{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T19:19:08Z","timestamp":1776107948142,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u202fT 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our findings revealed that the patients with OLE exhibited higher PSMD compared to healthy controls (2.459 vs. 2.079\u202f\u00d7\u202f10<jats:sup>\u22124<\/jats:sup>\u202fmm<jats:sup>2<\/jats:sup>\/s, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). In addition, PSMD positively correlated with age (<jats:italic>r<\/jats:italic>\u202f=\u202f0.412, <jats:italic>p<\/jats:italic>\u202f=\u202f0.032). 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1538598","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:11:33Z","timestamp":1739250693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Small-vessel-disease-induced white matter damage in occipital lobe epilepsy"],"prefix":"10.3389","volume":"16","author":[{"given":"Jinseung","family":"Kim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho-Joon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1002\/ana.410290611","article-title":"Epilepsy surgery in the posterior cortex","volume":"29","author":"Blume","year":"1991","journal-title":"Ann Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1111\/epi.17241","article-title":"International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: position paper by the ILAE Task Force on Nosology and Definitions","volume":"63","author":"Specchio","year":"2022","journal-title":"Epilepsia"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"288","DOI":"10.3978\/j.issn.2223-4292.2015.01.08","article-title":"Strengths and limitations of tractography methods to identify the optic radiation for epilepsy surgery","volume":"5","author":"Lilja","year":"2015","journal-title":"Quant Imaging Med Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pjnns.2015.10.003","article-title":"Diffusion tensor tractography imaging in pediatric epilepsy\u2014a systematic review","volume":"50","author":"Szmuda","year":"2016","journal-title":"Neurol Neurochir Pol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"20200002","DOI":"10.1259\/bjro.20200002","article-title":"The role of preoperative diffusion tensor imaging in predicting and improving functional outcome in pediatric patients undergoing epilepsy surgery: a systematic review","volume":"3","author":"Leon-Rojas","year":"2021","journal-title":"BJR Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2454","DOI":"10.1093\/brain\/awaa200","article-title":"White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-epilepsy study","volume":"143","author":"Hatton","year":"2020","journal-title":"Brain"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1186\/s12883-023-03326-z","article-title":"Structural brain network analysis in occipital lobe epilepsy","volume":"23","author":"Lee","year":"2023","journal-title":"BMC Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/jon.13083","article-title":"Glymphatic system dysfunction in patients with occipital lobe epilepsy","volume":"33","author":"Kim","year":"2023","journal-title":"J Neuroimaging"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e212780","DOI":"10.1148\/radiol.212780","article-title":"Peak width of skeletonized mean diffusivity: a neuroimaging marker for white matter injury","volume":"306","author":"Zanon Zotin","year":"2023","journal-title":"Radiology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1002\/ana.24758","article-title":"A novel imaging marker for small vessel disease based on skeletonization of white matter tracts and diffusion histograms","volume":"80","author":"Baykara","year":"2016","journal-title":"Ann Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.msard.2018.11.011","article-title":"Peak width of skeletonized mean diffusivity (PSMD) as marker of widespread white matter tissue damage in multiple sclerosis","volume":"27","author":"Vinciguerra","year":"2019","journal-title":"Mult Scler Relat Disord"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.3390\/life12091362","article-title":"Associations of peak-width skeletonized mean diffusivity and post-stroke","volume":"12","author":"Jochems","year":"2022","journal-title":"Cognition"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1051038","DOI":"10.3389\/fnins.2022.1051038","article-title":"Peak width of skeletonized mean diffusivity in cerebral amyloid angiopathy: spatial signature, cognitive, and neuroimaging associations","volume":"16","author":"Zanon Zotin","year":"2022","journal-title":"Front Neurosci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"238","DOI":"10.3389\/fnins.2020.00238","article-title":"Peak width of skeletonized mean diffusivity as a marker of diffuse cerebrovascular damage","volume":"14","author":"Low","year":"2020","journal-title":"Front Neurosci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.dadm.2019.09.003","article-title":"Peak width of skeletonized mean diffusivity and its association with age-related cognitive alterations and vascular risk factors","volume":"11","author":"Lam","year":"2019","journal-title":"Alzheimers Dement"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/j.1528-1157.1993.tb02590.x","article-title":"Parietal and occipital lobe epilepsy: a review","volume":"34","author":"Sveinbjornsdottir","year":"1993","journal-title":"Epilepsia"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3926","DOI":"10.1007\/s00415-021-10557-y","article-title":"Adult occipital lobe epilepsy: 12-years on","volume":"268","author":"Angus-Leppan","year":"2021","journal-title":"J Neurol"},{"key":"ref18","doi-asserted-by":"crossref","DOI":"10.1109\/ISBI56570.2024.10635502","article-title":"Quantifying white matter hyperintensity and brain volumes in heterogeneous clinical and low-field portable MRI","author":"Laso","year":"2024"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/j.clineuro.2012.07.009","article-title":"Prevalence and subtypes of radiological cerebrovascular disease in late-onset isolated seizures and epilepsy","volume":"115","author":"Maxwell","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.nicl.2015.07.016","article-title":"Structural and physiological MRI correlates of occult cerebrovascular disease in late-onset epilepsy","volume":"9","author":"Hanby","year":"2015","journal-title":"NeuroImage Clin"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e53455","DOI":"10.1371\/journal.pone.0053455","article-title":"Clinical symptoms and risk factors in cerebral microangiopathy patients","volume":"8","author":"Okroglic","year":"2013","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.eplepsyres.2014.10.012","article-title":"Epilepsy associated with leukoaraiosis mainly affects temporal lobe: a casual or causal relationship?","volume":"109","author":"Gasparini","year":"2015","journal-title":"Epilepsy Res"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.brainresbull.2017.02.003","article-title":"Cerebral small vessel disease predisposes to temporal lobe epilepsy in spontaneously hypertensive rats","volume":"130","author":"Russo","year":"2017","journal-title":"Brain Res Bull"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1212\/wnl.43.2.425","article-title":"Hypertension and the risk of new-onset unprovoked seizures","volume":"43","author":"Ng","year":"1993","journal-title":"Neurology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1111\/j.1528-1157.1997.tb01219.x","article-title":"Vascular determinants of epilepsy: the Rotterdam Study","volume":"38","author":"Li","year":"1997","journal-title":"Epilepsia"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2011\/130406","article-title":"Occult cerebrovascular disease and late-onset epilepsy: could loss of neurovascular unit integrity be a viable model?","volume":"2011","author":"Gibson","year":"2011","journal-title":"Cardiovasc Psychiatry Neurol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"230","DOI":"10.3988\/jcn.2022.0493","article-title":"Inflammatory cerebral amyloid angiopathy: a broad clinical spectrum","volume":"19","author":"de Souza","year":"2023","journal-title":"J Clin Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1111\/epi.14631","article-title":"Seizure-induced microvascular injury is associated with impaired neurovascular coupling and blood-brain barrier dysfunction","volume":"60","author":"Prager","year":"2019","journal-title":"Epilepsia"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1111\/epi.13827","article-title":"Postictal hypoperfusion\/hypoxia provides the foundation for a unified theory of seizure-induced brain abnormalities and behavioral dysfunction","volume":"58","author":"Farrell","year":"2017","journal-title":"Epilepsia"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1177\/1535759720975744","article-title":"Epilepsy as a disease of white matter","volume":"21","author":"Hogan","year":"2021","journal-title":"Epilepsy Curr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2930","DOI":"10.1016\/j.acra.2023.12.043","article-title":"Altered white-matter functional network in children with idiopathic generalized epilepsy","volume":"31","author":"Ran","year":"2024","journal-title":"Acad Radiol"},{"key":"ref32","first-page":"8980","article-title":"A tract-based spatial statistics study of white matter integrity in epilepsy","volume":"14","author":"Hou","year":"2022","journal-title":"Am J Transl Res"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2710","DOI":"10.14336\/AD.2023.1225","article-title":"Aging increases hypoxia-induced endothelial permeability and blood-brain barrier dysfunction by upregulating arginase-II","volume":"15","author":"Cheng","year":"2024","journal-title":"Aging Dis"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"33","DOI":"10.14336\/AD.2024.0201-1","article-title":"Vascular aging and atherosclerosis: a perspective on aging","volume":"16","author":"Ma","year":"2024","journal-title":"Aging Dis"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"111855","DOI":"10.1016\/j.mad.2023.111855","article-title":"Role of cytokines and reactive oxygen species in brain aging","volume":"214","author":"MohanKumar","year":"2023","journal-title":"Mech Ageing Dev"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s11010-024-05042-9","article-title":"Mitophagy in relation to chronic inflammation\/ROS in aging","author":"Kong","year":"2024","journal-title":"Mol Cell Biochem"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1538598\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T05:11:38Z","timestamp":1739250698000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1538598\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":36,"alternative-id":["10.3389\/fneur.2025.1538598"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1538598","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,11]]},"article-number":"1538598"}}