Tract-based spatial statistics applied to diffusion tensor and diffusion kurtosis imaging in patients with newly diagnosed epilepsy.

Epilepsy is one of the most common neurological disorders in humans, affecting all ages and both genders. The purpose of this study (approved by NHS Research Ethics Committee, Reference 14/NW/0332) was to evaluate the potential of diffusion tensor and kurtosis imaging for detecting differences in measures of regional white matter integrity in adult patients with newly diagnosed epilepsy (NDE) in comparison with healthy controls. Diffusion Kurtosis imaging (DKI) is an extension of diffusion tensor imaging (DTI) that can evaluate the abnormalities in white matter integrity, assuming a non-Gaussian distribution (Jensen at al. 2005). To our knowledge there are few studies reported using DKI in patients with Epilepsy (Zhang et al, 2013). Data were collected from patients attending Walton Centre NHS Foundation Trust and 15 NDE patients and 13 sex and age-matched healthy controls were recruited. All subjects were scanned using a Siemens 3T Trio whole-body scanner (Siemens, Germany) with eight-channel radiofrequency (RF) coil head coil and immobilization to comfortably restrict head motion. DKI sequence consisted of 3 B-values and 60 Directions with the following parameters; TR/TE 5700/104 ms, acquisition matrix 72*72 mm, and a scan time of 12 minutes. Pre-processing and extraction of DKI/DTI measurements such as fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK) was done using ExploreDTI. (http://www.exploredti.com). Tract-Based Spatial Statistics analysis (FMRIB, Oxford, UK, http://www.fmrib.ox.ac.uk/fsl) was performed to investigate the differences between patient and control groups. NDE patients exhibited significantly reduced FA in Forceps Major (