School-Age Learning Performance Associated with Brain Volume in Focal Epilepsy
Abstract number :
2.453
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2022
Submission ID :
2232913
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Jacob Pellinen, MD – University of Colorado School of Medicine; Heath Pardoe, PhD – The Florey Institute of Neuroscience and Mental Health, University of Melbourne; Stafan Sillau, PhD – University of Colorado School of Medicine; Sarah Barnard, MIPH – Monash University; Robert Knowlton, MD – University of California San Francisco School of Medicine; Jacqueline French, MD – New York University School of Medicine; Daniel Lowenstein, MD – University of California San Francisco School of Medicine; Gregory Cascino, MD – Mayo Clinic; Simon Glynn, MD – University of Michigan; Graeme Jackson, MD – The Florey Institute of Neuroscience and Mental Health; Jerzy Szaflarski, MD PhD – University of Alabama at Birmingham; Ruben Kuzniecky, MD – Northwell Health
This is a Late Breaking abstract
Rationale: Recent analysis of imaging data from the Human Epilepsy Project (HEP) found 18% of individuals with newly treated focal epilepsy had reduced brain volumes relative to age. We investigated the relationship between brain volume changes on MRI and pre-diagnostic factors including seizure burden and school-age developmental metrics._x000D_
Methods: HEP enrolled participants within 4 months of treatment for focal epilepsy between 2012 and 2017 across 34 sites in the USA, Canada, Europe, and Australia. A total of 408 underwent brain MRI at enrollment and completed pre-treatment medical histories. Pre-diagnostic seizure burden was based on seizure semiology, frequency, and duration. HEP exclusion criteria included moderate or greater developmental or cognitive delay, though some participants still reported a history of learning difficulties. We calculated a learning performance score based on history of a formal diagnosis of a learning disability, repeated grades, and remediation in school. Whole brain T1-weighted MRIs were analyzed using the Sequence Adaptive Multimodal Segmentation (SAMSEG) tool from Freesurfer v7.2. Derived neuroanatomical labels were used to calculate a brain tissue volume to intracranial volume ratio. This brain volume ratio was assumed to reflect either diffuse atrophy or hypoplasia and was compared to patient characteristics using multiple linear regression and Partial Spearman correlations.
Results: Brain volume ratio was modeled with seizure burden (log scale), age at MRI, learning performance score, sex, education (higher education vs. high school or less), employment (yes (including student) vs. no), and initial seizure semiology (motor vs. non-motor). There was no association between pre-diagnostic seizure burden and brain atrophy (p = 0.245). Each unit increase in learning performance score was associated with a decrease of 0.005 in brain size ratio (95% CI -0.007 to -0.002, p < 0.001, Fig 1). A 10-year increase in age at MRI decreased the brain volume ratio by 0.006 (95% CI -0.008 to -0.005, p < 0.001). For males, the brain volume ratio was 0.011 less than females (95% CI 0.007 to 0.014, p < 0.001). The effect of higher education, compared to high school or less, was marginally non-significant (p = 0.054), with the brain volume ratio among those with higher education being 0.004 higher than those without (95% CI 0.001 to 0.008). There were no effects from employment or initial seizure semiology. All findings were similar using Partial Spearman correlations.
Neuro Imaging