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Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy.

TitleAssociation between white matter hyperintensities, cortical volumes, and late-onset epilepsy.
Publication TypeJournal Article
Year of Publication2019
AuthorsJohnson EL, Krauss GL, Lee AK, Schneider ALC, Kucharska-Newton AMaria, Huang J, Jack CR
Secondary AuthorsGottesman RF
JournalNeurology
Volume92
Issue9
Paginatione988-e995
Date Published2019 02 26
ISSN1526-632X
KeywordsAged, 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
Abstract

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 Īµ4 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.

DOI10.1212/WNL.0000000000007010
Alternate JournalNeurology
PubMed ID30804067
PubMed Central IDPMC6404466
Grant ListU01 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