AccScience Publishing / AN / Online First / DOI: 10.36922/an.4823
CASE SERIES

Reduction in the number of subcortical white matter fibers in subcortical band heterotopia: A case series

Peter Stoeter1* Diogenes Santos-Viloria2 José Bido3 Evelyn Lora4 Diogenes Santos-Perez2
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1 Department of Radiology, CEDIMAT, Santo Domingo, Dominican Republic
2 Department of Neurology, CEDIMAT, Santo Domingo, Dominican Republic
3 Centro Médico Moderno, Santo Domingo, Dominican Republic
4 MedicalNet, Santo Domingo, Dominican Republic
Advanced Neurology, 4823 https://doi.org/10.36922/an.4823
Submitted: 11 September 2024 | Revised: 14 November 2024 | Accepted: 25 November 2024 | Published: 31 December 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Subcortical band heterotopia (SBH) is a developmental disorder in which neuroblasts migrating from the periventricular zone to the cortex cannot reach their final destination. Subcortical bands might interfere with axonal development. Therefore, this study examined white matter organization in 10 healthy controls and 2 patients with drug-resistant epilepsy (referred to as patients 1 and 2), in whom diagnostic magnetic resonance imaging revealed subcortical bands of gray matter. Diffusion tensor imaging, advanced tractography methods, and functional imaging were performed in patient 2. The number of subcortical fibers decreased significantly in both patients. The heterotopias interrupted the propagation of the tracking algorithm. Only a small number of tracts were generated from inside the heterotopias. According to the literature and our findings, SBHs appear to differ in their localization, extension, and structure. Some heterotopias might allow the propagation of tractography, thereby creating the impression that tracts are passing through, whereas others interrupt the propagation, as observed in our cases. In addition, a reduction in the number of subcortical white matter fibers was observed. These findings may have consequences in pre-surgical planning. The generalization of seizures might be facilitated by a non-reduction in SCWM fibers and tracts passing through the band, and these patients might benefit more from extensive resections of the epileptogenic zone than others.

Keywords
Subcortical white matter fibers
Subcortical band heterotopia
Tractography
Drug-resistant epilepsy
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Advanced Neurology, Electronic ISSN: 2810-9619 Print ISSN: 3060-8589, Published by AccScience Publishing