Micro structural abnormalities of the Cingulum in children with focal epilepsy: DTI study

Abstract

Abstract Aim of the work The aim of this study is to evaluate the microstructural alteration implicating the Cingulum (CG) as one of the major limbic system white matter fiber tracts; in children with focal epilepsy. Patients and methods Our study was carried out on twenty-one children with the clinical and EEG diagnosis of focal epilepsy and 22 control subjects who were age and sex matched to patient group in the study. All patients underwent an epilepsy specific MRI protocol. DTI and fiber tractography was performed to all subjects as well. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for CG. DTI metrics were compared between both hemispheres as well as between both groups patient group and control group. A p-value less than .05 was considered significant. Results Asymmetry in FA, RD, trace and AD values of the CG was demonstrated in patients with focal epilepsy between both hemispheres with significantly lower FA and higher diffusivity values reaching p < 0.001in CG in both hemispheres in patients with focal epilepsy when compared together regardless the seizure focus. Compared with controls, patients with left focal epilepsy demonstrated significant lower FA and higher diffusivity indices in both ipsilateral and contralateral fiber tracts as well p < 0.05. Patients with right focal epilepsy showed no significant asymmetry in different DTI metrics when compared to controls. Conclusion Reduction in FA values along with increased diffusivity measures in the CG reflects the microstructural changes taking place in children with focal epilepsy.