Biomarkers for epilepsy – a new ray of hope

Abstract

Epilepsy is a long term, non-communicable neurological disorder of the brain. Worldwide it is affecting 50-65 million people and the fourth most familiar neurological disorder. It is marked by repeated, voluntary and unforeseeable seizures with complication of epileptogenesis. Characteristic symptoms, such as a staring spell, loss of awareness or consciousness, disturbed or repetitive movement, sensation, mood, or other cognitive functions. Some common diagnostic methods include: blood test, neurological examination, electroencephalogram (EEG), computed tomography (CT) scan, magnetic resonance imaging (MRI), functional MRI & positron emission tomography (PET) scan. Diagnosis and treatment suffer due to the lack of reliable biomarkers, which could otherwise save 70% of epileptic patients. Due to the complex nature of epilepsy, diagnostic biomarkers are essential that can objectively measure variables associated with the occurrence or the predisposition to generate seizures. The review pivots the clinically functional diagnostic biomarkers, viz. genetic, serological, neuroimaging and electrophysiological. Genetic biomarkers include KCNQ2/3 and SCN2A which increase neuronal activity. Serological biomarkers include HMGB1 which leads to oxidative stress. Hormones include PRL, ACTH and cortisol lead to an increased epileptic seizure. Enzymes such as creatine kinase, neuropeptides such as BDNF increase epileptic seizure. Cytokines include pro-inflammatory IL-1B, IL-6 promotes neuronal growth. Identification of neuro-imaging biomarker and electrophysiologic biomarker are promising biomarker for representing epilepsy. Biomarkers can identify epileptogenicity, presence and seriousness of epileptic condition or its progression. It can diminish the present trial-and-error approach of pharmacotherapy. Also, it may facilitate pre-surgical evaluation, and cost-effective drug discovery to treat, avert and restore healthy neurological condition.