White matter disruption is associated with persistent seizures in tuberous sclerosis complex

Romina Moavero, Antonio Napolitano, Raffaella Cusmai, Federico Vigevano, Lorenzo Figà-Talamanca, Giuseppe Calbi, Paolo Curatolo, Bruno Bernardi

Research output: Contribution to journalArticlepeer-review


Background and aims: White matter is diffusely altered in tuberous sclerosis complex (TSC), and these alterations appear to be more evident in subjects with a more severe neurologic phenotype. However, little is known on the correlation between white matter alterations and epilepsy in TSC. The aims of this study were to evaluate the effects of early onset and refractory seizures on white matter by using diffusion tensor imaging (DTI). Methods: We enrolled 20 children with TSC and epilepsy onset in the first 3 years of life and grouped them according to seizure persistence or freedom. All patients underwent brain MRI with DTI. Specific ROIs have were placed to generate tracks to calculate fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Statistical analysis was performed by ANOVA. Results: Children with persistent seizures presented an overall reduced FA, with statistically significant differences on the cingulum (right p = 0.003, left p = 0.016), the left cerebral peduncle (p = 0.020), the superior cerebellar peduncles (right p = 0.008, left p = 0.002), the posterior limbs of internal capsule (right p = 0.037, left p = 0.015), the external capsule (right p = 0.018, left p = 0.031), the inferior frontooccipital fasciculus (right p = 0.010, left p = 0.026), and the temporal trunk (right p = 0.017, left p = 0.001). Conclusions: Our study demonstrated that children with persistent seizures present more significant alterations of brain connectivity in areas crucial for global cognitive maturation, executive functions, and verbal abilities, implying a higher risk of cognitive impairment, attention-deficit hyperactivity disorder, and autism.

Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalEpilepsy and Behavior
Publication statusPublished - Jul 1 2016


  • Autism
  • Cognitive impairment
  • Diffusion tensor imaging
  • Epilepsy
  • Tuberous sclerosis complex
  • White matter

ASJC Scopus subject areas

  • Clinical Neurology
  • Behavioral Neuroscience
  • Neurology


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