Authors :
First Author: Sarah Akel, MSc – University of Gothenburg
Presenting Author: Johan Zelano, MD PhD – University of Gothenburg
Fredrik Asztely, MD, PhD – University of Gothenburg / Sahlgrenska University Hospital; Rakesh Banote, PhD – University of Gothenburg / Sahlgrenska University Hospital; Markus Axelsson, MD, PhD – University of Gothenburg / Sahlgrenska University Hospital; Henrik Zetterberg, MD, PhD – University of Gothenburg / Sahlgrenska University Hospital; Johan Zelano, MD, PhD – University of Gothenburg / Sahlgrenska University Hospital
Rationale:
The question of whether seizures cause brain injury remains a topic of interest in epilepsy. While many individuals with epilepsy exhibit no signs of progressive brain damage, others do experience cognitive issues such as memory decline. Our research focuses on examining the levels of neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and tau—markers associated with brain injury—in a regional hospital-based cohort of individuals with epilepsy. We aimed to investigate whether the levels of these markers are indicative of brain injury after seizures.
Methods:
The biomarkers were measured in the plasma of 204 individuals with epilepsy that were selected from a prospective regional biobank study. We examined the absolute marker levels between two patient groups – those who report recent seizures (within the two months leading up to inclusion) and those who had been seizure-free for over one year. We also evaluated whether certain clinical characteristics were associated with higher levels.
Results:
NfL and GFAP were significantly increased in patients under 65 years with recent seizures as well as in patients with an epileptogenic lesion on radiology. Both markers correlated weakly to the number of days since a patient’s last seizure, with NfL also correlating to seizure frequency. In addition, twenty-seven patients had abnormally high levels of NfL, with factors such as recent seizures and epileptogenic lesion on radiology significantly associated with these levels.
Conclusions:
The results of our study align with the current understanding that epilepsy, in most cases, does not lead to brain injury on a scale comparable to neurodegenerative disorders. The possible association of NfL and GFAP to recent seizure activity requires further longitudinal study.
Funding:
This study was funded by the Jeanssen foundation, Swedish Society for Medical Research (SS18-0040), Region Västra Götaland (VGFOUREG-968476), grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (715781).