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Sammarra I, Caligiuri ME, Bonacci MC, Di Gennaro G, Fortunato F, Martino I, Giugno A, Labate A, Gambardella A. May anti-seizure medications alter brain structure in temporal lobe epilepsy? A prospective study. Epilepsia Open 2024. [PMID: 38475905 DOI: 10.1002/epi4.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 03/14/2024] Open
Abstract
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.
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Affiliation(s)
- Ilaria Sammarra
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Celeste Bonacci
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Gianfranco Di Gennaro
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Fortunato
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessia Giugno
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Angelo Labate
- Neurophysiopatology and Movement Disorders Clinic, University of Messina, Messina, Italy
| | - Antonio Gambardella
- Department of Medical and Surgical Sciences, Institute of Neurology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Zhang H, Li Q, Liu L, Qu X, Wang Q, Yang B, Xian J. Altered Microstructure of Cerebral Gray Matter in Neuromyelitis Optica Spectrum Disorder-Optic Neuritis: A DKI Study. Front Neurosci 2022; 15:738913. [PMID: 34987355 PMCID: PMC8720872 DOI: 10.3389/fnins.2021.738913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to analyze microstructural alterations in cerebral gray matter using non-Gaussian diffusion kurtosis imaging (DKI) in neuromyelitis optica spectrum disorder (NMOSD) patients with optic neuritis (NMOSD-ON). DKI was performed in 14 NMOSD-ON patients and 22 normal controls (NCs). DKI-derived metrics, including mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), fractional anisotropy (FA), and mean diffusivity (MD), were voxel-wisely compared by two-sample t-tests with gaussian random field (GRF) correction between the two groups. The correlations between altered DKI metrics and clinical features were analyzed. Compared with NCs, NMOSD-ON patients showed significantly decreased MK and RK both in the left inferior temporal gyrus (ITG), and decreased AK in the bilateral calcarine (CAL). While increased MD in the left fusiform gyrus (FFG), right CAL, and right hippocampus (HIP)/parahippocampal gyrus (PHG) were found. Furthermore, correlation analysis showed that mean deviation was negatively correlated with AK values of bilateral CAL and positively correlated with MD values of right CAL (q < 0.05, false discovery rate (FDR) corrected). For NMOSD-ON patients, microstructural abnormalities in the occipital visual cortex are correlated with clinical disability. These findings may provide complementary information to understand the neuropathological mechanisms underlying the impairments of cerebral gray matter in NMOSD-ON.
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Affiliation(s)
- Hanjuan Zhang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qing Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Liu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qian Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Bingbing Yang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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