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Published in: Journal of Neurology 4/2022

01-04-2022 | Juvenile Myoclonic Epilepsy | Original Communication

Glymphatic system dysfunction in patients with juvenile myoclonic epilepsy

Authors: Ho-Joon Lee, Dong Ah Lee, Kyong Jin Shin, Kang Min Park

Published in: Journal of Neurology | Issue 4/2022

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Abstract

Objective

The glymphatic system is a glial cell-dependent waste clearance pathway in the brain that is essential for the maintenance of brain homeostasis. In this study, we evaluated glymphatic system function in patients with juvenile myoclonic epilepsy (JME) compared with healthy controls.

Methods

Patients with JME and healthy controls were retrospectively enrolled in this study. All the participants underwent brain diffusion tensor imaging (DTI). The “DTI-analysis along the perivascular space (ALPS)”-index was calculated to evaluate the glymphatic system function of the participants. The ALPS-indices of the patients with JME were compared with those of the healthy controls. In addition, the correlations between ALPS-index and the clinical characteristics of the patients with JME were analyzed to validate changes in glymphatic system function.

Results

A total of 39 patients with JME and 38 healthy controls were enrolled in this study. The mean ALPS- index of the patients with JME was significantly lower than that of the healthy controls (1.541 vs. 1.653, p = 0.041). ALPS-index was negatively correlated with age in patients with JME (r = -0.375, p = 0.018). However, ALPS-index was not correlated with age at onset, duration of epilepsy, or anti-seizure medication load in patients with JME.

Conclusion

This study is the first in which the ALPS method was used to demonstrate that patients with JME have significant glymphatic system dysfunction. The results also show that glymphatic system index is negatively correlated with age in patients with JME, a finding which demonstrates that the glymphatic system function of patients with JME gradually declines with age. The ALPS-index might be a potential biomarker for monitoring glymphatic system function in patients with epilepsy.
Literature
11.
go back to reference Taoka T, Masutani Y, Kawai H, Nakane T, Matsuoka K, Yasuno F, Kishimoto T, Naganawa S (2017) Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space (DTI-ALPS) in Alzheimer’s disease cases. Jpn J Radiol 35(4):172–178. https://doi.org/10.1007/s11604-017-0617-zCrossRefPubMed Taoka T, Masutani Y, Kawai H, Nakane T, Matsuoka K, Yasuno F, Kishimoto T, Naganawa S (2017) Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space (DTI-ALPS) in Alzheimer’s disease cases. Jpn J Radiol 35(4):172–178. https://​doi.​org/​10.​1007/​s11604-017-0617-zCrossRefPubMed
28.
go back to reference Hanael E, Veksler R, Friedman A, Bar-Klein G, Senatorov VV Jr, Kaufer D, Konstantin L, Elkin M, Chai O, Peery D, Shamir MH (2019) Blood-brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast-enhanced magnetic resonance imaging. Epilepsia 60(5):1005–1016. https://doi.org/10.1111/epi.14739CrossRefPubMed Hanael E, Veksler R, Friedman A, Bar-Klein G, Senatorov VV Jr, Kaufer D, Konstantin L, Elkin M, Chai O, Peery D, Shamir MH (2019) Blood-brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast-enhanced magnetic resonance imaging. Epilepsia 60(5):1005–1016. https://​doi.​org/​10.​1111/​epi.​14739CrossRefPubMed
Metadata
Title
Glymphatic system dysfunction in patients with juvenile myoclonic epilepsy
Authors
Ho-Joon Lee
Dong Ah Lee
Kyong Jin Shin
Kang Min Park
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 4/2022
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-021-10799-w

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