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Asymmetrical cortical surface area decrease in epilepsy patients with postictal generalized electroencephalography

Chenyang Zhao1, Yingying Tang1, Yuan Xiao2

  • 1Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.

Cerebral Cortex (New York, N.Y. : 1991)
|February 11, 2024
PubMed
Summary
This summary is machine-generated.

Epilepsy patients with postictal generalized electroencephalographic suppression (PGES) show reduced insular cortex surface area, particularly on the right. This finding suggests impaired brain structure and potential links to sudden unexpected death in epilepsy.

Keywords:
MRIpostictal EEG suppressionsudden unexpected death in epilepsysurface area

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Area of Science:

  • Neuroimaging
  • Epileptology
  • Neurology

Background:

  • Postictal generalized electroencephalographic suppression (PGES) is a potential marker for sudden unexpected death in epilepsy (SUDEP).
  • Investigating cortical surface area abnormalities may elucidate the pathophysiology of PGES.

Purpose of the Study:

  • To investigate cortical surface area differences in epilepsy patients with and without PGES compared to healthy controls.
  • To explore correlations between cortical surface area abnormalities and clinical seizure variables.

Main Methods:

  • Retrospective analysis of 30 PGES+ patients, 21 PGES- patients, and 30 healthy controls.
  • Surface-based analysis of high-resolution T1-weighted MRI scans to compare cortical surface areas.
  • Correlation analysis with seizure-onset age and other seizure-related clinical variables.

Main Results:

  • PGES+ patients exhibited reduced bilateral insular surface area compared to PGES- patients, with right-sided predominance.
  • Reduced right insular surface area correlated with younger seizure-onset age.
  • PGES- patients showed reduced left caudal middle frontal gyrus surface area; PGES+ patients had widespread reductions in multiple right and left hemisphere regions compared to controls.

Conclusions:

  • Epilepsy patients with PGES demonstrate cortical microstructural impairment, particularly in the insular cortex.
  • Right-sided insular cortex surface area reduction in PGES+ patients suggests involvement of the autonomic network.
  • These findings indicate a potential shared abnormal brain network underlying PGES and SUDEP risk.