Abstract Details

Title Biomarkers as prognostic determinants of epilepsy after post-acute central nervous system insults: a systematic review and meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-017

Objective To conduct a systematic review of biofluid biomarkers to test their association with the risk of post-CNS insult epilepsy.

Background It remains unknown if there are shared common biological pathways of an epileptogenic mechanism associated with a range of cerebral insults i.e., stroke, traumatic brain injury, and infections; and if certain biological markers could predict the risk of post-CNS insult epilepsy.

Design/Methods We searched articles until January 25, 2022, in PubMed, Embase, PsycINFO, Google Scholar, and Web of Science. The primary outcome was the difference in mean biomarker levels in patients with post-CNS insult epilepsy compared to patients without post-CNS insult epilepsy. We used the modified quality score based on the Reporting Recommendations for Tumor Marker Prognostic Studies for risk of bias assessment. For each biomarker, the level difference was calculated using the pooled standardized mean difference (SMD) and 95% confidence intervals (CI). (PROSPERO CRD42021297110)

Results We included 22 studies of 1499 cases with post-CNS insult epilepsy and 7929 controls with no post-CNS insult epilepsy. They investigated 47 biomarkers in blood or cerebrospinal fluid (CSF). Of 22 studies, 21 had moderate-to-high risk of bias. A meta-analysis was possible for only 19 biomarkers. Only blood glucose levels in four studies were significantly higher in patients with post-stroke epilepsy (PSE) than in patients without PSE (SMD 0.44; CI 0.19 to 0.69). From individual studies, 15 biomarkers in blood and seven in CSF were significantly associated with post-CNS insult epilepsy.

Conclusions While several biomarkers were found to be associated with epilepsy due to CNS insults, we do not recommend using the reported biomarkers for use in clinical settings or clinical trials. A significant limitation of these studies is that they included fewer patients with CNS insults who developed post-cerebral insult epilepsy. Collaborative efforts to promote biomarker discovery are therefore warranted.

Authors/Disclosures
Shubham Misra, PhD (Yale University) PRESENTER	Dr. Misra has nothing to disclose.
Erum Khan (B.J.Medical College,Ahmedabad)	Ms. Khan has nothing to disclose.
	No disclosure on file
Rajarshi Mazumder, MD, MPH (UCLA)	Dr. Mazumder has nothing to disclose.
Ece Eldem, MSc	Ms. Eldem has nothing to disclose.
Kapil Gururangan, MD (Northwestern University)	Dr. Gururangan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceribell Inc. Dr. Gururangan has stock in Ceribell Inc. The institution of Dr. Gururangan has received research support from NIH-NINDS. The institution of Dr. Gururangan has received research support from Leon Levy Foundation.
Leonard B. Hickman, MD (UCLA)	Dr. Hickman has nothing to disclose.
Vaibhav Goswami, MD (Tower Health)	Dr. Goswami has nothing to disclose.
Melissa Funaro (Yale)	Melissa Funaro has nothing to disclose.
	No disclosure on file
Terry Quinn (University of Glasgow)	No disclosure on file
David S. Liebeskind, MD, FAAN (Neurovascular Imaging Research Core at UCLA)	Dr. Liebeskind has received research support from Cerenovus. Dr. Liebeskind has received research support from Genentech . Dr. Liebeskind has received research support from Medtronic. Dr. Liebeskind has received research support from Stryker.
Nishant K. Mishra, MD, MBBS, PhD, FESO (Yale University)	Dr. Mishra has nothing to disclose.

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