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Tavakol S, Kebets V, Royer J, Li Q, Auer H, DeKraker J, Jefferies E, Bernasconi N, Bernasconi A, Helmstaedter C, Arafat T, Armony J, Nathan Spreng R, Caciagli L, Frauscher B, Smallwood J, Bernhardt B. Differential relational memory impairment in temporal lobe epilepsy. Epilepsy Behav 2024; 155:109722. [PMID: 38643660 DOI: 10.1016/j.yebeh.2024.109722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is typically associated with pathology of the hippocampus, a key structure involved in relational memory, including episodic, semantic, and spatial memory processes. While it is widely accepted that TLE-associated hippocampal alterations underlie memory deficits, it remains unclear whether impairments relate to a specific cognitive domain or multiple ones. METHODS We administered a recently validated task paradigm to evaluate episodic, semantic, and spatial memory in 24 pharmacoresistant TLE patients and 50 age- and sex-matched healthy controls. We carried out two-way analyses of variance to identify memory deficits in individuals with TLE relative to controls across different relational memory domains, and used partial least squares correlation to identify factors contributing to variations in relational memory performance across both cohorts. RESULTS Compared to controls, TLE patients showed marked impairments in episodic and spatial memory, with mixed findings in semantic memory. Even when additionally controlling for age, sex, and overall cognitive function, between-group differences persisted along episodic and spatial domains. Moreover, age, diagnostic group, and hippocampal volume were all associated with relational memory behavioral phenotypes. SIGNIFICANCE Our behavioral findings show graded deficits across relational memory domains in people with TLE, which provides further insights into the complex pattern of cognitive impairment in the condition.
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Affiliation(s)
- Shahin Tavakol
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Valeria Kebets
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jessica Royer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Qiongling Li
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Hans Auer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jordan DeKraker
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Neda Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Andrea Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Thaera Arafat
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jorge Armony
- Department of Psychiatry, McGill University, Montreal, Canada.
| | - R Nathan Spreng
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA; UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Birgit Frauscher
- ANPHY Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Boris Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
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Yang D, Ren Q, Nie J, Zhang Y, Wu H, Chang Z, Wang B, Dai J, Fang Y. Black Phosphorus Flake-Enabled Wireless Neuromodulation for Epilepsy Treatment. NANO LETTERS 2024; 24:1052-1061. [PMID: 37955335 DOI: 10.1021/acs.nanolett.3c03472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Epilepsy is a prevalent and severe neurological disorder and generally requires prolonged electrode implantation and tether brain stimulation in refractory cases. However, implants may cause potential chronic immune inflammation and permanent tissue damage due to material property mismatches with soft brain tissue. Here, we demonstrated a nanomaterial-enabled near-infrared (NIR) neuromodulation approach to provide nongenetic and nonimplantable therapeutic benefits in epilepsy mouse models. Our study showed that crystal-exfoliated photothermal black phosphorus (BP) flakes could enhance neural activity by altering the membrane capacitive currents in hippocampus neurons through NIR photothermal neuromodulation. Optical stimulation facilitated by BP flakes in hippocampal slices evoked action potentials with a high spatiotemporal resolution. Furthermore, BP flake-enabled NIR neuromodulation of hippocampus neural circuits can suppress epileptic signals in epilepsy model mice with minimal invasiveness and high biocompatibility. Consequently, nanomaterial-enabled NIR neuromodulation may open up opportunities for nonimplantable optical therapy of epilepsy in nontransgenic organisms.
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Affiliation(s)
- Deqi Yang
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Qinjuan Ren
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Jianfang Nie
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Ya Zhang
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Haofan Wu
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Zhiqiang Chang
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Bingfang Wang
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Jing Dai
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
| | - Yin Fang
- Research Center for Translational Medicine, Shanghai East Hospital affiliated to Tongji University School of Medicine; The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, China
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Stasenko A, Kaestner E, Arienzo D, Schadler AJ, Helm JL, Shih JJ, Ben-Haim S, McDonald CR. Preoperative white matter network organization and memory decline after epilepsy surgery. J Neurosurg 2023; 139:1576-1587. [PMID: 37178024 PMCID: PMC10640663 DOI: 10.3171/2023.4.jns23347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/07/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Risk for memory decline is a common concern for individuals with temporal lobe epilepsy (TLE) undergoing surgery. Global and local network abnormalities are well documented in TLE. However, it is less known whether network abnormalities predict postsurgical memory decline. The authors examined the role of preoperative global and local white matter network organization and risk of postoperative memory decline in TLE. METHODS One hundred one individuals with TLE (n = 51 with left TLE and 50 with right TLE) underwent preoperative T1-weighted MRI, diffusion MRI, and neuropsychological memory testing in a prospective longitudinal study. Fifty-six age- and sex-matched controls completed the same protocol. Forty-four patients (22 with left TLE and 22 with right TLE) subsequently underwent temporal lobe surgery and postoperative memory testing. Preoperative structural connectomes were generated via diffusion tractography and analyzed using measures of global and local (i.e., medial temporal lobe [MTL]) network organization. Global metrics measured network integration and specialization. The local metric was calculated as an asymmetry of the mean local efficiency between the ipsilateral and contralateral MTLs (i.e., MTL network asymmetry). RESULTS Higher preoperative global network integration and specialization were associated with higher preoperative verbal memory function in patients with left TLE. Higher preoperative global network integration and specialization, as well as greater leftward MTL network asymmetry, predicted greater postoperative verbal memory decline for patients with left TLE. No significant effects were observed in right TLE. Accounting for preoperative memory score and hippocampal volume asymmetry, MTL network asymmetry uniquely explained 25%-33% of the variance in verbal memory decline for left TLE and outperformed hippocampal volume asymmetry and global network metrics. MTL network asymmetry alone produced good diagnostic classification of memory decline in left TLE (i.e., an area under the receiver operating characteristic curve of 0.80-0.84 and correct classification of 65%-76% of cases with cross-validation). CONCLUSIONS These preliminary data suggest that global white matter network disruption contributes to verbal memory impairment preoperatively and predicts postsurgical verbal memory outcomes in left TLE. However, a leftward asymmetry of MTL white matter network organization may confer the highest risk for verbal memory decline. Although this requires replication in a larger sample, the authors demonstrate the importance of characterizing preoperative local white matter network properties within the to-be-operated hemisphere and the reserve capacity of the contralateral MTL network, which may eventually be useful in presurgical planning.
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Affiliation(s)
- Alena Stasenko
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
- Departments of Psychiatry, San Diego State University, San Diego, California
| | - Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
- Departments of Psychiatry, San Diego State University, San Diego, California
| | - Donatello Arienzo
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
- Departments of Psychiatry, San Diego State University, San Diego, California
| | - Adam J. Schadler
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
- Departments of Psychiatry, San Diego State University, San Diego, California
| | - Jonathan L. Helm
- Department of Psychology, San Diego State University, San Diego, California
| | - Jerry J. Shih
- Neurosciences, University of California, San Diego, California
| | | | - Carrie R. McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
- Departments of Psychiatry, San Diego State University, San Diego, California
- Radiation Medicine & Applied Sciences, University of California, San Diego, California
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Castro‐Lima H, Passarelli V, Ribeiro ES, Adda CC, Preturlon‐Santos APP, Jorge CL, Valério R, Tzu WH, Boa‐Sorte N, Pipek LZ, Castro LHM. Bilateral ictal EEG is associated with better memory outcome after hippocampal sclerosis surgery. Epilepsia Open 2023; 8:1532-1540. [PMID: 37750472 PMCID: PMC10690677 DOI: 10.1002/epi4.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/17/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE To compare memory outcomes after surgery for unilateral hippocampal sclerosis (HS)-associated epilepsy in patients with unilateral and bilateral ictal electrographic involvement. METHODS We prospectively evaluated HS patients, aged 18-55 years and IQ ≥70. Left (L) and right (R) surgical groups underwent noninvasive video-EEG monitoring and Wada test. We classified patients as Ipsilateral if ictal EEG was restricted to the HS side, or Bilateral, if at least one seizure onset occurred contralaterally to the HS, or if ictal discharge evolved to the opposite temporal region. Patients who declined surgery served as controls. Memory was evaluated on two occasions with Rey Auditory-Verbal Learning Test and Rey Visual-Design Learning Test. Baseline neuropsychological test scores were compared between groups. Pre- and postoperative scores were compared within each group. Reliable change index Z-scores (RCI) were obtained using controls as references, and compared between surgical groups. RESULTS We evaluated 64 patients. Patients were classified as: L-Ipsilateral (9), L-Bilateral (15), L-Control (9), R-Ipsilateral (10), R-Bilateral (9), and R-Control (12). On preoperative evaluation, memory performance did not differ among surgical groups. Right HS patients did not present postoperative memory decline. L-Ipsilateral group presented postoperative decline on immediate (P = 0.036) and delayed verbal recall (P = 0.011), while L-Bilateral did not decline. L-Ipsilateral had lower RCI Z-scores, indicating delayed verbal memory decline compared to L-Bilateral (P = 0.012). SIGNIFICANCE Dominant HS patients with bilateral ictal involvement presented less pronounced postoperative verbal memory decline compared to patients with exclusive ipsilateral ictal activity. Surgery was indicated in these patients regardless of memory impairment on neuropsychological testing, since resection of the left sclerotic hippocampus could result in cessation of contralateral epileptiform activity, and, therefore, improved memory function.
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Affiliation(s)
| | - Valmir Passarelli
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Elyse S Ribeiro
- Division of Psychology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Carla C Adda
- Division of Psychology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Ana Paula P Preturlon‐Santos
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Carmen L Jorge
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Rosa Valério
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Wen Hung Tzu
- Department of Neurosurgery, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Ney Boa‐Sorte
- Bahiana School of Medicine and Public HealthSalvadorBrazil
| | - Leonardo Zumerkorn Pipek
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Luiz Henrique M Castro
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
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Xiao F, Caciagli L, Wandschneider B, Sone D, Young AL, Vos SB, Winston GP, Zhang Y, Liu W, An D, Kanber B, Zhou D, Sander JW, Thom M, Duncan JS, Alexander DC, Galovic M, Koepp MJ. Identification of different MRI atrophy progression trajectories in epilepsy by subtype and stage inference. Brain 2023; 146:4702-4716. [PMID: 37807084 PMCID: PMC10629797 DOI: 10.1093/brain/awad284] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/30/2023] [Accepted: 08/02/2023] [Indexed: 10/10/2023] Open
Abstract
Artificial intelligence (AI)-based tools are widely employed, but their use for diagnosis and prognosis of neurological disorders is still evolving. Here we analyse a cross-sectional multicentre structural MRI dataset of 696 people with epilepsy and 118 control subjects. We use an innovative machine-learning algorithm, Subtype and Stage Inference, to develop a novel data-driven disease taxonomy, whereby epilepsy subtypes correspond to distinct patterns of spatiotemporal progression of brain atrophy.In a discovery cohort of 814 individuals, we identify two subtypes common to focal and idiopathic generalized epilepsies, characterized by progression of grey matter atrophy driven by the cortex or the basal ganglia. A third subtype, only detected in focal epilepsies, was characterized by hippocampal atrophy. We corroborate external validity via an independent cohort of 254 people and confirm that the basal ganglia subtype is associated with the most severe epilepsy.Our findings suggest fundamental processes underlying the progression of epilepsy-related brain atrophy. We deliver a novel MRI- and AI-guided epilepsy taxonomy, which could be used for individualized prognostics and targeted therapeutics.
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Affiliation(s)
- Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
| | - Daichi Sone
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Alexandra L Young
- Centre for Medical Image Computing, Departments of Computer Science, Medical Physics, and Biomedical Engineering, UCL, London, WC1E 6BT, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Sjoerd B Vos
- Centre for Medical Image Computing, Departments of Computer Science, Medical Physics, and Biomedical Engineering, UCL, London, WC1E 6BT, UK
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
- Centre for Microscopy, Characterisation, and Analysis, University of Western Australia, Perth, WA 6009, Australia
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
- Department of Medicine, Division of Neurology, Queen’s University, Kingston, K7L 3N6, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, K7L 3N6, Canada
| | - Yingying Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wenyu Liu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Dongmei An
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Baris Kanber
- Centre for Medical Image Computing, Departments of Computer Science, Medical Physics, and Biomedical Engineering, UCL, London, WC1E 6BT, UK
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
| | - Josemir W Sander
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, China
- Stichting Epilepsie Instellingen Nederland – (SEIN), Heemstede, 2103SW, The Netherlands
| | - Maria Thom
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Departments of Computer Science, Medical Physics, and Biomedical Engineering, UCL, London, WC1E 6BT, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, CH-8091, Switzerland
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UCL-Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, SL9 0RJ, UK
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Reppert L, Sepeta LN, Panjeti-Moore D, Akinsoji E, Sherer C, Hamidullah-Thiam A, Theodore WH. Cognitive function and the longitudinal hippocampal axis in mesial temporal sclerosis. Epilepsy Behav 2023; 147:109413. [PMID: 37716331 PMCID: PMC10591949 DOI: 10.1016/j.yebeh.2023.109413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE The relationship of preoperative memory deficits in patients with mesial temporal lobe epilepsy (mTLE) and hippocampal sclerosis (HS) to the distribution of neuronal loss is uncertain. Building on the material specificity theory, we tested the hypothesis that visual memory deficits are associated with posterior hippocampal atrophy, whereas verbal memory deficits are associated with anterior hippocampal atrophy. METHODS We studied 22 adults with mTLE and HS, calculating hippocampal head, body, and tail volumes, correcting for estimated total intracranial volume, using automated segmentation. Preoperative memory ability was evaluated with the Wechsler Memory Scale (WMS-II: logical memory, verbal paired associates, family pictures, and faces subtests). We correlated memory ability with hippocampal division volumes using SPSS 26.1 (repeated measures ANOVAs, one-way ANOVAs, Pearson r correlations) for statistical analysis. RESULTS We found a significant main effect of hippocampal subdivision, reporting volumetric differences between the head, body, and tail. Pairwise comparisons reported that the hippocampal head had significantly greater volume than both the body and tail (p < 0.001). For both left and right focus groups, the ipsilateral hippocampi were significantly smaller than the contralateral. Linear regression reported a left hippocampal model (head, body, and tail volumes) predicted performance on logical memory with the left hippocampal tail volume being the strongest predictor. A right hippocampal model (head, body, and tail volumes) predicted memory ability for family pictures and verbal paired associates at a trend level. CONCLUSIONS Ipsilateral hippocampal head and tail seem more vulnerable to injury than the body in both the left and right mTLE. Our study suggests there may be functional differences along the hippocampal longitudinal axis, particularly for the left hippocampal tail with verbal memory. Our findings are consistent with material-specific right-left differences in memory processing.
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Affiliation(s)
- L Reppert
- National Institute of Neurological Disorders and Stroke, United States; Department of Neurology, Children's National Medical Center, United States
| | - L N Sepeta
- National Institute of Neurological Disorders and Stroke, United States; Department of Neurology, Children's National Medical Center, United States
| | - D Panjeti-Moore
- National Institute of Neurological Disorders and Stroke, United States
| | - E Akinsoji
- National Institute of Neurological Disorders and Stroke, United States
| | - C Sherer
- National Institute of Neurological Disorders and Stroke, United States
| | | | - W H Theodore
- National Institute of Neurological Disorders and Stroke, United States.
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Stasenko A, Kaestner E, Arienzo D, Schadler AJ, Helm JL, Shih J, Ben-Haim S, McDonald CR. White matter network organization predicts memory decline after epilepsy surgery. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.14.524071. [PMID: 36711617 PMCID: PMC9882113 DOI: 10.1101/2023.01.14.524071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The authors have withdrawn their manuscript owing to a substantial change in data analysis and findings/conclusions. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
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Jia R, Yuan X, Zhang X, Song P, Han S, Wang S, Li Y, Zhang S, Zhao X, Zhang Y, Cheng J, Song X. Oxidative stress impairs cognitive function by affecting hippocampal fimbria volume in drug-naïve, first-episode schizophrenia. Front Neurosci 2023; 17:1153439. [PMID: 37139526 PMCID: PMC10149877 DOI: 10.3389/fnins.2023.1153439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Objective The aim of the present study was to explore influencing factors of cognitive impairments and their interrelationships in drug-naïve, first-episode schizophrenia (SCZ). Methods Patients with drug naïve, first episode SCZ and healthy controls (HCs) were enrolled. Cognitive function was assessed by the MATRICS Consensus Cognitive Battery (MCCB). Serum levels of oxidative stress indices, including folate, superoxide dismutase (SOD), uric acid (UA) and homocysteine (Hcy), were determined after an overnight fast. Hippocampal subfield volumes were measured using FreeSurfer. Mediation models were conducted using the SPSS PROCESS v3.4 macro. A false discovery rate (FDR) correction was applied for multiple comparisons. Results Sixty-seven patients with SCZ and 65 HCs were enrolled in our study. The patient group had significantly lower serum levels of folate and SOD and higher serum levels of HCY compared with the HCs (all p < 0.05). The patient group had a significantly smaller volume of the whole hippocampus than the HC group (p < 0.05). We also found significant volume differences between the two groups in the following subfields: CA1, molecular layer, GC-ML-DG and fimbria (all p < 0.05, uncorrected). The partial correlation analysis controlling for age and sex showed that the fimbria volume in the patient group was significantly positively associated with NAB scores (r = 0.382, pFDR = 0.024); serum levels of SOD in the patient group showed a significantly positive correlation with fimbria volume (r = 0.360, pFDR = 0.036). Mediation analyses controlling for age and sex showed that the serum levels of SOD in patients with SCZ had significant indirect effects on the NAB scores which were mediated by the fimbria volume [indirect effect = 0.0565, 95% CI from the bootstrap test excluding zero (0.0066 to 0.0891)]. Conclusion Oxidative stress, a reduction in hippocampal subfield volumes and cognitive impairments occur in early SCZ. Oxidative stress impairs cognitive function by affecting hippocampal subfield volumes.
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Affiliation(s)
- Rufei Jia
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xiuxia Yuan
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xiaoyun Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Peilun Song
- School of Information Engineering, Zhengzhou University, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuying Wang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Yajun Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Siwei Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xinyi Zhao
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Yu Zhang
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jingliang Cheng, ;10
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
- *Correspondence: Xueqin Song,
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9
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Conde-Blanco E, Pariente JC, Carreño M, Boget T, Pascual-Díaz S, Centeno M, Manzanares I, Donaire A, Pintor L, Rumià J, Roldán P, Setoain X, Bargalló N. Testing an Adapted Auditory Verbal Learning Test Paradigm for fMRI to Lateralize Verbal Memory in Patients with Epilepsy. AJNR Am J Neuroradiol 2022; 43:1445-1452. [PMID: 36137657 PMCID: PMC9575519 DOI: 10.3174/ajnr.a7622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/01/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE fMRI is a noninvasive tool for predicting postsurgical deficits in candidates with pharmacoresistant temporal lobe epilepsy. We aimed to test an adapted paradigm of the Rey Auditory Verbal Learning Test to evaluate differences in memory laterality indexes between patients and healthy controls and its association with neuropsychological scores. MATERIALS AND METHODS We performed a prospective study of 50 patients with temporal lobe epilepsy and 22 healthy controls. Participants underwent a block design language and memory fMRI. Laterality indexes and the hippocampal anterior-posterior index were calculated. Language and memory lateralization was organized into typical and atypical on the basis of laterality indexes. A neuropsychological assessment was performed with a median time from fMRI of 8 months and was compared with fMRI performance. RESULTS We studied 40 patients with left temporal lobe epilepsy and 10 with right temporal lobe epilepsy. Typical language occurred in 65.3% of patients and 90.9% of healthy controls (P = .04). The memory fMRI laterality index was obtained in all healthy controls and 92% of patients. The verbal memory laterality index was bilateral (24.3%) more frequently than the language laterality index (7.69%) in patients with left temporal lobe epilepsy. Atypical verbal memory was greater in patients with left temporal lobe epilepsy (56.8%) than in healthy controls (36.4%), and the proportion of bilateral laterality indexes (53.3%) was larger than right laterality indexes (46.7%). Atypical verbal memory might be associated with higher cognitive scores in patients. No relevant differences were seen in the hippocampal anterior-posterior index according to memory impairment. CONCLUSIONS The adapted Rey Auditory Verbal Learning Test paradigm fMRI might support verbal memory lateralization. Temporal lobe epilepsy laterality influences hippocampal memory laterality indexes. Left temporal lobe epilepsy has shown a higher proportion of atypical verbal memory compared with language, potentially to memory functional reorganization.
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Affiliation(s)
- E Conde-Blanco
- From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
- EpiCARE: European Reference Network for Epilepsy (E.C.-B., M. Carreño, M. Centeno, A.D.), Dublin, Ireland
| | - J C Pariente
- Magnetic Resonance Imaging Core Facility (J.C.P., S.P.-D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - M Carreño
- From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
- EpiCARE: European Reference Network for Epilepsy (E.C.-B., M. Carreño, M. Centeno, A.D.), Dublin, Ireland
| | - T Boget
- Neuropsychology (T.B.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
| | - S Pascual-Díaz
- Magnetic Resonance Imaging Core Facility (J.C.P., S.P.-D.), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - M Centeno
- From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
- EpiCARE: European Reference Network for Epilepsy (E.C.-B., M. Carreño, M. Centeno, A.D.), Dublin, Ireland
| | - I Manzanares
- From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
| | - A Donaire
- From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (A.D., X.S.), Barcelona, Spain
- EpiCARE: European Reference Network for Epilepsy (E.C.-B., M. Carreño, M. Centeno, A.D.), Dublin, Ireland
| | - L Pintor
- Psychiatry (L.P.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
| | - J Rumià
- Neurosurgery (J.R., P.R.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
| | - P Roldán
- Neurosurgery (J.R., P.R.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
| | - X Setoain
- Nuclear Medicine (X.S.), Epilepsy Program, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (A.D., X.S.), Barcelona, Spain
| | - N Bargalló
- Radiology (N.B.)
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain
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10
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Harms A, Bauer T, Fischbach L, David B, Ernst L, Witt JA, Diers K, Baumgartner T, Weber B, Radbruch A, Becker AJ, Helmstaedter C, Reuter M, Elger CE, Surges R, Rüber T. Shape description and volumetry of hippocampus and amygdala in temporal lobe epilepsy - A beneficial combination with a clinical perspective. Epilepsy Behav 2022; 128:108560. [PMID: 35066389 DOI: 10.1016/j.yebeh.2022.108560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 11/25/2022]
Abstract
Shape-based markers have entered the field of morphometric neuroimaging analysis as a second mainstay alongside conventional volumetric approaches. We aimed to assess the added value of shape description for the analysis of lesional and autoimmune temporal lobe epilepsy (TLE) focusing on hippocampus and amygdala. We retrospectively investigated MRI and clinical data from 65 patients with lesional TLE (hippocampal sclerosis (HS) and astrogliosis) and from 62 patients with limbic encephalitis (LE) with serologically proven autoantibodies. Surface reconstruction and volumetric segmentation were performed with FreeSurfer. For the shape analysis, we used BrainPrint, a tool that utilizes eigenvalues of the Laplace-Beltrami operator on triangular meshes to calculate intra-subject asymmetry. Psychometric tests of memory performance were ascertained, to evaluate clinical relevance of the shape descriptor. The potential benefit of shape in addition to volumetric information for classification was assessed by five-fold repeated cross validation and logistic regression. For the LE group, the best performing classification model consisted of a combination of volume and shape asymmetry (mean AUC = 0.728), the logistic regression model was significantly improved considering both modalities instead of just volume asymmetry. For lesional TLE, the best model only considered volumetric information (mean AUC = 0.867). Shape asymmetry of the hippocampus was largely associated with verbal memory performance only in LE patients (OR = 1.07, p = 0.02). For lesional TLE, shape description is robust, but redundant when compared to volumetric approaches. For LE, in contrast, shape asymmetry as a complementary modality significantly improves the detection of subtle morphometric changes and is further associated with memory performance, which underscores the clinical relevance of shape asymmetry as a novel imaging biomarker.
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Affiliation(s)
- Antonia Harms
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Tobias Bauer
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Laura Fischbach
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Bastian David
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Leon Ernst
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Juri-Alexander Witt
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Kersten Diers
- Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE), Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Tobias Baumgartner
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Alexander Radbruch
- Department of Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Albert J Becker
- Department of Neuropathology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Christoph Helmstaedter
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Martin Reuter
- Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE), Venusberg-Campus 1, 53127 Bonn, Germany; Martinos Center for Biomedical Imaging, MGH/Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
| | - Christian E Elger
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Rainer Surges
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
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11
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Sone D, Ahmad M, Thompson PJ, Baxendale S, Vos SB, Xiao F, de Tisi J, McEvoy AW, Miserocchi A, Duncan JS, Koepp MJ, Galovic M. Optimal Surgical Extent for Memory and Seizure Outcome in Temporal Lobe Epilepsy. Ann Neurol 2021; 91:131-144. [PMID: 34741484 PMCID: PMC8916104 DOI: 10.1002/ana.26266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/21/2021] [Accepted: 10/31/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Postoperative memory decline is an important consequence of anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE), and the extent of resection may be a modifiable factor. This study aimed to define optimal resection margins for cognitive outcome while maintaining a high rate of postoperative seizure freedom. METHODS This cohort study evaluated the resection extent on postoperative structural MRI using automated voxel-based methods and manual measurements in 142 consecutive patients with unilateral drug refractory TLE (74 left, 68 right TLE) who underwent standard ATLR. RESULTS Voxel-wise analyses revealed that postsurgical verbal memory decline correlated with resections of the posterior hippocampus and inferior temporal gyrus, whereas larger resections of the fusiform gyrus were associated with worsening of visual memory in left TLE. Limiting the posterior extent of left hippocampal resection to 55% reduced the odds of significant postoperative verbal memory decline by a factor of 8.1 (95% CI 1.5-44.4, p = 0.02). Seizure freedom was not related to posterior resection extent, but to the piriform cortex removal after left ATLR. In right TLE, variability of the posterior extent of resection was not associated with verbal and visual memory decline or seizures after surgery. INTERPRETATION The extent of surgical resection is an independent and modifiable risk factor for cognitive decline and seizures after left ATLR. Adapting the posterior extent of left ATLR might optimize postoperative outcome, with reduced risk of memory impairment while maintaining comparable seizure-freedom rates. The current, more lenient, approach might be appropriate for right ATLR. ANN NEUROL 2021.
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Affiliation(s)
- Daichi Sone
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Maria Ahmad
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Centre for Medical Image Computing (CMIC), University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Andrew W McEvoy
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
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12
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Zhu G, Wang J, Xiao L, Yang K, Huang K, Li B, Huang S, Hu B, Xiao B, Liu D, Feng L, Wang Q. Memory Deficit in Patients With Temporal Lobe Epilepsy: Evidence From Eye Tracking Technology. Front Neurosci 2021; 15:716476. [PMID: 34557066 PMCID: PMC8453169 DOI: 10.3389/fnins.2021.716476] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore quantitative measurements of the visual attention and neuroelectrophysiological relevance of memory deficits in temporal lobe epilepsy (TLE) by eye tracking and electroencephalography (EEG). Methods: Thirty-four TLE patients and twenty-eight healthy controls were invited to complete neurobehavioral assessments, cognitive oculomotor tasks, and 24-h video EEG (VEEG) recordings using an automated computer-based memory assessment platform with an eye tracker. Visit counts, visit time, and time of first fixation on areas of interest (AOIs) were recorded and analyzed in combination with interictal epileptic discharge (IED) characteristics from the bilateral temporal lobes. Results: The TLE patients had significantly worse Wechsler Digit Span scores [F(1, 58) = 7.49, p = 0.008]. In the Short-Term Memory Game with eye tracking, TLE patients took a longer time to find the memorized items [F(1, 57) = 17.30, p < 0.001]. They had longer first fixation [F(1, 57) = 4.06, p = 0.049] and more visit counts [F(1, 57) = 7.58, p = 0.008] on the target during the recall. Furthermore, the performance of the patients in the Digit Span task was negatively correlated with the total number of IEDs [r(28) = −0.463, p = 0.013] and the number of spikes per sleep cycle [r(28) = −0.420, p = 0.026]. Conclusion: Eye tracking appears to be a quantitative, objective measure of memory evaluation, demonstrating memory retrieval deficits but preserved visual attention in TLE patients. Nocturnal temporal lobe IEDs are closely associated with memory performance, which might be the electrophysiological mechanism for memory impairment in TLE.
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Affiliation(s)
- Guangpu Zhu
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China.,University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
| | - Jing Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ling Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ke Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Beibin Li
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Bingliang Hu
- Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Quan Wang
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China.,Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
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13
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Doll A, Wegrzyn M, Benzait A, Mertens M, Woermann FG, Labudda K, Bien CG, Kissler J. Whole-brain functional correlates of memory formation in mesial temporal lobe epilepsy. NEUROIMAGE-CLINICAL 2021; 31:102723. [PMID: 34147817 PMCID: PMC8220377 DOI: 10.1016/j.nicl.2021.102723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
Large study of encoding and subsequent memory for words, faces, and scenes. Less ipsilateral mesial temporal activity in mesial temporal lobe epilepsy (mTLE). Extra-mTL activity in mTLE only partly relevant for memory formation. Across materials contralateral mTL decisive to maintain intact memory in mTLE. Left frontal activation correlates with better verbal memory only in left mTLE.
The mesial temporal lobe is a key region for episodic memory. Accordingly, memory impairment is frequent in patients with mesial temporal lobe epilepsy. However, the functional relevance of potentially epilepsy-induced reorganisation for memory formation is still not entirely clear. Therefore, we investigated whole-brain functional correlates of verbal and non-verbal memory encoding and subsequent memory formation in 56 (25 right sided) mesial temporal lobe epilepsy patients and 21 controls. We applied an fMRI task of learning scenes, faces, and words followed by an out-of-scanner recognition test. During encoding of faces and scenes left and right mesial temporal lobe epilepsy patients had consistently reduced activation in the epileptogenic mesial temporal lobe compared with controls. Activation increases in patients were apparent in extra-temporal regions, partly associated with subsequent memory formation (left frontal regions and basal ganglia), and patients had less deactivation in regions often linked to the default mode and auditory networks. The more specific subsequent memory contrast indicated only marginal group differences. Correlating patients’ encoding activation with memory performance both within the paradigm and with independent clinical measures demonstrated predominantly increased contralateral mesio-temporal activation supporting intact memory performance. In left temporal lobe epilepsy patients, left frontal activation was also correlated with better verbal memory performance. Taken together, our findings hint towards minor extra-temporal plasticity in mesial temporal lobe epilepsy patients, which is in line with pre-surgical impairment and post-surgical memory decline in many patients. Further, data underscore the importance of particularly the contralateral mesial temporal lobe itself, to maintain intact memory performance.
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Affiliation(s)
- Anna Doll
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Maraweg 21, Bielefeld 33617, Germany; Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld 33615, Germany.
| | - Martin Wegrzyn
- Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld 33615, Germany
| | - Anissa Benzait
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Maraweg 21, Bielefeld 33617, Germany; Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld 33615, Germany
| | - Markus Mertens
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Maraweg 21, Bielefeld 33617, Germany
| | - Friedrich G Woermann
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Maraweg 21, Bielefeld 33617, Germany
| | - Kirsten Labudda
- Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld 33615, Germany
| | - Christian G Bien
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Maraweg 21, Bielefeld 33617, Germany
| | - Johanna Kissler
- Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld 33615, Germany; Center for Cognitive Interaction Technology (CITEC), University of Bielefeld, Inspiration 1, Bielefeld 33619, Germany
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14
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Conde-Blanco E, Pascual-Diaz S, Carreño M, Muñoz-Moreno E, Pariente JC, Boget T, Manzanares I, Donaire A, Centeno M, Graus F, Bargalló N. Volumetric and shape analysis of the hippocampus in temporal lobe epilepsy with GAD65 antibodies compared with non-immune epilepsy. Sci Rep 2021; 11:10199. [PMID: 33986308 PMCID: PMC8119423 DOI: 10.1038/s41598-021-89010-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
Glutamic acid decarboxylase 65 antibodies (anti-GAD65) have been found in patients with late-onset chronic temporal lobe epilepsy (TLE). No prior neuroimaging studies have addressed how they affect hippocampal volume and shape and how they relate to cognitive abnormalities. We aimed to investigate both brain structure and function in patients with isolated TLE and high anti-GAD65 levels (RIA ≥ 2000 U/ml) compared to 8 non-immune mesial TLE (niTLE) and 8 healthy controls (HC). Hippocampal subfield volume properties were correlated with the duration of the disease and cognitive test scores. The affected hippocampus of GAD-TLE patients showed no volume changes to matched HC whereas niTLE volumes were significantly smaller. Epilepsy duration in GAD-TLE patients correlated negatively with volumes in the presubiculum, subiculum, CA1, CA2-3, CA4, molecular layer and granule cell-molecular layer of the dentate nucleus. We found differences by advanced vertex-wise shape analysis in the anterior hippocampus of the left GAD-TLE compared to HC whereas left niTLE showed bilateral posterior hippocampus deformation. Verbal deficits were similar in GAD-TLE and niTLE but did not correlate to volume changes. These data might suggest a distinct expression of hippocampal structural and functional abnormalities based on the immune response.
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Affiliation(s)
- Estefanía Conde-Blanco
- Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain.
| | | | - Mar Carreño
- Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | | | | | - Teresa Boget
- Epilepsy Program, Neuropsychology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Isabel Manzanares
- Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Antonio Donaire
- Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - María Centeno
- Epilepsy Program, Neurology Department, Hospital Clínic de Barcelona, EpiCARE: European Reference Network for Epilepsy, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - Francesc Graus
- Clinical and Experimental Neuroimmunology Research Team of IDIBAPS, Barcelona, Spain
| | - Nuria Bargalló
- Magnetic Resonance Imaging Core Facility, IDIBAPS, Barcelona, Spain.,Epilepsy Program, Neuroradiology Section, Radiology Department, Center of Image Diagnosis (CDIC), Barcelona, Spain
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Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy. Int J Mol Sci 2021; 22:ijms22083860. [PMID: 33917911 PMCID: PMC8068229 DOI: 10.3390/ijms22083860] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 12/11/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.
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Hattiangady B, Kuruba R, Shuai B, Grier R, Shetty AK. Hippocampal Neural Stem Cell Grafting after Status Epilepticus Alleviates Chronic Epilepsy and Abnormal Plasticity, and Maintains Better Memory and Mood Function. Aging Dis 2020; 11:1374-1394. [PMID: 33269095 PMCID: PMC7673840 DOI: 10.14336/ad.2020.1020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
Hippocampal damage after status epilepticus (SE) leads to multiple epileptogenic changes, which lead to chronic temporal lobe epilepsy (TLE). Morbidities such as spontaneous recurrent seizures (SRS) and memory and mood impairments are seen in a significant fraction of SE survivors despite the administration of antiepileptic drugs after SE. We examined the efficacy of bilateral intra-hippocampal grafting of neural stem/progenitor cells (NSCs) derived from the embryonic day 19 rat hippocampi, six days after SE for restraining SE-induced SRS, memory, and mood impairments in the chronic phase. Grafting of NSCs curtailed the progression of SRS at 3-5 months post-SE and reduced the frequency and severity of SRS activity when examined at eight months post-SE. Reduced SRS activity was also associated with improved memory function. Graft-derived cells migrated into different hippocampal cell layers, differentiated into GABA-ergic interneurons, astrocytes, and oligodendrocytes. Significant percentages of graft-derived cells also expressed beneficial neurotrophic factors such as the fibroblast growth factor-2, brain-derived neurotrophic factor, insulin-like growth factor-1 and glial cell line-derived neurotrophic factor. NSC grafting protected neuropeptide Y- and parvalbumin-positive host interneurons, diminished the abnormal migration of newly born neurons, and rescued the reelin+ interneurons in the dentate gyrus. Besides, grafting led to the maintenance of a higher level of normal neurogenesis in the chronic phase after SE and diminished aberrant mossy fiber sprouting in the dentate gyrus. Thus, intrahippocampal grafting of hippocampal NSCs shortly after SE considerably curbed the progression of epileptogenic processes and SRS, which eventually resulted in less severe chronic epilepsy devoid of significant cognitive and mood impairments.
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Affiliation(s)
- Bharathi Hattiangady
- 1Institute for Regenerative Medicine, Department of Molecular and Cellular Medicine, Texas A&M University College of Medicine, College Station, TX, USA.,2Research Service, Olin E. Teague Veterans' Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA.,3Department of Surgery (Neurosurgery) Duke University Medical Center, Durham, NC, USA.,4Research and Surgery Services, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Ramkumar Kuruba
- 3Department of Surgery (Neurosurgery) Duke University Medical Center, Durham, NC, USA.,4Research and Surgery Services, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Bing Shuai
- 1Institute for Regenerative Medicine, Department of Molecular and Cellular Medicine, Texas A&M University College of Medicine, College Station, TX, USA.,2Research Service, Olin E. Teague Veterans' Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA.,3Department of Surgery (Neurosurgery) Duke University Medical Center, Durham, NC, USA.,4Research and Surgery Services, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Remedios Grier
- 3Department of Surgery (Neurosurgery) Duke University Medical Center, Durham, NC, USA.,4Research and Surgery Services, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Ashok K Shetty
- 1Institute for Regenerative Medicine, Department of Molecular and Cellular Medicine, Texas A&M University College of Medicine, College Station, TX, USA.,2Research Service, Olin E. Teague Veterans' Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA.,3Department of Surgery (Neurosurgery) Duke University Medical Center, Durham, NC, USA.,4Research and Surgery Services, Durham Veterans Affairs Medical Center, Durham, NC, USA
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Transdiagnostic hippocampal damage patterns in neuroimmunological disorders. NEUROIMAGE-CLINICAL 2020; 28:102515. [PMID: 33396002 PMCID: PMC7721635 DOI: 10.1016/j.nicl.2020.102515] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 01/31/2023]
Abstract
Hippocampal damage and associated cognitive deficits are frequently observed in neuroimmunological disorders, but comparative analyses to identify shared hippocampal damage patterns are missing. Here, we adopted a transdiagnostic analytical approach and investigated hippocampal shape deformations and associated cognitive deficits in four neuroimmunological diseases. We studied 120 patients (n = 30 in each group), including patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), anti-NMDAR and anti-LGI1 encephalitis. A control group was matched to each patient sample from a pool of 79 healthy participants. We performed an MRI-based vertex-wise hippocampal shape analysis, extracted hippocampal volume estimates and scalar projection values as a measure of surface displacement. Cognitive testing included assessment of verbal memory and semantic fluency performance. Our cross-sectional analyses revealed characteristic patterns of bilateral inward deformations covering up to 32% of the hippocampal surface in MS, anti-NMDAR encephalitis, and anti-LGI1 encephalitis, whereas NMOSD patients showed no deformations compared to controls. Significant inversions were noted mainly on the hippocampal head, were accompanied by volume loss, and correlated with semantic fluency scores and verbal episodic memory in autoimmune encephalitis and MS. A deformation overlap analysis across disorders revealed a convergence zone on the left anterior hippocampus that corresponds to the CA1 subfield. This convergence zone indicates a shared downstream substrate of immune-mediated damage that appears to be particularly vulnerable to neuroinflammatory processes. Our transdiagnostic morphological view sheds light on mutual pathophysiologic pathways of cognitive deficits in neuroimmunological diseases and stimulates further research into the mechanisms of increased susceptibility of the hippocampus to autoimmunity.
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Larivière S, Bernasconi A, Bernasconi N, Bernhardt BC. Connectome biomarkers of drug-resistant epilepsy. Epilepsia 2020; 62:6-24. [PMID: 33236784 DOI: 10.1111/epi.16753] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
Drug-resistant epilepsy (DRE) considerably affects patient health, cognition, and well-being, and disproportionally contributes to the overall burden of epilepsy. The most common DRE syndromes are temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal epilepsy related to cortical malformations. Both syndromes have been traditionally considered as "focal," and most patients benefit from brain surgery for long-term seizure control. However, increasing evidence indicates that many DRE patients also present with widespread structural and functional network disruptions. These anomalies have been suggested to relate to cognitive impairment and prognosis, highlighting their importance for patient management. The advent of multimodal neuroimaging and formal methods to quantify complex systems has offered unprecedented ability to profile structural and functional brain networks in DRE patients. Here, we performed a systematic review on existing DRE network biomarker candidates and their contribution to three key application areas: (1) modeling of cognitive impairments, (2) localization of the surgical target, and (3) prediction of clinical and cognitive outcomes after surgery. Although network biomarkers hold promise for a range of clinical applications, translation of neuroimaging biomarkers to the patient's bedside has been challenged by a lack of clinical and prospective studies. We therefore close by highlighting conceptual and methodological strategies to improve the evaluation and accessibility of network biomarkers, and ultimately guide clinically actionable decisions.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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