title: Clinical significance of serological biomarkers and neuropsychological performances in patients with temporal lobe epilepsy.
abstract: BACKGROUND
  Temporal lobe epilepsy (TLE) is a common form of focal epilepsy. Serum biomarkers to predict cognitive performance in TLE patients without psychiatric comorbidities and the link with gray matter (GM) atrophy have not been fully explored.
  
  
  METHODS
  Thirty-four patients with TLE and 34 sex - and age-matched controls were enrolled for standardized cognitive tests, neuroimaging studies as well as measurements of serum levels of heat shock protein 70 (HSP70), S100ß protein (S100ßP), neuronal specific enolase (NSE), plasma nuclear and mitochondrial DNA levels.
  
  
  RESULTS
  Compared with the controls, the patients with TLE had poorer cognitive performances and higher HSP70 and S100ßP levels (p < 0.01). The patients with higher frequencies of seizures had higher levels of HSP70, NSE and S100ßP (p < 0.01). Serum HSP70 level correlated positively with duration of epilepsy (σ = 0.413, p < 0.01), and inversely with memory scores in the late registration (σ = -0.276, p = 0.01) and early recall score (σ = -0.304, p = 0.007). Compared with the controls, gray matter atrophy in the hippocampal and parahippocampal areas, putamen, thalamus and supplementary motor areas were found in the patient group. The HSP70 levels showed an inverse correlation with hippocampal volume (R square = 0.22, p = 0.007) after controlling for the effect of age.
  
  
  CONCLUSIONS
  Our results suggest that serum biomarkers were predictive of higher frequencies of seizures in the TLE group. HSP70 may be considered to be a stress biomarker in patients with TLE in that it correlated inversely with memory scores and hippocampal volume. In addition, the symmetric extratemporal atrophic patterns may be related to damage of neuronal networks and epileptogenesis in TLE.
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chiung-Chih
authors.initials: CC
authors.lastname: Chang
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: Shang-Der
authors.initials: SD
authors.lastname: Chen
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Nai-Ching
authors.initials: NC
authors.lastname: Chen
authors.forename: Alice Y W
authors.initials: AY
authors.lastname: Chang
authors.forename: Samuel H H
authors.initials: SH
authors.lastname: Chan
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002467:Cell Nucleus / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology*; D015331:Cohort Studies; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000097:blood* / Q000150:complications*; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009245:NADH Dehydrogenase / Q000235:genetics / Q000378:metabolism; D009414:Nerve Growth Factors / Q000097:blood; D009483:Neuropsychological Tests; D010751:Phosphopyruvate Hydratase / Q000097:blood; D010949:Plasma / Q000166:cytology; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D018840:HSP70 Heat-Shock Proteins; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D009245:NADH Dehydrogenase; C521326:NADH dehydrogenase subunit 2, human; D010751:Phosphopyruvate Hydratase