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The behavioral and cognitive comorbidities of epilepsy are increasingly recognized, but their etiologies remain elusive. Advances in structural and functional neuroimaging have led to increasing understanding of the brain systems that may be abnormal in individuals with epilepsy and that contribute to these cognitive difficulties.1
In this issue of Neurology®, McDonald et al.2 relate performance on tests of memory and language to white matter fiber tract integrity in 17 patients with temporal lobe epilepsy (TLE). The investigators used diffusion tensor imaging (DTI), an MRI technique that measures the movement of water molecules along white matter tracts, and quantified two DTI measures of tract integrity: fractional anisotropy (FA, which decreases in disease) and mean diffusivity (MD, which increases in disease) in TLE. They focused on fibers with connections related to the temporal lobe: the uncinate fasciculus (UF), arcuate fasciculus (AF), fornix …
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