Potential influence of IDH1 mutation and MGMT gene promoter methylation on glioma-related preoperative seizures and postoperative seizure control

• Published in: Seizure (London, England) England), 2019-07, Vol.69, p.283-289
• Main Authors: Feyissa, Anteneh M., Worrell, Gregory A., Tatum, William O., Chaichana, Kaisorn L, Jentoft, Mark E., Guerrero Cazares, Hugo, Ertekin-Taner, Nileufer, Rosenfeld, Steven S., ReFaey, Karim, Quinones-Hinojosa, Alfredo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Brain - physiopathology; Brain - surgery; Brain Neoplasms - genetics; Brain Neoplasms - physiopathology; Brain Neoplasms - surgery; DNA Methylation; DNA Modification Methylases - genetics; DNA Modification Methylases - metabolism; DNA Repair Enzymes - genetics; DNA Repair Enzymes - metabolism; Electrocorticography; Epilepsy surgery; Female; Glioma - genetics; Glioma - physiopathology; Glioma - surgery; Glioma-related seizures; Humans; IDH1 mutation; Isocitrate Dehydrogenase - genetics; Male; MGMT gene promotor methylation; Middle Aged; Postoperative Complications - genetics; Postoperative Complications - therapy; Preoperative Period; Promoter Regions, Genetic; Retrospective Studies; Seizures - etiology; Seizures - genetics; Seizures - physiopathology; Seizures - therapy; Tumor molecular markers; Tumor Suppressor Proteins - genetics; Tumor Suppressor Proteins - metabolism; Young Adult
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2019.05.018

•Patients with IDH1mut were likely to have high rate of GPS and favorable PSC than IDH1wt glioma.•Patients with MGMT gene promotor methylation status were also likely to have favorable PSC.•GPS or PSC were not associated with tumor grade, location, or histopathology.•Our findings support the emerging view that TMMs play a major role in GPS and PSC. To examine the occurrence of glioma-related preoperative seizures (GPS) and post-operative seizure control (PSC) with respect to patients characteristics including five commonly tested tumor molecular markers (TMMs). A single-center retrospective cohort study of patients with glioma evaluated at the Mayo Clinic, Florida between 2016 and 2018. 68 adult patients (mean age = 51-years, 45-males) were included. 46 patients had GPS. 57 patients underwent intra-operative electrocorticography during awake craniotomy-assisted glioma resection. All patients underwent glioma resection (53, gross-total resection) with histologies of pilocytic astrocytoma (n = 2), diffuse astrocytoma (n = 4), oligodendroglioma (n = 14), anaplastic astrocytoma (n = 16), anaplastic oligodendroglioma (n = 1), and glioblastoma (n = 31). 31 (67%) patients had PSC (median follow-up = 14.5 months; IQR = 7–16.5 months). IDH1 mutation (IDH1mut) was present in 32, ARTX retention in 53, MGMT gene promotor methylation in 15, 1p/19q co-deletion in 15, and over-expression of p53 in 19 patients. Patients with IDH1mut were more likely to have GPS (p = 0.037) and PSC (p = 0.035) compared to patients with IDH1 wild-type. Patients with MGMT gene promoter methylation were also likely to have PSC (p = 0.032). GPS or PSC did not differ by age, sex, extent of surgery, glioma grade, location, and histopathological subtype, p53 expression, ARTX retention, or 1p/19q co-deletion status. GPS and PSC may be associated with IDH1 mutation and MGMT gene promoter methylation status but not other glioma characteristics including tumor grade, location, or histopathology. Prospective studies with larger sample size are needed to clarify the exact mechanisms of GPS and PSC by the various TMMs to identify new treatment targets.