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Open Access Research article

Clinical significance of serological biomarkers and neuropsychological performances in patients with temporal lobe epilepsy

Chiung-Chih Chang124, Chun-Chung Lui3, Chen-Chang Lee3, Shang-Der Chen1, Wen-Neng Chang1, Cheng-Hsien Lu1, Nai-Ching Chen1, Alice Y W Chang2, Samuel H H Chan2 and Yao-Chung Chuang124*

Author Affiliations

1 Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

2 Center for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

3 Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

4 Department of Biological Science, National Sun Yet-sen University, Kaohsiung, Taiwan

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BMC Neurology 2012, 12:15  doi:10.1186/1471-2377-12-15

Published: 14 March 2012

Abstract

Background

Temporal lobe epilepsy (TLE) is a common form of focal epilepsy. Serum biomarkers to predict cognitive performance in TLE patients without psychiatric comorbidities and the link with gray matter (GM) atrophy have not been fully explored.

Methods

Thirty-four patients with TLE and 34 sex - and age-matched controls were enrolled for standardized cognitive tests, neuroimaging studies as well as measurements of serum levels of heat shock protein 70 (HSP70), S100ß protein (S100ßP), neuronal specific enolase (NSE), plasma nuclear and mitochondrial DNA levels.

Results

Compared with the controls, the patients with TLE had poorer cognitive performances and higher HSP70 and S100ßP levels (p < 0.01). The patients with higher frequencies of seizures had higher levels of HSP70, NSE and S100ßP (p < 0.01). Serum HSP70 level correlated positively with duration of epilepsy (σ = 0.413, p < 0.01), and inversely with memory scores in the late registration (σ = −0.276, p = 0.01) and early recall score (σ = −0.304, p = 0.007). Compared with the controls, gray matter atrophy in the hippocampal and parahippocampal areas, putamen, thalamus and supplementary motor areas were found in the patient group. The HSP70 levels showed an inverse correlation with hippocampal volume (R square = 0.22, p = 0.007) after controlling for the effect of age.

Conclusions

Our results suggest that serum biomarkers were predictive of higher frequencies of seizures in the TLE group. HSP70 may be considered to be a stress biomarker in patients with TLE in that it correlated inversely with memory scores and hippocampal volume. In addition, the symmetric extratemporal atrophic patterns may be related to damage of neuronal networks and epileptogenesis in TLE.

Keywords:
Biomarkers; Neuropsychological performances; Temporal lobe epilepsy; Gray matter atrophy; Heat shock proteins