Towards prognostic biomarkers from BOLD fluctuations to differentiate a first epileptic seizure from new-onset epilepsy

Lalit Gupta, Rick Janssens, Mariëlle C.G. Vlooswijk, Rob P.W. Rouhl, Anton de Louw, Albert P. Aldenkamp, Shrutin Ulman, René M.H. Besseling, Paul A.M. Hofman, Vivianne H. van Kranen-Mastenbroek, Danny M. Hilkman, Jacobus F.A. Jansen, Walter H. Backes

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Abstract

Objective: The diagnosis of epilepsy cannot be reliably made prior to a patient's second seizure in most cases. Therefore, adequate diagnostic tools are needed to differentiate subjects with a first seizure from those with a seizure preceding the onset of epilepsy. The objective was to explore spontaneous blood oxygen level–dependent (BOLD) fluctuations in subjects with a first-ever seizure and patients with new-onset epilepsy (NOE), and to find characteristic biomarkers for seizure recurrence after the first seizure. Methods: We examined 17 first-seizure subjects, 19 patients with new-onset epilepsy (NOE), and 18 healthy controls. All subjects underwent clinical investigation and received electroencephalography and resting-state functional magnetic resonance imaging (MRI). The BOLD time series were analyzed in terms of regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuations (fALFFs). Results: We found significantly stronger amplitudes (higher fALFFs) in patients with NOE relative to first-seizure subjects and healthy controls. The frequency range of 73–198 mHz (slow-3 subband) appeared most useful for discriminating patients with NOE from first-seizure subjects. The ReHo measure did not show any significant differences. Significance: The fALFF appears to be a noninvasive measure that characterizes spontaneous BOLD fluctuations and shows stronger amplitudes in the slow-3 subband of patients with NOE relative first-seizure subjects and healthy controls. A larger study population with follow-up is required to determine whether fALFF holds promise as a potential biomarker for identifying subjects at increased risk to develop epilepsy.

Original languageEnglish
Pages (from-to)476-483
Number of pages8
JournalEpilepsia
Volume58
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • BOLD time series
  • First-seizure
  • Functional magnetic resonance imaging
  • Low frequency oscillations
  • New-onset epilepsy
  • Regional homogeneity
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Male
  • Electroencephalography
  • Epilepsy/blood
  • Young Adult
  • Brain/diagnostic imaging
  • Magnetic Resonance Imaging
  • Image Processing, Computer-Assisted
  • Adolescent
  • Aged, 80 and over
  • Electrocardiography
  • Adult
  • Female
  • Aged
  • Retrospective Studies
  • Oxygen/blood

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