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Brain iron redistribution in mesial temporal lobe epilepsy: a susceptibility-weighted magnetic resonance imaging
Zhiqiang Zhang1, Wei Liao2,3, Boris Bernhardt4
1Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305# Eastern Zhongshan Rd, Nanjing, 210002, China. zhangzq2001@126.com.
Background:
The roles of iron in epilepsy and its pathophysiological significance are poorly understood, especially whether iron levels are abnormal in subcortcal structures. This study aims to demonstrate whole-brain iron alterations and its clinical relevancies in mesial temporal lobe epilepsy (mTLE) in vivo, using susceptibility-weighted magnetic resonance imaging (SWI).
Methods:
We studied 62 patients with mTLE and 62 healthy controls. Brain iron concentration was quantified using SWI phase values. Voxel-wise analysis was carried out to compare iron levels between mTLE and controls, and to assess the relationship between altered iron concentration and clinical parameters in mTLE.
Results:
Patients with mTLE showed decreases of iron levels in the subcortical structures such as substantia nigra, red nucleus, and basal ganglia. Conversely, iron levels were decreased in the cortex. Subcortical iron levels were negatively correlated to those in the cortex. Moreover, cortical and basal ganglia iron levels were related to clinical variables including epilepsy duration, age at seizures onset, and histories of precipitating factors.
Conclusions:
Our SWI findings suggest a redistribution of iron between subcortical and cortical structures in mTLE. The degree of redistribution is affected by both progression of epilepsy and precipitating factors. Investigation on brain iron redistribution offers new insights into the pathogenesis of mTLE, and may be a potential biomarker for monitoring the clinical progression of epilepsy.
Insights
Iron levels are redistributed between brain structures in mesial temporal lobe epilepsy (mTLE). This iron redistribution correlates with epilepsy progression and clinical factors, offering new insights into mTLE pathogenesis.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- The role of iron in epilepsy pathophysiology remains unclear, particularly in subcortical brain regions.
- Investigating iron distribution in mesial temporal lobe epilepsy (mTLE) is crucial for understanding disease mechanisms.
Purpose of the Study:
- To demonstrate whole-brain iron alterations in mTLE patients using in vivo susceptibility-weighted imaging (SWI).
- To explore the clinical relevance of these iron changes in mTLE.
Main Methods:
- Compared brain iron concentration using SWI phase values in 62 mTLE patients and 62 healthy controls.
- Utilized voxel-wise analysis to identify differences in iron levels and their correlation with clinical parameters.
Main Results:
- Decreased iron levels were observed in subcortical structures (substantia nigra, red nucleus, basal ganglia) and the cortex in mTLE patients.
- Subcortical iron levels showed a negative correlation with cortical iron levels.
- Cortical and basal ganglia iron concentrations correlated with epilepsy duration, age at seizure onset, and precipitating factors.
Conclusions:
- SWI reveals a significant redistribution of iron between subcortical and cortical areas in mTLE.
- The extent of iron redistribution is influenced by epilepsy progression and precipitating factors.
- Brain iron redistribution may serve as a potential biomarker for monitoring mTLE clinical progression.
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