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Tapia JL, Aras LM, Duñabeitia JA. Enhancing Executive Functions in Pediatric Epilepsy: Feasibility and Efficacy of a Computerized Cognitive Training Program. CHILDREN (BASEL, SWITZERLAND) 2024; 11:484. [PMID: 38671701 PMCID: PMC11049550 DOI: 10.3390/children11040484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Epilepsy, a prevalent neurological disorder characterized by recurrent seizures, significantly impacts individuals' neurobiological, cognitive, and social lives. This report presents a feasibility study investigating the effects of a computerized cognitive training program on enhancing executive functions, particularly inhibitory control, in children and adolescents with epilepsy. Employing a pre-test-intervention-post-test design, the study involved 26 participants with diverse epileptic syndromes, focusing on those without severe intellectual disabilities. The intervention, based on the CogniFit Inc. platform, consisted of personalized tasks aiming to improve participants' inhibitory skills over 16 weeks, with an average of 40 sessions completed per participant. Results indicated significant improvements in reaction times and error rates in an anti-saccade task, demonstrating enhanced inhibitory control and general performance post-intervention. These findings suggest that targeted cognitive training is a feasible approach to bolster executive functions in young individuals with epilepsy, potentially improving their academic performance, employability, and social interactions. The study underscores the importance of early cognitive interventions in epilepsy management, highlighting the potential for computerized programs to aid in mitigating cognitive deficits associated with the condition.
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Affiliation(s)
- José Luis Tapia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, 28043 Madrid, Spain;
| | | | - Jon Andoni Duñabeitia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Nebrija, 28043 Madrid, Spain;
- Department of Languages and Culture, UiT The Arctic University of Norway, 9019 Tromsø, Norway
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Cámpora N, Nasimbera A, Daza A, Giagante B, Oddo S, Kochen S. Dancing epilepsy: A stereo encephalography case report. Epileptic Disord 2024; 26:126-132. [PMID: 37846949 DOI: 10.1002/epd2.20172] [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: 03/09/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 10/18/2023]
Abstract
Ictal semiology is essential to identify the epileptogenic zone (EZ), especially in drug-resistant focal epilepsy (DRE), as its accurate identification determines the surgical prognosis. Dancing is highly unusual ictal semiology, and its underlying neural networks remain somehow unclear since both temporal and frontal lobe (FL) have been implicated in its generation. We present a 21-year-old male with DRE characterized by dancing seizures. Homemade videos were obtained. Through a non-invasive pre-surgical evaluation, the epileptogenic zone was localized within a gross lesion in the left FL. Using stereo electroencephalography (SEEG), we successfully identified the ictal-onset zone in the mesial middle, inferior, and orbito-frontal cortex, with rapid propagation of ictal activity extending backward and laterally to the precentral regions. Subsequently, a left frontal middle and inferior gyrectomy was performed, resulting in seizure freedom for the patient. Pathology results revealed a mild malformation of cortical development with oligodendroglial hyperplasia (MOGHE). Atypical seizure semiology, such as dancing, provides an interesting starting point for the analysis of the areas involved in the EZ. Further intracranial recordings are required to fully comprehend the underlying networks and interactions of cerebral areas during dancing seizures.
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Affiliation(s)
- Nuria Cámpora
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
- CONICET La Plata Ringgold standard institution - Studies in Neuroscience and Complex Systems (ENyS), Buenos Aires, Argentina
| | - Alejandro Nasimbera
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
- CONICET La Plata Ringgold standard institution - Studies in Neuroscience and Complex Systems (ENyS), Buenos Aires, Argentina
| | - Anilu Daza
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
| | - Brenda Giagante
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
| | - Silvia Oddo
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
- CONICET La Plata Ringgold standard institution - Studies in Neuroscience and Complex Systems (ENyS), Buenos Aires, Argentina
| | - Silvia Kochen
- Hospital El Cruce Ringgold standard institution - Neurology, Buenos Aires, Argentina
- CONICET La Plata Ringgold standard institution - Studies in Neuroscience and Complex Systems (ENyS), Buenos Aires, Argentina
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Remore LG, Rifi Z, Nariai H, Eliashiv DS, Fallah A, Edmonds BD, Matsumoto JH, Salamon N, Tolossa M, Wei W, Locatelli M, Tsolaki EC, Bari AA. Structural connections of the centromedian nucleus of thalamus and their relevance for neuromodulation in generalized drug-resistant epilepsy: insight from a tractography study. Ther Adv Neurol Disord 2023; 16:17562864231202064. [PMID: 37822361 PMCID: PMC10563482 DOI: 10.1177/17562864231202064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/01/2023] [Indexed: 10/13/2023] Open
Abstract
Background Epilepsy is a widespread neurologic disorder and almost one-third of patients suffer from drug-resistant epilepsy (DRE). Neuromodulation targeting the centromediannucleus of the thalamus (CM) has been showing promising results for patients with generalized DRE who are not surgical candidates. Recently, the effect of CM- deep brain stimulation (DBS) in DRE patients was investigated in the Electrical Stimulation of Thalamus for Epilepsy of Lennox-Gastaut phenotype (ESTEL) trial, a monocentric randomized-controlled study. The same authors described a 'cold-spot' and a 'sweet-spot', which are defined as the volume of stimulation in the thalamus yielding the least and the best clinical response, respectively. However, it remains unclear which structural connections may contribute to the anti-seizure effect of the stimulation. Objective We investigated the differences in structural connectivity among CM, the sweet-spot and the cold-spot. Furthermore, we tried to validate our results in a cohort of DRE patients who underwent CM-DBS or CM-RNS (responsive neurostimulation). We hypothesized that the sweet-spot would share similar structural connectivity with responder patients. Methods By using the software FMRIB Software Library (FSL), probabilistic tractography was performed on 100 subjects from the Human Connectome Project to calculate the probability of connectivity of the whole CM, the sweet-spot and the cold-spot to 45 cortical and subcortical areas. Results among the three seeds were compared with multivariate analysis of variance (MANOVA). Similarly, the structural connectivity of volumes of tissue activated (VTAs) from eight DRE patients was investigated. Patients were divided into responders and non-responders based on the degree of reduction in seizure frequency, and the mean probabilities of connectivity were similarly compared between the two groups. Results The sweet-spot demonstrated a significantly higher probability of connectivity (p < 0.001) with the precentral gyrus, superior frontal gyrus, and the cerebellum than the whole CM and the cold-spot. Responder patients displayed a higher probability of connectivity with both ipsilateral (p = 0.011) and contralateral cerebellum (p = 0.04) than the non-responders. Conclusion Cerebellar connections seem to contribute to the beneficial effects of CM-neuromodulation in patients with drug-resistant generalized epilepsy.
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Affiliation(s)
- Luigi G. Remore
- Surgical Neuromodulation and Brain Mapping Laboratory, ULCA
- Department of Neurosurgery, 300 Stein Plaza, Los Angeles, CA 90095, USA
- University of Milan ‘La Statale’, Milan, Italy
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ziad Rifi
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Hiroki Nariai
- Division of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Dawn S. Eliashiv
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Aria Fallah
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
- Division of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin D. Edmonds
- Division of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Joyce H. Matsumoto
- Division of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Noriko Salamon
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Meskerem Tolossa
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Wexin Wei
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Marco Locatelli
- University of Milan ‘La Statale’, Milan, Italy
- Department of Neurosurgery, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- ‘Aldo Ravelli’ Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Evangelia C. Tsolaki
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Ausaf A. Bari
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
- Geffen School of Medicine David California Los Angeles University of Angeles Los CA, USA
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Ferrand M, Baumann C, Aron O, Vignal JP, Jonas J, Tyvaert L, Colnat-Coulbois S, Koessler L, Maillard L. Intracerebral Correlates of Scalp EEG Ictal Discharges Based on Simultaneous Stereo-EEG Recordings. Neurology 2023; 100:e2045-e2059. [PMID: 36963841 PMCID: PMC10186237 DOI: 10.1212/wnl.0000000000207135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/18/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES It remains unknown to what extent ictal scalp EEG can accurately predict the localization of the intracerebral seizure onset in presurgical evaluation of drug-resistant epilepsies. In this study, we aimed to define homogeneous ictal scalp EEG profiles (based on their first ictal abnormality) and assess their localizing value using simultaneously recorded scalp EEG and stereo-EEG. METHODS We retrospectively included consecutive patients with drug-resistant focal epilepsy who had simultaneous stereo-EEG and scalp EEG recordings of at least 1 seizure in the epileptology unit in Nancy, France. We analyzed 1 seizure per patient and used hierarchical cluster analysis to group similar seizure profiles on scalp EEG and then performed a descriptive analysis of their intracerebral correlates. RESULTS We enrolled 129 patients in this study. The hierarchical cluster analysis showed 6 profiles on scalp EEG first modification. None were specific to a single intracerebral localization. The "normal EEG" and "blurred EEG" clusters (early muscle artifacts) comprised only 5 patients each and corresponded to no preferential intracerebral localization. The "temporal discharge" cluster (n = 46) was characterized by theta or delta discharges on ipsilateral anterior temporal scalp electrodes and corresponded to a preferential mesial temporal intracerebral localization. The "posterior discharge" cluster (n = 42) was characterized by posterior ipsilateral or contralateral rhythmic alpha discharges or slow waves on scalp and corresponded to a preferential temporal localization. However, this profile was the statistically most frequent scalp EEG correlate of occipital and parietal seizures. The "diffuse suppression" cluster (n = 9) was characterized by a bilateral and diffuse background activity suppression on scalp and corresponded to mesial, and particularly insulo-opercular, localization. Finally, the "frontal discharge" cluster (n = 22) was characterized by bilateral frontal rhythmic fast activity or preictal spike on scalp and corresponded to preferential ventrodorsal frontal intracerebral localizations. DISCUSSION The hierarchical cluster analysis identified 6 seizure profiles regarding the first abnormality on scalp EEG. None of them were specific of a single intracerebral localization. Nevertheless, the strong relationships between the "temporal," "frontal," "diffuse suppression," and "posterior" profiles and intracerebral discharge localizations may contribute to hierarchize hypotheses derived from ictal scalp EEG analysis regarding intracerebral seizure onset.
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Affiliation(s)
- Mickaël Ferrand
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Cédric Baumann
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Olivier Aron
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Jean-Pierre Vignal
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Jacques Jonas
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Louise Tyvaert
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Sophie Colnat-Coulbois
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Laurent Koessler
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France
| | - Louis Maillard
- From the Department of Neurology (M.F., O.A., J.-P.V., J.J., L.T., L.M.), and University Hospital of Nancy, Lorraine University; Department of Epidemiology and Clinical Evaluation (C.B.), INSERM CIC-EC CIE6, Lorraine University, Vandoeuvre; Neurosciences of Systems and Cognition Project (O.A., J.J., L.T., L.K., L.M.), BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre; and Department of Neurosurgery (S.C.-C.), University Hospital of Nancy, Lorraine University, Nancy, France.
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Khoo A, Alim-Marvasti A, de Tisi J, Diehl B, Walker MC, Miserocchi A, McEvoy AW, Chowdhury FA, Duncan JS. Value of semiology in predicting epileptogenic zone and surgical outcome following frontal lobe epilepsy surgery. Seizure 2023; 106:29-35. [PMID: 36736149 DOI: 10.1016/j.seizure.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/11/2023] [Accepted: 01/30/2023] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To evaluate the ability of semiology alone in localising the epileptogenic zone (EZ) in people with frontal lobe epilepsy (FLE) who underwent resective surgery. METHODS We examined data on all individuals who had FLE surgery at our centre between January 01, 2011 and December 31, 2020. Descriptions of ictal semiology were obtained from video-EEG telemetry reports and presurgical multidisciplinary meeting summaries. The putative EZ was represented by the final site of resection. We assessed how well initial and combined set-of-semiologies correlated anatomically with the EZ, using a semiology visualisation tool to generate probabilistic cortical heatmaps of involvement in seizures. RESULTS Sixty-one individuals had FLE surgery over the study period. Twelve months following surgery, 28/61 (46%) were completely seizure-free, with a further eight experiencing only auras. Comparing the semiology database with the putative EZ, combined set-of-semiology correctly lateralised in 77% (95% CI: 69-85%), localised to the frontal lobe in 57% (95% CI: 48-67%), frontal lobe subregions in 52% (95% CI: 43-62%), and frontal gyri in 25% (95% CI: 16-33%). No difference in degree of correlation was seen comparing those with ongoing seizures 12 months after surgery to those seizure free. SIGNIFICANCE Semiology alone was able to correctly lateralize the putative EZ in 77%, and localise to a sublobar level in approximately half of individuals who had FLE surgery. Semiology is not adequate alone and must be combined with imaging and EEG data to identify the epileptogenic zone.
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Affiliation(s)
- Anthony Khoo
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK; College of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia.
| | - Ali Alim-Marvasti
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Jane de Tisi
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Beate Diehl
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK; Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Matthew C Walker
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Anna Miserocchi
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Andrew W McEvoy
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Fahmida A Chowdhury
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - John S Duncan
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
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Restrepo CE, Balaguera P, Thompson SA, Johnson J, Lacuey N, Pati S, Harris K, Lhatoo SD, Tandon N. Safety and efficacy of bihemispheric sampling via transmidline stereoelectroencephalography. J Neurosurg 2022:1-9. [PMID: 36585867 DOI: 10.3171/2022.11.jns221144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/16/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Stereoelectroencephalography (SEEG) is designed to target distributed cortical networks responsible for electroclinical seizure syndrome and to enable localization of the site of seizure onset in patients with intractable epilepsy. When the preimplantation hypothesis invokes the bilateral mesial frontal lobes, sampling of several deep-seated cortical sites in both hemispheres is required. In this study, the authors have demonstrated the feasibility of sampling bihemispheric areas with intentional implantation of an SEEG electrode crossing the midline (SECM) for sampling the cortex on both sides of the interhemispheric fissure. METHODS An analysis of 231 consecutive SEEG procedures over 8 years was used to identify instances of bihemispheric sampling by using the transmidline SEEG technique. RESULTS The authors identified 53 SEEG cases, with a total of 126 electrodes that crossed the interhemispheric fissure; all were in the frontal lobes. Eighty-three electrodes targeted the cingulate gyrus (18 rostral, 43 anterior, and 22 middle), 31 targeted the posterior orbitofrontal region, 8 sampled the medial prefrontal cortex, and 4 targeted nodular heterotopia around the frontal horns. The ictal onset zone was localized to the frontal lobe in 16 cases. SECM isolated interictal and ictal activity in the contralateral hemisphere in 6 cases and independent bihemispheric seizure activity in 2 cases. No hemorrhagic or infectious complications were noted in any of these cases. CONCLUSIONS Based on this extensive experience of bihemispheric sampling, the authors concluded that this technique is safe and effective. In this series, SECM showed contralateral interictal and/or ictal epileptiform activity in 8 (15%) cases, and 9 (16%) cases (with unilateral implantation) had sufficient data to discard contralateral involvement, contributing to support of the epileptogenic network. SECM may reduce the number of electrodes used to sample bilateral mesial frontal or orbitofrontal cortices, and such an approach may lower the risk of hemorrhage and costs.
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Affiliation(s)
- Carlos E Restrepo
- 1Vivian L. Smith Department of Neurosurgery, McGovern Medical School at University of Texas Health Science Center at Houston.,2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Pedro Balaguera
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Stephen A Thompson
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Jessica Johnson
- 1Vivian L. Smith Department of Neurosurgery, McGovern Medical School at University of Texas Health Science Center at Houston.,2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston
| | - Nuria Lacuey
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Sandipan Pati
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Katherine Harris
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Samden D Lhatoo
- 2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,3Department of Neurology, McGovern Medical School at University of Texas Health Science Center at Houston; and.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
| | - Nitin Tandon
- 1Vivian L. Smith Department of Neurosurgery, McGovern Medical School at University of Texas Health Science Center at Houston.,2Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston.,4Memorial Hermann Hospital, Texas Medical Center, Houston, Texas
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Zhu Q, Wang H, Xu B, Zhang Z, Shao W, Zhang D. Multimodal Triplet Attention Network for Brain Disease Diagnosis. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:3884-3894. [PMID: 35969575 DOI: 10.1109/tmi.2022.3199032] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Multi-modal imaging data fusion has attracted much attention in medical data analysis because it can provide complementary information for more accurate analysis. Integrating functional and structural multi-modal imaging data has been increasingly used in the diagnosis of brain diseases, such as epilepsy. Most of the existing methods focus on the feature space fusion of different modalities but ignore the valuable high-order relationships among samples and the discriminative fused features for classification. In this paper, we propose a novel framework by fusing data from two modalities of functional MRI (fMRI) and diffusion tensor imaging (DTI) for epilepsy diagnosis, which effectively captures the complementary information and discriminative features from different modalities by high-order feature extraction with the attention mechanism. Specifically, we propose a triple network to explore the discriminative information from the high-order representation feature space learned from multi-modal data. Meanwhile, self-attention is introduced to adaptively estimate the degree of importance between brain regions, and the cross-attention mechanism is utilized to extract complementary information from fMRI and DTI. Finally, we use the triple loss function to adjust the distance between samples in the common representation space. We evaluate the proposed method on the epilepsy dataset collected from Jinling Hospital, and the experiment results demonstrate that our method is significantly superior to several state-of-the-art diagnosis approaches.
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8
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Arrotta K, Reyes A, Kaestner E, McDonald CR, Hermann BP, Barr WB, Sarmey N, Sundar S, Kondylis E, Najm I, Bingaman W, Busch RM. Cognitive phenotypes in frontal lobe epilepsy. Epilepsia 2022; 63:1671-1681. [PMID: 35429174 PMCID: PMC9545860 DOI: 10.1111/epi.17260] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Neuropsychological profiles are heterogeneous both across and within epilepsy syndromes, but especially in frontal lobe epilepsy (FLE), which has complex semiology and epileptogenicity. This study aimed to characterize the cognitive heterogeneity within FLE by identifying cognitive phenotypes and determining their demographic and clinical characteristics. METHOD One hundred and six patients (age 16-66; 44% female) with FLE completed comprehensive neuropsychological testing, including measures within five cognitive domains: language, attention, executive function, processing speed, and verbal/visual learning. Patients were categorized into one of four phenotypes based on the number of impaired domains. Patterns of domain impairment and clinical and demographic characteristics were examined across phenotypes. RESULTS Twenty-five percent of patients met criteria for the Generalized Phenotype (impairment in at least four domains), 20% met criteria for the Tri-Domain Phenotype (impairment in three domains), 36% met criteria for the Domain-Specific Phenotype (impairment in one or two domains), and 19% met criteria for the Intact Phenotype (no impairment). Language was the most common domain-specific impairment, followed by attention, executive function, and processing speed. In contrast, learning was the least impacted cognitive domain. The Generalized Phenotype had fewer years of education compared to the Intact Phenotype, but otherwise, there was no differentiation between phenotypes in demographic and clinical variables. However, qualitative analysis suggested that the Generalized and Tri-Domain Phenotypes had a more widespread area of epileptogenicity, whereas the Intact Phenotype most frequently had seizures limited to the lateral frontal region. SIGNIFICANCE This study identified four cognitive phenotypes in FLE that were largely indistinguishable in clinical and demographic features, aside from education and extent of epileptogenic zone. These findings enhance our appreciation of the cognitive heterogeneity within FLE and provide additional support for the development and use of cognitive taxonomies in epilepsy.
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Affiliation(s)
- Kayela Arrotta
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Anny Reyes
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCaliforniaUSA
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Erik Kaestner
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Carrie R. McDonald
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCaliforniaUSA
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Bruce P. Hermann
- Department of NeurologySchool of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - William B. Barr
- Department of NeurologyNYU Grossman School of MedicineNew York CityNew YorkUSA
| | - Nehaw Sarmey
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Swetha Sundar
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Efstathios Kondylis
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Imad Najm
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - William Bingaman
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Robyn M. Busch
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
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9
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Leifeld J, Förster E, Reiss G, Hamad MIK. Considering the Role of Extracellular Matrix Molecules, in Particular Reelin, in Granule Cell Dispersion Related to Temporal Lobe Epilepsy. Front Cell Dev Biol 2022; 10:917575. [PMID: 35733853 PMCID: PMC9207388 DOI: 10.3389/fcell.2022.917575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
The extracellular matrix (ECM) of the nervous system can be considered as a dynamically adaptable compartment between neuronal cells, in particular neurons and glial cells, that participates in physiological functions of the nervous system. It is mainly composed of carbohydrates and proteins that are secreted by the different kinds of cell types found in the nervous system, in particular neurons and glial cells, but also other cell types, such as pericytes of capillaries, ependymocytes and meningeal cells. ECM molecules participate in developmental processes, synaptic plasticity, neurodegeneration and regenerative processes. As an example, the ECM of the hippocampal formation is involved in degenerative and adaptive processes related to epilepsy. The role of various components of the ECM has been explored extensively. In particular, the ECM protein reelin, well known for orchestrating the formation of neuronal layer formation in the cerebral cortex, is also considered as a player involved in the occurrence of postnatal granule cell dispersion (GCD), a morphologically peculiar feature frequently observed in hippocampal tissue from epileptic patients. Possible causes and consequences of GCD have been studied in various in vivo and in vitro models. The present review discusses different interpretations of GCD and different views on the role of ECM protein reelin in the formation of this morphological peculiarity.
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Affiliation(s)
- Jennifer Leifeld
- Department of Neuroanatomy and Molecular Brain Research, Medical Faculty, Ruhr University Bochum, Bochum, Germany
- Department of Biochemistry I—Receptor Biochemistry, Faculty of Chemistry and Biochemistry, Ruhr University Bochum, Bochum, Germany
- *Correspondence: Jennifer Leifeld, ; Eckart Förster,
| | - Eckart Förster
- Department of Neuroanatomy and Molecular Brain Research, Medical Faculty, Ruhr University Bochum, Bochum, Germany
- *Correspondence: Jennifer Leifeld, ; Eckart Förster,
| | - Gebhard Reiss
- Institute for Anatomy and Clinical Morphology, School of Medicine, Faculty of Health, Witten/ Herdecke University, Witten, Germany
| | - Mohammad I. K. Hamad
- Institute for Anatomy and Clinical Morphology, School of Medicine, Faculty of Health, Witten/ Herdecke University, Witten, Germany
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10
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Caciagli L, Paquola C, He X, Vollmar C, Centeno M, Wandschneider B, Braun U, Trimmel K, Vos SB, Sidhu MK, Thompson PJ, Baxendale S, Winston GP, Duncan JS, Bassett DS, Koepp MJ, Bernhardt BC. Disorganization of language and working memory systems in frontal versus temporal lobe epilepsy. Brain 2022; 146:935-953. [PMID: 35511160 PMCID: PMC9976988 DOI: 10.1093/brain/awac150] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/28/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is a common comorbidity of epilepsy and adversely impacts people with both frontal lobe (FLE) and temporal lobe (TLE) epilepsy. While its neural substrates have been investigated extensively in TLE, functional imaging studies in FLE are scarce. In this study, we profiled the neural processes underlying cognitive impairment in FLE and directly compared FLE and TLE to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE and 52 controls) using neuropsychological tests and four functional MRI tasks probing expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-seizure medication load. We devised a multiscale approach to map brain activation and deactivation during cognition and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects across established motifs of functional brain organization: (i) canonical resting-state functional systems; and (ii) the principal functional connectivity gradient, which encodes a continuous transition of regional connectivity profiles, anchoring lower-level sensory and transmodal brain areas at the opposite ends of a spectrum. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, as well as reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. The imaging signatures of dysfunction in FLE are broadly similar to those in TLE, but some patterns are syndrome-specific: altered default-mode deactivation is more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands is more marked in TLE. Functional abnormalities in FLE and TLE appear overall modulated by disease load. On balance, our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies and sheds light on system behaviour that may be amenable to future remediation strategies.
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Affiliation(s)
- Lorenzo Caciagli
- Correspondence to: Lorenzo Caciagli, MD, PhD Department of Bioengineering University of Pennsylvania, 240 Skirkanich Hall 210 South 33rd Street, Philadelphia, PA 19104, USA E-mail: ;
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Christian Vollmar
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Maria Centeno
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Epilepsy Unit, Hospital Clínic de Barcelona, IDIBAPS, 08036 Barcelona, Spain
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Urs Braun
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karin Trimmel
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Centre for Medical Image Computing, University College London, London, UK,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Meneka K Sidhu
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Medicine, Division of Neurology, Queen’s University, Kingston, Ontario, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Dani S Bassett
- Correspondence may also be addressed to: Dani S. Bassett, PhD E-mail:
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11
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Fonseca-Barriendos D, Pérez-Pérez D, Fuentes-Mejía M, Orozco-Suárez S, Alonso-Vanegas M, Martínez-Juárez IE, Guevara-Guzmán R, Castañeda-Cabral JL, Rocha L. Protein expression of P-glycoprotein in neocortex from patients with frontal lobe epilepsy. Epilepsy Res 2022; 181:106892. [DOI: 10.1016/j.eplepsyres.2022.106892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 01/16/2023]
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12
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Otani M, Matsuhashi M, Ikeda A, Miyamoto S, Takahashi R. [Epidural electrodes could safely delineate ictal focus of hyperkinetic seizure in intractable frontal lobe epilepsy]. Rinsho Shinkeigaku 2022; 62:130-134. [PMID: 35095047 DOI: 10.5692/clinicalneurol.cn-001634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 42-year-old male had intractable hyperkinetic seizure since childhood. Bottom-of-sulcus dysplasia was shown by MRI to be most likely an ictal focus, whereas ictal semiology suggested possible focus in the left frontal cortex. Scalp-recorded EEG could not delineate ictal EEG change at all partly because of violent hyperkinetic seizure, and thus intracranial EEG study by epidural electrodes was conducted as the best procedure for the safety concern. It showed ictal focus over the bottom-of-sulcus dysplasia and thus it was completely resected with seizure free more then 20 years until now. It was concluded that epidural electrodes are regarded as safe invasive recording method especially for violent hyperkinetic seizure, and that can provide us with essential information before epilepsy surgery.
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Affiliation(s)
- Mayumi Otani
- Department of Neurology, Kyoto University Graduate School of Medicine
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine
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13
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McGonigal A. Frontal lobe seizures: overview and update. J Neurol 2022; 269:3363-3371. [PMID: 35006387 DOI: 10.1007/s00415-021-10949-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/27/2022]
Abstract
Frontal lobe seizures (FLS) are debilitating for patients, highly diverse and often challenging for clinicians to evaluate. Frontal lobe epilepsy is the second most common localization for focal epilepsy, and if pharmacoresistant, can be amenable to resective surgery. Detailed study of frontal seizure semiology in conjunction with careful anatomical and electrophysiological correlation based on intracerebral recording with stereoelectroencephalography (SEEG) has allowed demonstration that ictal motor semiology reflects a hierarchical rostro-caudal axis of frontal lobe functional organization, thus helping with presurgical localization. Main semiological features allowing distinction between different frontal sublobar regions include motor signs and emotional signs. Frontal lobe seizure semiology also represents a valuable source of in vivo human behavioral data from a neuroscientific perspective. Advances in defining underlying etiologies of FLE are likely to be crucial for appropriate selection and exploration of potential surgical candidates, which could improve upon current surgical outcomes. Future research on investigating the genetic basis of epilepsies and relation to structural substrate (e.g. focal cortical dysplasia) and seizure organization and expression, could permit a "genotype-phenotype" approach that could be complementary to anatomical electroclinical correlations in better defining the spectrum of FLS. This could help with optimizing patient selection and prognostication with regards to therapeutic choices.
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Affiliation(s)
- Aileen McGonigal
- Clinical Neurophysiology, Timone Hospital, APHM, Marseille, France. .,Inserm, INS, Institut de Neurosciences Des Systèmes, Aix Marseille Univ, Marseille, France.
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14
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Alim-Marvasti A, Romagnoli G, Dahele K, Modarres H, Pérez-García F, Sparks R, Ourselin S, Clarkson MJ, Chowdhury F, Diehl B, Duncan JS. Probabilistic landscape of seizure semiology localizing values. Brain Commun 2022; 4:fcac130. [PMID: 35663381 PMCID: PMC9156627 DOI: 10.1093/braincomms/fcac130] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/19/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Semiology describes the evolution of symptoms and signs during epileptic seizures and contributes to the evaluation of individuals with focal drug-resistant epilepsy for curative resection. Semiology varies in complexity from elementary sensorimotor seizures arising from primary cortex to complex behaviours and automatisms emerging from distributed cerebral networks. Detailed semiology interpreted by expert epileptologists may point towards the likely site of seizure onset, but this process is subjective. No study has captured the variances in semiological localizing values in a data-driven manner to allow objective and probabilistic determinations of implicated networks and nodes. We curated an open data set from the epilepsy literature, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, linking semiology to hierarchical brain localizations. A total of 11 230 data points were collected from 4643 patients across 309 articles, labelled using ground truths (postoperative seizure-freedom, concordance of imaging and neurophysiology, and/or invasive EEG) and a designation method that distinguished between semiologies arising from a predefined cortical region and descriptions of neuroanatomical localizations responsible for generating a particular semiology. This allowed us to mitigate temporal lobe publication bias by filtering studies that preselected patients based on prior knowledge of their seizure foci. Using this data set, we describe the probabilistic landscape of semiological localizing values as forest plots at the resolution of seven major brain regions: temporal, frontal, cingulate, parietal, occipital, insula, and hypothalamus, and five temporal subregions. We evaluated the intrinsic value of any one semiology over all other ictal manifestations. For example, epigastric auras implicated the temporal lobe with 83% probability when not accounting for the publication bias that favoured temporal lobe epilepsies. Unbiased results for a prior distribution of cortical localizations revised the prevalence of temporal lobe epilepsies from 66% to 44%. Therefore, knowledge about the presence of epigastric auras updates localization to the temporal lobe with an odds ratio (OR) of 2.4 [CI95% (1.9, 2.9); and specifically, mesial temporal structures OR: 2.8 (2.3, 2.9)], attesting the value of epigastric auras. As a further example, although head version is thought to implicate the frontal lobes, it did not add localizing value compared with the prior distribution of cortical localizations [OR: 0.9 (0.7, 1.2)]. Objectification of the localizing values of the 12 most common semiologies provides a complementary view of brain dysfunction to that of lesion-deficit mappings, as instead of linking brain regions to phenotypic-deficits, semiological phenotypes are linked back to brain sources. This work enables coupling of seizure propagation with ictal manifestations, and clinical support algorithms for localizing seizure phenotypes.
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Affiliation(s)
- Ali Alim-Marvasti
- Department of Clinical and Experimental Epilepsy, Queen Square Institute of Neurology, UCL, London, UK.,Department of Medical Physics and Biomedical Engineering, UCL, London, UK.,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Gloria Romagnoli
- Department of Clinical and Experimental Epilepsy, Queen Square Institute of Neurology, UCL, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Karan Dahele
- University College London Medical School, London, UK
| | - Hadi Modarres
- Faculty of Engineering, University of Cambridge, Cambridge, UK
| | - Fernando Pérez-García
- Department of Medical Physics and Biomedical Engineering, UCL, London, UK.,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, UK.,School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Rachel Sparks
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Sébastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Matthew J Clarkson
- Department of Medical Physics and Biomedical Engineering, UCL, London, UK.,Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), London, UK
| | - Fahmida Chowdhury
- Department of Clinical and Experimental Epilepsy, Queen Square Institute of Neurology, UCL, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, Queen Square Institute of Neurology, UCL, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, Queen Square Institute of Neurology, UCL, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
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15
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Mills GN, Raskin SA, DiMario FJ. Remembering to remember: prospective memory in children with epilepsy. Child Neuropsychol 2021; 28:14-29. [PMID: 34236944 DOI: 10.1080/09297049.2021.1944615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Prospective memory, the ability to remember to perform an intended act in the future, is a complex process that involves several stages and cognitive domains. This study sought to investigate prospective memory functioning in children with idiopathic epilepsy using tasks from the Rivermead Behavioral Memory Test for Children (RBMT-C) and the Memory for Intentions Screening Test for Youth (MISTY). Performances on prospective memory task characteristics of the MISTY (i.e., cue-type, length of time delay, and response type) were also compared between and across participant groups. Healthy children (N = 26) were found to have higher overall IQ and verbal IQ scores when compared to children with epilepsy (N = 19). Group differences in prospective memory functioning were found in subtests of the RBMT-C but not on the MISTY. Lastly, while there was no significant interaction effect between the groups and MISTY task characteristics, main effects were found across participant groups; all participants performed better on event-based tasks when compared to time-based tasks and on two-minute when compared to 10-minute time delays. Overall, findings suggest potential differences in cognitive functioning, particularly in IQ and prospective memory, in children with idiopathic epilepsy, though due to differences in findings across prospective memory tasks, further research is warranted to more definitively ascertain the extent, if any, of prospective memory deficits in children with epilepsy.
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Affiliation(s)
- Ginger N Mills
- Department of Psychology, University of Hartford, West Hartford, CT, USA
| | - Sarah A Raskin
- Department of Psychology and Neuroscience Program, Trinity College, Hartford, CT, USA
| | - Francis J DiMario
- Department of Neurology, Connecticut Children's Medical Center, Hartford, CT, USA
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16
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Zhao B, Zhang C, Wang X, Wang Y, Mo J, Zheng Z, Ai L, Zhang K, Zhang J, Shao XQ, Hu W. Orbitofrontal epilepsy: distinct neuronal networks underlying electroclinical subtypes and surgical outcomes. J Neurosurg 2021; 135:255-265. [PMID: 32823264 DOI: 10.3171/2020.5.jns20477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/14/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to characterize the clinical and electrophysiological findings of epilepsy originating from the orbitofrontal cortex (OFC) as well as its surgical outcomes. METHODS The authors retrospectively reviewed 27 consecutive cases of patients with drug-resistant orbitofrontal epilepsy (OFE) who underwent tailored resective surgery after a detailed presurgical workup. Demographic features, seizure semiology, imaging characteristics, resection site, pathological results, and surgical outcomes were analyzed. Patients were categorized according to semiology. The underlying neural network was further explored through quantitative FDG-PET and ictal stereo-electroencephalography (SEEG) analysis at the group level. FDG-PET studies between the semiology group and the control group were compared using a voxel-based independent t-test. Ictal SEEG was quantified by calculating the energy ratio (ER) of high- and low-frequency bands. An ER comparison between the anterior cingulate cortex (ACC) and the amygdala was performed to differentiate seizure spreading patterns in groups with different semiology. RESULTS Scalp electroencephalography (EEG) and MRI were inconclusive to a large extent. Patients were categorized into the following 3 semiology groups: the frontal group (n = 14), which included patients with hyperactive automatisms with agitated movements; the temporal group (n = 11), which included patients with oroalimentary or manual automatisms; and the other group (n = 2), which included patients with none of the abovementioned or indistinguishable manifestations. Patients in the frontal and temporal groups (n = 23) or in the frontal group only (n = 14) demonstrated significant hypometabolism mainly across the ipsilateral OFC, ACC, and anterior insula (AI), while patients in the temporal group (n = 9) had hypometabolism only in the OFC and AI. The ER results (n = 15) suggested distinct propagation pathways that allowed us to differentiate between the frontal and temporal groups. Pathologies included focal cortical dysplasia, dysembryoplastic neuroepithelial tumor, cavernous malformation, glial scar, and nonspecific findings. At a minimum follow-up of 12 months, 19 patients (70.4%) were seizure free, and Engel class II, III, and IV outcomes were observed in 4 patients (14.8%), 3 patients (11.1%), and 1 patient (3.7%), respectively. CONCLUSIONS The diagnosis of OFE requires careful presurgical evaluation. Based on their electrophysiological and metabolic evidence, the authors propose that varied semiological patterns could be explained by the extent of involvement of a network that includes at least the OFC, ACC, AI, and temporal lobe. Tailored resections for OFE may lead to a good overall outcome.
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Affiliation(s)
| | | | | | | | | | - Zhong Zheng
- 2Department of Neurosurgery, Beijing Fengtai Hospital, Beijing
| | - Lin Ai
- 3Imaging and Nuclear Medicine, and
| | - Kai Zhang
- Departments of1Neurosurgery
- 4Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing; and
- 5Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Jianguo Zhang
- Departments of1Neurosurgery
- 4Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing; and
- 5Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Xiao-Qiu Shao
- 6Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing
| | - Wenhan Hu
- Departments of1Neurosurgery
- 4Stereotactic and Functional Neurosurgery Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing; and
- 5Beijing Key Laboratory of Neurostimulation, Beijing, China
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17
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Poole BJ, Phillips NL, Stewart E, Harris IM, Lah S. Working Memory in Pediatric Epilepsy: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 31:569-609. [PMID: 33818735 DOI: 10.1007/s11065-021-09491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley's working memory model includes four components: the phonological loop, visuo-spatial sketchpad, the central executive, and episodic buffer. The aim of this review was to establish the gravity and pattern of working memory deficits in pediatric epilepsy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided electronic searches. Sixty-five studies were included in the review. Meta-analyses revealed significant impairments across each working memory component: phonological loop (g = 0.739), visuo-spatial sketchpad (g = 0.521), and central executive (g = 0.560) in children with epilepsy compared to controls. The episodic buffer was not examined. The pattern of impairments, however, differed according to the site and side of seizure focus. This suggests that working memory components are differentially vulnerable to the location of seizure focus in the developing brain.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natalie L Phillips
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Elizabeth Stewart
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Irina M Harris
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia.
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18
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Chou CC, Lee CC, Lin CF, Chen YH, Peng SJ, Hsiao FJ, Yu HY, Chen C, Chen HH, Shih YH. Cingulate gyrus epilepsy: semiology, invasive EEG, and surgical approaches. Neurosurg Focus 2021; 48:E8. [PMID: 32234986 DOI: 10.3171/2020.1.focus19914] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/27/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The semiology of cingulate gyrus epilepsy is varied and may involve the paracentral area, the adjacent limbic system, and/or the orbitofrontal gyrus. Invasive electroencephalography (iEEG) recording is usually required for patients with deeply located epileptogenic foci. This paper reports on the authors' experiences in the diagnosis and surgical treatment of patients with focal epilepsy originating in the cingulate gyrus. METHODS Eighteen patients (median age 24 years, range 5-53 years) with a mean seizure history of 23 years (range 2-32 years) were analyzed retrospectively. The results of presurgical evaluation, surgical strategy, and postoperative pathology are reported, as well as follow-up concerning functional morbidity and seizures (median follow-up 7 years, range 2-12 years). RESULTS Patients with cingulate gyrus epilepsy presented with a variety of semiologies and scalp EEG patterns. Prior to ictal onset, 11 (61%) of the patients presented with aura. Initial ictal symptoms included limb posturing in 12 (67%), vocalization in 5, and hypermotor movement in 4. In most patients (n = 16, 89%), ictal EEG presented as widespread patterns with bilateral hemispheric origin, as well as muscle artifacts obscuring the onset of EEG during the ictal period in 11 patients. Among the 18 patients who underwent resection, the pathology revealed mild malformation of cortical development in 2, focal cortical dysplasia (FCD) Ib in 4, FCD IIa in 4, FCD IIb in 4, astrocytoma in 1, ganglioglioma in 1, and gliosis in 2. The seizure outcome after surgery was satisfactory: Engel class IA in 12 patients, IIB in 3, IIIA in 1, IIIB in 1, and IVB in 1 at the 2-year follow-up. CONCLUSIONS In this study, the authors exploited the improved access to the cingulate epileptogenic network made possible by the use of 3D electrodes implanted using stereoelectroencephalography methodology. Under iEEG recording and intraoperative neuromonitoring, epilepsy surgery on lesions in the cingulate gyrus can result in good outcomes in terms of seizure recurrence and the incidence of postoperative permanent deficits.
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Affiliation(s)
- Chien-Chen Chou
- 1School of Medicine and.,3Neurology, Neurological Institute, Taipei Veterans General Hospital; and.,5Brain Research Center, National Yang-Ming University
| | - Cheng-Chia Lee
- 1School of Medicine and.,Departments of2Neurosurgery and.,5Brain Research Center, National Yang-Ming University
| | - Chun-Fu Lin
- 1School of Medicine and.,Departments of2Neurosurgery and
| | | | - Syu-Jyun Peng
- 4Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fu-Jung Hsiao
- 5Brain Research Center, National Yang-Ming University
| | - Hsiang-Yu Yu
- 1School of Medicine and.,3Neurology, Neurological Institute, Taipei Veterans General Hospital; and.,5Brain Research Center, National Yang-Ming University
| | - Chien Chen
- 1School of Medicine and.,3Neurology, Neurological Institute, Taipei Veterans General Hospital; and
| | - Hsin-Hung Chen
- 1School of Medicine and.,Departments of2Neurosurgery and
| | - Yang-Hsin Shih
- 1School of Medicine and.,Departments of2Neurosurgery and
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19
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Yin F, Ni D, Xu C, Yan X, Ma K, Zhang X, Gao R, Zhang G. Auras in intractable frontal lobe epilepsy: Clinical characteristics, values, and limitations. Epilepsy Behav 2021; 115:107724. [PMID: 33423014 DOI: 10.1016/j.yebeh.2020.107724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022]
Abstract
Auras are essential in preoperative evaluation and can provide valuable information for delineating seizure onset zones. Frontal lobe epilepsy (FLE) is the second most common focal epilepsy, while a few studies have focused on auras in FLE. To better understand FLE, we analyzed the clinical characteristics, values, and limitations of auras in FLE. The incidence rate of aura in FLE was 37.9% in our study. We included 54 patients and 76 auras in 11 categories were reported. The rate of auras in the decreasing order are as follows: autonomic aura; emotional aura; somatosensory aura; psychic aura; cephalic aura; abdominal aura; whole-body sensory aura, visual aura; auditory aura; and vestibular and unclassified aura. A significant number of aura types can be reported by FLE patients; autonomic aura was the most frequent category and somatosensory auras are most likely associated with the contralateral motor areas.
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Affiliation(s)
- Fangzhao Yin
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Duanyu Ni
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Cuiping Xu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Xiaoming Yan
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Kai Ma
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Xi Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Runshi Gao
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China; Department of Functional Neurology, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China.
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20
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Miyazaki M, Tanaka T, Adachi Y, Miya K. Learning difficulties in Japanese schoolchildren with focal epilepsy. Brain Dev 2020; 42:655-662. [PMID: 32624240 DOI: 10.1016/j.braindev.2020.06.004] [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: 11/07/2019] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children with epilepsy often show some degree of cognitive impairment. In this study, we investigated their learning skills to clarify the characteristics of the difficulties related to learning in Japanese-speaking children with focal epilepsy. METHODS The study included 13 boys and 17 girls of mean age 9.7 years (standard deviation 2.61; range 6-14 years) with focal epilepsy and a normal magnetic resonance brain scan. None of the patients had any other neurological disorder. RESULTS Twenty-two children had "learning difficulties", i.e., an intellectual disability or low scores on a learning abilities task. Significant differences were found in age (P = 0.030), age at onset of epilepsy (P = 0.033), and electroencephalographic findings, as well as between bilateral vs. unilateral (P = 0.028) and right-localized vs. left-localized or bilateral (P = 0.014) involvement between subjects with and without learning difficulties. Seven (88%) of eight children with low scores on a learning abilities task showed abnormalities in reading speed. DISCUSSION More than half of Japanese-speaking children with focal epilepsy need learning assistance. This finding points to a need for learning support in children with focal epilepsy regardless of language. Measurement of reading speed is useful in children with learning difficulties to identify those who require early intervention.
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Affiliation(s)
- Mitsuaki Miyazaki
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kazushi Miya
- Department of Educational Sciences, Faculty of Human Development, University of Toyama, Toyama, Japan.
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21
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Valls-Carbó A, Gajate V, Romeral M, Gutiérrez-Viedma Á, Parejo-Carbonell B, Cabrera-Martín MN, Matías-Guiu J, Matías-Guiu JA, García-Morales I. Non-Convulsive Status Epilepticus in Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2020; 77:985-991. [PMID: 32804149 DOI: 10.3233/jad-200512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Epilepsy in frontotemporal dementia is considered to be less frequent than in Alzheimer's disease. We report two cases of patients with non-convulsive status epilepticus associated with behavioral variant frontotemporal dementia. In the first case, status epilepticus was the first symptom of the disease, and consisted of loss of consciousness and mutism. In the second case, status epilepticus led to a clinical worsening one year after the diagnosis. Our study highlights the importance of suspecting non-convulsive status epilepticus in patients with frontotemporal dementia, and including frontotemporal dementia within the differential diagnosis of new-onset seizures.
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Affiliation(s)
- Adrián Valls-Carbó
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Vicente Gajate
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - María Romeral
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Álvaro Gutiérrez-Viedma
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Parejo-Carbonell
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - María Nieves Cabrera-Martín
- Nuclear Medicine, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matías-Guiu
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Jordi A Matías-Guiu
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
| | - Irene García-Morales
- Department of Neurology, Hospital Clinico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid, Madrid, Spain
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22
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Lin H, Leng X, Qin C, Wang W, Zhang C, Qiu S. Altered White Matter Structural Network in Frontal and Temporal Lobe Epilepsy: A Graph-Theoretical Study. Front Neurol 2020; 11:561. [PMID: 32625164 PMCID: PMC7311567 DOI: 10.3389/fneur.2020.00561] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 05/18/2020] [Indexed: 01/28/2023] Open
Abstract
Temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) are the largest subgroup of partial epilepsy, and focal cortical dysplasias (FCDs) are highly epileptogenic brain lesions and are a frequent cause for antiepileptic drug (AED)-resistant focal epilepsies that mostly occur in the temporal and frontal lobes. We performed a graph-theoretical study based on the diffusion tensor imaging (DTI) data of patients with FLE or TLE caused by FCDs or lesions with high suspicion of FCDs and evaluated their cognitive function by the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA-BC). The construction of the white matter structural network and graph-theoretical analysis was performed by Pipeline for Analysing Brain Diffusion Images (PANDA) and Graph-theoretical Network Analysis (GRETNA). We used the nonparametric analysis of covariance to compare the differences in diffusion metrics, network attributes and nodal attributes among FLE, TLE, and healthy control (HC) groups and then performed post hoc pairwise comparisons. Nonparametric Spearman partial correlation analysis was performed to analyse the correlation of network attributes with the age of onset, duration of disease, and MoCA-BC scores in patients with FLE and TLE. The results showed that the white matter structural network in patients with FLE and TLE was impaired in a more extensive set of regions than the FCD location. The similarities in white matter alterations between FLE and TLE suggested that their epileptogenic network might affect the fronto-temporal white matter tracts and thalamo-occipital connections, which might be responsible for the overlapping cognitive deficits in FLE and TLE. The white matter impairments in patients with FLE were more severe than those in patients with TLE, which might be explained by more affected nodes in the areas of DMN in patients with FLE.
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Affiliation(s)
- Huan Lin
- Department of Radiology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xi Leng
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunhong Qin
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wensheng Wang
- Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Chi Zhang
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shijun Qiu
- Department of Radiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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23
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Barot N. Networks in Frontal Lobe Epilepsy. Neurosurg Clin N Am 2020; 31:319-324. [PMID: 32475482 DOI: 10.1016/j.nec.2020.03.001] [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] [Indexed: 11/18/2022]
Abstract
Epilepsy affects about 1% of the general population. Frontal lobe epilepsy is the second most common focal epilepsy accounting for nearly 25% of medically refractory epilepsies. This paper reviews frontal lobe epilepsy from a perspective of a network disease that may help us to understand epilepsy from the microscale of genes, to local neuronal circuits, to the macrolevel of a whole-brain network. Surgical interventions, such as ablation and resection act by removing the active target nodes in the network, while responsive neurostimulation and vagus nerve stimulation act by modulating networks at the local neuronal circuit level and whole-brain level.
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Affiliation(s)
- Niravkumar Barot
- University of Pittsburgh, Kaufmann Medical Building, 3471 Fifth Avenues, Suite 810, Pittsburgh, PA 15213, USA.
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24
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Hirata S, Morino M, Nakae S, Matsumoto T. Surgical Technique and Outcome of Extensive Frontal Lobectomy for Treatment of Intracable Non-lesional Frontal Lobe Epilepsy. Neurol Med Chir (Tokyo) 2020; 60:17-25. [PMID: 31801933 PMCID: PMC6970070 DOI: 10.2176/nmc.oa.2018-0286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although extensive frontal lobectomy (eFL) is a common surgical procedure for intractable frontal lobe epilepsy (FLE), there have been very few reports regarding surgical techniques for eFL. This article provides step-by-step descriptions of our surgical technique for non-lesional FLE. Sixteen patients undergoing eFL were included in this study. The goals were to maximize gray matter removal, including the orbital gyrus and subcallosal area, and to spare the primary motor and premotor cortexes and anterior perforated substance. The eFL consists of three steps: (1) positioning, craniotomy, and exposure; (2) lateral frontal lobe resection; and (3), resection of the rectus gyrus and orbital gyrus. Resection ahead of bregma allows preservation of motor and premotor area function. To remove the orbital gyrus preserving anterior perforated substance, it is essential to visualize the olfactory trigone beneath the pia. It is important to observe the surface of the contralateral medial frontal lobe for complete removal of the subcallosal area of the frontal lobe. Thirteen patients (81.25%) became seizure-free and three patients (18.75%) continued to have seizures. None of the patients showed any complications. The eFL is a good surgical technique for the treatment of intractable non-lesional FLE. For treatment of epilepsy by eFL, it is important to resect the non-eloquent area of the frontal lobe as much as possible with preservation of the eloquent cortex.
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25
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Computational modelling in source space from scalp EEG to inform presurgical evaluation of epilepsy. Clin Neurophysiol 2019; 131:225-234. [PMID: 31812920 PMCID: PMC6941468 DOI: 10.1016/j.clinph.2019.10.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/26/2019] [Accepted: 10/26/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The effectiveness of intracranial electroencephalography (iEEG) to inform epilepsy surgery depends on where iEEG electrodes are implanted. This decision is informed by noninvasive recording modalities such as scalp EEG. Herein we propose a framework to interrogate scalp EEG and determine epilepsy lateralization to aid in electrode implantation. METHODS We use eLORETA to map source activities from seizure epochs recorded from scalp EEG and consider 15 regions of interest (ROIs). Functional networks are then constructed using the phase-locking value and studied using a mathematical model. By removing different ROIs from the network and simulating their impact on the network's ability to generate seizures in silico, the framework provides predictions of epilepsy lateralization. We consider 15 individuals from the EPILEPSIAE database and study a total of 62 seizures. Results were assessed by taking into account actual intracranial implantations and surgical outcome. RESULTS The framework provided potentially useful information regarding epilepsy lateralization in 12 out of the 15 individuals (p=0.02, binomial test). CONCLUSIONS Our results show promise for the use of this framework to better interrogate scalp EEG to determine epilepsy lateralization. SIGNIFICANCE The framework may aid clinicians in the decision process to define where to implant electrodes for intracranial monitoring.
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26
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Wiwchar LD, Hader W, Pauranik A, Joseph JT, Appendino JP. Focal seizures associated with the chapeau de gendarme sign or ictal pouting of insular origin. Epilepsy Behav Rep 2019; 12:100347. [PMID: 31828237 PMCID: PMC6888707 DOI: 10.1016/j.ebr.2019.100347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/02/2022] Open
Abstract
We report a teenager with childhood onset focal seizures associated with the chapeau de gendarme sign or ictal pouting of anterior insular lobe origin. The chapeau de gendarme sign has been associated with frontal lobe seizures in patients with focal epilepsy. However, in this case, stereo-electroencephalography (SEEG) localized seizures to the anterior insular cortex prior to her typical clinical manifestations. Surgical resection of the insular and frontal-lobe network resulted in seizure freedom. We propose that the anterior insular cortex should be a site of investigation during pre-surgical phase 2 evaluation in patients exhibiting the chapeau de gendarme sign during focal seizures. Chapeau de gendarme seizures or ictal pouting could have insular lobe involvement at electrical seizure onset. Phase 2 investigation should include insular monitoring when assessing for this kind of seizures. Pediatric population could also have chapeau de gendarme or ictal pouting seizures. Ripples were associated with epileptogenicity in insular cortex requiring resection.
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Affiliation(s)
- Logan D Wiwchar
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada
| | - Walter Hader
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, AB T2N 4N1, Canada
| | - Anvita Pauranik
- Division of Pediatric Neuroradiology, Department of Radiology, Alberta Children's Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada
| | - Jeffrey T Joseph
- Dept. of Pathology and Laboratory Medicine. University of Calgary. McCaig 7539 Alberta Public Laboratories, Foothills Medical Centre, 1403 - 29 St. NW, Calgary, Alberta T2N2T9, Canada
| | - Juan P Appendino
- Section of Paediatric Neurology, Department of Pediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada
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27
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Kibby MY, Cohen MJ, Stanford L, Park YD. Are frontal and temporal lobe epilepsy dissociable in their memory functioning? Epilepsy Behav 2019; 99:106487. [PMID: 31476730 DOI: 10.1016/j.yebeh.2019.106487] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/19/2022]
Abstract
There is controversy in the literature as to how dissociable frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE) are in terms of memory deficits. Some researchers have demonstrated that FLE is associated with greater executive dysfunction including working memory, whereas TLE is associated with greater memory impairment. Others have found the two groups to be comparable in memory functioning. Hence, we examined this question in children with FLE and TLE versus typically developing controls. We found most of the expected effects when the groups with focal onset epilepsy were compared to controls. Specifically, children with left TLE performed worse on verbal short-term memory/learning and long-term memory measures. In contrast, children with right TLE exhibited a more global pattern of difficulty on short-term memory/learning measures but performed worse than controls on long-term memory for faces. Children with FLE performed worse than controls on verbal working memory. Nevertheless, laterality effects were mild, as children with right and left TLE did not differ significantly from each other. Further, children with FLE did not differ from those with TLE on most measures except delayed facial recognition, where children with right TLE performed worse. In addition, attention problems and poor behavioral regulation were related to encoding problems in both the total epilepsy sample and in children with TLE specifically. Hence, our findings overall are consistent with prior studies indicating that children with TLE and FLE are commensurate in most aspects of memory impairment when compared to each other, likely related to rapid propagation between the frontal and temporal lobes, as would be expected with an excitatory lesion.
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Affiliation(s)
- Michelle Y Kibby
- Southern Illinois University, Department of Psychology, LSII, Room 281, Carbondale, IL 62901-6502, USA.
| | - Morris J Cohen
- Pediatric Neuropsychology International, 2963 Foxhall Circle, Augusta, GA 30907, USA.
| | - Lisa Stanford
- NeuroDevelopmental Science Center, Akron Children's Hospital, Considine Professional Building, 215 W. Bowery St., Suite 4400, Akron, OH 44308, United States of America.
| | - Yong D Park
- Department of Neurology, Medical College of Georgia at Augusta University Children's Medical Center, 1446 Harper Street, Augusta, GA 30912, USA.
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28
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Boss N, Abela E, Weisstanner C, Schindler K, Wiest R. Local thalamic atrophy associates with large-scale functional connectivity alterations of fronto-parietal cortices in genetic generalized epilepsies. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2019. [DOI: 10.1177/2514183x19850325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Genetic generalized epilepsies (GGEs) are a group of seizure syndromes that start in childhood and adolescence. Although generally viewed as benign, large-scale epidemiological studies suggest that a significant proportion of GGE patients suffer from drug-resistant seizures, cognitive impairment and social problems. This motivates further research into their pathophysiology, which is still incompletely understood. GGE is characterized clinically and on the encephalogram by seizures that seem to involve both hemispheres simultaneously – hence the idea of a ‘generalized’ process. However, findings from experimental animal studies suggest that seizures in GGE arise due to complex functional alterations within a network that involves fronto-parietal cortex and midline thalamus. In line with these results, neuroimaging studies have found metabolic changes in midline frontal and posterior parietal cortices during GGE seizures and atrophy of both frontal lobe structures and thalamus in GGE patients. Pathology of fronto-thalamic networks seems therefore to be a core feature of GGE. It is unknown how alterations of structure and function between different sites of the network influence each other. Given that the thalamus exerts widespread influence on cortical function, we hypothesized that thalamic atrophy in GGE patients would lead to functional impairment in cortical networks. To test this hypothesis, we performed a case–control study on patients with GGE and healthy controls (HCs), using computational neuroanatomical and functional connectivity techniques. Confirming our hypothesis, we found atrophy in midline thalamic regions preferentially connected to midline (pre-) frontal cortex, and correlated functional disconnection between midline frontal and posterior parietal cortex. Of note, we found increased functional connectivity between the left-sided thalamus and the left medial prefrontal cortex, and a decrease in interhemispheric functional connectivity between bilateral parietal cortex in patients compared to HCs. Taken together, our results suggest that even highly localized subcortical structural changes might lead to large-scale network effects in GGE.
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Affiliation(s)
- Nicolas Boss
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern, Switzerland
| | - Eugenio Abela
- Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience, Institute of Psychiatry Psychology and Neuroscience, King’s Kollege Hospital, London, UK
| | | | | | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern, Switzerland
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29
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Abela E, Pawley AD, Tangwiriyasakul C, Yaakub SN, Chowdhury FA, Elwes RDC, Brunnhuber F, Richardson MP. Slower alpha rhythm associates with poorer seizure control in epilepsy. Ann Clin Transl Neurol 2019; 6:333-343. [PMID: 30847365 PMCID: PMC6389754 DOI: 10.1002/acn3.710] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/26/2018] [Indexed: 01/27/2023] Open
Abstract
Objective Slowing and frontal spread of the alpha rhythm have been reported in multiple epilepsy syndromes. We investigated whether these phenomena are associated with seizure control. Methods We prospectively acquired resting-state electroencephalogram (EEG) in 63 patients with focal and idiopathic generalized epilepsy (FE and IGE) and 39 age- and gender-matched healthy subjects (HS). Patients were divided into good and poor (≥4 seizures/12 months) seizure control groups based on self-reports and clinical records. We computed spectral power from 20-sec EEG segments during eyes-closed wakefulness, free of interictal abnormalities, and quantified power in high- and low-alpha bands. Analysis of covariance and post hoc t-tests were used to assess group differences in alpha-power shift across all EEG channels. Permutation-based statistics were used to assess the topography of this shift across the whole scalp. Results Compared to HS, patients showed a statistically significant shift of spectral power from high- to low-alpha frequencies (effect size g = 0.78 [95% confidence interval 0.43, 1.20]). This alpha-power shift was driven by patients with poor seizure control in both FE and IGE (g = 1.14, [0.65, 1.74]), and occurred over midline frontal and bilateral occipital regions. IGE exhibited less alpha power shift compared to FE over bilateral frontal regions (g = -1.16 [-0.68, -1.74]). There was no interaction between syndrome and seizure control. Effects were independent of antiepileptic drug load, time of day, or subgroup definitions. Interpretation Alpha slowing and anteriorization are a robust finding in patients with epilepsy and might represent a generic indicator of seizure liability.
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Affiliation(s)
- Eugenio Abela
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
- Department of Clinical NeurophysiologyKing's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - Adam D. Pawley
- Social, Genetic and Developmental Psychiatry Research CenterInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
| | - Chayanin Tangwiriyasakul
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
| | - Siti N. Yaakub
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
- School of Biomedical Engineering & Imaging SciencesKing's College LondonLondonUnited Kingdom
| | - Fahmida A. Chowdhury
- National Hospital for Neurology and NeurosurgeryUCL Hospitals NHS Foundation TrustLondonUnited Kingdom
| | - Robert D. C. Elwes
- Department of Clinical NeurophysiologyKing's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - Franz Brunnhuber
- Department of Clinical NeurophysiologyKing's College Hospital NHS Foundation TrustLondonUnited Kingdom
| | - Mark P. Richardson
- Department of Basic and Clinical NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUnited Kingdom
- Department of Clinical NeurophysiologyKing's College Hospital NHS Foundation TrustLondonUnited Kingdom
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Neuropsychology of frontal lobe epilepsy in children and adults: Systematic review and meta-analysis. Epilepsy Behav 2018; 88:15-20. [PMID: 30212723 DOI: 10.1016/j.yebeh.2018.08.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/08/2018] [Accepted: 08/08/2018] [Indexed: 11/22/2022]
Abstract
Frontal lobe epilepsy (FLE) is associated with cognitive problems, especially in areas related to frontal lobe functioning as executive functions, attention, and motor skills, but with impact on memory and psychosocial adaptation. Deficits are similar in both adults and children with FLE, although no studies have compared adult and pediatric performance in the same study. The aim of this research was to analyze the existing evidence concerning the cognition in adults and children with FLE. A random effect meta-analysis was used using Cohen's d, and the confidence interval for each cognitive factor was calculated. The results in the meta-analysis show a general pattern of cognitive dysfunction in FLE, especially in functions related to the frontal lobe, with an influence of the duration and the age at onset of epilepsy, as well as the age of the sample used. In addition, researches in this type of epilepsy are heterogeneous, with too many different sampling and methodological characteristics, which is not a standard format for reporting clinical sample characterization, making it difficult to study FLE in depth.
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31
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Profile of neuropsychological impairment in Sleep-related Hypermotor Epilepsy. Sleep Med 2018; 48:8-15. [DOI: 10.1016/j.sleep.2018.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/03/2018] [Accepted: 03/14/2018] [Indexed: 11/21/2022]
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Wu Q, Zhao CW, Long Z, Xiao B, Feng L. Anatomy Based Networks and Topology Alteration in Seizure-Related Cognitive Outcomes. Front Neuroanat 2018; 12:25. [PMID: 29681801 PMCID: PMC5898178 DOI: 10.3389/fnana.2018.00025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 03/20/2018] [Indexed: 01/19/2023] Open
Abstract
Epilepsy is a paroxysmal neurological disorder characterized by recurrent and unprovoked seizures affecting approximately 50 million people worldwide. Cognitive dysfunction induced by seizures is a severe comorbidity of epilepsy and epilepsy syndromes and reduces patients’ quality of life. Seizures, along with accompanying histopathological and pathophysiological changes, are associated with cognitive comorbidities. Advances in imaging technology and computing allow anatomical and topological changes in neural networks to be visualized. Anatomical components including the hippocampus, amygdala, cortex, corpus callosum (CC), cerebellum and white matter (WM) are the fundamental components of seizure- and cognition-related topological networks. Damage to these structures and their substructures results in worsening of epilepsy symptoms and cognitive dysfunction. In this review article, we survey structural, network changes and topological alteration in different regions of the brain and in different epilepsy and epileptic syndromes, and discuss what these changes may mean for cognitive outcomes related to these disease states.
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Affiliation(s)
- Qian Wu
- Department of Neurology, First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Charlie W Zhao
- Department of Neuroscience, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Zhe Long
- Sydney Medical School and the Brain & Mind Institute, The University of Sydney, Camperdown, NSW, Australia
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Kamenskiy IS, Kaymovskiy IL, Gersamiya AG, Vavilina IS. [Cognitive impairment. The effects of seizures?]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:50-54. [PMID: 29213039 DOI: 10.17116/jnevro20171179250-54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review discusses articles on cognitive impairments developing after one or more convulsive seizures. Cognitive disorders seem to be frequent complications of epilepsy. According to recent clinical studies, the intensity of cognitive declines depends on a frequency and severity of seizures. However, presence of an epileptic focus does not always indicate an increase in cognitive impairments. An effect of a single convulsive seizure on cognitive functions at this stage is uncertain. According to some data, cognitive impairments after a single generalized seizures develop only in specific clinical syndromes, on the other hand, they are influenced by the emotional state of the subject. This problem remains relevant today. Further work is needed in this direction.
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Affiliation(s)
| | | | - A G Gersamiya
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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Nuyts S, D'Souza W, Bowden SC, Vogrin SJ. Structural brain abnormalities in genetic generalized epilepsies: A systematic review and meta-analysis. Epilepsia 2017; 58:2025-2037. [DOI: 10.1111/epi.13928] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Shauni Nuyts
- Department of Psychological Sciences; University of Leuven; Leuven Belgium
- Department of Statistics; University of Leuven; Leuven Belgium
- Melbourne School of Psychological Sciences; University of Melbourne; Parkville Victoria Australia
| | - Wendyl D'Souza
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Fitzroy Victoria Australia
| | - Stephen C. Bowden
- Melbourne School of Psychological Sciences; University of Melbourne; Parkville Victoria Australia
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Fitzroy Victoria Australia
| | - Simon J. Vogrin
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Fitzroy Victoria Australia
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Ahmedt-Aristizabal D, Fookes C, Dionisio S, Nguyen K, Cunha JPS, Sridharan S. Automated analysis of seizure semiology and brain electrical activity in presurgery evaluation of epilepsy: A focused survey. Epilepsia 2017; 58:1817-1831. [DOI: 10.1111/epi.13907] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
- David Ahmedt-Aristizabal
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - Clinton Fookes
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - Sasha Dionisio
- Mater Centre for Neurosciences; Brisbane Queensland Australia
| | - Kien Nguyen
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
| | - João Paulo S. Cunha
- The Institute of Systems and Computer Engineering; Technology and Science; and Faculty of Engineering; University of Porto; Porto Portugal
| | - Sridha Sridharan
- The Speech, Audio, Image and Video Technologies (SAIVT) and Science and Engineering Faculty; Queensland University of Technology; Brisbane Queensland Australia
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Rayner G, Tailby C. Current Concepts of Memory Disorder in Epilepsy: Edging Towards a Network Account. Curr Neurol Neurosci Rep 2017. [DOI: 10.1007/s11910-017-0765-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Fujikawa M, Nishio Y, Kakisaka Y, Ogawa N, Iwasaki M, Nakasato N. Fantastic confabulation in right frontal lobe epilepsy. EPILEPSY & BEHAVIOR CASE REPORTS 2016; 6:55-7. [PMID: 27630818 PMCID: PMC5014757 DOI: 10.1016/j.ebcr.2016.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/06/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
Abstract
Background Interictal behavioral symptoms in frontal lobe epilepsy (FLE) are variable and often difficult to discriminate from other localization-related epilepsies. Methods and results We report two female patients with right FLE who exhibited fantastic confabulations. One of the patients had a 14-year history of hypermotor seizures, and the other had a 10-year history of dyscognitive seizures with automatism. Their fantastic confabulations arose in the context of moderate-to-severe cognitive impairment and of a variety of behavioral abnormalities, including emotional withdrawal and compulsive behaviors. Conclusion Fantastic confabulations are rare but may be a relatively specific behavioral marker for FLE-associated psychosis.
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Affiliation(s)
- Mayu Fujikawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Nishio
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
- Corresponding author at: Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi Aoba-ku, Sendai 980-8575, Japan.Department of Behavioral Neurology and Cognitive NeuroscienceTohoku University Graduate School of Medicine2-1 Seiryo-machi Aoba-kuSendai980-8575Japan
| | - Yosuke Kakisaka
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nanayo Ogawa
- Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Hu Y, Jiang Y, Hu P, Ma H, Wang K. Impaired social cognition in patients with interictal epileptiform discharges in the frontal lobe. Epilepsy Behav 2016; 57:46-54. [PMID: 26921598 DOI: 10.1016/j.yebeh.2016.01.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 01/23/2016] [Accepted: 01/23/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with epilepsy frequently experience cognitive impairments, including impairments in social cognition. However, there is a lack of direct examinations of the affective and cognitive aspects of social cognition in such patients. The neural correlates remain to be identified. The present study was designed to examine the degree of impairments in different aspects of social cognition including empathy, emotion recognition, and Theory of Mind (ToM) in patients with epilepsy. In addition, we further explored factors related to the impairments, highlighting the specific importance of the frontal region. MATERIALS AND METHODS After 24-hour EEG monitoring, 53 patients with epilepsy were administered a neuropsychological battery of tests for basic intelligence assessment and then were tested with the Interpersonal Reactive Index, the "Yoni" task, the Emotion Recognition Test, the Reading the Mind in the Eyes test, and other neuropsychological tests. The clinical variables potentially affecting the ability to accomplish these tests were taken into account. We divided the patients into those having frontal lobe interictal epileptiform discharges (group with frontal IEDs) and those with seizures originating outside the frontal or temporal lobes (group with extrafrontal IEDs). Sixty healthy individuals served as controls. RESULTS The group with frontal IEDs achieved the most severe deficits in emotion recognition, ToM, and cognitive empathy, while affective empathy was intact. Moreover, the performance scores of empathy in the group with frontal IEDs were selectively correlated with their executive function scores, which are believed to be associated with orbitofrontal functioning. In contrast, patients with epilepsies not originating from the frontal or temporal lobes may also be at risk of impairments in social cognition, albeit to a lesser extent. CONCLUSIONS The preliminary findings suggest that patients with epilepsy, especially those having frontal lobe interictal epileptiform discharges, have associated general social cognition deficits. At the clinical level, these results are in line with previous findings regarding social cognition and the importance of the prefrontal area in the integration of cognition and affect. At the theoretical level, our findings also provide evidence for the functional independence of cognitive from affective aspects of empathy.
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Affiliation(s)
- Ying Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 of JiXi Road, 230022 Hefei City, Anhui Province, PR China.
| | - Yubao Jiang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 of JiXi Road, 230022 Hefei City, Anhui Province, PR China.
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 of JiXi Road, 230022 Hefei City, Anhui Province, PR China.
| | - Huijuan Ma
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 of JiXi Road, 230022 Hefei City, Anhui Province, PR China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 of JiXi Road, 230022 Hefei City, Anhui Province, PR China.
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Gibbs SA, Proserpio P, Terzaghi M, Pigorini A, Sarasso S, Lo Russo G, Tassi L, Nobili L. Sleep-related epileptic behaviors and non-REM-related parasomnias: Insights from stereo-EEG. Sleep Med Rev 2016; 25:4-20. [DOI: 10.1016/j.smrv.2015.05.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/13/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
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Matiasek K, Pumarola I Batlle M, Rosati M, Fernández-Flores F, Fischer A, Wagner E, Berendt M, Bhatti SFM, De Risio L, Farquhar RG, Long S, Muñana K, Patterson EE, Pakozdy A, Penderis J, Platt S, Podell M, Potschka H, Rusbridge C, Stein VM, Tipold A, Volk HA. International veterinary epilepsy task force recommendations for systematic sampling and processing of brains from epileptic dogs and cats. BMC Vet Res 2015; 11:216. [PMID: 26324339 PMCID: PMC4595046 DOI: 10.1186/s12917-015-0467-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 06/29/2015] [Indexed: 01/06/2023] Open
Abstract
Traditionally, histological investigations of the epileptic brain are required to identify epileptogenic brain lesions, to evaluate the impact of seizure activity, to search for mechanisms of drug-resistance and to look for comorbidities. For many instances, however, neuropathological studies fail to add substantial data on patients with complete clinical work-up. This may be due to sparse training in epilepsy pathology and or due to lack of neuropathological guidelines for companion animals.The protocols introduced herein shall facilitate systematic sampling and processing of epileptic brains and therefore increase the efficacy, reliability and reproducibility of morphological studies in animals suffering from seizures.Brain dissection protocols of two neuropathological centres with research focus in epilepsy have been optimised with regards to their diagnostic yield and accuracy, their practicability and their feasibility concerning clinical research requirements.The recommended guidelines allow for easy, standardised and ubiquitous collection of brain regions, relevant for seizure generation. Tissues harvested the prescribed way will increase the diagnostic efficacy and provide reliable material for scientific investigations.
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Affiliation(s)
- Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Martí Pumarola I Batlle
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB Bellaterra, 08193, Barcelona, Spain.
| | - Marco Rosati
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Francisco Fernández-Flores
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB Bellaterra, 08193, Barcelona, Spain.
| | - Andrea Fischer
- Department of Animal and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Eva Wagner
- Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Mette Berendt
- Department of Animal and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Sofie F M Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, UK.
| | - Robyn G Farquhar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, UK.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia.
| | - Karen Muñana
- North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Edward E Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, UK.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, UK. .,School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, UK.
| | - Veronika M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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Niso G, Carrasco S, Gudín M, Maestú F, Del-Pozo F, Pereda E. What graph theory actually tells us about resting state interictal MEG epileptic activity. NEUROIMAGE-CLINICAL 2015; 8:503-15. [PMID: 26106575 PMCID: PMC4475779 DOI: 10.1016/j.nicl.2015.05.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 05/07/2015] [Accepted: 05/19/2015] [Indexed: 01/21/2023]
Abstract
Graph theory provides a useful framework to study functional brain networks from neuroimaging data. In epilepsy research, recent findings suggest that it offers unique insight into the fingerprints of this pathology on brain dynamics. Most studies hitherto have focused on seizure activity during focal epilepsy, but less is known about functional epileptic brain networks during interictal activity in frontal focal and generalized epilepsy. Besides, it is not clear yet which measures are most suitable to characterize these networks. To address these issues, we recorded magnetoencephalographic (MEG) data using two orthogonal planar gradiometers from 45 subjects from three groups (15 healthy controls (7 males, 24 ± 6 years), 15 frontal focal (8 male, 32 ± 16 years) and 15 generalized epileptic (6 male, 27 ± 7 years) patients) during interictal resting state with closed eyes. Then, we estimated the total and relative spectral power of the largest principal component of the gradiometers, and the degree of phase synchronization between each sensor site in the frequency range [0.5–40 Hz]. We further calculated a comprehensive battery of 15 graph-theoretic measures and used the affinity propagation clustering algorithm to elucidate the minimum set of them that fully describe these functional brain networks. The results show that differences in spectral power between the control and the other two groups have a distinctive pattern: generalized epilepsy presents higher total power for all frequencies except the alpha band over a widespread set of sensors; frontal focal epilepsy shows higher relative power in the beta band bilaterally in the fronto-central sensors. Moreover, all network indices can be clustered into three groups, whose exemplars are the global network efficiency, the eccentricity and the synchronizability. Again, the patterns of differences were clear: the brain network of the generalized epilepsy patients presented greater efficiency and lower eccentricity than the control subjects for the high frequency bands, without a clear topography. Besides, the frontal focal epileptic patients showed only reduced eccentricity for the theta band over fronto-temporal and central sensors. These outcomes indicate that functional epileptic brain networks are different to those of healthy subjects during interictal stage at rest, with a unique pattern of dissimilarities for each type of epilepsy. Further, when properly selected, three network indices suffice to provide a comprehensive description of these differences. Yet, since such uniqueness in the pattern of differences is also evident in the power spectrum, we conclude that the added value of the graph theory approach in this context should not be overestimated. We study MEG activity during interictal resting state with closed eyes. Generalized epilepsy presents higher total power over a widespread set of sensors. Frontal epilepsy shows higher relative power in beta band on fronto-central sensors. We also found altered functional brain networks in epilepsy using graph theory. The pattern of differences from control subjects is unique for each type of epilepsy.
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Affiliation(s)
- Guiomar Niso
- Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain ; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Sira Carrasco
- Teaching General Hospital of Ciudad Real, Ciudad Real, Spain
| | - María Gudín
- Teaching General Hospital of Ciudad Real, Ciudad Real, Spain
| | - Fernando Maestú
- Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain ; Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Francisco Del-Pozo
- Center for Biomedical Technology, Technical University of Madrid, Madrid, Spain ; Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - Ernesto Pereda
- Dept. of Industrial Engineering, Electrical Engineering and Bioengineering Group, Institute of Biomedical Technology (ITB-CIBICAN), University of La Laguna, Tenerife, Spain
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Pillai JA, Haut SR, Masur D. Orbitofrontal cortex dysfunction in psychogenic non-epileptic seizures. A proposal for a two-factor model. Med Hypotheses 2015; 84:363-9. [DOI: 10.1016/j.mehy.2015.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/21/2015] [Indexed: 11/26/2022]
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Coito A, Plomp G, Genetti M, Abela E, Wiest R, Seeck M, Michel CM, Vulliemoz S. Dynamic directed interictal connectivity in left and right temporal lobe epilepsy. Epilepsia 2015; 56:207-17. [PMID: 25599821 DOI: 10.1111/epi.12904] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE There is increasing evidence that epileptic activity involves widespread brain networks rather than single sources and that these networks contribute to interictal brain dysfunction. We investigated the fast-varying behavior of epileptic networks during interictal spikes in right and left temporal lobe epilepsy (RTLE and LTLE) at a whole-brain scale using directed connectivity. METHODS In 16 patients, 8 with LTLE and 8 with RTLE, we estimated the electrical source activity in 82 cortical regions of interest (ROIs) using high-density electroencephalography (EEG), individual head models, and a distributed linear inverse solution. A multivariate, time-varying, and frequency-resolved Granger-causal modeling (weighted Partial Directed Coherence) was applied to the source signal of all ROIs. A nonparametric statistical test assessed differences between spike and baseline epochs. Connectivity results between RTLE and LTLE were compared between RTLE and LTLE and with neuropsychological impairments. RESULTS Ipsilateral anterior temporal structures were identified as key drivers for both groups, concordant with the epileptogenic zone estimated invasively. We observed an increase in outflow from the key driver already before the spike. There were also important temporal and extratemporal ipsilateral drivers in both conditions, and contralateral only in RTLE. A different network pattern between LTLE and RTLE was found: in RTLE there was a much more prominent ipsilateral to contralateral pattern than in LTLE. Half of the RTLE patients but none of the LTLE patients had neuropsychological deficits consistent with contralateral temporal lobe dysfunction, suggesting a relationship between connectivity changes and cognitive deficits. SIGNIFICANCE The different patterns of time-varying connectivity in LTLE and RTLE suggest that they are not symmetrical entities, in line with our neuropsychological results. The highest outflow region was concordant with invasive validation of the epileptogenic zone. This enhanced characterization of dynamic connectivity patterns could better explain cognitive deficits and help the management of epilepsy surgery candidates.
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Affiliation(s)
- Ana Coito
- Functional Brain Mapping Lab, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
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Rayner G, Jackson GD, Wilson SJ. Behavioral profiles in frontal lobe epilepsy: Autobiographic memory versus mood impairment. Epilepsia 2015; 56:225-33. [PMID: 25582326 DOI: 10.1111/epi.12902] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Autobiographic memory encompasses the encoding and retrieval of episodes, people, and places encountered in everyday life. It can be impaired in both epilepsy and frontal lobe damage. Here, we performed an initial investigation of how autobiographic memory is impacted by chronic frontal lobe epilepsy (FLE) together with its underlying pathology. METHOD We prospectively studied a series of nine consecutive patients with medically refractory FLE, relative to 24 matched healthy controls. Seven of the nine patients had frontal lobe structural abnormalities. Episodic and semantic autobiographic memory functioning was profiled, and factors associated with impaired autobiographic memory were identified among epileptologic, neuroimaging, neuropsychiatric, and cognitive variables including auditory-verbal and visual memory, and the executive function of cognitive control. RESULTS Results showed that the FLE group experienced significantly higher rates of autobiographic memory and mood disturbance (p < 0.001), with detailed assessment of individual patients revealing two profiles of impairment, primarily characterized by cognitive or mood disturbance. Five of the patients (56%) exhibited significant episodic autobiographic memory deficits, whereas in three of these, knowledge of semantic autobiographic facts was preserved. Four of them also had reduced cognitive control. Mood disorder was largely unrelated to poor autobiographic memory. In contrast, the four cases with preserved autobiographic memory were notable for their past or current depressive symptoms. SIGNIFICANCE These findings provide preliminary data that frontal lobe seizure activity with its underlying pathology may selectively disrupt large-scale cognitive or affective networks, giving rise to different neurobehavioral profiles that may be used to inform clinical management.
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Affiliation(s)
- Genevieve Rayner
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, Brain Research Institute, The University of Melbourne, Heidelberg, Victoria, Australia
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Jiang Y, Hu Y, Wang Y, Zhou N, Zhu L, Wang K. Empathy and emotion recognition in patients with idiopathic generalized epilepsy. Epilepsy Behav 2014; 37:139-44. [PMID: 25022822 DOI: 10.1016/j.yebeh.2014.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/12/2014] [Accepted: 06/04/2014] [Indexed: 12/30/2022]
Abstract
Patients with epilepsy have deficits in social cognition. In this study, we examined the changes in empathy and eye emotion recognition using the Interpersonal Reactivity Index and eye emotion recognition tasks. Forty-two patients with idiopathic generalized epilepsy and 47 healthy controls were involved. The eye emotion recognition and cognitive empathy abilities of the patients with IGE were impaired, but the affective empathy was intact. The cognitive empathy performance of the patients with IGE was positively correlated with their performance in sadness recognition, MoCA, verbal fluency, and the Stroop test. These results suggest that the empathy ability was impaired in patients with IGE, and this impairment may be caused by deficits in frontal lobe function.
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Affiliation(s)
- Yubao Jiang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
| | - Ying Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
| | - Nong Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
| | - Li Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, PR China.
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Bonini F, McGonigal A, Trébuchon A, Gavaret M, Bartolomei F, Giusiano B, Chauvel P. Frontal lobe seizures: From clinical semiology to localization. Epilepsia 2013; 55:264-77. [PMID: 24372328 DOI: 10.1111/epi.12490] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Francesca Bonini
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
| | - Aileen McGonigal
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Clinical Neurophysiology Department; Timone Hospital; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Agnès Trébuchon
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Clinical Neurophysiology Department; Timone Hospital; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Martine Gavaret
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Clinical Neurophysiology Department; Timone Hospital; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Fabrice Bartolomei
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Clinical Neurophysiology Department; Timone Hospital; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Bernard Giusiano
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Division of Public Health; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Patrick Chauvel
- INSERM UMR 1106; Institut de Neurosciences des Systèmes; Marseille France
- Faculty of Medicine; Aix-Marseille University; Marseille France
- Clinical Neurophysiology Department; Timone Hospital; Assistance Publique des Hôpitaux de Marseille; Marseille France
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Baldissin MM, Souza EMD. Investigation of magnetic resonance imaging texture analysis as an aid tool for characterization of refractory epilepsies. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 71:920-4. [PMID: 24347009 DOI: 10.1590/0004-282x20130219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 07/10/2013] [Indexed: 11/21/2022]
Abstract
Refractory epilepsies are syndromes for which therapies that employ two or more antiepileptic drugs, separately or in association, do not result in control of crisis. Patients may present focal cortical dysplasia or diffuse dysplasia and/or hippocampal atrophic alterations that may not be detectable by a simple visual analysis in magnetic resonance imaging. The aim of this study was to evaluate MRI texture in regions of interest located in the hippocampi, limbic association cortex and prefrontal cortex of 20 patients with refractory epilepsy and to compare them with the same areas in 20 healthy individuals, in order to find out if the texture parameters could be related to the presence of the disease. Of the 11 texture parameters calculated, three indicated the existence of statistically significant differences between the studied groups. Such findings suggest the possibility of this technique contributing to studies of refractory epilepsies.
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Affiliation(s)
- Maurício Martins Baldissin
- Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brazil, CampinasSP
| | - Edna Marina de Souza
- Departamento de Engenharia Biomédica, Faculdade de Engenharia Elétrica e Computação, Universidade Estadual de Campinas, Brazil, CampinasSP
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Affiliation(s)
- Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK.
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McGonigal A, Chauvel P. Prefrontal seizures manifesting as motor stereotypies. Mov Disord 2013; 29:1181-5. [DOI: 10.1002/mds.25718] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/12/2013] [Accepted: 09/22/2013] [Indexed: 02/03/2023] Open
Affiliation(s)
- Aileen McGonigal
- Institut de Neurosciences des Systèmes; INSERM UMR 1106; Marseille France
- Aix Marseille Université; Faculté de Médecine; Marseille France
- Service de Neurophysiologie Clinique; Hôpital de la Timone; Assistance Publique des Hôpitaux de Marseille; Marseille France
| | - Patrick Chauvel
- Institut de Neurosciences des Systèmes; INSERM UMR 1106; Marseille France
- Aix Marseille Université; Faculté de Médecine; Marseille France
- Service de Neurophysiologie Clinique; Hôpital de la Timone; Assistance Publique des Hôpitaux de Marseille; Marseille France
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Catani M, Dell'acqua F, Bizzi A, Forkel SJ, Williams SC, Simmons A, Murphy DG, Thiebaut de Schotten M. Beyond cortical localization in clinico-anatomical correlation. Cortex 2012; 48:1262-87. [PMID: 22995574 DOI: 10.1016/j.cortex.2012.07.001] [Citation(s) in RCA: 168] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 07/31/2012] [Accepted: 07/31/2012] [Indexed: 01/07/2023]
Affiliation(s)
- Marco Catani
- Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK.
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