Cerebral Blood Flow Alterations in Temporal Lobe Epilepsy Using Interictal Arterial Spin Labeling MRI
Abstract number :
2.161
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2021
Submission ID :
1826192
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Frederika Rentzeperis, AB - National Institute of Neurological Disorders and Stroke; Myriam Abdennadher, MD - Neurology Department, Boston Medical Center - Boston University School of Medicine; Kate Dembny, BS - National Institute of Neurological Disorders and Stroke - National Institutes of Health; Kathryn Snyder, BS - National Institute of Neurological Disorders and Stroke - National Institutes of Health; Lalith Talagala, PhD - National Institute of Neurological Disorders and Stroke - National Institutes of Health; Kareem Zaghloul, MD, PhD - National Institute of Neurological Disorders and Stroke - National Institutes of Health; William Theodore, MD - National Institute of Neurological Disorders and Stroke - National Institutes of Health; Sara Inati, MD - National Institute of Neurological Disorders and StrokeNational Institute of Neurological Disorders and Stroke - National Institutes of Health
Rationale: Non-invasive imaging studies play a critical role in seizure focus localization and lateralization in patients with drug-resistant focal epilepsy undergoing presurgical evaluation. Arterial Spin Labeling (ASL) MRI is a widely available, safe, noninvasive imaging modality used to study cerebral blood flow (CBF). Previous studies have suggested that ASL may have utility in identification of seizure foci, although with variable results. Here, we characterize alterations in temporal lobe CBF in lesional and non-lesional patients with TLE compared to healthy volunteers.
Methods: Study participants were prospectively enrolled through an IRB-approved epilepsy imaging protocol at the NIH Clinical Center. Inclusion criteria were temporal lobe epilepsy as confirmed by MRI, pathology, or well-lateralized EEG with TLE semiology. Exclusion criteria were destructive or mass lesions, poorly localized or lateralized epilepsy, poor quality ASL data, or poor alignment between ASL and anatomical data. ASL images were co-registered to the MPRAGE images using rigid-body registration, followed by nonlinear registration to MNI space. CBF was calculated from ASL data using a single compartment, then median normalizing within each subject. Using the Brainnetome atlas parcellations, average CBF values and asymmetry indices were computed for lateral (LTL) and medial (MTL) temporal lobe parcels, anterior (ATL) and posterior (PTL) temporal neocortical parcels, and the hippocampus, amygdala, and parahippocampal gyrus (PHG). Results were compared between healthy volunteers (HVs), lesional (MRI+) and non-lesional (MRI-) groups (Kruskal Wallis test with posthoc Dunn’s test with Bonferroni adjustment).
Results: Participants included 14 HVs (7 female, mean age 33.3 years), 8 MRI+ (4 female, mean age 29.3 years) and 13 MRI- (7 female, mean age 35.1 years) TLE patients. MRI+ participants had asymmetric LTL and MTL CBF compared to HVs and asymmetric LTL compared to MRI- TLE participants (p< 0.05). Compared to HVs and MRI- participants, MRI+ participants showed significantly different CBF AIs at PHG (p=0.031), ATL (p=0.026), and no difference at amygdala (p=0.375), hippocampus (p=0.292) and PTL (p=0.378). Compared to HVs, there was significant ipsilateral hypoperfusion in MRI+ participants in the LTL, ATL, and PHG, and in MRI- participants only in the ipsilateral ATL.
Neuro Imaging