耐药性癫痫的血脑屏障功能障碍成像:多中心可行性研究

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY Epilepsia Pub Date : 2024-11-06 DOI:10.1111/epi.18145
Nir Cafri, Sheida Mirloo, Daniel Zarhin, Lyna Kamintsky, Yonatan Serlin, Laith Alhadeed, Ilan Goldberg, Mark A Maclean, Ben Whatley, Ilia Urman, Colin P Doherty, Chris Greene, Claire Behan, Declan Brennan, Matthew Campbell, Chris Bowen, Gal Ben-Arie, Ilan Shelef, Britta Wandschneider, Matthias Koepp, Alon Friedman, Felix Benninger
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引用次数: 0

摘要

目的:血脑屏障功能障碍(BBBD)与包括癫痫在内的多种神经系统疾病有关。本研究旨在利用动态对比增强磁共振成像(DCE-MRI)来识别和比较癫痫患者(PWE)和健康人存在血脑屏障功能障碍的脑区:我们使用 DCE-MRI 扫描了来自全球四个专业癫痫中心的 50 名耐药性癫痫 (DRE) 患者和 58 名对照组参与者。方法:我们使用 DCE-MRI 扫描了来自全球四个专业癫痫中心的 50 名耐药性癫痫患者和 58 名对照组参与者,分析并比较了 PWE 和健康对照组之间 BBBD 的存在和程度:结果:与健康对照组相比,PWE 患者的脑容量更大,具有 BBBD 的脑区数量更多(p -7)。在被诊断为局灶性癫痫发作或全身性癫痫的患者中,尽管受影响的区域不同,但未观察到伴有BBBD的总脑容量存在差异。与无病变病例相比,有磁共振成像可见病灶的PWE患者有BBBD的总脑容量没有差异。82%的患者(n = 39)在怀疑与癫痫发作有关的脑区观察到了BBBD,并且通常在怀疑致痫病灶(n = 10)所在、邻近和/或同一半球中发现:这些研究结果与临床前研究一致,临床前研究强调了 BBBD 在 DRE 发病中的作用,并将稳定微血管确定为一种潜在的治疗策略。
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Imaging blood-brain barrier dysfunction in drug-resistant epilepsy: A multi-center feasibility study.

Objective: Blood-brain barrier dysfunction (BBBD) has been linked to various neurological disorders, including epilepsy. This study aims to utilize dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to identify and compare brain regions with BBBD in patients with epilepsy (PWE) and healthy individuals.

Methods: We scanned 50 drug-resistant epilepsy (DRE) patients and 58 control participants from four global specialized epilepsy centers using DCE-MRI. The presence and extent of BBBD were analyzed and compared between PWE and healthy controls.

Results: Both greater brain volume and higher number of brain regions with BBBD were significantly present in PWE compared to healthy controls (p < 10-7). No differences in total brain volume with BBBD were observed in patients diagnosed with either focal seizures or generalized epilepsy, despite variations in the affected regions. Overall brain volume with BBBD did not differ in PWE with MRI-visible lesions compared with non-lesional cases. BBBD was observed in brain regions suspected to be related to the onset of seizures in 82% of patients (n = 39) and was typically identified in, adjacent to, and/or in the same hemisphere as the suspected epileptogenic lesion (n = 10).

Significance: These findings are consistent with pre-clinical studies that highlight the role of BBBD in the development of DRE and identify microvascular stabilization as a potential therapeutic strategy.

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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
期刊最新文献
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