Evidence for interictal blood-brain barrier dysfunction in people with epilepsy.

Autor: Reiter JT; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany., Schulte F; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany., Bauer T; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany., David B; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Endler C; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany., Isaak A; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany., Schuch F; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Bitzer F; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany., Witt JA; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Hattingen E; Institute of Neuroradiology, University Hospital and Goethe University Frankfurt, Frankfurt am Main, Germany., Deichmann R; Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany., Attenberger U; Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany., Becker AJ; Department of Neuropathology, University Hospital Bonn, Bonn, Germany., Helmstaedter C; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Radbruch A; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany., Surges R; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Friedman A; Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.; Departments of Cognitive and Brain Sciences, Physiology, and Cell Biology, Ben-Gurion University of the Negev, Beer Sheva, Israel., Rüber T; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Jazyk: angličtina
Zdroj: Epilepsia [Epilepsia] 2024 May; Vol. 65 (5), pp. 1462-1474. Date of Electronic Publication: 2024 Mar 04.
DOI: 10.1111/epi.17929
Abstrakt: Objective: Interictal blood-brain barrier dysfunction in chronic epilepsy has been demonstrated in animal models and pathological specimens. Ictal blood-brain barrier dysfunction has been shown in humans in vivo using an experimental quantitative magnetic resonance imaging (MRI) protocol. Here, we hypothesized that interictal blood-brain barrier dysfunction is also present in people with drug-resistant epilepsy.
Methods: Thirty-nine people (21 females, mean age at MRI ± SD = 30 ± 8 years) with drug-resistant epilepsy were prospectively recruited and underwent interictal T1-relaxometry before and after administration of a paramagnetic contrast agent. Likewise, quantitative T1 was acquired in 29 people without epilepsy (12 females, age at MRI = 48 ± 18 years). Quantitative T1 difference maps were calculated and served as a surrogate imaging marker for blood-brain barrier dysfunction. Values of quantitative T1 difference maps inside hemispheres ipsilateral to the presumed seizure onset zone were then compared, on a voxelwise level and within presumed seizure onset zones, to the contralateral side of people with epilepsy and to people without epilepsy.
Results: Compared to the contralateral side, ipsilateral T1 difference values were significantly higher in white matter (corrected p < .05), gray matter (uncorrected p < .05), and presumed seizure onset zones (p = .04) in people with epilepsy. Compared to people without epilepsy, significantly higher T1 difference values were found in the anatomical vicinity of presumed seizure onset zones (p = .004). A subgroup of people with hippocampal sclerosis demonstrated significantly higher T1 difference values in the ipsilateral hippocampus and in regions strongly interconnected with the hippocampus compared to people without epilepsy (corrected p < .01). Finally, z-scores reflecting the deviation of T1 difference values within the presumed seizure onset zone were associated with verbal memory performance (p = .02) in people with temporal lobe epilepsy.
Significance: Our results indicate a blood-brain barrier dysfunction in drug-resistant epilepsy that is detectable interictally in vivo, anatomically related to the presumed seizure onset zone, and associated with cognitive deficits.
(© 2024 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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