Diffusion MRI in drug-resistant epilepsy

Analysis of diffusion-weighted MRI (dMRI) allows for non-invasive inference of tissue microstructure. Through mathematical models and representations, it is possible to obtain information at the microscopic level. In the last two decades, dMRI has become a valuable research tool in many fields of neurology, including epilepsy, where it has been used to document extensive brain abnormalities in patients with various forms of epilepsy. Slowly but surely, it has also proven to be a valuable tool for the diagnostic workup of drug-resistant epilepsy patients, aiding in the detection of epileptogenic lesions and associated abnormalities of brain connectivity. Finally, it has shown tremendous potential to aid in the prediction of seizure freedom following surgical resection, as well as post-surgical alterations of cognitive performance. In this talk I will briefly discuss the biophysical underpinnings of dMRI and example applications, with special emphasis on the realistic extent of the technique for accurate clinical interpretation