Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy

Objective: Recent studies revealed the effect of valproate (VPA) on brain structural changes in idiopathic generalized epilepsy (IGE). We aimed to investigate the volume of the entire hippocampus and subfields in patients with IGE, and explored their associations with VPA use. Methods: A total of 21...

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Main Authors: Xiang Huang, Yingying Zhang, Qiuxing Lin, Kailing Huang, Yuming Li, Peiwen Liu, Danyang Cao, Wenhao Li, Wei Li, Xiuli Li, Qiyong Gong, Dong Zhou, Dongmei An
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:NeuroImage: Clinical
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213158225000142
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author Xiang Huang
Yingying Zhang
Qiuxing Lin
Kailing Huang
Yuming Li
Peiwen Liu
Danyang Cao
Wenhao Li
Wei Li
Xiuli Li
Qiyong Gong
Dong Zhou
Dongmei An
author_facet Xiang Huang
Yingying Zhang
Qiuxing Lin
Kailing Huang
Yuming Li
Peiwen Liu
Danyang Cao
Wenhao Li
Wei Li
Xiuli Li
Qiyong Gong
Dong Zhou
Dongmei An
author_sort Xiang Huang
collection DOAJ
description Objective: Recent studies revealed the effect of valproate (VPA) on brain structural changes in idiopathic generalized epilepsy (IGE). We aimed to investigate the volume of the entire hippocampus and subfields in patients with IGE, and explored their associations with VPA use. Methods: A total of 211 patients with IGE and 97 healthy controls (HCs) were enrolled in this study. All participants underwent T1-weighted images. Each hippocampus was segmented into seven subfields using HippUnfold. The volumes of bilateral hippocampi and each hippocampal subfield were evaluated. Spearman correlation analyses were performed to identify VPA use related abnormalities in IGE. Subgroup analyses for juvenile myoclonic epilepsy (JME), epilepsy with generalized tonic–clonic seizures alone (GTCA), and absence epilepsy (AE) were conducted. Results: The volumes of bilateral hippocampi were reduced in IGE compared with HCs. Subgroup analysis showed significant volume reductions in right hippocampus and its subfields in GTCA. Additionally, significant volume reductions were detected in bilateral hippocampal volumes and subfields in IGE patients currently taking VPA compared with HCs. A negative correlation was observed between the left CA2 volume and the age of onset. Conclusions: Our study revealed volume reductions in bilateral hippocampi in IGE, as well as in the right hippocampus and its subfields in GTCA. Abnormalities in both subfields and the whole hippocampus were associated with VPA use. These findings suggest that VPA may have more extensive neuroanatomical effects in IGE, potentially accounting for the heterogeneity observed in neuroimaging studies.
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spelling doaj-art-9b98c73d340542d2b0447e6d45ae80b02025-02-06T05:11:34ZengElsevierNeuroImage: Clinical2213-15822025-01-0145103744Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsyXiang Huang0Yingying Zhang1Qiuxing Lin2Kailing Huang3Yuming Li4Peiwen Liu5Danyang Cao6Wenhao Li7Wei Li8Xiuli Li9Qiyong Gong10Dong Zhou11Dongmei An12Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Geriatric Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, ChinaHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Corresponding authors.Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Corresponding authors.Objective: Recent studies revealed the effect of valproate (VPA) on brain structural changes in idiopathic generalized epilepsy (IGE). We aimed to investigate the volume of the entire hippocampus and subfields in patients with IGE, and explored their associations with VPA use. Methods: A total of 211 patients with IGE and 97 healthy controls (HCs) were enrolled in this study. All participants underwent T1-weighted images. Each hippocampus was segmented into seven subfields using HippUnfold. The volumes of bilateral hippocampi and each hippocampal subfield were evaluated. Spearman correlation analyses were performed to identify VPA use related abnormalities in IGE. Subgroup analyses for juvenile myoclonic epilepsy (JME), epilepsy with generalized tonic–clonic seizures alone (GTCA), and absence epilepsy (AE) were conducted. Results: The volumes of bilateral hippocampi were reduced in IGE compared with HCs. Subgroup analysis showed significant volume reductions in right hippocampus and its subfields in GTCA. Additionally, significant volume reductions were detected in bilateral hippocampal volumes and subfields in IGE patients currently taking VPA compared with HCs. A negative correlation was observed between the left CA2 volume and the age of onset. Conclusions: Our study revealed volume reductions in bilateral hippocampi in IGE, as well as in the right hippocampus and its subfields in GTCA. Abnormalities in both subfields and the whole hippocampus were associated with VPA use. These findings suggest that VPA may have more extensive neuroanatomical effects in IGE, potentially accounting for the heterogeneity observed in neuroimaging studies.http://www.sciencedirect.com/science/article/pii/S2213158225000142ValproateHippocampusIdiopathic Generalized EpilepsyHippUnfold
spellingShingle Xiang Huang
Yingying Zhang
Qiuxing Lin
Kailing Huang
Yuming Li
Peiwen Liu
Danyang Cao
Wenhao Li
Wei Li
Xiuli Li
Qiyong Gong
Dong Zhou
Dongmei An
Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
NeuroImage: Clinical
Valproate
Hippocampus
Idiopathic Generalized Epilepsy
HippUnfold
title Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
title_full Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
title_fullStr Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
title_full_unstemmed Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
title_short Association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
title_sort association of valproate use and hippocampal atrophy in idiopathic generalized epilepsy
topic Valproate
Hippocampus
Idiopathic Generalized Epilepsy
HippUnfold
url http://www.sciencedirect.com/science/article/pii/S2213158225000142
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