Dynamic susceptibility contrast enhanced (DSC) MRI perfusion and plasma cytokine levels in patients after tonic-clonic seizures
Article Category: Research Article
Published Online: Aug 14, 2017
Page range: 277 - 285
Received: Apr 17, 2017
Accepted: Jun 14, 2017
DOI: https://doi.org/10.1515/raon-2017-0031
© 2017 Tatjana Filipovic, Katarina Surlan Popovic, Alojz Ihan, David Bozidar Vodusek
This work is licensed under the Creative Commons Attribution 4.0 International License.
Background
Inflammatory events in brain parenchyma and glial tissue are involved in epileptogenesis. Blood concentration of cytokines is shown to be elevated after tonic-clonic seizures. As a result of inflammation, blood-brain barrier leakage occurs. This can be documented by imaging techniques, such is dynamic susceptibility contrast enhanced (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.
Patients and methods
We prospectively enrolled 30 patients, 8–24 hours after single or repeated tonic-clonic seizures.
Results
25 of them had normal perfusion parameters, 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 proinflammatory cytokines IL-10, IFN-ϒ and TNF-α in a whole cohort. In patients with hyperperfusion, there were significantly lower concentrations of antiinflammatory cytokine IL-4 and higher concentrations of proinflammatory TNF-a.
Conclusions
Long lasting blood- brain barrier disruption may be crucial for epileptogenesis in selected patients.