Evidence map›Paper›PMID 37857465›Full record

ArticleEpilepsia2023

Altered amygdala volumes and microstructure in focal epilepsy patients with tonic-clonic seizures, ictal, and post-convulsive central apnea.

Claudia Zeicu, Antoine Legouhy, Catherine A Scott, Joana F A Oliveira, Gavin P Winston, John S Duncan, Sjoerd B Vos, Maria Thom, Samden Lhatoo, Hui Zhang and 2 more

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

Article in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
3.3field-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

17 citing papers in PubMed, 15 citations in OpenAlex.

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  17. Repeated seizures lead to progressive ventilatory dysfunction in SSJournal of applied physiology (Bethesda, Md. : 1985) · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 4 countries.

Claudia ZeicuDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.ORCID 0000-0001-8566-2625
Antoine LegouhyCentre for Medical Image Computing and Department of Computer Science, University College London, London, UK.
Catherine A ScottDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
Joana F A OliveiraDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
Gavin P WinstonDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.ORCID 0000-0001-9395-1478
John S DuncanDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.
Sjoerd B VosCentre for Medical Image Computing and Department of Computer Science, University College London, London, UK.ORCID 0000-0002-8502-4487
Maria ThomDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.ORCID 0000-0001-7712-2629
Samden LhatooDepartment of Neurology, University of Texas Health Sciences Center at Houston, Houston, Texas, USA.ORCID 0000-0002-0260-3855
Hui ZhangCentre for Medical Image Computing and Department of Computer Science, University College London, London, UK.
Ronald M HarperBrain Research Institute, University of California at Los Angeles, Los Angeles, California, USA.
Beate DiehlDepartment of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.ORCID 0000-0002-6896-854X
National Hospital for Neurology and Neurosurgery · GBUniversity College London Hospitals NHS Foundation Trust · GBUniversity College London · GBQueen's University · CAThe University of Texas Health Science Center at Houston · USThe University of Western Australia · AUUniversity of California, Los Angeles · US

Funding

SUDEP Translational Research Alliance (SUTRA): Autonomic and Imaging Biomarkers of SUDEP; SUTRA 3 of 7U01NS090407 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI DIEHL, BEATE, HARPER, RONALD MARVEN · 2014 to 2018
$7.3M
The Administrative Core of the Center of SUDEP ResearchU01NS090405 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI LHATOO, SAMDEN, NOEBELS, JEFFREY · 2014 to 2018
$3.2M
Medical Research Council G0802012 MR/M00841X/1NINDS NIH HHS NS090405NINDS NIH HHS U01 NS090405NINDS NIH HHS U01 NS090407NINDS NIH HHS U01-NS090407
6 · The paper itself

Abstract

objectivesSudden unexpected death in epilepsy (SUDEP) is a leading cause of death for patients with epilepsy; however, the pathophysiology remains unclear. Focal-to-bilateral tonic-clonic seizures (FBTCS) are a major risk factor, and centrally-mediated respiratory depression may increase the risk further. Here, we determined the volume and microstructure of the amygdala, a key structure that can trigger apnea in people with focal epilepsy, stratified by the presence or absence of FBTCS, ictal central apnea (ICA), and post-convulsive central apnea (PCCA).

methodsSeventy-three patients with focal impaired awareness seizures without FBTC seizures (FBTCneg group) and 30 with FBTCS (FBTCpos group) recorded during video electroencephalography (VEEG) with respiratory monitoring were recruited prospectively during presurgical investigations. We acquired high-resolution T1-weighted anatomic and multi-shell diffusion images, and computed neurite orientation dispersion and density imaging (NODDI) metrics in all patients with epilepsy and 69 healthy controls. Amygdala volumetric and microstructure alterations were compared between three groups: healthy subjects, FBTCneg and FBTCpos groups. The FBTCpos group was further subdivided by the presence of ICA and PCCA, verified by VEEG.

resultsBilateral amygdala volumes were significantly increased in the FBTCpos cohort compared to healthy controls and the FBTCneg group. Patients with recorded PCCA had the highest increase in bilateral amygdala volume of the FBTCpos cohort. Amygdala neurite density index (NDI) values were decreased significantly in both the FBTCneg and FBTCpos groups relative to healthy controls, with values in the FBTCpos group being the lowest of the two. The presence of PCCA was associated with significantly lower NDI values vs the non-apnea FBTCpos group (p = 0.004). SIGNIFICANCE: Individuals with FBTCpos and PCCA show significantly increased amygdala volumes and disrupted architecture bilaterally, with greater changes on the left side. The structural alterations reflected by NODDI and volume differences may be associated with inappropriate cardiorespiratory patterns mediated by the amygdala, particularly after FBTCS. Determination of amygdala volumetric and architectural changes may assist identification of individuals at risk.

Indexed as

Epilepsies, PartialEpilepsyEpilepsy, Tonic-ClonicSleep Apnea, CentralAmygdalaApneaElectroencephalographyHumansSeizuresamygdalaapneadiffusion MRINODDISUDEPtonic-clonic seizures

Identifiers

PMID37857465
PMCPMC10952501
OpenAlexW4387768945

What OpenQuestion holds

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Registered trials

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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.