White Matter Hyperintensities on Brain Magnetic Resonance Imaging in People with Epilepsy: A Hospital-Based Study.
We aim to explore whether people with epilepsy have increased white matter hyperintensities (WMHs).



Eligible patients were categorized into newly diagnosed epilepsy (NE) and chronic epilepsy (CE); the latter were subdivided to those treated with enzyme-inducing antiepileptic drugs (EIAEDs) with or without non-enzyme-inducing antiepileptic drugs (NEIAEDs) and those with NEIAEDs only. WMHs were measured using age-related white matter changes (ARWMC) scale and compared between patients and healthy control group. Higher scores indicate greater WMH changes. The strengths of associations were estimated as incidence rate ratios (IRRs) with 95% confidence interval (CI).



A total of 217 patients were included in the analysis, of whom 67 had NE, 45 had CE treated with NEIAEDs, and 105 had CE treated with EIAEDs. Age was positively associated with ARWMC score (IRR per year, 1.03; 95%CI, 1.03-1.04, P < 0.001). Compared with the healthy control group (n = 23), all patient groups had higher ARWMC score (P < 0.05). The difference was greatest in patients receiving EIAEDs (IRR, 2.13; 95%CI, 1.22-3.70, P = 0.007).



WMHs tended to be observed in people with epilepsy, especially in those treated with EIAEDs. People with epilepsy with white matter changes should be evaluated for stroke risk, particularly if they are receiving EIAEDs.
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Yi-Ting
YT
Mao
Departments of Medicine and Neurology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Enid
E
Goh
Florey Institute of Neuroscience and Mental Health, Melbourne, Vic, Australia.|School of Mathematical and Geospatial Sciences, RMIT University, Melbourne, Vic, Australia.
Leonid
L
Churilov
Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.|The Epilepsy Research Centre, Austin Health, The University of Melbourne, Melbourne, VIC, Australia.
Anne
A
McIntosh
Departments of Medicine and Neurology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Yi-Fan
YF
Ren
Departments of Medicine and Neurology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.|Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Terence J
TJ
O'Brien
Departments of Medicine and Neurology, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.|Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Stephen
S
Davis
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
Qiang
Q
Dong
Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Bernard
B
Yan
Melbourne Brain Centre, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Vic, Australia.
Patrick
P
Kwan
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006761:Hospitals; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
D000927:Anticonvulsants
Antiepileptic drugs; Epilepsy; Magnetic resonance imaging; Stroke; White matter hyperintensities