Accelerated Brain Aging in Mesial Temporal Lobe Epilepsy: Prominent Involvement of Limbic and Default Mode Network Region
Abstract number :
2.471
Submission category :
5. Neuro Imaging / 5A. Structural Imaging
Year :
2024
Submission ID :
1380
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Hyunjin Jo, MD, PhD – Samsung Medical Center
Suyeon Seo, MD – Samsung Medical Center
Hea Ree Park, MD, PhD – Ilsan Paik Hospital
Gilsoon Park, PhD – 1USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California
Eun Yeon Joo, MD, PhD – Samsung Medical Center
Hosung Kim, PhD – 1USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California
Rationale: Mesial temporal lobe epilepsy (MTLE) is associated with long-term brain structural changes and subsequent cognitive impairment, suggesting accelerated brain aging in chronic stages. However, research on brain aging in MTLE remains limited. This study aims to evaluate the pathologic brain aging in patients with MTLE using regional brain age index (BAI) derived from structural MRIs.
Methods: We included 55 TLE patients (age: 48.1±5.92 years; 38 females; seizure onset: 26.7±13.1 years) and 6,563 healthy controls (age: 64.8±7.15 years; 3,110 females), all of whom underwent T1-weighted MRI scans. Using graphical convolutional networks (GCNs) trained on healthy controls, we built regional brain age prediction models. Using graphical convolutional networks (GCNs) trained on healthy controls, we built regional brain age prediction models. We defined 9 functional regions (sensorimotor, frontoparietal, dorsal attention, ventral attention - language, default mode, salience, auditory, visual, and limbic) and one anatomical region (parahippocampal gyrus) on the cerebral cortex, based on automated anatomical labeling. A GCN model was trained for each of the 10 regions (9 functional regions and parahippocampal gyrus) in both hemispheres. The BAI for each subject was calculated by subtracting their chronological age from the predicted brain age. The BAIs of TLE patients were adjusted using the BAIs of healthy controls (mean BAI≈0). We then compared the BAIs between TLE patients and healthy controls, as well as between ipsilesional and contralesional BAIs in TLE patients.
Results: MTLE patients showed significantly increased BAI in all functional areas and the parahippocampal gyrus (Table 1). This increase in regional BAIs was observed not only on the ipsilateral side of the epileptic focus (BAI 7.0 ± 2.0) but also on the contralateral side (BAI 6.4 ± 1.5). The highest increase in BAI was observed in the ipsilateral default mode network (DMN) region (mean BAI 10.1), followed by the limbic (8.8), visual (8.5), and contralateral DMN (8.5) regions. In the dorsal network, DMN, auditory, limbic regions and parahippocampal gyrus, the ipsilateral side showed a significantly higher BAI compared to the contralateral side.
Conclusions: This study is the first to evaluate regional BAI across different functional domains in MTLE patients. It found that accelerated brain aging occurs in extensive areas, with prominent acceleration in the DMN and limbic areas. These findings highlight the importance of early-stage treatment in MTLE patients to mitigate long-term consequences beyond seizure control.
Funding: None
Neuro Imaging