Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic-clonic seizure: A voxel-based diffusional kurtosis imaging study

Abstract

Purpose To investigate the diffusion abnormalities in the brain of children with idiopathic generalized epilepsy (IGE) with generalized tonic-clonic seizure (GTCS) by using diffusion kurtosis imaging (DKI). Materials and Methods Twenty-one IGE children with GTCS and 16 controls were recruited. DKI was performed and maps of radial diffusivity (λ⊥), axial diffusivity (λ//), mean diffusivity (MD), fractional anisotropy (FA), radial kurtosis (K⊥), axial kurtosis (K//) and mean kurtosis (MK) were calculated. Voxel-based analyses were employed to compare diffusion metrics in epilepsy versus the controls. Results In the case group, MD was found significantly higher in the right temporal lobe, the right occipital lobe, hippocampus, and some subcortical regions, while FA increased in bilateral supplementary motor area and the left superior frontal lobe (false discovery rate corrected P < 0.05). Analysis of λ⊥ and λ// showed that the increased MD was mainly due to the elevated λ//. Significantly decreased MK was also detected in bilateral temporo-occipital regions, the right hippocampus, the left insula, the left post-central area, and some subcortical regions (false discovery rate corrected P < 0.05). In most regions the changed MK were due to the decreased K//. Conclusion The kurtosis parameters (K⊥, K//, and MK) reflect different microstructural information in the IGE children with GTCS, and this support the value of DKI in studying children GTCS.