Document Detail


Blood-brain barrier disruption in post-traumatic epilepsy.
MedLine Citation:
PMID:  17991703     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Traumatic brain injury (TBI) is an important cause of focal epilepsy. Animal experiments indicate that disruption of the blood-brain barrier (BBB) plays a critical role in the pathogenesis of post-traumatic epilepsy (PTE). OBJECTIVE: To investigate the frequency, extent and functional correlates of increased BBB permeability in patient with PTE. METHODS: 32 head trauma patients were included in the study, with 17 suffering from PTE. Patients underwent brain MRI (bMRI) and were evaluated for BBB disruption, using a novel semi-quantitative technique. Cortical dysfunction was measured using electroencephalography (EEG), and localised using standardised low-resolution brain electromagnetic tomography (sLORETA). RESULTS: Spectral EEG analyses revealed significant slowing in patients with TBI, with no significant differences between patients with epilepsy and those without. Although bMRI revealed that patients with PTE were more likely to present with intracortical lesions (p = 0.02), no differences in the size of the lesion were found between the groups (p = 0.19). Increased BBB permeability was found in 76.9% of patients with PTE compared with 33.3% of patients without epilepsy (p = 0.047), and could be observed years following the trauma. Cerebral cortex volume with BBB disruption was larger in patients with PTE (p = 0.001). In 70% of patients, slow (delta band) activity was co-localised, by sLORETA, with regions showing BBB disruption. CONCLUSIONS: Lasting BBB pathology is common in patients with mild TBI, with increased frequency and extent being observed in patients with PTE. A correlation between disrupted BBB and abnormal neuronal activity is suggested.
Authors:
O Tomkins; I Shelef; I Kaizerman; A Eliushin; Z Afawi; A Misk; M Gidon; A Cohen; D Zumsteg; A Friedman
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Publication Detail:
Type:  Journal Article     Date:  2007-11-08
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  79     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-18     Completed Date:  2008-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  774-7     Citation Subset:  IM    
Affiliation:
Department of Physiology, Zlotowski Center for Neuroscience, Ben-Gurion University, 84105 Beer-Sheva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood-Brain Barrier / metabolism*,  pathology
Brain Injuries / complications*,  metabolism*,  pathology
Capillary Permeability / physiology*
Case-Control Studies
Cohort Studies
Electroencephalography
Epilepsy / etiology*,  metabolism*,  pathology
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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