Disease duration and arcuate fasciculus abnormalities correlate with psychoticism in patients with epilepsy

PURPOSE We sought to investigate the relationship between interictal personality changes and white matter abnormalities in epilepsy patients. METHODS A total of 65 individuals with epilepsy and 40 demographically matched controls were evaluated by Eysenck Personality Questionnaire (EPQ) and diffusion tensor imaging (DTI) on 3T. Fractional anisotropy (FA) values of fibers were acquired. The relationship between EPQ scores, clinical variables and FA values was confirmed by Pearson correlation analysis and multiple linear regression analysis. RESULTS Epilepsy patients had higher psychoticism scores (P score) and lower extraversion scores (E score) compared with controls. P scores were higher in patients with long duration (>10 years) and taking multiple antiepileptic drugs. No difference was found in E score according to all the clinical variables. Epilepsy patients showed significantly lower mean FA value compared with healthy controls in the bilateral uncinate fasciculus, cingulum bundle, arcuate fasciculus and forceps minor of the corpus callosum. Multivariate linear regression analysis revealed that duration of epilepsy and FA value of the right arcuate fasciculus was independent risk factors of psychoticism in epilepsy patients. CONCLUSIONS Long disease duration and impairment of arcuate fasciculus integrity may predispose the development of psychoticism in patients with epilepsy. Our results provide important insights into the pathophysiological mechanisms underlying personality change in epilepsy.