Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan.
Sci Rep. 2024 Aug 19;14(1):19156. doi: 10.1038/s41598-024-70313-w.
Abnormal brain aging is suggested in epilepsy. Given the brain network dysfunction in epilepsy, the white matter tracts, which primarily interconnect brain regions, could be of special importance. We focused on white matter brain aging in diverse forms of epilepsy and comorbid psychosis. We obtained brain diffusion tensor imaging (DTI) data at 3 T-MRI in 257 patients with epilepsy and 429 healthy subjects. The tract-based fractional anisotropy values of the healthy subjects were used to build a brain-age prediction model, and we calculated the brain-predicted age difference (brain-PAD: predicted age-chronological age) of all subjects. As a result, almost all epilepsy categories showed significantly increased brain-PAD (p < 0.001), including temporal lobe epilepsy (TLE) with no MRI-lesion (+ 4.2 yr), TLE with hippocampal sclerosis (+ 9.1 yr), extratemporal focal epilepsy (+ 5.1 yr), epileptic encephalopathy or progressive myoclonus epilepsy (+ 18.4 yr), except for idiopathic generalized epilepsy (IGE). Patients with psychogenic non-epileptic seizures also presented increased brain-PAD. In TLE, interictal psychosis significantly raised brain-PAD by 8.7 years. In conclusion, we observed increased brain aging in most types of epilepsy, which was generally consistent with brain morphological aging results in previous studies. Psychosis may accelerate brain aging in TLE. These findings may suggest abnormal aging mechanisms in epilepsy and comorbid psychotic symptoms.
脑老化异常在癫痫中被提出。鉴于癫痫中的脑网络功能障碍，主要连接脑区的白质束可能具有特殊意义。我们关注了各种类型癫痫和合并精神病的白质脑老化。我们在 3T-MRI 上获得了 257 名癫痫患者和 429 名健康对照者的脑弥散张量成像（DTI）数据。利用健康对照者的基于束的分数各向异性值构建脑龄预测模型，并计算所有受试者的脑预测年龄差（脑-PAD：预测年龄-实际年龄）。结果表明，几乎所有癫痫类型都表现出明显的脑-PAD 增加（p < 0.001），包括无 MRI 病变的颞叶癫痫（TLE，+ 4.2 岁）、伴有海马硬化的 TLE（+ 9.1 岁）、颞外局灶性癫痫（+ 5.1 岁）、癫痫性脑病或进行性肌阵挛性癫痫（+ 18.4 岁），除特发性全面性癫痫（IGE）外。假性癫痫发作患者也表现出脑-PAD 增加。在 TLE 中，发作间期精神病使脑-PAD 显著增加了 8.7 岁。总之，我们观察到大多数类型的癫痫患者脑老化增加，这与先前研究中的脑形态老化结果基本一致。精神病可能会加速 TLE 患者的脑老化。这些发现可能表明癫痫和合并精神病症状存在异常的衰老机制。
