Authors :
Presenting Author: Yun Lien, MSc – University of Alabama at Birmingham
Ayushe Sharma, PhD – Neurology – University of Alabama at Birmingham; William Willoughby, PhD – Radiology – University of Alabama at Birmingham; Jerzy Szaflarski, MD, PhD – Professor, Neurology, University of Alabama at Birmingham; Adam Goodman, PhD – Neurology – University of Alabama at Birmingham; Jane Allendorfer, PhD – Neurology – University of Alabama at Birmingham
Rationale:
Pulsed arterial spin labeling (PASL) is an advanced neuroimaging method that allows noninvasively estimating cerebral blood flow (CBF)
in vivo. Prior studies have found increased CBF in patients with lesions and neurological disorders, suggesting CBF could be a potential biomarker for these conditions. Mood disorders such as depression and anxiety often co-occur with epilepsy; however, few studies have investigated the relationship between the CBF and mood. It was hypothesized that participants with idiopathic generalized epilepsy (IGE) would exhibit greater mood disturbance than healthy controls (HCs), and that this would be associated with higher CBF in emotion-related brain regions. We also investigated whether seizure-free (≤ 6 months) IGE participants (IGE-) differ in their mood status and emotion network CBF from those who still experience seizures (IGE+).
Methods:
Twenty-three IGE participants (11 IGE+, 12 IGE-) and nineteen HCs were recruited for this study. Total mood disturbance (TMD) was assessed using the Profile of Mood States (POMS) questionnaire. An increased TMD indicates poor mood status. A Siemens Prisma 3T scanner with a 20-channel head coil was used to acquire T1-weighted images and PASL images. PASL images were analyzed using BASIL (
https://fsl.fmrib.ox.ac.uk/fsl/fslwiki/BASIL) and were motion-corrected and co-registered to MNI space. The PASL data were processed with partial volume correction with gray matter and calibrated with M0 image to obtain absolute CBF in gray matter. The structural images were processed with brain extraction and nonlinear registration to MNI space and were used as reference images for partial volume correction of PASL image. A binary mask consisting of
bilateral prefrontal cortex, cingulate gyrus, insula, amygdala, hippocampus and parahippocampal gyrus were used to estimate CBF in the emotion network. Independent-sample t-tests compared groups and Pearson correlation examined CBF relationships with TMD.
Results:
IGE [M=57.4, SD=32.3] had higher TMD than the HCs [M=2.1, SD=19.9; p< 0.001]; both IGE- [M=56.2, SD=38.0; p< 0.001] and IGE+ [M=58.7, SD=26.5; p< 0.001] had higher TMD than HCs. However, TMD was similar between IGE+ and IGE-. In regions comprising the emotion network, participants with IGE had significantly greater CBF [M=65.4, SD=11.8] than HCs [M=58.1, SD=11.1; p=0.045]. Pearson correlation showed that TMD positively correlated with emotion network CBF [R=0.36, p=0.019].
Conclusions:
Participants with IGE had significantly greater mood disturbance than HCs regardless of seizure status. Additionally, IGE participants had higher CBF (IGEs >HCs) within the emotion network, and also exhibited greater mood disturbance. These findings suggest that increased CBF within the emotion network may be associated with worse mood.
Funding:
This work was supported by NIH R01HD102723 to JBA, the State of AL General Fund (Carly’s Law) to JPS, and the UAB Epilepsy Center.