John S Duncan,et al.  Neuroimaging methods to evaluate the etiology and consequences of epilepsy , 2002, Epilepsy Research.

[6]  In Chan Song,et al.  Role of immediate postictal diffusion-weighted MRI in localizing epileptogenic foci of mesial temporal lobe epilepsy and non-lesional neocortical epilepsy , 2004, Seizure.

[7]  Fabrice Bartolomei,et al.  Dynamique des réseaux neuraux dans les épilepsies partielles humaines , 2005 .

[8]  Karl J. Friston,et al.  A Voxel-Based Morphometric Study of Ageing in 465 Normal Adult Human Brains , 2001, NeuroImage.

[9]  L Tassi,et al.  Video-stereo-electroencephalographic investigation of orbitofrontal cortex. Ictal electroclinical patterns. , 1995, Advances in neurology.

[10]  J Bancaud,et al.  Somatomotor seizures of frontal lobe origin. , 1992, Advances in neurology.

[11]  Karl J. Friston,et al.  Commentary and Opinion: II. Statistical Parametric Mapping: Ontology and Current Issues , 1995, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[12]  M Xue,et al.  Postictal Alteration of Sodium Content and Apparent Diffusion Coefficient in Epileptic Rat Brain Induced by Kainic Acid , 1996, Epilepsia.

[13]  M. Symms,et al.  Diffusion changes in status epilepticus , 1997, The Lancet.

[14]  J Bancaud,et al.  The clinical signs and symptoms of frontal lobe seizures. Phenomenology and classification. , 1995, Advances in neurology.

[15]  J. Gotman,et al.  Temporal and Extratemporal BOLD Responses to Temporal Lobe Interictal Spikes , 2006, Epilepsia.

[16]  C R Jack,et al.  Comparative diagnostic utility of 1H MRS and DWI in evaluation of temporal lobe epilepsy , 2002, Neurology.

[17]  B C Jobst,et al.  Frontal lobe epilepsy. , 2000, Advances in neurology.

[18]  F Bartolomei,et al.  [Spatio-temporal dynamics of neuronal networks in partial epilepsy]. , 2005, Revue neurologique.

[19]  Barbara C Jobst,et al.  Frontal lobe seizures. , 2005, The Psychiatric clinics of North America.

[20]  Andreas Hufnagel,et al.  Brain Diffusion after Single Seizures , 2003, Epilepsia.

[21]  Karl J. Friston,et al.  Voxel-Based Morphometry of Herpes Simplex Encephalitis , 2001, NeuroImage.

[22]  P. Sundgren,et al.  Diffusion tensor imaging of the brain: review of clinical applications , 2004, Neuroradiology.

[23]  Francesco Cardinale,et al.  Stereoelectroencephalography in the Presurgical Evaluation of Focal Epilepsy: A Retrospective Analysis of 215 Procedures , 2005, Neurosurgery.

[24]  Afraim Salek-Haddadi,et al.  Simultaneous EEG-Correlated Ictal fMRI , 2002, NeuroImage.

[25]  S. Morikawa,et al.  Diffusion-weighted MR in experimental sustained seizures elicited with kainic acid. , 1995, AJNR. American journal of neuroradiology.

[26]  Fabrice Bartolomei,et al.  Metabolic and Electrophysiological Alterations in Subtypes of Temporal Lobe Epilepsy: A Combined Proton Magnetic Resonance Spectroscopic Imaging and Depth Electrodes Study , 2002, Epilepsia.

[27]  Jean Régis,et al.  1H-MRS imaging in intractable frontal lobe epilepsies characterized by depth electrode recording , 2005, NeuroImage.

[28]  M. Symms,et al.  Diffusion tensor imaging in patients with epilepsy and malformations of cortical development. , 2001, Brain : a journal of neurology.

[29]  J C Gore,et al.  Reversible, reproducible reduction of brain water apparent diffusion coefficient by cortical electroshocks , 1997, Magnetic resonance in medicine.

[30]  Alan Connelly,et al.  Abnormalities in hippocampi remote from the seizure focus: a T2 relaxometry study. , 2003, Brain : a journal of neurology.

[31]  H. Lüders,et al.  Presurgical evaluation of epilepsy. , 2001, Brain : a journal of neurology.

[32]  Dominique Hasboun,et al.  Interictal diffusion MRI in partial epilepsies explored with intracerebral electrodes. , 2006, Brain : a journal of neurology.

[33]  J H Lee,et al.  Limited utility of interictal apparent diffusion coefficient in the evaluation of hippocampal sclerosis , 2004, Acta neurologica Scandinavica.

[34]  S Geier,et al.  [New approach to the neurosurgery of epilepsy. Stereotaxic methodology and therapeutic results. 1. Introduction and history]. , 1974, Neuro-Chirurgie.

[35]  G J Barker,et al.  Magnetization transfer imaging in focal epilepsy , 2003, Neurology.

[36]  F. Wendling,et al.  Temporal lobe epilepsy , 2019, Radiopaedia.org.

[37]  Didier Dormont,et al.  Diffusion tensor imaging in medial temporal lobe epilepsy with hippocampal sclerosis , 2005, NeuroImage.

[38]  J C Gore,et al.  Diffusion‐weighted NMR imaging changes caused by electrical activation of the brain , 1995, NMR in biomedicine.

[39]  G. Pell,et al.  Structural abnormalities remote from the seizure focus , 2004, Neurology.

[40]  M Ohno,et al.  Changes in diffusion-weighted MRI after status epilepticus. , 2000, Pediatric neurology.

[41]  M. Symms,et al.  Diffusion tensor imaging in refractory epilepsy , 2002, The Lancet.

[42]  Scott H Faro,et al.  Diffusion tensor imaging of the hippocampal formation in temporal lobe epilepsy. , 2003, AJNR. American journal of neuroradiology.

[43]  B Diehl,et al.  Postictal Diffusion‐Weighted Imaging for the Localization of Focal Epileptic Areas in Temporal Lobe Epilepsy , 2001, Epilepsia.

[44]  John D Carew,et al.  Diffusion tensor MRI in temporal lobe epilepsy. , 2002, Magnetic resonance imaging.

[45]  C Munari,et al.  Surgical therapy for frontal epilepsies. , 1992, Advances in neurology.

[46]  G J Barker,et al.  Diffusion tensor imaging of cryptogenic and acquired partial epilepsies. , 2001, Brain : a journal of neurology.

[47]  J. Gore,et al.  Changes in water diffusion and relaxation properties of rat cerebrum during status epilepticus , 1993, Magnetic resonance in medicine.

[48]  M. Weiner,et al.  MR spectroscopic imaging and diffusion‐weighted MRI for early detection of kainate‐induced status epilepticus in the rat , 1996, Magnetic resonance in medicine.

[49]  Marc Guenot,et al.  Neurophysiological Monitoring for Epilepsy Surgery: The Talairach SEEG Method , 2002, Stereotactic and Functional Neurosurgery.

[50]  John S Duncan,et al.  Seizure-induced neuronal injury: Human data , 2002, Neurology.

[51]  B Diehl,et al.  Periictal Diffusion‐Weighted Imaging in a Case of Lesional Epilepsy , 1999, Epilepsia.

[52]  Karl J. Friston,et al.  Voxel-Based Morphometry—The Methods , 2000, NeuroImage.