Variances of quantifying of Virchow–Robin spaces detecting the different functional status of glymphatic system in simple febrile seizures affected by seizures duration

Abstract

The Virchow–Robin spaces (VRs) in the cerebral glymphatic system play a vital role in waste clearance from the brain. Simple febrile seizures (SFS) are a common type of seizures marked by an inappropriate fluid exchange. The mechanism of evident differences in glymphatic function among SFS with varying seizure duration is unknown. Therefore, the goal of this study was to see whether there were any variations in glymphatic function among SFS based on seizures duration. We retrospectively studied 30 children with SFS lasting more than 5 minutes (SFS > 5M), 40 children with SFS lasting 5 minutes or less (SFS ≤ 5M), and 35 healthy controls aged 6 to 60 months who underwent magnetic resonance imaging (MRI). A custom-designed automated method that used T2-weighted imaging (T2WI) to segment the visible VRs. The VRs metrics were measured and compared studied groups. The VRs metrics, seizure duration the time gap between seizure onset and MRI scan were studied as well. VRs counts were lower ( P < .001) in the SFS ≤ 5M (445.80 ± 66.10) and the control (430.77 ± 182.55) groups in comparison to SFS > 5M (642.70 ± 100.62). Similar results were found for VRs volume (VRs vol _SFS > 5M, 8514.63 ± 835.33mm 3 , VRs vol _SFS ≤ 5M, 6390.43 ± 692.74 mm 3 , VRs vol _control, 6048.37 ± 111.50 mm 3 ; P < .001). However, in the SFS ≤ 5M, VRs measurements were lower than in the SFS > 5M ( P < .001). VRs measurements were positively connected with seizure duration and inversely correlated with the course following seizure onset and MRI scan time in both SFS groups. SFS are positively correlated to glymphatic dysfunction since they cause enlarged VRs; additionally, VRs can be used as a biomarker in SFS > 5M and contribute to the mechanism.

The cerebral lymphatic drainage system and its implications in epilepsy

“…Retrospective analyses of patients with epilepsy (Table 2) show that GS function is lower than in control subjects (Kim et al., 2023; Lee, Lee, Shin, & Park, 2022; Lee, Park, Ko, Park, Lee, et al., 2022; Li, Ruan, et al., 2022; Liu et al., 2020; Salimeen et al., 2021; Zhao et al., 2023), and that GS function is completely restored in patients with temporal lobe epilepsy after anterior temporal lobectomy (Zhang, Xu, et al., 2023), suggesting an important role for the GS in epilepsy. Interestingly, in patients with focal epilepsy, no changes in GS were found by Lee, Park, Ko, Park, Park, et al.…”