MRI of inflammation in epilepsy
Research type
Research Study
Full title
Identifying MRI and blood biomarkers of neuroinflammation in treatment pharmacoresistent epilepsy
IRAS ID
220138
Contact name
Anthony Marson
Contact email
Sponsor organisation
The University of Liverpool
Duration of Study in the UK
2 years, 7 months, 1 days
Research summary
Summary of Research
For patients with epilepsy, the use of anti-epileptic drugs (AEDs) helps to control seizures; up to 70% patients no longer experience seizures after AED administration. However, for the remainder of patients, AEDs do not control seizures. It is thought that inflammation in the brain may be a contributing factor to the development and progression of epilepsy, and in particular may contribute to medically refractory epilepsy. Furthermore, it is important to understand the role of brain connectivity win epilepsy and how connectivity is related to patient response to AEDs.\n\nWe will perform quantitative MRI studies in (i) patients with well-controlled epilepsy, (ii) patients with medically refractory epilepsy, and (iii) healthy controls, who will be scanned at the Magnetic Resonance and Image Analysis Research Centre (MARIARC), University of Liverpool. One part of the MRI protocol will be to investigate whether this method of safe non-invasive imaging can identify markers of brain inflammation. Because it is not known whether MRI can reliably identify brain inflammation, we will also obtain peripheral markers of inflammation from blood serum in all participants, and investigate the relationship between central (imaging) and peripheral (serum) inflammation. Inflammatory markers and imaging measures of brain connectivity may differentiate patients from controls, and potentially patients who respond to AEDs and those who do not. We anticipate that patients with medically refractory epilepsy will show increased brain inflammation compared to patients with well-controlled epilepsy, and healthy controls. This research may help inform future treatment strategies in patients with epilepsy.
Summary of Results
This project provided pilot data for the use of novel MRI approaches to study epilepsy. One of the MRI approaches was thought to be a marker of inflammation in the brain. There is still that potential, but this was not ascertained in the study. We recruited the intended 30 patients with long-term epilepsy and 15 healthy controls. We found that a special MRI approach sensitive to water diffusion in the brain identified differences between patients and controls, and between patients with refractory (uncontrolled) seizures and patients with well-controlled seizures. We have disseminated those findings in two publications (PMID: 33605514, 34974117). We also took blood samples from all participants to look at circulating inflammatory biomarkers. Unfortunately, there were no clear findings and this data was not published. All of the work done in context of this REC approval was written up by the student (Bryant) as a PhD thesis and is now freely available online and held by the University of Liverpool library repository (https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbQcg6foIs2yPgFNdqcGkOZaPJiY4bZATpsl-2FzKZINd7-2Bgm3axN-2Bo27ieSPynKDUkVQ-3D-3Dnrmr_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YLBL-2BT3I2KXNX8mjF2Yr2GuI0YrZqtIlAnU7igqIae7PDS0xCaaFT6-2Bmn4bJqvaj7BdqABJbJeMdmbtGNPntOpZSzYHzF48cWEF-2BRkaF6Gd4YA5U-2BF27iDnQq8pv-2BPbW0b3TiZa4vCx-2FQ1ST63RbmE3WeAh1nBsg7hwj-2BzifRfYVw-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7C4ca8b4fafe394c536f9a08da6d9e171c%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C637942823000072212%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=aFuPTnZMpuXIto67WtajCqCk%2BA9l8JCoYCYvcSQEwBE%3D&reserved=0
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
17/NW/0342
Date of REC Opinion
12 Jul 2017
REC opinion
Further Information Favourable Opinion