Identification of neuro-inflammatory biomarkers through non-invasive advanced neuroimaging techniques in pharmaco-resistant epilepsy: A systematic review.
Level 5 - mechanism / opinion, no new human data
Systematic review of preclinical animal studies
PubMed 40848443 · doi:10.1016/j.yebeh.2025.110641
What was done
Authors searched PubMed, Embase, Web of Science, and Google Scholar to review non-invasive neuroimaging methods for neuro-inflammatory biomarkers in pharmaco-resistant epilepsy. Screening, extraction, and ARRIVE 2.0 quality evaluation were conducted by two independent reviewers.
What was found
Twelve experimental preclinical studies were included from 562 identified records. Six neuroinflammatory biomarkers were reported: TSPO (evaluated in 6 of 12 studies), BBBD, HMGB1, LRP1, P-gp, and MPO. Neuroimaging modalities utilized across studies were PET (8 studies), MRI (5 studies, one using a T2 sequence), SPECT (4 studies), and CT (1 study). The abstract provides no quantitative effect sizes or diagnostic accuracy metrics.
Why it matters
Identifying non-invasive imaging targets for neuroinflammation could eventually aid in delineating epileptic foci during presurgical workups for drug-resistant epilepsy.
Limits
All included studies were conducted in preclinical animal models, limiting direct applicability to human clinical practice. The review is purely qualitative with no meta-analysis or pooled diagnostic performance metrics reported in the abstract, and non-TSPO biomarkers were supported by very few studies.
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