Highlights
- •Data harmonization is an integral step in removing MRI protocol-based differences.
- •Diffusion tensor imaging metrics reveal white matter abnormalities in FCD patients.
- •Diffusion tensor imaging abnormalities are correlated with neurocognitive indices in FCD subjects.
Abstract
Our study assessed diffusion tensor imaging (DTI) metrics of fractional anisotropy
(FA), mean diffusivity (MD), and radial diffusivity (RD) in pediatric subjects with
epilepsy secondary to Focal Cortical Dysplasia (FCD) to improve our understanding
of structural network changes associated with FCD related epilepsy. We utilized a
data harmonization (DH) approach to minimize confounding effects induced by MRI protocol
differences. We also assessed correlations between DTI metrics and neurocognitive
measures of the fluid reasoning index (FRI), verbal comprehension index (VCI), and
visuospatial index (VSI). Data (n = 51) from 23 FCD patients and 28 typically developing
controls (TD) scanned clinically on either 1.5T, 3T, or 3T-wide-bore MRI were retrospectively
analyzed. Tract-based spatial statistics (TBSS) with threshold-free cluster enhancement
and permutation testing with 100,000 permutations were used for statistical analysis.
To account for imaging protocol differences, we employed non-parametric data harmonization
prior to permutation testing. Our analysis demonstrates that DH effectively removed
MRI protocol-based differences typical in clinical acquisitions while preserving group
differences in DTI metrics between FCD and TD subjects. Furthermore, DH strengthened
the association between DTI metrics and neurocognitive indices. Fractional anisotropy,
MD, and RD metrics showed stronger correlation with FRI and VSI than VCI. Our results
demonstrate that DH is an integral step to reduce the confounding effect of MRI protocol
differences during the analysis of white matter tracts and highlights biological differences
between FCD and healthy control subjects. Characterization of white matter changes
associated with FCD-related epilepsy may better inform prognosis and treatment approaches.
Keywords
Abbreviations:
DTI (diffusion tensor imaging), ANCOVA (analysis of covariance), FA (fractional anisotropy), FCD (focal cortical dysplasia), FRI (fluid reasoning index), FOV (field of view), JHU (Johns Hopkins University), MD (mean diffusivity), MRI (magnetic resonance imaging), RD (radial diffusivity), TBSS (tract-based spatial statistics), TD (typically developing), TE (echo time), TFCE (threshold-free cluster enhancement), TR (repetition time), VCI (verbal comprehension index), VSI (visual spatial index), WISC (Wechsler intelligence scale for children), SLF (superior longitudinal fasciculus), IFOF (inferior frontal-occipital fasciculus), UF (uncinate fasciculus)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 01, 2023
Accepted:
March 18,
2023
Received in revised form:
March 16,
2023
Received:
September 12,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
