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Brain aging in temporal lobe epilepsy: Chronological, structural, and functional.

Gyujoon Hwang1, Bruce Hermann2, Veena A Nair3

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Temporal lobe epilepsy (TLE) is linked to accelerated brain aging, with functional brain age correlating with cognitive decline. Understanding this accelerated aging is crucial for mitigating cognitive deficits in TLE patients.

Keywords:
Accelerated brain agingAge predictionCognitive agingFunctional connectivityTemporal lobe epilepsy (TLE)

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Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Aging Studies

Background:

  • Epilepsy is associated with structural brain changes and cognitive issues.
  • Concerns exist about accelerated brain aging and neurocognitive disorders in epilepsy patients.
  • Temporal lobe epilepsy (TLE) is a common form of epilepsy.

Purpose of the Study:

  • To investigate age-related processes in structural and functional neuroimaging in TLE patients.
  • To determine if TLE is associated with accelerated brain aging.
  • To explore the relationship between accelerated brain aging and cognitive function in TLE.

Main Methods:

  • Used support vector regression (SVR) models trained on 151 healthy controls.
  • Predicted brain ages (structural and functional) for 104 TLE patients from the Epilepsy Connectome Project (ECP).
  • Correlated brain age with seizure frequency, anti-epileptic drug intake, and cognitive abilities (fluid and crystallized cognition).

Main Results:

  • TLE patients showed significantly older structural (+6.6 years) and functional (+8.3 years) brain ages compared to controls.
  • Accelerated functional brain age showed a mild correlation with seizure frequency and anti-epileptic drug load (corrected P=0.07).
  • Functional brain age significantly correlated with declining fluid cognition and partially mediated age-cognition relationships.

Conclusions:

  • Accelerated brain aging is evident in both structural and functional neuroimaging of TLE patients.
  • Understanding the mechanisms of accelerated aging in TLE is vital for clinical intervention.
  • This research highlights the importance of addressing cognitive aging in epilepsy management.