Posttraumatic epilepsy: Integrating clinical, inflammatory, and genetic profiles in traumatic brain injury patients

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Epilepsy Research Pub Date : 2024-07-06 DOI:10.1016/j.eplepsyres.2024.107402

Amanda C. Mosini , Viviam Sanabria , Thábatta K.E. Nakamura , Michele L. Calió , Clara Pompeu , Clivandir S. Silva , Priscila Nicolicht-Amorim , Maria da Graça Naffah-Mazzacoratti , Marimelia A. Porcionatto , Luiz Eugênio Mello , Maira L. Foresti

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引用次数: 0

Abstract

Objective

This study aims to assess the clinical, inflammatory, and genetic profiles of traumatic brain injury (TBI) patients over a 2-year follow-up period, focusing on the development of posttraumatic epilepsy (PTE).

Methods

Fifty-nine patients with acute TBI were recruited in the emergency unit of a hospital in Brazil. Clinical data and blood samples were collected after 10 days of hospitalization for posterior genetic profile (Apolipoprotein E- ApoE and Glutamic Acid Descarboxylase-GAD sequencing) analyses. A subset of 19 patients were assessed for cytokine markers (mRNA expression). The development of PTE was investigated for two years following TBI. Statistical analyses including univariate analysis, multiple correspondence analysis, and Mann-Whitney test were performed.

Results

Analysis revealed an association between severe TBI and requirement for neurosurgery and polytrauma (p<0.05), as well as the development of PTE over a two-year follow-up period (p<0.05). Multiple correspondence analysis identified two distinct profiles associated with PTE and Non-PTE outcomes. The PTE profile showed a higher prevalence of the ApoE genotype E3/E3 and GAD1 SNP (rs769391) genotype AA in our study, while the Non-PTE profile showed a higher presence of E3/E4. mRNA expression analysis demonstrated acute elevated levels of TNF-α in the PTE group as compared to Non-PTE patients (6.70±1.53 vs 5.31 ±0.33, p<0.01).

Significance

Our findings underscore the multifactorial nature of aspects potentially contributing to PTE. It is unlikely that any single factor might in isolation have a strong causative influence over the development of epilepsy after TBI. Our results provide a suggestion of potential clustering that might be relevant as prognostic factors for PTE.

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创伤后癫痫：整合脑外伤患者的临床、炎症和遗传特征

本研究旨在评估创伤性脑损伤（TBI）患者在两年随访期内的临床、炎症和遗传特征，重点关注创伤后癫痫（PTE）的发展。住院10天后收集临床数据和血液样本，进行后遗基因图谱（载脂蛋白E-载脂蛋白E和谷氨酸脱羧酶-GAD测序）分析。对 19 名患者的子集进行了细胞因子标记物（mRNA 表达）评估。对创伤后两年内 PTE 的发展情况进行了调查。结果分析表明，严重创伤性脑损伤与需要神经外科手术和多发性创伤之间存在关联（p<0.05），并且在两年的随访期间出现了 PTE（p<0.05）。多重对应分析确定了两种与 PTE 和非 PTE 结果相关的不同特征。在我们的研究中，PTE 特征显示 ApoE 基因型 E3/E3 和 GAD1 SNP (rs769391) 基因型 AA 的患病率较高，而非 PTE 特征则显示 E3/E4 的患病率较高。mRNA表达分析表明，与非PTE患者相比，PTE组患者的TNF-α水平急剧升高（6.70±1.53 vs 5.31±0.33，p<0.01）。任何单一因素都不可能单独对创伤性脑损伤后癫痫的发生产生强烈的致病影响。我们的研究结果提供了可能与 PTE 的预后因素相关的潜在群集。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsy Research 医学-临床神经学

CiteScore

0.10

自引率

4.50%

发文量

143

审稿时长

62 days

期刊介绍： Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.