The following is a summary of “Mapping Lesion-Related Epilepsy to a Human Brain Network,” published in the July 2023 issue of Neurology by Schaper et al.
For a study, researchers determined that while some lesions cause epilepsy, others do not. In the case of epilepsy, mapping lesions in brain regions or networks could provide insights into prognosis and possibly guide intervention.
Investigators conducted a retrospective case-control study on poststroke epilepsy patients using a discovery dataset with 76 stroke lesions plus epilepsy and 625 without stroke lesions. The validation dataset included 347 epilepsy cases & 1,126 controls. Data were analyzed from September 2018 to December 2022, with no exclusions in inpatient data.
The results analyzed lesion locations from 76 post-stroke epilepsy patients (39 [51%] male; mean age 61.0 [SD 14.6] years; mean follow-up 6.7 [SD 2.0] years) and 625 stroke control patients (366 [59%] male; mean age 62.0 [SD 14.1] years; follow-up range 3-12 months) were studied. Epilepsy-associated lesions were found in various brain areas connected to a specific network involving the basal ganglia and cerebellum. Validation in 4 cohorts with 772 patients having brain lesions (271 [35%] with epilepsy; 515 [67%] male; median age 60 [IQR 50-70] years; follow-up range 3-35 years) confirmed increased epilepsy risk (OR 2.82; 95% CI 2.02-4.10; P< .001) and improved seizure control (r, 0.63; P< .001) with deep brain stimulation targeting this network in 30 drug-resistant epilepsy patients (21 [70%] male; median age 39 [IQR 32-46] years; median follow-up 24 [IQR 16-30] months).
Investigators concluded that lesion-related epilepsy is linked to a brain network, aiding risk identification and guiding brain stimulation therapies.
Source: jamanetwork.com/journals/jamaneurology/fullarticle/2806404?resultClick=3