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• Clinical Articles •
Evaluation of white matter microstructural impairment in temporal lobe epilepsy using peak width of skeletonized mean diffusivity
WEI Yuanyuan  LI Jinqin  SONG Dengyan  WANG Zhuo  YE Hao  YANG Wenrui  LI Jian  CHEN Bing 

Cite this article as WEI Y Y, LI J Q, SONG D Y, et al. Evaluation of white matter microstructural impairment in temporal lobe epilepsy using peak width of skeletonized mean diffusivity[J]. Chin J Magn Reson Imaging, 2026, 17(8): 57-63. DOI:10.12015/issn.1674-8034.2026.08.005.


[Abstract] Objective To explore the clinical value of the peak width of skeletonized mean diffusivity (PSMD) parameter in reflecting white matter damage and disease severity in patients with temporal lobe epilepsy (TLE).Materials and Methods A total of 32 patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS), 31 patients with nonlesional temporal lobe epilepsy (TLE-NL), and 40 healthy controls (HC) were included. Diffusion tensor imaging (DTI) data of the brain were collected to calculate whole-brain white matter PSMD values. Differences among the three groups were compared, and the correlations between PSMD and disease duration, the National Hospital Seizure Severity Scale (NHS3), as well as the Montreal Cognitive Assessment (MoCA) were analyzed.Results The overall distribution of PSMD values differed significantly among the three groups (H = 17.950, P < 0.001). Post-hoc pairwise comparisons showed that the overall PSMD level in the TLE-HS group was higher than that in the HC group (P < 0.001). No statistically significant differences were observed between the TLE-NL group and the HC group, or between the TLE-HS group and the TLE-NL group. In the TLE-HS group, PSMD values were positively correlated with disease duration (r = 0.416, P = 0.018) and NHS3 scores (r = 0.542, P = 0.001), and negatively correlated with MoCA scores (r = -0.428, P = 0.015). In the TLE-NL group, PSMD values were positively correlated with disease duration (r = 0.423, P = 0.018) and NHS3 scores (r = 0.328, P = 0.072), but the latter correlation did not reach statistical significance. PSMD values in the TLE-NL group were negatively correlated with MoCA scores (r = -0.488, P = 0.005).Conclusions PSMD was higher in TLE-HS patients than in the HC group and was associated with disease duration, seizure severity, and cognitive impairment. In TLE-NL patients, PSMD was associated with disease duration and cognitive function, but its association with seizure severity did not reach statistical significance. PSMD may serve as a potential imaging biomarker for white matter damage and disease progression in TLE.
[Keywords] temporal lobe epilepsy；peak width of skeletonized mean diffusivity；white matter；diffusion tensor imaging；magnetic resonance imaging；cognitive

WEI Yuanyuan1   LI Jinqin1   SONG Dengyan1   WANG Zhuo1   YE Hao1   YANG Wenrui2   LI Jian2   CHEN Bing2*  

1 School of the First Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China

2 Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Corresponding author: CHEN B, E-mail: chenbing135501@163.com

Conflicts of interest   None.

Received  2026-03-17
Accepted  2026-07-14
DOI: 10.12015/issn.1674-8034.2026.08.005
Cite this article as WEI Y Y, LI J Q, SONG D Y, et al. Evaluation of white matter microstructural impairment in temporal lobe epilepsy using peak width of skeletonized mean diffusivity[J]. Chin J Magn Reson Imaging, 2026, 17(8): 57-63. DOI:10.12015/issn.1674-8034.2026.08.005.

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