Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
Division of Neurosurgery, Department of Neurology, University of California Los Angeles School of Medicine, Los Angeles, CA, USA.
Epilepsia. 2019 Nov;60(11):2151-2162. doi: 10.1111/epi.16357. Epub 2019 Oct 8.
Traumatic brain injury (TBI) affects 2.5 million people annually within the United States alone, with over 300 000 severe injuries resulting in emergency room visits and hospital admissions. Severe TBI can result in long-term disability. Posttraumatic epilepsy (PTE) is one of the most debilitating consequences of TBI, with an estimated incidence that ranges from 2% to 50% based on severity of injury. Conducting studies of PTE poses many challenges, because many subjects with TBI never develop epilepsy, and it can be more than 10 years after TBI before seizures begin. One of the unmet needs in the study of PTE is an accurate biomarker of epileptogenesis, or a panel of biomarkers, which could provide early insights into which TBI patients are most susceptible to PTE, providing an opportunity for prophylactic anticonvulsant therapy and enabling more efficient large-scale PTE studies. Several recent reviews have provided a comprehensive overview of this subject (Neurobiol Dis, 123, 2019, 3; Neurotherapeutics, 11, 2014, 231). In this review, we describe acute and chronic imaging methods that detect biomarkers for PTE and potential mechanisms of epileptogenesis. We also describe shortcomings in current acquisition methods, analysis, and interpretation that limit ongoing investigations that may be mitigated with advancements in imaging techniques and analysis.
创伤性脑损伤（TBI）仅在美国每年就影响 250 万人，其中超过 30 万人因严重受伤而需要紧急就诊和住院治疗。严重的 TBI 可能导致长期残疾。外伤性癫痫（PTE）是 TBI 最具致残性的后果之一，根据损伤的严重程度，其发病率估计在 2%至 50%之间。由于许多 TBI 患者从未发生过癫痫，并且在 TBI 后 10 多年才开始出现癫痫发作，因此对 PTE 进行研究存在许多挑战。在 PTE 研究中未满足的需求之一是癫痫发生的准确生物标志物或一组生物标志物，这可以提供有关哪些 TBI 患者最易发生 PTE 的早期见解，为预防抗惊厥治疗提供机会，并使更有效的大规模 PTE 研究成为可能。最近的几篇综述对这一主题进行了全面概述（Neurobiol Dis，123，2019，3；Neurotherapeutics，11，2014，231）。在这篇综述中，我们描述了检测 PTE 生物标志物和癫痫发生潜在机制的急性和慢性成像方法。我们还描述了当前采集方法、分析和解释中的缺点，这些缺点限制了正在进行的研究，而影像学技术和分析的进步可能会缓解这些缺点。
