TBI causes early seizures and is the leading cause of post-traumatic epilepsy. The study was done to assess structural imaging biomarkers differentiating patients who develop seizures secondary to TBI from patients who do not.
Multicentre prospective cohort study starting in 2018. Imaging data are acquired around day 14 post-injury, detection of seizure events occurred early within 7 days and late up to 3 months post TB.
96 patients surviving moderate-to-severe TBI were selected to participate in the study, shape analysis of local volume deficits in subcortical areas was done and cortical ribbon thinning (analysable sample: 46 patients; 29 no seizure, 10 early, 7 late). Right hippocampal volume deficit and inferior temporal cortex thinning demonstrated a significant effect across groups. Additionally, the degree of left frontal and temporal pole thinning, and clinical score at the time of the MRI, could differentiate patients experiencing early seizures from patients not experiencing them with 89% accuracy.
The study concluded that specific areas of localised volume deficit, as visible on routine imaging data, are associated with the emergence of seizures after TBI.