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Singh P, Kaur R, Saggar K, Singh G, Aggarwal S. Amygdala Volumetry in Patients with Temporal Lobe Epilepsy and Normal Magnetic Resonance Imaging. Pol J Radiol 2016; 81:212-8. [PMID: 27231493 PMCID: PMC4865273 DOI: 10.12659/pjr.896077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/27/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND It has been suggested that the pathophysiology of temporal lobe epilepsy may relate to abnormalities in various brain structures, including the amygdala. Patients with mesial temporal lobe epilepsy (MTLE) without MRI abnormalities (MTLE-NMRI) represent a challenge for diagnosis of the underlying abnormality and for presurgical evaluation. To date, however, only few studies have used quantitative structural Magnetic Resonance Imaging-based techniques to examine amygdalar pathology in these patients. MATERIAL/METHODS Based on clinical examination, 24-hour video EEG recordings and MRI findings, 50 patients with EEG lateralized TLE and normal structural Magnetic Resonance Imaging results were included in this study. Volumetric magnetic resonance imaging (MRI) studies of the amygdalas and hippocampi were conducted in 50 non-epileptic controls (age 7-79 years) and 50 patients with MTLE with normal MRI on a 1.5-Tesla scanner. Visual assessment and amygdalar volumetry were performed on oblique coronal T2W and T1W MP-RAGE images respectively. The T2 relaxation times were measured using the 16-echo Carr-Purcell-Meiboom-Gill sequence (TE, 22-352). Volumetric data were normalized for variation in head size between individuals. Results were assessed by SSPS statistic program. RESULTS Individual manual volumetric analysis confirmed statistically significant amygdala enlargement (AE) in eight (16%) patients. Overall, among all patients with AE and a defined epileptic focus, 7 had predominant increased volume ipsilateral to the epileptic focus. The T2 relaxometry demonstrated no hyperintense signal of the amygdala in any patient with significant AE. CONCLUSIONS This paper presented AE in a few patients with TLE and normal MRI. These findings support the hypothesis that there might be a subgroup of patients with MTLE-NMRI in which the enlarged amygdala could be related to the epileptogenic process.
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Affiliation(s)
- Paramdeep Singh
- Department of Radiology, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, India
| | - Rupinderjeet Kaur
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, India
| | - Kavita Saggar
- Department of Radiology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Gagandeep Singh
- Department of Neurology, Dayanand Medical College and Hospital, Ludhiana, India
| | - Simmi Aggarwal
- Department of Radiology, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, India
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202
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Kuzmanovski I, Cvetkovska E, Babunovska M, Kiteva Trencevska G, Kuzmanovska B, Boshkovski B, Isjanovska R. Seizure outcome following medical treatment of mesial temporal lobe epilepsy: Clinical phenotypes and prognostic factors. Clin Neurol Neurosurg 2016; 144:91-5. [DOI: 10.1016/j.clineuro.2016.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/20/2016] [Accepted: 03/08/2016] [Indexed: 01/03/2023]
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203
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Martinoni M, Berti PP, Marucci G, Rubboli G, Volpi L, Riguzzi P, Marliani F, Toni F, Bisulli F, Tinuper P, Michelucci R, Baruzzi A, Giulioni M. Pathology-Based Approach to Seizure Outcome After Surgery for Pharmacoresistant Medial Temporal Lobe Epilepsy. World Neurosurg 2016; 90:448-453. [PMID: 26968448 DOI: 10.1016/j.wneu.2016.02.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hippocampal sclerosis (HS) is the most common cause of drug-resistant medial temporal lobe epilepsy (MTLE). Structural abnormalities such as HS, granule cell pathology (GCP), and focal cortical dysplasia (FCD) have been classified histopathologically, possibly allowing a more accurate assessment of prognostic seizure and neuropsychologic outcomes. We correlated seizure outcome with comprehensive temporal lobe pathologic findings, identified according to the most recent classification systems of HS, GCP, and FCD. METHODS All the 83 patients who underwent anterior temporal lobectomy (ATL) for drug-resistant MTLE and with a proven diagnosis of HS between April 2001 and May 2014 were collected. Patients were divided in 2 main groups: 1) isolated HS with/without GCP (HS +/- GCP); and 2) HS associated with FCD with/without GCP (HS+FCD +/- GCP). Patients were followed up at least 1 year, and seizure outcome was reported in accordance with Engel classification. RESULTS Group I: HS +/- GCP: Statistical analysis confirmed a better outcome in HS + GCP patients than in HS-no GCP (P < 0.05). Moreover, a better outcome for the patients affected by GCP type I was observed (P < 0.05). Group II: HS+FCD +/- GCP: Patients with HS variant type I presented a better seizure outcome than the patients with HS type II (Engel class IA HS type I vs. type II: 69% vs. 40%). CONCLUSIONS A pathology-based approach to epilepsy surgery might improve the interpretation of the results, could predict which cases will enjoy a better seizure outcome, and could help to the comprehension of the causes of failures.
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Affiliation(s)
- Matteo Martinoni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy.
| | - Pier Paolo Berti
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Section of Pathology, "M. Malpighi," Bellaria Hospital, Azienda USL-IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Guido Rubboli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Danish Epilepsy Centre, Dianalund, Denmark
| | - Lilia Volpi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Patrizia Riguzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Federica Marliani
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesco Toni
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesca Bisulli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Paolo Tinuper
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Roberto Michelucci
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Agostino Baruzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Giulioni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
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204
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Dallérac G, Rouach N. Astrocytes as new targets to improve cognitive functions. Prog Neurobiol 2016; 144:48-67. [PMID: 26969413 DOI: 10.1016/j.pneurobio.2016.01.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/07/2016] [Accepted: 01/24/2016] [Indexed: 01/09/2023]
Abstract
Astrocytes are now viewed as key elements of brain wiring as well as neuronal communication. Indeed, they not only bridge the gap between metabolic supplies by blood vessels and neurons, but also allow fine control of neurotransmission by providing appropriate signaling molecules and insulation through a tight enwrapping of synapses. Recognition that astroglia is essential to neuronal communication is nevertheless fairly recent and the large body of evidence dissecting such role has focused on the synaptic level by identifying neuro- and gliotransmitters uptaken and released at synaptic or extrasynaptic sites. Yet, more integrated research deciphering the impact of astroglial functions on neuronal network activity have led to the reasonable assumption that the role of astrocytes in supervising synaptic activity translates in influencing neuronal processing and cognitive functions. Several investigations using recent genetic tools now support this notion by showing that inactivating or boosting astroglial function directly affects cognitive abilities. Accordingly, brain diseases resulting in impaired cognitive functions have seen their physiopathological mechanisms revisited in light of this primary protagonist of brain processing. We here provide a review of the current knowledge on the role of astrocytes in cognition and in several brain diseases including neurodegenerative disorders, psychiatric illnesses, as well as other conditions such as epilepsy. Potential astroglial therapeutic targets are also discussed.
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Affiliation(s)
- Glenn Dallérac
- Neuroglial Interactions in Cerebral Physiopathology, Center for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique UMR 7241, Institut National de la Santé et de la Recherche Médicale U1050, Labex Memolife, PSL Research University, Paris, France.
| | - Nathalie Rouach
- Neuroglial Interactions in Cerebral Physiopathology, Center for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique UMR 7241, Institut National de la Santé et de la Recherche Médicale U1050, Labex Memolife, PSL Research University, Paris, France.
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205
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Auras in patients with temporal lobe epilepsy and mesial temporal sclerosis. J Neurol Sci 2016; 364:24-6. [PMID: 27084209 DOI: 10.1016/j.jns.2016.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/18/2016] [Accepted: 03/02/2016] [Indexed: 11/23/2022]
Abstract
We investigated auras in patients with drug-resistant temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS). We also investigated the clinical differences between patients with MTS and abdominal auras and those with MTS and non-mesial temporal auras. All patients with drug-resistant TLE and unilateral MTS who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center from 1986 through 2014 were evaluated. Patients with good postoperative seizure outcome were investigated. One hundred forty-nine patients (71 males and 78 females) were studied. Thirty-one patients (20.8%) reported no auras, while 29 patients (19.5%) reported abdominal aura, and 30 patients (20.1%) reported non-mesial temporal auras; 16 patients (10.7%) had sensory auras, 11 patients (7.4%) had auditory auras, and five patients (3.4%) reported visual auras. A history of preoperative tonic-clonic seizures was strongly associated with non-mesial temporal auras (odds ratio 3.8; 95% CI: 1.15-12.98; p=0.02). About one-fifth of patients who had MTS in their MRI and responded well to surgery reported auras that are historically associated with non-mesial temporal structures. However, the presence of presumed non-mesial temporal auras in a patient with MTS may herald a more widespread epileptogenic zone.
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206
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Wei W, Zhang Z, Xu Q, Yang F, Sun K, Lu G. More Severe Extratemporal Damages in Mesial Temporal Lobe Epilepsy With Hippocampal Sclerosis Than That With Other Lesions: A Multimodality MRI Study. Medicine (Baltimore) 2016; 95:e3020. [PMID: 26962820 PMCID: PMC4998901 DOI: 10.1097/md.0000000000003020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS) presents different clinical presentations from that with other lesions (OL). It is significant to investigate the neural mechanism underlying the different clinical presentations using neuroimaging study.Thirty mTLE patients with mTLE-HS, 30 mTLE patients with other lesions (mTLE-OL), and 30 age- and sex-matched healthy controls were involved. Amplitude of low-frequency fluctuation (ALFF) analysis-based resting-state functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM) based morphometric MRI were employed to describing functional and structural imaging alterations in mTLE. Imaging parameters of ALFF and gray matter volume (GMV) were compared among groups and correlated with clinical variables and cognitive scores.For parameter of ALFF, both patient groups of mTLE-HS and mTLE-OL showed decrease in the frontal cortices relative to the healthy controls; mTLE-HS showed more decrease in the prefrontal and brain default regions relative to mTLE-OL. For GMV, both patient groups showed decrease in the frontal cortex, thalamus, and cerebellum; mTLE-HS showed more GMV decrease relative to the mTLE-OL, also mainly in the prefrontal and brain default regions. In both patient groups, the prefrontal regions showed negative correlation between GMV and epilepsy duration.This work revealed distinct alteration patterns of functional and structural brain organizations in mTLEs with different forms. MTLE-HS, despite with smaller lesion size of the pathological focus, presented more severe functional and structural damages in the extratemporal regions than mTLE-OL. The findings provided imaging evidence to support the proposal that mTLE-HS is a special epilepsy syndrome.
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Affiliation(s)
- Wei Wei
- From the Department of Medical Imaging (WW, ZZ, QX, GL), Department of Neurology (QX), Department of Neurosurgery (FY), Jinling Hospital, Nanjing University School of Medicine, and State Key Laboratory of Analytical Chemistry for Life Science (ZZ, GL), Nanjing University, Nanjing, China
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207
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Cardim DA, Frigieri GH, Cabella BCT, Malheiros JM, Cardim AC, Wang CC, de Albuquerque Pacheco Andrade R, Covolan L, Tannús A, Mascarenhas S. Characterization of Intracranial Pressure Behavior in Chronic Epileptic Animals: A Preliminary Study. ACTA NEUROCHIRURGICA. SUPPLEMENT 2016; 122:329-33. [PMID: 27165931 DOI: 10.1007/978-3-319-22533-3_65] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Intracranial pressure (ICP) is a major neurological parameter in animals and humans. ICP is a function of the relationship between the contents of the cranium (brain parenchyma, cerebrospinal fluid, and blood) and the volume of the skull. Increased ICP can cause serious physiological effects or even death in patients who do not quickly receive proper care, which includes ICP monitoring. Epilepsies are a set of central nervous system disorders resulting from abnormal and excessive neuronal discharges, usually associated with hypersynchronism and/or hyperexcitability. Temporal lobe epilepsy (TLE) is one of the most common forms of epilepsy and is also refractory to medication. ICP characteristics of subjects with epilepsy have not been elucidated because there are few studies associating these two important neurological factors. In this work, an invasive (ICPi) and the new minimally invasive (ICPmi) methods were used to evaluate ICP features in rats with chronic epilepsy, induced by the experimental model of pilocarpine, capable of generating the main features of human TLE in these animals.
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Affiliation(s)
- Danilo Augusto Cardim
- Federal University of Sao Carlos, Joint Graduate Program in Physiological Sciences, PIPGCF. Rodovia Washington Luis, km 235, SP-310. CEP 13565-905., Sao Carlos, Sao Paulo, Brazil.
| | | | | | | | - Ana Carolina Cardim
- Physics Institute of Sao Carlos, University of Sao Paulo, Sao Carlos, Brazil
| | | | | | - Luciene Covolan
- Department of Physiology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Alberto Tannús
- Physics Institute of Sao Carlos, University of Sao Paulo, Sao Carlos, Brazil
| | - Sérgio Mascarenhas
- Physics Institute of Sao Carlos, University of Sao Paulo, Sao Carlos, Brazil
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208
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Kim J, Kim SH, Lim SC, Kim W, Shon YM. Clinical characteristics of patients with benign nonlesional temporal lobe epilepsy. Neuropsychiatr Dis Treat 2016; 12:1887-91. [PMID: 27555776 PMCID: PMC4968857 DOI: 10.2147/ndt.s110400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the evolution of nonlesional temporal lobe epilepsy (TLE-NL) in patients treated exclusively with antiepileptic drugs and to elucidate clinical phenotypes related to the prognosis of these patients. METHODS Clinical, radiological, and electroencephalographic (EEG) findings in 84 patients with TLE-NL were reviewed. A good response group (GRG) and a poor response group (PRG) were defined if the duration of their seizure-free period was >1 year, or <1 year, respectively. RESULTS There were 46 (54.8%) patients in the GRG and 38 (45.2%) patients in the PRG. The number of antiepileptic drugs administered was significantly lower in the GRG than that in the PRG (1.3±0.8 vs 2.8±1.0, respectively; P<0.05). The GRG had a significantly older age of onset than the PRG and a lower occurrence of initial precipitating events, such as febrile seizures, central nervous system infection, and head trauma (P<0.05). The prevalence of EEG abnormality, presence of aura, generalized seizures, and automatism was less frequently observed in the GRG (P<0.05). Multivariate analysis showed that the presence of automatism and initial precipitating events were significantly associated with a poor prognosis (P<0.05). CONCLUSION In contrast to the commonly assumed intractability of TLE, we found that more than 54% of patients with TLE-NL achieved a long seizure-free period. Older age at onset of TLE-NL was associated with a better prognosis. However, the presence of automatism and initial precipitating events were related to a poor prognosis. Future prospective studies with a much larger population are warranted.
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Affiliation(s)
- Jiyeon Kim
- Department of Neurology, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan
| | - Seong Hoon Kim
- Department of Neurology, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seocho-gu
| | - Sung Chul Lim
- Department of Neurology, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seocho-gu
| | - Woojun Kim
- Department of Neurology, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seocho-gu
| | - Young-Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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209
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Li BY, Chen SD. Potential Similarities in Temporal Lobe Epilepsy and Alzheimer’s Disease: From Clinic to Pathology. Am J Alzheimers Dis Other Demen 2015; 30:723-8. [PMID: 24906967 PMCID: PMC10852563 DOI: 10.1177/1533317514537547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer’s disease (AD) is clinically characterized by insidious onset of memory and cognitive impairments, which are also presented in patients with temporal lobe epilepsy (TLE). Many studies have shown that seizures occur in some patients with AD, and AD is a risk factor for epilepsy, mainly complex partial and secondary generalized seizure. Here, we focus on the relationship between TLE and AD in clinical and pathological aspects, as they are having similar comorbidities and mechanisms. In this study, we first reviewed the clinical observations that showed concomitant AD and TLE. Then, we picked up common genetic and pathological changes in both the diseases from neurobiological researches. Although both the diseases have delicate differences in many aspects, their common characteristics intrigue more detailed research to be done by newer technology.
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Affiliation(s)
- Bin-Yin Li
- Department of Neurology & Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sheng-Di Chen
- Department of Neurology & Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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210
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Exposure to Mozart music reduces cognitive impairment in pilocarpine-induced status epilepticus rats. Cogn Neurodyn 2015; 10:23-30. [PMID: 26834859 DOI: 10.1007/s11571-015-9361-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022] Open
Abstract
Patients with temporal lobe epilepsy (TLE) often display cognitive deficits. However, current epilepsy therapeutic interventions mainly aim at how to reduce the frequency and degree of epileptic seizures. Recovery of cognitive impairment is not attended enough, resulting in the lack of effective approaches in this respect. In the pilocarpine-induced temporal lobe epilepsy rat model, memory impairment has been classically reported. Here we evaluated spatial cognition changes at different epileptogenesis stages in rats of this model and explored the effects of long-term Mozart music exposure on the recovery of cognitive ability. Our results showed that pilocarpine rats suffered persisting cognitive impairment during epileptogenesis. Interestingly, we found that Mozart music exposure can significantly enhance cognitive ability in epileptic rats, and music intervention may be more effective for improving cognitive function during the early stages after Status epilepticus. These findings strongly suggest that Mozart music may help to promote the recovery of cognitive damage due to seizure activities, which provides a novel intervention strategy to diminish cognitive deficits in TLE patients.
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211
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Löscher W, Hirsch LJ, Schmidt D. The enigma of the latent period in the development of symptomatic acquired epilepsy - Traditional view versus new concepts. Epilepsy Behav 2015; 52:78-92. [PMID: 26409135 DOI: 10.1016/j.yebeh.2015.08.037] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 08/30/2015] [Indexed: 01/21/2023]
Abstract
A widely accepted hypothesis holds that there is a seizure-free, pre-epileptic state, termed the "latent period", between a brain insult, such as traumatic brain injury or stroke, and the onset of symptomatic epilepsy, during which a cascade of structural, molecular, and functional alterations gradually mediates the process of epileptogenesis. This review, based on recent data from both animal models and patients with different types of brain injury, proposes that epileptogenesis and often subclinical epilepsy can start immediately after brain injury without any appreciable latent period. Even though the latent period has traditionally been the cornerstone concept representing epileptogenesis, we suggest that the evidence for the existence of a latent period is spotty both for animal models and human epilepsy. Knowing whether a latent period exists or not is important for our understanding of epileptogenesis and for the discovery and the trial design of antiepileptogenic agents. The development of antiepileptogenic treatments to prevent epilepsy in patients at risk from a brain insult is a major unmet clinical need.
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Affiliation(s)
- Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine, 30559 Hannover, Germany; Center for Systems Neuroscience, 30559 Hannover, Germany.
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212
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Coras R, Blümcke I. Clinico-pathological subtypes of hippocampal sclerosis in temporal lobe epilepsy and their differential impact on memory impairment. Neuroscience 2015; 309:153-61. [DOI: 10.1016/j.neuroscience.2015.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 07/30/2015] [Accepted: 08/02/2015] [Indexed: 12/26/2022]
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213
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Li H, Fan W, Yang J, Song S, Liu Y, Lei P, Shrestha L, Mella G, Chen W, Xu H. Asymmetry in cross-hippocampal connectivity in unilateral mesial temporal lobe epilepsy. Epilepsy Res 2015; 118:14-21. [PMID: 26561924 DOI: 10.1016/j.eplepsyres.2015.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/15/2015] [Accepted: 10/25/2015] [Indexed: 01/06/2023]
Abstract
Mesial temporal lobe epilepsy (mTLE) is mostly characterized by hippocampal sclerosis (HS) changes. Although considerable progress has been made in understanding the altered functional network of mTLE patients, whether one side of the abnormal hippocampal (HP) structure will affect the other healthy side of the hippocampal network is still unclear. Here, we used a seed-based method to explore the commonly alterative hippocampal network in mTLE patients by comparing the bilateral hippocampal network of unilateral mTLE patients with healthy control participants. We observed that both sides of the hippocampal network in unilateral mTLE patients were changed independent of the affected or "healthy" side, which may suggest a common plasticity network for both sides of hippocampal sclerosis mesial temporal lobe epilepsy patients. Furthermore, using the HP as the ROI, we found that the functional connectivity of the intra-HP in the left mTLE-HS group was moderately positively correlated with the duration of the disease, while a strong negative correlation between functional connectivity of the intra-HP and duration were detected in the right mTLE-HS group, which suggested that it was easier for the right HP than the left HP to communicate with the contralateral HP according to the progression of mTLE disease because the hippocampus plays different roles in the communication and compensatory mechanism associated with the contralateral side of the hemisphere. We hope that this potential relevance may help us to better characterize mTLE with hippocampal sclerosis and ultimately assist in providing a better diagnosis and more accurate invasive treatments of mTLE.
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Affiliation(s)
- Hong Li
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Wenliang Fan
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Jie Yang
- Department of Communication Sciences and Disorders, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA.
| | - Shuyan Song
- School of Life Science and Technology, Key Laboratory of Image Processing and Intelligent Control of Education Ministry of China, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Yuan Liu
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Ping Lei
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Lochan Shrestha
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Grace Mella
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Wei Chen
- Department of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Radiology and Medical Imaging Center, The First People's Hospital of Yibin, Sichuan 644000, China.
| | - Haibo Xu
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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214
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Zhang Y, Seeburg DP, Pulli B, Wojtkiewicz GR, Bure L, Atkinson W, Schob S, Iwamoto Y, Ali M, Zhang W, Rodriguez E, Milewski A, Keliher EJ, Wang C, Pan Y, Swirski FK, Chen JW. Myeloperoxidase Nuclear Imaging for Epileptogenesis. Radiology 2015; 278:822-30. [PMID: 26397127 DOI: 10.1148/radiol.2015141922] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine if myeloperoxidase (MPO) is involved in epileptogenesis and if molecular nuclear imaging can be used to noninvasively map inflammatory changes in epileptogenesis. MATERIALS AND METHODS The animal and human studies were approved by the institutional review boards. Pilocarpine-induced epileptic mice were treated with 4-aminobenzoic acid hydrazide (n = 46), a specific irreversible MPO inhibitor, or saline (n = 42). Indium-111-bis-5-hydroxytryptamide-diethylenetriaminepentaacetate was used to image brain MPO activity (n = 6 in the 4-aminobenzoic acid hydrazide and saline groups; n = 5 in the sham group) by using single photon emission computed tomography/computed tomography. The role of MPO in the development of spontaneous recurrent seizures was assessed by means of clinical symptoms and biochemical and histopathologic data. Human brain specimens from a patient with epilepsy and a patient without epilepsy were stained for MPO. The Student t test, one-way analysis of variance, and Mann-Whitney and Kruskal-Wallis tests were used. Differences were regarded as significant if P was less than .05. RESULTS MPO and leukocytes increased in the brain during epileptogenesis (P < .05). Blocking MPO delayed spontaneous recurrent seizures (99.6 vs 142 hours, P = .016), ameliorated the severity of spontaneous recurrent seizures (P < .05), and inhibited mossy fiber sprouting (Timm index, 0.31 vs 0.03; P = .003). Matrix metalloproteinase activity was upregulated during epileptogenesis in an MPO-dependent manner (1.44 vs 0.94 U/mg, P = .049), suggesting that MPO acts upstream of matrix metalloproteinases. MPO activity was mapped during epileptogenesis in vivo in the hippocampal regions. Resected temporal lobe tissue from a human patient with refractory epilepsy but not the temporal lobe tissue from a patient without seizures demonstrated positive MPO immunostaining, suggesting high translational potential for this imaging technology. CONCLUSION The findings of this study highlight an important role for MPO in epileptogenesis and show MPO to be a potential therapeutic target and imaging biomarker for epilepsy.
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Affiliation(s)
- Yinian Zhang
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Daniel P Seeburg
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Benjamin Pulli
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Gregory R Wojtkiewicz
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Lionel Bure
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Wendy Atkinson
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Stefan Schob
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Yoshiko Iwamoto
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Muhammad Ali
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Wei Zhang
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Elisenda Rodriguez
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Andrew Milewski
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Edmund J Keliher
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Cuihua Wang
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Yawen Pan
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - Filip K Swirski
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
| | - John W Chen
- From the Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, China (Y.Z., Y.P.); Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, 185 Cambridge St, Boston, MA 02114 (Y.Z., D.P.S., B.P., G.R.W., L.B., W.A., S.S., Y.I., M.A., E.R., A.M., E.J.K., C.W., F.K.S., J.W.C.); and Department of Neurosurgery, Massachusetts General Hospital, Boston, Mass (W.Z.)
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Sun Z, Zuo H, Yuan D, Sun Y, Zhang K, Cui Z, Wang J. Predictors of prognosis in patients with temporal lobe epilepsy after anterior temporal lobectomy. Exp Ther Med 2015; 10:1896-1902. [PMID: 26640569 DOI: 10.3892/etm.2015.2753] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 07/13/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the predictive value of prognostic factors for the surgical outcome of patients with mesial temporal lobe epilepsy (MTLE) using Engel seizure classification. The clinical data of 121 patients with MTLE who underwent anterior temporal lobectomy (ATL) and received a 1-year minimum follow-up were collected between January 2005 and December 2008. Patients were divided into seizure and seizure-free groups according to the Engel seizure classification. Univariate analysis and multivariate logistic regression analysis were used to analyze the potential predictive and prognostic factors, including medical history, clinical features of seizures, magnetic resonance imaging (MRI) and video-electroencephalogram (EEG) monitoring results. Univariate analysis indicated no statistically significant differences in gender, age at seizure onset, age at surgery, history of traumatic brain injury, perinatal anoxia, intracranial infection, family history of seizure, auras or site of surgery between the two groups; however, significant differences were detected in pre-surgical seizure duration, history of febrile seizures, seizure types, MRI and video-EEG results. Multivariate logistic regression analysis demonstrated that a pre-surgical seizure duration of <10 years, history of positive febrile seizures, simple complex partial seizure, positive MRI results and unilateral local video-EEG spikes may be considered as predictors of a good prognosis. These results indicate that remission may be achieved in patients with MTLE via the collection of accurate clinical information and adequate pre-surgical evaluation.
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Affiliation(s)
- Zhenxing Sun
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China
| | - Huancong Zuo
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China
| | - Dan Yuan
- Department of Neurology, The Luhe Teaching Hospital, Capital Medical University, Beijing 101149, P.R. China
| | - Yaxing Sun
- Department of Psychiatry, The Second Municipal Hospital of Zaozhuang, Zaozhuang, Shandong 277100, P.R. China
| | - Kai Zhang
- Department of Neurosurgery, Tiantan Hospital, Capital Medical University, Beijing 101149, P.R. China
| | - Zhiqiang Cui
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100084, P.R. China
| | - Jin Wang
- Department of Neurosurgery, Changgung Hospital, Tsinghua University Medical Center, Beijing 100084, P.R. China
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216
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Coughlin CR, van Karnebeek CDM, Al-Hertani W, Shuen AY, Jaggumantri S, Jack RM, Gaughan S, Burns C, Mirsky DM, Gallagher RC, Van Hove JLK. Triple therapy with pyridoxine, arginine supplementation and dietary lysine restriction in pyridoxine-dependent epilepsy: Neurodevelopmental outcome. Mol Genet Metab 2015; 116:35-43. [PMID: 26026794 DOI: 10.1016/j.ymgme.2015.05.011] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/22/2015] [Accepted: 05/22/2015] [Indexed: 11/21/2022]
Abstract
Pyridoxine-dependent epilepsy (PDE) is an epileptic encephalopathy characterized by response to pharmacologic doses of pyridoxine. PDE is caused by deficiency of α-aminoadipic semialdehyde dehydrogenase resulting in impaired lysine degradation and subsequent accumulation of α-aminoadipic semialdehyde. Despite adequate seizure control with pyridoxine monotherapy, 75% of individuals with PDE have significant developmental delay and intellectual disability. We describe a new combined therapeutic approach to reduce putative toxic metabolites from impaired lysine metabolism. This approach utilizes pyridoxine, a lysine-restricted diet to limit the substrate that leads to neurotoxic metabolite accumulation and L-arginine to compete for brain lysine influx and liver mitochondrial import. We report the developmental and biochemical outcome of six subjects who were treated with this triple therapy. Triple therapy reduced CSF, plasma, and urine biomarkers associated with neurotoxicity in PDE. The addition of arginine supplementation to children already treated with dietary lysine restriction and pyridoxine further reduced toxic metabolites, and in some subjects appeared to improve neurodevelopmental outcome. Dietary lysine restriction was associated with improved seizure control in one subject, and the addition of arginine supplementation increased the objective motor outcome scale in two twin siblings, illustrating the contribution of each component of this treatment combination. Optimal results were noted in the individual treated with triple therapy early in the course of the disease. Residual disease symptoms could be related to early injury suggested by initial MR imaging prior to initiation of treatment or from severe epilepsy prior to diagnosis. This observational study reports the use of triple therapy, which combines three effective components in this rare condition, and suggests that early diagnosis and treatment with this new triple therapy may ameliorate the cognitive impairment in PDE.
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Affiliation(s)
- Curtis R Coughlin
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado, Aurora, CO, United States
| | - Clara D M van Karnebeek
- Division of Biochemical Diseases &Treatable Intellectual Disability Endeavour in British Columbia (TIDE-BC), Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Walla Al-Hertani
- Department of Medical Genetics, Montreal Children's Hospital, McGill University of Health Centre, Montreal, QC, Canada
| | - Andrew Y Shuen
- Department of Medical Genetics, Montreal Children's Hospital, McGill University of Health Centre, Montreal, QC, Canada
| | - Sravan Jaggumantri
- Division of Biochemical Diseases &Treatable Intellectual Disability Endeavour in British Columbia (TIDE-BC), Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Rhona M Jack
- Department of Laboratory Medicine, Seattle Children's Hospital Laboratory, Seattle, WA, United States
| | - Sommer Gaughan
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado, Aurora, CO, United States
| | - Casey Burns
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado, Aurora, CO, United States
| | - David M Mirsky
- Department of Radiology, University of Colorado, Aurora, CO, United States
| | - Renata C Gallagher
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado, Aurora, CO, United States
| | - Johan L K Van Hove
- Section of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado, Aurora, CO, United States.
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217
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Carletti F, Gambino G, Rizzo V, Ferraro G, Sardo P. Cannabinoid and nitric oxide signaling interplay in the modulation of hippocampal hyperexcitability: Study on electrophysiological and behavioral models of temporal lobe epilepsy in the rat. Neuroscience 2015; 303:149-59. [DOI: 10.1016/j.neuroscience.2015.06.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/10/2015] [Accepted: 06/23/2015] [Indexed: 02/04/2023]
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219
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Banerjee J, Banerjee Dixit A, Tripathi M, Sarkar C, Gupta YK, Chandra PS. Enhanced endogenous activation of NMDA receptors in pyramidal neurons of hippocampal tissues from patients with mesial temporal lobe epilepsy: A mechanism of hyper excitation. Epilepsy Res 2015; 117:11-6. [PMID: 26320079 DOI: 10.1016/j.eplepsyres.2015.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/17/2015] [Accepted: 08/08/2015] [Indexed: 11/30/2022]
Abstract
Altered excitatory synaptic transmission is one of the primary causes of seizure generation in patients with mesial temporal lobe epilepsy (MTLE). The present study is designed to delineate the contribution of glutamatergic tone under resting conditions to the hyper excitability in patients with MTLE. Resected hippocampal tissues were obtained from patients with MTLE. In these samples spontaneous excitatory postsynaptic currents (EPSCs), sensitive to NMDA receptor antagonist APV (50μM) and AMPA receptor antagonist CNQX (10μM) were recorded from pyramidal neurons at -70mV. We observed that frequency of EPSCs were 28.2% higher in slices obtained from patients with MTLE compared to that in case of non-epileptic controls. We also examined spontaneous fast current transients (CTs) recorded from these pyramidal neurons under cell-attached configuration. The frequency of CTs increased in the absence of extracellular Mg(2+) in brain slice preparations and was completely blocked by APV. We found that the frequency of CTs in pyramidal neurons were higher in case of MTLE samples compared to non-epileptic controls. This study suggests that enhanced endogenous activity of NMDA receptor contributes to excitability in pyramidal neurons of slice preparations obtained from patients with MTLE.
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Affiliation(s)
- Jyotirmoy Banerjee
- Center of Excellence for Epilepsy, National Brain Research Center, Manesar, India.
| | | | - Manjari Tripathi
- Center of Excellence for Epilepsy, National Brain Research Center, Manesar, India; Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - Chitra Sarkar
- Department of Neuropathology, All India Institute of Medical Sciences, New Delhi, India.
| | - Yogendra Kumar Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
| | - P Sarat Chandra
- Center of Excellence for Epilepsy, National Brain Research Center, Manesar, India; Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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220
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López-Valenzuela CL, Morales-Villagrán A, Medina-Ceja L. A novel method for simultaneous glutamate and extracellular activity measurement in brain slices with high temporal resolution. Talanta 2015; 144:1231-8. [PMID: 26452952 DOI: 10.1016/j.talanta.2015.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/02/2015] [Accepted: 08/05/2015] [Indexed: 11/30/2022]
Abstract
Measurement of neurotransmitters during normal or altered function in cerebral slices could be an important tool to better understand the relationship between biochemical changes and electrophysiological activity. Some attempts of this analysis have been made; however, the current techniques do not have the appropriate time resolution to establish this relationship. The use of electrochemical biosensors has allowed for good time resolution, but problems related to the reduction of signal noise and biofouling of the electrode surface could be an important issue. In this work, we propose a new alternative to simultaneously measure glutamate and electrical activity with a high temporal resolution in brain slices. This approach is based on the use of enzymatic reactors that generate a fluorescent derivative from glutamate that can be measured at high temporal resolution. The results presented here show a reliable measurement of this neurotransmitter in brain slices obtained from intact animals under the effect of a glutamate transporter blocker DL-threo-beta-benzyloxyaspartate as well as the potassium channel blocker 4-aminopyridine. Differences in the levels of glutamate and high frequency and amplitude discharges as an effect of drug administration were found in brain slices obtained from epileptic rats (p<0.05). In conclusion, this method could be used to measure neurotransmitter concentration online at a near physiological temporal resolution, which can then be correlated to the electrical activity that is simultaneously recorded.
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Affiliation(s)
- C L López-Valenzuela
- Laboratory of Neurophysiology and Neurochemistry, Department of Cellular and Molecular Biology, CUCBA, University of Guadalajara, Jalisco, Mexico
| | - A Morales-Villagrán
- Laboratory of Neurophysiology and Neurochemistry, Department of Cellular and Molecular Biology, CUCBA, University of Guadalajara, Jalisco, Mexico.
| | - L Medina-Ceja
- Laboratory of Neurophysiology and Neurochemistry, Department of Cellular and Molecular Biology, CUCBA, University of Guadalajara, Jalisco, Mexico
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221
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Asadi-Pooya AA, Sperling MR. Age at onset in patients with medically refractory temporal lobe epilepsy and mesial temporal sclerosis: Impact on clinical manifestations and postsurgical outcome. Seizure 2015. [DOI: 10.1016/j.seizure.2015.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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222
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Monti G, Meletti S. Emotion recognition in temporal lobe epilepsy: A systematic review. Neurosci Biobehav Rev 2015; 55:280-93. [DOI: 10.1016/j.neubiorev.2015.05.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/30/2015] [Accepted: 05/08/2015] [Indexed: 11/25/2022]
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223
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Coan AC, Campos BM, Bergo FPG, Kubota BY, Yasuda CL, Morita ME, Guerreiro CAM, Cendes F. Patterns of seizure control in patients with mesial temporal lobe epilepsy with and without hippocampus sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:79-82. [PMID: 25742574 DOI: 10.1590/0004-282x20140199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/14/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients with mesial temporal lobe epilepsy (MTLE) may present unstable pattern of seizures. We aimed to evaluate the occurrence of relapse-remitting seizures in MTLE with (MTLE-HS) and without (MTLE-NL) hippocampal sclerosis. METHOD We evaluated 172 patients with MTLE-HS (122) or MTLE-NL (50). Relapse-remitting pattern was defined as periods longer than two years of seizure-freedom intercalated with seizure recurrence. "Infrequent seizures" was considered as up to three seizures per year and "frequent seizures" as any period of seizures higher than that. RESULTS Thirty-seven (30%) MTLE-HS and 18 (36%) MTLE-NL patients had relapse-remitting pattern (X2, p = 0.470). This was more common in those with infrequent seizures (X2, p < 0.001). Twelve MTLE-HS and one MTLE-NL patients had prolonged seizure remission between the first and second decade of life (X2, p = 0.06). CONCLUSION Similar proportion of MTLE-HS or MTLE-NL patients present relapse-remitting seizures and this occurs more often in those with infrequent seizures.
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Affiliation(s)
- Ana Carolina Coan
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Brunno M Campos
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Felipe P G Bergo
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Bruno Y Kubota
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Clarissa L Yasuda
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Marcia E Morita
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Carlos A M Guerreiro
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Fernando Cendes
- Laboratório de Neuroimagem, Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Iwase T, Yoshida M, Mizuno T, Sato S, Nokura K. An autopsy case of hemiconvulsion-hemiplegia-epilepsy syndrome manifesting as cerebral hemiatrophy in an elderly man. Neuropathology 2015; 35:592-8. [PMID: 26179932 DOI: 10.1111/neup.12225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
We report an autopsy case of hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome in a 79-year-old man. HHE syndrome usually occurs in children younger than 4 years of age. Although most HHE syndrome patients live into adult life, only a few cases of the syndrome have been reported in the elderly. In our case, cerebral hemiatrophy, left mesial temporal sclerosis and crossed cerebellar atrophy were observed. Because this is the oldest case ever reported, we further investigated age-related neuropathological changes and found an interhemispheric difference in amyloid-β-related neuropathologic changes. There were almost no senile plaques or amyloid-laden vessels in the left hemisphere. As far as we know, this is the first report of age-related neuropathology in a brain manifesting HHE syndrome.
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Affiliation(s)
- Tamaki Iwase
- Department of Neurology, Nagoya City Koseiin Medical Welfare Center, Aichi, Japan
| | - Mari Yoshida
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan
| | - Tomoyuki Mizuno
- Department of Neurology, Nagoya City Koseiin Medical Welfare Center, Aichi, Japan
| | - Shinya Sato
- Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kazuya Nokura
- Department of Neurology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Aichi, Japan
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de Oliveira Taveira M, Morita ME, Yasuda CL, Coan AC, Secolin R, Luiz Cunha da Costa A, Cendes F. Neurocysticercotic Calcifications and Hippocampal Sclerosis: A Case-Control Study. PLoS One 2015; 10:e0131180. [PMID: 26132287 PMCID: PMC4488485 DOI: 10.1371/journal.pone.0131180] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 05/31/2015] [Indexed: 11/18/2022] Open
Abstract
Objective The exact role of calcified neurocysticercotic lesions (CNLs) in epilepsy is yet unknown and controversial. Although the relationship between CNLs, epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) has already been addressed, to our knowledge, no study has actually provided strong statistical evidence, nor reported the ODDS ratio for these associations. Therefore, we designed this case-control study to assess the likelihood of having MTLE-HS versus other forms of epilepsy in the presence of CNLs. Methods In this case-control study we included 119 consecutive patients with epilepsy and 106 disease controls (headache) with previous CT scans. We subdivided cases into MTLE-HS and other epilepsies. We used brain CT scans to define presence or absence of CNLs. After exploratory analyses, we used logistic regression to analyze the association between CNLs, epilepsy subgroups and disease controls. Results CNLs were found in 31.09% of cases and in 11.32% of controls (p<0.001). The initial analysis comparing epilepsy versus controls revealed a significant association between CNLs and epilepsy (OR = 5.32; 95%CI = 2.43-11.54; p<0.001). However, when we compared MTLE-HS versus other epilepsies versus controls we confirmed that CNLs were associated with MTLE-HS (OR = 11.27, 95%CI = 4.73-26.85; p<0.001) but other epilepsies were not. We found no difference in the CNLs load and no difference in the location of the CNLs when we compared patients with MTLE-HS, other epilepsies and disease controls. Significance The inclusion of controls allowed us to estimate the likelihood of having epilepsy in the presence of CNLs. We found that patients with CNLs were 11 times more likely to have MTLE-HS; however, the presence of CNLs did not change the odds of having other types of epilepsy. These findings raise the possibility of neurocysticercosis playing a role in the pathophysiology of MTLE-HS and need further confirmation in other series.
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Affiliation(s)
| | | | - Clarissa Lin Yasuda
- Department of Neurology, University of Campinas—UNICAMP, Campinas, SP, Brazil
| | - Ana Carolina Coan
- Department of Neurology, University of Campinas—UNICAMP, Campinas, SP, Brazil
| | - Rodrigo Secolin
- Department of Medical Genetics, University of Campinas—UNICAMP, Campinas, SP, Brazil
| | | | - Fernando Cendes
- Department of Neurology, University of Campinas—UNICAMP, Campinas, SP, Brazil
- * E-mail:
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Kim CH. Cav3.1 T-type calcium channel modulates the epileptogenicity of hippocampal seizures in the kainic acid-induced temporal lobe epilepsy model. Brain Res 2015; 1622:204-16. [PMID: 26111648 DOI: 10.1016/j.brainres.2015.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
The molecular mechanism of temporal lobe epilepsy has not been clearly identified. T-type calcium channels play a role in burst firing in neurons and have been implicated in several seizure models. In this study, the role of Cav3.1 T-type (α1G) calcium channel has been investigated in the kainic acid (KA)-induced temporal lobe epilepsy model (TLE) by using conventional α1G knock-out (ko) mice. After intraperitoneal (i.p.) administration or intrahippocampal injection of KA, depth hippocampal and cortical electroencephalogram (EEG) and behavioral monitoring were recorded, and timm and Nissl staining of brain sections were made later. Seizure was mainly identified by EEG signals, rather than behaviorally, with analytic criteria. During the acute status epilepticus (SE) period, both the duration and the frequency of hippocampal seizures were significantly reduced and increased, respectively, in αlG ko mice compared to those of wild type mice. Epileptogenicity, the total period of seizures (hr(-1)), was also significantly reduced in α1G ko mice. However, the latency of seizure occurrence was not significantly different between wild type and ko mice. These differential effects were not observed in cortical seizures. Furthermore, the injection of KA caused a strong increase in δ rhythm power spectrum density (PSD) of EEG in αlG ko mice compared to that in wild type mice. The results with conventional ko mice indicate that α1G T-type calcium channel plays a modulatory role in the duration and frequency of hippocampal seizures as well as the epileptogenicity of KA-induced TLE in mice, mostly during acute periods.
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Affiliation(s)
- Chong-Hyun Kim
- Center for Neuroscience, Brain Science Institute, Korea Institute of Science & Technology, Seoul 136-791, Republic of Korea; Department of Neuroscience, Korea University of Science & Technology, Daejeon 305-333, Republic of Korea.
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227
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Huang W, Huang D, Chen Z, Ye W, Lv Z, Diao L, Zheng J. Alterations in the functional connectivity of a verbal working memory-related brain network in patients with left temporal lobe epilepsy. Neurosci Lett 2015; 602:6-11. [PMID: 26101832 DOI: 10.1016/j.neulet.2015.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 04/21/2015] [Accepted: 06/12/2015] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the alterations in a verbal working memory (VWM)-related network in left temporal lobe epilepsy (lTLE) at rest. We evaluated 14 patients with lTLE and 14 control subjects by resting-state functional connectivity (RSFC). The region of interest was defined by the voxel with the highest Z-score during a VWM task according to functional magnetic resonance imaging in 16 healthy volunteers. Our study revealed that the network of RSFC was similar to the task-induced network in the healthy volunteers. Moreover, the patients with lTLE exhibited significantly decreased RSFC in the bilateral middle frontal gyrus, the inferior frontal gyrus and the inferior parietal lobule at rest compared to the control subjects. We found no significant correlation between the mean reaction time of the accurate responses in a 2-back task and the mean z-values within the regions that exhibited significant differences in RSFC at the individual level. The alterations in FCs of VWM-related network in lTLE suggested that epileptiform discharges can damage the brain regions, both local focus and remote areas and that the alterations were not associated with VWM performance.
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Affiliation(s)
- Wenli Huang
- Department of Neurology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Donghong Huang
- Department of Neurology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Zirong Chen
- Department of Neurology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Wei Ye
- Department of Radiology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Zongxia Lv
- Department of Neurology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China
| | - Limei Diao
- Department of Neurology, the First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning 530023, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China.
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Dupont S, Samson Y, Nguyen-Michel VH, Zavanone C, Clémenceau S, Miles R, Baulac M, Adam C. Are auras a reliable clinical indicator in medial temporal lobe epilepsy with hippocampal sclerosis? Eur J Neurol 2015; 22:1310-6. [DOI: 10.1111/ene.12747] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 03/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
- S. Dupont
- Epilepsy Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Rehabilitation Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
| | - Y. Samson
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
- Stroke Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
| | - V.-H. Nguyen-Michel
- Epilepsy Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Neurophysiology Unit of the Charles Foix Hospital, APHP; Paris France
| | - C. Zavanone
- Rehabilitation Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
| | - S. Clémenceau
- Epilepsy Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
- Neurosurgery Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
| | - R. Miles
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
| | - M. Baulac
- Epilepsy Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
| | - C. Adam
- Epilepsy Unit; Hôpital de la Pitié-Salpêtrière, APHP; Paris France
- Inserm U 1127; CNRS UMR 7225; UPMC Univ Paris 06 UMR S 1127; Institut du Cerveau et de la Moelle épinière; ICM; Sorbonne Universités; Paris France
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Sawant N, Ravat S, Muzumdar D, Shah U. Is psychiatric assessment essential for better epilepsy surgery outcomes? Int J Surg 2015; 36:460-465. [PMID: 26079497 DOI: 10.1016/j.ijsu.2015.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/25/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022]
Abstract
Epilepsy surgery is one of the most accepted and beneficial treatment for resistant epilepsies. However there is some variability in the comprehensive epilepsy care programs offered globally. Many centers do not do a psychiatric assessment unless required. It is now evident from a large body of research that epilepsy is associated with psychiatric morbidity which is also seen in patients considered for epilepsy surgery. There is also evidence to state that the risk for worsening or de novo psychiatric disorders is often seen post surgery. This calls for a comprehensive psychiatric assessment of all patients enrolled for the epilepsy surgery program to be evaluated pre and post surgically to minimize the risk of post surgical psychological disturbances and/or poor quality of life. Efficacious treatment of psychiatric disorders in those having psychiatric morbidity contributes to improved patient wellbeing, seizure freedom and better quality of life. Hence there is a need for most centers globally to include regular psychiatric assessment of epilepsy surgery patients as a protocol.
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Affiliation(s)
- Neena Sawant
- Dept of Psychiatry, Comprehensive Epilepsy Care Unit, Seth GSMC & KEM Hospital, Parel, Mumbai 400012, India.
| | - Sangeeta Ravat
- Dept of Neurology, Comprehensive Epilepsy Care Unit, Seth GSMC & KEM Hospital, Parel, Mumbai 400012, India.
| | - Dattatraya Muzumdar
- Dept of Neurosurgery, Comprehensive Epilepsy Care Unit, Seth GSMC & KEM Hospital, Parel, Mumbai 400012, India.
| | - Urvashi Shah
- Dept of Neurology, Comprehensive Epilepsy Care Unit, Seth GSMC & KEM Hospital, Parel, Mumbai 400012, India.
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Eryurt B, Oner AY, Ucar M, Capraz I, Kurt G, Bilir E, Tali ET. Presurgical evaluation of mesial temporal lobe epilepsy with multiple advanced MR techniques at 3T. J Neuroradiol 2015; 42:283-90. [PMID: 26024772 DOI: 10.1016/j.neurad.2015.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/08/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE Accurate localization of the epileptogenic zone is essential for successful surgical treatment of mesial temporal lobe epilepsy (MTLE). The aim of this study was to analyze and compare the hippocampal volumetry (HV), MR spectroscopy (MRS), Dynamic susceptibility contrast (DSC) and pulsed arterial spin labeling (pASL) perfusion techniques in a large sample size of refractory MTLE patients. MATERIALS AND METHODS Forty-two patients with medically refractory MTLE who underwent preoperative evaluation and eleven normal controls were studied. Pathologic and control hippocampi were compared in terms of hippocampal volume, metabolite ratios and relative hippocampal perfusion values. By using cut-off points and asymmetry indexes, percentages of performance indicators for each technique were calculated in groups of MR (+), MR (-) and bilateral MTLE. RESULTS For all techniques, a statistically significant difference was found between the pathologic and control hippocampus groups (P<0.001). Also, all of them except HV had diagnostic value in groups of MR (-) and bilateral MTLE. CONCLUSION HV, MRS, DSC and pASL have achieved comparable performance and each of them provides important information about the lateralization of epileptogenic focus. Among those, pASL and MRS may easily be used as an adjunct to conventional MR.
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Affiliation(s)
- Bulent Eryurt
- Department of Radiology, Gazi University School of Medicine, 06560 Ankara, Turkey.
| | - A Yusuf Oner
- Department of Radiology, Gazi University School of Medicine, 06560 Ankara, Turkey
| | - Murat Ucar
- Department of Radiology, Gazi University School of Medicine, 06560 Ankara, Turkey
| | - Irem Capraz
- Department of Neurology, Gazi University School of Medicine, Ankara, Turkey
| | - Gokhan Kurt
- Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey
| | - Erhan Bilir
- Department of Neurology, Gazi University School of Medicine, Ankara, Turkey
| | - E Turgut Tali
- Department of Radiology, Gazi University School of Medicine, 06560 Ankara, Turkey
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Toydemir HE, Özkara Ç, Uysal O, Ozyurt E, Uzan M. Complete seizure freedom is possible in patients with MTLE-HS after surgery in spite of extratemporal electro-clinical features. Epilepsy Res 2015; 113:104-12. [PMID: 25986197 DOI: 10.1016/j.eplepsyres.2015.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/13/2015] [Accepted: 03/28/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim was to identify the common typical and atypical ictal semiologic and EEG features of patients with mesial temporal lobe epilepsy and hippocampal sclerosis who became seizure-free postoperatively. METHOD The semiologic and EEG findings of 126 ictal video-EEG recordings of 50 patients who remained seizure-free for at least 2 years (mean=9.46±3.20; range=3-14.5 years) after surgery were reviewed. Statistical analysis was used to determine the frequencies of the most common auras, semiologic features and EEG patterns and to define the symptom clusters. RESULTS Aura was reported in 82% (n:41) of patients and the most common type was epigastric sensation. Early symptoms were contralateral upper extremity dystonic posturing (66%), oro-alimentary automatisms (50%) and ipsilateral hand automatisms (40%). Ictal EEG findings revealed localized and lateralized activity in 62% of patients. Of the 17 most common early symptoms, there was a tendency toward two clusters. Cluster 2 consisted of findings that were typical for patients with mesial temporal lobe epilepsy whereas Cluster 1 mostly consisted of atypical findings. CONCLUSIONS This study demonstrated two clusters of the semiologic repertoire, and the most frequent EEG finding was lateralized and localized ictal activity, while other types of EEG patterns were also recorded. Although the presence of atypical findings may suggest a more extended or even extratemporal zone, the seizure-free outcome demonstrated that if the critical amount of tissue can be resected within the epileptogenic network, this may be sufficient for termination of seizures.
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Affiliation(s)
| | - Çiğdem Özkara
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Neurology, Division of Clinical Electro-Neurophysiology, Istanbul, Turkey
| | - Omer Uysal
- Bezmialem Vakıf University School of Medicine, Department of Biostatistics, Istanbul, Turkey
| | - Emin Ozyurt
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
| | - Mustafa Uzan
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
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232
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Wang J, Tan L, Tan L, Tian Y, Ma J, Tan CC, Wang HF, Liu Y, Tan MS, Jiang T, Yu JT. Circulating microRNAs are promising novel biomarkers for drug-resistant epilepsy. Sci Rep 2015; 5:10201. [PMID: 25984652 PMCID: PMC4435024 DOI: 10.1038/srep10201] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 04/02/2015] [Indexed: 12/12/2022] Open
Abstract
MicroRNAs (miRNAs) open up a new field for molecular diagnosis for cancer and other diseases based on their stability in serum. However, the role of circulating miRNAs in plasma/serum in epilepsy diagnosis is still unclear. The aim of this study was to evaluate whether miRNAs can be used as biomarkers for drug-resistant epilepsy. We measured the differences in serum miRNA levels between 30 drug-resistant patients and 30 drug-responsive epilepsy patients in discovery and training phases using Illumina HiSeq2000 sequencing followed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) assays. The selected miRNAs were then validated in 77 drug-resistant epilepsy patients, 81 drug-responsive epilepsy patients and 85 healthy controls by qRT-PCR. We found that circulating miRNAs are differentially expressed between drug-resistant group and drug-responsive group. MiR-194-5p, -301a-3p, -30b-5p, -342-5p and -4446-3p were significantly deregulated in drug-resistant group compared to drug-responsive group and control group. Among these 5 miRNAs, miR-301a-3p had the best diagnostic value for drug-resistant epilepsy with 80.5% sensitivity and 81.2% specificity, and was negatively associated with seizure severity. These provide the rationale for further confirmation studies in larger prospective cohorts and in other ethnics.
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Affiliation(s)
- Jun Wang
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Qingdao, China
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, China
| | - Lin Tan
- Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Yan Tian
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Jing Ma
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Hui-Fu Wang
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Qingdao, China
| | - Ying Liu
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, China
| | - Meng-Shan Tan
- Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
| | - Teng Jiang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Municipal Hospital, College of Medicine and Pharmaceutics, Ocean University of China, Qingdao, China
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Qingdao, China
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Barnett AJ, Park MTM, Pipitone J, Chakravarty MM, McAndrews MP. Functional and structural correlates of memory in patients with mesial temporal lobe epilepsy. Front Neurol 2015; 6:103. [PMID: 26029159 PMCID: PMC4429573 DOI: 10.3389/fneur.2015.00103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 04/25/2015] [Indexed: 11/13/2022] Open
Abstract
Individuals with medial temporal lobe epilepsy (mTLE) often show material-specific memory impairment (verbal for left, visuospatial for right hemisphere), which can be exacerbated following surgery aimed at the epileptogenic regions of medial and anterolateral temporal cortex. There is a growing body of evidence suggesting that characterization of structural and functional integrity of these regions using MRI can aid in prediction of post-surgical risk of further memory decline. We investigated the nature of the relationship between structural and functional indices of hippocampal integrity with pre-operative memory performance in a group of 26 patients with unilateral mTLE. Structural integrity was assessed using hippocampal volumes, while functional integrity was assessed using hippocampal activation during the encoding of novel scenes. We quantified structural and functional integrity in terms of asymmetry, calculated as (L - R)/(L + R). Factor scores for verbal and visual memory were calculated from a clinical database and an asymmetry score (verbal - visual) was used to characterize memory performance. We found, as expected, a significant difference between left and right mTLE (RTLE) groups for hippocampal volume asymmetry, with each group showing an asymmetry favoring the unaffected temporal lobe. Encoding activation asymmetry showed a similar pattern, with left mTLE patients showing activation preferential to the right hemisphere and RTLE patients showing the reverse. Finally, we demonstrated that functional integrity mediated the relationship between structural integrity and memory performance for memory asymmetry, suggesting that even if structural changes are evident, ultimately it is the functional integrity of the tissue that most closely explains behavioral performance.
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Affiliation(s)
| | - Min Tae M Park
- Schulich School of Medicine and Dentistry, Western University , London, ON , Canada ; Douglas Mental Health University Institute , Montreal, QC , Canada
| | - Jon Pipitone
- Research Imaging Centre, Centre for Addiction and Mental Health , Toronto, ON , Canada
| | - M Mallar Chakravarty
- Douglas Mental Health University Institute , Montreal, QC , Canada ; Department of Psychiatry and Biomedical Engineering, McGill University , Montreal, QC , Canada
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234
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Neural correlates of mirth and laughter: A direct electrical cortical stimulation study. Cortex 2015; 66:134-40. [DOI: 10.1016/j.cortex.2014.11.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 07/28/2014] [Accepted: 11/10/2014] [Indexed: 11/20/2022]
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235
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Oner AY, Eryurt B, Ucar M, Capraz I, Kurt G, Bilir E, Tali T. pASL versus DSC perfusion MRI in lateralizing temporal lobe epilepsy. Acta Radiol 2015; 56:477-81. [PMID: 24782571 DOI: 10.1177/0284185114531128] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accurate lateralization of the epileptogenic focus in temporal lobe epilepsy (TLE) is crucial. Pulsed arterial spin labeling (pASL) has the capability of quantifying local relative cerebral blood flow (rCBF) by measuring the inflow of electromagnetically labeled arterial blood into the target area, and can be used in the presurgical workup of refractory TLE. PURPOSE To evaluate pASL in detecting mesial temporal lobe (mTL) perfusion asymmetry for the lateralization of the epileptogenic focus in patients with refractory TLE and to compare it with dynamic susceptibility contrast enhanced (DSC) magnetic resonance imaging (MRI) technique. MATERIAL AND METHODS This study was approved by the local ethical committee, and written informed consent was obtained in each patient. Thirty-six patients with medically refractory TLE and 11 healthy volunteer was enrolled in this study. Following brain MRI, pASL and DSC perfusion were performed in all subjects at 3T. rCBF measurements with two different perfusion MRI technique were compared between the patient and healthy volunteers. Lateralization based on perfusion asymmetry index (AI) were also evaluated and compared with clinical lateralization. RESULTS rCBF ratios measured in healthy volunteers by two different perfusion technique did not show any statistically significant difference. In TLE patients rCBF ratio of the ipsilateral (affected) side was found to be significantly lower than the contralateral (unaffected) side with both technique. The AI in the patient group was 8.86 ± 3.88 with pASL and 8.39 ± 4.06 with DSC. Correlation coefficient between clinical laterality and perfusion AI were 0.86 for pASL and 0.83 for DSC. CONCLUSION pASL can successfully detect interictal asymmetry in patients with TLE and can readily be combined with routine structural assessment for lateralization, providing an alternative to DSC perfusion.
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Affiliation(s)
- A Yusuf Oner
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
| | - Bulent Eryurt
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
| | - Murat Ucar
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
| | - Irem Capraz
- Department of Neurology, Gazi University School of Medicine, Ankara, Turkey
| | - Gokhan Kurt
- Department of Neurosurgery, Gazi University School of Medicine, Ankara, Turkey
| | - Erhan Bilir
- Department of Neurology, Gazi University School of Medicine, Ankara, Turkey
| | - Turgut Tali
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
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Oliveira CVD, Grigoletto J, Funck VR, Ribeiro LR, Royes LFF, Fighera MR, Furian AF, Oliveira MS. Evaluation of potential gender-related differences in behavioral and cognitive alterations following pilocarpine-induced status epilepticus in C57BL/6 mice. Physiol Behav 2015; 143:142-50. [PMID: 25749198 DOI: 10.1016/j.physbeh.2015.03.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 11/16/2022]
Abstract
Together with pharmacoresistant seizures, the quality of life of temporal lobe epilepsy (TLE) patients is negatively impacted by behavioral comorbidities including but not limited to depression, anxiety and cognitive deficits. The pilocarpine model of TLE has been widely used to study characteristics of human TLE, including behavioral comorbidities. Since the outcomes of pilocarpine-induced TLE might vary depending on several experimental factors, we sought to investigate potential gender-related differences regarding selected behavioral alterations in C57BL6 mice. We found that epileptic mice, independent of gender, displayed increased anxiety-like behavior in the open-field test. In the object recognition test, epileptic mice, regardless of gender, showed a decreased recognition index at 24 (but not at 4) hours after training. On the other hand, no significant differences were found regarding mice learning and memory performance in the Barnes maze paradigm. Motor coordination and balance as assessed by the beam walk and rotarod tests were not impaired in epileptic mice of both genders. However, female mice, independent of epilepsy, performed the beam walk and rotarod tasks better than their male counterparts. We also found that only male epileptic mice displayed disturbed behavior in the forced swim test, but the mice of both genders displayed anhedonia-like behavior in the taste preference test. Lastly, we found that the extent of hilar cell loss is similar in both genders. In summary, both genders can be successfully employed to study behavioral comorbidities of TLE; however, taking the potential gender differences into account may help choose the more appropriated gender for a given task, which may be of value for the minimization of the number of animals used during the experiments.
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Affiliation(s)
| | - Jéssica Grigoletto
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Vinícius Rafael Funck
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Michele Rechia Fighera
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Ana Flávia Furian
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
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237
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Rathore C, Alexander A, Sarma PS, Radhakrishnan K. Memory outcome following left anterior temporal lobectomy in patients with a failed Wada test. Epilepsy Behav 2015; 44:207-12. [PMID: 25768711 DOI: 10.1016/j.yebeh.2015.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/09/2015] [Accepted: 02/09/2015] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aimed to compare the memory outcome following left anterior temporal lobectomy (ATL) between patients with a failed Wada test and patients who passed the Wada test. METHODS From 1996 to 2002, we performed the Wada test on all patients with unilateral left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and concordant electroclinical data before ATL. We used a 12-item recognition paradigm for memory testing and awarded a score of +1 for each correct response and -0.5 for each incorrect response. No patient was denied surgery on the basis of Wada scores. We assessed cognitive and memory functions using the Wechsler Adult Intelligence Scale and the Wechsler Memory Scale preoperatively and at one year after ATL. We compared the number of patients who showed decline in memory scores, as per the published reliable change indices, between the patients with a failed Wada test and the patients who passed the Wada test. RESULTS Out of the 116 eligible patients with left MTLE-HS, 88 underwent bilateral Wada test, while 28 underwent ipsilateral Wada test. None of them developed postoperative amnesia. Approximately, one-third of patients with a failed Wada memory test when the failure was defined as a contralateral score of <4, as an ipsilateral score of >8, and as an asymmetry score of <0. The patients with Wada memory failure had a longer pre-ATL duration of epilepsy (p<0.003). The memory and quality-of-life outcomes did not differ between the group with a failed Wada memory test and the group who passed the Wada memory test. The results remained the same when analyses were repeated at various other cutoff points. CONCLUSION The patients with left MTLE-HS with concordant electroclinical, MRI, and neuropsychological data should not be denied ATL solely on the basis of Wada memory test results.
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Affiliation(s)
- Chaturbhuj Rathore
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Aley Alexander
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - P Sankara Sarma
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Kurupath Radhakrishnan
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
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238
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Surgical treatment for mesial temporal lobe epilepsy associated with hippocampal sclerosis. Rev Neurol (Paris) 2015; 171:315-25. [DOI: 10.1016/j.neurol.2015.01.561] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/01/2015] [Accepted: 01/30/2015] [Indexed: 02/07/2023]
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239
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Kahane P, Barba C, Rheims S, Job-Chapron A, Minotti L, Ryvlin P. The concept of temporal ‘plus’ epilepsy. Rev Neurol (Paris) 2015; 171:267-72. [DOI: 10.1016/j.neurol.2015.01.562] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/27/2015] [Indexed: 11/29/2022]
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240
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MTLE with hippocampal sclerosis in adult as a syndrome. Rev Neurol (Paris) 2015; 171:259-66. [DOI: 10.1016/j.neurol.2015.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 11/19/2022]
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241
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Du X, Usui N, Terada K, Baba K, Matsuda K, Tottori T, Inoue Y. Semiological and electroencephalographic features of epilepsy with amygdalar lesion. Epilepsy Res 2015; 111:45-53. [DOI: 10.1016/j.eplepsyres.2015.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/13/2015] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
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242
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Huberfeld G, Blauwblomme T, Miles R. Hippocampus and epilepsy: Findings from human tissues. Rev Neurol (Paris) 2015; 171:236-51. [PMID: 25724711 PMCID: PMC4409112 DOI: 10.1016/j.neurol.2015.01.563] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022]
Abstract
Surgical removal of the epileptogenic zone provides an effective therapy for several focal epileptic syndromes. This surgery offers the opportunity to study pathological activity in living human tissue for pharmacoresistant partial epilepsy syndromes including temporal lobe epilepsies with hippocampal sclerosis, cortical dysplasias, epilepsies associated with tumors and developmental malformations. Slices of tissue from patients with these syndromes retain functional neuronal networks and may generate epileptic activities. The properties of cells in this tissue may not be greatly changed, but excitatory synaptic transmission is often enhanced and GABAergic inhibition is preserved. Typically epileptic activity is not generated spontaneously by the neocortex, whether dysplastic or not, but can be induced by convulsants. The initiation of ictal discharges in the neocortex depends on both GABAergic signaling and increased extracellular potassium. In contrast, a spontaneous interictal-like activity is generated by tissues from patients with temporal lobe epilepsies associated with hippocampal sclerosis. This activity is initiated, not in the hippocampus but in the subiculum, an output region, which projects to the entorhinal cortex. Interictal events seem to be triggered by GABAergic cells, which paradoxically excite about 20% of subicular pyramidal cells while simultaneously inhibiting the majority. Interictal discharges thus depend on both GABAergic and glutamatergic signaling. The depolarizing effects of GABA depend on a pathological elevation in levels of chloride in some subicular cells, similar to those of developmentally immature cells. Such defect is caused by a perturbed expression of the cotransporters regulating intracellular chloride concentration, the importer NKCC1 and the extruder KCC2. Blockade of NKCC1 actions by the diuretic bumetanide restores intracellular chloride and thus hyperpolarizing GABAergic actions and consequently suppressing interictal activity.
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Affiliation(s)
- G Huberfeld
- Département de neurophysiologie, Sorbonne universités, UPMC - université Paris 06, UPMC, CHU de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France; INSERM Unit U1129 Infantile Epilepsies and Brain Plasticity, University Paris Descartes, Sorbonne Paris Cité, CEA, 12, rue de l'École-de-Médecine, 75006 Paris, France.
| | - T Blauwblomme
- INSERM Unit U1129 Infantile Epilepsies and Brain Plasticity, University Paris Descartes, Sorbonne Paris Cité, CEA, 12, rue de l'École-de-Médecine, 75006 Paris, France; Neurosurgery Department, Necker-Enfants Malades Hospital, University Paris Descartes, PRES Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75006 Paris, France
| | - R Miles
- Inserm U1127, CNRS UMR7225, Sorbonne universités, UPMC - université Paris 6 UMR S1127, Institut du cerveau et de la moelle épinière, 47, boulevard de l'Hôpital, 75013 Paris, France
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243
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Thom M. Review: Hippocampal sclerosis in epilepsy: a neuropathology review. Neuropathol Appl Neurobiol 2015; 40:520-43. [PMID: 24762203 PMCID: PMC4265206 DOI: 10.1111/nan.12150] [Citation(s) in RCA: 328] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/23/2014] [Indexed: 12/12/2022]
Abstract
Hippocampal sclerosis (HS) is a common pathology encountered in mesial temporal lobe epilepsy (MTLE) as well as other epilepsy syndromes and in both surgical and post-mortem practice. The 2013 International League Against Epilepsy (ILAE) classification segregates HS into typical (type 1) and atypical (type 2 and 3) groups, based on the histological patterns of subfield neuronal loss and gliosis. In addition, granule cell reorganization and alterations of interneuronal populations, neuropeptide fibre networks and mossy fibre sprouting are distinctive features of HS associated with epilepsies; they can be useful diagnostic aids to discriminate from other causes of HS, as well as highlighting potential mechanisms of hippocampal epileptogenesis. The cause of HS remains elusive and may be multifactorial; the contribution of febrile seizures, genetic susceptibility, inflammatory and neurodevelopmental factors are discussed. Post-mortem based research in HS, as an addition to studies on surgical samples, has the added advantage of enabling the study of the wider network changes associated with HS, the long-term effects of epilepsy on the pathology and associated comorbidities. It is likely that HS is heterogeneous in aspects of its cause, epileptogenetic mechanisms, network alterations and response to medical and surgical treatments. Future neuropathological studies will contribute to better recognition and understanding of these clinical and patho-aetiological subtypes of HS.
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Affiliation(s)
- Maria Thom
- Departments of Neuropathology and Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
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244
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Shiha AA, de Cristóbal J, Delgado M, Fernández de la Rosa R, Bascuñana P, Pozo MA, García-García L. Subacute administration of fluoxetine prevents short-term brain hypometabolism and reduces brain damage markers induced by the lithium-pilocarpine model of epilepsy in rats. Brain Res Bull 2015; 111:36-47. [DOI: 10.1016/j.brainresbull.2014.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 12/30/2022]
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245
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Shima A, Nitta N, Suzuki F, Laharie AM, Nozaki K, Depaulis A. Activation of mTOR signaling pathway is secondary to neuronal excitability in a mouse model of mesio-temporal lobe epilepsy. Eur J Neurosci 2015; 41:976-88. [DOI: 10.1111/ejn.12835] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/15/2014] [Accepted: 12/17/2014] [Indexed: 01/15/2023]
Affiliation(s)
- Ayako Shima
- Department of Neurosurgery; Shiga University of Medical Science, Seta-Tsukinowa-Cho; Otsu Shiga 520-2192 Japan
- Department of Neurosurgery; Koto Memorial Hospital; Higashioumi Shiga Japan
| | - Naoki Nitta
- Department of Neurosurgery; Shiga University of Medical Science, Seta-Tsukinowa-Cho; Otsu Shiga 520-2192 Japan
- Inserm, U836; Grenoble France
- Grenoble Institut des Neurosciences; University of Grenoble Alpes; Grenoble France
| | - Fumio Suzuki
- Department of Neurosurgery; Koto Memorial Hospital; Higashioumi Shiga Japan
| | - Anne-Marie Laharie
- Inserm, U836; Grenoble France
- Grenoble Institut des Neurosciences; University of Grenoble Alpes; Grenoble France
| | - Kazuhiko Nozaki
- Department of Neurosurgery; Shiga University of Medical Science, Seta-Tsukinowa-Cho; Otsu Shiga 520-2192 Japan
| | - Antoine Depaulis
- Inserm, U836; Grenoble France
- Grenoble Institut des Neurosciences; University of Grenoble Alpes; Grenoble France
- CHU de Grenoble; Hôpital Michallon; Grenoble France
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246
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Alhusaini S, Whelan CD, Doherty CP, Delanty N, Fitzsimons M, Cavalleri GL. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings. Cereb Cortex 2015; 26:1234-41. [PMID: 25576532 DOI: 10.1093/cercor/bhu315] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable.
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Affiliation(s)
- Saud Alhusaini
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Christopher D Whelan
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | | | - Norman Delanty
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland Neurology Division
| | - Mary Fitzsimons
- Brain Morphomerty Laboratory, Epilepsy Programme, Beaumont Hospital, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
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247
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Klang A, Thaller D, Schmidt P, Kovacs GG, Halasz P, Pakozdy A. Bilateral Dentate Gyrus Structural Alterations in a Cat Associated With Hippocampal Sclerosis and Intraventricular Meningioma. Vet Pathol 2015; 52:1183-6. [PMID: 25572262 DOI: 10.1177/0300985814564979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 13-year-old cat had a history of seizures for 3 years that resembled temporal lobe epilepsy. Histologic examination of the brain revealed bilateral hippocampal alterations, including hypergyration and broadening of the dentate gyrus associated with hippocampal sclerosis and an intraventricular meningioma near the hippocampal region. The findings in the dentate gyrus were interpreted as a congenital malformation; however, it could not be ruled out that the alterations were induced by the seizures. Similar changes of the dentate gyrus have not been previously described in cats.
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Affiliation(s)
- A Klang
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - D Thaller
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - P Schmidt
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - G G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - P Halasz
- National Institute of Neuroscience, Budapest, Hungary
| | - A Pakozdy
- University Clinic for Small Animals, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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248
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Memory, executive function and language function are similarly impaired in both temporal and extra temporal refractory epilepsy—A prospective study. Epilepsy Res 2015; 109:72-80. [DOI: 10.1016/j.eplepsyres.2014.09.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/18/2014] [Accepted: 09/29/2014] [Indexed: 11/23/2022]
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249
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Abstract
Epilepsy is a common, serious neurological disease characterized by recurring seizures. Such abnormal, excessive synchronous firing of neurons arises in part because of imbalances in excitation and inhibition in the brain. The process of epileptogenesis, during which the normal brain is transformed after injury to one capable of generating spontaneous seizures, is associated with large-scale changes in gene expression. These contribute to the remodelling of brain networks that permanently alters excitability. Components of the microRNA (miRNA) biogenesis pathway have been found to be altered in brain tissue from epilepsy patients and experimental epileptogenic insults result in select changes to miRNAs regulating neuronal microstructure, cell death, inflammation, and ion channels. Targeting key miRNAs has been shown to alter brain excitability and suppress or exacerbate seizures, indicating potential for miRNA-based therapeutics in epilepsy. Altered miRNA profiles in biofluids may be potentially useful biomarkers of epileptogenesis. In summary, miRNAs represent an important layer of gene expression control in epilepsy with therapeutic and biomarker potential.
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250
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Miller-Delaney SFC, Bryan K, Das S, McKiernan RC, Bray IM, Reynolds JP, Gwinn R, Stallings RL, Henshall DC. Differential DNA methylation profiles of coding and non-coding genes define hippocampal sclerosis in human temporal lobe epilepsy. ACTA ACUST UNITED AC 2014; 138:616-31. [PMID: 25552301 DOI: 10.1093/brain/awu373] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Temporal lobe epilepsy is associated with large-scale, wide-ranging changes in gene expression in the hippocampus. Epigenetic changes to DNA are attractive mechanisms to explain the sustained hyperexcitability of chronic epilepsy. Here, through methylation analysis of all annotated C-phosphate-G islands and promoter regions in the human genome, we report a pilot study of the methylation profiles of temporal lobe epilepsy with or without hippocampal sclerosis. Furthermore, by comparative analysis of expression and promoter methylation, we identify methylation sensitive non-coding RNA in human temporal lobe epilepsy. A total of 146 protein-coding genes exhibited altered DNA methylation in temporal lobe epilepsy hippocampus (n = 9) when compared to control (n = 5), with 81.5% of the promoters of these genes displaying hypermethylation. Unique methylation profiles were evident in temporal lobe epilepsy with or without hippocampal sclerosis, in addition to a common methylation profile regardless of pathology grade. Gene ontology terms associated with development, neuron remodelling and neuron maturation were over-represented in the methylation profile of Watson Grade 1 samples (mild hippocampal sclerosis). In addition to genes associated with neuronal, neurotransmitter/synaptic transmission and cell death functions, differential hypermethylation of genes associated with transcriptional regulation was evident in temporal lobe epilepsy, but overall few genes previously associated with epilepsy were among the differentially methylated. Finally, a panel of 13, methylation-sensitive microRNA were identified in temporal lobe epilepsy including MIR27A, miR-193a-5p (MIR193A) and miR-876-3p (MIR876), and the differential methylation of long non-coding RNA documented for the first time. The present study therefore reports select, genome-wide DNA methylation changes in human temporal lobe epilepsy that may contribute to the molecular architecture of the epileptic brain.
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Affiliation(s)
- Suzanne F C Miller-Delaney
- 1 Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Kenneth Bryan
- 2 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Sudipto Das
- 2 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Ross C McKiernan
- 1 Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Isabella M Bray
- 2 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - James P Reynolds
- 1 Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Ryder Gwinn
- 3 Centre for Neuromodulation and Functional Restoration, Swedish Neuroscience Institute, 550 17th Ave. Suite 540, Seattle, WA 98122, USA
| | - Raymond L Stallings
- 2 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland 4 National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - David C Henshall
- 1 Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
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