Ali Tabesh1,
2, Jens H. Jensen1, 2, Edward S. Hui1,
2, Maria V. Spampinato1, 2, Jonathan C. Edwards3,
Joseph A. Helpern1, 2, Leonardo Bonilha, 23
1Radiology
and Radiological Science, Medical University of South Carolina, Charleston,
SC, United States; 2Center for Biomedical Imaging, Medical
University of South Carolina, Charleston, SC, United States; 3Comprehensive
Epilepsy Center, Neurosciences, Medical University of South Carolina,
Charleston, SC, United States
This study aimed to provide biophysical interpretation of microstructural abnormalities in medial temporal lobe epilepsy (MTLE), and to determine their association with disease severity. Biophysical modeling was performed with a newly developed cerebral microenvironment modeling (CMM) method compatible with diffusional kurtosis imaging. Nineteen patients with MTLE and 28 matched healthy volunteers were studied. The results suggest that diffusion abnormalities in MTLE may be predominantly associated with cerebral neurite loss. Seizure frequency may be related to myelin degradation, gliosis, and possibly other changes in tissue morphology and permeability. CMM markers may potentially enable early identification of patients with medication-refractory MTLE.