Is there a role for microRNAs in epilepsy diagnostics?

Introduction: Epilepsy is a disease group that encompasses numerous brain pathologies, all leading to spontaneous seizures. Several diagnostic needs in the area of epilepsy diagnostics remain unmet. MicroRNAs (miRNAs) have emerged as potential biomarkers of disease. Areas covered: We review clinical trials in epilepsy patients that investigated circulating miRNAs (CmiRNAs) as diagnostic biomarkers. Expert opinion: The surveyed trial results are highly discordant and do not confidently support the identification of definite diagnostic biomarkers yet. Important progress comes from studies that identified measures to increase the discriminatory power of CmiRNAs, such as an investigation of specific miRNA compartments (e.g. exosomal vs. Argonaute-bound) or a study that developed point-of-care detection devices for CmiRNAs. No sufficient data elucidating the validity of CmiRNAs as biomarkers for monitoring disease status, the responses to treatment, the likelihood of treatment effects, prognosis, or safety or susceptibility are available. Further studies should adopt standardized designs and in-depth phenotyping to improve their validity. One of the most important and promising future research topics will be the identification of biomarkers for epileptogenesis in humans.