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Clinical Article
Magnetic resonance voxel analysis and diffusion kurtosis imaging of medial temporal lobe in patients with temporal lobe epilepsy and cognitive impairment
MA Pengcheng  CUI Shulan  WANG Jin  GAO Yating  FENG Yusen  WU Gang 

Cite this article as: MA P C, CUI S L, WANG J, et al. Magnetic resonance voxel analysis and diffusion kurtosis imaging of medial temporal lobe in patients with temporal lobe epilepsy and cognitive impairment[J]. Chin J Magn Reson Imaging, 2023, 14(2): 1-5, 20. DOI:10.12015/issn.1674-8034.2023.02.001.

[Abstract] Objective In this study, diffusion kurtosis imaging (DKI) and voxel-based morphometry (VBM) techniques were used to investigate the changes of brain macro-structure and micro-structure in patients with temporal lobe epilepsy (TLE) with or without cognitive function.Materials and Methods A total of eighty TLE patients treated in the Department of Neurology, Yan'An Hospital Affiliated to Kunming Medical University from January 2018 to March 2022 were retrospectively analyzed, including forty patients with cognitive impairment and forty patients without cognitive impairment, and forty healthy controls (HC) matched with sex, age and years of education were recruited. The Montreal Cognitive Assessment Scale Beijing Edition was used to evaluate the cognitive function, and a score lower than twenty-six was considered as having cognitive impairment. The DKI and VBM data of TLE patients and healthy controls were collected by three tesla superconducting magnetic resonance scanner, and the parameters were calculated and analyzed.Results The electroencephalography of 80 TLE patients showed multiple abnormal bands in left or right temporal region, including sharp-slow and spine-slow complex waves. VBM results showed that gray matter volume of the left hippocampus, bilateral lingual gyrus, left thalamus, cingulate gyrus and cuneus decreased in TLE group with cognitive impairment compared with the healthy group. The volume of gray matter in the left hippocampus decreased in TLE with and without cognitive impairment compared with TLE without cognitive impairment. There was no difference in gray matter volume between TLE group without cognitive impairment and healthy group. DKI results showed that there was a statistically significant difference in mean kurtosis (MK) among all groups (P<0.001), and the MK and fractional anisotropy (FA) values of the healthy group, TLE group without cognitive impairment, and TLE group with cognitive impairment showed a downward trend. Pair comparison showed that there were statistically significant differences in MK and FA values among all groups.Conclusions The results of VBM and DKI analysis can be used to determine the brain structure changes of TLE with and without cognitive impairment. The micro injury of brain parenchyma in TLE patients is earlier than the decrease of gray matter volume, which has certain clinical value for clinical treatment and prognostic evaluation.
[Keywords] temporal lobe epilepsy;cognitive impairment;diffusion kurtosis imaging;voxel-based morphometry;Montreal Cognitive Assessmen Scale;magnetic resonance imaging

MA Pengcheng1   CUI Shulan1   WANG Jin1   GAO Yating1   FENG Yusen1   WU Gang2*  

1 Department of Radiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming 650051, China

2 Department of Neurology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming 650051, China

*Correspondence to: WU G, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Applied Basic Department of Yunnan Province and Kunming Medical University Research Project (No. 202101AY070001-210); Kunming Health Science and Technology Talent Training Project [No. 2020-SW (backup)-10, 2022-SW (leading)-24].
Received  2022-08-18
Accepted  2023-01-30
DOI: 10.12015/issn.1674-8034.2023.02.001
Cite this article as: MA P C, CUI S L, WANG J, et al. Magnetic resonance voxel analysis and diffusion kurtosis imaging of medial temporal lobe in patients with temporal lobe epilepsy and cognitive impairment[J]. Chin J Magn Reson Imaging, 2023, 14(2): 1-5, 20. DOI:10.12015/issn.1674-8034.2023.02.001.

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