Glymphatic system dysfunction in epilepsy: a systematic review and meta-analysis.
Rishu Raj, Arkansh Sharma, Annu Singhal et al.
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In 30 seconds
This systematic review and meta-analysis examined glymphatic system dysfunction in epilepsy by analyzing DTI-ALPS-derived indices across 17 studies involving 1,255 participants. The results indicated that DTI-ALPS values were significantly lower in epilepsy patients compared to healthy controls (MD -0.157, 95% CI -0.197 to -0.116; p < 0.0001), suggesting a potential neuroimaging biomarker for glymphatic impairment in epilepsy.
Key findings
- DTI-ALPS values were significantly reduced in epilepsy patients compared to controls (MD -0.157, 95% CI -0.197 to -0.116; p < 0.0001).
- Disease duration showed the strongest inverse correlation with DTI-ALPS values (r = -0.392; p = 0.0014).
- Age at epilepsy onset had a modest association with DTI-ALPS values (r = -0.148; p = 0.020).
- Trim-and-fill-adjusted estimates remained significant (MD -0.107, 95% CI -0.156 to -0.059).
Why it matters
Understanding glymphatic dysfunction in epilepsy may provide insights into disease mechanisms and potential biomarkers for monitoring disease progression. This could enhance clinical management and therapeutic strategies for epilepsy patients.
What to keep in mind
Substantial heterogeneity among studies and possible confounding factors related to medication use limit the current findings.