Brain lesion locations associated with secondary seizure generalization in tumors and strokes.
Brain lesion locations associated with secondary seizure generalization in tumors and strokes.
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DOI：
10.1002/hbm.26268
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发表时间：
2023-06-01
影响因子：
4.8
通讯作者：
Joutsa, Juho
中科院分区：
文献类型：
--
作者：
Nordberg, Janne;Schaper, Frederic L. W. V. J.;Bucci, Marco;Nummenmaa, Lauri;Joutsa, Juho
结构性脑损伤是成人发作性癫痫的最常见原因。病灶位置可能会导致癫痫发生的风险，但具体的病灶位置是否与继发性癫痫发作泛化（从局灶性到双侧强直阵挛性癫痫发作）的风险相关尚不清楚。我们确定了2004-2017年在图尔库大学医院诊断为缺血性卒中或肿瘤引起的成人发作性癫痫的患者。在患者特定MR成像上分割病变位置，并将其转换为通用脑图谱（MNI空间）。进行了感兴趣区域分析（与皮质、半球和肺叶相交）和体素分析，以确定与局灶性癫痫发作相比，与局灶性至双侧强直阵挛性癫痫发作相关的病变位置。我们纳入了170例病变诱发癫痫患者（94例肿瘤，76例卒中）。病变主要位于大脑皮质（OR 2.50，95% C.I. 1.21-5.15，p = 0.01）和右半球（OR 2.22，95% C.I. 1.17-4.20，p = .01）与局灶性至双侧强直阵挛性癫痫发作独立相关。在脑叶水平，局灶性至双侧强直阵挛性癫痫发作与右额叶皮质病变相关（OR 4.41，95% C.I. 1.44-13.5，p = .009）。没有单个体素与癫痫发作类型显著相关。这些影响与病变病因无关。我们的研究结果表明，病变部位与继发性全身性癫痫发作的风险有关。这些发现可能有助于识别有局灶性至双侧强直阵挛性癫痫发作风险的患者。结构性脑损伤是成人发作性癫痫的最常见原因。病变位置可能导致癫痫发生的风险，但具体病变位置是否与从局灶性癫痫发作到双侧强直阵挛性癫痫发作的继发性癫痫发作泛化风险相关尚不清楚。我们的研究结果表明，病灶位置与继发性全身性癫痫发作的风险相关，而与病灶病因无关。
Structural brain lesions are the most common cause of adult‐onset epilepsy. The lesion location may contribute to the risk for epileptogenesis, but whether specific lesion locations are associated with a risk for secondary seizure generalization from focal to bilateral tonic–clonic seizures, is unknown. We identified patients with a diagnosis of adult‐onset epilepsy caused by an ischemic stroke or a tumor diagnosed at the Turku University Hospital in 2004–2017. Lesion locations were segmented on patient‐specific MR imaging and transformed to a common brain atlas (MNI space). Both region‐of‐interest analyses (intersection with the cortex, hemisphere, and lobes) and voxel‐wise analyses were conducted to identify the lesion locations associated with focal to bilateral tonic–clonic compared to focal seizures. We included 170 patients with lesion‐induced epilepsy (94 tumors, 76 strokes). Lesions predominantly localized in the cerebral cortex (OR 2.50, 95% C.I. 1.21–5.15, p = .01) and right hemisphere (OR 2.22, 95% C.I. 1.17–4.20, p = .01) were independently associated with focal to bilateral tonic–clonic seizures. At the lobar‐level, focal to bilateral tonic–clonic seizures were associated with lesions in the right frontal cortex (OR 4.41, 95% C.I. 1.44–13.5, p = .009). No single voxels were significantly associated with seizure type. These effects were independent of lesion etiology. Our results demonstrate that lesion location is associated with the risk for secondary generalization of epileptic seizures. These findings may contribute to identifying patients at risk for focal to bilateral tonic–clonic seizures. Structural brain lesions are the most common cause of adult‐onset epilepsy. The lesion location may contribute to the risk for epileptogenesis, but whether specific lesion locations are associated with a risk for secondary seizure generalization from focal to bilateral tonic‐clonic seizures, is unknown. Our results demonstrate that lesion location is associated with the risk for secondary generalization of epileptic seizures independent of lesion etiology.
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影响因子：
5.7
作者：
Jenkinson, M;Bannister, P;Smith, S
通讯作者：
Smith, S
影响因子：
5.7
作者：
Karnath HO;Sperber C;Rorden C
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影响因子：
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作者：
Baud, Maxime O.;Vulliemoz, Serge;Seeck, Margitta
通讯作者：
Seeck, Margitta
影响因子：
4.1
作者：
Chang, Edward F.;Potts, Matthew B.;Berger, Mitchel S.
通讯作者：
Berger, Mitchel S.