Neuroimmune activation in temporal lobe epilepsy patients with worsening seizure following the COVID-19 pandemic: A [ ¹⁸ F]DPA-714 PET/MR study

Patients with temporal lobe epilepsy (TLE) frequently experience worsening epilepsy following COVID-19, referred to as post-COVID-19 active TLE. While neuroinflammatory changes are suspected in these patients, measurements of both central and systemic inflammation in the brain remain unexplored. We investigate whether the translocator protein standardized uptake value ratio (TSPO SUVr), a quantifiable marker of neuroinflammation using positron emission tomography (PET), is elevated in the brains of patients with post-COVID-19 active TLE. In addition, we examine correlations between TSPO SUVr and inflammatory factors to identify potential peripheral blood inflammatory predictors of post-COVID-19 active epilepsy. Our study highlights the presence of widespread neuroinflammation in the brain and increased levels of inflammatory cytokines in the plasma of individuals with post-COVID-19 active TLE. Furthermore, strong correlations between plasma levels of interleukin-1β (IL-1β), IL-10, and interferon-γ (IFN-γ) and neuroimmune activation suggest the potential for integrating plasma inflammatory factors with TSPO PET as a dependable approach for clinical diagnosis, dynamic monitoring, and assessment of immune-based therapeutic efficacy in TLE-associated neuroinflammation.