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

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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.

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Funding

This work was supported by the NINDS K08NS092895 Grant (MD).

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Authors and Affiliations

  1. Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue CSC K3/803, Madison, WI, 53792, USA

    Mario Henriquez & Mahua Dey

  2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Nicola Lancki & Denise M. Scholtens

  3. Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA

    Alexander O. Vortmeyer

  4. Department of Neurosurgery and Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Atique U. Ahmed

  5. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Teresa P. Easwaran

  6. Department of Neurosurgery, Dell Medical School, The University of Texas, Austin, TX, USA

    Nicholas M. Barbaro

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  1. Teresa P. Easwaran
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  2. Nicola Lancki
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  3. Mario Henriquez
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  4. Alexander O. Vortmeyer
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  8. Mahua Dey
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Contributions

TPE: Contributed to data collection and manuscript writing. NL and DMS: Contributed to data analysis and manuscript writing. AOV and MH: Contributed to data identification and figure generation. NMB and AUA: Contributed to study design and manuscript review. MD: Contributed to article conception, study design, manuscript writing, and over all supervision.

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Correspondence to Mahua Dey.

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Easwaran, T.P., Lancki, N., Henriquez, M. et al. Molecular Classification of Gliomas is Associated with Seizure Control: A Retrospective Analysis. Neuromol Med 23, 315–326 (2021). https://doi.org/10.1007/s12017-020-08624-0

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  • DOI: https://doi.org/10.1007/s12017-020-08624-0

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