European radiology experimental
Reassessment of the DTI-ALPS index in focal epilepsy
By Chambers S, Hofer L, Tranfa M and 13 others.
Abstract
Objective
Recent evidence highlights the limited specificity of diffusion tensor imaging (DTI) along perivascular spaces (ALPS) as a noninvasive glymphatic biomarker because microstructural tract degeneration and crossing-fiber geometry confound it. We aimed to reassess the interpretation of the DTI-ALPS index in people with focal epilepsy.
Materials and methods
Seventy-nine people with drug-resistant focal epilepsy (PWFE) underwent comprehensive presurgical work-up and 3-T magnetic resonance imaging (MRI). Etiologies included MRI-negative epilepsy, malformations of cortical development, temporal lobe epilepsy, and low-grade epilepsy-associated tumors. DTI preprocessing was conducted using QSIPrep with automated region-of-interest (ROI) placement. Linear regression models and Wilcoxon signed-rank tests were used to assess group differences and associations with clinical variables. Twenty-five age- and sex-matched healthy controls were included for comparison.