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Published on: November 8, 2018
Early diffusion-weighted MRI predicts regional neuronal damage in generalized status epilepticus in rats treated with
T Engelhorn1, J Weise, T Hammen
1Department of Neuroradiology, University of Erlangen, Erlangen, Germany. tobias.engelhorn@nrad.imed.uni-erlangen.de
Abstract:
We applied diffusion-weighted MRI (DWI) in the pilocarpine-induced status epilepticus (SE) model to investigate the evolution of acute phase changes in brain diffusion with and without early anticonvulsive therapy correlated to long-term SE-induced neuronal cell loss. Hereby, DWI was performed before (baseline) and serially between 3 and 120 min after onset of SE in untreated and treated animals (n=15 in each group). Anticonvulsive-treated animals received 20 mg/kg diazepam at 15 min after onset of SE. Apparent diffusion coefficients (ADC) were calculated for the parietal, temporal and piriform cortex, thalamus, hippocampus and amygdala and compared to baseline. Neuronal cell loss was quantified at 2 weeks after onset of SE utilizing cresyle-violet-staining. The results of ADC-mapping demonstrated a significant transient increase in ADC (to 116+/-4% of baseline) in the very acute phase starting 3 min after SE onset, lasting for 10 min in both groups. In untreated animals, there was a significant gradual decline in ADC to 75+/-12% of baseline while this decline in diazepam-treated animals was significantly less pronounced (P<0.05) and ADC recovered to 93+/-6% of baseline. There was good correlation between neuronal cell loss in specific brain regions at 2 weeks after SE and maximal decrease in ADC (r>0.79). In conclusion, serial DWI is a sensitive noninvasive technique for early detection, monitoring and prediction of SE-induced neuronal alterations. Using ADC-mapping, verification of early anticonvulsive therapy in SE seems to be possible as there is good correlation between the maximal decrease in ACD in the acute phase of SE and late neuronal cell loss.
Insights
Diffusion-weighted MRI (DWI) detects acute brain changes during status epilepticus (SE). Early anticonvulsant therapy, monitored by apparent diffusion coefficients (ADC), correlates with reduced long-term neuronal cell loss.
Area of Science:
- Neuroscience
- Radiology
- Medical Imaging
Background:
- Status epilepticus (SE) is a neurological emergency with potential for long-term brain damage.
- Diffusion-weighted MRI (DWI) is a non-invasive imaging technique that measures water molecule diffusion in tissues.
- Apparent diffusion coefficients (ADC) quantify diffusion, providing insights into tissue microstructure.
Purpose of the Study:
- To investigate acute changes in brain diffusion during pilocarpine-induced SE using DWI.
- To assess the impact of early anticonvulsant therapy on these diffusion changes.
- To correlate acute DWI findings with long-term neuronal cell loss.
Main Methods:
- Pilocarpine-induced SE model in animals.
- Serial DWI performed at various time points after SE onset.
- Administration of diazepam as early anticonvulsant therapy.
- Calculation of apparent diffusion coefficients (ADC) in specific brain regions.
- Quantification of neuronal cell loss at 2 weeks post-SE.
Main Results:
- A transient increase in ADC was observed in the acute phase of SE in both treated and untreated groups.
- Untreated animals showed a significant decline in ADC over time.
- Diazepam treatment significantly attenuated the ADC decline, with partial recovery observed.
- A strong correlation (r>0.79) was found between maximal ADC decrease and subsequent neuronal cell loss.
Conclusions:
- Serial DWI is a sensitive tool for early detection and monitoring of SE-induced neuronal alterations.
- ADC-mapping can potentially verify the efficacy of early anticonvulsant therapy in SE.
- The degree of acute ADC changes predicts long-term neuronal damage in SE.
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