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.
Brain regions map lesions associated with epilepsy, guiding interventions, and unclear causes of epilepsy. Researchers conducted a retrospective study and mapped epilepsy-associated lesion locations to specific brain regions and networks, revealing the potential for targeted treatments.
They utilized lesion location and network mapping to pinpoint brain regions and networks linked to epilepsy. Patients with poststroke epilepsy (n = 76) and stroke controls (n = 625) were included in the dataset. Validation involved 4 independent cohorts, 347 patients with epilepsy and 1,126 without, across all datasets. The therapeutic potential was assessed using deep brain stimulation sites for seizure control. The primary outcomes and measures were categorized as either epilepsy or no epilepsy.
The results showed post-stroke epilepsy patients (76 individuals, 39 male [51%], mean age 61.0 [SD 14.6] years, mean follow-up 6.7 [SD 2.0] years) and stroke control patients (625 individuals, 366 male [59%], mean age 62.0 [SD 14.1] years, follow-up range 3-12 months), lesion locations associated with epilepsy were found across various brain regions. These sites were connected to a brain network with basal ganglia and cerebellum links. Validation across 4 cohorts (772 patients, 271 [35%] with epilepsy, median age 60 [IQR 50-70] years, follow-up 3-35 years) confirmed higher epilepsy risk for network-connected lesions (OR 2.82; 95% CI 2.02-4.10; P< 0.001), regardless of lesion type (OR 2.85; 95% CI 2.23-3.69; P<0.001). In 30 drug-resistant epilepsy patients (21 male [70%], median age 39 [IQR 32-46] years, median follow-up 24 [IQR 16-30] months), deep brain stimulation targeting this network improved seizure control (r 0.63; P < 0.001).
They concluded the study identifies epilepsy risk after brain lesions through brain network mapping and guiding stimulation therapies.
Source: jamanetwork.com/journals/jamaneurology/fullarticle/2806404?resultClick=1
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