Epilepsy is linked to volume and thickness in the grey matter regions of the brain, according to the findings of the largest neuro-imaging study to date, reported today.
The findings by University College London (UCL) and the Keck School of Medicine of USC, Los Angeles USA, show that epilepsy has greater physical differences than previously believed.
Lead study author Professor Sanjay Sisodiya, of UCL Institute of Neurology & Epilepsy Society, said: “We found differences in brain matter even in common epilepsies that are often considered to be comparatively benign.
“While we haven’t yet assessed the impact of these differences, our findings suggest there’s more to epilepsy than we realise, and now we need to do more research to understand the causes of these differences.”
The study, which is published in the latest edition of Brain, was conducted by the global ENIGMA-Epilepsy consortium and pooled data from 24 research centres across Europe, North and South America, Asia and Australia.
Structural brain measures from MRI brain scans were taken from 2,149 people with epilepsy and 1,727 people without the condition and the researchers found reduced thickness of grey matter in parts of the brain’s cortex and reduced volume in subcortical brain regions in all epilepsy groups when compared to the control group.
Reduced volume and thickness were associated with longer duration of epilepsy, while the study also found that people with epilepsy had lower volume in the right thalamus and reduced thickness in the motor cortex.
The team said these differences were also found in people with idiopathic generalised epilepsies, which are characterised by a lack of any noticeable changes in the brain.
First author Dr Christopher Whelan, of the Keck School of Medicine of USC and also the Royal College of Surgeons in Ireland, said: “Some of the differences we found were so subtle they could only be detected due to the large sample size that provided us with very robust, detailed data.
“We have identified a common neuroanatomical signature of epilepsy, across multiple epilepsy types. We found that structural changes are present in multiple brain regions, which informs our understanding of epilepsy as a network disorder.”
The authors now want to follow up their study with longitudinal and genetic studies, which could help them to establish the cause of the structural differences.
Whelan C et al. Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA stud. Brain 22 January 2018.
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