Ludwig Klein , Gordian Prasse , Alim E. Basaran , Jost-Julian Rumpf , Martin Vychopen , Johannes Wach , Erdem Güresir , Tim Wende
{"title":"White matter integrity and its correlation to seizures in diffuse glioma","authors":"Ludwig Klein , Gordian Prasse , Alim E. Basaran , Jost-Julian Rumpf , Martin Vychopen , Johannes Wach , Erdem Güresir , Tim Wende","doi":"10.1016/j.eplepsyres.2025.107627","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Seizures are one of the most common symptoms in patients with diffuse glioma, occurring in 30–80 % of cases. Although seizure control can be achieved in up to 90 %, seizures remain a significant burden and are hardly predictable. The aim of this analysis was, therefore, to investigate the association between white matter integrity and seizure occurrence in patients with diffuse glioma using diffusion tensor imaging (DTI).</div></div><div><h3>Methods</h3><div>Patients with first diagnosis of diffuse glioma (WHO-grade 2, 3, 4) who received preoperative DTI sequences for surgical planning were analyzed. Tractography of corpus callosum and cingulum was carried out, extracting mean FA values of the resulting volumes.</div></div><div><h3>Results</h3><div>50 patients (17 female) were included with a mean age of 59.5 ± 2.2 years. Glioma WHO grade 4 was most common (82 %), followed by grade 3 (10 %) and grade 2 (8 %). Most gliomas were located left temporal (32 %) and bilateral frontal (each hemisphere 16 %). 16 % presented with multifocal glioma. 48 % had suffered seizures prior to surgery, and were thus diagnosed with structural epilepsy. 22 % of all patients presented recurring seizures despite surgery and anti-seizure medication, and 6 % developed new seizures after surgery. After correction for multiple comparisons, increased FA in the left parahippocampal cingulum was significantly associated with preoperative seizures (0.30 ± 0.01 versus 0.27 ± 0.01, p<sub>corr</sub> = 0.007), while increased FA in the forceps minor of the corpus callosum correlated with postoperative seizures (0.49 ± 0.01 versus 0.43 ± 0.01, p<sub>corr</sub> = 0.014).</div></div><div><h3>Conclusion</h3><div>Higher preoperative white matter integrity was associated with increased risk for occurrence of seizures in diffuse glioma. Further research is warranted to investigate the relation with tumor pathology.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107627"},"PeriodicalIF":2.0000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epilepsy Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0920121125001287","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Seizures are one of the most common symptoms in patients with diffuse glioma, occurring in 30–80 % of cases. Although seizure control can be achieved in up to 90 %, seizures remain a significant burden and are hardly predictable. The aim of this analysis was, therefore, to investigate the association between white matter integrity and seizure occurrence in patients with diffuse glioma using diffusion tensor imaging (DTI).
Methods
Patients with first diagnosis of diffuse glioma (WHO-grade 2, 3, 4) who received preoperative DTI sequences for surgical planning were analyzed. Tractography of corpus callosum and cingulum was carried out, extracting mean FA values of the resulting volumes.
Results
50 patients (17 female) were included with a mean age of 59.5 ± 2.2 years. Glioma WHO grade 4 was most common (82 %), followed by grade 3 (10 %) and grade 2 (8 %). Most gliomas were located left temporal (32 %) and bilateral frontal (each hemisphere 16 %). 16 % presented with multifocal glioma. 48 % had suffered seizures prior to surgery, and were thus diagnosed with structural epilepsy. 22 % of all patients presented recurring seizures despite surgery and anti-seizure medication, and 6 % developed new seizures after surgery. After correction for multiple comparisons, increased FA in the left parahippocampal cingulum was significantly associated with preoperative seizures (0.30 ± 0.01 versus 0.27 ± 0.01, pcorr = 0.007), while increased FA in the forceps minor of the corpus callosum correlated with postoperative seizures (0.49 ± 0.01 versus 0.43 ± 0.01, pcorr = 0.014).
Conclusion
Higher preoperative white matter integrity was associated with increased risk for occurrence of seizures in diffuse glioma. Further research is warranted to investigate the relation with tumor pathology.
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.