Journal: medRxiv
Article Title: Brain Damage During New-Onset Refractory Status Epilepticus
doi: 10.1101/2025.08.05.25332982
Figure Lengend Snippet: (A, F) Selected axial slices from the first, third, and fifth MRI scans performed during NORSE in each case. Progressive enlargement of cerebrospinal fluid spaces, consistent with brain atrophy, is evident in the final scan compared to the initial one. (B, G) Relative changes in brain morphometry over time from SE onset, referenced to the first available MRI scan. Each square represents one MRI, with scans from the same individual connected by lines. Both cases showed rapid grey matter volume loss, particularly affecting subcortical structures, with minimal change in white matter volume. (C, H) Annualized whole-brain morphometric changes between the first and last MRI during NORSE, mapped onto cortical and subcortical templates. Brain shrinkage was bilateral and widespread in both cases. (D, I) Longitudinal trajectories of fluid biomarkers of neurodegeneration (neurofilament light chain, NfL; glial fibrillary acidic protein, GFAP; Total Tau), referenced to the internal epilepsy cohort mean (log-scale, k-fold increase from epilepsy mean). (E, J) Neuropathological findings compared with a representative healthy cortex (bottom panel). In Case 1 (E) , cortical tissues showed decreased numbers of neuronal nuclear antigen (NeuN) positive neurons with preserved layering with Luxol fast blue staining and marked GFAP-positive reactive astrogliosis. In Case 2 (F) there were several fragments of cerebral cortex and subcortical white matter with reduced neuronal numbers and reactive astrogliosis. NORSE, new onset refractory status epilepticus; NfL, neurofilament light chain; GFAP, glial fibrillary acidic protein; CSF, cerebrospinal fluid; neuronal nuclear antigen, NeuN; T, thalamus; H, hippocampus; A, amygdala; Pa, pallidum; Pu, putamen .
Article Snippet: CSF total Tau concentrations were quantified using the Lumipulse G Total Tau assay (Fujirebio Inc., Tokyo, Japan).
Techniques: Staining