Evidence map›Paper›PMID 32675079›Full record

ArticleNeurology2020

Postictal brainstem hypoperfusion and risk factors for sudden unexpected death in epilepsy.

Jonathan Liu, Joseph S Peedicail, Ismael Gaxiola-Valdez, Emmy Li, Victoria Mosher, William Wilson, Tefani Perera, Shaily Singh, G Campbell Teskey, Paolo Federico and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. A Postictal Traffic Jam.Epilepsy currents
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Jonathan LiuFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Joseph S PeedicailFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Ismael Gaxiola-ValdezFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Emmy LiFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Victoria MosherFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
William WilsonFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Tefani PereraFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Shaily SinghFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
G Campbell TeskeyFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada.
Paolo FedericoFrom Hotchkiss Brain Institute (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., G.C.T., P.F.), Seaman Family MR Research Centre (J.L., J.S.P., I.G.-V., E.L., V.M., W.W., T.P., S.S., P.F.), Department of Clinical Neurosciences (J.S.P., S.S., P.F.), and Department of Radiology (P.F.), Cumming School of Medicine, University of Calgary, Canada. pfederic@ucalgary.ca.
Calgary Comprehensive Epilepsy Program Collaborators
S.P.E.C.I.E.S. · US

Funding

CIHR MOP-136839
6 · The paper itself

Abstract

objectiveSince the strongest risk factor for sudden unexpected death in epilepsy (SUDEP) is frequent bilateral tonic-clonic seizures (BTCS), our aim was to determine whether postictal hypoperfusion in brainstem respiratory centers (BRCs) is more common following tonic-clonic seizures.

methodsWe studied 21 patients with focal epilepsies who underwent perfusion imaging with arterial spin labeling MRI. Subtraction maps of cerebral blood flow were obtained from the postictal and baseline scans. We identified 6 regions of interest in the brainstem that contain key BRCs. Patients were considered to have postictal BRC hypoperfusion if any of the 6 regions of interest were significantly hypoperfused.

resultsAll 6 patients who experienced BTCS during the study had significant clusters of postictal hypoperfusion in BRCs compared to 7 who had focal impaired awareness seizures (7/15). The association between seizure type studied and the presence of BRC hypoperfusion was significant. Duration of epilepsy and frequency of BTCS were not associated with postictal brainstem hypoperfusion despite also being associated with risk for SUDEP.

conclusionPostictal hypoperfusion in brainstem respiratory centers occurs more often following BTCS than other seizure types, providing a possible explanation for the increased risk of SUDEP in patients who regularly experience BTCS.

Indexed as

AdultBrain StemCerebrovascular CirculationEpilepsies, PartialFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPerfusion ImagingRisk FactorsSeizuresSudden Unexpected Death in EpilepsyYoung Adult

Identifiers

PMID32675079
PMCPMC7713728
OpenAlexW3042751754

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.