Cerebral small vessel disease increases risk for epilepsy : a Mendelian randomization study

© 2023. Fondazione Società Italiana di Neurologia..

BACKGROUND: Despite previous research suggesting a potential association between cerebral small vessel disease (CSVD) and epilepsy, the precise causality and directionality between cerebral small vessel disease (CSVD) and epilepsy remain incompletely understood. We aimed to investigate the causal link between CSVD and epilepsy.

METHOD: A bidirectional two-sample Mendelian randomization (MR) analysis was performed to evaluate the causal relationship between CSVD and epilepsy. The analysis included five dimensions of CSVD, namely small vessel ischemic stroke (SVS), intracerebral hemorrhage (ICH), white matter damage (including white matter hyperintensity [WMH], fractional anisotropy, and mean diffusivity), lacunar stroke, and cerebral microbleeds. We also incorporated epilepsy encompassing both focal epilepsy and generalized epilepsy. Inverse variance weighted (IVW) was used as the primary estimate while other four MR techniques were used to validate the results. Pleiotropic effects were controlled by adjusting vascular risk factors through multivariable MR.

RESULT: The study found a significant association between SVS (odds ratio [OR] 1.117, PFDR = 0.022), fractional anisotropy (OR 0.961, PFDR = 0.005), mean diffusivity (OR 1.036, PFDR = 0.004), and lacunar stroke (OR 1.127, PFDR = 0.007) with an increased risk of epilepsy. The aforementioned correlations primarily occurred in focal epilepsy rather than generalized epilepsy on subgroup analysis and retained their significance in the multivariable MR analysis.

CONCLUSION: Our study demonstrated that genetic susceptibility to CSVD independently elevates the risk of epilepsy, especially focal epilepsy. Diffusion tensor imaging may help screen patients at high risk for epilepsy in CSVD. Improved management of CSVD may be a significant approach in reducing the overall prevalence of epilepsy.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:45

Enthalten in:

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology - 45(2024), 5 vom: 01. Apr., Seite 2171-2180

Sprache:

Englisch

Beteiligte Personen:

Wang, Yuzhu [VerfasserIn]
Zuo, Hongzhou [VerfasserIn]
Li, Wei [VerfasserIn]
Wu, Xiaohui [VerfasserIn]
Zhou, Fu [VerfasserIn]
Chen, Xuan [VerfasserIn]
Liu, Fei [VerfasserIn]
Xi, Zhiqin [VerfasserIn]

Links:

Volltext

Themen:

Cerebral small vessel disease
Epilepsy
GWAS
Journal Article
Mendelian Randomization
Stroke
White matter hyperintensity

Anmerkungen:

Date Completed 17.04.2024

Date Revised 17.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s10072-023-07221-w

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM36503648X