Clinical MRI Morphological Analysis of Functional Seizures Compared to Seizure-naïve and Psychiatric Controls
Abstract number :
1.24
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2022
Submission ID :
2203906
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Wesley Kerr, MD, PhD – University of Michigan; Hiroyuki Tatekawa, MD – UCLA; John Lee, MD, PhD – UCLA; Amir Karimi, BA – UCLA; Siddhika Sreenivasan, MS – UCLA; Joseph O'Neill, PhD – UCLA; Ivanka Savic, MD, PhD – Karolinska Institute; Nilab Nasrullah, BA – Karolinska Institute; Randall Espinoza, MD – UCLA; Katherine Narr, PhD – UCLA; Noriko Salamon, MD – UCLA; Nicholas Beimer, MD – University of Michigan; Lubomir Hadjiiski, PhD – University of Michigan; Dawn Eliashiv, MD – UCLA; William Stacey, MD, PhD – University of Michigan; Jamie Feusner, MD – UCLA; John Stern, MD – UCLA
This abstract has been invited to present during the Neuroimaging platform session
Rationale: Functional seizures (FS), also known as psychogenic nonepileptic seizures (PNES), are physical manifestations of acute or chronic psychological distress. Functional and structural neuroimaging have identified objective signs of this disorder. We evaluated whether MRI morphometry differed between patients with FS and clinically relevant comparison populations.
Methods: Quality-screened clinical-grade MRIs were acquired from 666 patients from 2006 to 2020. Morphometric features were quantified with FreeSurfer v6. Mixed-effects linear regression compared the volume, thickness, and surface area within 201 regions-of-interest for 90 patients with FS, compared to seizure-naïve patients with depression (n=243), anxiety (n=68), and obsessive-compulsive disorder (OCD, n=41), respectively, and to other seizure-naïve controls with similar quality MRIs, accounting for the influence of multiple confounds including depression and anxiety based on chart review. These comparison populations were obtained through review of clinical records plus research studies obtained on similar scanners.
Results: After Bonferroni-Holm correction, patients with FS compared with seizure-naïve controls exhibited thinner bilateral superior temporal cortex (left 0.053mm, p=0.014; right 0.071mm, p=0.00006), thicker left lateral occipital cortex (0.052mm, p=0.0035), and greater left cerebellar white-matter volume (1085mm3, p=0.0065). These findings were not accounted for by lower MRI quality in patients with FS.
Conclusions: These results reinforce prior indications of structural neuroimaging correlates of FS and, in particular, distinguish brain morphology in FS from that in depression, anxiety, and OCD. Future work may entail comparisons with other psychiatric disorders including bipolar and schizophrenia, as well as exploration of brain structural heterogeneity within FS.
Funding: This work was supported by National Institutes of Health [grant numbers: R25NS065723, R25NS089450, U01MH110008, R01MH085900, R01NS033310, P20NS080181, T32GM08042, T90DA022768, R90DA022768, R90DA023422]; the Muriel Harris Chair of Geriatric Psychiatry; and the William M. Keck Foundation.
Neuro Imaging