Genes May Predict Whether Surgery is Effective for Epilepsy

Genes May Predict Whether Surgery is Effective for Epilepsy

Researchers at the University of Arizona have identified possible genetic causes of recurrent seizures following brain surgery. The findings could lead to a test that might determine if surgery will benefit a epilepsy patient, based on the patient’s genetic code.

The research report, “Cortical gene expression: prognostic value for seizure outcome following temporal lobectomy and amygdalohippocampectomy,” was recently published in Neurogenetics.

For about 2/3 of people who have epilepsy, anti-medication exists to control seizures. For those who do not respond to medication, surgery is an option.

But because surgery can cause brain damage and loss of functions that include language, memory, and vision, it is vital to weigh risks and assess which patients would most likely benefit from surgery.

Led by Dr. Martin Weinand of the College of Medicine, Department of Surgery and Division of Neurosurgery at the University of Arizona, scientists examined brain biopsies from 24 epilepsy patients, ages 12 through 59, who had surgery to treat the condition.

The investigators analyzed the genetic codes of the patients who stopped having seizures and compared them to patients who continued to have seizures. They looked at RNA, which is the message created from DNA that then goes on to produce specific proteins. To identify RNA, they created “probes” which stick to specific RNA types.

Overall, they found four previously identified and seven unidentified genes that were different between the two groups. The gene differences might be used to develop a test for predicting who can benefit from surgery to treat epilepsy.

In the study report, the investigators noted:  “This study describes the predictive value of temporal cortical gene expression for seizure-free outcome after [epilepsy surgery]. Four genes and seven RNA probes were found to predict post-operative seizure-free outcome.”

Though promising, more research using larger groups of people with epilepsy is needed to confirm that genetic changes consistently predict surgery effectiveness. Findings may establish predictive biological indicators called biomarkers, that could be used in pre-surgery testing.

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