Kevin Phan1, Wyatt Ng2, Victor M Lu3, Kerrie L McDonald4, Jacob Fairhall5, Rajesh Reddy5, Peter Wilson5. 1. Faculty of Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia. Electronic address: kphan.vc@gmail.com. 2. Faculty of Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia. 3. Faculty of Medicine, Sydney Medical School, University of Sydney, Sydney, Australia. 4. Cure Brain Cancer Foundation Biomarkers and Translational Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia. 5. Department of Neurosurgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Abstract
BACKGROUND: Patients with brain tumors, particularly gliomas, commonly present with seizures. Higher incidence of seizure has been reported in low-grade gliomas and tumors located within the temporal and insular area. The association between IDH1 and IDH2 mutations with preoperative seizures in glioma and the magnitude of this association in low-grade versus high-grade gliomas are unclear. To clarify this relationship, a systematic review and meta-analysis was performed. METHODS: Following accepted guidelines and systematic review recommendations, electronic searches were performed in journal databases up to May 2017. Data were extracted and pooled via meta-analysis. RESULTS: We compared 782 patients with IDH1 and IDH2 mutations with 803 patients with wild-type IDH1 and IDH2 before surgery. There was a significant difference in seizure incidence between the IDH1 mutation group (61.6%) and wild-type IDH1 group (32.1%) (odds ratio 2.76; 95% confidence interval, 1.26-6.02; I2 = 73%; P = 0.01). Similar findings were observed in analysis of IDH1 and IDH2 mutations (odds ratio 2.74; 95% confidence interval, 1.74-4.33; I2 = 58%; P < 0.0001). The difference remained in both mutation groups (IDH1, IDH1 and IDH2) with grade II gliomas but not with grade III and IV gliomas. Patients with grade II gliomas showed a higher rate of IDH1 and IDH2 mutations and seizures than patients with grade III and IV gliomas. CONCLUSIONS: This study demonstrated a significant association of IDH1 and IDH2 mutations with incidence of preoperative seizures. This association was significant only in patients with low-grade glioma (grade II) and not in patients with higher grade gliomas (grade III and IV).
BACKGROUND: Patients with brain tumors, particularly gliomas, commonly present with seizures. Higher incidence of seizure has been reported in low-grade gliomas and tumors located within the temporal and insular area. The association between IDH1 and IDH2 mutations with preoperative seizures in glioma and the magnitude of this association in low-grade versus high-grade gliomas are unclear. To clarify this relationship, a systematic review and meta-analysis was performed. METHODS: Following accepted guidelines and systematic review recommendations, electronic searches were performed in journal databases up to May 2017. Data were extracted and pooled via meta-analysis. RESULTS: We compared 782 patients with IDH1 and IDH2 mutations with 803 patients with wild-type IDH1 and IDH2 before surgery. There was a significant difference in seizure incidence between the IDH1 mutation group (61.6%) and wild-type IDH1 group (32.1%) (odds ratio 2.76; 95% confidence interval, 1.26-6.02; I2 = 73%; P = 0.01). Similar findings were observed in analysis of IDH1 and IDH2 mutations (odds ratio 2.74; 95% confidence interval, 1.74-4.33; I2 = 58%; P < 0.0001). The difference remained in both mutation groups (IDH1, IDH1 and IDH2) with grade II gliomas but not with grade III and IV gliomas. Patients with grade II gliomas showed a higher rate of IDH1 and IDH2 mutations and seizures than patients with grade III and IV gliomas. CONCLUSIONS: This study demonstrated a significant association of IDH1 and IDH2 mutations with incidence of preoperative seizures. This association was significant only in patients with low-grade glioma (grade II) and not in patients with higher grade gliomas (grade III and IV).
Authors: Pim B van der Meer; Linda Dirven; Marta Fiocco; Maaike J Vos; Mathilde C M Kouwenhoven; Martin J van den Bent; Martin J B Taphoorn; Johan A F Koekkoek Journal: Neurology Date: 2022-06-08 Impact factor: 11.800
Authors: Mark P van Opijnen; Pim B van der Meer; Linda Dirven; Marta Fiocco; Mathilde C M Kouwenhoven; Martin J van den Bent; Martin J B Taphoorn; Johan A F Koekkoek Journal: J Neurooncol Date: 2021-07-01 Impact factor: 4.130