Abstract Details

Title Widespread Pattern of White Matter Dysfunction Associates with Pharmacoresistant Seizures in Temporal Lobe Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S48 - Epilepsy/Clinical Neurophysiology (EEG) III (2:06 PM-2:17 PM)

Poster/Presentation
Number 007

Background Besides hippocampal sclerosis (HS), extensive areas of WM atrophy have been reported in TLE. Unfortunately, few studies investigated correlation between the WM abnormalities and seizure frequency. Here, we evaluated the pattern of WM dysfunction through Diffusion tensor imaging (DTI) in TLE-HS subjects according to seizure control.

Objective To evaluate the pattern of white matter (WM) integrity in temporal lobe epilepsy (TLE) according to seizure control

Design/Methods We acquired 3T DTI (32 directions) along with 3D/T1-weighted images from 117 patients with TLE and HS (from outpatient Clinics) and 117 healthy controls. Patients were divided into three groups according to seizure control: refractory (58 subjects), fluctuating (42 subjects) and seizure-free (17 subjects). Corpus callosum and other 4 tracts were draw through semi-automated tractography (http://www.exploredti.com/). We performed multivariate analyses using FA, MD and RD with SPSS22 (p<0.05, with Bonferroni correction).

Results Groups were balanced for age and sex (p>0.05). We observed reduced FA and increased MD and RD of corpus callosum for all patients compared to controls (p<0.001). However, while FREE-GROUP showed fewer alterations (elevated MD of left CST and RD of left IFO only), the REFR-GROUP presented reduced FA in the left CST, bilateral IFO and right CING, associated with increased MD of right CST and bilateral IFO, ARC and CING (p<0.05). Besides, RD was elevated in the bilateral IFO and CING and left ARC (p<0.05). In the FLUCT-GROUP, FA was reduced in the left CING, associated with higher MD of right CST and ARC, and elevated RD of left IFO and CING (p<0.05).

Conclusions Patients with TLE and HS and refractory seizures appear to have more extensive WM integrity abnormalities than fluctuating or seizure-free patients.

Authors/Disclosures
Leticia Franceschet Ribeiro PRESENTER	No disclosure on file
	No disclosure on file
Marina K. Alvim (Hospital Das Clinicas Unicamp)	Dr. Alvim has nothing to disclose.
Marilise Katsurayama, MD (Rua Dr. José Gomes Vieira)	No disclosure on file
Lucas S. Silva, MD (University of Campinas)	Dr. Silva has nothing to disclose.
Fernando Cendes, MD, PhD, FAAN (Departamento de Neurologia; FCM; UNICAMP)	Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Biopharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for United Medical – Brazil. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zodiac Pharma . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eurofarma – Brazil . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology - Epilepsy. The institution of Dr. Cendes has received research support from São Paulo Research Foundation - FAPESP. The institution of Dr. Cendes has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil . The institution of Dr. Cendes has received research support from NIH.
Clarissa L. Yasuda, MD, PhD (University of Campinas)	Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for LIBBS. Prof. Yasuda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ABBOTT. Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for LIBBS.

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