May anti-seizure medications alter brain structure in temporal lobe epilepsy? A prospective study.

Autor: Sammarra I; Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy., Caligiuri ME; Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy., Bonacci MC; Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy., Di Gennaro G; Department of Health Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy., Fortunato F; Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy., Martino I; Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy., Giugno A; Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy., Labate A; Neurophysiopatology and Movement Disorders Clinic, University of Messina, Messina, Italy., Gambardella A; Department of Medical and Surgical Sciences, Institute of Neurology, Magna Græcia University of Catanzaro, Catanzaro, Italy.
Jazyk: angličtina
Zdroj: Epilepsia open [Epilepsia Open] 2024 Jun; Vol. 9 (3), pp. 1076-1082. Date of Electronic Publication: 2024 Mar 12.
DOI: 10.1002/epi4.12912
Abstrakt: Mild mesial temporal lobe epilepsy (MTLE) patients may remain untreated for a considerable time after disease onset or achieve seizure control with a single anti-seizures medication (ASM). Thus, they represent an optimal population to investigate whether ASMs might have influence on brain structure. We consecutively enrolled 56 mild MTLE patients (22/56 untreated, 34/56 on-monotherapy) and 58 healthy controls, matched for age and gender. All subjects underwent 3T-brain MRI, using FreeSurfer for automated morphometry. Differences in gray matter were assessed using one-way Analysis of Covariance (ANCOVA), adjusting for age, disease duration and intracranial volume. No significant change was observed between treated and untreated patients. We observed a significant reduction in cortical thickness of left inferior parietal, inferior temporal, middle temporal gyri, and right inferior parietal gyrus, temporal pole in monotherapy patients compared to healthy controls, as well as an increase in left isthmus of cingulate gyrus in untreated MTLE subjects compared to controls. Surface and subcortical volumes analysis revealed no differences among groups. Our study demonstrated no substantial morphological abnormalities between untreated mild MTLE patients and those undergoing monotherapy. Although exploratory, these results may reassure about safety of commonly used drugs and their marginal role in influencing neuroimaging results. PLAIN LANGUAGE SUMMARY: This study investigated the following question: can medications against epileptic seizures have an effect on brain structure in mild mesial temporal lobe? Preliminary results from our analyses suggest not, as we did not find any difference in brain gray matter between untreated patients and those treated with a single anti-seizures medication. On the other hand, epilepsy patients presented cortical thinning compared to healthy controls in several regions of the temporal and parietal lobes, in line with previous studies investigating the disease.
(© 2024 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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