Abstracts

Rationale: Pediatric epilepsy is a prevalent neurological disorder; and the etiology and natural history of this disorder is poorly understood. Epilepsy is classified a priority research area by the National Institute of Neurological Disorders and Stroke. (Curing Epilepsy 2007: Translating Discoveries into Therapies).The aim of this study is to characterize abnormalities in baseline and prospective cerebral white matter development, and determine the clinical significance of identified abnormalities in new-onset pediatric epilepsy through diffusion tensor imaging (DTI). We predict that microstructural abnormalities of clinical consequence (cognition) will be detected by DTI in children with epilepsy. The goal of utilizing this methodology is to augment and corroborate abnormalities of brain connectivity in pediatric epileptic patients. Methods: Research participants included four epileptic adolescents, and four controls of healthy first-degree cousins. The participants under went a Diffusion tensor Imaging (DTI) scan with following parameters: TR = 4500ms, TE = 71.8ms, field of view = 24cm x 24cm, 21 contiguous slices, 3mm slice thickness. The amplitude of the total diffusion gradient was 40 mT/m and was applied in 25 non-collinear directions uniformly distributed in three-dimensional space. All DTI images (b=0 sec/mm2 and b=1001sec/mm2) were acquired 2 times. The duration of the DTI scan was 9 minutes and 12 seconds. From the DTI data, we created whole brain white matter tracks for each subject with the Camino Diffusion Toolbox. Then we used TrackVis to visualize and generate specific tracks of the cingulumResults: We found a difference in cerebral white mater microstructure between subjects and normals. Conclusions: The cingulum is major tract, which interconnects the medial frontal cortex and the precuneus/posterior cingulate, key regions of the default mode network. The default mode network is a highly connected functional network that is implicated in many executive functions. We hypotheses that microstructural differences measured with DTI tractography would correlate with functional difference between controls and children with epilepsy.