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Abstracts

Magnetic Resonance Fingerprinting for Identifying Biomarkers of Impaired Cognition in Older Patients with Epilepsy

Abstract number : 1.349
Submission category : 5. Neuro Imaging / 5A. Structural Imaging
Year : 2025
Submission ID : 690
Source : www.aesnet.org
Presentation date : 12/6/2025 12:00:00 AM
Published date :

Authors :
Presenting Author: Eric Zhou, MD, MPH – Cleveland Clinic

Ting-Yu Su, PhD – Cleveland Clinic
Anny Reyes, PhD – Cleveland Clinic
Lisa Ferguson, MA – Cleveland Clinic
Siyuan Hu, PhD – Case Western Reserve University
Dan Ma, PhD – Case Western Reserve University
Robyn Busch, PhD – Cleveland Clinic
Carrie McDonald, PhD – University of California, San Diego
Zhong Irene Wang, PhD – Cleveland Clinic

Rationale: Older patients with epilepsy have higher rates of impaired cognition compared to healthy controls. Imaging biomarkers of cognition in epilepsy patients could be used to identify patients that are at risk of developing cognitive impairment. Magnetic resonance fingerprinting (MRF) is a novel imaging modality that allows for fast and quantitative measurement of intrinsic tissue properties such as T1 and T2 relaxation times. In this study, we determined whether MRF could be used to correlate tissue property changes in the temporal lobe with memory function in older patients with epilepsy.

Methods: We enrolled patients with focal epilepsy 55+ years old receiving care at Cleveland Clinic. Participants underwent whole-brain 3T-MRF and conventional MRI using a protocol adapted from the Alzheimer’s Disease Neuroimaging Initiative. Participants also underwent a variety of neuropsychological tests, including measures of visual and verbal memory.  After reconstruction of raw MRF data, we generated quantitative T1 and T2 relaxometry maps, which were then co-registered with T1-weighted and T2-weighted conventional MRI images using Advanced Normalization Tools. We identified and segmented regions of interest (hippocampal subfields, frontal white/gray matter, and temporal white/gray matter) using FreeSurfer. Mean T1 and T2 signal intensities in each region were then calculated. We performed an independent two-sample T-test to identify significant differences between regions of interest that were ipsilateral and contralateral to the side of the patients’ epilepsy. Finally, we calculated Pearson correlation coefficients to identify significant associations between signal intensities for each region of interest and a composite delayed memory score (mean of delayed visual and verbal memory scores). 


Results: We included 28 participants (mean age 66.4y), of whom 57% were women. Twenty-one (75%) participants had unilateral focal epilepsy. Twenty-four (86%) patients had nonlesional conventional MRI. In patients with unilateral focal epilepsy, there were significant increases seen in T2 signal intensities in several of the ipsilateral regions of interest compared to their corresponding contralateral regions, including CA1 (mean percent increase 6.5%, p = 0.01), hippocampal fissure (mean increase 11.2%, p = 0.02), and hippocampal head/body (mean increase 7.8%, p = 0.02). On neuropsychological testing, there was a significant negative correlation seen between the memory composite score and T2 intensities in the hippocampal fissure (r = –0.54, p = 0.01), and the correlation trended towards significance for the hippocampal head/body (r = –0.42, p = 0.06).

Conclusions: Our study shows initial efficacy of MRF to identify subtle tissue property changes, particularly T2, in older patients with unilateral focal epilepsy and nonlesional conventional MRI.  These changes showed correlation with episodic memory scores, suggesting their potential role as noninvasive imaging markers for impaired cognition in this patient population.


Funding: NIH R01 NS120976/NS109439
 
 


Neuro Imaging