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Leyden KM, Kucukboyaci NE, Puckett OK, et al. What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?. Quant Imaging Med Surg. 2015;5(2):247-63doi: 10.3978/j.issn.2223-4292.2015.02.01.
Leyden, K. M., Kucukboyaci, N. E., Puckett, O. K., Lee, D., Loi, R. Q., Paul, B., & McDonald, C. R. (2015). What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?. Quantitative imaging in medicine and surgery, 5(2), 247-63. https://doi.org/10.3978/j.issn.2223-4292.2015.02.01
Leyden, Kelly M, et al. "What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?." Quantitative imaging in medicine and surgery vol. 5,2 (2015): 247-63. doi: https://doi.org/10.3978/j.issn.2223-4292.2015.02.01
Leyden KM, Kucukboyaci NE, Puckett OK, Lee D, Loi RQ, Paul B, McDonald CR. What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?. Quant Imaging Med Surg. 2015 Apr;5(2):247-63. doi: 10.3978/j.issn.2223-4292.2015.02.01. PMID: 25853083; PMCID: PMC4379319.
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Quant Imaging Med Surg. 2015 Apr;5(2):247-63. doi: 10.3978/j.issn.2223-4292.2015.02.01.

What does diffusion tensor imaging (DTI) tell us about cognitive networks in temporal lobe epilepsy?.

Quantitative imaging in medicine and surgery

Kelly M Leyden, N Erkut Kucukboyaci, Olivia K Puckett, Davis Lee, Richard Q Loi, Brianna Paul, Carrie R McDonald

Affiliations

  1. 1 Multimodal Imaging Laboratory, University of California, San Diego, CA, USA ; 2 San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA ; 3 Department of Cognitive Science, 4 Department of Biology, University of California, San Diego, CA, USA ; 5 Comprehensive Epilepsy Center, Department of Neurology, University of California, San Francisco, CA, USA ; 6 Department of Psychiatry, University of California, San Diego, CA, USA.

PMID: 25853083 PMCID: PMC4379319 DOI: 10.3978/j.issn.2223-4292.2015.02.01

Abstract

Diffusion tensor imaging (DTI) has provided considerable insight into our understanding of epilepsy as a network disorder, revealing subtle alterations in white matter microstructure both proximal and distal to the epileptic focus. These white matter changes have been shown to assist with lateralizing the seizure focus, as well as delineating the location/anatomy of key white matter tracts (i.e., optic radiations) for surgical planning. However, only recently have studies emerged describing the utility of DTI for probing cognitive networks in patients with epilepsy and for examining the structural plasticity within these networks both before and after epilepsy surgery. Here, we review the current literature describing the use of DTI for understanding language and memory networks in patients with temporal lobe epilepsy (TLE), as well as the extant literature on networks associated with executive functioning and global intelligence. Studies of memory and language reveal a complex network of frontotemporal fibers that contribute to naming and fluency performance in TLE, and demonstrate that these networks appear to undergo adaptive changes in response to surgical intervention. Although studies of executive functioning and global intelligence have been less conclusive, there is accumulating evidence that aberrant communication between frontoparietal and medial temporal networks may underlie working memory impairment in TLE. More recently, multimodal imaging studies have provided evidence that disruptions within these white matter networks co-localize with functional changes observed on functional MRI. However, structure-function associations are not entirely coherent and may breakdown in patients with TLE, especially those with a left-sided seizure focus. Although the reasons for discordant findings are unclear, small sample sizes, heterogeneity within patient populations and limitations of the current tensor model may account for contradictory and null findings. Improvements in imaging hardware and higher field strengths have now paved the way for the implementation of advanced diffusion techniques, and these advanced models show great promise for improving our understanding of how network dysfunction contributes to cognitive morbidity in TLE.

Keywords: Diffusion tensor imaging (DTI); epilepsy; executive function; language; memory; temporal lobe (TL)

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