Jin Bo, Xu Jiahui, Hu Jing, Li Hong, Wang Shan, Chen Cong, Ye Linqi, Cheng Hui, Zhang Lisan, Wang Shuang, Wang Jin, Aung Thandar
Department of Neurology, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Seizure. 2025 Feb;125:31-36. doi: 10.1016/j.seizure.2024.12.021. Epub 2024 Dec 31.
Glymphatic function has not been explored in patients with focal cortical dysplasia (FCD)-related epilepsy. This study aimed to investigate the glymphatic system's involvement in these patients and to evaluate its correlation with response patterns to different antiseizure medications (ASMs) using diffusion tensor imaging along the perivascular space (DTI-ALPS).
Fifty-two patients with FCD-related epilepsy (10 with drug-responsive epilepsy and 42 with drug-resistant epilepsy) and 24 healthy controls (HC) were included. Bilateral DTI-ALPS index were calculated and compared among drug-responsive epilepsy, drug-resistant epilepsy, and HC groups. Additionally, we analyzed correlations between the DTI-ALPS index and clinical characteristics.
Compared to HC, patients with FCD-related epilepsy showed significantly lower DTI-ALPS index in the bilateral hemispheres (p < 0.001). Notably, a significant decrease in the DTI-ALPS index was noted in the hemisphere ipsilateral to the epileptogenic foci, compared to the contralateral hemisphere (p < 0.001). Further analysis revealed that, in patients with drug-resistant epilepsy, the ipsilateral DTI-ALPS index was significantly lower than the contralateral DTI-ALPS index (p < 0.001), whereas patients with drug-responsive epilepsy did not show a significant difference between ipsilateral and contralateral DTI-ALPS index. No significant correlations were found between the DTI-ALPS index and clinical characteristics such as age and duration of epilepsy.
Our findings suggest a correlation between glymphatic system dysfunction and patients with FCD-related epilepsy, particularly in drug-resistant patients.
尚未在局灶性皮质发育不良（FCD）相关癫痫患者中探究类淋巴功能。本研究旨在调查这些患者的类淋巴系统参与情况，并使用沿血管周围间隙的扩散张量成像（DTI-ALPS）评估其与不同抗癫痫药物（ASM）反应模式的相关性。
纳入52例FCD相关癫痫患者（10例药物反应性癫痫患者和42例药物难治性癫痫患者）和24名健康对照者（HC）。计算并比较药物反应性癫痫、药物难治性癫痫和HC组之间的双侧DTI-ALPS指数。此外，我们分析了DTI-ALPS指数与临床特征之间的相关性。
与HC相比，FCD相关癫痫患者双侧半球的DTI-ALPS指数显著降低（p<0.001）。值得注意的是，与对侧半球相比，癫痫灶同侧半球的DTI-ALPS指数显著降低（p<0.001）。进一步分析显示，在药物难治性癫痫患者中，同侧DTI-ALPS指数显著低于对侧DTI-ALPS指数（p<0.001），而药物反应性癫痫患者同侧和对侧DTI-ALPS指数之间无显著差异。DTI-ALPS指数与年龄和癫痫病程等临床特征之间未发现显著相关性。
我们的研究结果表明类淋巴系统功能障碍与FCD相关癫痫患者之间存在相关性，尤其是在药物难治性患者中。
