Molecular Classification of Gliomas is Associated with Seizure Control: A Retrospective Analysis

Teresa P. Easwaran, Nicola Lancki, Mario Henriquez, Alexander O. Vortmeyer, Nicholas M. Barbaro, Denise M. Scholtens, Atique U. Ahmed, Mahua Dey*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Classically, histologic grading of gliomas has been used to predict seizure association, with low-grade gliomas associated with an increased incidence of seizures compared to high-grade gliomas. In 2016, WHO reclassified gliomas based on histology and molecular characteristics. We sought to determine whether molecular classification of gliomas is associated with preoperative seizure presentation and/or post-operative seizure control across multiple glioma subtypes. All gliomas operated at our institution from 2007 to 2017 were identified based on ICD 9 and 10 billing codes and were retrospectively assessed for molecular classification of the IDH1 mutation, and 1p/19q codeletion. Logistic regression models were performed to assess associations of seizures at presentation as well as post-operative seizures with IDH status and the new WHO integrated classification. Our study included 376 patients: 82 IDH mutant and 294 IDH wildtype. The presence of IDH mutation was associated with seizures at presentation [OR 3.135 (1.818–5.404), p < 0.001]. IDH-mutant glioblastomas presented with seizures less often than other IDH-mutant glioma subtypes grade II and III [OR 0.104 (0.032–0.340), p < 0.001]. IDH-mutant tumors were associated with worse post-operative seizure outcomes, demonstrated by Engel Class [OR 2.666 (1.592–4.464), p < 0.001]. IDH mutation in gliomas is associated with an increased risk of seizure development and worse post-operative seizure control, in all grades except for GBM.

Original languageEnglish (US)
JournalNeuromolecular medicine
DOIs
StateAccepted/In press - 2020

Keywords

  • Antiepileptic drugs
  • Astrocytoma
  • Glioblastoma
  • Glioma
  • IDH1 mutation
  • Seizures

ASJC Scopus subject areas

  • Molecular Medicine
  • Neurology
  • Cellular and Molecular Neuroscience

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