局灶性癫痫脑萎缩的预测因素

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-07-03 DOI:10.1016/j.ejrad.2025.112278

Stefanie Chambers , Leo Hofer , Patric Kienast , Christoph Baumgartner , Johannes Koren , Giuseppe Pontillo , Christian Dorfer , Karl Rössler , Judith Jud , Silvia Bonelli , Susanne Aull-Watschinger , Frederik Barkhof , Ekaterina Pataraia , Gilbert Hangel , Gregor Kasprian , Lukas Haider

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引用次数: 0

摘要

癫痫作为一种进行性疾病是一个有争议的话题，只有有限的证据支持神经退行性假说跨越结构病因，而不是海马硬化。方法：我们对59例耐药局灶性癫痫（PWFE）患者进行了t1加权MRI扫描的横断面脑容量测定，这些患者在三级癫痫中心接受了广泛的评估，并与三个独立的年龄和性别匹配的健康对照队列进行了比较。36例（61%）PWFE患者表现出皮层发育畸形、低度癫痫相关神经上皮肿瘤、海马硬化或脑膨出等结构性病理，23例（19%）PWFE患者mri阴性。结果59例PWFE患者（女/男：25/34，平均年龄32.4岁，SD: 10.5）癫痫发作频率评分（SFS）中位数为7（范围1-10），平均癫痫持续时间14.3年（SD: 9.9），与59例健康对照（f/m: 33/26，平均年龄33.7岁，SD 9.9）进行比较。调整年龄和性别的影响后，高SFS（≥7）的PWFE皮质灰质体积减少30.1 ml (CI:−46.92 ml -−13.34 ml, p <；0.001)。深灰质总体积也出现了类似的结果，减少了- 4.35 ml (CI: - 6.13 ml - - 2.58 ml, p <；发作频率高的患者脑白质体积为- 40.65 ml （CI: - 57.70 ml - - 23.59 ml, p = 0.001）。这种效果不受结构病因、癫痫发作严重程度和病变部位的显著影响。结论局灶性癫痫大范围脑容量损失超过正常衰老，与结构病因无关，与高发作频率有关。

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Predictors of brain atrophy in focal epilepsy

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.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.