Page 116 - AN-4-3

Advanced Neurology

CASE SERIES
Reduction in the number of subcortical white

matter fibers in subcortical band heterotopia: A
case series

4
1
3
Peter Stoeter * , Diogenes Santos-Viloria , José Bido , Evelyn Lora , and
2
Diogenes Santos-Perez 2
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

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
*Corresponding author: whom diagnostic magnetic resonance imaging revealed subcortical bands of gray
Peter Stoeter
(pstoeter@cedimat.net) matter. Diffusion tensor imaging, advanced tractography methods, and functional
imaging were performed in patient 2. The number of subcortical fibers decreased
Citation: Stoeter P, Santos-Viloria D,
Bido J, Lora E, Santos-Perez D. significantly in both patients. The heterotopias interrupted the propagation of the
Reduction in the number of tracking algorithm. Only a small number of tracts were generated from inside the
subcortical white matter fibers in heterotopias. According to the literature and our findings, SBHs appear to differ
subcortical band heterotopia: A case
series. Adv Neurol. 2025; in their localization, extension, and structure. Some heterotopias might allow the
4(3):110-116. propagation of tractography, thereby creating the impression that tracts are passing
doi: 10.36922/an.4823 through, whereas others interrupt the propagation, as observed in our cases. In
Received: September 11, 2024 addition, a reduction in the number of subcortical white matter fibers was observed.
1st revised: November 10, 2024 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
2nd revised: November 14, 2024
through the band, and these patients might benefit more from extensive resections
Accepted: November 25, 2024 of the epileptogenic zone than others.
Published online: December 31,
2024
Keywords: Subcortical white matter fibers; Subcortical band heterotopia; Tractography;
Copyright: © 2024 Author(s). Drug-resistant epilepsy
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Subcortical band heterotopia (SBH) is a developmental disorder in which neuroblasts
Publisher’s Note: AccScience migrating peripherally from the periventricular zone cannot reach their final destination
Publishing remains neutral with within the cerebral cortex. Most SBH cases are linked to de novo mutations of the
1
regard to jurisdictional claims in
published maps and institutional DCX gene; however, mutations in other genes such as LIS1 and rarely TUBB have been
affiliations. detected. In case of SBH with DCX mutation, affected hemizygous men tend to present
2,3
Volume 4 Issue 3 (2025) 110 doi: 10.36922/an.4823