Factors Influencing Neuroimaging-Based Advanced Brain Aging in Drug-Resistant Epilepsy
Poster No:
1209
Submission Type:
Abstract Submission
Authors:
Ezequiel Gleichgerrcht1, Kathryn Davis2, Rebecca Roth1, Sarah Newman-Norlund3, Alexandra Parashos4, Jennifer Cashwell4, Neha Gandhi5, Samaneh Nemati3, Erik Kaestner6, Carrie McDonald7, Sigfus Kristinsson3, Anto Bagić8, Patricia Dugan9, Daniel Deane1, Julius Fridriksson3, Ruben Kuzniecky10, Leonardo Bonilha3
Institutions:
1Emory University, Atlanta, GA, 2Perelman School of Medicine, University of Pennsylvania, PA, USA, Philadelphia, PA, 3University of South Carolina, Columbia, SC, 4Medical University of South Carolina, Charleston, SC, 5Texas Institute of Neurology, Dallas, TX, 6University of California San Diego, San Diego, CA, 7University of California, San Diego, San Diego, CA, 8University of Pittsburgh, Pittsburgh, PA, 9New York University School of Medicine, New York, NY, 10Northwell/Hosftra, Hampstead, NY
First Author:
Co-Author(s):
Introduction:
Temporal lobe epilepsy demonstrates patterns of atrophy comparable to those seen in neurodegenerative disorders. However, the factors influencing these patterns of atrophy remain poorly understood. Here, we sought to evaluate the independent contribution of epilepsy-related variables and modifiable risk factors, as well as their interaction, on premature brain aging in epilepsy.
Methods:
Brain age was estimated using a machine learning model from MRI in 515 patients with TLE and 615 neurologically healthy controls (HC). The difference between the MRI-estimated brain age and chronological age, i.e., the brain age gap (BAG) was computed for each participant. Complete risk factor data were available for 301 HC and 167 patients with TLE. Group-wise differences in BAG were determined, including voxel-wise comparisons of regional contributors to BAG specific to each group. Propensity score matching was used to balance the datasets based on demographic and risk factor profiles, and multiple linear regression with interaction terms was used to evaluate the contributions of epilepsy and comorbidities on BAG.
·Visual overview of the study methods
Results:
Compared with HC, TLE was associated with double the risk of advanced brain aging. Epilepsy was independently associated with 3.35 additional brain years. Brain regions disproportionally affected in TLE contributing to advanced BAG were medial temporal, perisylvian, and subcortical areas. An average increase of 0.97 years in BAG was observed per comorbidity, with an additional 0.83 BAG increase per comorbidity due to an interaction with epilepsy.
·Summary of brain regions driving the patterns of brain aging seen in patients and healthy controls
Conclusions:
Advanced brain aging is pervasive in TLE and is related to epilepsy-specific and modifiable risk factors. This observation has direct public health relevance since attention to modifiable risk factors is not typically at the forefront of epilepsy care, but targeted interventions could directly affect brain health in epilepsy.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 2
Lifespan Development:
Aging 1
Modeling and Analysis Methods:
Classification and Predictive Modeling
Keywords:
Aging
Epilepsy
STRUCTURAL MRI
1|2Indicates the priority used for review
Provide references using author date format
2. Helmstaedter C, Kurthen M, Lux S, Reuber M, Elger CE. Chronic epilepsy and cognition: a longitudinal study in temporal lobe epilepsy. Ann Neurol. 2003 Oct;54(4):425-32.
3. Lin JJ, Mula M, Hermann BP. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. Lancet. 2012 Sep 29;380(9848):1180-92.
4. McDonald CR, Hagler DJ, Jr., Ahmadi ME, et al. Regional neocortical thinning in mesial temporal lobe epilepsy. Epilepsia. 2008 May;49(5):794-803.
5. Mueller SG, Laxer KD, Barakos J, Cheong I, Garcia P, Weiner MW. Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis. Neuroimage. 2009 Jun;46(2):353-9.
6. Dabbs K, Becker T, Jones J, Rutecki P, Seidenberg M, Hermann B. Brain structure and aging in chronic temporal lobe epilepsy. Epilepsia. 2012 Jun;53(6):1033-43.
7. Lin JJ, Salamon N, Lee AD, et al. Reduced neocortical thickness and complexity mapped in mesial temporal lobe epilepsy with hippocampal sclerosis. Cereb Cortex. 2007 Sep;17(9):2007-18.
8. Bonilha L, Elm JJ, Edwards JC, et al. How common is brain atrophy in patients with medial temporal lobe epilepsy? Epilepsia. 2010 Sep;51(9):1774-9.