Quantitative magnetic resonance imaging evidence for altered structural remodeling of the temporal lobe in West syndrome

Summary Objective To explore the structure–function relation of the temporal lobe in newly diagnosed West syndrome of unknown cause (uWS). Methods Quantitative magnetic resonance imaging (three‐dimensional [3D] structural MRI and diffusion tensor imaging [DTI]) was analyzed using voxel‐based morphometry (VBM) and tract‐based spatial statistics (TBSS) in 22 patients and healthy age‐matched controls. The electrophysiologic responsiveness of the temporal lobe was measured using the N100 auditory event‐related potential (aERP) to a repeated 1,000 Hz tone. Neurocognitive function was assessed using the Bayley Scales of Infant Development, Second Edition (BSID‐II). Tests followed first‐line treatment with vigabatrin (17 patients) or high‐dose oral prednisolone (5 patients). Results Total temporal lobe volume was similar in patients and controls. Patients had a smaller temporal stem (TS) (p