Assessing White Matter Disruptions in Epileptic Networks: Concordance of FDG PET Hypometabolism and DTI-Defined Microstructural Alterations

Motivation: Due to heterogeneous underlying mechanisms epileptic seizure origins, it is not clear whether disconnectome mapping can be applied to predict white matter damage in epilepsy. Goal(s): This study aims to investigate whether FDG PET hypometabolism predicted white matter disconnections corresponds to fractional anisotropy changes in a cohort of drug resistant focal epilepsy patients. Approach: This study aims to involve 40 drug-resistant epilepsy patients with focal lesions for imaging using a hybrid PET/MR scanner. Data processing includes DTI and FDG PET analysis, comparing FA abnormalities in patients with predicted white matter disconnection derived from PET analysis. Impact: The results may enhance understanding of the relationship between metabolic dysfunction and structural abnormalities in epilepsy, potentially guiding clinicians toward more tailored treatment strategies. It may also inspire further inquiries into the underlying mechanisms of drug resistance.