Topografia uszkodzenia bruzdy środkowej mózgu wiąże się z padaczką po udarze mózgu: Badanie mapowania objawów w oparciu o woksele
Central sulcus lesion topology is associated with post-stroke epilepsy: A voxel-based lesion-symptom mapping study
W skrócie
[Preprint - wstępne wyniki] Naukowcy badali, czy uszkodzenie konkretnych obszarów mózgu zwiększa ryzyko rozwoju padaczki po udarze. Okazało się, że osoby z uszkodzeniami w rejonie bruzdy środkowej (obszar odpowiedzialny za czucie i ruchy) miały wyraźnie wyższe ryzyko padaczki, nawet po uwzględnieniu innych czynników ryzyka. Wyniki sugerują, że dokładna mapa uszkodzenia mózgu może pomóc lekarzom lepiej przewidywać, którzy pacjenci po udarze będą zagrożeni padaczką.
Oryginalny abstract (angielski)
Abstract Background Current prediction models for post-stroke epilepsy (PSE) rely on clinical characteristics and broad radiological descriptors, such as cortical involvement, but do not account for whether damage to specific brain regions confers additional risk. We investigated whether specific lesion topologies are independently associated with the development of PSE. Methods We studied a single-center cohort of patients with first-ever ischemic stroke or intracerebral hemorrhage, retrospectively identified from consecutive hospital admissions between 2012 and 2014. Of the 682 eligible patients, epilepsy status was ascertained systematically using a validated epilepsy screening questionnaire, telephone interviews, and review of electronic medical records. The final sample analyzed included 203 patients with determinable epilepsy status, of which 46 patients developed PSE. Lesions were delineated on routine clinical CT or MRI scans. Voxel-based lesion-symptom mapping with permutation-based family-wise error correction was performed, adjusting for lesion volume and, in a second analysis, for established risk factors, including age, stroke severity, early seizures, stroke subtype, and etiology. Results Lesions involving the depth of the central sulcus, including the postcentral gyrus and sulcal superficial white matter, were associated with the development of PSE. This association remained significant after adjustment for established clinical risk factors. Conclusions Lesion topology provides information beyond established clinical predictors of PSE. The central sulcus and Rolandic region consistently emerged as anatomical correlates of PSE across independent studies and represent promising candidate neuroimaging biomarkers for future multimodal risk prediction. Prospective studies should determine whether incorporation of lesion topology improves individualized risk prediction of PSE.