|Title||Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Johnson EL, Krauss GL, Lee AK, Schneider ALC, Kucharska-Newton AMaria, Huang J, Jack CR|
|Secondary Authors||Gottesman RF|
|Date Published||2019 02 26|
|Keywords||Aged, Cerebral Cortex, Cohort Studies, Epilepsy, Female, Humans, Late Onset Disorders, Logistic Models, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Organ Size, Proportional Hazards Models, Survival Analysis, White Matter|
OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy.
METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and ε4 allele status.
RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95% confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95% CI 1.16-3.02) per age-adjusted SD.
CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.
|PubMed Central ID||PMC6404466|
|Grant List||U01 HL096812 / HL / NHLBI NIH HHS / United States |
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
K24 AG052573 / AG / NIA NIH HHS / United States