Ge Tan1, Xiuli Li2, Deng Chen1, Haijiao Wang1, Qiyong Gong2, Ling Liu3. 1. From the Epilepsy Center, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan Province, China. 2. From the Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan Province, China. 3. From the Epilepsy Center, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan Province, China. neurologyliuling@163.com.
Abstract
PURPOSE: We aimed to analyze the characteristics of brain function and microstructure linked to epilepsy relapse after drug withdrawal in patients with focal epilepsy. METHODS: Resting-state functional magnetic resonance imaging and high-resolution T1-weighted images were acquired within 1 month prior to drug withdrawal from 15 patients who did not have epilepsy relapse (PER - group) and 16 patients who subsequently had epilepsy relapse (PER + group). Additionally, 23 healthy participants undergoing the same scanning protocol were included as controls. Fractional amplitude of low-frequency fluctuation (fALFF) and gray matter density (GMD) were compared among groups. Subgroup and correlation analyses were also performed. RESULTS: There were no significant differences in fALFF between patient groups, but the PER + group showed lower GMD in the bilateral calcarine, left precuneus, and right superior temporal gyrus than the PER - group (Gaussian random field correction, voxel-level P < 0.001 and cluster-level P < 0.05). Both increased seizure number and polytherapy were associated with lower GMD; also, patients using other antiseizure medications showed lower GMD than those using only levetiracetam (Gaussian random field correction, voxel-level P < 0.001, and cluster-level P < 0.05). The active period and disease duration showed both positive and negative correlations with GMD, while the seizure-free period mainly showed positive correlations with GMD (uncorrected, P < 0.001). CONCLUSION: Gray matter microstructure, but not local functional activity, showed distinct characteristics between patients with and without epilepsy relapse and may serve as a potential biomarker for predicting seizure recurrence upon drug withdrawal.
PURPOSE: We aimed to analyze the characteristics of brain function and microstructure linked to epilepsy relapse after drug withdrawal in patients with focal epilepsy. METHODS: Resting-state functional magnetic resonance imaging and high-resolution T1-weighted images were acquired within 1 month prior to drug withdrawal from 15 patients who did not have epilepsy relapse (PER - group) and 16 patients who subsequently had epilepsy relapse (PER + group). Additionally, 23 healthy participants undergoing the same scanning protocol were included as controls. Fractional amplitude of low-frequency fluctuation (fALFF) and gray matter density (GMD) were compared among groups. Subgroup and correlation analyses were also performed. RESULTS: There were no significant differences in fALFF between patient groups, but the PER + group showed lower GMD in the bilateral calcarine, left precuneus, and right superior temporal gyrus than the PER - group (Gaussian random field correction, voxel-level P < 0.001 and cluster-level P < 0.05). Both increased seizure number and polytherapy were associated with lower GMD; also, patients using other antiseizure medications showed lower GMD than those using only levetiracetam (Gaussian random field correction, voxel-level P < 0.001, and cluster-level P < 0.05). The active period and disease duration showed both positive and negative correlations with GMD, while the seizure-free period mainly showed positive correlations with GMD (uncorrected, P < 0.001). CONCLUSION: Gray matter microstructure, but not local functional activity, showed distinct characteristics between patients with and without epilepsy relapse and may serve as a potential biomarker for predicting seizure recurrence upon drug withdrawal.
Entities:
Keywords:
Drug withdrawal; Epilepsy; Functional MRI; Relapse; Structural MRI
Authors: Lalit Gupta; Rick Janssens; Mariëlle C G Vlooswijk; Rob P W Rouhl; Anton de Louw; Albert P Aldenkamp; Shrutin Ulman; René M H Besseling; Paul A M Hofman; Vivianne H van Kranen-Mastenbroek; Danny M Hilkman; Jacobus F A Jansen; Walter H Backes Journal: Epilepsia Date: 2017-01-18 Impact factor: 5.864
Authors: Herm J Lamberink; Willem M Otte; Ada T Geerts; Milen Pavlovic; Julio Ramos-Lizana; Anthony G Marson; Jan Overweg; Letícia Sauma; Luigi M Specchio; Michael Tennison; Tania M O Cardoso; Shlomo Shinnar; Dieter Schmidt; Karin Geleijns; Kees P J Braun Journal: Lancet Neurol Date: 2017-05-05 Impact factor: 44.182
Authors: Simon S Keller; Paul Cresswell; Christine Denby; Udo Wieshmann; Paul Eldridge; Gus Baker; Neil Roberts Journal: Epilepsy Res Date: 2007-04-06 Impact factor: 3.045