Association of Epilepsy Surgery With Changes in Imaging-Defined Brain Age.
Association of Epilepsy Surgery With Changes in Imaging-Defined Brain Age.
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DOI：
10.1212/wnl.0000000000012289
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发表时间：
2021-08-10
期刊：
影响因子：
9.9
通讯作者：
Keller SS
中科院分区：
文献类型：
--
作者：
de Bézenac CE;Adan G;Weber B;Keller SS
为了确定内侧颞叶癫痫(MTLE)患者的手术是否与作为整体大脑健康神经标记物的脑预测年龄减少有关，我们比较了健康对照组患者手术前后的脑预测年龄差异和实际年龄差异(脑年龄差距估计[BrainAGE])。我们获得了48例MTLE患者在颞叶手术前后的3DT1加权MRI扫描，以使用高斯过程回归模型来估计脑年龄。我们检查了手术前后控制脑容量变化的BrainAGE，将患者与37名年龄和性别匹配的对照组进行了比较。手术前，与对照组相比，患者的脑平均年龄增加了7年以上。然而，无论手术是否导致癫痫完全缓解，手术与平均脑平均寿命缩短5年有关。我们观察到左侧MTLE患者术后的脑AGE值与对照组的值更接近时的偏侧化效应。我们的发现表明，虽然在MTLE中观察到了与加速衰老有关的脑组织形态变化，但手术可能与某些患者逆转这种变化有关。这项工作突出了切除手术对难治性局灶性癫痫患者整体脑健康的优势。
To determine whether surgery in patients with mesial temporal lobe epilepsy (mTLE) is associated with reduced brain-predicted age as a neural marker overall brain health, we compared brain-predicted and chronologic age difference (brain age gap estimation [BrainAGE]) in patients before and after surgery with healthy controls. We acquired 3D T1-weighted MRI scans for 48 patients with mTLE before and after temporal lobe surgery to estimate brain age using a gaussian processes regression model. We examined BrainAGE before and after surgery controlling for brain volume change, comparing patients to 37 age- and sex-matched controls. Preoperatively, patients showed an increased BrainAGE of more than 7 years compared to controls. However, surgery was associated with a mean BrainAGE reduction of 5 years irrespective of whether or not surgery resulted in complete seizure freedom. We observed a lateralization effect as patients with left mTLE had BrainAGE values that more closely resembled control group values following surgery. Our findings suggest that while morphologic brain alterations linked to accelerated aging have been observed in mTLE, surgery may be associated with changes that reverse such alterations in some patients. This work highlights the advantages of resective surgery on overall brain health in patients with refractory focal epilepsy.