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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Epilepsiaarrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Epilepsia
Article . 2025 . Peer-reviewed
License: Wiley Online Library User Agreement
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Enlarged perivascular spaces in the basal ganglia across epilepsy subtypes

Authors: Benjamin Sinclair; Clarissa Lin Yasuda; John‐Paul Nicolo; Gernot Hlauschek; Thais Maria Santos Bezerra; Zhibin Chen; Lucy Vivash; +10 Authors

Enlarged perivascular spaces in the basal ganglia across epilepsy subtypes

Abstract

Abstract Objective The glymphatic system is thought to be the brain's primary waste clearance system, responsible for eliminating soluble metabolites and proteins from the central nervous system. It consists of the cerebrospinal fluid, the interstitial fluid, and a conduit between the two, perivascular spaces (PVS). PVS and glymphatics may impact the pathophysiology of epilepsy and its associated neuropsychiatric comorbidities, potentially via reduced clearance of excitotoxic substances. This study investigates enlarged PVS burden in a large patient group with various types of epilepsy. Methods A total of 467 people with various types of epilepsy were recruited from the Hospital das Clínicas, University of Campinas, Brazil; 267 had temporal lobe epilepsy with hippocampal sclerosis (TLE‐HS), 71 had TLE with no magnetic resonance imaging (MRI)‐visible lesions, 65 had focal extratemporal epilepsy, and 64 had idiopathic generalized epilepsy. They were matched for age and sex with 473 healthy volunteers as controls. All participants were scanned with T1‐weighted MRI, and a deep‐learning algorithm, PINGU (Perivascular‐Space Identification Nnunet for Generalized Usage), was applied to segment PVS. The volumes of PVS in the white matter (WM) and basal ganglia (BG) were calculated, and PVS volume fraction (PVS‐VF) was used as a dependent variables in a general linear model, with the diagnostic group as the independent variable of interest. Results The epilepsy group, across all subtypes, had higher PVS‐VF in the BG compared to controls (101%–140%, effect size = .95–1.37, p < 3.77 × 10 −15 ). There was no difference in PVS‐VF in the WM between the epilepsy groups and healthy controls, or between different epilepsy subtypes. Only the TLE‐HS group had a PVS‐VF asymmetry in the WM, with more PVS on the contralateral side, particularly in the temporal lobes. There was no association between PVS‐VF and duration of illness. Significance There is an increase in PVS volume in the BG across broad subtypes of epilepsy, suggesting either a common mechanism of seizure generation or a common consequence of seizures.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Average
Top 10%
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