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Roshan JHN, Chamanabad AG, Mashhadi A, Motamedi M. Cathodal HD-tDCS and attention: A study on patients with intractable left lateral frontal lobe epilepsy. Epilepsy Res 2024; 199:107265. [PMID: 38071911 DOI: 10.1016/j.eplepsyres.2023.107265] [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: 09/14/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Defects in the attentional network in patients with epilepsy are influenced by factors such as the location of epileptic foci. Examining the impact of cathodal high-definition transcranial direct current stimulation (HD-tDCS) on attention components could provide insights into potential attention-related side effects of tDCS. This study aimed to investigate the effect of cathodal HD-tDCS on interictal epileptiform discharges (IEDs), auditory/visual (A/V) attention components, and reaction time (RT) in patients with intractable focal left lateral frontal lobe epilepsy (LFLE). METHODS To control for variations in individual epilepsy syndrome, 12 adult participants diagnosed with drug-resistant left LFLE with focal cortical IEDs on C3 underwent repeated measurements at pretest, posttest, and follow-up steps. 4 × 1 ring electrodes (cathode on C3 and four anodes on F3, P3, T3, and Cz) delivered 2 mA DC for 20 min per session for 10 consecutive days. The integrated visual and auditory continuous performance test (IVA+) assessed the A/V attention components and RT. One-way repeated-measure ANOVA was used. RESULTS The findings suggest a significant effect in reducing IEDs. The IVA+ results showed a significant improvement in auditory divided attention and visual selective and focused attention (p < 0.05). In the follow-up, these changes demonstrated lasting efficacy. A/V speed scales increased (p < 0.05), showing a significant decrease in reaction time. CONCLUSIONS Cathodal HD-tDCS significantly reduced IEDs and improved the components of auditory divided attention, visual focused attention, and visual selective attention, with a reduction in patient reaction time. A significant lasting, side-effect-free positive effect was observed for up to one month after the intervention.
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Affiliation(s)
| | - Ali Ghanaei Chamanabad
- Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran; Cognitive Science Research Center, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Ali Mashhadi
- Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran; Cognitive Science Research Center, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mahmoud Motamedi
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Sina Hospital, Tehran University of Medical Science, Tehran, Iran
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Hasegawa N, Annaka H. Long-term effect associated with seizures and dynamic effect associated with treatment on cognitive dysfunction of adult patients with focal epilepsy as evaluated by the Trail Making Test. Epileptic Disord 2023; 25:731-738. [PMID: 37518899 DOI: 10.1002/epd2.20137] [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: 03/06/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE This study was performed to clarify the utility of the Trail Making Test (TMT) in evaluating the effects of the course of epilepsy on cognitive function by evaluating the course of epileptic seizures and the results of the TMT over time. METHODS We performed the TMT twice at a 1-year interval for each patient with focal epilepsy. We performed multiple regression analyses with the first TMT scores as dependent variables and clinical features as independent variables. Next, we performed a multivariate analysis of covariance (MANCOVA) to evaluate the difference between the first and second TMT scores for patients in each seizure prognosis group. RESULTS We enrolled 132 adult patients in this study. Multiple regression analyses showed that longer active seizure periods were associated with worse first TMT-B performance (β = .318, p < .001) and B-A (β = .377, p < .001) and that the number of antiseizure medicines was associated with worse first TMT-A performance (β = .186, p = .025). In addition, topiramate and zonisamide adversely affected TMT performance. MANCOVA showed an interaction between the prognosis of TMT-B performance and the seizure prognosis [F(2, 120) = 3.68, p = .028]. Subeffect tests revealed that the second TMT-B performance improved only in the seizure improvement group [F(1, 10) = 10.07, p = .01]. SIGNIFICANCE Epileptic seizures were shown to be associated with both long-term and dynamic adverse effects on cognitive function evaluated with the TMT in adult patients with focal epilepsy. Seizure control is important for improving the cognitive function of patients with epilepsy; however, the potential adverse effects of polypharmacy and some antiseizure medicines such as zonisamide and topiramate on cognitive function should be considered.
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Affiliation(s)
- Naoya Hasegawa
- Department of Psychiatry, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, Niigata, Japan
| | - Hiroki Annaka
- Department of Occupational Therapy, Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan
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Kishk NA, Farghaly M, Nawito A, Shamloul RM, Moawad MK. Neuropsychological performance in patients with focal drug-resistant epilepsy and different factors that affect their performance. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Drug-resistant epilepsy (DRE) accounts for nearly 30% of patients with epilepsy, which is associated with high incidence of cognitive comorbidity. The aim of this work was to study the role of neuropsychological assessment in patients with epilepsy, and different factors that affect their performance in patients with multiple factors (focal onset DRE).
Methods
118 patients were recruited from Kasr Alainy hospital, epilepsy outpatient clinic with focal DRE. The patients’ demographic and clinical data were collected, Electroencephalograph (EEG) interictal/ictal (when available), and brain imaging (MRI epilepsy protocol). Neuropsychological assessment by Wechsler Adult Intelligence Scale (WAIS-IV), proposed neurocognitive assessment battery and mood assessment was done. Their performance in neuropsychological assessment was correlated with the collected data. Concordance between different assessment modalities and brain lesion were done.
Results
Among recruited patients, 67.3% of patients showed Full-scale Intelligence Quotient (FSIQ) was less than average. FSIQ score significantly correlated with years of education, and number of anti-seizure medications (ASMs). Neurocognitive assessment battery could achieve cognitive profile of the patients but with poor lateralizing value. Executive function was the most affected cognitive domain. History of status epilepticus significantly affect FSIQ and executive function performance. Fifty-six percent of patients had depression. Among the analyzed factors, FSIQ and lesional brain imaging significantly affected neurocognitive performance of studied patients. Clinical semiology had better concordance in lateralization (74.7%) and localization (69.5%) with brain imaging compared to ictal EEG. Among patients who had ictal EEG recording, 36.4% patients (25% were temporal lobe) had complete concordance, while 38.6% patients had partial concordance.
Conclusions
Among analyzed factors, FSIQ was the most significant determinant of studied population’s neurocognitive performance. Clinical semiology were the best correlated with brain lesion. Complete concordance was best detected at the temporal lobe.
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Latreille V, Schiller K, Peter-Derex L, Frauscher B. Does epileptic activity impair sleep-related memory consolidation in epilepsy? A critical and systematic review. J Clin Sleep Med 2022; 18:2481-2495. [PMID: 35866226 PMCID: PMC9516593 DOI: 10.5664/jcsm.10166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES People with epilepsy often complain about disturbed sleep and cognitive impairment. Beyond seizures, the occurrence of interictal epileptic activity during sleep is also increasingly recognized to negatively impact cognitive functioning, including memory processes. The aim of this study was to critically review the effect of interictal epileptic activity on sleep-related memory consolidation. METHODS PubMed and PsychINFO databases were systematically searched to identify experimental studies that investigated sleep-related memory consolidation and the relationships between sleep-related epileptic activity and memory in adults and children with epilepsy. This review also highlights hypotheses regarding the potential pathophysiological mechanisms. RESULTS A total of 261 studies were identified; 27 of these met selection criteria. Only 13 studies prospectively assessed the effect of sleep on memory in epilepsy. Most studies reported no alteration of sleep-related memory consolidation in patients, with either similar retention levels following a period containing sleep (n = 5) or improved memory performance postsleep (n = 4). Two studies in children with epilepsy found impaired sleep-related memory consolidation. Ten studies, of which 6 were in childhood epilepsy syndromes, reported a debilitating effect of sleep-related epileptic activity on memory functioning. CONCLUSIONS Conclusions from existing studies were hampered by small sample sizes, heterogeneous patient groups, and variations in memory assessment techniques. Overall, results to date preclude any definitive conclusions on the alteration of sleep-related memory consolidation in epilepsy. We discuss methodological considerations specific to people with epilepsy and provide suggestions on how to best investigate the relationship between epileptic activity, sleep, and memory consolidation in future studies. CITATION Latreille V, Schiller K, Peter-Derex L, Frauscher B. Does epilepticimpair sleep-related memory consolidation in epilepsy? A critical and systematic review. J Clin Sleep Med. 2022;18(10):2481-2495.
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Affiliation(s)
- Véronique Latreille
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Katharina Schiller
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
- Department of Pediatrics, Hospital Group Ostallgaeu-Kaufbeuren, Kaufbeuren, Germany
| | - Laure Peter-Derex
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, University Hospital of Lyon, Lyon 1 University, France
- Lyon Neuroscience Research Center, INSERM 1028/CNRS 5292, Lyon, France
| | - Birgit Frauscher
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
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Epileptiform EEG discharges during sevoflurane anesthesia in children: A meta-analysis. Clin Neurophysiol 2022; 143:48-55. [PMID: 36108521 DOI: 10.1016/j.clinph.2022.08.019] [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: 12/13/2021] [Revised: 08/08/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the overall incidence and associated factors of epileptiform discharges in children during sevoflurane anesthesia. METHODS Our group systematically searched the PubMed, Cochrane library (Central) and EMBASE for the relevant trials from their inception until September 2020. The primary endpoint was the incidence of epileptiform discharges during sevoflurane induction. The secondary endpoints were the incidence of different types of epileptiform discharges, factors associated with these epileptiform events, and other adverse events such as seizure-like movements. RESULTS After screening of 713 records, eleven studies involving 448 participants were included into the final analysis. Meta-analysis indicated that the overall incidence of Epileptiform EEG discharges was 38.1% (95%confidence interval [CI], 19.1%-59.2%) during sevoflurane anesthesia in children. Subgroup analysis showed that the incidence of these EEG patters was lower when participants were inducted by using the low initial concentration of sevoflurane, compared with the high initial concentration sevoflurane (1.7%, 95%CI, 0.0% to 8.4% versus 47.7%, 95%CI, 25.5% to 70.3%, P < 0.05). The longer exposure (>3 min) of high concentration sevoflurane during induction showed higher rate of epileptiform discharges than a shorter exposure (≤3 min) (48.4%, 95%CI, 20.1% to 77.3% versus 5.7%, 95%CI, 0.00% to 23.5%; P < 0.05). No significant difference for the incidence of epileptiform discharges was observed in subgroup analysis of addition of nitrous oxide (69.2%, 95%CI, 34.0% to 95.7% versus 41.3%, 95%CI, 15.6% to 69.7%, P﹥0.05) and type of EEG monitoring (26.9%, 95%CI, 3.8% to 60.7% versus 53.1%, 95%CI, 25.4% to 79.8%, P﹥0.05). CONCLUSIONS The incidence of epileptiform EEG events in children during sevoflurane anesthesia varied from 19.1%-59.2%. The low initial concentration technique and shorter exposure time of high concentration sevoflurane may be associated with a decreased incidence of these epileptiform discharges in EEG. SIGNIFICANCE Epileptiform EEG discharges during sevoflurane anesthesia in children should arouse clinicians' attention. The use of low initial concentration technique and shorter exposure time of high concentration sevoflurane may be associated with a lower occurrence of these paradoxical events.
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Zhang D, Chen S, Xu S, Wu J, Zhuang Y, Cao W, Chen X, Li X. The clinical correlation between Alzheimer's disease and epilepsy. Front Neurol 2022; 13:922535. [PMID: 35937069 PMCID: PMC9352925 DOI: 10.3389/fneur.2022.922535] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Alzheimer's disease and epilepsy are common nervous system diseases in older adults, and their incidence rates tend to increase with age. Patients with mild cognitive impairment and Alzheimer's disease are more prone to have seizures. In patients older than 65 years, neurodegenerative conditions accounted for ~10% of all late-onset epilepsy cases, most of which are Alzheimer's disease. Epilepsy and seizure can occur in the early and late stages of Alzheimer's disease, leading to functional deterioration and behavioral alterations. Seizures promote amyloid-β and tau deposits, leading to neurodegenerative processes. Thus, there is a bi-directional association between Alzheimer's disease and epilepsy. Epilepsy is a risk factor for Alzheimer's disease and, in turn, Alzheimer's disease is an independent risk factor for developing epilepsy in old age. Many studies have evaluated the shared pathogenesis and clinical relevance of Alzheimer's disease and epilepsy. In this review, we discuss the clinical associations between Alzheimer's disease and epilepsy, including their incidence, clinical features, and electroencephalogram abnormalities. Clinical studies of the two disorders in recent years are summarized, and new antiepileptic drugs used for treating Alzheimer's disease are reviewed.
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Hasegawa N, Annaka H. Cognitive features of adult focal epilepsy with unknown etiology revealed by the trail making test. Epilepsy Behav 2022; 129:108625. [PMID: 35245763 DOI: 10.1016/j.yebeh.2022.108625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether the Trail Making Test (TMT) can clarify cognitive dysfunction in focal epilepsy with unknown etiology. METHODS Trail Making Test data were obtained from patients with focal epilepsy with no structural abnormalities on magnetic resonance imaging, history or coexistence of central nerve system diseases, intellectual disability, psychiatric disorders, or medications that might interfere with cognitive function. We performed multiple regression analyses with TMT scores as dependent variables and clinical features as independent variables. RESULTS We enrolled 125 patients in the study. The statistical analyses revealed that taking fewer antiseizure medications, having a longer duration of education, exhibiting left non-temporal epileptic discharge, and exhibiting right temporal epileptic discharge were associated with shorter time to complete the TMT-A and TMT-B. Older age at the time of last seizure was associated with longer time to complete the TMT-B. In addition, a longer active seizure period was associated with longer time to complete the TMT-A subtracted from time to complete the TMT-B. CONCLUSIONS This study indicated that the TMT can be used for assessing the cumulative effects of seizures and the effects of polypharmacy on cognitive function in patients with focal epilepsy. Furthermore, our results indicated that the visuospatial cognitive ability associated with the TMT may depend on the site of epileptic focus of non-lesional focal epilepsy.
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Affiliation(s)
- Naoya Hasegawa
- Department of Psychiatry, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, 1-14-1 Masago, Nishi-ku, Niigata 950-2085 Japan.
| | - Hiroki Annaka
- Department of Rehabilitation, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, 1-14-1 Masago, Nishi-ku, Niigata 950-2085 Japan; Graduate School, Niigata University of Health and Welfare, 1398 Shimami-tyou, Kita-ku, Niigata, Niigata 950-3198 Japan
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Nie L, Jiang Y, Lv Z, Pang X, Liang X, Chang W, Zheng J. A study of brain functional network and alertness changes in temporal lobe epilepsy with and without focal to bilateral tonic-clonic seizures. BMC Neurol 2022; 22:14. [PMID: 34996377 PMCID: PMC8740350 DOI: 10.1186/s12883-021-02525-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Temporal lobe epilepsy (TLE) is commonly refractory. Epilepsy surgery is an effective treatment strategy for refractory epilepsy, but patients with a history of focal to bilateral tonic-clonic seizures (FBTCS) have poor outcomes. Previous network studies on epilepsy have found that TLE and idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTCS) showed altered global and nodal topological properties. Alertness deficits also were found in TLE. However, FBTCS is a common type of seizure in TLE, and the implications for alertness as well as the topological rearrangements associated with this seizure type are not well understood. METHODS We obtained rs-fMRI data and collected the neuropsychological assessment data from 21 TLE patients with FBTCS (TLE- FBTCS), 18 TLE patients without FBTCS (TLE-non- FBTCS) and 22 controls, and constructed their respective functional brain networks. The topological properties were analyzed using the graph theoretical approach and correlations between altered topological properties and alertness were analyzed. RESULTS We found that TLE-FBTCS patients showed more serious impairment in alertness effect, intrinsic alertness and phasic alertness than the patients with TLE-non-FBTCS. They also showed significantly higher small-worldness, normalized clustering coefficient (γ) and a trend of higher global network efficiency (gE) compared to TLE-non-FBTCS patients. The gE showed a significant negative correlation with intrinsic alertness for TLE-non-FBTCS patients. CONCLUSION Our findings show different impairments in brain network information integration, segregation and alertness between the patients with TLE-FBTCS and TLE-non-FBTCS, demonstrating that impairments of the brain network may underlie the disruptions in alertness functions.
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Affiliation(s)
- Liluo Nie
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Yanchun Jiang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Zongxia Lv
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Weiwei Chang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, No.6, Shuangyong Road, Nanning, 530021, China.
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Luo WY, Liu H, Feng Y, Hao JX, Zhang YJ, Peng WF, Zhang PM, Ding J, Wang X. Efficacy of cathodal transcranial direct current stimulation on electroencephalographic functional networks in patients with focal epilepsy: Preliminary findings. Epilepsy Res 2021; 178:106791. [PMID: 34837824 DOI: 10.1016/j.eplepsyres.2021.106791] [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] [Received: 04/25/2021] [Revised: 09/13/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neuromodulation is a promising therapeutic alternative for epilepsy. We aimed to explore the efficacy and safety of cathodal transcranial current direct stimulation (ctDCS) on electroencephalographic functional networks in focal epilepsy. METHODS A sham-controlled, double-blinded, randomized study was conducted on 25 participants with focal epilepsy who underwent a 5-day, -1.0 mA, 20 min ctDCS, which targeted at the most active interictal epileptiform discharge (IED) region. We examined the electroencephalograms (EEGs) at baseline, immediately and at 4 weeks following ctDCS. The graph theory-based brain networks were established through time-variant partial directed coherence (TVPDC), and were calculated between each pair of EEG signals. The functional networks were characterized using average clustering coefficient, characteristic path length, and small-worldness index. The seizure frequencies, IEDs, graph-theory metrics and cognitive tests were compared. RESULTS Preliminary findings indicated an IED reduction of 30.2% at the end of 5-day active ctDCS compared to baseline (p < 0.10) and a significant IED reduction of 33.4% 4 weeks later (p < 0.05). In terms of the EEG functional network, the small-worldness index significantly reduced by 3.5% (p < 0.05) and the characteristic path length increased by 1.8% (p < 0.10) at the end of the session compared to the baseline. No obvious change was found in the seizure frequency during follow-up (p > 0.05). The Mini-Mental State Examination (MMSE) showed no difference between the active and sham groups (p > 0.05). No severe adverse reactions were observed. CONCLUSIONS In focal epilepsy, the 5-day consecutive ctDCS may potentially decrease the IEDs and ameliorate the EEG functional network, proposing a novel personalized therapeutic scenario for epilepsy.
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Affiliation(s)
- Wen-Yi Luo
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hao Liu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Feng
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jia-Xin Hao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Jun Zhang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei-Feng Peng
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Pu-Ming Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
| | - Xin Wang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China; Department of The State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China.
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Disrupted alertness and related functional connectivity in patients with focal impaired awareness seizures in temporal lobe epilepsy. Epilepsy Behav 2020; 112:107369. [PMID: 32858367 DOI: 10.1016/j.yebeh.2020.107369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Focal impaired awareness seizures are common in temporal lobe epilepsy (TLE). The cognitive impairment associated with this type of seizure is unclear. Alertness is a fundamental aspect of cognition. The locus coeruleus (LC) is closely related to alertness. We aimed to assess the impairment in alertness and LC-related alertness network in patients with focal impaired awareness seizures. METHODS Patients with unilateral TLE were grouped into the only focal impaired awareness seizure group (focal group, n = 19) and the focal impaired awareness seizure with focal to bilateral tonic-clonic seizure (FBTCS) group (FBTCS group, n = 19) and compared with matched healthy controls (HC, n = 19). Alertness was assessed with the attention network test. Functional magnetic resonance imaging (fMRI) was used to construct an alertness-related LC-based functional connectivity (FC) network. RESULTS The focal group exhibited impaired tonic and phasic alertness and exhibited a decreased trend of LC-based FC to the left superior frontal gyrus (SFG). The FBTCS group exhibited impaired tonic alertness, phasic alertness, and alertness efficiency. No significant difference or trend in LC-based FC was found in the FBTCS group. SIGNIFICANCE This study reveals disrupted alertness and alertness-related LC-based FC in patients with focal impaired awareness seizures. Our results further demonstrate that the patterns of impaired alertness and of changed LC-based FC were not significantly different between focal impaired awareness seizures and FBTCS.
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Liu J, Zhou X, Zhang Z, Qin L, Ye W, Zheng J. Disrupted functional network in patients with temporal lobe epilepsy with impaired alertness. Epilepsy Behav 2019; 101:106573. [PMID: 31677580 DOI: 10.1016/j.yebeh.2019.106573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/14/2019] [Accepted: 09/14/2019] [Indexed: 10/25/2022]
Abstract
Cognitive impairment is common in patients with temporal lobe epilepsy (TLE). Alertness is an important subfunction of cognition, but it is poorly understood in TLE. We hypothesized that disruptions to underlying brain networks may affect alertness in patients with TLE. Patients with unilateral TLE were grouped into low-alertness and high-alertness groups, and they were matched with healthy controls (HCs) (n = 20 each). Functional magnetic resonance imaging (fMRI) was used to construct functional brain networks, and graph theory was used to identify topological parameters of the networks. At the global level, patients with low alertness had networks with less small-worldness and less normalized clustering than HCs. At the nodal level, patients with low alertness exhibited decreased centrality of the bilateral parahippocampal gyrus compared with HCs and increased centrality of the right postcentral gyrus compared with patients with high alertness. This study reveals a decreased separation, tending toward randomization, of the functional network in patients with TLE with impaired alertness. Our results also suggest that the parahippocampal gyrus may contribute to impaired alertness and the right postcentral gyrus plays an important role in the modulation of alertness in patients with TLE.
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Affiliation(s)
- Jinping Liu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xia Zhou
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zhao Zhang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Lu Qin
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Wei Ye
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
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Miao M, Xu Y, Cong X, Zhang L, Zhang J. Epileptiform EEG discharges and sevoflurane in children: Protocol of a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17401. [PMID: 31577750 PMCID: PMC6783243 DOI: 10.1097/md.0000000000017401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Epileptiform discharges in electroencephalogram (EEG) have been frequently reported in children undergoing sevoflurane mask induction. However, the incidence, characteristics and risk factors of these epileptiform patterns during sevoflurane anesthesia in children are poorly understood. The aim of this study is to systematically review the epileptic potential of sevoflurane in children with the EEG monitoring. METHODS PubMed, EMBASE, Cochrane library (Central) will be systematically searched from inception to December 2018. The effect of sevoflurane on epileptic EEG patters in children will be studied. The primary outcome will be the incidence of epileptic discharges, the characteristics and risk factors of these epileptic discharges. Meta-analysis will be calculated using R software 3.5.1. RESULTS This study will offer new evidence of the incidence, characteristics and risk factors of EEG epileptic discharges during sevoflurane anesthesia. CONCLUSION The conclusion drawn from this systematic review will benefit the children with or without epilepsy undergoing sevoflurane anesthesia. ETHICS AND DISSEMINATION Ethics approval is unnecessary because data of individual patients will not be included and no privacy will be involved. The results of this review will be published in a peer-reviewed journal or a conference report. Amendments of the basic protocol will be documented in the comprehensive review. PROSPERO REGISTRATION NUMBER PROSPERO CRD 42019122008.
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Affiliation(s)
- Mengrong Miao
- Department of Anesthesia and perioperative medicine, Henan University People's Hospital, Henan Provincial People's Hospital of Henan University
- Department of Anesthesia and perioperative medicine, Henan Provincial People's Hospital
| | - Yuehua Xu
- Department of Anesthesia and perioperative medicine, Henan Provincial People's Hospital
- Department of Surgery, First Hospital of Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Xuhui Cong
- Department of Anesthesia and perioperative medicine, Henan Provincial People's Hospital
| | - Liyuan Zhang
- Department of Anesthesia and perioperative medicine, Henan Provincial People's Hospital
| | - Jiaqiang Zhang
- Department of Anesthesia and perioperative medicine, Henan University People's Hospital, Henan Provincial People's Hospital of Henan University
- Department of Anesthesia and perioperative medicine, Henan Provincial People's Hospital
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13
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Tedrus GM, Negreiros LM, Ballarim RS, Marques TA, Fonseca LC. Correlations Between Cognitive Aspects and Quantitative EEG in Adults With Epilepsy. Clin EEG Neurosci 2019; 50:348-353. [PMID: 30198328 DOI: 10.1177/1550059418793553] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. Cognitive impairment frequently occurs in adult patients with epilepsy (PWE), but its pathophysiological basis is not well known. This study assessed cognition and its correlations with quantitative EEG coherence (QEEG) of patients with epilepsy. Method. Eighty PWE seen consecutively in the clinic and 40 normal subjects (NC) were assessed by neurological evaluation, Mini Mental State Examination, immediate and delayed recall of 10 simple figures, phonemic verbal fluency (FAS), category fluency test (VF animals), clock drawing, and QEEG. The mean global inter- and intrahemispheric coherences for the delta, theta, alpha, and beta bands were calculated. Cognitive functions and QEEG coherence of the PWE and the NC were compared, and logistic regression analysis determined the factors associated with impaired cognitive functions in PWE. The significance level was set at P < .05. Results. Regression analysis showed that FAS impairment (14.5 ± 8.6 vs 24.3 ± 15.7, respectively) and delayed recall of figures in PWE (7.3 ± 2.07 vs 8.6 ± 1.48) differed significantly between the PWE and the NC (Nagelkerke R2 = 0.266). Absolute power was greater in all the frequency bands in PWE. Interhemispheric and intrahemispheric beta coherences in the theta frequency was higher in the PWE than in the NC. Logistic regression analysis showed a significant association between interhemispheric delta coherence and VF animal impairment (cutoff point of 12), and between an interhemipheric beta coherence with level of education and delayed recall of figures impairment (cutoff point of 7) (Nagelkerke R2 = 0.297). Other variables were not associated. Conclusions. There was cognitive impairment of PWE and it was significantly associated with QEEG, which suggests that QEEG measures may contribute to the understanding of physiopathological events and as a marker for cognitive alterations in epilepsy.
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Affiliation(s)
- Gloria Maria Tedrus
- 1 Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Leandro M Negreiros
- 1 Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Raquel S Ballarim
- 1 Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Tamires A Marques
- 1 Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Lineu Correa Fonseca
- 1 Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil
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14
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Sambin S, Gaspard N, Legros B, Depondt C, De Breucker S, Naeije G. Role of Epileptic Activity in Older Adults With Delirium, a Prospective Continuous EEG Study. Front Neurol 2019; 10:263. [PMID: 30941098 PMCID: PMC6434717 DOI: 10.3389/fneur.2019.00263] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/27/2019] [Indexed: 12/29/2022] Open
Abstract
Background/Objectives: Delirium occurs in up to 50 % of hospitalized old patients and is associated with increased morbidity and mortality. Acute medical conditions favor delirium, but the pathophysiology is unclear. Preliminary evidence from retrospective and prospective studies suggests that a substantial minority of old patients with unexplained delirium have non-convulsive seizures or status epilepticus (NCSE). Yet, seeking epileptic activity only in unexplained cases of delirium might result in misinterpretation of its actual prevalence. We aimed to systematically investigate the role of epileptic activity in all older patients with delirium regardless of the underlying etiology. Design, Setting: Prospective observational study in a tertiary medical center. Adults >65 years with delirium underwent at least 24 h of continuous electro-encephalographic monitoring (cEEG). Background patterns and ictal and interictal epileptic discharges were identified, as well as clinical and biological characteristics. Participants: Fifty patients were included in the study. Results: NCSE was found in 6 (12%) patients and interictal discharges in 15 (30%). There was no difference in the prevalence of epileptic activity rates between delirium associated with an acute medical condition and delirium of unknown etiology. Conclusion: Epileptic activity may play a substantial role in the pathophysiology of delirium by altering brain functioning and neuronal metabolism. No clinical or biological marker was found to distinguish delirious patients with or without epileptic activity, underlining the importance of cEEG in this context.
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Affiliation(s)
- Sara Sambin
- Neurology Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Nicolas Gaspard
- Neurology Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Benjamin Legros
- Neurology Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Chantal Depondt
- Neurology Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sandra De Breucker
- Geriatrics Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gilles Naeije
- Neurology Department, ULB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
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15
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Landi S, Petrucco L, Sicca F, Ratto GM. Transient Cognitive Impairment in Epilepsy. Front Mol Neurosci 2019; 11:458. [PMID: 30666185 PMCID: PMC6330286 DOI: 10.3389/fnmol.2018.00458] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 11/28/2018] [Indexed: 02/05/2023] Open
Abstract
Impairments of the dialog between excitation and inhibition (E/I) is commonly associated to neuropsychiatric disorders like autism, bipolar disorders and epilepsy. Moderate levels of hyperexcitability can lead to mild alterations of the EEG and are often associated with cognitive deficits even in the absence of overt seizures. Indeed, various testing paradigms have shown degraded performances in presence of acute or chronic non-ictal epileptiform activity. Evidences from both animal models and the clinics suggest that anomalous activity can cause cognitive deficits by transiently disrupting cortical processing, independently from the underlying etiology of the disease. Here, we will review our understanding of the influence of an abnormal EEG activity on brain computation in the context of the available clinical data and in genetic or pharmacological animal models.
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Affiliation(s)
- Silvia Landi
- NEST, Istituto Nanoscienze-CNR and Scuola Normale Superiore, Pisa, Italy
| | - Luigi Petrucco
- Graduate School of Systemic Neurosciences, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Federico Sicca
- Department of Developmental Neuroscience, Fondazione IRCCS Stella Maris, Pisa, Italy
| | - Gian Michele Ratto
- NEST, Istituto Nanoscienze-CNR and Scuola Normale Superiore, Pisa, Italy
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16
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Emergence delirium in children is related to epileptiform discharges during anaesthesia induction. Eur J Anaesthesiol 2018; 35:929-936. [DOI: 10.1097/eja.0000000000000867] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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17
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Abstract
PURPOSE OF REVIEW Our purpose is to review evidence relating to the concept that interictal epileptiform discharges (IEDs) impair brain performance. RECENT FINDINGS Sophisticated measures of motor and cognitive performance have clarified older observations, confirming that in both animals and humans, IEDs affect aspects of performance, IED morphology, frequency, anatomical distribution, and duration matter. However, we now know that it is difficult to draw a line between IEDs and seizures, not only by electrical criteria but even by metabolic and molecular measures. IEDs impair performance acutely and probably chronically. Thus, there are good theoretical reasons for suppressing them, but no consensus has been reached on how much effort this deserves. Many antiepileptic medications effective for control of clinical seizures have little effect on IEDs. Better methods of measuring outcomes may allow selection of individual patients for whom treatment aimed at IEDs is worthwhile.
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Affiliation(s)
- Edward Faught
- Emory University, Brain Health Center 292, 12 Executive Park Drive NE, Atlanta, GA, 30306, USA.
| | - Ioannis Karakis
- Emory University, Brain Health Center 292, 12 Executive Park Drive NE, Atlanta, GA, 30306, USA
| | - Daniel L Drane
- Emory University, Brain Health Center 292, 12 Executive Park Drive NE, Atlanta, GA, 30306, USA.,University of Washington, Seattle, WA, USA
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18
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Koch S, Rupp L, Prager C, Mörgeli R, Kramer S, Wernecke KD, Fahlenkamp A, Spies C. Incidence of epileptiform discharges in children during induction of anaesthesia using Propofol versus Sevoflurane. Clin Neurophysiol 2018; 129:1642-1648. [DOI: 10.1016/j.clinph.2018.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/26/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
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19
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Ebrahimzadeh-Bideskan AR, Mansouri S, Ataei ML, Jahanshahi M, Hosseini M. The effects of soy and tamoxifen on apoptosis in the hippocampus and dentate gyrus in a pentylenetetrazole-induced seizure model of ovariectomized rats. Anat Sci Int 2018; 93:218-230. [PMID: 28283880 DOI: 10.1007/s12565-017-0398-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 03/02/2017] [Indexed: 12/13/2022]
Abstract
The effects of tamoxifen and soy on apoptosis of the hippocampus and dentate gyrus of ovariectomized rats after repeated seizures were investigated. Female rats were divided into: (1) Control, (2) Sham, (3) Sham-Tamoxifen (Sham-T), (4) Ovariectomized (OVX), (5) OVX-Tamoxifen (OVX-T), (6)OVX-Soy(OVX-S) and (7) OVX-S-T. The animals in the OVX-S, OVX-T and OVX-S-T groups received soy extract (60 mg/kg; i.p.), tamoxifen (10 mg/kg) or both for 2 weeks before induction of seizures. The animals in these groups additionally received the mentioned treatments before each injection of pentylenetetrazole (PTZ; 40 mg/kg) for 6 days. The animals in the Sham and OVX groups received a vehicle of tamoxifen and soy. A significant decrease in the seizure score and TUNEL-positive neurons was seen in the OVX group compared to the Sham (P < 0.001). The animals in both the OVX-T and OVX-S groups had a significantly higher seizure score as well as number of TUNEL-positive neurons compared to the OVX group (P < 0.01-P < 0.001). Co-treatment of the OVX rats by the extract and tamoxifen decreased the seizure score and number of TUNEL-positive neurons compared to OVX-S (P < 0.001). Treatment of the OVX rats by either soy or tamoxifen increased the seizure score as well as the number of TUNEL-positive neurons in the hippocampal formation. Co-administration of tamoxifen and soy extract inhibited the effects of the soy extract and tamoxifen when they were administered alone. It might be suggested that both soy and tamoxifen have agonistic effects on estrogen receptors by changing the seizure severity.
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Affiliation(s)
- Ali Reza Ebrahimzadeh-Bideskan
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Microanatomy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somaieh Mansouri
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mariam Lale Ataei
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrdad Jahanshahi
- Department of Anatomy, School of Medicine, Golestan University of Medical Sciences, Grogan, Iran
| | - Mahmoud Hosseini
- Division of Neurocognitive Sciences, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Azadi Square, Mashhad, Iran.
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20
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Dynamic functional disturbances of brain network in seizure-related cognitive outcomes. Epilepsy Res 2018; 140:15-21. [DOI: 10.1016/j.eplepsyres.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/13/2017] [Accepted: 12/02/2017] [Indexed: 11/23/2022]
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21
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Horváth A, Szűcs A, Barcs G, Fabó D, Kelemen A, Halász P, Erőss L, Kamondi A. Interictal Epileptiform Activity in the Foramen Ovale Electrodes of a Frontotemporal Dementia Patient. J Alzheimers Dis Rep 2017; 1:89-96. [PMID: 30480231 PMCID: PMC6159658 DOI: 10.3233/adr-170020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Frontotemporal dementia (FTD) is a frequent cause of cognitive decline. While epilepsy is an important comorbidity of Alzheimer’s disease, we lack studies on its presence in FTD. We report on an FTD patient with transient, short-term changes of behavior and cognitive performance suggesting non-convulsive epilepsy. Video-EEG recording with foramen ovale (FO) electrodes revealed mesio-temporal epileptiform potentials, undetectable by scalp leads. We also found beta spindles in the FO electrodes, not described in the literature. We conclude that video-EEG monitoring with FO electrodes might usefully complement the assessment of dementia-associated epilepsy opening new perspectives in dementia-research.
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Affiliation(s)
- András Horváth
- National Institute of Clinical Neurosciences, Budapest, Hungary.,Semmelweis University School of PhD Studies, János Szentágothai Doctoral School of Neurosciences, Budapest, Hungary.,Department of Anatomy Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Anna Szűcs
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Gábor Barcs
- National Institute of Clinical Neurosciences, Budapest, Hungary.,Semmelweis University School of PhD Studies, János Szentágothai Doctoral School of Neurosciences, Budapest, Hungary
| | - Dániel Fabó
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Anna Kelemen
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Péter Halász
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Loránd Erőss
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Anita Kamondi
- National Institute of Clinical Neurosciences, Budapest, Hungary.,Department of Neurology, Semmelweis University, Budapest, Hungary
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22
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Moguilner S, García AM, Mikulan E, Del Carmen García M, Vaucheret E, Amarillo Y, Bekinschtein TA, Ibáñez A. An unaware agenda: interictal consciousness impairments in epileptic patients. Neurosci Conscious 2017; 2017:niw024. [PMID: 30042834 PMCID: PMC6007167 DOI: 10.1093/nc/niw024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/16/2016] [Accepted: 12/21/2016] [Indexed: 01/07/2023] Open
Abstract
Consciousness impairments have been described as a cornerstone of epilepsy. Generalized seizures are usually characterized by a complete loss of consciousness, whereas focal seizures have more variable degrees of responsiveness. In addition to these impairments that occur during ictal episodes, alterations of consciousness have also been repeatedly observed between seizures (i.e. during interictal periods). In this opinion article, we review evidence supporting the novel hypothesis that epilepsy produces consciousness impairments which remain present interictally. Then, we discuss therapies aimed to reduce seizure frequency, which may modulate consciousness between epileptic seizures. We conclude with a consideration of relevant pathophysiological mechanisms. In particular, the thalamocortical network seems to be involved in both seizure generation and interictal consciousness impairments, which could inaugurate a promising translational agenda for epilepsy studies.
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Affiliation(s)
- Sebastian Moguilner
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,Fundación Escuela de Medicina Nuclear (FUESMEN) and Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Instituto Balseiro and Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Cuyo (UNCuyo), Mendoza, Argentina
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Ezequiel Mikulan
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Maria Del Carmen García
- Programa de Cirugía de Epilepsia, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Esteban Vaucheret
- Servicio de Neurologia Infantil del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Yimy Amarillo
- Consejo Nacional de Investigaciones Científicas y Técnicas, Física Estadística e Interdisciplinaria, Centro Atómico Bariloche, San Carlos de Bariloche, Rio Negro, Argentina
| | | | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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