Identification of neuro-inflammatory biomarkers through non-invasive advanced neuroimaging techniques in...

The primary aim is to conduct a comprehensive review focusing on the identification of neuro-inflammatory biomarkers using advanced non-invasive neuroimaging tools in pharmaco-resistant epilepsy.

A systematic search was conducted through four different databases, namely PubMed, Embase, Web of Science, and Google Scholar. Title and abstract screening, full text assessment, data extraction, and quality evaluation, were performed by two independent reviewers. ARRIVE 2.0 guidelines tool, was used to evaluate the quality of the included studies in this review.

A total of 562 records were generated through literature search. Among these, 12 experimental studies met the eligibility criteria, and were included in the qualitative review. These studies identified the following six neuroinflammatory biomarkers in pharmacoresistant epilepsy: TSPO, BBBD, HMGB1, LRP1, P-gp, and MPO. TSPO was the most frequent identified biomarker by six studies out of 12. Within the included studies, eight use positron emission tomography (PET) as their neuroimaging modality of choice, five employ magnetic resonance imaging (MRI), with one specifically employing an MRI T2 sequence, four utilize single photon emission computed tomography (SPECT), and one study uses computed tomography (CT) imaging technique.

This review identified six neuroinflammatory biomarkers in drug-resistant epilepsy using noninvasive neuroimaging tools. These biomarkers could be used as diagnostic, predictive, and therapeutic targets. Moreover, they can be used to delineate epileptic foci in the presurgical evaluation of refractory epileptic patients. However, these studies are still in the preclinical phase, requiring further research in this field.