Association of KEAP1 and NFE2L2 polymorphisms with temporal lobe epilepsy and drug resistant epilepsy

BackgroundApproximately 1/3 of patients with epilepsy have drug-resistant epilepsy (DRE) and require surgical interventions. This meta-analysis aimed to review the effectiveness of MRI-guided laser interstitial thermal therapy (MRgLITT) in DRE.MethodsThe Population, Intervention, Comparator and Outcome approach and Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. PubMed, MEDLINE and EMBASE databases were systematically searched for English language publications from 2012 to Nov 2020. Data on the prevalence outcome using the Engel Epilepsy Surgery Outcome Scale (Class I–IV), and postoperative complications were analysed with 95% CIs.ResultsTwenty-eight studies that included a total of 559 patients with DRE were identified. The overall prevalence of Engel class I outcome was 56% (95% CI 0.52% to 0.60%). Hypothalamic hamartomas (HH) patients had the highest seizure freedom rate of 67% (95% CI 0.57% to 0.76%) and outcome was overall comparable between mesial temporal lobe epilepsy (mTLE) (56%, 95% CI 0.50% to 0.61%) and extratemporal epilepsy (50% 95% CI 0.40% to 0.59%). The mTLE cases with mesial temporal sclerosis had better outcome vs non-lesional cases of mTLE. The prevalence of postoperative adverse events was 19% (95% CI 0.14% to 0.25%) and the most common adverse event was visual field deficits. The reoperation rate was 9% (95% CI 0.05% to 0.14%), which included repeat ablation and open resection.ConclusionMRgLITT is an effective and safe intervention for DRE with different disease aetiologies. The seizure freedom outcome is overall comparable in between extratemporal and temporal lobe epilepsy; and highest with HH.Trail registration numberThe study protocol was registered with the National Institute for Health Research (CRD42019126365), which serves as a prospective register of systematic reviews. It is an international database of prospectively registered systematic reviews with a focus on health-related outcomes. Details about the protocol can be found at https://wwwcrdyorkacuk/PROSPERO/.

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CpG Methylation Signature Define Human Temporal Lobe Epilepsy and Predict Drug-Resistant

SSRN Electronic Journal ◽

10.2139/ssrn.3460635 ◽

2019 ◽

Author(s):

Wenbiao Xiao ◽

Chaorong Liu ◽

Kuo Zhong ◽

Shangwei Ning ◽

Rui Hou ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Cpg Methylation ◽

Drug Resistant ◽

Human Temporal Lobe

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Low-frequency Stimulation at the Subiculum is Anti-convulsant and Anti-drug-resistant in a Mouse Model of Lamotrigine-resistant Temporal Lobe Epilepsy

Neuroscience Bulletin ◽

10.1007/s12264-020-00482-x ◽

2020 ◽

Vol 36 (6) ◽

pp. 654-658

Author(s):

Yeping Ruan ◽

Cenglin Xu ◽

Jile Lan ◽

Jiazhen Nao ◽

Shuo Zhang ◽

...

Keyword(s):

Mouse Model ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Low Frequency ◽

Drug Resistant ◽

Low Frequency Stimulation ◽

Frequency Stimulation

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Long-term efficacy and cognitive effects of bilateral hippocampal deep brain stimulation in patients with drug-resistant temporal lobe epilepsy

Neurological Sciences ◽

10.1007/s10072-020-04554-8 ◽

2020 ◽

Author(s):

Shu Wang ◽

Meng Zhao ◽

Tianfu Li ◽

Chunsheng Zhang ◽

Jian Zhou ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Brain Stimulation ◽

Drug Resistant ◽

Cognitive Effects ◽

Term Efficacy ◽

Deep Brain

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Survival of mossy cells of the hippocampal dentate gyrus in humans with mesial temporal lobe epilepsy

Journal of Neurosurgery ◽

10.3171/2008.11.jns08779 ◽

2009 ◽

Vol 111 (6) ◽

pp. 1237-1247 ◽

Cited By ~ 17

Author(s):

László Seress ◽

Hajnalka Ábrahám ◽

Zsolt Horváth ◽

Tamás Dóczi ◽

József Janszky ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Dentate Gyrus ◽

Temporal Lobe ◽

Pyramidal Neurons ◽

Hippocampal Sclerosis ◽

Mesial Temporal Lobe Epilepsy ◽

Drug Resistant ◽

Hippocampal Dentate Gyrus ◽

Mossy Cells ◽

Mesial Temporal Lobe

Object Hippocampal sclerosis can be identified in most patients with mesial temporal lobe epilepsy (TLE). Surgical removal of the sclerotic hippocampus is widely performed to treat patients with drug-resistant mesial TLE. In general, both epilepsy-prone and epilepsy-resistant neurons are believed to be in the hippocampal formation. The hilar mossy cells of the hippocampal dentate gyrus are usually considered one of the most vulnerable types of neurons. The aim of this study was to clarify the fate of mossy cells in the hippocampus in epileptic humans. Methods Of the 19 patients included in this study, 15 underwent temporal lobe resection because of drug-resistant TLE. Four patients were used as controls because they harbored tumors that had not invaded the hippocampus and they had experienced no seizures. Histological evaluation of resected hippocampal tissues was performed using immunohistochemistry. Results Mossy cells were identified in the control as well as the epileptic hippocampi by using cocaine- and amphetamine-regulated transcript peptide immunohistochemistry. In most cases the number of mossy cells was reduced and thorny excrescences were smaller in the epileptic hippocampi than in controls; however, there was a significant loss of pyramidal cells and a partial loss of granule cells in the same epileptic hippocampi in which mossy cell loss was apparent. The loss of mossy cells could be correlated with the extent of hippocampal sclerosis, patient age at seizure onset, duration of epilepsy, and frequency of seizures. Conclusions In many cases large numbers of mossy cells were present in the hilus of the dentate gyrus when most pyramidal neurons of the CA1 and CA3 areas of the Ammon's horn were lost, suggesting that mossy cells may not be more vulnerable to epileptic seizures than the hippocampal pyramidal neurons.

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