Early brain biomarkers of post-traumatic seizures: initial report of the multicentre epilepsy bioinformatics study for antiepileptogenic therapy (EpiBioS4Rx) prospective study.
BACKGROUND
Traumatic brain injury (TBI) causes early seizures and is the leading cause of post-traumatic epilepsy. We prospectively assessed structural imaging biomarkers differentiating patients who develop seizures secondary to TBI from patients who do not.


DESIGN
Multicentre prospective cohort study starting in 2018. Imaging data are acquired around day 14 post-injury, detection of seizure events occurred early (within 1 week) and late (up to 90 days post-TBI).


RESULTS
From a sample of 96 patients surviving moderate-to-severe TBI, we performed shape analysis of local volume deficits in subcortical areas (analysable sample: 57 patients; 35 no seizure, 14 early, 8 late) and cortical ribbon thinning (analysable sample: 46 patients; 29 no seizure, 10 early, 7 late). Right hippocampal volume deficit and inferior temporal cortex thinning demonstrated a significant effect across groups. Additionally, the degree of left frontal and temporal pole thinning, and clinical score at the time of the MRI, could differentiate patients experiencing early seizures from patients not experiencing them with 89% accuracy.


CONCLUSIONS AND RELEVANCE
Although this is an initial report, these data show that specific areas of localised volume deficit, as visible on routine imaging data, are associated with the emergence of seizures after TBI.
['Lutkenhoff|Evan S|ES|', 'Shrestha|Vikesh|V|', 'Ruiz Tejeda|Jesus|J|', 'Real|Courtney|C|', 'McArthur|David L|DL|', 'Duncan|Dominique|D|', 'La Rocca|Marianna|M|', 'Garner|Rachael|R|', 'Toga|Arthur W|AW|', 'Vespa|Paul M|PM|', 'Monti|Martin M|MM|0000-0001-5511-3780', '|||']
D000328:Adult D000070624:Brain Contusion D020201:Brain Hemorrhage, Traumatic D000070642:Brain Injuries, Traumatic D000082643:Cerebral Cortical Thinning D000081415:Clinical Decision Rules D019295:Computational Biology D004569:Electroencephalography D004834:Epilepsy, Post-Traumatic D005260:Female D005625:Frontal Lobe D015600:Glasgow Coma Scale D006624:Hippocampus D006801:Humans D007091:Image Processing, Computer-Assisted D016015:Logistic Models D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009929:Organ Size D011446:Prospective Studies D013702:Temporal Lobe D013997:Time Factors D055815:Young Adult
epilepsy traumatic brain injury MRI