Increased Peak Width of Skeletonized Mean Diffusivity in Status Epilepticus: Implication for Diffuse White Matter Microstructural Alteration

Objectives Peak width of skeletonized mean diffusivity (PSMD) serves as a new biomarker for diffuse white matter microstructural damage. This study is aimed at quantifying PSMD in patients with status epilepticus (SE) to investigate white matter microstructural abnormalities and their potential association with small vessel disease (SVD) mechanisms in SE. Methods We retrospectively enrolled patients with SE and healthy controls matched for age and sex. Diffusion tensor imaging (DTI) was performed using a 3.0 Tesla magnetic resonance imaging scanner to measure PSMD. We compared the PSMD values between patients with SE and healthy controls. Additionally, we analyzed correlations between PSMD and clinical factors in patients with SE. Results Twenty‐eight patients with SE and 31 healthy controls were included in this study. PSMD values were significantly higher in patients with SE compared with controls (3.024 vs. 2.257, p < 0.001). Additionally, in patients with SE, PSMD positively correlated with age ( r = 0.721, p < 0.001). However, PSMD was not significantly correlated with other clinical characteristics, including the duration of SE and the number of antiseizure medications ( r = 0.031, p = 0.876; r = −0.340, p = 0.076, respectively). Conclusion Patients with SE exhibited significantly elevated PSMD, which was associated with white matter microstructural abnormalities. These findings suggested that PSMD may be a useful imaging marker for assessing white matter changes in SE and warrant further investigation into its association with underlying vascular and nonvascular mechanisms.