Study on correlation between changes of blood brain barrier permeability and seizure frequency
Objective To investigate the correlation between the changes of blood brain barrier(BBB)permeability and seizure fre-quency.Methods A total of 182 patients with epilepsy admitted to The First Affiliated Hospital of Harbin Medical University,The First Affiliated Hospital of Jiamusi Medical University and Nanjing Tongren Hospital Affiliated to Southeast University from January 2021 to December 2023 were selected as the study objects.BBB permeability parameters,including cerebral blood flow(CBF),cerebral blood volume(CBV)and volume transfer parameter(Ktrans)were evaluated by dynamic contrast enhanced magnetic resonance ima-ging,and seizure frequency was regularly followed up.Spearman or Pearson correlation analysis was used to evaluate the relationship between BBB permeability parameters and seizure frequency.Logistic multivariate regression analysis was used to investigate the inde-pendent influencing factors of seizure frequency.Kaplan-Meier survival analysis was used to evaluate the recurrence rate of epilepsy in different Ktrans groups.CBF and Ktrans in patients with different etiology and different attack types were compared.Results The fre-quency of seizures generally decreased during the follow-up period.BBB permeability parameters Ktrans,CBF and CBV gradually im-proved and showed a decreasing trend during follow-up.Correlation analysis showed that Ktrans was positively correlated with seizure frequency(r=0.52,P＜0.001).CBF was positively correlated with seizure frequency(r=0.38,P=0.014).There was no correlation between CBV and seizure frequency(r=0.22,P=0.091).The results of multivariate regression analysis showed that Ktrans and SI00B were independent influencing factors of seizure frequency(P＜0.05).At 24 months of follow-up,patients with Ktrans values below the median of all patients were included in the low Ktrans group(n=99),and those with Ktrans values above the median were included in the high Ktrans group(n=83).The seizure free survival rate in the high Ktrans group was 40％,compared with 70％in the low Ktrans group,and the difference was statistically significant(P＜0.05).Patients were divided into idiopathic epilepsy group(n=98)and symptomatic epilepsy group(n=84)according to different etiologies.The Ktrans and CBF in the idiopathic epilepsy group were lower than those in the symptomatic epilepsy group,and the difference was statistically significant(P＜0.05).Patients were divided into systemic seizure group(n=72)and focal seizure group(n=110)according to different types of seizures.There was no statistically significant difference in Ktrans and CBF between the systemic attack group and the focal attack group(P＞0.05).Conclusion Ktrans is closely related to the frequency and recurrence risk of seizures,and can be used as a potential predictor of sei-zures,which is of great significance for clinical treatment and prognosis.
Epileptic seizureBlood brain barrierPermeabilityVolume transfer parameterSurvival analysis
万方数据
维普
