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@ARTICLE{Held:282575,
author = {Held, Nina Rebecca and Bauer, Tobias and Stirnberg,
Rüdiger and Recke, Theda von der and Lehnen, Nils Christian
and Baumgartner, Tobias and Witt, Juri-Alexander and Rácz,
Attila and Pukropski, Jan and Walger, Lennart and von Wrede,
Randi and Badr, Mostafa and Wolf, David and Kersting,
Lennart Nils and Lange, Annalena and Bisten, Justus and
Schmidt, Markus and Pracht, Eberhard and Löwen, Daniel and
Faber, Jennifer and Helmstaedter, Christoph and Reuter,
Martin and Friedman, Alon and Radbruch, Alexander and
Surges, Rainer and Stöcker, Tony and Rüber, Theodor},
title = {{Q}uantitative susceptibility mapping at 7{T} as a
biomarker of post- and interictal extravascular iron in
patients with focal epilepsy.},
journal = {EBioMedicine},
volume = {122},
issn = {2352-3964},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DZNE-2025-01335},
pages = {106040},
year = {2025},
abstract = {Iron deposition in the brain has been associated with
epilepsy, but its anatomical distribution and its temporal
association to seizures remain unclear. Here, we investigate
brain iron in individuals with focal epilepsy using
interictal and postictal quantitative susceptibility mapping
(QSM) at 7 T MRI and explore its functional relevance.80
consecutive participants with focal epilepsy undergoing
presurgical evaluation and 50 healthy controls were
included. 8/80 participants with focal epilepsy had
interictal and postictal scans. High-resolution T1- and
susceptibility-weighted images were acquired and processed
using custom pipelines for QSM. Seizure onset zones were
determined by expert consensus, and neuropsychological
assessments included memory and mood. Parcel-wise analyses
examined group differences and correlations with cognitive
scores, controlling for age and sex.Participants with focal
epilepsy showed significantly higher interictal
susceptibility, which colocalised with the presumed seizure
onset zone. Impaired memory performance and more severe
depressive symptoms were correlated with higher interictal
susceptibility. Postictal susceptibility was significantly
higher than interictal susceptibility and associated to the
number of preceding seizures.QSM reflects both ictal iron
extravasation and interictal iron accumulation. If further
validated, it may help to non-invasively delineate the
epileptogenic zone and become a long-term biomarker for
seizure-burden.N.R.H. and T.Bauer were supported by the
BONFOR research commission of the Medical Faculty of the
University of Bonn. T.Bauer was funded by the Deutsche
Forschungsgemeinschaft. T.Bauer., L.W., A.L. and T.R. are
funded by the German Ministry for Research, Technology and
Space.},
keywords = {Blood–brain-barrier dysfunction (Other) /
Neuroinflammation (Other) / Postictal imaging (Other) /
Ultra-high-field MRI (Other)},
cin = {AG Stöcker / Clinical Research (Bonn) / AG Reuter / AG
Radbruch},
ddc = {610},
cid = {I:(DE-2719)1013026 / I:(DE-2719)1011001 /
I:(DE-2719)1040310 / I:(DE-2719)5000075},
pnm = {354 - Disease Prevention and Healthy Aging (POF4-354) / 353
- Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-354 / G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41314150},
doi = {10.1016/j.ebiom.2025.106040},
url = {https://pub.dzne.de/record/282575},
}