دورية أكاديمية
Retinal nerve fibre layer thinning is associated with drug resistance in epilepsy.
العنوان: | Retinal nerve fibre layer thinning is associated with drug resistance in epilepsy. |
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المؤلفون: | Balestrini S; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK Neuroscience Department, Polytechnic University of Marche, Ancona, Italy., Clayton LM; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Bartmann AP; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Chinthapalli K; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Novy J; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Coppola A; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Wandschneider B; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Stern WM; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Acheson J; Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, UK., Bell GS; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK., Sander JW; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK Stichting Epilepsie Instellingen Nederland, Heemstede (SEIN), Heemstede, The Netherlands., Sisodiya SM; Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London, UK. |
المصدر: | Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2016 Apr; Vol. 87 (4), pp. 396-401. Date of Electronic Publication: 2015 Apr 17. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 2985191R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-330X (Electronic) Linking ISSN: 00223050 NLM ISO Abbreviation: J Neurol Neurosurg Psychiatry Subsets: MEDLINE |
أسماء مطبوعة: | Publication: London : BMJ Publishing Group Original Publication: London : British Medical Association |
مواضيع طبية MeSH: | Drug Resistant Epilepsy/*pathology , Retinal Neurons/*pathology, Adult ; Anticonvulsants/adverse effects ; Anticonvulsants/therapeutic use ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Intellectual Disability/complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Fibers/pathology ; Tomography, Optical Coherence ; Vigabatrin/adverse effects ; Vigabatrin/therapeutic use ; Visual Fields |
مستخلص: | Objective: Retinal nerve fibre layer (RNFL) thickness is related to the axonal anterior visual pathway and is considered a marker of overall white matter 'integrity'. We hypothesised that RNFL changes would occur in people with epilepsy, independently of vigabatrin exposure, and be related to clinical characteristics of epilepsy. Methods: Three hundred people with epilepsy attending specialist clinics and 90 healthy controls were included in this cross-sectional cohort study. RNFL imaging was performed using spectral-domain optical coherence tomography (OCT). Drug resistance was defined as failure of adequate trials of two antiepileptic drugs to achieve sustained seizure freedom. Results: The average RNFL thickness and the thickness of each of the 90° quadrants were significantly thinner in people with epilepsy than healthy controls (p<0.001, t test). In a multivariate logistic regression model, drug resistance was the only significant predictor of abnormal RNFL thinning (OR=2.09, 95% CI 1.09 to 4.01, p=0.03). Duration of epilepsy (coefficient -0.16, p=0.004) and presence of intellectual disability (coefficient -4.0, p=0.044) also showed a significant relationship with RNFL thinning in a multivariate linear regression model. Conclusions: Our results suggest that people with epilepsy with no previous exposure to vigabatrin have a significantly thinner RNFL than healthy participants. Drug resistance emerged as a significant independent predictor of RNFL borderline attenuation or abnormal thinning in a logistic regression model. As this is easily assessed by OCT, RNFL thickness might be used to better understand the mechanisms underlying drug resistance, and possibly severity. Longitudinal studies are needed to confirm our findings. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/) |
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معلومات مُعتمدة: | United Kingdom Wellcome Trust; 084730 United Kingdom Wellcome Trust |
المشرفين على المادة: | 0 (Anticonvulsants) GR120KRT6K (Vigabatrin) |
تواريخ الأحداث: | Date Created: 20150419 Date Completed: 20160725 Latest Revision: 20190131 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC4819648 |
DOI: | 10.1136/jnnp-2015-310521 |
PMID: | 25886782 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1468-330X |
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DOI: | 10.1136/jnnp-2015-310521 |