May anti-seizure medications alter brain structure in temporal lobe epilepsy? A prospective study.
anti-seizures medications (ASMs)
cerebral gray matter
mesial temporal lobe epilepsy (MTLE)
neuroimaging
Journal
Epilepsia open
ISSN: 2470-9239
Titre abrégé: Epilepsia Open
Pays: United States
ID NLM: 101692036
Informations de publication
Date de publication:
12 Mar 2024
12 Mar 2024
Historique:
revised:
18
01
2024
received:
09
06
2023
accepted:
25
01
2024
medline:
13
3
2024
pubmed:
13
3
2024
entrez:
13
3
2024
Statut:
aheadofprint
Résumé
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
Références
Whelan CD, Altmann A, Botía JA, Jahanshad N, Hibar DP, Absil J, et al. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study. Brain. 2018;141(2):391-408.
Shanmugarajah PD, Hoggard N, Aeschlimann DP, Aeschlimann PC, Dennis GJ, Howell SJ, et al. Phenytoin-related ataxia in patients with epilepsy: clinical and radiological characteristics. Seizure. 2018;56:26-30.
Pardoe HR, Berg AT, Jackson GD. Sodium valproate use is associated with reduced parietal lobe thickness and brain volume. Neurology. 2013;80(20):1895-1900.
Tang Y, Yu X, Zhang X, Xia W, Wu X, Zou X, et al. Single-dose intravenous administration of antiepileptic drugs induces rapid and reversible remodeling in the brain: evidence from a voxel-based morphometry evaluation of valproate and levetiracetam in rhesus monkeys. Neuroscience. 2015;303:595-603.
Xu Y, Yang F, Hu Z, He Y, Zhang Q, Xu Q, et al. Anti-seizure medication correlated changes of cortical morphology in childhood epilepsy with centrotemporal spikes. Epilepsy Res. 2021;173:106621.
Operto FF, Pastorino GMG, Mazza R, Roccella M, Carotenuto M, Margari L, et al. Cognitive profile in BECTS treated with levetiracetam: a 2-year follow-up. Epilepsy Behav. 2019;97:187-191.
Labate A, Gambardella A, Andermann E, Aguglia U, Cendes F, Berkovic SF, et al. Benign mesial temporal lobe epilepsy. Nat Rev Neurol. 2011;7(4):237-240.
Labate A, Aguglia U, Tripepi G, Mumoli L, Ferlazzo E, Baggetta R, et al. Long-term outcome of mild mesial temporal lobe epilepsy: a prospective longitudinal cohort study. Neurology. 2016;86(20):1904-1910.
Aguglia U, Gambardella A, Le Piane E, Messina D, Oliveri RL, Russo C, et al. Mild non-lesional temporal lobe epilepsy. A common, unrecognized disorder with onset in adulthood. Can J Neurol Sci. 1998;25(4):282-286.
Labate A, Cerasa A, Aguglia U, Mumoli L, Quattrone A, Gambardella A. Neocortical thinning in “benign” mesial temporal lobe epilepsy. Epilepsia. 2011;52(4):712-717.
Bernasconi A, Cendes F, Theodore WH, Gill RS, Koepp MJ, Hogan RE, et al. Recommendations for the use of structural magnetic resonance imaging in the care of patients with epilepsy: a consensus report from the International League Against Epilepsy Neuroimaging Task Force. Epilepsia. 2019;60(6):1054-1068.
Fischl B. FreeSurfer. Neuroimage. 2012;62(2):774-781.
Labate A, Caligiuri ME, Fortunato F, Ferlazzo E, Aguglia U, Gambardella A. Late drug-resistance in mild MTLE: can it be influenced by preexisting white matter alterations? Epilepsia. 2020;61(5):924-934.
Tondelli M, Vaudano AE, Sisodiya SM, Meletti S. Valproate use is associated with posterior cortical thinning and ventricular enlargement in epilepsy patients. Front Neurol. 2020;11:622.
Morte MI, Carreira BP, Falcão MJ, Ambrósio AF, Soares-da-Silva P, Araújo IM, et al. Evaluation of neurotoxic and neuroprotective pathways affected by antiepileptic drugs in cultured hippocampal neurons. Toxicol In Vitro. 2013;27(8):2193-2202.
Douw L, Leveroni CL, Tanaka N, Emerton BC, Cole AJ, Reinsberger C, et al. Loss of resting-state posterior cingulate flexibility is associated with memory disturbance in left temporal lobe epilepsy. PLoS One. 2016;11(2):e0148664.
Wandschneider B, Stretton J, Sidhu M, Centeno M, Kozák LR, Symms M, et al. Levetiracetam reduces abnormal network activations in temporal lobe epilepsy. Neurology. 2014;83(17):1508-1512.