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Jin BZ, Capiglioni M, Federspiel A, Ahmadli U, Schindler K, Kiefer C, Wiest R. Neuronal current imaging of epileptic activity: An MRI study in patients with a first unprovoked epileptic seizure. Epilepsia Open 2024. [PMID: 38970780 DOI: 10.1002/epi4.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVE This study evaluates the performance of the novel MRI sequence stimulus-induced rotary saturation (SIRS) to map responses to interictal epileptic activity in the human cortex. Spin-lock pulses have been applied to indirectly detect neuronal activity through magnetic field perturbations. Following initial reports about the feasibility of the method in humans and animals with epilepsy, we aimed to investigate the diagnostic yield of spin-lock MR pulses in comparison with scalp-EEG in first seizure patients. METHODS We employed a novel method for measurements of neuronal activity through the detection of a resonant oscillating field, stimulus-induced rotary saturation contrast (SIRS) at spin-lock frequencies of 120 and 240 Hz acquired at a single 3T MRI system. Within a prospective observational study, we conducted SIRS experiments in 55 patients within 7 days after a suspected first unprovoked epileptic seizure and 61 healthy control subjects. In this study, we report on the analysis of data from a single 3T MRI system, encompassing 35 first seizure patients and 31 controls. RESULTS The SIRS method was applicable in all patients and healthy controls at frequencies of 120 and 240 Hz. We did not observe any significant age- or sex-related differences. Specificity of SIRS at 120 Hz was 90.3% and 93.5% at 240 Hz. Sensitivity was 17.1% at 120 Hz and 40.0% at 240 Hz. SIGNIFICANCE SIRS targets neuronal oscillating magnetic fields in patients with epilepsy. The coupling of presaturated spins to epilepsy-related magnetic field perturbations may serve as a-at this stage experimental-diagnostic test in first seizure patients to complement EEG findings as a standard screening test. PLAIN LANGUAGE SUMMARY Routine diagnostic tests carry several limitations when applied after a suspected first seizure. SIRS is a noninvasive MRI method to enable time-sensitive diagnosis of image correlates of epileptic activity with increased sensitivity compared to routine EEG.
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Affiliation(s)
- Baudouin Zongxin Jin
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School of Health Sciences, Medical Faculty, University of Bern, Bern, Switzerland
| | - Milena Capiglioni
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Andrea Federspiel
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Uzeyir Ahmadli
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Kaspar Schindler
- Sleep-Wake-Epilepsy-Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claus Kiefer
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging, Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Sitem-Insel, Bern, Switzerland
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Ribeiro-Constante J, Tristán-Noguero A, Martínez Calvo FF, Ibañez-Mico S, Peña Segura JL, Ramos-Fernández JM, Moyano Chicano MDC, Camino León R, Soto Insuga V, González Alguacil E, Valera Dávila C, Fernández-Jaén A, Plans L, Camacho A, Visa-Reñé N, Martin-Tamayo Blázquez MDP, Paredes-Carmona F, Marti-Carrera I, Hernández-Fabián A, Tomas Davi M, Sanchez MC, Herraiz LC, Pita PF, Gonzalez TB, O'Callaghan M, Iglesias Santa Polonia FF, Cazorla MR, Ferrando Lucas MT, González-Meneses A, Sala-Coromina J, Macaya A, Lasa-Aranzasti A, Cueto-González AM, Valera Párraga F, Campistol Plana J, Serrano M, Alonso X, Del Castillo-Berges D, Schwartz-Palleja M, Illescas S, Ramírez Camacho A, Sans Capdevila O, García-Cazorla A, Bayés À, Alonso-Colmenero I. Developmental outcome of electroencephalographic findings in SYNGAP1 encephalopathy. Front Cell Dev Biol 2024; 12:1321282. [PMID: 38505260 PMCID: PMC10948473 DOI: 10.3389/fcell.2024.1321282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/22/2024] [Indexed: 03/21/2024] Open
Abstract
SYNGAP1 haploinsufficiency results in a developmental and epileptic encephalopathy (DEE) causing generalized epilepsies accompanied by a spectrum of neurodevelopmental symptoms. Concerning interictal epileptiform discharges (IEDs) in electroencephalograms (EEG), potential biomarkers have been postulated, including changes in background activity, fixation-off sensitivity (FOS) or eye closure sensitivity (ECS). In this study we clinically evaluate a new cohort of 36 SYNGAP1-DEE individuals. Standardized questionnaires were employed to collect clinical, electroencephalographic and genetic data. We investigated electroencephalographic findings, focusing on the cortical distribution of interictal abnormalities and their changes with age. Among the 36 SYNGAP1-DEE cases 18 presented variants in the SYNGAP1 gene that had never been previously reported. The mean age of diagnosis was 8 years and 8 months, ranging from 2 to 17 years, with 55.9% being male. All subjects had global neurodevelopmental/language delay and behavioral abnormalities; 83.3% had moderate to profound intellectual disability (ID), 91.7% displayed autistic traits, 73% experienced sleep disorders and 86.1% suffered from epileptic seizures, mainly eyelid myoclonia with absences (55.3%). A total of 63 VEEGs were revised, observing a worsening of certain EEG findings with increasing age. A disorganized background was observed in all age ranges, yet this was more common among older cases. The main IEDs were bilateral synchronous and asynchronous posterior discharges, accounting for ≥50% in all age ranges. Generalized alterations with maximum amplitude in the anterior region showed as the second most frequent IED (≥15% in all age ranges) and were also more common with increasing age. Finally, diffuse fast activity was much more prevalent in cases with 6 years or older. To the best of our knowledge, this is the first study to analyze EEG features across different age groups, revealing an increase in interictal abnormalities over infancy and adolescence. Our findings suggest that SYNGAP1 haploinsufficiency has complex effects in human brain development, some of which might unravel at different developmental stages. Furthermore, they highlight the potential of baseline EEG to identify candidate biomarkers and the importance of natural history studies to develop specialized therapies and clinical trials.
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Affiliation(s)
| | - Alba Tristán-Noguero
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
- Molecular Physiology of the Synapse Laboratory, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - José Luis Peña Segura
- Pediatric Neurology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Rafael Camino León
- Pediatric Neurology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Víctor Soto Insuga
- Pediatric Neurology Department, Hospital Universitario Infantil del Niño Jesús, Madrid, Spain
| | - Elena González Alguacil
- Pediatric Neurology Department, Hospital Universitario Infantil del Niño Jesús, Madrid, Spain
| | - Carlos Valera Dávila
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Alberto Fernández-Jaén
- Pediatric Neurology Department, Neurogenetics Section, Hospital Universitario Quironsalud, Madrid, Spain
| | - Laura Plans
- Mental Health in Intellectual Disability Specialized Service Althaia, Xarxa Assistencial, Manresa, Spain
| | - Ana Camacho
- Pediatric Neurology Department, Hospital 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria Visa-Reñé
- Paediatric Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | | | | | - Itxaso Marti-Carrera
- Pediatric Neurology Department, Hospital Universitario Donostia, San Sebastian, Spain
| | | | - Meritxell Tomas Davi
- Mental Health in Intellectual Disability Specialized Service Althaia, Xarxa Assistencial, Manresa, Spain
| | - Merce Casadesus Sanchez
- Mental Health in Intellectual Disability Specialized Service Althaia, Xarxa Assistencial, Manresa, Spain
| | | | - Patricia Fuentes Pita
- Pediatric Neurology Department, Hospital Clínico Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Mar O'Callaghan
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | | | - María Rosario Cazorla
- Pediatric Neurology Department, Puerta de Hierro Majadahonda Universitary Hospital, Madrid, Spain
| | | | | | - Júlia Sala-Coromina
- Pediatric Neurology Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Bercelona, Spain
| | - Alfons Macaya
- Pediatric Neurology Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Bercelona, Spain
| | - Amaia Lasa-Aranzasti
- Department of Clinical and Molecular Genetic Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Bercelona, Spain
| | - Anna Ma Cueto-González
- Department of Clinical and Molecular Genetic Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Bercelona, Spain
| | | | - Jaume Campistol Plana
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Mercedes Serrano
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Xenia Alonso
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Diego Del Castillo-Berges
- Molecular Physiology of the Synapse Laboratory, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Schwartz-Palleja
- Eurecat, Technology Center of Catalonia, Multimedia Technologies, Barcelona, Spain
- Center for Brain and Cognition (CBC), Department of Information Technologies and Communications (DTIC), Pompeu Fabra University, Barcelona, Catalonia, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Sofía Illescas
- Pediatric Neurometabolism: Neural Communication Mechanisms and Personalized Therapies Pediatric Neurology Department: Neural Communication Mechanisms and Personalized Therapies Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Alia Ramírez Camacho
- Department of Child Neurology, Epilepsy and Neurophysiology Unit, Member of the ERN EpiCARE, Hospital Sant Joan de Dèu, Barcelona, Spain
| | - Oscar Sans Capdevila
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Angeles García-Cazorla
- Pediatric Neurology Department Sant Joan de Déu (SJD) Children’s Hospital, Barcelona, Spain
| | - Àlex Bayés
- Molecular Physiology of the Synapse Laboratory, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
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