title: Interictal serum brain-derived neurotrophic factor level reflects white matter integrity, epilepsy severity, and cognitive dysfunction in chronic temporal lobe epilepsy.
abstract: Most patients with temporal lobe epilepsy (TLE) have epileptic foci originating from the medial temporal lobe, particularly the hippocampus. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin growth factor mainly expressed in the hippocampus, though it is not known whether the circulating level of BDNF reflects cognitive performance or white matter structural changes in chronic TLE.
  
  
  
  Thirty-four patients with TLE and 22 healthy controls were enrolled for standardized cognitive tests, diffusion tensor imaging, and serum BDNF measurement. The patients were further divided into a subgroup with unilateral TLE (n=23) and a subgroup with bilateral TLE (n=11) for clinical and neuroimaging comparisons.
  
  
  
  There were significantly lower BDNF levels in the patients with TLE compared with the controls, with significance contributed mainly from the subgroup with bilateral TLE, which also had more frequent seizures. The BDNF levels correlated with epilepsy duration (σ=-0.355; p=0.040) and fractional anisotropy (FA) in the left temporal lobe, left thalamus, and right hippocampus. Using a regression model, BDNF level predicted verbal memory score. Further, design fluency scores were predicted by serum BDNF level via the interactions with left temporal FA.
  
  
  
  Serum BDNF levels reflected longer epilepsy duration, impaired white matter integrity, and poor cognitive function in patients with chronic TLE.
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Health and Beauty, Shu-Zen College of Medicine and Management, Taiwan.
authors.forename: Nai-Ching
authors.initials: NC
authors.lastname: Chen
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yao-Chung
authors.initials: YC
authors.lastname: Chuang
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Health and Beauty, Shu-Zen College of Medicine and Management, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Huang
authors.affiliation: Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
authors.affiliation: Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chen-Chang
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Hsu
authors.affiliation: Department of Health and Beauty, Shu-Zen College of Medicine and Management, Taiwan.
authors.forename: Pin-Hsuan
authors.initials: PH
authors.lastname: Lin
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yan-Ting
authors.initials: YT
authors.lastname: Lu
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Health and Beauty, Shu-Zen College of Medicine and Management, Taiwan.
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Che-Wei
authors.initials: CW
authors.lastname: Hsu
authors.affiliation: Cognition and Aging Center, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: neur099@adm.cgmh.org.tw.
authors.forename: Chiung-Chih
authors.initials: CC
authors.lastname: Chang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D016022:Case-Control Studies; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000097:blood* / Q000000981:diagnostic imaging*; D056324:Diffusion Tensor Imaging / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000097:blood* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D066127:White Matter / Q000000981:diagnostic imaging* / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human
keywords: Brain-derived neurotrophic factor; Corpus callosum; Demyelinating; Diffusion tensor imaging; Interictal epileptiform discharges