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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Epilepsy ll: Types01:22

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.
Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
Seizures l: Introduction01:20

Seizures l: Introduction

Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...

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Lipidomics and Transcriptomics in Neurological Diseases
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Published on: March 18, 2022

Glymphatic system dysfunction in epilepsy: a systematic review and meta-analysis.

Rishu Raj1, Arkansh Sharma2, Annu Singhal3

  • 1Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India.

Epilepsy & Behavior : E&B
|June 6, 2026
PubMed
Summary
This summary is machine-generated.

Glymphatic system impairment, measured by Diffusion Tensor Imaging-based Analysis of Longitudinal Perfusion (DTI-ALPS), is significantly reduced in epilepsy patients. This reduction correlates with disease duration, suggesting DTI-ALPS as a potential biomarker for glymphatic dysfunction in epilepsy.

Keywords:
Aquaporin-4DTI-ALPSEpilepsyGlymphatic systemMeta-analysisNeuroimaging biomarkerPerivascular spaceSystematic review

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Area of Science:

  • Neuroimaging
  • Neuroscience
  • Biomarkers

Background:

  • The glymphatic system clears metabolic waste via astrocytic aquaporin-4-mediated exchange.
  • Epilepsy is associated with structural changes that may impair glymphatic function.
  • Quantitative neuroimaging data on glymphatic impairment in epilepsy are lacking.

Purpose of the Study:

  • To systematically review and meta-analyze studies quantifying DTI-ALPS in epilepsy.
  • To assess DTI-ALPS as a proxy marker of glymphatic impairment in epilepsy.
  • To evaluate the clinical correlates of DTI-ALPS in epilepsy.

Main Methods:

  • Systematic review and meta-analysis following PRISMA 2020 guidelines.
  • Searched PubMed, Embase, Web of Science, and Scopus for observational studies.
  • Pooled mean differences and correlation coefficients using random-effects models.
  • Assessed study quality using Newcastle-Ottawa Scale and publication bias via Egger's test.

Main Results:

  • Seventeen studies (1255 participants) were included; 15 contributed to the primary meta-analysis.
  • DTI-ALPS values were significantly reduced in epilepsy patients compared to controls (MD -0.157, p < 0.0001).
  • Reductions were inversely correlated with disease duration (r = -0.392, p = 0.0014) and age at onset (r = -0.148, p = 0.020).

Conclusions:

  • DTI-ALPS is consistently reduced in epilepsy and correlates with disease chronicity.
  • DTI-ALPS shows potential as a biomarker for glymphatic burden in epilepsy.
  • Limitations include heterogeneity, potential medication confounding, and limited population diversity; further multicenter studies are needed.