Magnetic resonance fingerprinting of temporal lobe white matter in mesial temporal lobe epilepsy

Objective Mesial temporal lobe epilepsy (MTLE) is a network disorder. We aimed to quantify the white matter alterations in the temporal lobe of MTLE patients with hippocampal sclerosis (MTLE-HS) by using magnetic resonance fingerprinting (MRF), a novel imaging technique, which allows simultaneous measurements of multiple parameters with a single acquisition. Methods We consecutively recruited 27 unilateral MTLE-HS patients and 22 healthy controls. Measurements including T1, T2, and PD values in the temporopolar white matter and temporal stem were recorded and analyzed. Results We found increased T2 value in both sides, and increased T1 value in the ipsilateral temporopolar white matter of MTLE-HS patients, as compared with healthy controls. The T1 and T2 values were higher in the ipsilateral than the contralateral side. In the temporal stem, increased T1 and T2 values in the ipsilateral side of the MTLE-HS patients were also observed. Only increased T2 values were observed in the contralateral temporal stem. No significant differences in PD values were observed in either the temporopolar white matter or temporal stem of the MTLE-HS patients. Correlation analysis revealed that T1 and T2 values in the ipsilateral temporopolar white matter were negatively correlated with the age at epilepsy onset. Interpretation By using MRF, we were able to assess the alterations of T1 and T2 in the temporal lobe white matter of MTLE-HS patients. MRF could be a promising imaging technique in identifying mild changes in MTLE patients, which might optimize the pre-surgical evaluation and therapeutic interventions in these patients.