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Journal of Neurosurgical Sciences 2020 October;64(5):456-63

DOI: 10.23736/S0390-5616.17.04015-2


lingua: Inglese

Mapping seizure foci and tumor genetic factors in glioma associated seizure patients

Mao YUNHE 1, Yang YUAN 2, Wang XIANG 2, Liu YANHUI 2, Mao QING 2

1 Department of Neurosurgery, West China Hospital, Si Chuan University, Chengdu, China; 2 West China Hospital, Si Chuan University, Chengdu, China

BACKGROUND: Epilepsy, which is the most common symptom accompanying gliomas, was reported as an independent favorable prognosis factor for glioma patients. However, the correlation between glioma location and epilepsy prognosis, genesis and genetic phenotypes of the glioma associated seizure (GAS) patients is far from clear, the purpose of the current study was to provide probabilistic radiographic atlases reflecting seizure susceptible regions, relationship between tumor associated biomarkers and seizure initiation and poor epilepsy prognosis areas.
METHODS: Preoperative MRIs were collected from 119 newly diagnosed patients with histologically confirmed gliomas. These samples were analyzed for seizure status and tumor genetic makers (TP53 mutations, MMP-9.PTEN, MGMT, EGFR and IDH1) using a statistical voxel-based lesion-symptom mapping (VLSM) method.
RESULTS: We found bilaterally that the frontal lobe containing regions were associated with GAS for low grades gliomas, moreover lesions with the PTEN mutation and IDH1 mutation and seizure susceptible regions were located close together and partially overlapped, Patients with preoperative tumor involving the right frontal lobe may have good seizure control; however, for the glioma-infiltrated regions in front of the precentral regions in the left hemisphere, the epilepsy prognosis is poor.
CONCLUSIONS: The current results of seizure associated molecules and specific regions on structural MRI could be used in preoperative surgical planning, seizure prognosis predictions and anti-epilepsy drug usage.

KEY WORDS: Glioma; Neoplasms; Prognosis

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