DTI OF POST-ICTAL CHANGES IN PATIENTS WITH TEMPORAL LOBE EPILEPSY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. INTRODUCTION: Behavioral observations show that epileptic seizures have significant short term functional consequences lasting up to 24 hours following the seizure itself. Many epileptic patients suffer from a post-ictal paresis that lasts for several hours, and occasionally for a day or more. It is thought that this post-ictal state correlates with cellular changes such as edema. Thus measurements using diffusion tensor imaging (DTI) during the post-ictal period may reveal specific differences in diffusivity, which could be used to aid in the localization of seizure foci. In addition, long-term, intractable epilepsy causes neuronal death and eventual sclerosis. Since DTI can measure changes produced by such sclerotic lesions, a comparison of the changes in the fiber tracts in patients with long-term epilepsy with those of normal controls may aid in our understanding of how intractable seizures alter normal cortical organization. METHODS: We are using whole brain DTI to make measurements of white matter tract changes in epileptic patients. In this study, we have two specific aims: (1) to use DTI to measure post-ictal changes in diffusivity in focal temporal lobe epilepsy (TLE) and (2) to compare the inter-ictal DTI measurements of white matter fiber tracts in patients with long-term TLE with those of normal subjects. Thus far, we have developed basic visualization and statistical software for analyzing DTI data, and we have collected measurements on two epileptic subjects to confirm that this work is feasible.