当前位置： SCI文献检索 > EPILEPSIA期刊下所有文献 > Cliniconeuropathologic correlations show astroglial albumin storage as a common factor in epileptogenic vascular lesions.

Cliniconeuropathologic correlations show astroglial albumin storage as a common factor in epileptogenic vascular lesions.

Abstract：

PURPOSE:Intracerebral vascular malformations including cavernous angiomas (CAs) and arteriovenous malformations (AVMs) are an important cause of chronic pharmacoresistant epilepsies. Little is known about the pathogenetic basis of epilepsy in patients with vascular malformations. Intracerebral deposits of iron-containing blood products have been generally regarded as responsible for the strong epileptogenic potential of CAs. Here, we have analyzed whether blood-brain barrier (BBB) dysfunction and subsequent astrocytic albumin uptake, recently described as critical trigger of focal epilepsy, represent pathogenetic factors in vascular lesion-associated epileptogenesis. METHODS:We examined the correlation between hemosiderin deposits, albumin accumulation, and several clinical characteristics in a series of 80 drug-refractory epilepsy patients with CAs or AVMs who underwent surgical resection. Analysis of clinical parameters included gender, age of seizure onset, epilepsy frequency, duration of epilepsy before surgery, and postoperative seizure outcome classification according to Engel class scale. Hemosiderin deposits in the adjacent brain tissue of the vascular lesion were semiquantitatively analyzed. Fluorescent double-immunohistochemistry using GFAP/albumin costaining was performed to study albumin extravasation. KEY FINDINGS:Our results suggest that a shorter duration of preoperative epilepsy is correlated with significantly better postsurgical outcome (p < 0.05), whereas no additional clinical or neuropathologic parameter correlated significantly with the postsurgical seizure situation. Intriguingly, we observed strong albumin immunoreactivity within the vascular lesion and in perilesional astrocytes (57.65 ± 4.05%), but not in different control groups. SIGNIFICANCE:Our present data on albumin uptake in brain tissue adjacent to AVMs and CAs suggests BBB dysfunction and accumulation of albumin within astrocytes as a new pathologic feature potentially associated with the epileptogenic mechanism for vascular lesions and provides novel therapy perspectives for antiepileptogenesis in affected patients.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Raabe A,Schmitz AK,Pernhorst K,Grote A,von der Brelie C,Urbach H,Friedman A,Becker AJ,Elger CE,Niehusmann P

doi

10.1111/j.1528-1167.2012.03405.x

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

539-48

issue

eissn

0013-9580

issn

1528-1167

journal_volume

pub_type

杂志文章

在线工具

Cliniconeuropathologic correlations show astroglial albumin storage as a common factor in epileptogenic vascular lesions.