Introduction: Iron deposition plays a significant role in epilepsy associated with cerebral cavernous malformations. This study aims to correlate lesion iron deposition, assessed through quantitative susceptibility mapping, with clinical and disease characteristics in patients with cerebral cavernous malformations related epilepsy.
Methods: As part of a prospective multicenter cohort study, Quantitative Susceptibility Biomarker and Brain Structural Property for Cerebral Cavernous Malformation Related Epilepsy (CRESS), this research utilized quantitative susceptibility mapping to quantify iron deposition in patients with sporadic cerebral cavernous malformations. Lesions were segmented into intralesional, perilesional, and extralesional areas. The mean susceptibility of each cerebral cavernous malformation lesion and its subregions were measured and correlated with the severity and duration of epilepsy.
Results: Among the 46 patients studied, those with a history of epilepsy had significantly higher iron deposition values in the perilesional (P=0.012) and extralesional areas (P=0.01), as well as a greater extent of iron deposition (P < 0.001) compared to those without epilepsy. The extent of iron deposition effectively distinguished patients with and without epilepsy, with an AUC of 0.901 (95% CI 0.816-0.985). Among patients with epilepsy, iron deposition in the extralesional area was positively correlated with the severity of epilepsy (r²=0.181, P=0.043), and the extent of iron deposition was positively correlated with the duration of epilepsy (r²=0.214, P=0.026).
Conclusion : Higher iron deposition in the perilesional and extralesional areas is associated with the presence and severity of epilepsy in patients with sporadic cerebral cavernous malformations.
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