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Fractional anisotropy of the optic radiations correlates with the visual field after epilepsy surgery

  • João Paulo Sant Ana Santos de SouzaEmail author
  • Gabriel Ayub
  • Pamela Castro Pereira
  • José Paulo Cabral Vasconcellos
  • Clarissa Yasuda
  • Andrei Fernandes Joaquim
  • Helder Tedeschi
  • Brunno Machado Campos
  • Fernando Cendes
  • Enrico Ghizoni
Functional Neuroradiology

Abstract

Purpose

This study assessed whether optic radiations (OR) microstructure after temporal lobe epilepsy (TLE) surgery correlated with visual field defects (VFD).

Methods

Patients were subjected to diffusion tensor imaging (DTI) tractography of the OR and Humphrey perimetry after TLE surgery. We used Spearman’s test to verify correlations between tractographic parameters and perimetry mean deviation. Tractographic variables were compared between patients with VFD or intact perimetry. Multiple logistic regression was applied between DTI and perimetry values. DTI sensitivity and specificity were assessed with a receiver operating characteristic (ROC) curve to evaluate VFD.

Results

Thirty-nine patients had reliable perimetry and OR tractography. There was a significant correlation between (1) fractional anisotropy (FA) and both total (rho = 0.569, p = 0.0002) and quadrant (rho = 0.453, p = 0.0037) mean deviation and (2) radial diffusivity and total mean deviation (rho = − 0.350, p = 0.0286). There was no other significant correlation. Patients with VFD showed a significantly lower FA compared with patients with normal perimetry (p = 0.0055), and a 0.01 reduction in FA was associated with a 44% increase in presenting VFD after surgery (confidence interval, CI = 1.10–1.88; p = 0.0082). Using a FA of 0.457, DTI tractography showed a specificity of 95.2% and a sensitivity of 50% to detect VFD after surgery (area under the curve = 0.7619, CI = 0.6020–0.9218).

Conclusion

The postoperative OR microstructure correlated with visual loss after epilepsy surgery. DTI postoperative OR tractography may be helpful in evaluating VFD.

Keywords

Perimetry Visual field defect Optic radiations Epilepsy surgery Tractography 

Notes

Funding information

This work was funded by the São Paulo Research Foundation (FAPESP).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

234_2019_2281_MOESM1_ESM.pdf (475 kb)
ESM. 1 Scatterplots that show the distribution of DTI and perimetry variables according to the surgical approach. Red dots and blue triangles represent patients who underwent modified anterior temporal lobectomy (mATL) and the transsylvian approach, respectively (PDF 474 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • João Paulo Sant Ana Santos de Souza
    • 1
    Email author
  • Gabriel Ayub
    • 2
  • Pamela Castro Pereira
    • 1
  • José Paulo Cabral Vasconcellos
    • 2
  • Clarissa Yasuda
    • 1
    • 3
  • Andrei Fernandes Joaquim
    • 3
  • Helder Tedeschi
    • 3
  • Brunno Machado Campos
    • 1
  • Fernando Cendes
    • 1
    • 3
  • Enrico Ghizoni
    • 3
  1. 1.Neuroimaging Laboratory (LNI)University of Campinas (UNICAMP)CampinasBrazil
  2. 2.Department of OphthalmologyUniversity of Campinas (UNICAMP)CampinasBrazil
  3. 3.Department of Neurology and NeurosurgeryUniversity of Campinas (UNICAMP)CampinasBrazil

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