Schedule of Events | Symposia

Correlating the effect of the size and location of TBI induced lesions on the likelihood of developing epilepsy through functional connectivity mapping

Poster Session D - Monday, March 31, 2025, 8:00 – 10:00 am EDT, Back Bay Ballroom/Republic Ballroom

Shivek Narang¹ (shivekn@sas.upenn.edu), James Gugger²; ¹University of Pennsylvania, ²University of Rochester

Traumatic brain injury (TBI) is a leading cause of epilepsy, with approximately 1 in 10 patients developing post-traumatic epilepsy (PTE). Initial seizures often occur within weeks of the injury, persisting for months in some cases. Identifying pathways linked to increased PTE risk is essential for targeted therapies, prevention strategies, and improved patient care. While biomarkers for PTE remain limited, neuroimaging shortly after TBI may hold predictive potential. However, the relationship between post-traumatic lesions, remote neural networks, and epileptogenesis remains unclear. This study leverages Magnetic Resonance Imaging (MRI) and functional MRI (fMRI) to assess lesion characteristics and their effects on brain connectivity. Using data from phase one of the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study, we manually segmented lesions on two-week post-injury MRIs of participants. Lesion cores and edema were identified using coregistered T1 and FLAIR sequences. These lesion maps were normalized to standard space and used as seeds for connectivity analyses, incorporating normative connectomes from the Human Connectome Project. Comparisons were made between lesion network maps of participants who developed seizures and those who did not. Preliminary results from 100 participants with at least one contusion revealed an average lesion core volume of 2.2 mL and edema volume of 128 mL. Group analysis, conducted using the generalized linear model and threshold-free cluster enhancement in FSL, aims to uncover connectivity patterns predictive of seizure development. These findings will enhance understanding of TBI-related epileptogenesis and inform future clinical interventions and therapeutic strategies worldwide.

Topic Area: METHODS: Neuroimaging