Epilepsy in Pediatric Patients—Evaluation of Brain Structures’ Volume Using VolBrain Software

Woźniak, Magdalena; Zbroja, Monika; Matuszek, Małgorzata; Pustelniak, Olga; Cyranka, Weronika; Drelich, Katarzyna; Kopyto, Ewa; Materniak, Andrzej; Słomka, Tomasz; Cebula, Maciej; Brodzisz, Agnieszka

doi:10.3390/jcm11164657

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…In a large cross‐sectional study widespread patterns of altered subcortical volume and reduced GM thickness was observed in adults with epilepsy in comparison to healthy controls 13 . Data in children are more limited but overall, there are clear indications that epilepsy can result in brain volume loss 14 . In addition, our results might be limited by a selection bias, as visual assessment of volume loss has been shown to be unreliable.…”

Section: Discussionmentioning

confidence: 69%

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Valproate associated brain volume‐loss in pediatric epilepsy—A case series

et al. 2023

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Brain atrophy associated with valproate therapy is known from single case reports and frequently accompanied by cognitive deterioration. We present a case series of incidental finding of brain volume‐loss in children treated with valproate and employed automatic brain volumetry to assess the effect size of volume loss. 3D T1w datasets were automatically segmented into white matter, gray matter, and cerebrospinal fluid using the SPM‐12 algorithm. Respective volumes of cerebrum and cerebellum were read out and normalized to the total intracranial volume.We identified six patients (median age 148.5 (85‐178) months) who had received valproate for a median time of 5 (2‐23) months prior to MRI in which a loss of brain volume was noted. None had reported the occurrence of new clinical symptoms. Volumetry showed a volume loss of up to 28% for cerebral GM, 25% for cerebellar GM, 10% for cerebral WM and 20% for cerebellar WM. A volume loss of >5% in at least one of the subvolumes was found in all patients, with the more prominent volume loss in the cerebrum and in gray matter. In one patient, post‐valproate MRI was available and showed normalization of brain volume. Our case series indicates that valproate therapy might be associated with an asymptomatic volume loss of brain parenchyma in children with epilepsy and that this volume loss is assessable with automatic volumetry.

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Section: Discussionmentioning

confidence: 69%

“…13 Data in children are more limited but overall, there are clear indications that epilepsy can result in brain volume loss. 14 In addition, our results might be limited by a selection bias, as visual assessment of volume loss has been shown to be unreliable.…”

Section: Resultsmentioning

confidence: 89%

Valproate associated brain volume‐loss in pediatric epilepsy—A case series

et al. 2023

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“…To today, the volumes of individual anatomical structures have been assessed via autopsy, computed tomography and MRI. In addition to studies using traditional measurement methods [40][41][42], more objective and practical automated analysis methods have also been developed [32,33,43]. It is well known that the thalamus mediates communication between sensory, motor, and cognitive brain regions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of thalamic volume in patients diagnosed with ESES using the MRI-Cloud method

Güngör,

Kaban

et al. 2024

Preprint

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Purpose Benign epilepsy with centrotemporal spikes (BECTS) is one of the most common epilepsy syndromes in childhood. Accordingly, the main aim of this study was to investigate brain anatomical differences in patients with BECTS using MRI-Cloud, a more objective and quantitative evaluation method for the first time in the literature. Methods We included 27 patients diagnosed with BECTS and 27 healthy subjects in the study. We analysed magnetic resonance imaging (MRI) scans of patients diagnosed with BECTS for the first time via the "MRI-Cloud" method. Results The mean age of the 54 patients in our study was 8.0 (4–14) years for patients with BECTS, 7.75 (5–14) years for patients with ESES and 8.0 (4–14) years for the control group. Total relative thalamic volume was significantly lower in patients with ESES than in healthy controls (2045.57 ± 343.84 vs. 8775.85 ± 3687.58, p < 0.001), and the total relative thalamic volume was significantly lower in patients with ESES than in patients with BECTS without ESES (2045.57 ± 343.84 vs. 7829.60 ± 3152.85, p < 0.001). The thalamus volumes in patients with ESES were significantly lower than those in patients with BECTS without ESES (right thalamus: 1028 ± 260 vs. 3844 ± 1572, p < 0.001; left thalamus: 1017 ± 150 vs. 3985 ± 2135, p < 0.001). Conclusion In this study, we emphasize the contribution of volume analysis and the MRI-Cloud method for detecting microstructural changes at the thalamic level in ESES patients even when conventional MRI findings are normal.

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“…Of course, this is something different from supporting a systematic role of cerebellum in epileptogenesis, which was sporadically demonstrated in anecdotal cases with cerebellar masses [ 36 , 37 ]. Recent volumetric studies comparing epileptic subjects and healthy controls, indeed, showed volumetric anomalies in the brain, lateral ventricles, and putamen, but not in the cerebellum [ 38 ]. On these grounds, the role of the cerebellum and, in particular, CM1, in epilepsy remains undemonstrated.…”

Section: Discussionmentioning

confidence: 99%

Chiari 1 Malformation and Epilepsy in Children: A Missing Relationship

Massimi

Palombi

Contaldo

et al. 2022

JCM

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Purpose: Once believed a result of pathophysiological correlations, the association between Chiari 1 malformation (CM1) and epilepsy has since been considered as a coincidence, due to missing etiologic or clinical matching points. At present, the problem is being newly debated because of the increasing number of CM1 diagnoses, often among children with seizures. No specific studies on this topic are available yet. The present study aimed at updating the information on this topic by reporting on a series of children specifically enrolled and retrospectively analyzed for this purpose. Methods: All children admitted between January 2015 and June 2020 for epilepsy and CM1 were considered (Group 1). They were compared with children admitted in the same period for symptoms/signs related to CM1 and/or syringomyelia (Group 2). Syndromic patients were excluded, as well as those with tumoral or other overt intracranial lesions. All patients received a complete preoperative work-up, including MRI and EEG. Symptomatic children with CM1/syringomyelia were operated on. The pertinent literature was reviewed. Results: Group 1 was composed of 29 children (mean age: 6.2 years) showing CM1 and epilepsy with several types of seizures. A share of 27% had CM1-related symptoms and syringomyelia. The mean tonsillar ectopia was 7.5 mm. Surgery was performed in 31% of cases. Overall, 62% of children are currently seizure-free (including 5/9 children who were operated on). Tonsillar herniation and syringomyelia regressed in 4/9 cases and 4/8 cases, improved in 4/9 cases and 3/8 cases, and remained stable in 1/9 and 1/8 cases, respectively. CM1 signs/symptoms regressed completely in 6/8 cases and improved or remained stable in one case in each of the two remaining patients. Group 2 consisted of 77 children (mean age: 8.9 years) showing symptoms of CM1 (75%) and/or syringomyelia (39%). The mean tonsillar ectopia was 11.8 mm. Non-specific EEG anomalies were detected in 13 children (17%). Surgery was performed in 76.5% of cases (18 children were not operated on because of oligosymptomatic). Preoperative symptoms regressed in 26%, improved in 50%, remained stable 22%, and worsened in 2%; CM1 radiologically regressed in 39%, improved in 37%, remained unchanged in 22%, and worsened in 2%; and syringomyelia/hydromyelia regressed in 61%, improved in 30%, and was stable in 9%. No statistically significant differences between the two groups were detected regarding the M/F ratio, presence of syringomyelia/hydromyelia, or CM1/syringomyelia outcome; moreover, no correlation occurred between seizure-free condition and PF decompression in Group 1, or between disappearance of EEG anomalies and PF decompression in Group 2. A significant difference between the two groups was noticed regarding the mean age at admission (p = 0.003), amount of tonsillar herniation (p < 0.00001), and PF decompression (p = 0.0001). Conclusions: These findings do not support clinical correlations between CM1 and epilepsy. Their course depends on surgery and antiepileptic drugs, respectively. The analysis of the literature does not provide evidence of a relationship between seizures and cerebellar anomalies such as CM1. Rather than being linked to a syndrome that could explain such an association, the connection between the two now has to be considered to be random.

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Epilepsy in Pediatric Patients—Evaluation of Brain Structures’ Volume Using VolBrain Software

Cited by 7 publications

References 36 publications

Valproate associated brain volume‐loss in pediatric epilepsy—A case series

Valproate associated brain volume‐loss in pediatric epilepsy—A case series

Evaluation of thalamic volume in patients diagnosed with ESES using the MRI-Cloud method

Chiari 1 Malformation and Epilepsy in Children: A Missing Relationship

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