Histopathological characterization of cerebral small vessel disease in epilepsy patients with temporal lobe epilepsy submitted to surgery : A case-control study
© 2023 European Academy of Neurology..
BACKGROUND: Cerebrovascular disease (CVD) is a major contributor to epilepsy; however, patients with epilepsy also have a significantly increased risk of stroke. The way in which epilepsy contributes to the increased risk of stroke is still uncertain and is ill-characterized in neuropathological studies. A neuropathological characterization of cerebral small vessel disease (cSVD) in patients with chronic epilepsy was performed.
METHODS: Thirty-three patients with refractory epilepsy and hippocampal sclerosis (HS) submitted to epilepsy surgery from a reference center were selected between 2010 and 2020 and compared with 19 autopsy controls. Five randomly selected arterioles from each patient were analyzed using a previously validated scale for cSVD. The presence of CVD disease imaging markers in pre-surgical brain magnetic resonance imaging (MRI) was studied.
RESULTS: There were no differences in age (43.8 vs. 41.6 years; p = 0.547) or gender distribution (female gender 60.6% vs. male gender 52.6%; p = 0.575) between groups. Most CVD findings in brain MRI were mild. Patients had a mean time between the epilepsy onset and surgery of 26 ± 14.7 years and were medicated with a median number of three antiseizure medication (ASMs) [IQR 2-3]. Patients had higher median scores in arteriolosclerosis (3 vs. 1; p < 0.0001), microhemorrhages (4 vs. 1; p < 0.0001) and total score value (12 vs. 8.9; p = 0.031) in comparison with controls. No correlation was found between age, number of years until surgery, number of ASMs or cumulative defined daily dosage of ASM.
CONCLUSION: The present study provides evidence supporting the increased burden of cSVD in the neuropathological samples of patients with chronic epilepsy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
European journal of neurology - 30(2023), 10 vom: 28. Okt., Seite 2999-3007 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Coelho, Pedro [VerfasserIn] |
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| Links: |
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| Themen: |
Atherosclerosis |
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| Anmerkungen: |
Date Completed 08.09.2023 Date Revised 11.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ene.15963 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359034020 |
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| 100 | 1 | |a Coelho, Pedro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Histopathological characterization of cerebral small vessel disease in epilepsy patients with temporal lobe epilepsy submitted to surgery |b A case-control study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 08.09.2023 | ||
| 500 | |a Date Revised 11.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 European Academy of Neurology. | ||
| 520 | |a BACKGROUND: Cerebrovascular disease (CVD) is a major contributor to epilepsy; however, patients with epilepsy also have a significantly increased risk of stroke. The way in which epilepsy contributes to the increased risk of stroke is still uncertain and is ill-characterized in neuropathological studies. A neuropathological characterization of cerebral small vessel disease (cSVD) in patients with chronic epilepsy was performed | ||
| 520 | |a METHODS: Thirty-three patients with refractory epilepsy and hippocampal sclerosis (HS) submitted to epilepsy surgery from a reference center were selected between 2010 and 2020 and compared with 19 autopsy controls. Five randomly selected arterioles from each patient were analyzed using a previously validated scale for cSVD. The presence of CVD disease imaging markers in pre-surgical brain magnetic resonance imaging (MRI) was studied | ||
| 520 | |a RESULTS: There were no differences in age (43.8 vs. 41.6 years; p = 0.547) or gender distribution (female gender 60.6% vs. male gender 52.6%; p = 0.575) between groups. Most CVD findings in brain MRI were mild. Patients had a mean time between the epilepsy onset and surgery of 26 ± 14.7 years and were medicated with a median number of three antiseizure medication (ASMs) [IQR 2-3]. Patients had higher median scores in arteriolosclerosis (3 vs. 1; p < 0.0001), microhemorrhages (4 vs. 1; p < 0.0001) and total score value (12 vs. 8.9; p = 0.031) in comparison with controls. No correlation was found between age, number of years until surgery, number of ASMs or cumulative defined daily dosage of ASM | ||
| 520 | |a CONCLUSION: The present study provides evidence supporting the increased burden of cSVD in the neuropathological samples of patients with chronic epilepsy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a atherosclerosis | |
| 650 | 4 | |a cerebral small vessel disease | |
| 650 | 4 | |a epilepsy | |
| 650 | 4 | |a hippocampal sclerosis | |
| 650 | 4 | |a neuropathology | |
| 650 | 4 | |a stroke | |
| 700 | 1 | |a Madureira, João |e verfasserin |4 aut | |
| 700 | 1 | |a Franco, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Peralta, Ana Rita |e verfasserin |4 aut | |
| 700 | 1 | |a Bentes, Carla |e verfasserin |4 aut | |
| 700 | 1 | |a Campos, Alexandre Rainha |e verfasserin |4 aut | |
| 700 | 1 | |a Anink, Jasper |e verfasserin |4 aut | |
| 700 | 1 | |a Aronica, Eleonora |e verfasserin |4 aut | |
| 700 | 1 | |a Roque, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Pimentel, José |e verfasserin |4 aut | |
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