Unraveling the Diffusion MRI-Based Glymphatic System Alterations in Children with Rolandic Epilepsy

Yu Yin; Mengqiu Ma; Fuqin Wang; Chao Ju; Xinyu Luo; Haoyue Yu; Lisha Nie; Jun Liu; Heng Liu

doi:10.1016/j.acra.2024.11.010

Unraveling the Diffusion MRI-Based Glymphatic System Alterations in Children with Rolandic Epilepsy

Acad Radiol. 2024 Nov 25:S1076-6332(24)00856-0. doi: 10.1016/j.acra.2024.11.010. Online ahead of print.

Authors

Yu Yin¹, Mengqiu Ma², Fuqin Wang², Chao Ju¹, Xinyu Luo², Haoyue Yu², Lisha Nie³, Jun Liu⁴, Heng Liu⁵

Affiliations

¹ Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China (Y.Y., C.J., J.L.).
² Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Engineering Research Center of Intelligent Medical Imaging in Guizhou Higher Education Institutions, Zunyi 563003, China (M.M., F.W., X.L., H.Y., H.L.).
³ GE Healthcare, MR Research China, Beijing, China (L.N.).
⁴ Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China (Y.Y., C.J., J.L.); Clinical Research Center for Medical Imaging, Changsha 410011, China (J.L.); Department of Radiology Quality Control Center, Changsha 410011, China (J.L.).
⁵ Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Engineering Research Center of Intelligent Medical Imaging in Guizhou Higher Education Institutions, Zunyi 563003, China (M.M., F.W., X.L., H.Y., H.L.). Electronic address: zmcliuh@163.com.

PMID: 39592382
DOI: 10.1016/j.acra.2024.11.010

Abstract

Rationale and objectives: Although dysfunction of the glymphatic system in adult epilepsy has been extensively studied, there is a lack of research on the changes in this system during childhood development, particularly in children with Rolandic epilepsy (RE). This study aimed to investigate the changes in diffusion MRI measures related to the glymphatic function in children with RE.

Materials and methods: A total of thirty-eight children with RE and thirty-six demographically matched healthy children were enrolled in the study. All participants performed structural and diffusion MRI using a 3.0 T MRI scanner, and children with RE also underwent intellectual assessment. Diffusion MRI measures, including fractional volume of free water in white matter (FW-WM) and diffusion tensor imaging-along the perivascular space (DTI-ALPS) indices, were calculated and compared between the two groups. Spearman correlation were employed to assess the associations of the MRI indices with epilepsy age and intelligence quotients.

Results: Children with RE had significantly higher cerebral FW-WM (0.227 vs. 0.210; p < 0.001) and lower ALPS index (1.482 vs. 1.667; p < 0.001) than controls. The higher cerebral FW-WM was negatively correlated with full-scale IQ (r ＝ -0.389, p ＝ 0.021), while the lower ALPS index was positively correlated with age (r ＝ 0.529, p ＝ 0.001).

Conclusion: Children with RE exhibited altered diffusion MRI measures, which could be triggered by impairment of the glymphatic system. Additionally, our findings also indicate the associations of diffusion MRI measures with epilepsy age and lower intelligence levels.

Keywords: Diffusion tensor image analysis along the perivascular space; Diffusion weighted imaging; Free water imaging; Glymphatic system; Rolandic epilepsy.