Volumetric changes in temporal regions associated with late post-traumatic seizures
Poster No:
2302
Submission Type:
Abstract Submission
Authors:
Akul Sharma1, Paul Vespa2, Dominique Duncan1
Institutions:
1University of Southern California, Los Angeles, CA, 2University of California Los Angeles, Los Angeles, CA
First Author:
Co-Author(s):
Introduction:
Traumatic brain injury (TBI) is a major cause of death and disability worldwide [1]. TBI-induced symptoms may last for years, reducing patients' quality of life and posing a financial burden. Up to 50% of TBI patients may develop a seizure more than one week after injury, classified as a late post-traumatic seizure (late-PTS) [2]. Currently, there are no valid clinical biomarkers for late-PTS, making the diagnosis and treatment a major challenge. In recent years magnetic resonance imaging (MRI) techniques have been used to probe brain structural and functional effects of TBI and PTS [3]. Previous studies have associated structural abnormalities in the temporal and hippocampal regions with the probability of developing late-PTS after TBI [4]. However, the relationship between cortical structural abnormalities and lesion volume is not fully understood. Accounting for lesion volume is crucial given the heterogeneity of TBI, as it ensures a more accurate interpretation of structural alterations associated with late-PTS. This work is part of the Epilepsy Bioinformatics Study for Antiepileptogenic Therapy (EpiBioS4Rx), a project designed to facilitate the development of antiepileptogenic therapies [5]. We aim to identify volumetric changes in temporal and hippocampal regions associated with the development of late-PTS among TBI patients while accounting for the potential confounding effect of lesion volumes.
Methods:
A subset of 68 TBI patients, 50 patients with non-late-PTS (PTS-) and 18 patients with late-PTS (PTS+) from EpiBioS4Rx were used. T1-weighted images were acquired with the EpiBioS4Rx protocol [6]. Preprocessing and morphometric analysis were conducted using FreeSurfer, and volumetric measures from 65 cortical regions were extracted using the Desikan-Killinay atlas [7]. Manual lesion segmentation was performed using ITK-SNAP to compute the total lesion pathological volume [8]. Twelve temporal and hippocampal regions were chosen as primary predictors of interest. A logistic regression model was used to assess the relationship between the predictor variables and the likelihood of late-PTS, while adjusting for the effects of lesion edema volume and lesion core volume using R and glmnet package [9]. The level of significance was set at α=0.05; values less than this threshold were considered statistically significant.
Results:
We employed a logistic regression model to investigate the relationship between various hippocampal and temporal regions and the probability of late-PTS, while controlling for the effects of lesion volume characteristics. Increases in the right inferior temporal volume were associated with decreased odds of late-PTS (β=−6.992×10−4, =0.0381), while increases in the left parahippocampal volume were associated with increased odds of late-PTS (β=2.150×10−3, p=0.0384) [Figure 1]. The other regions were not found to be statistically significant predictors of late-PTS.
Conclusions:
Our findings suggest a region-specific association between cortical brain volumes and the likelihood of developing late-PTS after TBI when controlling for lesion volume characteristics, such as edema and core volume. Specifically, decreased volume in the right inferior temporal region and increased volume in the left parahippocampal region is associated with late-PTS. Structural alterations in hippocampal and temporal regions have previously been implicated in PTS and epilepsy cohorts [10]. By controlling for lesion volume characteristics, we accounted for the potential confounding effects of lesion volumes on the relationship between cortical brain volumes in temporal and hippocampal regions and late-PTS. Volumetric alterations in these regions could serve as potential clinical biomarkers for late-PTS. Future studies with larger cohorts are needed to further understand the interaction of lesion and cortical volume and the influence of lesion location in the development of late-PTS.
Modeling and Analysis Methods:
Classification and Predictive Modeling 2
Connectivity (eg. functional, effective, structural)
Neuroinformatics and Data Sharing:
Workflows
Informatics Other
Novel Imaging Acquisition Methods:
Anatomical MRI 1
Keywords:
Data analysis
Epilepsy
MRI
STRUCTURAL MRI
Other - TBI
1|2Indicates the priority used for review
Provide references using author date format
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