Chambers, Stefanie;
Hofer, Leo;
Kienast, Patric;
Baumgartner, Christoph;
Koren, Johannes;
Pontillo, Giuseppe;
Dorfer, Christian;
... Haider, Lukas; + view all
(2025)
Predictors of brain atrophy in focal epilepsy.
European Journal of Radiology
, 191
, Article 112278. 10.1016/j.ejrad.2025.112278.
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Abstract
BACKGROUND: Epilepsy as a progressive disease is a topic of dispute, with only limited evidence supportive of a neurodegenerative hypothesis across structural etiologies other than hippocampal sclerosis. METHODS: We performed cross-sectional brain volumetry on T1-weighted MRI scans in 59 people with drug-resistant focal epilepsy (PWFE), who had undergone extensive evaluation at a tertiary epilepsy center and were compared to three independent age-and sex-matched healthy control cohorts. 36 (61%) PWFE showed structural pathologies such as malformations of cortical development, low-grade epilepsy-associated neuroepithelial tumours and hippocampal sclerosis or encephaloceles, 23 (19%) PWFE were MRI-negative. RESULTS: 59 PWFE (female/male: 25/34, mean age 32.4 years, SD: 10.5) presenting with a median seizure frequency score (SFS) of 7 (range 1-10) and mean epilepsy duration of 14.3 years (SD: 9.9) were compared to 59 healthy control subjects (f/m: 33/26, mean age 33.7 years, SD 9.9). Adjusted for effects of age and gender, cortical gray matter volume in PWFE with a high SFS (≥ 7) was decreased by 30.1 ml (CI: -46.92 ml - -13.34 ml, p < 0.001). Similar results were observed for total deep gray matter volume, decreasing -4.35 ml (CI: -6.13 ml - -2.58 ml, p < 0.001) and white matter volume -40.65 ml (CI: -57.70 ml - -23.59 ml, p = 0.001) in patients suffering from a high seizure frequency. This effect was not significantly influenced by the structural etiology, seizure severity, nor lesion location. CONCLUSIONS: Widespread brain volume loss, exceeding that of normal aging, shows correlation with a high seizure frequency irrespective of structural etiology in focal epilepsy.
| Type: | Article |
|---|---|
| Title: | Predictors of brain atrophy in focal epilepsy |
| Location: | Ireland |
| DOI: | 10.1016/j.ejrad.2025.112278 |
| Publisher version: | https://doi.org/10.1016/j.ejrad.2025.112278 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211412 |
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