Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy

Emily L. Johnson, Gregory L. Krauss, Alexandra K. Lee, Andrea L.C. Schneider, Anna M. Kucharska-Newton, Juebin Huang, Clifford R Jr. Jack, Rebecca F. Gottesman

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Abstract

OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy. METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and APOE ε4 allele status. RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95% confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95% CI 1.16-3.02) per age-adjusted SD. CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.

Original languageEnglish (US)
Pages (from-to)e988-e995
JournalNeurology
Volume92
Issue number9
DOIs
StatePublished - Feb 26 2019

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ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Johnson, E. L., Krauss, G. L., Lee, A. K., Schneider, A. L. C., Kucharska-Newton, A. M., Huang, J., Jack, C. R. J., & Gottesman, R. F. (2019). Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy. Neurology, 92(9), e988-e995. https://doi.org/10.1212/WNL.0000000000007010