Temporal Lobe Epilepsy and Anxiety: Cortico-subcortical and Superficial White Matter Differences
Abstract number :
3.368
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2024
Submission ID :
445
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Donatello Arienzo, PhD – University of California San Diego
Ze Sun, BS – University of California San Diego
Alice Ballerini, PhD – University of Modena and Reggio Emilia
Alena Stasenko, PhD – UCSD
Taha Gholipour, MD – UC San Diego
Adam Schadler, MS – UCSD
Erik Kaestner, PhD – UCSD
Carrie McDonald, PhD – UCSD
Rationale: Anxiety is a common comorbidity in people with epilepsy. In adults with epilepsy, comorbid anxiety is associated with worse seizure control and reduced quality of life. However, most of the studies investigating structural differences between epilepsy patients with and without anxiety are confined to children, non epileptic seizures, amygdala and hippocampus regions and do not examine Superficial White Matter (SWM) integrity differences. In the current study, we performed a retrospective analysis of neocortical and sub-cortical Gray matter GM and SWM degeneration profiles in Temporal Lobe Epilepsy (TLE) as a function of anxiety
Methods: 74 patients with TLE, with (40) and without anxiety (34) and 31 healthy controls (HC) with no anxiety were enrolled. T1-weighted images were used to compute subcortical volumes and cortical thickness. Diffusion-weighted imaging was used to obtain Fractional Anisotropy (FA) and Mean Diffusivity (MD) of the SWM. Analysis of covariance was used to examine patterns of GM and SWM alterations in TLE with and without anxiety, relative to HC, controlling for age and sex
Results: Relative to HC, TLE with and without anxiety exhibited a widespread, bilateral pattern of cortical thinning, pronounced in posterior centroparietal regions (pBNF < 0.001), particularly in the lingual, superior parietal, paracentral lobe and precuneus and of ipsilateral hippocampal volume decrease (p < .005). As far as SWM integrity, FA in TLE with and without anxiety was lower in the fibers appearing in the ipsilateral temporal regions (p < 0.005) (lingual, parahippocampal and temporal pole) while only the TLE with anxiety showed lower FA in the ipsilateral entorhinal (p = .004). Also, MD in TLE with and without anxiety was higher in the fiber appearing in the ipsilateral parahippocampal (p = .002; p = .02) and temporal pole regions (pBNF < 0.001, p = .007).
Relative to non-anxious participants, TLE with anxiety showed thinning in the controlateral posterior cingulate and in the lateral occipital compared to controls (pBNF = .023; p < .001) and no anxious TLE (p = .004; p = .02), Fig.1. TLE with anxiety showed higher MD in the ipsilateral superior frontal, rostral middle frontal, precentral and especially in the fibers eliciting the cingulate bundle comprising the caudal and rostral anterior and posterior cingulate compared to HC (p = .006) and no anxious TLE (p = .02), Fig.2.
A decrease in cortical thickness and an increase in SWM MD in the controlateral and ipsilateral posterior cingulate respectively, significantly correlated with the results on the Beck Anxiety scale (r = -.31, pBNF = .007; r = .33, pBNF = .003)
Conclusions: Anxiety is a common psychiatric comorbidity in TLE patients with thinner cortex in posterior cingulate cortex, and higher SWM MD in the cingulate bundle, which has been previously demonstrated to have a robust anxiolytic response in epilepsy suggesting the important contribution of SWM in shaping anxiety in TLE patients
Funding: “Enhancing NeuroImaging and Genetics through Meta-Analysis (ENIGMA)”
NIH, 2023 – 2028, PI Dr. McDonald Co-I Dr. Arienzo
Neuro Imaging