High-resolution diffusion tensor imaging of the hippocampus in temporal lobe epilepsy

Purpose: To assess the quantitative diffusion characteristics of the hippocampus with high-resolution diffusion tensor imaging (DTI) in temporal lobe epilepsy (TLE). Methods: Thirteen controls and seven unilateral TLE patients (six with hippocampal sclerosis, one with normal magnetic resonance imaging (MRI)) were scanned with DTI using a zonally magnified oblique multislice echo planar imaging (ZOOM-EPI) acquisition. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in the hippocampi. Results: The mean hippocampal MD ipsilateral to the seizure focus was higher than the contralateral MD in patients (p < 0.05) and the mean MD in controls (p < 0.001). Hippocampal FA ipsilateral to the seizure focus was lower than the mean FA in controls (p < 0.05). MD asymmetry indexes were significantly different between the patient and control groups (p < 0.01). All six individual HS patients had ipsilateral hippocampal MD >= 2 standard deviations (S.D.) above the control mean. The patient with normal structural MRI had bilaterally low hippocampal FA and high MD. Discussion: High-resolution DTI identifies lateralizing abnormalities of MD and FA in TLE patients. This quantitative data on hippocampal integrity may assist in evaluating TLE patients with normal MRI, and in longitudinal studies. (c) 2006 Elsevier B.V. All rights reserved.