Seizures are a potentially devastating complication of brain tumors
1
and negatively affect quality of life and neurocognitive function,
- Stupp R.
- Mason W.P.
- van den Bent M.J.
- et al.
European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy
Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus
concomitant and adjuvant temozolomide for glioblastoma.
N Engl J Med. 2005; 352: 987-996
2
with a burden of disease that includes psychosocial, economic, and management ramifications.
3
Both gliomas and seizures arise directly from the brain and alter multiple large-scale
networks of neuronal function and connectivity, leading to bihemispheric disruption.
4
Changes in functional connectivity affecting both hemispheres of patients have been
found using electroencephalography, magnetoencephalography, functional magnetic resonance
imaging, and magnetic resonance tractography despite the presence of a tumor isolated
to a single hemisphere.
3
Widespread global decreases in functional connectivity observed in patients with
focal epilepsy probably reflect the deleterious electrophysiological effects of recurrent
seizures as opposed to primarily metabolic alterations in remote areas.
4
Magnetoencephalographic recordings have exhibited similar alterations in functional
connectivity in broadband frequency (0.5-60 Hz) and gamma frequency (30-80 Hz) analyses
widely distributed in remote areas of the brain in patients with tumor.
3
Electrophysiological techniques correlating frequency domains and measures of Granger
causality phase locking in gliomas and epilepsy could provide a link to the global
network disruption caused by seizures.
4
Even gross total resection of brain tumors and a suspected epileptogenic zone may
not result in successful outcomes because of preexisting functional connectivity in
remaining brain regions.
3
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References
- European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.N Engl J Med. 2005; 352: 987-996
- Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life.Ann Neurol. 2003; 54: 514-520
- How do brain tumors alter functional connectivity? A magnetoencephalography study.Ann Neurol. 2006; 59: 128-138
- Global and regional functional connectivity maps of neural oscillations in focal epilepsy.Brain. 2015; 138: 2249-2262
- High-frequency oscillations in awake patients undergoing brain tumor-related epilepsy surgery.Neurology. 2018; 90: e1119-e1125
- Seizures and gliomas—towards a single therapeutic approach.Nat Rev Neurol. 2016; 12: 204-216
- Seizure prophylaxis in patients with brain tumors: a meta-analysis.Mayo Clin Proc. 2004; 79: 1489-1494
- Postoperative seizure control in patients with tumor-associated epilepsy.Epilepsia. 2016; 57: 1779-1788
- Upregulation of breast cancer resistance protein and major vault protein in drug resistant epilepsy.Seizure. 2017; 47: 9-12
- Seizure outcome after radiotherapy and chemotherapy in low-grade glioma patients: a systematic review.Neuro Oncol. 2015; 17: 924-934
- Factors associated with seizure freedom in the surgical resection of glioneuronal tumors.Epilepsia. 2012; 53: 51-57
- Efficacy of anti-epileptic drugs in patients with gliomas and seizures.J Neurol. 2009; 256: 1519-1526
- Effect of valproic acid on seizure control and on survival in patients with glioblastoma multiforme.Neuro Oncol. 2013; 15: 961-967
- Altered metabolomic-genomic signature: a potential noninvasive biomarker of epilepsy.Epilepsia. 2017; 58: 1626-1636
Article Info
Publication History
Published online: August 10, 2018
Footnotes
Potential Competing Interests: Dr Tatum has received research support from Mayo Clinic for investigator-initiated studies and industry-supported studies; Brain Sentinel, Inc.; and the Martin Family Foundation; he has also received stipend from Elsevier as Editor-in-Chief of Epilepsy Behavior Case Reports and publishing royalties from Demos and Springer publishers.
Grant Support: Dr Quinones-Hinojosa was supported by the Mayo Clinic Professorship and a Mayo Clinician Investigator award as well as the National Institutes of Health (R43CA221490, R01CA200399, R01CA183827, R01CA195503, R01CA216855).
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© 2018 Mayo Foundation for Medical Education and Research
