Publications

Seizure-susceptible brain regions in glioblastoma: identification of patients at risk

authors:

  • Cayuela, N.
    • ,
  • Simó, M.
    • ,
  • Majós, C.
    • ,
  • Rifà-Ros, X.
    • ,
  • Gállego, J.
    • ,
  • Ripollés, P.
    • ,
  • Vidal, N.
    • ,
  • Miró, J.
    • ,
  • Gil, F.
    • ,
  • Gil-Gil, M.
    • ,
  • Plans, G.
    • ,
  • Graus, F.
    • ,
  • Bruna, J.
    • (2018)

Abstract

Background: The main aim of this study was to identify which glioblastoma multiforme (GBM) patients have a higher risk to present seizures during follow-up.

Methods: Patients with newly diagnosed GBM were reviewed (n=306), and classified in patients with (Group 1) and without (Group 2) seizures at onset. Group 2 was split into patients with seizures during follow-up (Group 2A) and patients who never had seizures (Group 2B). Anatomical location of GBM was identified and compared by voxel-based lesion symptom mapping (VLSM) (discovery set). Seizures-susceptible brain regions obtained were assessed visually and automatically in an external GBM validation series (n=85).

Results: In GBM patients who had no seizures at onset, an increased risk of presenting seizures during follow-up were identified in the superior frontal and inferior occipital lobe, as well as in inferoposterior regions of temporal lobe. Conversely, those GBM located in medial and inferoanterior temporal areas had a significantly lower risk of suffering from seizures during follow-up. Additionally, the seizures-susceptible brain regions maps obtained, classified patients in the validation set with high positive and negative predictive values.

Conclusions: Tumor location is a useful marker to identify GBM patients at risk of suffering from seizures during follow-up. These results may help to support the use of antiepileptic prophylaxis in a selected GBM population and to improve stratification in antiepileptic clinical trials.