. 2020 Aug 1;143(8):2454-2473.

doi: 10.1093/brain/awaa200.

White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study

Sean N Hatton¹, Khoa H Huynh², Leonardo Bonilha³, Eugenio Abela⁴, Saud Alhusaini^{5

6}, Andre Altmann⁷, Marina K M Alvim⁸, Akshara R Balachandra^{9

10}, Emanuele Bartolini^{11

12}, Benjamin Bender¹³, Neda Bernasconi¹⁴, Andrea Bernasconi¹⁴, Boris Bernhardt¹⁵, Núria Bargallo¹⁶, Benoit Caldairou¹⁴, Maria E Caligiuri¹⁷, Sarah J A Carr¹⁸, Gianpiero L Cavalleri^{19

20}, Fernando Cendes⁸, Luis Concha²¹, Esmaeil Davoodi-Bojd²², Patricia M Desmond²³, Orrin Devinsky²⁴, Colin P Doherty^{25

26}, Martin Domin²⁷, John S Duncan^{28

29}, Niels K Focke^{30

31}, Sonya F Foley³², Antonio Gambardella^{19

33}, Ezequiel Gleichgerrcht³, Renzo Guerrini¹¹, Khalid Hamandi^{34

35}, Akari Ishikawa⁸, Simon S Keller^{36

37}, Peter V Kochunov³⁸, Raviteja Kotikalapudi^{39

40}, Barbara A K Kreilkamp^{36

37}, Patrick Kwan^{41

42}, Angelo Labate^{17

33}, Soenke Langner^{43

44}, Matteo Lenge^{11

45}, Min Liu⁴⁶, Elaine Lui^{23

47}, Pascal Martin³¹, Mario Mascalchi⁴⁸, José C V Moreira⁸, Marcia E Morita-Sherman^{8

49}, Terence J O'Brien^{41

42

50}, Heath R Pardoe⁵¹, José C Pariente¹⁶, Letícia F Ribeiro⁸, Mark P Richardson⁵², Cristiane S Rocha⁸, Raúl Rodríguez-Cruces^{15

21}, Felix Rosenow^{53

54}, Mariasavina Severino⁵⁵, Benjamin Sinclair^{42

50}, Hamid Soltanian-Zadeh^{56

57}, Pasquale Striano^{58

59}, Peter N Taylor⁶⁰, Rhys H Thomas^{61

62}, Domenico Tortora⁵⁶, Dennis Velakoulis^{63

64}, Annamaria Vezzani⁶⁵, Lucy Vivash^{41

42}, Felix von Podewils⁶⁶, Sjoerd B Vos^{67

68}, Bernd Weber⁶⁹, Gavin P Winston^{68

70

71}, Clarissa L Yasuda⁸, Alyssa H Zhu⁷², Paul M Thompson⁷², Christopher D Whelan^{6

73}, Neda Jahanshad⁷², Sanjay M Sisodiya^{71

74}, Carrie R McDonald⁷⁵

Affiliations

¹ Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.
² Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.
³ Department of Neurology, Medical University of South Carolina, Charleston 29425 SC, USA.
⁴ Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 9NU UK.
⁵ Neurology Department, Yale School of Medicine, New Haven 6510 CT, USA.
⁶ Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland.
⁷ Centre of Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London WC1V 6LJ, UK.
⁸ Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888 São Paulo, Brazil.
⁹ Center for Multimodal Imaging and Genetics, UCSD School of Medicine, La Jolla 92037 CA, USA.
¹⁰ Boston University School of Medicine, Boston 2118 MA, USA.
¹¹ Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
¹² USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy.
¹³ Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen 72076, Germany.
¹⁴ Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal H3A 2B4 QC, Canada.
¹⁵ Montreal Neurological Institute, McGill University, Montreal H3A2B4 QC, Canada.
¹⁶ Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain.
¹⁷ Neuroscience Research Center, University Magna Graecia, viale Europa, Germaneto, 88100, Catanzaro, Italy.
¹⁸ Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK.
¹⁹ Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin D02 YN77 Ireland.
²⁰ FutureNeuro Research Centre, Science Foundation Ireland, Dublin D02 YN77, Ireland.
²¹ Institute of Neurobiology, Universidad Nacional Autonoma de Mexico, Queretaro 76230, Mexico.
²² Radiology and Research Administration, Henry Ford Hospital, 1 Detroit 48202 MI, USA.
²³ Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne 3050 Victoria, Australia.
²⁴ Director, NYU Epilepsy Center, New York 10016 NY, USA.
²⁵ Division of Neurology, Trinity College Dublin, TBSI, Pearce Street, Dublin D02 R590, Ireland.
²⁶ FutureNeuro SFI Centre for Neurological Disease, RCSI, St Stephen's Green, Dublin D02 H903, Ireland.
²⁷ Functional Imaging Unit, University Medicine Greifswald, Greifswald 17475 M/V, Germany.
²⁸ Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK.
²⁹ MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter, Buckinghamshire SL9 0RJ, UK.
³⁰ Clinical Neurophysiology, University Medicine Göttingen, 37099 Göttingen, Germany.
³¹ Department of Epileptology, University of Tübingen, 72076 Tübingen, Germany.
³² CUBRIC, Cardiff University, Cardiff CF24 4HQ, Wales.
³³ Institute of Neurology, University Magna Graecia, 88100, Catanzaro, Italy.
³⁴ The Wales Epilepsy Unit, Cardiff and Vale University Health Board, Cardiff CF144XW, UK.
³⁵ Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK.
³⁶ Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK.
³⁷ Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK.
³⁸ Maryland Psychiatric Research Center, 55 Wade Ave, Baltimore 21228, MD, USA.
³⁹ Department of Neurology and Epileptology, University Hospital Tübingen, Tübingen 72076 BW, Germany.
⁴⁰ Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen 72076 BW, Germany.
⁴¹ Department of Neuroscience, Central Clinical School, Monash University, Melbourne 3004 Victoria, Australia.
⁴² Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville 3050 Victoria, Australia.
⁴³ Institute for Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald Faculty of Medicine, Greifswald 17475, Germany.
⁴⁴ Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Centre, Rostock 18057, Germany.
⁴⁵ Functional and Epilepsy Neurosurgery Unit, Children's Hospital A. Meyer-University of Florence, Florence 50139, Italy.
⁴⁶ Department of Neurology, Montreal Neurological Institute, Montreal H3A 2B4 QC, Canada.
⁴⁷ Department of Medicine and Radiology, University of Melbourne, 3Parkville 3050 Victoria, Australia.
⁴⁸ Meyer Children Hospital University of Florence, Florence 50130 Tuscany, Italy.
⁴⁹ Cleveland Clinic, Cleveland 44195 OH, USA.
⁵⁰ Department of Neurology, Alfred Health, Melbourne 3004 Victoria, Australia.
⁵¹ Department of Neurology, New York University School of Medicine, New York City 10016 NY, USA.
⁵² Division of Neuroscience, King's College London, Institute of Psychiatry, London SE5 8AB, UK.
⁵³ Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Germany, Frankfurt 60528 Hesse, Germany.
⁵⁴ Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt a. M. 60528, Germany.
⁵⁵ Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy.
⁵⁶ Radiology and Research Administration, Henry Ford Health System, Detroit 48202-2692 MI, USA.
⁵⁷ School of Electrical and Computer Engineering, University of Tehran, Tehran 14399-57131, Iran.
⁵⁸ IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy.
⁵⁹ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.
⁶⁰ School of Computing, Newcastle University, Urban Sciences Building, Science Square, Newcastle upon Tyne NE4 5TG, UK.
⁶¹ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
⁶² Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
⁶³ Royal Melbourne Hospital, Melbourne 3050 Victoria, Australia.
⁶⁴ University of Melbourne, Parkville, Melbourne 3050 Victoria, Australia.
⁶⁵ Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano 20156 Italy.
⁶⁶ Epilepsy Center, University Medicine Greifswald, Greifswald 17489 Mecklenburg-Vorpommern, Germany.
⁶⁷ Centre for Medical Image Computing, University College London, London, WC1V 6LJ, UK.
⁶⁸ Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK.
⁶⁹ Institute of Experimental Epileptology and Cognition Research, University of Bonn, Venusberg Campus 1, Bonn 53127 NRW, Germany.
⁷⁰ Department of Medicine, Division of Neurology, Queen's University, Kingston K7L 3N6 ON, Canada.
⁷¹ MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter, Buckinghamshire, SL9 0RJ UK.
⁷² Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA.
⁷³ Research and Early Development (RED), Biogen Inc., Cambridge, MA 02139, USA.
⁷⁴ Chalfont Centre for Epilepsy, Chalfont-St-Peter, SL9 0RJ Bucks, UK.
⁷⁵ Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.

PMID: 32814957
PMCID: PMC7567169
DOI: 10.1093/brain/awaa200

White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study

Sean N Hatton et al. Brain. 2020.

. 2020 Aug 1;143(8):2454-2473.

doi: 10.1093/brain/awaa200.

Authors

Affiliations

¹ Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.
² Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.
³ Department of Neurology, Medical University of South Carolina, Charleston 29425 SC, USA.
⁴ Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London SE5 9NU UK.
⁵ Neurology Department, Yale School of Medicine, New Haven 6510 CT, USA.
⁶ Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland.
⁷ Centre of Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London WC1V 6LJ, UK.
⁸ Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888 São Paulo, Brazil.
⁹ Center for Multimodal Imaging and Genetics, UCSD School of Medicine, La Jolla 92037 CA, USA.
¹⁰ Boston University School of Medicine, Boston 2118 MA, USA.
¹¹ Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy.
¹² USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy.
¹³ Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen 72076, Germany.
¹⁴ Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal H3A 2B4 QC, Canada.
¹⁵ Montreal Neurological Institute, McGill University, Montreal H3A2B4 QC, Canada.
¹⁶ Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain.
¹⁷ Neuroscience Research Center, University Magna Graecia, viale Europa, Germaneto, 88100, Catanzaro, Italy.
¹⁸ Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK.
¹⁹ Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin D02 YN77 Ireland.
²⁰ FutureNeuro Research Centre, Science Foundation Ireland, Dublin D02 YN77, Ireland.
²¹ Institute of Neurobiology, Universidad Nacional Autonoma de Mexico, Queretaro 76230, Mexico.
²² Radiology and Research Administration, Henry Ford Hospital, 1 Detroit 48202 MI, USA.
²³ Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne 3050 Victoria, Australia.
²⁴ Director, NYU Epilepsy Center, New York 10016 NY, USA.
²⁵ Division of Neurology, Trinity College Dublin, TBSI, Pearce Street, Dublin D02 R590, Ireland.
²⁶ FutureNeuro SFI Centre for Neurological Disease, RCSI, St Stephen's Green, Dublin D02 H903, Ireland.
²⁷ Functional Imaging Unit, University Medicine Greifswald, Greifswald 17475 M/V, Germany.
²⁸ Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK.
²⁹ MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter, Buckinghamshire SL9 0RJ, UK.
³⁰ Clinical Neurophysiology, University Medicine Göttingen, 37099 Göttingen, Germany.
³¹ Department of Epileptology, University of Tübingen, 72076 Tübingen, Germany.
³² CUBRIC, Cardiff University, Cardiff CF24 4HQ, Wales.
³³ Institute of Neurology, University Magna Graecia, 88100, Catanzaro, Italy.
³⁴ The Wales Epilepsy Unit, Cardiff and Vale University Health Board, Cardiff CF144XW, UK.
³⁵ Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK.
³⁶ Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK.
³⁷ Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK.
³⁸ Maryland Psychiatric Research Center, 55 Wade Ave, Baltimore 21228, MD, USA.
³⁹ Department of Neurology and Epileptology, University Hospital Tübingen, Tübingen 72076 BW, Germany.
⁴⁰ Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen 72076 BW, Germany.
⁴¹ Department of Neuroscience, Central Clinical School, Monash University, Melbourne 3004 Victoria, Australia.
⁴² Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Parkville 3050 Victoria, Australia.
⁴³ Institute for Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt University Greifswald Faculty of Medicine, Greifswald 17475, Germany.
⁴⁴ Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, Rostock University Medical Centre, Rostock 18057, Germany.
⁴⁵ Functional and Epilepsy Neurosurgery Unit, Children's Hospital A. Meyer-University of Florence, Florence 50139, Italy.
⁴⁶ Department of Neurology, Montreal Neurological Institute, Montreal H3A 2B4 QC, Canada.
⁴⁷ Department of Medicine and Radiology, University of Melbourne, 3Parkville 3050 Victoria, Australia.
⁴⁸ Meyer Children Hospital University of Florence, Florence 50130 Tuscany, Italy.
⁴⁹ Cleveland Clinic, Cleveland 44195 OH, USA.
⁵⁰ Department of Neurology, Alfred Health, Melbourne 3004 Victoria, Australia.
⁵¹ Department of Neurology, New York University School of Medicine, New York City 10016 NY, USA.
⁵² Division of Neuroscience, King's College London, Institute of Psychiatry, London SE5 8AB, UK.
⁵³ Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Germany, Frankfurt 60528 Hesse, Germany.
⁵⁴ Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt a. M. 60528, Germany.
⁵⁵ Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy.
⁵⁶ Radiology and Research Administration, Henry Ford Health System, Detroit 48202-2692 MI, USA.
⁵⁷ School of Electrical and Computer Engineering, University of Tehran, Tehran 14399-57131, Iran.
⁵⁸ IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy.
⁵⁹ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.
⁶⁰ School of Computing, Newcastle University, Urban Sciences Building, Science Square, Newcastle upon Tyne NE4 5TG, UK.
⁶¹ Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
⁶² Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
⁶³ Royal Melbourne Hospital, Melbourne 3050 Victoria, Australia.
⁶⁴ University of Melbourne, Parkville, Melbourne 3050 Victoria, Australia.
⁶⁵ Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano 20156 Italy.
⁶⁶ Epilepsy Center, University Medicine Greifswald, Greifswald 17489 Mecklenburg-Vorpommern, Germany.
⁶⁷ Centre for Medical Image Computing, University College London, London, WC1V 6LJ, UK.
⁶⁸ Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK.
⁶⁹ Institute of Experimental Epileptology and Cognition Research, University of Bonn, Venusberg Campus 1, Bonn 53127 NRW, Germany.
⁷⁰ Department of Medicine, Division of Neurology, Queen's University, Kingston K7L 3N6 ON, Canada.
⁷¹ MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter, Buckinghamshire, SL9 0RJ UK.
⁷² Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA.
⁷³ Research and Early Development (RED), Biogen Inc., Cambridge, MA 02139, USA.
⁷⁴ Chalfont Centre for Epilepsy, Chalfont-St-Peter, SL9 0RJ Bucks, UK.
⁷⁵ Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla 92093 CA, USA.

PMID: 32814957
PMCID: PMC7567169
DOI: 10.1093/brain/awaa200

Abstract

The epilepsies are commonly accompanied by widespread abnormalities in cerebral white matter. ENIGMA-Epilepsy is a large quantitative brain imaging consortium, aggregating data to investigate patterns of neuroimaging abnormalities in common epilepsy syndromes, including temporal lobe epilepsy, extratemporal epilepsy, and genetic generalized epilepsy. Our goal was to rank the most robust white matter microstructural differences across and within syndromes in a multicentre sample of adult epilepsy patients. Diffusion-weighted MRI data were analysed from 1069 healthy controls and 1249 patients: temporal lobe epilepsy with hippocampal sclerosis (n = 599), temporal lobe epilepsy with normal MRI (n = 275), genetic generalized epilepsy (n = 182) and non-lesional extratemporal epilepsy (n = 193). A harmonized protocol using tract-based spatial statistics was used to derive skeletonized maps of fractional anisotropy and mean diffusivity for each participant, and fibre tracts were segmented using a diffusion MRI atlas. Data were harmonized to correct for scanner-specific variations in diffusion measures using a batch-effect correction tool (ComBat). Analyses of covariance, adjusting for age and sex, examined differences between each epilepsy syndrome and controls for each white matter tract (Bonferroni corrected at P < 0.001). Across 'all epilepsies' lower fractional anisotropy was observed in most fibre tracts with small to medium effect sizes, especially in the corpus callosum, cingulum and external capsule. There were also less robust increases in mean diffusivity. Syndrome-specific fractional anisotropy and mean diffusivity differences were most pronounced in patients with hippocampal sclerosis in the ipsilateral parahippocampal cingulum and external capsule, with smaller effects across most other tracts. Individuals with temporal lobe epilepsy and normal MRI showed a similar pattern of greater ipsilateral than contralateral abnormalities, but less marked than those in patients with hippocampal sclerosis. Patients with generalized and extratemporal epilepsies had pronounced reductions in fractional anisotropy in the corpus callosum, corona radiata and external capsule, and increased mean diffusivity of the anterior corona radiata. Earlier age of seizure onset and longer disease duration were associated with a greater extent of diffusion abnormalities in patients with hippocampal sclerosis. We demonstrate microstructural abnormalities across major association, commissural, and projection fibres in a large multicentre study of epilepsy. Overall, patients with epilepsy showed white matter abnormalities in the corpus callosum, cingulum and external capsule, with differing severity across epilepsy syndromes. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric co-morbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research.

Keywords: diffusion tensor imaging; epilepsy; multisite analysis; white matter.

PubMed Disclaimer

Figures

**Figure 2**
**Diffusion MRI harmonization using ComBat**. Average FA (*top*) and MD (*bottom*) measures across 24 scanners showing differences in mean FA measures per scanner (*left*) which are harmonized using ComBat (*middle*). The process corrects the variance in scanner without altering the biological variance expected with age (*right*). Red = before correction; Blue = after correction.

**Figure 3**
**FA effect size bar graphs.** ALIC = anterior limb of the internal capsule; CST = corticospinal tract; EC = external capsule; FX.ST = fornix/stria terminalis; L = left; PCR = posterior corona radiata; PLIC = posterior limb of the internal capsule; PTR = posterior thalamic radiation; R = right; RLIC = rentrolenticular part of the internal capsule; SCR = superior corona radiata; SFO = superior fronto-occipital fasciculus; SS = sagittal stratum; TAP = tapetum; UNC = uncinate.

**Figure 4**
**MD effect size bar graphs.** ALIC = anterior limb of the internal capsule; CST = corticospinal tract; EC = external capsule; FX.ST = fornix/stria terminalis; L = left; PCR = posterior corona radiata; PLIC = posterior limb of the internal capsule; PTR = posterior thalamic radiation; R = right; RLIC = rentrolenticular part of the internal capsule; SCR = superior corona radiata; SFO = superior fronto-occipital fasciculus; SS = sagittal stratum; TAP = tapetum; UNC = uncinate.

**Figure 5**
**Syndromic difference in average FA and MD in five ROIs.** Mean FA (*left*) and MD (*right*) for each patient syndrome, controlling for age, age², sex, age of onset, and disease duration. Error bars reflect 95% confidence intervals. Dotted red lines reflect the means of controls. For FA, average = 0.585, ACR = 0.481, BCC = 0.690, CGC = 0.627, external capsule (EC) = 0.484. For MD, average = 0.000801, ACR = 0.000741, BCC = 0.000881, CGC = 0.000733, external capsule = 0.000739. Significant differences are indicated with asterisks (**P <* 0.05, ** *P <* 0.01, *** *P <* 0.001). L = left; R = right.

**Figure 6**
**Comparisons of fractional anisotropy measures across neuropsychiatric disorders.** (A) Heat map of FA effect sizes for the ‘all epilepsies’ group compared to those in four other ENIGMA disorders: BP = bipolar disorder; MDD = major depressive disorder; SCZ = schizophrenia. (B). Radar plot of the four disorders that showed significant correlations across white matter tracts. Positive values reflect patient group values were on average higher than controls, whereas negative values reflect cases where patient group values were on average lower than that of controls. ALIC = anterior limb of the internal capsule; CST = corticospinal tract; EC = external capsule; FX.ST = fornix/stria terminalis; PCR = posterior corona radiata; PLIC = posterior limb of the internal capsule; PTR = posterior thalamic radiation; RLIC = rentrolenticular part of the internal capsule; SCR = superior corona radiata; SFO = superior fronto-occipital fasciculus; SS = sagittal stratum; TAP = tapetum; UNC = uncinate.

See this image and copyright information in PMC

Comment in

Epilepsy as a Disease of White Matter.
Hogan RE. Hogan RE. Epilepsy Curr. 2020 Dec 3;21(1):27-29. doi: 10.1177/1535759720975744. eCollection 2021 Jan-Feb. Epilepsy Curr. 2020. PMID: 34025269 Free PMC article. No abstract available.

References

1. Abarrategui B, Parejo-Carbonell B, García García ME, Di Capua D, García-Morales I.. The cognitive phenotype of idiopathic generalized epilepsy. Epilepsy Behav 2018; 89: 99–104. - PubMed
1. Ahmadi ME, Hagler DJ, McDonald CR, Tecoma ES, Iragui VJ, Dale AM, et al.Side matters: diffusion tensor imaging tractography in left and right temporal lobe epilepsy. AJNR Am J Neuroradiol 2009; 30: 1740–7. - PMC - PubMed
1. Altmann A, Ryten M, Nunzio MD, Ravizza T, Tolomeo D, Reynolds RH, et al. A systems-level analysis highlights microglial activation as a modifying factor in common forms of human epilepsy bioRxiv 2017: 470518. doi: 10.1101/470518. - PMC - PubMed
1. Arfanakis K, Hermann BP, Rogers BP, Carew JD, Seidenberg M, Meyerand ME.. Diffusion tensor MRI in temporal lobe epilepsy. Magn Reson Imaging 2002; 20: 511–9. - PubMed
1. Baker JT, Dillon DG, Patrick LM, Roffman JL, Brady RO, Pizzagalli DA, et al.Functional connectomics of affective and psychotic pathology. Proc Natl Acad Sci USA 2019; 116: 9050–9. - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study

Affiliations

White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study

Authors

Affiliations

Abstract

Figures

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous