Open AccessMolecular Classification of Gliomas is Associated with Seizure Control: A Retrospective Analysis
Author(s) -
Teresa Easwaran,
Nicola Lancki,
Mario Henriquez,
Alexander O. Vortmeyer,
Nicholas M. Barbaro,
Denise Scholtens,
Atique U. Ahmed,
Mahua Dey
Publication year - 2020
Publication title -
neuromolecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.098
H-Index - 73
eISSN - 1559-1174
pISSN - 1535-1084
DOI - 10.1007/s12017-020-08624-0
Subject(s) - glioma , medicine , grading (engineering) , epilepsy , neurology , oncology , retrospective cohort study , incidence (geometry) , pathology , biology , cancer research , psychiatry , ecology , physics , optics
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.