Ultrahigh-Field MRI Detection of Biomarkers in Posttraumatic Epilepsy
Abstract
Background: After a traumatic injury to the head – such as might occur if someone hits their head while falling or is struck in the head by a blunt object – new symptoms can develop, even as the initial injury seems to be healing. One of the conditions that can occur following a traumatic injury to the head are recurrent seizures, or post-traumatic epilepsy (PTE). In general, the seizures due to PTE don’t start right away. In fact, there may be months or years between the initial injury and the first seizure. However, previous research has shown that the initial injury can lead to structural changes in the brain. There is no good way to figure out which patients are going to develop epilepsy due to their head injury and which patients will not. This makes it difficult to test out drugs and treatments aimed at preventing PTE and leads to the prescription of drugs aimed at preventing epilepsy to patients with no way of determining what the risk of developing epilepsy is for that individual patient. Magnetic resonance imaging (MRI) is used to investigate changes in brain tissue without the need for invasive procedures, and is commonly used to diagnose and assess people with epilepsy. Ultra-high field MRI, such as systems where the MRI is operating at field strengths of 7 Tesla, has allowed us to create sharper, more highly detailed images of the brain than ever before. Research into epilepsy (not caused by a head injury) has revealed that there are a number of abnormalities in the brains of people with epilepsy that we can now detect using ultra-high field MRI. These changes include alterations to the way the brain is connected, changes to the way blood vessels are distributed, and changes to the chemicals, or brain metabolites, being produced and used by the brain. Although some of these changes are located in the part of the brain thought to be causing the seizures, there are a number of other changes that have been detected which aren’t. We believe that by using advanced imaging technology and new imaging methods and analyses, we can detect changes in the brain that may indicate whether a patient with a brain injury is likely to develop epilepsy. We hypothesize that after a head injury, structural changes occur in the patient’s brain; we believe that these changes will occur both at the site of the injury and in other locations. Finally, we think that by comparing images acquired from the brains of patients with PTE and the brains of patients who have had a head injury but not developed epilepsy, we will be able to figure out what to look for in the brains of patients in order to predict which patients are at risk of developing PTE and which are not. Goal 1: We are going to start by collecting brain images from patients who have PTE and images from patients with no previous brain injury. We are going to use the images to measure how their brains are connected. Particularly we are going to look at: (A) short connections along the surface of the brain that might affect how the abnormal signals that cause seizures spread; (B) how the parts of the hippocampus, the memory center of the brain are connected; (C) volumes of different parts of the thalamus – the router of the brain; (D) how blood vessels are distributed, both in size and number; and (E) the quantity and ratio of different chemicals (or metabolites) produced the cells of the brain, which will tell us if certain brain processes have been affected. Goal 2: Once we have assessed which of these indices have changed in patients with PTE, we are going to look at the same set of images for patients who have had a brain injury, but have not developed epilepsy. We are also going to compare to a database of images of patients who have epilepsy but have not had a brain injury. We will then evaluate all of the markers and identify which are common for all patients, which are common only to patients who have had a traumatic injury, and which are comm
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910616
Entities
People
- Rebecca E Feldman
Organizations
- Icahn School of Medicine at Mount Sinai
- United States Army