Patterns of seizure spread in temporal lobe epilepsy are associated with distinct white matter tracts

•Callosal fibers are strongly associated with seizure propagation in medial-lateral direction.•Cingulate tracts & intrahemispheric bundles are strongly associated with anterior-posterior propagation.•The relationship between white matter and seizure phenotypes can shed light on network abnormali...

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Veröffentlicht in:Epilepsy research 2021-03, Vol.171, p.106571-106571, Article 106571
Hauptverfasser: Gleichgerrcht, Ezequiel, Greenblatt, Adam S., Kellermann, Tanja S., Rowland, Nathan, Vandergrift, W. Alexander, Edwards, Jonathan, Davis, Kathryn A., Bonilha, Leonardo
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container_issue
container_start_page 106571
container_title Epilepsy research
container_volume 171
creator Gleichgerrcht, Ezequiel
Greenblatt, Adam S.
Kellermann, Tanja S.
Rowland, Nathan
Vandergrift, W. Alexander
Edwards, Jonathan
Davis, Kathryn A.
Bonilha, Leonardo
description •Callosal fibers are strongly associated with seizure propagation in medial-lateral direction.•Cingulate tracts & intrahemispheric bundles are strongly associated with anterior-posterior propagation.•The relationship between white matter and seizure phenotypes can shed light on network abnormalities in TLE. It is commonly hypothesized that seizure spread patterns in patients with focal epilepsy are associated with structural brain pathways. However, this relationship is poorly understood and has not been fully demonstrated in patients with temporal lobe epilepsy. Here, we sought to determine whether directionality of seizure spread (DSS) is associated with specific cerebral white matter tracts in patients with temporal lobe epilepsy. Thirty-three adult patients with temporal lobe epilepsy who underwent stereoelectroencephalography (sEEG) and magnetic resonance diffusion tensor imaging (MR-DTI) as part of their standard-of-care clinical evaluation were included in the study. DSS was defined as anterior-posterior (AP) or medial-lateral (ML) spread based upon sEEG evaluation by two independent specialists who demonstrated excellent inter-rater agreement (Cohen’s kappa = .92). DTI connectometry was used to assess differences between seizure spread pattern groups along major fiber pathways regarding fractional anisotropy (FA). Twenty-four participants showed seizures with AP spread and nine participants showed seizures with ML spread. There were no significant differences between the groups on their demographic and clinical profile. Patients with ML seizures had higher FA along the corpus callosum and, to a lesser degree, some portions of the bilateral cingulate tracts. In contrast, patients with AP seizures had higher FA along several anterior-posterior white matter projections bundles, including the cingulate fasciculus and the inferior longitudinal, with significantly less involvement of the corpus callosum compared with ML seizures. This study confirms the hypothesis that the anatomical pattern of electrophysiological ictal propagation is associated with the structural reinforcement of supporting pathways in temporal lobe epilepsy. This observation can help elucidate mechanisms of ictal propagation and may guide future translational approaches to curtail seizure spread.
doi_str_mv 10.1016/j.eplepsyres.2021.106571
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Here, we sought to determine whether directionality of seizure spread (DSS) is associated with specific cerebral white matter tracts in patients with temporal lobe epilepsy. Thirty-three adult patients with temporal lobe epilepsy who underwent stereoelectroencephalography (sEEG) and magnetic resonance diffusion tensor imaging (MR-DTI) as part of their standard-of-care clinical evaluation were included in the study. DSS was defined as anterior-posterior (AP) or medial-lateral (ML) spread based upon sEEG evaluation by two independent specialists who demonstrated excellent inter-rater agreement (Cohen’s kappa = .92). DTI connectometry was used to assess differences between seizure spread pattern groups along major fiber pathways regarding fractional anisotropy (FA). Twenty-four participants showed seizures with AP spread and nine participants showed seizures with ML spread. There were no significant differences between the groups on their demographic and clinical profile. 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source MEDLINE; Elsevier ScienceDirect Journals
subjects Connectome
Corpus Callosum
Diffusion Tensor Imaging
Epilepsy, Temporal Lobe - diagnostic imaging
Humans
Seizure
Seizures - diagnostic imaging
Temporal lobe epilepsy
Tractography
White Matter - diagnostic imaging
title Patterns of seizure spread in temporal lobe epilepsy are associated with distinct white matter tracts
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