Fellow in Clinical Neurophysiology Medical School (FMB) of São Paulo State University (Unesp), Sao Paulo, Brazil
This abstract has been invited to present during the Better Patient Outcomes through Diversity Platform poster session
Rationale: Brain Magnetic Resonance Imaging (MRI) studies in patients with idiopathic generalized epilepsy (IGE) have reported anatomical and functional abnormalities in the gray matter (GM). These changes could be influenced by several factors including antiepileptic drugs (AED). The influence of the AED in the cortical volume of patients with IGE remains under study. Methods: Twenty-five patients with IGE and 25 healthy controls were included (14 women, mean age 33.2±9.5). All subjects underwent 3T MRI. Voxel-based morphometry (VBM) was used to assess GM volume. Volumetric T1 images were automatically segmented and registered into MNI space using the DARTEL algorithm. Patients were divided into two groups according to the type of AED in use (appropriate or inappropriate) accessed by serial dosage. Age and sex were included as covariates. Statiscal analysis was performed using generalized linear model comparing patients from each subgroup with controls. Results: In the appropriate group, there were 13 patients (7 women, 29.5±9.4) all of them using valproate or lamotrigine. In the inappropriate group, there were 12 patients (7 women, 37.7±10.4) using carbamazepine or phenytoin. VBM showed: for the appropriate group GM atrophy in the left middle temporal gyrus (1734mm³, p=0.048 FWE) and in the right basal ganglia (1023mm³, p=0.04 unc); for the inappropriate group GM atrophy in the cerebellum (8581mm³, p< 0.001 FWE). There were no areas of increased GM in the patients groups. Conclusions: Different types of AED regimen are associated with distinct structural GM lesions in patients with IGE. Primary AED adverse effects may be responsible for these patterns. However, a different modulation of IGE pathogenical circuitry probably is also present. Neuroimaging investigations of patients with IGE must consider the underlying treatment for an appropriate interpretation. Funding: Please list any funding that was received in support of this abstract.: FAPESP and FAMESP / HC UNESP
