El uso de biomarcadores en la epilepsia del lóbulo temporal
Resumen
Los biomarcadores desempeñan un papel crucial en el diagnóstico, pronóstico y manejo de las enfermedades. En el caso de la epilepsia del lóbulo temporal, su uso se ha centrado en hallazgos electrofisiológicos, de neuroimagen y moleculares, con el objetivo de caracterizar la enfermedad y a personalizar el tratamiento a futuro. Esta revisión se enfocará en proporcionar información sobre posibles biomarcadores en la epilepsia del lóbulo temporal. Los estudios electroencefalográficos han identificado patrones característicos de actividad eléctrica, como descargas interictales de oscilaciones de alta frecuencia, las espigas interictales y actividad de onda lenta. Los estudios de neuroimagen, como la resonancia magnética, son fundamentales para detectar anomalías estructurales, entre ellas la esclerosis hipocampal, un marcador característico de epilepsia del lóbulo temporal. Como biomarcador, la resonancia magnética ofrece un enfoque no invasivo y clínicamente aplicable para detectar indicios tempranos de epileptogénesis y monitorear la progresión de la enfermedad. Las alteraciones moleculares, incluidas las sinápticas, inflamatorias y epigenéticas, han adquirido una importancia creciente en la comprensión de esta enfermedad. La detección de moléculas está emergiendo como una herramienta prometedora, ya que pueden identificarse en líquidos biológicos como sangre o saliva, lo que facilita su implementación en el entorno clínico. Lo importante a considerar es la integración de estos posibles biomarcadores electrofisiológicos, de neuroimagen y moleculares para mejorar la precisión en el diagnóstico, predecir la evolución de la enfermedad y evaluar la respuesta a intervenciones quirúrgicas o farmacológicas, optimizando el manejo integral de la epilepsia del lóbulo temporal.
Abstract
Biomarkers play a crucial role in disease diagnosis, prognosis, and management. In the case of temporal lobe epilepsy, their use has focused on electrophysiological, neuroimaging, and molecular findings, aiming to characterize the disease and personalize treatment in the future. This review will provide information on potential biomarkers in temporal lobe epilepsy. Electroencephalographic studies have identified characteristic patterns of electrical activity, such as interictal discharges of high-frequency oscillations, interictal spikes, and slow-wave activity. Neuroimaging studies, such as magnetic resonance imaging, are instrumental in detecting structural abnormalities, including hippocampal sclerosis, a characteristic marker of temporal lobe epilepsy. As a biomarker, magnetic resonance imaging provides a noninvasive and clinically applicable approach to detect early signs of epileptogenesis and monitor disease progression. Molecular studies, such as synaptic, inflammatory, and epigenetic alterations, have acquired an increasingly relevant role in this disease. The detection of molecules is emerging as a promising tool since they can be detected in biological fluids (blood or saliva), which facilitates their application in the clinical setting. What is important to consider is the integration of these possible electrophysiological, neuroimaging, and molecular biomarkers to improve diagnostic accuracy, predict the evolution of the disease, and evaluate the response to surgical or pharmacological interventions, optimizing the comprehensive management of temporal lobe epilepsy.
Keywords: biomarker; epilepsy; electrophysiological; neuroimaging; molecular.
Palabras clave
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DOI: https://doi.org/10.25009/eb.v16i40.2639
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