DSC MRI and cytokines after tonic clonic seizures

  • Tatjana Filipović University Medical Centre Ljubljana

Abstract

ABSTRACT

OBJECTIVE: Inflammatory events in brain parenchima and glial tissue are involved in epileptogenesis. Blood concentration of cytokines is  shown to be elevated  after tonic- clonic seizures. As a result of inflamation, blood-brain barier leekage occurs. This can be documented by immaging techniques, such is dynamic susceptibility contrast enchanced (DSC) MRI perfusion. Our aim was to check for postictal brain inflammation by studying  DSC MRI  perfusion and plasma level of cytokines. We looked for correlations between number and type of introducing seizures, postictal plasma level of cytokines and parameters of DSC MRI perfusion. Furthermore, we looked for correlation of those parameters and course of the disease over one year follow up. METHODS: We prospectively enroled 30 patients, 8-24 hours after single or repeated tonic-clonic seizures. RESULTS: 25 of them had normal  perfusion parametrs, while 5 had  hyperperfusion. Patients with hyperperfusion were tested again, 3 months later. Two of 5 had hyperperfusion also on control measurements.  Number of index seizures negatively correlated with concentration of proinflamatory cytokines IL-10, IFN-ϒ and  TNF-α in a whole cohort. In patients with  hyperperfusion, there were significantly lower concentrations of antiinflamatory cytokine IL-4 and higher concentrations  of proinflamatory TNF-α. SIGNIFICANCE: Long lasting blood- brain barier dysruption may be crucial for epileptogenesis in selected patients.

IZVLEČEK

NAMEN:Vnetno dogajanje v možganskem parenhimu in glialnem tkivu je del procesa epileptogeneze. Koncentracija citokinov v  krvi je povečana po tonično-kloničnih epileptičnih napadih. Posledica vnetja je povečana prepustnost krvnožilne možganske pregrade, ki jo lahko ocenjujemo s slikovnimi tehnikami, kot je dinamična kontrastno dovzetna MR perfuzija (DSC-MRI). Namen naše raziskave je bila ocena vnetnega dogajanja v možganih po epileptičnem napadu z DSC-MRI in količino citokinov v plazmi. Ocenjevali smo povezavo med tipom in številom epileptičnih napadov, nivojem citokinov v plazmi po epileptičnem napadu in parametri DSC-MRI. Ocenjevali smo tudi povezavo med naštetimi paremetri in enoletnim spremljanjem razvoja bolezni.

METODE: V raziskavo smo vključili 30 bolnikov, 8-24 ur po enem ali ponavljajočih se tonično-kloničnih napadih.

REZULTATI: 25 bolnikov je imelo normalne parametre perfuzije, pri 5 bolnikih smo našli področja hipoperfuzije.  Pri 2 bolnikih je hipoperfuzija vztrajala tudi na kontrolni  DSC-MRI po 3 mesecih. Število napadov je negativno koreliralo s koncentracijo citokinov  IL-10, IFN-ϒ in TNF-α v plazmi pri vseh bolnikih. Pri bolnikih s hipoperfuzijo smo ugotavljali statistično značilne nižje vrednosti protivnetnih citokinov IL-4 in višje vrednosti provnetnih TNF-α .

ZAKLJUČEK: Dolgotrajna prepustnost krvnožilne možganske pregrade je pomembna v procesu epiletogeneze v izbrani skupini bolnikov.

 

 

Author Biography

Tatjana Filipović, University Medical Centre Ljubljana

Division of Neurology

Emergency Department

Published
2017-09-10
How to Cite
Filipović, T. (2017). DSC MRI and cytokines after tonic clonic seizures. Radiology and Oncology, 51(3). Retrieved from https://radioloncol.com/index.php/ro/article/view/2811
Section
Radiology