Abstract
BACKGROUND: Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. This study aimed to investigate the presence of small vessel disease in patients with occipital lobe epilepsy (OLE) using PSMD. METHODS: We enrolled 27 patients newly diagnosed with OLE and included 29 healthy controls. The age and sex of the patients and controls were comparable. Diffusion tensor imaging (DTI) was performed using a 3 T MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the FSL program. We compared PSMD between patients with OLE and healthy controls. Additionally, we performed a correlation analysis between PSMD and clinical factors in patients with OLE. RESULTS: Our findings revealed that the patients with OLE exhibited higher PSMD compared to healthy controls (2.459 vs. 2.079 × 10(-4) mm(2)/s, p < 0.001). In addition, PSMD positively correlated with age (r = 0.412, p = 0.032). However, the PSMD of the patients with OLE was not associated with other clinical factors such as age at seizure onset and duration of epilepsy. CONCLUSION: We demonstrated that patients with OLE had a higher PSMD than healthy controls, indicating evidence of small vessel disease in patients with OLE. This finding also highlights the potential of PSMD as a marker for detecting small vessel diseases in epileptic disorders.