The Relationship Between DTI-ALPS, Sleep Quality, and WM Integrity in Patients with Focal Epilepsy
Poster No:
1614
Submission Type:
Abstract Submission
Authors:
En-Chi Tsui1, Siew-Na Lim2, Yi-Ping Chao1
Institutions:
1Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan, 2Chang Gung Memorial Hospital, Linkou, Taiwan
First Author:
En-Chi Tsui
Department of Computer Science and Information Engineering, Chang Gung University
Taoyuan, Taiwan
Department of Computer Science and Information Engineering, Chang Gung University
Taoyuan, Taiwan
Co-Author(s):
Yi-Ping Chao
Department of Computer Science and Information Engineering, Chang Gung University
Taoyuan, Taiwan
Department of Computer Science and Information Engineering, Chang Gung University
Taoyuan, Taiwan
Introduction:
The glymphatic system has recently attracted heightened attention due to its potential implications for brain health and disease. Substantial evidence supports the glymphatic system's role in facilitating the extracellular drainage of waste within the cerebrospinal fluid (CSF), and disruptions in this system may be associated with neuroinflammation and functional impairments. Utilizing diffusion tensor imaging (DTI)-derived indices of ventricular diffusion velocity along the perpendicular planes of the projection and association fiber white matter pathways, a technique referred to as DTI-based analysis along the perivascular space (DTI-ALPS) has been applied to investigate the glymphatic system. Here, we aimed to investigate the glymphatic system function using DTI-ALPS and its relationship with sleep quality and tract-based white matter integrity in patients with focal epilepsy.
Methods:
In this study, 54 patients with focal epilepsy (mean age: 37.5±13.4, 25 males) and 39 healthy controls (HCs) (mean age: 32.7±8.8, 19 males) were recured. The 54 patients could be classified into four subgroups, including temporal lobe epilepsy (TLE, 8), frontal lobe epilepsy (FLE, 10), Mesial temporal lobe epilepsy (MTLE, 25), and MTLE with hippocampal sclerosis (MTLE with HS, 11). All DTI data were collected using Siemens 3T Trio scanners at Chang Gung Memorial Hospital at Linkou, Taiwan. DTI was conducted using spin‐echo single‐shot EPI sequences with 64 different diffusion directions on each shell (b-values = 1000 and 2000 s/mm2). DSI Studio software was utilized for data preprocessing and DTI reconstruction. Manual regions of interest (ROIs) were delineated to obtain the fiber orientation and diffusivities of the three directions along the x-, y-, and z-axes as voxel levels within the ROIs. Subsequently, the DTI-ALPS index was calculated using the formula shown in Figure 1 The tract-based white matter integrity was assessed using the PANDA (Pipeline for Analyzing braiN Diffusion imAges) toolbox, and sleep quality for all subjects was evaluated using the Pittsburgh Sleep Quality Index (PSQI) score.
Results:
The results indicate that there is no statistically significant difference in ALPS values between patients with focal epilepsy and HCs (1.60 vs. 1.57, p=0.52). Even though the patients are divided into four subgroups, there is still no significant difference observed among the subgroups or between the subgroups and NCs. Moreover, there is still no significant difference observed when the right and left ALPS indices were calculated in both hemispheres. In the correlation analysis between clinical characters and ALPS, a significant negative correlation was observed between PSQI score and ALPS in both NCs and the MTLE group (r=-0.387 with p<0.05 and r=-0.521 with p<0.01).
Conclusions:
However, no significant correlation was found in the other three groups and all focal patients. Furthermore, in the correlation analysis between ALPS and the diffusion characteristics of white matter tracts, the results indicate a significant negative correlation between the mean diffusivity in the right Tapetum and ALPS in the all focal patients group (r=-0.461 with p<0.01). Additionally, within the sub-groups, both FLE and TLE also exhibit a significant negative correlation (r=-0.675 and -0.782, p<0.05). The results of correlation analyses were shown in Figure 2. These findings align with previous research, suggesting no significant DTI‐ALPS differences between patients and HCs. ALPS correlated negatively with the PSQI in HCs and MTLE groups, indicating a glymphatic function-sleep duration relationship. Ipsilateral atrophy of the tapetum was found in both TLE-HS and TLE, suggesting a common lateralized effect of focal seizures. Ongoing recruitment efforts are planned to increase the number of participants in the future. This will allow for a more comprehensive understanding of the effects of ALPS on the sleep quality of focal epilepsy patients and white matter integrity.
Modeling and Analysis Methods:
Diffusion MRI Modeling and Analysis 1
Novel Imaging Acquisition Methods:
Diffusion MRI 2
Keywords:
Data analysis
Epilepsy
MRI
Sleep
White Matter
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
1|2Indicates the priority used for review
Provide references using author date format
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