Investigating Hippocampal Microstructural Differences in Temporal Lobe Epilepsy Patients with Cognitive Impairment Using NODDI

Motivation: Temporal lobe epilepsy (TLE) significantly impacts patients' quality of life, with cognitive impairment (CI) being a common comorbidity. Understanding hippocampal microstructure changes is crucial for diagnosing TLE and its associated CI. Goal(s): To investigate hippocampal microstructure differences between TLE patients with CI (TLE-CI) and those with normal cognition (TLE-CN) using NODDI technology. Approach: 66 TLE patients and 40 healthy controls underwent NODDI imaging. NODDI metrics were analyzed to assess microstructural differences and their correlation with clinical characteristics. Results: TLE-CI patients showed significant hippocampal microstructural abnormalities, with elevated fiso values and reduced NDI values, correlating with earlier epilepsy onset and longer disease duration. Impact: This study's findings on hippocampal microstructural abnormalities in TLE-CI patients can guide early diagnosis and surgical treatments, potentially improving cognitive outcomes. It opens avenues for further research on bilateral impacts of unilateral TLE and long-term disease progression.