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Brain functional and structural characteristics of patients with seizure recurrence following drug withdrawal

  • Functional Neuroradiology
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Abstract

Purpose

We aimed to analyze the characteristics of brain function and microstructure linked to epilepsy relapse after drug withdrawal in patients with focal epilepsy.

Methods

Resting-state functional magnetic resonance imaging and high-resolution T1-weighted images were acquired within 1 month prior to drug withdrawal from 15 patients who did not have epilepsy relapse (PER − group) and 16 patients who subsequently had epilepsy relapse (PER + group). Additionally, 23 healthy participants undergoing the same scanning protocol were included as controls. Fractional amplitude of low-frequency fluctuation (fALFF) and gray matter density (GMD) were compared among groups. Subgroup and correlation analyses were also performed.

Results

There were no significant differences in fALFF between patient groups, but the PER + group showed lower GMD in the bilateral calcarine, left precuneus, and right superior temporal gyrus than the PER − group (Gaussian random field correction, voxel-level P < 0.001 and cluster-level P < 0.05). Both increased seizure number and polytherapy were associated with lower GMD; also, patients using other antiseizure medications showed lower GMD than those using only levetiracetam (Gaussian random field correction, voxel-level P < 0.001, and cluster-level P < 0.05). The active period and disease duration showed both positive and negative correlations with GMD, while the seizure-free period mainly showed positive correlations with GMD (uncorrected, P < 0.001).

Conclusion

Gray matter microstructure, but not local functional activity, showed distinct characteristics between patients with and without epilepsy relapse and may serve as a potential biomarker for predicting seizure recurrence upon drug withdrawal.

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Data availability

Data are available upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

The authors thank all participants for their collaboration.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81420108014), the Post-Doctor Research Project, Sichuan University (Grant No. 20826041E4076), and the Post-Doctor Research Project, West China Hospital, Sichuan University (Grant No. 20HXBH031).

Author information

Authors and Affiliations

  1. From the Epilepsy Center, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan Province, China

    Ge Tan, Deng Chen, Haijiao Wang & Ling Liu

  2. From the Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, Sichuan Province, China

    Xiuli Li & Qiyong Gong

Authors
  1. Ge Tan
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  2. Xiuli Li
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  3. Deng Chen
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  4. Haijiao Wang
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  5. Qiyong Gong
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  6. Ling Liu
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Contributions

G.T., L.L. and Q.G. formulated the study design. G.T. and X.L. performed the MRI scanning and image preprocessing. G.T. and D.C. performed statistical analysis and results interpretation. T.G. and L.L. drafted the paper. G.T., L.L. and Q.G revised the paper. G.T. and H.W. recruited participants and collected clinical materials.

Corresponding author

Correspondence to Ling Liu.

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Conflict of interest

We declare that we have no conflicts of interest.

Ethical approval

This project was approved by the ethical committee of West China Hospital of Sichuan University, and all procedures performed in the study involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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All authors have read and approved the submitted manuscript.

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Tan, G., Li, X., Chen, D. et al. Brain functional and structural characteristics of patients with seizure recurrence following drug withdrawal. Neuroradiology 63, 2087–2097 (2021). https://doi.org/10.1007/s00234-021-02755-2

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  • DOI: https://doi.org/10.1007/s00234-021-02755-2

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