The Evaluation of White Matter Intensities in Patients with Pediatric Epilepsy

Aim: Neuroimaging is an important tool, in combination with a detailed medical history, physical examination, and electroencephalography, in the diagnosis and classification of epilepsy. White matter hyperintensities (WMHs) are bright areas of high signal intensity seen in white matter at T2-weighted MRI. Researchers aimed to evaluate whether white matter hyperintensities are more common in children with epilepsy.

Material-method: Patients who underwent cranial MRI with diagnoses of epilepsy based on International League Against Epilepsy (ILAE) criteria at the Balıkesir University Medical Faculty Pediatric neurology clinic, Türkiye, between 01.08.2019 and 01.03.2024 and patients who underwent cranial MRI during the same period due to indications other than epilepsy, such as headache, syncope, and vertigo, were included in the study. Written informed consent was received from all patients.

Study Overview

• Status: Completed
• Conditions: White Matter Alterations; Epilepsies

Detailed Description

Aim: Neuroimaging is an important tool, in combination with a detailed medical history, physical examination, and electroencephalography, in the diagnosis and classification of epilepsy. White matter hyperintensities (WMHs) are bright areas of high signal intensity seen in white matter at T2-weighted MRI. Researchers aimed to evaluate whether white matter hyperintensities are more common in children with epilepsy.

Material-method: Patients who underwent cranial MRI with diagnoses of epilepsy based on International League Against Epilepsy (ILAE) criteria at the Balıkesir University Medical Faculty Pediatric neurology clinic, Türkiye, between 01.08.2019 and 01.03.2024 and patients who underwent cranial MRI during the same period due to indications other than epilepsy, such as headache, syncope, and vertigo, were included in the study. Written informed consent was received from all patients.

• Study Type: Observational
• Enrollment (Actual): 173

Contacts and Locations

Study Locations

• Turkey
  • Mersin, Turkey, 33343
    • Mersin University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

The study group included patients diagnosed with epilepsy who underwent cranial MRI according to the epilepsy protocol between 01.08.2019 and 01.03.2024, and the control group included patients who underwent cranial MRI according to the standard protocol for indications other than epilepsy. Patients with psychiatric disorders, a history of any chronic disease other than seizure medication, a history of vascular disease or demyelinating disease, acute symptomatic seizures or a single unprovoked seizure, incomplete file data, and MRI performed at a location other than the hospital were excluded from the study. The age and weight of patients diagnosed with epilepsy, seizure type, anti-seizure medications used, and EEG findings were recorded retrospectively from the hospital information system module, and cranial MRI images were recorded retrospectively from the PACS archive system.

Description

Inclusion Criteria:

Cranial MRI during the same period due to indications other than epilepsy;

• headache
• syncope and
• vertigo

Exclusion Criteria:

Patients with neuropsychiatric disorders;

• depression,
• psychotic disorders,
• autism spectrum disorder History of medication use for any chronic disease other than seizure medication, History of vascular disease ;
• Collagen tissue diseases;
• lupus,
• juvenile rheumatoid arthritis,
• polyarteritis nodosa,
• Kawasaki disease Demyelinating disease
• acute demyelinating disease (ADEM),
• Multiple sclerosis Acute symptomatic seizure or a single unprovoked seizure, İncomplete file data, or MRI performed at a location other than our hospital

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Patients diagnosed with epilepsy who underwent epilepsy protocol cranial MRI between 01.08.2019 and; All patients underwent imaging on a 1.5 T MRI device (Ingenia, release 5.3-5.7 software, Philips Medical Systems, Best, the Netherlands). The epilepsy protocol consisted of axial T1-weighted imaging (WI) spin-echo (SE)(repetition time/echo time (TR/TE): 450/15; field of view (FOV): 230 mm, slice thickness: 5 mm, matrix: 308 ×183), axial fat suppressed (FS) T1-WI SE(TR/TE: 633/15; field of view (FOV): 230 mm, slice thickness: 5 mm, matrix: 308 × 183), axial T2-WI turbo spin-echo (TSE) (TR/TE: 5240/100, FOV: 230 mm, slice thickness: 5 mm, matrix: 384 × 237), coronal FS fluid- attenuated inversion recovery (FLAIR) sequence (TR/TE: 11,000/130; FOV: 230 mm, slice thickness: 5 mm, matrix: 256 × 157), coronal T2-WI TSE (TR/TE: 3027/100; FO): 200 mm, slice thickness: 3 mm, matrix: 336 × 217), coronal T1-WI inversion recovery (IR) (TR/TE: 3079/15; field of view (FOV): 200 mm, slice thickness: 3.5 mm, matrix: 336 × 211), coronal FLAIR sequence (TR/TE: 11,000/130; FOV: 230 mm, slice thic

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Evaluation of White Matter Intensities in Patients with Pediatric Epilepsy	To determine whether white matter hyperintensities are more frequent in children with epilepsy by comparing epilepsy and control groups.	01.08.2019 and 01.03.2024
The Evaluation of White Matter Intensities in Patients with Pediatric Epilepsy	Better understanding the association between pediatric epilepsy patients and white matter changes.	01.08.2019 and 01.03.2024

Collaborators and Investigators

• Sponsor: Aysen Orman

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2019
• Primary Completion (Actual): March 1, 2024
• Study Completion (Actual): April 1, 2024

Study Registration Dates

• First Submitted: February 17, 2025
• First Submitted That Met QC Criteria: March 13, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 13, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: Children; epilepsy; white matter; hyperintensity
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Pathologic Processes; Epilepsy; Leukoaraiosis
• Other Study ID Numbers: Balikesir Univercity

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No