ArticleNeuroradiology2025
White matter and glymphatic system alterations in patients with focal epilepsy: insights from PSMD and DTI-ALPS index.
Article in Neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Glymphatic system dysfunction in epilepsy: a review of mechanisms and clinical evidence.Encephalitis (Seoul, Korea) · 2026Article
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3 authors.
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Abstract
objectivesPeak width of skeletonized mean diffusivity (PSMD) is a neuroimaging biomarker of white matter integrity in cerebral small-vessel disease. However, the significance of PSMD in focal epilepsy remains unclear. This study aimed to investigate alterations in white matter microstructure and glymphatic system function in patients with focal epilepsy by comparing PSMD and the diffusion tensor imaging (DTI) along perivascular spaces (DTI-ALPS) index with healthy controls and by exploring their associations with seizure lateralization and treatment response.
methodsWe retrospectively analyzed DTI data from 102 patients with focal epilepsy and 88 healthy controls. PSMD values and the DTI-ALPS index were obtained using a standard processing pipeline, and between-group comparisons were performed. Associations between PSMD and clinical characteristics were also evaluated.
resultsPSMD was significantly higher in patients with focal epilepsy than in healthy controls (2.218 ± 0.355 × 10
conclusionOur findings suggest that PSMD is increased in patients with focal epilepsy, potentially reflecting microstructural white matter alterations. Increased PSMD in the ipsilateral hemisphere supports its potential role in lateralizing seizure onset. The significant positive correlation between PSMD and age and the inverse relationship between PSMD and the DTI-ALPS index suggest that PSMD is associated with changes in the glymphatic system and white matter microstructure.
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