Interictal blood-brain barrier dysfunction in piriform cortex of people with epilepsy.

Autor: Schulte F; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Reiter JT; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Bauer T; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Taube J; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Bitzer F; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Witt JA; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Piper R; Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK., Thanabalasingam A; Department of Epileptology, University Hospital Bonn, Bonn, Germany., von Wrede R; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Racz A; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Baumgartner T; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Borger V; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany., Specht-Riemenschneider L; Center for Medical Data Usability and Translation, Bonn, Germany., Vatter H; Department of Neurosurgery, University Hospital Bonn, Bonn, Germany., Hattingen E; Department of Neuroradiology, Clinics of Johann Wolfgang-Goethe University, Frankfurt am Main, Germany.; Brain Imaging Center, Goethe-Universität Frankfurt, Frankfurt am Main, Germany., Deichmann R; Brain Imaging Center, Goethe-Universität Frankfurt, Frankfurt am Main, Germany., Helmstaedter C; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Radbruch A; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Center for Medical Data Usability and Translation, Bonn, Germany.; German Center for Neurodegenerative Diseases, Bonn, Germany., Friedman A; Department of Brain and Cognitive Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.; Department of Medical Neuroscience, Dalhousie University, Halifax, Canada., Surges R; Department of Epileptology, University Hospital Bonn, Bonn, Germany., Rüber T; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.; Department of Epileptology, University Hospital Bonn, Bonn, Germany.; Center for Medical Data Usability and Translation, Bonn, Germany.
Jazyk: angličtina
Zdroj: Annals of clinical and translational neurology [Ann Clin Transl Neurol] 2024 Oct; Vol. 11 (10), pp. 2623-2632. Date of Electronic Publication: 2024 Aug 27.
DOI: 10.1002/acn3.52176
Abstrakt: Objective: The piriform cortex is considered to be highly epileptogenic. Its resection during epilepsy surgery is a predictor for postoperative seizure freedom in temporal lobe epilepsy. Epilepsy is associated with a dysfunction of the blood-brain barrier. We investigated blood-brain barrier dysfunction in the piriform cortex of people with temporal lobe epilepsy using quantitative T1-relaxometry.
Methods: Gadolinium-based contrast agent was administered ictally and interictally in 37 individuals before undergoing quantitative T1-relaxometry. Postictal and interictal images were co-registered, and subtraction maps were created as biomarkers for peri-ictal (∆qT1 interictal-postictal ) and interictal (∆qT1 noncontrast-interictal ) blood-brain barrier dysfunction. Values were extracted for the piriform cortex, hippocampus, amygdala, and the whole cortex.
Results: In temporal lobe epilepsy (n = 14), ∆qT1 noncontrast-interictal was significantly higher in the piriform cortex than in the whole cortex (p = 0.02). In extratemporal lobe epilepsy (n = 23), ∆qT1 noncontrast-interictal was higher in the hippocampus than in the whole cortex (p = 0.05). Across all individuals (n = 37), duration of epilepsy was correlated with ∆qT1 noncontrast-interictal (ß = 0.001, p < 0.001) in all regions, while the association was strongest in the piriform cortex. Impaired verbal memory was associated with ∆qT1 noncontrast-interictal only in the piriform cortex (p = 0.04). ∆qT1 interictal-postictal did not show differences in any region.
Interpretation: Interictal blood-brain barrier dysfunction occurs in the piriform cortex in temporal lobe epilepsy. This dysfunction is linked to longer disease duration and worse cognitive deficits, emphasizing the central role of the piriform cortex in the epileptogenic network of temporal lobe epilepsy.
(© 2024 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)
Databáze: MEDLINE
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