Brain Damage During New-Onset Refractory Status Epilepticus
Year: 2025
Type: preprint
Study design: Observational Study
Abstract: Status epilepticus (SE) has long been linked to neuronal damage in experimental and animal studies, yet direct human evidence remains scarce. The risk of seizure-induced brain injury is central to the definition, urgency, treatment, and prognosis of SE. We studied 2,055 longitudinal MRI scans from 559 individuals, including 33 patients with new-onset refractory SE (NORSE) across multiple centres, to quantify grey matter volume changes during and after SE. We demonstrate a rapid, widespread, and irreversible decline in grey matter volume during NORSE, exceeding normal aging by 80-fold and Alzheimer’s disease by 20-fold. Fluid biomarkers confirmed marked neurodegeneration during NORSE, correlated with grey matter volume reduction, and returned to low levels after SE. Accelerated atrophy was linked to longer SE duration, poorer long-term outcome, and cryptogenic aetiology. These findings underscore the urgency of treating SE to limit brain damage and provide a framework for evaluating potentially neuroprotective interventions in humans.
Source: medRxiv
Authors: Cyril F Simmen, Miranda Stattmann, Claudio Togni, Amanda Eisele, Tibor Hortobágyi, Kai Michael Schubert, Andreas Albert Braun, Francesca Casagrande, Carolina Ferreira Atuesta, Niels Briel, Anton Schmick, Marina Herwerth, Anna Lasne, Nadia Mock, Sarah Appenzeller, Sandra Loosli, Rebecca Liu, John S Duncan, Sanjeev Rajakulendran, Matthew C Walker, Aidan Neligan, Jennifer Kilmer, Ferran Prados Carrasco, Stefan Kunst, Nicholas Fearns, Konstantinos Dimitriadis, Moritz Luigi Schmidbauer, Urs Fisch, Raoul Sutter, Stephan Rüegg, Pilar Bosque Varela, Giorgi Kuchukhidze, Eugen Trinka, Johan Zelano, Sarah Akel, Henrik Zetterberg, Pia De Stefano, Margitta Seeck, Dominique Flügel, Dominik Zieglgänsberger, Frederic L.W.V.J. Schaper, Joseph I. Turner, Patrick Roth, Markus Florian Oertel, Nathalie Nierobisch, Matthias J Koepp, Lars Michels, Nicolin Hainc, Giovanna Brandi, Marian Galovic, the Alzheimer’s Disease Neuroimaging Initiative
Institutions: University of Zurich, University Hospital Zurich, ETH Zurich, Royal Free London NHS Foundation Trust, National Hospital for Neurology and Neurosurgery, University College London, Universitat Oberta de Catalunya, UCL Queen Square Institute of Neurology, LMU Klinikum, Ludwig-Maximilians-Universität München, Brigham and Women's Hospital, Harvard University, University Hospital of Basel, University of Basel, University of Salzburg, Paracelsus Medical University, Christian Doppler Klinik, Sahlgrenska University Hospital, Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, UK Dementia Research Institute, University Hospital of Geneva, University of Geneva, Kantonsspital St. Gallen, Mass General Brigham
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413137355