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Structural connectivity as a predictive factor for responsiveness to levetiracetam treatment in epilepsy

  • Advanced Neuroimaging
  • Published:
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Abstract

Purpose

To investigate whether structural connectivity or glymphatic system function is a potential predictive factor for levetiracetam (LEV) response in patients with newly diagnosed epilepsy.

Methods

We enrolled patients with newly diagnosed epilepsy who were administered LEV as initial monotherapy and underwent diffusion tensor imaging (DTI) at diagnosis. We categorized the patients into drug response. We used graph theory to calculate the network measures for structural connectivity based on the DTI scans in patients with epilepsy. Additionally, we evaluated glymphatic system function by calculating the DTI analysis along the perivascular space (DTI-ALPS) index based on DTI scans.

Results

We enrolled 84 patients with epilepsy. The clinical factors and DTI-ALPS index did not differ between the groups. However, some of the structural connectivity measures significantly differ between the groups. The poor responders exhibited a higher mean clustering coefficient, global efficiency, and small-worldness index than the good responders (p = 0.003, p = 0.048, and p = 0.038, respectively). In the receiver operating characteristic curve analysis, the mean clustering coefficient exhibited the highest performance in predicting the responsiveness to LEV (area under the curve of 0.677). In the multiple logistic regression analysis, the mean clustering coefficient of the structural connectivity measures was the only significant predictor of LEV response (p = 0.014). Furthermore, in the survival analysis, the mean clustering coefficient was the only significant predictor of LEV response (p = 0.026).

Conclusion

We demonstrated that structural connectivity is a potential predictive factor for responsiveness to LEV treatment in patients with newly diagnosed epilepsy.

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Data availability

Data that support the findings of this study are available upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

This study was supported by Daewoong Bio Inc.

Funding

This study has not been funded.

Author information

Author notes

  1. DAL and HJL contributed equally to this study.

Authors and Affiliations

  1. Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, Korea

    Dong Ah Lee & Kang Min Park

  2. Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea

    Ho-Joon Lee

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  1. Dong Ah Lee
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Correspondence to Kang Min Park.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Lee, D.A., Lee, HJ. & Park, K.M. Structural connectivity as a predictive factor for responsiveness to levetiracetam treatment in epilepsy. Neuroradiology 66, 93–100 (2024). https://doi.org/10.1007/s00234-023-03261-3

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  • DOI: https://doi.org/10.1007/s00234-023-03261-3

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