Ziyun Wang,1,2,* Weiping Liu,3,* Ximei Feng,4 Qian Wang,1,2 Xun Ning,1,2 Wu Xing1,2 

1Department of Radiology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Department of Neurology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4Department of Radiology, Changsha Central Hospital, University of South China, Changsha, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wu Xing, Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Email xingwu@csu.edu.cn

Purpose: The study aims to further investigate the relationship between the Sleep-related epilepsies (SRE) and alterations in the White Matter (WM) microstructure, as well as to explore the clinical value of diffusion tensor imaging (DTI) in patients with SRE.
Methods: DTI data were acquired for 52 patients with SRE and 74 Healthy Controls (HC), all of whom were matched for sex and age. The DTI indicators, including Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD) and Radial Diffusivity (RD), were compared between the two groups using Tract-Based Spatial Statistics (TBSS) to analyze alterations in WM microstructure. Altered WM was correlated with the age of onset and disease duration of SRE.
Results: Compared to the HC, FA decreased in the genu of the corpus callosum (GCC) and the left anterior corona radiata (ACR_L) in SRE. Conversely, the RD of the bilateral superior corona radiata (SCR), the anterior corona radiata (ACR), the GCC, and the body of the corpus callosum (BCC) increased. Furthermore, a negative correlation was identified between the increased RD values and age of onset in SRE.
Conclusion: The FA and RD values derived from DTI serve as neuroimaging markers to evaluate WM damage in SRE. These findings indicate that alterations in WM microstructure within the bilateral frontal lobes and corpus callosum may contribute to a potential pathophysiological mechanism underlying seizures in SRE. Furthermore, myelin damage appears to be more severe in early-onset SRE patients, highlighting the necessity for clinical vigilance regarding WM microstructural changes in young SRE patients.

Keywords: sleep-related epilepsies, diffusion tensor imaging, tract-based spatial statistics, white matter microstructure