Corpus Callosum Morphometric Analysis in Paediatric Epilepsy: A Retrospective MRI Study

Abstract

INTRODUCTION: The corpus callosum (CC) plays a central role in interhemispheric communication and seizure propagation. Structural alteration of the CC in paediatric epilepsy has been inconsistently reported, highlighting the need for further comparative morphometric analysis during this critical neurodevelopmental period. This study aimed to evaluate differences in CC morphometry between epileptic and non-epileptic children aged 6-17 years. MATERIALS AND METHODS: This retrospective case-control study analysed brain magnetic resonance imaging (MRI) scans acquired between July 2023 and October 2024 at a single tertiary hospital, including 50 epileptic and 42 non-epileptic children. CC morphometry, including anterior-posterior diameter, total length, and thickness of genu, body, isthmus, and splenium, was measured on mid-sagittal T2-weighted images. Statistical analyses were performed using the independent t-tests and Mann-Whitney tests as appropriate. RESULT: No significant overall differences were found in CC morphometry between epileptic and non-epileptic groups. However, subgroup analysis revealed significantly reduced body thickness in epileptic children aged 12-14 years and shorter total CC length among epileptic females. In contrast, epileptic children without extra-callosal abnormalities showed greater genu thickness compared to non-epileptic controls. These findings were associated with a moderate-to-large effect size (Hedges’ g>0.6), suggesting subtle deviations in callosal maturation patterns. CONCLUSION: Epilepsy may be associated with region-specific and sex-related variation in CC morphometry during critical stages of brain maturation. Although these differences are subtle and not evident on conventional MRI, quantitative CC morphometry may serve as a complementary, hypothesis-generating approach to investigating neurodevelopmental alterations in paediatric epilepsy