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Zhu H, Michalak AJ, Merricks EM, Agopyan-Miu AHCW, Jacobs J, Hamberger MJ, Sheth SA, McKhann GM, Feldstein N, Schevon CA, Hillman EMC. Spectral-switching analysis reveals real-time neuronal network representations of concurrent spontaneous naturalistic behaviors in human brain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.08.600416. [PMID: 39026706 PMCID: PMC11257469 DOI: 10.1101/2024.07.08.600416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Despite abundant evidence of functional networks in the human brain, their neuronal underpinnings, and relationships to real-time behavior have been challenging to resolve. Analyzing brain-wide intracranial-EEG recordings with video monitoring, acquired in awake subjects during clinical epilepsy evaluation, we discovered the tendency of each brain region to switch back and forth between 2 distinct power spectral densities (PSDs 2-55Hz). We further recognized that this 'spectral switching' occurs synchronously between distant sites, even between regions with differing baseline PSDs, revealing long-range functional networks that would be obscured in analysis of individual frequency bands. Moreover, the real-time PSD-switching dynamics of specific networks exhibited striking alignment with activities such as conversation and hand movements, revealing a multi-threaded functional network representation of concurrent naturalistic behaviors. Network structures and their relationships to behaviors were stable across days, but were altered during N3 sleep. Our results provide a new framework for understanding real-time, brain-wide neural-network dynamics.
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Baltos JA, Casillas-Espinosa PM, Rollo B, Gregory KJ, White PJ, Christopoulos A, Kwan P, O'Brien TJ, May LT. The role of the adenosine system in epilepsy and its comorbidities. Br J Pharmacol 2024; 181:2143-2157. [PMID: 37076128 DOI: 10.1111/bph.16094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/09/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023] Open
Abstract
Epilepsy is one of the most serious and common chronic neurological conditions, characterised by recurrent hypersynchronous electrical activity in the brain that lead to seizures. Despite over 50 million people being affected worldwide, only ~70% of people with epilepsy have their seizures successfully controlled with current pharmacotherapy, and many experience significant psychiatric and physical comorbidities. Adenosine, a ubiquitous purine metabolite, is a potent endogenous anti-epileptic substance that can abolish seizure activity via the adenosine A1 G protein-coupled receptor. Activation of A1 receptors decreases seizure activity in animal models, including models of drug-resistant epilepsy. Recent advances have increased our understanding of epilepsy comorbidities, highlighting the potential for adenosine receptors to modulate epilepsy-associated comorbidities, including cardiovascular dysfunction, sleep and cognition. This review provides an accessible resource of the current advances in understanding the adenosine system as a therapeutic target for epilepsy and epilepsy-associated comorbidities. LINKED ARTICLES: This article is part of a themed issue Therapeutic Targeting of G Protein-Coupled Receptors: hot topics from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists 2021 Virtual Annual Scientific Meeting. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.14/issuetoc.
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Affiliation(s)
- Jo-Anne Baltos
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Pablo M Casillas-Espinosa
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Ben Rollo
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Karen J Gregory
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- ARC Centre for Cryo-Electron Microscopy of Membrane Proteins, Monash Institute of Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Paul J White
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Arthur Christopoulos
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash University, Melbourne, Victoria, Australia
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Lauren T May
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
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Chartampila E, Elayouby KS, Leary P, LaFrancois JJ, Alcantara-Gonzalez D, Jain S, Gerencer K, Botterill JJ, Ginsberg SD, Scharfman HE. Choline supplementation in early life improves and low levels of choline can impair outcomes in a mouse model of Alzheimer's disease. eLife 2024; 12:RP89889. [PMID: 38904658 PMCID: PMC11192536 DOI: 10.7554/elife.89889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024] Open
Abstract
Maternal choline supplementation (MCS) improves cognition in Alzheimer's disease (AD) models. However, the effects of MCS on neuronal hyperexcitability in AD are unknown. We investigated the effects of MCS in a well-established mouse model of AD with hyperexcitability, the Tg2576 mouse. The most common type of hyperexcitability in Tg2576 mice are generalized EEG spikes (interictal spikes [IIS]). IIS also are common in other mouse models and occur in AD patients. In mouse models, hyperexcitability is also reflected by elevated expression of the transcription factor ∆FosB in the granule cells (GCs) of the dentate gyrus (DG), which are the principal cell type. Therefore, we studied ΔFosB expression in GCs. We also studied the neuronal marker NeuN within hilar neurons of the DG because reduced NeuN protein expression is a sign of oxidative stress or other pathology. This is potentially important because hilar neurons regulate GC excitability. Tg2576 breeding pairs received a diet with a relatively low, intermediate, or high concentration of choline. After weaning, all mice received the intermediate diet. In offspring of mice fed the high choline diet, IIS frequency declined, GC ∆FosB expression was reduced, and hilar NeuN expression was restored. Using the novel object location task, spatial memory improved. In contrast, offspring exposed to the relatively low choline diet had several adverse effects, such as increased mortality. They had the weakest hilar NeuN immunoreactivity and greatest GC ΔFosB protein expression. However, their IIS frequency was low, which was surprising. The results provide new evidence that a diet high in choline in early life can improve outcomes in a mouse model of AD, and relatively low choline can have mixed effects. This is the first study showing that dietary choline can regulate hyperexcitability, hilar neurons, ΔFosB, and spatial memory in an animal model of AD.
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Affiliation(s)
- Elissavet Chartampila
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
| | - Karim S Elayouby
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
| | - Paige Leary
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
- Department of Neuroscience and Physiology, New York University Grossman School of MedicineNew YorkUnited States
| | - John J LaFrancois
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
- Departments of Child and Adolescent Psychiatry, New York University Grossman School of MedicineNew YorkUnited States
| | - David Alcantara-Gonzalez
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
- Departments of Child and Adolescent Psychiatry, New York University Grossman School of MedicineNew YorkUnited States
| | - Swati Jain
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
| | - Kasey Gerencer
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
| | - Justin J Botterill
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
| | - Stephen D Ginsberg
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
- Department of Neuroscience and Physiology, New York University Grossman School of MedicineNew YorkUnited States
- Department of Psychiatry, New York University Grossman School of MedicineNew YorkUnited States
- NYU Neuroscience Institute, New York University Grossman School of MedicineNew YorkUnited States
| | - Helen E Scharfman
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric ResearchOrangeburgUnited States
- Department of Neuroscience and Physiology, New York University Grossman School of MedicineNew YorkUnited States
- Departments of Child and Adolescent Psychiatry, New York University Grossman School of MedicineNew YorkUnited States
- Department of Psychiatry, New York University Grossman School of MedicineNew YorkUnited States
- NYU Neuroscience Institute, New York University Grossman School of MedicineNew YorkUnited States
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Chartampila E, Elayouby KS, Leary P, LaFrancois JJ, Alcantara-Gonzalez D, Jain S, Gerencer K, Botterill JJ, Ginsberg SD, Scharfman HE. Choline supplementation in early life improves and low levels of choline can impair outcomes in a mouse model of Alzheimer's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.05.12.540428. [PMID: 37214805 PMCID: PMC10197642 DOI: 10.1101/2023.05.12.540428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Maternal choline supplementation (MCS) improves cognition in Alzheimer's disease (AD) models. However, effects of MCS on neuronal hyperexcitability in AD are unknown. We investigated effects of MCS in a well-established mouse model of AD with hyperexcitability, the Tg2576 mouse. The most common type of hyperexcitability in Tg2576 mice are generalized EEG spikes (interictal spikes; IIS). IIS also are common in other mouse models and occur in AD patients. Im mouse models, hyperexcitability is also reflected by elevated expression of the transcription factor ΔFosB in the granule cells (GCs) of the dentate gyrus (DG), which are the principal cell type. Therefore we studied ΔFosB expression in GCs. We also studied the the neuronal marker NeuN within hilar neurons of the DG because other studies have reduced NeuN protein expression is a sign of oxidative stress or other pathology. This is potentially important because hilar neurons regulate GC excitability. Tg2576 breeding pairs received a diet with a relatively low, intermediate or high concentration of choline. After weaning, all mice received the intermediate diet. In offspring of mice fed the high choline diet, IIS frequency declined, GC ΔFosB expression was reduced, and NeuN expression was restored. Using the novel object location task, spatial memory improved. In contrast, offspring exposed to the relatively low choline diet had several adverse effects, such as increased mortality. They had the weakest hilar NeuN immunoreactivity and greatest GC ΔFosB protein expression. However, their IIS frequency was low, which was surprising. The results provide new evidence that a diet high in choline in early life can improve outcomes in a mouse model of AD, and relatively low choline can have mixed effects. This is the first study showing that dietary choline can regulate hyperexcitability, hilar neurons, ΔFosB and spatial memory in an animal model of AD.
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Affiliation(s)
- Elissavet Chartampila
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Current address:Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27510
| | - Karim S. Elayouby
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Current address: Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029
| | - Paige Leary
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY 100016
| | - John J. LaFrancois
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Department of Child and Adolescent Psychiatry , New York University Grossman School of Medicine, New York, NY 10016
| | - David Alcantara-Gonzalez
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Department of Child and Adolescent Psychiatry , New York University Grossman School of Medicine, New York, NY 10016
| | - Swati Jain
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
| | - Kasey Gerencer
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Current address: Department of Psychology, University of Maine, Orono, ME 04469
| | - Justin J. Botterill
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Current address: Department of Anatomy, Physiology, & Pharmacology, College of Medicine, Saskatoon, SK S7N 5E5
| | - Stephen D. Ginsberg
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY 100016
- Department of Psychiatry, New York University Grossman School of Medicine New York, NY 10016
- NYU Neuroscience Institute,, New York University Grossman School of Medicine, New York, NY 10016
| | - Helen E. Scharfman
- Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY 100016
- Department of Child and Adolescent Psychiatry , New York University Grossman School of Medicine, New York, NY 10016
- Department of Psychiatry, New York University Grossman School of Medicine New York, NY 10016
- NYU Neuroscience Institute,, New York University Grossman School of Medicine, New York, NY 10016
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Smith RA, Mir F, Butler MP, Maharathi B, Loeb JA. Spike-induced cytoarchitectonic changes in epileptic human cortex are reduced via MAP2K inhibition. Brain Commun 2024; 6:fcae152. [PMID: 38741662 PMCID: PMC11089420 DOI: 10.1093/braincomms/fcae152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/01/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
Interictal spikes are electroencephalographic discharges that occur at or near brain regions that produce epileptic seizures. While their role in generating seizures is not well understood, spikes have profound effects on cognition and behaviour, depending on where and when they occur. We previously demonstrated that spiking areas of human neocortex show sustained MAPK activation in superficial cortical Layers I-III and are associated with microlesions in deeper cortical areas characterized by reduced neuronal nuclear protein staining and increased microglial infiltration. Based on these findings, we chose to investigate additional neuronal populations within microlesions, specifically inhibitory interneurons. Additionally, we hypothesized that spiking would be sufficient to induce similar cytoarchitectonic changes within the rat cortex and that inhibition of MAPK signalling, using a MAP2K inhibitor, would not only inhibit spike formation but also reduce these cytoarchitectonic changes and improve behavioural outcomes. To test these hypotheses, we analysed tissue samples from 16 patients with intractable epilepsy who required cortical resections. We also utilized a tetanus toxin-induced animal model of interictal spiking, designed to produce spikes without seizures in male Sprague-Dawley rats. Rats were fitted with epidural electrodes, to permit EEG recording for the duration of the study, and automated algorithms were implemented to quantify spikes. After 6 months, animals were sacrificed to assess the effects of chronic spiking on cortical cytoarchitecture. Here, we show that microlesions may promote excitability due to a significant reduction of inhibitory neurons that could be responsible for promoting interictal spikes in superficial layers. Similarly, we found that the induction of epileptic spikes in the rat model produced analogous changes, including reduced neuronal nuclear protein, calbindin and parvalbumin-positive neurons and increased microglia, suggesting that spikes are sufficient for inducing these cytoarchitectonic changes in humans. Finally, we implicated MAPK signalling as a driving force producing these pathological changes. Using CI-1040 to inhibit MAP2K, both acutely and after spikes developed, resulting in fewer interictal spikes, reduced microglial activation and less inhibitory neuron loss. Treated animals had significantly fewer high-amplitude, short-duration spikes, which correlated with improved spatial memory performance on the Barnes maze. Together, our results provide evidence for a cytoarchitectonic pathogenesis underlying epileptic cortex, which can be ameliorated through both early and delayed MAP2K inhibition. These findings highlight the potential role for CI-1040 as a pharmacological treatment that could prevent the development of epileptic activity and reduce cognitive impairment in both patients with epilepsy and those with non-epileptic spike-associated neurobehavioural disorders.
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Affiliation(s)
- Rachael A Smith
- Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Fozia Mir
- Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Mitchell P Butler
- Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Biswajit Maharathi
- Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Jeffrey A Loeb
- Department of Neurology and Rehabilitation, University of Illinois Chicago, Chicago, IL 60612, USA
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Höller Y, Eyjólfsdóttir S, Van Schalkwijk FJ, Trinka E. The effects of slow wave sleep characteristics on semantic, episodic, and procedural memory in people with epilepsy. Front Pharmacol 2024; 15:1374760. [PMID: 38725659 PMCID: PMC11079234 DOI: 10.3389/fphar.2024.1374760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/04/2024] [Indexed: 05/12/2024] Open
Abstract
Slow wave sleep (SWS) is highly relevant for verbal and non-verbal/spatial memory in healthy individuals, but also in people with epilepsy. However, contradictory findings exist regarding the effect of seizures on overnight memory retention, particularly relating to procedural and non-verbal memory, and thorough examination of episodic memory retention with ecologically valid tests is missing. This research explores the interaction of SWS duration with epilepsy-relevant factors, as well as the relation of spectral characteristics of SWS on overnight retention of procedural, verbal, and episodic memory. In an epilepsy monitoring unit, epilepsy patients (N = 40) underwent learning, immediate and 12 h delayed testing of memory retention for a fingertapping task (procedural memory), a word-pair task (verbal memory), and an innovative virtual reality task (episodic memory). We used multiple linear regression to examine the impact of SWS duration, spectral characteristics of SWS, seizure occurrence, medication, depression, seizure type, gender, and epilepsy duration on overnight memory retention. Results indicated that none of the candidate variables significantly predicted overnight changes for procedural memory performance. For verbal memory, the occurrence of tonic-clonic seizures negatively impacted memory retention and higher psychoactive medication load showed a tendency for lower verbal memory retention. Episodic memory was significantly impacted by epilepsy duration, displaying a potential nonlinear impact with a longer duration than 10 years negatively affecting memory performance. Higher drug load of anti-seizure medication was by tendency related to better overnight retention of episodic memory. Contrary to expectations longer SWS duration showed a trend towards decreased episodic memory performance. Analyses on associations between memory types and EEG band power during SWS revealed lower alpha-band power in the frontal right region as significant predictor for better episodic memory retention. In conclusion, this research reveals that memory modalities are not equally affected by important epilepsy factors such as duration of epilepsy and medication, as well as SWS spectral characteristics.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland
| | | | - Frank Jasper Van Schalkwijk
- Hertie-Institute for Clinical Brain Research, Center for Neurology, University Medical Center Tübingen, Tübingen, Germany
| | - Eugen Trinka
- Department of Neurology, Christian Doppler University Hospital, Member of the European Reference Network EpiCARE, Neuroscience Institute, Paracelsus Medical University and Centre for Cognitive Neuroscience Salzburg, Salzburg, Austria
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Kalogeropoulos K, Psarropoulou C. Immature Status Epilepticus Alters the Temporal Relationship between Hippocampal Interictal Epileptiform Discharges and High-frequency Oscillations. Neuroscience 2024; 543:108-120. [PMID: 38401712 DOI: 10.1016/j.neuroscience.2024.02.019] [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: 12/15/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
The aim was to investigate the long-term effects of a single episode of immature Status Epilepticus (SE) on the excitability of the septal and temporal hippocampus in vitro, by studying the relationship between interictal-like epileptiform discharges (IEDs) and high-frequency oscillations (HFOs; Ripples, Rs and Fast Ripples, FRs). A pentylenetetrazol-induced Status Epilepticus-(SE)-like generalized seizure was induced at postnatal day 20 in 22 male and female juvenile rats, sacrificed >40 days later to prepare hippocampal slices. Spontaneous IEDs induced by Mg2+-free ACSF were recorded from the CA3 area of temporal (T) or septal (S) slices. Recordings were band-pass filtered off-line revealing Rs and FRs and a series of measurements were conducted, with mean values compared with those obtained from age-matched controls (CTRs). In CTR S (vs T) slices, we recorded longer R & FR durations, a longer HFO-IED temporal overlap, higher FR peak power and more frequent FR initiation preceding IEDs (% events). Post-SE, in T slices all types of events duration (IED, R, FR) and the time lag between their onsets (R-IED, FR-IED, R-FR) increased, while FR/R peak power decreased; in S slices, the IED 1st population spike and the FR amplitudes, the R and FR peak power and the (percent) events where Rs or FRs preceded IEDs all decreased. The CA3 IED-HFO relationship offers insights to the septal-to-temporal synchronization patterns; its post-juvenile-SE changes indicate permanent modifications in the septotemporal excitability gradient. Moreover, these findings are in line to region-specific regulation of various currents post-SE, as reported in literature.
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Affiliation(s)
- Konstantinos Kalogeropoulos
- Laboratory of Animal and Human Physiology, Department of Biological Applications and Technology, Faculty of Health Sciences, University of Ioannina, 45110, Greece.
| | - Caterina Psarropoulou
- Laboratory of Animal and Human Physiology, Department of Biological Applications and Technology, Faculty of Health Sciences, University of Ioannina, 45110, Greece.
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Di Lisa D, Cortese K, Chiappalone M, Arnaldi P, Martinoia S, Castagnola P, Pastorino L. Electrophysiological and morphological modulation of neuronal-glial network by breast cancer and nontumorigenic mammary cell conditioned medium. Front Bioeng Biotechnol 2024; 12:1368851. [PMID: 38638322 PMCID: PMC11024227 DOI: 10.3389/fbioe.2024.1368851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Breast cancer is a significant global health concern, with the overexpression of human epidermal growth factor receptor 2 (HER2/ERBB2) being a driver oncogene in 20%-30% of cases. Indeed, HER2/ERBB2 plays a crucial role in regulating cell growth, differentiation, and survival via a complex signaling network. Overexpression of HER2/ERBB2 is associated with more aggressive behavior and increased risk of brain metastases, which remains a significant clinical challenge for treatment. Recent research has highlighted the role of breast cancer secretomes in promoting tumor progression, including excessive proliferation, immune invasion, and resistance to anti-cancer therapy, and their potential as cancer biomarkers. In this study, we investigated the impact of ERBB2+ breast cancer SKBR-3 cell line compared with MCF10-A mammary non-tumorigenic cell conditioned medium on the electrophysiological activity and morphology of neural networks derived from neurons differentiated from human induced pluripotent stem cells. Our findings provide evidence of active modulation of neuronal-glial networks by SKBR-3 and MCF10-A conditioned medium. These results provide insights into the complex interactions between breast cancer cells and the surrounding microenvironment. Further research is necessary to identify the specific factors within breast cancer conditioned medium that mediate these effects and to develop targeted therapies that disrupt this interaction.
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Affiliation(s)
- Donatella Di Lisa
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Katia Cortese
- Department of Experimental Medicine, Cellular Electron Microscopy Lab, University of Genoa, Genova, Italy
| | - Michela Chiappalone
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- RAISE Ecosystem, Genova, Italy
| | - Pietro Arnaldi
- Department of Experimental Medicine, Cellular Electron Microscopy Lab, University of Genoa, Genova, Italy
| | - Sergio Martinoia
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- RAISE Ecosystem, Genova, Italy
| | | | - Laura Pastorino
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
- RAISE Ecosystem, Genova, Italy
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Neumann H, Daseking M, Thiels C, Köhler C, Lücke T. Cognitive development in children with new-onset Rolandic epilepsy and Rolandic discharges without seizures: Focusing on intelligence, visual perception, working memory and the role of parents' education. Epilepsy Behav 2024; 152:109596. [PMID: 38350362 DOI: 10.1016/j.yebeh.2023.109596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE Our aim was to assess intelligence, visual perception and working memory in children with new-onset Rolandic epilepsy (RE) and children with Rolandic discharges without seizures (RD). METHODS The participants in the study were 12 children with RE and 26 children with RD aged 4 to 10 years (all without medication and shortly after diagnosis) and 31 healthy controls. Their cognitive performance was assessed using the German versions of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), the Wechsler Intelligence Scale for Children (WISC-IV), the Developmental Test of Visual Perception-2 (DTVP-2), the Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A) (each according to age) and the Word Order, Hand Movements and Spatial Memory subtests of the German version of the Kaufman Assessment Battery for Children (K-ABC). RESULTS The comparison of the entire group of children with RE/RD and the control group conducted in the first step of our analysis revealed a weaker performance of the children with RE/RD in all cognitive domains. Significant deficits, however, were found exclusively in the RD group. Compared to the controls, they performed significantly weaker regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.002; processing speed: p = 0.005), visual perception (general visual perception: p = 0.005; visual-motor integration: p = 0.002) and working memory (WISC working memory: p = 0.002 and K-ABC Word Order (p = 0.010) and Hand Movements (p = 0.001) subtests. Also, the children without seizures scored significantly lower than those with seizures on the WISC Working Memory Index (p = 0.010) and on the K-ABC Word Order (p = 0.021) and Hand Movements (p = 0.027) subtests. Further analysis of our data demonstrated the particular importance of the family context for child development. Significant cognitive deficits were found only in children with RD from parents with lower educational levels. This group consistently scored lower compared to the control group regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.012; processing speed: p = 0.034), visual perception (general visual perception: p = 0.018; visual-motor integration: p = 0.010) and auditory working memory (WISC working memory: p = 0.014). Furthermore, compared to the children with RE, they performed significantly weaker on verbal IQ (p = 0.020), auditory working memory consistently (WISC working memory: p = 0.027; K-ABC: Word Order: p = 0.046) as well as in one of the K-ABC spatial working memory subtests (Hand Movements: p = 0.029). Although we did not find significant deficits in children with new-onset RE compared to healthy controls, the performance of this group tended to be weaker more often. No statistically significant associations were observed between selected clinical markers (focus types: centrotemporal/other foci/laterality of foci and spread of Rolandic discharges) and cognitive test results. Except for spatial working memory, we also found no evidence that the age of our patients at the time of study participation was of significant importance to their cognitive performance. CONCLUSIONS Our study provides some evidence that children with Rolandic discharges, with and without seizures, may be at higher risk of cognitive impairment. In addition to medical care, we emphasise early differentiated psychosocial diagnostics to provide these children and their families with targeted support if developmental problems are present.
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Affiliation(s)
- Helmut Neumann
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany.
| | - Monika Daseking
- Department of Educational Psychology, Helmut Schmidt University/University of the Armed Forces Hamburg, Hamburg, Germany
| | - Charlotte Thiels
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
| | - Cornelia Köhler
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
| | - Thomas Lücke
- University Children's Hospital, Ruhr University Bochum, Department of Neuropediatrics Bochum, Germany
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Lu G, Cheng Y, Wang Y, Hu J, Zhang F, Li W, Xia M, Lu X, Yang W. The Prevalence and Risk Factors of Electrical Status Epilepticus During Slow-Wave Sleep in Self-Limited Epilepsy With Centrotemporal Spikes. Clin EEG Neurosci 2024; 55:265-271. [PMID: 37331959 DOI: 10.1177/15500594231182758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Objective. To investigate the prevalence and risk factors for electrical status epilepticus during slow-wave sleep (ESES) in patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). Methods. The clinical and follow-up data of children with SeLECTS were collected between 2017 and 2021. Patients were divided into typical ESES, atypical ESES, and non-ESES groups according to spike-wave indices (SWI). Clinical and electroencephalography characteristics were retrospectively analyzed. Logistic regression was used to identify risk factors for ESES. Results. A total of 95 patients with SeLECTS were enrolled. Seven patients (7.4%) developed typical ESES, 30 (31.6%) developed atypical ESES, 25 (26.3%) developed ESES at the first visit, and 12 (12.6%) developed ESES during treatment and follow-up. Multivariate logistic regression analysis showed that the risk factors for SeLECTS combined with ESES were Rolandic double or multiple spikes (OR = 8.626, 95% CI: 2.644-28.147, P < .001) and Rolandic slow waves (OR = 53.550, 95% CI: 6.339-452.368, P < .001). There were no significant differences in seizure characteristics, electroencephalogram (EEG) findings, or cognitive impairment between the atypical and typical ESES groups. Conclusion. More than one-third of the SeLECTS patients combined with ESES. Both atypical and typical ESES scores can affect cognitive function. On electroencephalography, interictal Rolandic double/multiple spikes and slow-wave abnormalities may indicate SeLECTS with ESES.
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Affiliation(s)
- Guangshuang Lu
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Yun Cheng
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Yun Wang
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Jie Hu
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Fan Zhang
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Wenbo Li
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Minnong Xia
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Xiaoyan Lu
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
| | - Wu Yang
- Department of Pediatrics, The Lu'an Hospital Affiliated to Anhui Medical University, The Lu'an People's Hospital, Lu'an, China
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11
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Nous A, Seynaeve L, Feys O, Wens V, De Tiège X, Van Mierlo P, Baroumand AG, Nieboer K, Allemeersch GJ, Mangelschots S, Michiels V, van der Zee J, Van Broeckhoven C, Ribbens A, Houbrechts R, De Witte S, Wittens MMJ, Bjerke M, Vanlersberghe C, Ceyssens S, Nagels G, Smolders I, Engelborghs S. Subclinical epileptiform activity in the Alzheimer continuum: association with disease, cognition and detection method. Alzheimers Res Ther 2024; 16:19. [PMID: 38263073 PMCID: PMC10804650 DOI: 10.1186/s13195-023-01373-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Epileptic seizures are an established comorbidity of Alzheimer's disease (AD). Subclinical epileptiform activity (SEA) as detected by 24-h electroencephalography (EEG) or magneto-encephalography (MEG) has been reported in temporal regions of clinically diagnosed AD patients. Although epileptic activity in AD probably arises in the mesial temporal lobe, electrical activity within this region might not propagate to EEG scalp electrodes and could remain undetected by standard EEG. However, SEA might lead to faster cognitive decline in AD. AIMS 1. To estimate the prevalence of SEA and interictal epileptic discharges (IEDs) in a well-defined cohort of participants belonging to the AD continuum, including preclinical AD subjects, as compared with cognitively healthy controls. 2. To evaluate whether long-term-EEG (LTM-EEG), high-density-EEG (hd-EEG) or MEG is superior to detect SEA in AD. 3. To characterise AD patients with SEA based on clinical, neuropsychological and neuroimaging parameters. METHODS Subjects (n = 49) belonging to the AD continuum were diagnosed according to the 2011 NIA-AA research criteria, with a high likelihood of underlying AD pathophysiology. Healthy volunteers (n = 24) scored normal on neuropsychological testing and were amyloid negative. None of the participants experienced a seizure before. Subjects underwent LTM-EEG and/or 50-min MEG and/or 50-min hd-EEG to detect IEDs. RESULTS We found an increased prevalence of SEA in AD subjects (31%) as compared to controls (8%) (p = 0.041; Fisher's exact test), with increasing prevalence over the disease course (50% in dementia, 27% in MCI and 25% in preclinical AD). Although MEG (25%) did not withhold a higher prevalence of SEA in AD as compared to LTM-EEG (19%) and hd-EEG (19%), MEG was significantly superior to detect spikes per 50 min (p = 0.002; Kruskall-Wallis test). AD patients with SEA scored worse on the RBANS visuospatial and attention subset (p = 0.009 and p = 0.05, respectively; Mann-Whitney U test) and had higher left frontal, (left) temporal and (left and right) entorhinal cortex volumes than those without. CONCLUSION We confirmed that SEA is increased in the AD continuum as compared to controls, with increasing prevalence with AD disease stage. In AD patients, SEA is associated with more severe visuospatial and attention deficits and with increased left frontal, (left) temporal and entorhinal cortex volumes. TRIAL REGISTRATION Clinicaltrials.gov, NCT04131491. 12/02/2020.
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Affiliation(s)
- Amber Nous
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Laboratory of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology (EFAR), Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Laura Seynaeve
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
| | - Odile Feys
- Department of Neurology, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
| | - Vincent Wens
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
- Department of Translational Neuroimaging, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
- Department of Translational Neuroimaging, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
| | | | | | - Koenraad Nieboer
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gert-Jan Allemeersch
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Shana Mangelschots
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
| | - Veronique Michiels
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Julie van der Zee
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, Antwerp, Belgium
| | - Christine Van Broeckhoven
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, Antwerp, Belgium
| | | | | | - Sara De Witte
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
| | - Mandy Melissa Jane Wittens
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
| | - Maria Bjerke
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Department of Clinical Biology, Laboratory of Clinical Neurochemistry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Caroline Vanlersberghe
- Department of Anaesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sarah Ceyssens
- Department of Nuclear Medicine, Universitair Ziekenhuis Antwerpen, University of Antwerp, Antwerpen, Belgium
| | - Guy Nagels
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Artificial Intelligence Supported Modelling in Clinical Sciences (AIMS) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ilse Smolders
- Laboratory of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology (EFAR), Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sebastiaan Engelborghs
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium.
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium.
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12
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Sands TT, Gelinas JN. Epilepsy and Encephalopathy. Pediatr Neurol 2024; 150:24-31. [PMID: 37948790 DOI: 10.1016/j.pediatrneurol.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/14/2023] [Accepted: 09/24/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Epilepsy encompasses more than the predisposition to unprovoked seizures. In children, epileptic activity during (ictal) and between (interictal) seizures has the potential to disrupt normal brain development. The term "epileptic encephalopathy (EE)" refers to the concept that such abnormal activity may contribute to cognitive and behavioral impairments beyond that expected from the underlying cause of the epileptic activity. METHODS In this review, we survey the concept of EE across a diverse selection of syndromes to illustrate its broad applicability in pediatric epilepsy. We review experimental evidence that provides mechanistic insights into how epileptic activity has the potential to impact normal brain processes and the development of neural networks. We then discuss opportunities to improve developmental outcomes in epilepsy now and in the future. RESULTS Epileptic activity in the brain poses a threat to normal physiology and brain development. CONCLUSION Until we have treatments that reliably target and effectively treat the underlying causes of epilepsy, a major goal of management is to prevent epileptic activity from worsening developmental outcomes.
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Affiliation(s)
- Tristan T Sands
- Center for Translational Research in Neurodevelopmental Disease, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Departments of Neurology and Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
| | - Jennifer N Gelinas
- Center for Translational Research in Neurodevelopmental Disease, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Departments of Neurology and Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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13
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Silva AB, Leonard MK, Oganian Y, D’Esopo E, Krish D, Kopald B, Tran EB, Chang EF, Kleen JK. Interictal epileptiform discharges contribute to word-finding difficulty in epilepsy through multiple cognitive mechanisms. Epilepsia 2023; 64:3266-3278. [PMID: 37753856 PMCID: PMC10841419 DOI: 10.1111/epi.17781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE Cognitive impairment often impacts quality of life in epilepsy even if seizures are controlled. Word-finding difficulty is particularly prevalent and often attributed to etiological (static, baseline) circuit alterations. We sought to determine whether interictal discharges convey significant superimposed contributions to word-finding difficulty in patients, and if so, through which cognitive mechanism(s). METHODS Twenty-three patients undergoing intracranial monitoring for drug-resistant epilepsy participated in multiple tasks involving word production (auditory naming, short-term verbal free recall, repetition) to probe word-finding difficulty across different cognitive domains. We compared behavioral performance between trials with versus without interictal discharges across six major brain areas and adjusted for intersubject differences using mixed-effects models. We also evaluated for subjective word-finding difficulties through retrospective chart review. RESULTS Subjective word-finding difficulty was reported by the majority (79%) of studied patients preoperatively. During intracranial recordings, interictal epileptiform discharges (IEDs) in the medial temporal lobe were associated with long-term lexicosemantic memory impairments as indexed by auditory naming (p = .009), in addition to their established impact on short-term verbal memory as indexed by free recall (p = .004). Interictal discharges involving the lateral temporal cortex and lateral frontal cortex were associated with delayed reaction time in the auditory naming task (p = .016 and p = .018), as well as phonological working memory impairments as indexed by repetition reaction time (p = .002). Effects of IEDs across anatomical regions were strongly dependent on their precise timing within the task. SIGNIFICANCE IEDs appear to act through multiple cognitive mechanisms to form a convergent basis for the debilitating clinical word-finding difficulty reported by patients with epilepsy. This was particularly notable for medial temporal spikes, which are quite common in adult focal epilepsy. In parallel with the treatment of seizures, the modulation of interictal discharges through emerging pharmacological means and neurostimulation approaches may be an opportunity to help address devastating memory and language impairments in epilepsy.
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Affiliation(s)
- Alexander B. Silva
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Medical Scientist Training Program, University of California, San Francisco, CA, USA
- University of California, Berkeley - University of California, San Francisco Graduate Program in Bioengineering, Berkeley, CA, USA
| | - Matthew K. Leonard
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Emma D’Esopo
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Devon Krish
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brandon Kopald
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Edwina B. Tran
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Edward F. Chang
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
- University of California, Berkeley - University of California, San Francisco Graduate Program in Bioengineering, Berkeley, CA, USA
| | - Jonathan K. Kleen
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
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14
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Hoshino H, Miyasato Y, Handa T, Tomi Y, Kanemura H. Effect of Lacosamide on Interictal Epileptiform Discharges in Pediatric Patients With Newly Diagnosed Focal Epilepsy. Pediatr Neurol 2023; 147:1-8. [PMID: 37499552 DOI: 10.1016/j.pediatrneurol.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 04/24/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The purpose of this study was to determine the efficacy of lacosamide (LCM) on interictal epileptiform discharges (IEDs) and evaluate the relationships between IEDs and seizure outcome in pediatric patients with focal epilepsy. METHODS Patient inclusion criteria included (1) newly diagnosed focal epilepsy with unknown etiology; and (2) electroencephalogram recorded twice (before and after starting LCM) under the same conditions. The difference between the highest number of IEDs over five successive minutes (IEDs/5 min) and the location of IEDs was determined. Seizure outcome was evaluated one year after achieving the maintenance dose of LCM. Responders were identified as showing a ≥50% reduction in the pre-LCM seizure frequency. RESULTS Of 22 patients, 10 showed an increase in IEDs/5 min after starting LCM. The median IEDs/5 min before and after starting LCM was not significantly different, at 1.5 (interquartile range: 0, 31.75) and 10.5 (0, 80.5), respectively. No relationship was identified between the difference in IEDs/5 min and seizure outcome. Patients with multiple regional or diffuse IEDs had significantly poorer seizure outcome compared with patients without those IEDs (P = 0.036 and P = 0.039, respectively). Of 10 patients with single regional IEDs, a tendency of IEDs to disappear was observed between patients with frontal and non-frontal IEDs. CONCLUSION The effects of LCM on the number of IEDs may be unrelated to seizure outcome. LCM may be ineffective at improving seizure outcomes in patients with multiple regional or diffuse IEDs.
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Affiliation(s)
- Hiroki Hoshino
- Department of Pediatrics, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan.
| | - Yoshihiro Miyasato
- Department of Pediatrics, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan
| | - Takayuki Handa
- Department of Pediatrics, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan; Department of Pediatrics, Toho University Medical Center Omori Hospital, Ota, Tokyo, Japan
| | - Yutaro Tomi
- Department of Pediatrics, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan; Department of Pediatrics, Toho University Medical Center Omori Hospital, Ota, Tokyo, Japan
| | - Hideaki Kanemura
- Department of Pediatrics, Toho University Medical Center Sakura Hospital, Sakura, Chiba, Japan
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15
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Lemus HN, Sarkis RA. Interictal epileptiform discharges in Alzheimer's disease: prevalence, relevance, and controversies. Front Neurol 2023; 14:1261136. [PMID: 37808503 PMCID: PMC10551146 DOI: 10.3389/fneur.2023.1261136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Alzheimer's disease (AD) is the most common type of dementia and remains an incurable, progressive disease with limited disease-modifying interventions available. In patients with AD, interictal epileptiform discharges (IEDs) have been identified in up to 54% of combined cohorts of mild cognitive impairment (MCI) or mild dementia and are a marker of a more aggressive disease course. Studies assessing the role of IEDs in AD are limited by the lack of standardization in the definition of IEDs or the different neurophysiologic techniques used to capture them. IEDs are an appealing treatment target given the availability of EEG and anti-seizure medications. There remains uncertainty regarding when to treat IEDs, the optimal drug and dose for treatment, and the impact of treatment on disease course. This review covers the state of knowledge of the field of IEDs in AD, and the steps needed to move the field forward.
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Affiliation(s)
| | - Rani A. Sarkis
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
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Skorucak J, Bölsterli BK, Storz S, Leach S, Schmitt B, Ramantani G, Huber R. Automated analysis of a large-scale paediatric dataset illustrates the interdependent relationship between epilepsy and sleep. Sci Rep 2023; 13:12882. [PMID: 37553387 PMCID: PMC10409812 DOI: 10.1038/s41598-023-39984-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/03/2023] [Indexed: 08/10/2023] Open
Abstract
Slow waves are an electrophysiological characteristic of non-rapid eye movement sleep and a marker of the restorative function of sleep. In certain pathological conditions, such as different types of epilepsy, slow-wave sleep is affected by epileptiform discharges forming so-called "spike-waves". Previous evidence shows that the overnight change in slope of slow waves during sleep is impaired under these conditions. However, these past studies were performed in a small number of patients, considering only short segments of the recording night. Here, we screened a clinical data set of 39'179 pediatric EEG recordings acquired in the past 25 years (1994-2019) at the University Children's Hospital Zurich and identified 413 recordings of interest. We applied an automated approach based on machine learning to investigate the relationship between sleep and epileptic spikes in this large-scale data set. Our findings show that the overnight change in the slope of slow waves was correlated with the spike-wave index, indicating that the impairment of the net reduction in synaptic strength during sleep is spike dependent.
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Affiliation(s)
- Jelena Skorucak
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bigna K Bölsterli
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Sarah Storz
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sven Leach
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bernhard Schmitt
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Georgia Ramantani
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reto Huber
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
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Fan HC, Chiang KL, Chang KH, Chen CM, Tsai JD. Epilepsy and Attention Deficit Hyperactivity Disorder: Connection, Chance, and Challenges. Int J Mol Sci 2023; 24:ijms24065270. [PMID: 36982345 PMCID: PMC10049646 DOI: 10.3390/ijms24065270] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/20/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023] Open
Abstract
Comorbidities are common in children with epilepsy, with nearly half of the patients having at least one comorbidity. Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by hyperactivity and inattentiveness level disproportional to the child’s developmental stage. The burden of ADHD in children with epilepsy is high and can adversely affect the patients’ clinical outcomes, psychosocial aspects, and quality of life. Several hypotheses were proposed to explain the high burden of ADHD in childhood epilepsy; the well-established bidirectional connection and shared genetic/non-genetic factors between epilepsy and comorbid ADHD largely rule out the possibility of a chance in this association. Stimulants are effective in children with comorbid ADHD, and the current body of evidence supports their safety within the approved dose. Nonetheless, safety data should be further studied in randomized, double-blinded, placebo-controlled trials. Comorbid ADHD is still under-recognized in clinical practice. Early identification and management of comorbid ADHD are crucial to optimize the prognosis and reduce the risk of adverse long-term neurodevelopmental outcomes. The identification of the shared genetic background of epilepsy and ADHD can open the gate for tailoring treatment options for these patients through precision medicine.
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Affiliation(s)
- Hueng-Chuen Fan
- Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital, Wuchi, Taichung 435, Taiwan
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan
- Department of Life Sciences, Agricultural Biotechnology Center, National Chung Hsing University, Taichung 402, Taiwan
| | - Kuo-Liang Chiang
- Department of Pediatric Neurology, Kuang-Tien General Hospital, Taichung 433, Taiwan
- Department of Nutrition, Hungkuang University, Taichung 433, Taiwan
| | - Kuang-Hsi Chang
- Department of Medical Research, Tungs’ Taichung Metroharbor Hospital, Wuchi, Taichung 435, Taiwan
| | - Chuan-Mu Chen
- Department of Life Sciences, Agricultural Biotechnology Center, National Chung Hsing University, Taichung 402, Taiwan
- The iEGG and Animal Biotechnology Center, and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
- Correspondence: (C.-M.C.); (J.-D.T.); Tel.: +886-4-22840319-701 (C.-M.C.); +886-4-24730022-21731 (J.-D.T.)
| | - Jeng-Dau Tsai
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: (C.-M.C.); (J.-D.T.); Tel.: +886-4-22840319-701 (C.-M.C.); +886-4-24730022-21731 (J.-D.T.)
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Fan D, Qi L, Yang Z, Luan G, Wang Q. Putative cause of seizure-induced cognitive alterations: The oscillatory reconfiguration of seizure network. Front Neurosci 2023; 17:1126875. [PMID: 36743804 PMCID: PMC9893114 DOI: 10.3389/fnins.2023.1126875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
Introduction The dynamic reconfiguration of network oscillations is connected with cognitive processes. Changes in how neural networks and signaling pathways work are crucial to how epilepsy and related conditions develop. Specifically, there is evidence that prolonged or recurrent seizures may induce or exacerbate cognitive impairment. However, it still needs to be determined how the seizure brain configures its functional structure to shape the battle of strong local oscillations vs. slow global oscillations in the network to impair cognitive function. Methods In this paper, we aim to deduce the network mechanisms underlying seizure-induced cognitive impairment by comparing the evolution of strong local oscillations with slow global oscillations and their link to the resting state of healthy controls. Here, we construct a dynamically efficient network of pathological seizures by calculating the synchrony and directionality of information flow between nine patients' SEEG signals. Then, using a pattern-based method, we found hierarchical modules in the brain's functional network and measured the functional balance between the network's local strong and slow global oscillations. Results and discussion According to the findings, a tremendous rise in strong local oscillations during seizures and an increase in slow global oscillations after seizures corresponded to the initiation and recovery of cognitive impairment. Specifically, during the interictal period, local strong and slow global oscillations are in metastable balance, which is the same as a normal cognitive process and can be switched easily. During the pre-ictal period, the two show a bimodal pattern of separate peaks that cannot be easily switched, and some flexibility is lost. During the seizure period, a single-peak pattern with negative peaks is showcased, and the network eventually transitions to a very intense strong local oscillation state. These results shed light on the mechanism behind network oscillations in epilepsy-induced cognitive impairment. On the other hand, the differential (similarity) of oscillatory reorganization between the local (non) epileptogenic network and the global network may be an emergency protective mechanism of the brain, preventing the spread of pathological information flow to more healthy brain regions.
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Affiliation(s)
- Denggui Fan
- School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China
| | - Lixue Qi
- School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China
| | - Zecheng Yang
- School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China
| | - Guoming Luan
- Epilepsy Center, Sanbo Brain Hospital, Capital Medical University, Beijing, China,*Correspondence: Guoming Luan,
| | - Qingyun Wang
- Department of Dynamics and Control, Beihang University, Beijing, China
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19
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Zhu F, Wang H, Li L, Bragin A, Cao D, Cheng Y. Intracranial electrophysiological recordings on a swine model of mesial temporal lobe epilepsy. Front Neurol 2023; 14:1077702. [PMID: 37139062 PMCID: PMC10150775 DOI: 10.3389/fneur.2023.1077702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective To test the feasibility and reliability of intracranial electrophysiological recordings in an acute status epilepticus model on laboratory swine. Method Intrahippocampal injection of kainic acid (KA) was performed on 17 male Bama pigs (Sus scrofa domestica) weighing between 25 and 35 kg. Two stereoelectroencephalography (SEEG) electrodes with a total of 16 channels were implanted bilaterally along the sensorimotor cortex to the hippocampus. Brain electrical activity was recorded 2 h daily for 9-28 days. Three KA dosages were tested to evaluate the quantities capable of evoking status epilepticus. Local field potentials (LFPs) were recorded and compared before and after the KA injection. We quantified the epileptic patterns, including the interictal spikes, seizures, and high-frequency oscillations (HFOs), up to 4 weeks after the KA injection. Test-retest reliability using intraclass correlation coefficients (ICCs) were performed on interictal HFO rates to evaluate the recording stability of this model. Results The KA dosage test suggested that a 10 μl (1.0 μg/μl) intrahippocampal injection could successfully evoke status epilepticus lasting from 4 to 12 h. At this dosage, eight pigs (50% of total) had prolonged epileptic events (tonic-chronic seizures + interictal spikes n = 5, interictal spikes alone n = 3) in the later 4 weeks of the video-SEEG recording period. Four pigs (25% of total) had no epileptic activities, and another four (25%) had lost the cap or did not complete the experiments. Animals that showed epileptiform events were grouped as E + (n = 8) and the four animals showing no signs of epileptic events were grouped as E- (n = 4). A total of 46 electrophysiological seizures were captured in the 4-week post-KA period from 4 E + animals, with the earliest onset on day 9. The seizure durations ranged from 12 to 45 s. A significant increase of hippocampal HFOs rate (num/min) was observed in the E+ group during the post-KA period (weeks 1, 2,4, p < 0.05) compared to the baseline. But the E-showed no change or a decrease (in week 2, p = 0.43) compared to their baseline rate. The between-group comparison showed much higher HFO rates in E + vs. E - (F = 35, p < 0.01). The high ICC value [ICC (1, k) = 0.81, p < 0.05] quantified from the HFO rate suggested that this model had a stable measurement of HFOs during the four-week post-KA periods. Significance This study measured intracranial electrophysiological activity in a swine model of KA-induced mesial temporal lobe epilepsy (mTLE). Using the clinical SEEG electrode, we distinguished abnormal EEG patterns in the swine brain. The high test-retest reliability of HFO rates in the post-KA period suggests the utility of this model for studying mechanisms of epileptogenesis. The use of swine may provide satisfactory translational value for clinical epilepsy research.
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Affiliation(s)
- Fengjun Zhu
- Department of Neurosurgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
- Department of Neurosurgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Hanwen Wang
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Lin Li
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
- Department of Biomedical Engineering, University of North Texas, Denton, TX, United States
| | - Anatol Bragin
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Dezhi Cao
- Department of Neurosurgery, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Dezhi Cao,
| | - Yuan Cheng
- Department of Neurosurgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Yuan Cheng,
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20
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Bae S, Lim HK, Jeong Y, Kim SG, Park SM, Shon YM, Suh M. Deep brain stimulation of the anterior nuclei of the thalamus can alleviate seizure severity and induce hippocampal GABAergic neuronal changes in a pilocarpine-induced epileptic mouse brain. Cereb Cortex 2022; 32:5530-5543. [PMID: 35258078 DOI: 10.1093/cercor/bhac033] [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: 11/09/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 01/25/2023] Open
Abstract
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) has been widely used as an effective treatment for refractory temporal lobe epilepsy. Despite its promising clinical outcome, the exact mechanism of how ANT-DBS alleviates seizure severity has not been fully understood, especially at the cellular level. To assess effects of DBS, the present study examined electroencephalography (EEG) signals and locomotor behavior changes and conducted immunohistochemical analyses to examine changes in neuronal activity, number of neurons, and neurogenesis of inhibitory neurons in different hippocampal subregions. ANT-DBS alleviated seizure activity, abnormal locomotor behaviors, reduced theta-band, increased gamma-band EEG power in the interictal state, and increased the number of neurons in the dentate gyrus (DG). The number of parvalbumin- and somatostatin-expressing inhibitory neurons was recovered to the level in DG and CA1 of naïve mice. Notably, BrdU-positive inhibitory neurons were increased. In conclusion, ANT-DBS not only could reduce the number of seizures, but also could induce neuronal changes in the hippocampus, which is a key region involved in chronic epileptogenesis. Importantly, our results suggest that ANT-DBS may lead to hippocampal subregion-specific cellular recovery of GABAergic inhibitory neurons.
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Affiliation(s)
- Sungjun Bae
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon 16419, South Korea.,IMNEWRUN Inc., N Center Bldg. A 5F, Sungkyunkwan University, Suwon 16419, South Korea
| | - Hyun-Kyoung Lim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon 16419, South Korea.,Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, South Korea
| | - Yoonyi Jeong
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon 16419, South Korea
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon 16419, South Korea
| | - Sung-Min Park
- Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 37673, South Korea
| | - Young-Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea.,Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Suwon 16419, South Korea
| | - Minah Suh
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon 16419, South Korea.,IMNEWRUN Inc., N Center Bldg. A 5F, Sungkyunkwan University, Suwon 16419, South Korea.,Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon 16419, South Korea.,Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Suwon 16419, South Korea
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21
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Curot J, Barbeau E, Despouy E, Denuelle M, Sol JC, Lotterie JA, Valton L, Peyrache A. Local neuronal excitation and global inhibition during epileptic fast ripples in humans. Brain 2022; 146:561-575. [PMID: 36093747 PMCID: PMC9924905 DOI: 10.1093/brain/awac319] [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: 02/09/2022] [Revised: 07/01/2022] [Accepted: 08/01/2022] [Indexed: 11/12/2022] Open
Abstract
Understanding the neuronal basis of epileptic activity is a major challenge in neurology. Cellular integration into larger scale networks is all the more challenging. In the local field potential, interictal epileptic discharges can be associated with fast ripples (200-600 Hz), which are a promising marker of the epileptogenic zone. Yet, how neuronal populations in the epileptogenic zone and in healthy tissue are affected by fast ripples remain unclear. Here, we used a novel 'hybrid' macro-micro depth electrode in nine drug-resistant epileptic patients, combining classic depth recording of local field potentials (macro-contacts) and two or three tetrodes (four micro-wires bundled together) enabling up to 15 neurons in local circuits to be simultaneously recorded. We characterized neuronal responses (190 single units) with the timing of fast ripples (2233 fast ripples) on the same hybrid and other electrodes that target other brain regions. Micro-wire recordings reveal signals that are not visible on macro-contacts. While fast ripples detected on the closest macro-contact to the tetrodes were always associated with fast ripples on the tetrodes, 82% of fast ripples detected on tetrodes were associated with detectable fast ripples on the nearest macro-contact. Moreover, neuronal recordings were taken in and outside the epileptogenic zone of implanted epileptic subjects and they revealed an interlay of excitation and inhibition across anatomical scales. While fast ripples were associated with increased neuronal activity in very local circuits only, they were followed by inhibition in large-scale networks (beyond the epileptogenic zone, even in healthy cortex). Neuronal responses to fast ripples were homogeneous in local networks but differed across brain areas. Similarly, post-fast ripple inhibition varied across recording locations and subjects and was shorter than typical inter-fast ripple intervals, suggesting that this inhibition is a fundamental refractory process for the networks. These findings demonstrate that fast ripples engage local and global networks, including healthy tissue, and point to network features that pave the way for new diagnostic and therapeutic strategies. They also reveal how even localized pathological brain dynamics can affect a broad range of cognitive functions.
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Affiliation(s)
- Jonathan Curot
- Correspondence to: Jonathan Curot, MD, PhD CerCo CNRS UMR 5549, Université Toulouse III CHU Purpan, Pavillon Baudot, 31052 Toulouse Cedex, France E-mail:
| | - Emmanuel Barbeau
- Brain and Cognition Research Center (CerCo), Centre National de la Recherche Scientifique, UMR5549, Toulouse, France,Faculty of Health, University of Toulouse, Paul Sabatier University, Toulouse, France
| | - Elodie Despouy
- Brain and Cognition Research Center (CerCo), Centre National de la Recherche Scientifique, UMR5549, Toulouse, France
| | - Marie Denuelle
- Departments of Neurology and Neurosurgery, Toulouse University Hospital, Toulouse, France,Brain and Cognition Research Center (CerCo), Centre National de la Recherche Scientifique, UMR5549, Toulouse, France
| | - Jean Christophe Sol
- Departments of Neurology and Neurosurgery, Toulouse University Hospital, Toulouse, France,Faculty of Health, University of Toulouse, Paul Sabatier University, Toulouse, France,Toulouse Neuro Imaging Center (ToNIC), INSERM, U1214, Toulouse, France
| | - Jean-Albert Lotterie
- Departments of Neurology and Neurosurgery, Toulouse University Hospital, Toulouse, France,Toulouse Neuro Imaging Center (ToNIC), INSERM, U1214, Toulouse, France
| | - Luc Valton
- Departments of Neurology and Neurosurgery, Toulouse University Hospital, Toulouse, France,Brain and Cognition Research Center (CerCo), Centre National de la Recherche Scientifique, UMR5549, Toulouse, France
| | - Adrien Peyrache
- Correspondence may also be addressed to: Adrien Peyrache, PhD Montreal Neurological Institute Department of Neurology and Neurosurgery McGill University, 3810 University Street Montreal, Quebec, Canada E-mail:
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22
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Eriksson MH, Baldeweg T, Pressler R, Boyd SG, Huber R, Cross JH, Bölsterli BK, Chan SYS. Sleep homeostasis, seizures, and cognition in children with focal epilepsy. Dev Med Child Neurol 2022; 65:701-711. [PMID: 36069073 DOI: 10.1111/dmcn.15403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022]
Abstract
AIM To investigate the link between sleep disruption and cognitive impairment in childhood epilepsy by studying the effect of epilepsy on sleep homeostasis, as reflected in slow-wave activity (SWA). METHOD We examined SWA from overnight EEG-polysomnography in 19 children with focal epilepsy (mean [SD] age 11 years 6 months [3 years], range 6 years 6 months-15 years 6 months; 6 females, 13 males) and 18 age- and sex-matched typically developing controls, correlating this with contemporaneous memory consolidation task scores, full-scale IQ, seizures, and focal interictal discharges. RESULTS Children with epilepsy did not differ significantly from controls in overnight SWA decline (p = 0.12) or gain in memory performance with sleep (p = 0.27). SWA was lower in patients compared to controls in the first hour of non-rapid eye movement sleep (p = 0.021), although not in those who remained seizure-free (p = 0.26). Full-scale IQ did not correlate with measures of SWA in patients or controls. There was no significant difference in SWA measures between focal and non-focal electrodes. INTERPRETATION Overnight SWA decline is conserved in children with focal epilepsy and may underpin the preservation of sleep-related memory consolidation in this patient group. Reduced early-night SWA may reflect impaired or immature sleep homeostasis in those with a higher seizure burden.
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Affiliation(s)
- Maria H Eriksson
- Developmental Neurosciences Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Neuropsychology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Torsten Baldeweg
- Developmental Neurosciences Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Neuropsychology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Ronit Pressler
- Neurophysiology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Stewart G Boyd
- Neurophysiology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Reto Huber
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Pediatric Sleep Disorders Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - J Helen Cross
- Developmental Neurosciences Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Neurology, Great Ormond Street Hospital NHS Trust, London, UK.,Young Epilepsy, Lingfield, UK
| | - Bigna K Bölsterli
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Samantha Y S Chan
- Developmental Neurosciences Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Paediatric Neurology, St George's Hospital, London, UK
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23
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Ricci M, Ruggeri M, Gnisci C, Pizzoni L, Gerace C, Blundo C. Improving Amnesia Diagnostic Accuracy with RAVLT Single Scores and Composite Indices: Italian Normative Data. Arch Clin Neuropsychol 2022; 37:1749-1764. [DOI: 10.1093/arclin/acac055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The Rey Auditory Verbal Learning Test (RAVLT) is a widely used verbal memory measure that provides scores for different aspects of memory. It involves repeated auditory presentation and recall of a 15-item word list (List A) followed by presentation and recall of a distractor list (List B) and then un-cued immediate and delayed recalls (at 15 min and 1 week) of List A as well as recognition testing. Aims of this study are to provide Italian normative data for certain RAVLT Scores and Composite Indices to improve the diagnostic accuracy of the test in clinical settings and to provide further evidence on how RAVLT can differentiate different amnesia profiles due to focal lesions.
Methods
We enrolled 440 healthy participants and RAVLT Single Scores and Composite Indices have been analyzed by means of multiple regression to verify the influence of age, education, and gender.
Results
We computed the best linear models with RAVLT Single Scores and Composite Indices, as dependent variables, and the most suitable transformation of independent variables. By reversing the signs of the regression coefficients, the adjustment factors for each level of age and, if needed, education and gender have been computed and the adjusted scores have been standardized into Equivalent Scores.
Conclusion
Using these standardized measures, we differentiate three profiles of amnesia due to selective hippocampal sclerosis with severe encoding deficit, fornix lesions with source memory problems, and temporal lobe epilepsy with consolidation failure.
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Affiliation(s)
- Monica Ricci
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
| | - Massimiliano Ruggeri
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
- CAR – Rehabilitation Centre , Rome , Italy
| | - Cristina Gnisci
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
| | - Luca Pizzoni
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
| | - Carmela Gerace
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
| | - Carlo Blundo
- Centre for Cognitive Disorders and Dementia (CDCD) , Neuroscience Departement, , Rome , Italy
- San Camillo-Forlanini Hospital , Neuroscience Departement, , Rome , Italy
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24
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Camarillo-Rodriguez L, Leenen I, Waldman Z, Serruya M, Wanda PA, Herweg NA, Kahana MJ, Rubinstein D, Orosz I, Lega B, Podkorytova I, Gross RE, Worrell G, Davis KA, Jobst BC, Sheth SA, Weiss SA, Sperling MR. Temporal lobe interictal spikes disrupt encoding and retrieval of verbal memory: A subregion analysis. Epilepsia 2022; 63:2325-2337. [PMID: 35708911 DOI: 10.1111/epi.17334] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The medial temporal lobe (MTL) encodes and recalls memories and can be a predominant site for interictal spikes (IS) in patients with focal epilepsy. It is unclear whether memory deficits are due to IS in the MTL producing a transient decline. Here, we investigated whether IS in the MTL subregions and lateral temporal cortex impact episodic memory encoding and recall. METHODS Seventy-eight participants undergoing presurgical evaluation for medically refractory focal epilepsy with depth electrodes placed in the temporal lobe participated in a verbal free recall task. IS were manually annotated during the pre-encoding, encoding, and recall epochs. We examined the effect of IS on word recall using mixed-effects logistic regression. RESULTS IS in the left hippocampus (odds ratio [OR] = .73, 95% confidence interval [CI] = .63-.84, p < .001) and left middle temporal gyrus (OR = .46, 95% CI = .27-.78, p < .05) during word encoding decreased subsequent recall performance. Within the left hippocampus, this effect was specific for area CA1 (OR = .76, 95% CI = .66-.88, p < .01) and dentate gyrus (OR = .74, 95% CI = .62-.89, p < .05). IS in other MTL subregions or inferior and superior temporal gyrus and IS occurring during the prestimulus window did not affect word encoding (p > .05). IS during retrieval in right hippocampal (OR = .22, 95% CI = .08-.63, p = .01) and parahippocampal regions (OR = .24, 95% CI = .07-.8, p < .05) reduced the probability of recalling a word. SIGNIFICANCE IS in medial and lateral temporal cortex contribute to transient memory decline during verbal episodic memory.
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Affiliation(s)
| | - Iwin Leenen
- Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Zachary Waldman
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mijail Serruya
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Paul A Wanda
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nora A Herweg
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael J Kahana
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel Rubinstein
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Iren Orosz
- Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | | | | | - Robert E Gross
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | | | - Kathryn A Davis
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbara C Jobst
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Sameer A Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Shennan A Weiss
- Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.,Department of Physiology and Pharmacology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.,Departments of Neurology, New York City Health + Hospitals/Kings County, Brooklyn, New York, USA
| | - Michael R Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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25
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Ahmed GK, Darwish AM, Khalifa H, Haridy NA. Relationship between Attention Deficit Hyperactivity Disorder and epilepsy: a literature review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00482-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurological disorder. ADHD has been linked to epilepsy.
Main body
ADHD was found to be present in 30–40% of epileptic children. Researchers have developed numerous theories to explain how and why ADHD and epilepsy coexist. Whether ADHD and epilepsy symptoms are caused by co-occurring psychiatric disorders or by the temporary effects of epileptic discharges or by antiepileptic medicines is critical to consider. Diagnosis and treatment of individuals with ADHD and epilepsy are complicated and challenging from the clinical base.
Conclusions
Comorbidity between ADHD and epilepsy is still challenging to understand. The two diseases have a bidirectional link, so the association may not be coincidental. A disputable point is whether co-occurring ADHD and epilepsy symptoms represent a comorbid psychiatric disorder or are the epileptic discharges’ temporary effects, and are they related to antiepileptic drugs (AEDs). It is recommended to follow up with children with epilepsy or ADHD as they may develop comorbidity after a while.
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Abstract
SUMMARY Although interictal spikes (IISs) are a well-established EEG biomarker for epilepsy, whether they are also a biomarker of cognitive deficits is unclear. Interictal spikes are dynamic events consisting of a synchronous discharge of neurons producing high frequency oscillations and a succession of action potentials which disrupt the ongoing neural activity. There are robust data showing that IISs result in transitory cognitive impairment with the type of deficit specific to the cognitive task and anatomic location of the IIS. Interictal spike, particularly if frequent and widespread, can impair cognitive abilities, through interference with waking learning and memory and memory consolidation during sleep. Interictal spikes seem to be particularly concerning in the developing brain where animal data suggest that IISs can lead to adverse cognitive effects even after the disappearance of the spikes. Whether a similar phenomenon occurs in human beings is unclear. Thus, although IISs are a clear biomarker of transitory cognitive impairment, currently, they lack sensitivity and specificity as a biomarker for enduring cognitive impairment.
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Affiliation(s)
- Gregory L Holmes
- Department of Neurological Sciences Larner College of Medicine at the University of Vermont, Burlington, Vermont, U.S.A
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27
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Kalscheur EJ, Farias-Moeller R, Koop J. Role of neuropsychology in identification of CSWS in a school-aged child with a remote neurological insult. Epilepsy Behav Rep 2022; 18:100514. [PMID: 35198953 PMCID: PMC8850745 DOI: 10.1016/j.ebr.2021.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/18/2021] [Accepted: 12/02/2021] [Indexed: 10/25/2022] Open
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28
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Oser N, Hubacher M, Nageleisen-Weiss A, van Mierlo P, Huber R, Weber P, Bölsterli BK, Datta AN. 6-year course of sleep homeostasis in a case with epilepsy-aphasia spectrum disorder. Epilepsy Behav Rep 2021; 16:100488. [PMID: 34693247 PMCID: PMC8517280 DOI: 10.1016/j.ebr.2021.100488] [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: 05/27/2021] [Revised: 08/27/2021] [Accepted: 09/24/2021] [Indexed: 11/11/2022] Open
Abstract
The overnight change of the slope of SSW as EEG marker for nocturnal regeneration. Reorganization of brain networks can rescue cognitive functions at least partially. Corticosteroids lead to a stabilization of the homeostasis of slope of SSW.
The epilepsy-aphasia spectrum consists of epilepsies with a strong activation of epileptic discharges during non-rapid-eye-movement (NREM) sleep, variable seizure burden and language problems. The homeostatic decrease of slow waves (SW) during NREM sleep (i.e. their amplitude/slope and power) has been related to brain recovery and cognitive function. Epileptic discharges during NREM-sleep were related to an impairment of the decrease of the slope of SW and to cognitive deficits. In this longitudinal case study, we aim to relate this electrophysiological marker, i.e. overnight change of slope of SW, to imaging and behavior. We report a young girl with a fluctuating course in the epilepsy-aphasia spectrum, ranging from the benign end with self-limited childhood epilepsy with centrotemporal spikes (SLECTS) to the severe end with epileptic encephalopathy with continuous spike waves during sleep (CSWS) with two phases of cognitive regression. She was documented over a period of six years including 12 PSGs, six language fMRIs and seven neuropsychological assessments. We longitudinally studied focal and total spike wave index (SWI), detected SW during NREM sleep, calculated their slopes (first and last hour of NREM sleep and overnight change). Deterioration of overnight decrease of the slope of SW was paralleled by the occurrence of the EEG picture of bilateral synchronous electrical status epilepticus during sleep (ESES) and neuropsychological deficits, and this impairment was reversible with resolution of ESES and was accompanied by cognitive improvement. A laterality switch from left to right sided language dominance occurred during recovery from the second regression phase. This might reflect a compensating process. Later, the laterality switched back to the left, possibly facilitated by a low SWI on the left hemisphere. The qualitative analysis of this case supports the view that the longitudinal course of the overnight change of the slope of SW, as an objective, quantitative EEG measure, is related to the course of cognitive function and functional language MR analysis.
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Affiliation(s)
- Nadine Oser
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland
| | - Martina Hubacher
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland
| | - Annette Nageleisen-Weiss
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland
| | - Pieter van Mierlo
- Epilog NV, Ghent, Belgium.,Medical Image and Signal Processing Group, Ghent University, Belgium
| | - Reto Huber
- Department of Pediatric Neurology and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Switzerland.,Child Development Center and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Switzerland.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Switzerland
| | - Peter Weber
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland
| | - Bigna K Bölsterli
- Department of Pediatric Neurology and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Switzerland
| | - Alexandre N Datta
- Department of Pediatric Neurology and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland
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Lin F, Han J, Xue T, Lin J, Chen S, Zhu C, Lin H, Chen X, Lin W, Huang H. Predicting cognitive impairment in outpatients with epilepsy using machine learning techniques. Sci Rep 2021; 11:20002. [PMID: 34625614 PMCID: PMC8501137 DOI: 10.1038/s41598-021-99506-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022] Open
Abstract
Many studies report predictions for cognitive function but there are few predictions in epileptic patients; therefore, we established a workflow to efficiently predict outcomes of both the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in outpatients with epilepsy. Data from 441 outpatients with epilepsy were included; of these, 433 patients met the 12 clinical characteristic criteria and were divided into training (n = 304) and experimental (n = 129) groups. After descriptive statistics were analyzed, cross-validation was used to select the optimal model. The random forest (RF) algorithm was combined with the redundancy analysis (RDA) algorithm; then, optimal feature selection and resampling were carried out after removing linear redundancy information. The features that contributed more to multiple outcomes were selected. Finally, the external traceability of the model was evaluated using the follow-up data. The RF algorithm was the best prediction model for both MMSE and MoCA outcomes. Finally, seven markers were screened by overlapping the top ten important features for MMSE ranked by RF modeling, those ranked for MoCA ranked by RF modeling, and those for both assessments ranked by RDA. The optimal combination of features were namely, sex, age, age of onset, seizure frequency, brain MRI abnormalities, epileptiform discharge in EEG and usage of drugs. which was the most efficient in predicting outcomes of MMSE, MoCA, and both assessments.
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Affiliation(s)
- Feng Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China
| | - Jiarui Han
- BaoFeng Key Laboratory of Genetics and Metabolism, Beijing, People's Republic of China
| | - Teng Xue
- Zhongguancun Biological and Medical Big Data Center, Beijing, People's Republic of China
| | - Jilan Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China
| | - Shenggen Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China
| | - Chaofeng Zhu
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China
| | - Han Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China
| | - Xianyang Chen
- BaoFeng Key Laboratory of Genetics and Metabolism, Beijing, People's Republic of China
| | - Wanhui Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China.
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fujian, People's Republic of China.
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An inventory of basic research in temporal lobe epilepsy. Rev Neurol (Paris) 2021; 177:1069-1081. [PMID: 34176659 DOI: 10.1016/j.neurol.2021.02.390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 12/25/2022]
Abstract
Temporal lobe epilepsy is a severe neurological disease, characterized by seizure occurrence and invalidating cognitive co-morbidities, which affects up to 1% of the adults. Roughly one third of the patients are resistant to any conventional pharmacological treatments. The last option in that case is the surgical removal of the epileptic focus, with no guarantee for clinical symptom alleviation. This state of affairs requests the identification of cellular or molecular targets for novel therapeutic approaches with limited side effects. Here we review some generalities about the disease as well as some of the most recent discoveries about the cellular and molecular mechanisms of TLE, and the latest perspectives for novel treatments.
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Operto FF, Pastorino GMG, Di Bonaventura C, Scuoppo C, Padovano C, Vivenzio V, Donadio S, Coppola G. Effects of antiseizure monotherapy on visuospatial memory in pediatric age. Eur J Paediatr Neurol 2021; 32:106-114. [PMID: 33895643 DOI: 10.1016/j.ejpn.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Visuospatial abilities are fundamental for good school achievements and good daily functioning. Previous studies showed an impairment of visuospatial skills in pediatric patients with epilepsy; pharmacological treatment, although indispensable for the seizure control, could further affect cognitive functions. The aim of our study was to evaluate the visuospatial skills in children and adolescents with different forms of epilepsy well-controlled by antiseizure monotherapy, both at baseline and after one year follow-up, through a standardized neuropsychological assessment. METHODS We recruited 207 children and adolescents (mean age = 10.35 ± 2.39 years) with epilepsy, well controlled by monotherapy with levetiracetam, valproic acid, ethosuximide, oxcarbazepine or carbamazepine and 45 age/sex-matched controls. All the participants performed the Rey-Osterrieth Complex Figure, a standardized test for visuospatial perception and visuospatial memory assessment, at baseline and after 12 month of drug therapy. Age, sex, executive functions, non-verbal intelligence, age at onset of epilepsy, epilepsy duration, epilepsy type, lobe and side of seizure onset were considered in our analysis. EEG, seizure frequency, and drug dose were also recorded. RESULTS At baseline, the epilepsy group performed significantly worse than controls in the Immediate Recall test but not the Direct Copy test, without differences between epilepsy subgroups. Immediate Recall scores were related to age of seizure onset and epilepsy duration and executive functions. The re-assessment after 1 year showed that the Immediate Recall mean scores were not significantly changed in the levetiracetam and oxcarbazepine group, while they significantly worsened in the valproic acid, ethosuximide and carbamazepine groups. The Immediate Recall scores were correlated to age, age at onset of epilepsy, epilepsy duration, and executive functions. CONCLUSIONS Children with epilepsy may exhibit visuospatial memory impairment compared to their peer, that may be correlated to some features of the epilepsy itself and to the impairment of executive functions. Different antiseizure medications can affect visuospatial memory differently, so it is important monitoring this aspect in pediatric patients.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Carlo Di Bonaventura
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Chiara Scuoppo
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Chiara Padovano
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Valentina Vivenzio
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Serena Donadio
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Sumbul O, Aygun H. Chronic effects of different quercetin doses in penicillin-induced focal seizure model. Neurosci Lett 2021; 753:135848. [PMID: 33812925 DOI: 10.1016/j.neulet.2021.135848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/27/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
AIM The aim of the present study was to examine the effects of different quercetin pretreatment doses on focal epileptiform activity induced by penicillin in adult male rat cortex. METHOD Twenty-eight male Wistar rats weighing 200-235 g were randomly divided into four groups: control (only penicillin-injected group) and penicillin + 25, 50 or 100 mg/kg quercetin doses. All quercetin-treated rats had a daily single dose of 25, 50 or 100 mg/kg intraperitoneally administered quercetin for 21 days, and the last dose was given 30 min before the penicillin injection. Epileptiform activity was induced by a single intracortical (i.c.) microinjection of penicillin (500 units/2.5 μl) into left motor cortex. After penicillin injection ECoG was recorded for the following 180 min. RESULTS Quercetin pretreatments of 25, 50 and 100 mg/kg significantly increased the duration of latency (initial spike activity) and decreased spike frequency of the epileptiform activity compared to the control group (p < 0.05). Duration of latency was significantly longer in 25 mg/kg quercetin pretreatment group compared to 100 mg/kg group (p < 0.05). Spike amplitude of epileptiform activity was not different in the study groups (p > 0.05). CONCLUSION Quercetin had an anticonvulsant activity in penicillin-induced focal seizure model in the present study. In addition, lower quercetin doses had highest anticonvulsant effect in this model.
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Affiliation(s)
- Orhan Sumbul
- Department of Neurology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Hatice Aygun
- Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.
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Thomschewski A, Trinka E, Jacobs J. Temporo-Frontal Coherences and High-Frequency iEEG Responses during Spatial Navigation in Patients with Drug-Resistant Epilepsy. Brain Sci 2021; 11:brainsci11020162. [PMID: 33530531 PMCID: PMC7911024 DOI: 10.3390/brainsci11020162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 11/16/2022] Open
Abstract
The prefrontal cortex and hippocampus function in tight coordination during multiple cognitive processes. During spatial navigation, prefrontal neurons are linked to hippocampal theta oscillations, presumably in order to enhance communication. Hippocampal ripples have been suggested to reflect spatial memory processes. Whether prefrontal-hippocampal-interaction also takes place within the ripple band is unknown. This intracranial EEG study aimed to investigate whether ripple band coherences can also be used to show this communication. Twelve patients with epilepsy and intracranial EEG evaluation completed a virtual spatial navigation task. We calculated ordinary coherence between prefrontal and temporal electrodes during retrieval, re-encoding, and pre-task rest. Coherences were compared between the conditions via permutation testing. Additionally, ripples events were automatically detected and changes in occurrence rates were investigated excluding ripples on epileptic spikes. Ripple-band coherences yielded no general effect of the task on coherences across all patients. Furthermore, we did not find significant effects of task conditions on ripple rates. Subsequent analyses pointed to rather short periods of synchrony as opposed to general task-related changes in ripple-band coherence. Specifically designed tasks and adopted measures might be necessary in order to map these interactions in future studies.
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Affiliation(s)
- Aljoscha Thomschewski
- Affiliated Centre of the European Reference Network EpiCARE, Department of Neurology and Centre for Cognitive Neuroscience, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer-Str. 79, 5020 Salzburg, Austria;
- Department of Psychology, Paris-Lodron University of Salzburg, Hellbrunnerstraße 34, 5020 Salzburg, Austria
- Correspondence:
| | - Eugen Trinka
- Affiliated Centre of the European Reference Network EpiCARE, Department of Neurology and Centre for Cognitive Neuroscience, Christian-Doppler Medical Centre, Paracelsus Medical University, Ignaz-Harrer-Str. 79, 5020 Salzburg, Austria;
| | - Julia Jacobs
- Member of the European Reference Network EpiCARE, Epilepsy Center, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany;
- Department of Neuropediatrics and Muscle Disorders, University Hospital Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany
- Room 293, Alberta Children’s Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, Heritage Medical Research Building, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
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Lambert I, Tramoni-Negre E, Lagarde S, Pizzo F, Trebuchon-Da Fonseca A, Bartolomei F, Felician O. Accelerated long-term forgetting in focal epilepsy: Do interictal spikes during sleep matter? Epilepsia 2021; 62:563-569. [PMID: 33476422 DOI: 10.1111/epi.16823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022]
Abstract
Accelerated long-term forgetting (ALF) is a particular form of amnesia mostly encountered in focal epilepsy, particularly in temporal lobe epilepsy. This type of memory loss is characterized by an impairment of long-term consolidation of declarative memory, and its mechanisms remain poorly understood. In particular, the respective contribution of lesion, seizures, interictal epileptic discharges, and sleep is still debated. Here, we provide an overview of the relationships intertwining epilepsy, sleep, and memory consolidation and, based on recent findings from intracranial electroencephalographic recordings, we propose a model of ALF pathophysiology that integrates the differential role of interictal spikes during wakefulness and sleep. This model provides a framework to account for the different timescales at which ALF may occur.
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Affiliation(s)
- Isabelle Lambert
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Eve Tramoni-Negre
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Neurology and Neuropsychology Department, Timone Hospital, Marseille, France
| | - Stanislas Lagarde
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Francesca Pizzo
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Agnès Trebuchon-Da Fonseca
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Fabrice Bartolomei
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Olivier Felician
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Neurology and Neuropsychology Department, Timone Hospital, Marseille, France
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Lenck-Santini PP, Sakkaki S. Alterations of Neuronal Dynamics as a Mechanism for Cognitive Impairment in Epilepsy. Curr Top Behav Neurosci 2021; 55:65-106. [PMID: 33454922 DOI: 10.1007/7854_2020_193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Epilepsy is commonly associated with cognitive and behavioral deficits that dramatically affect the quality of life of patients. In order to identify novel therapeutic strategies aimed at reducing these deficits, it is critical first to understand the mechanisms leading to cognitive impairments in epilepsy. Traditionally, seizures and epileptiform activity in addition to neuronal injury have been considered to be the most significant contributors to cognitive dysfunction. In this review we however highlight the role of a new mechanism: alterations of neuronal dynamics, i.e. the timing at which neurons and networks receive and process neural information. These alterations, caused by the underlying etiologies of epilepsy syndromes, are observed in both animal models and patients in the form of abnormal oscillation patterns in unit firing, local field potentials, and electroencephalogram (EEG). Evidence suggests that such mechanisms significantly contribute to cognitive impairment in epilepsy, independently of seizures and interictal epileptiform activity. Therefore, therapeutic strategies directly targeting neuronal dynamics rather than seizure reduction may significantly benefit the quality of life of patients.
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Affiliation(s)
- Pierre-Pascal Lenck-Santini
- Aix-Marseille Université, INSERM, INMED, Marseille, France. .,Department of Neurological sciences, University of Vermont, Burlington, VT, USA.
| | - Sophie Sakkaki
- Department of Neurological sciences, University of Vermont, Burlington, VT, USA.,Université de. Montpellier, CNRS, INSERM, IGF, Montpellier, France
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Arski ON, Young JM, Smith ML, Ibrahim GM. The Oscillatory Basis of Working Memory Function and Dysfunction in Epilepsy. Front Hum Neurosci 2021; 14:612024. [PMID: 33584224 PMCID: PMC7874181 DOI: 10.3389/fnhum.2020.612024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
Working memory (WM) deficits are pervasive co-morbidities of epilepsy. Although the pathophysiological mechanisms underpinning these impairments remain elusive, it is thought that WM depends on oscillatory interactions within and between nodes of large-scale functional networks. These include the hippocampus and default mode network as well as the prefrontal cortex and frontoparietal central executive network. Here, we review the functional roles of neural oscillations in subserving WM and the putative mechanisms by which epilepsy disrupts normative activity, leading to aberrant oscillatory signatures. We highlight the particular role of interictal epileptic activity, including interictal epileptiform discharges and high frequency oscillations (HFOs) in WM deficits. We also discuss the translational opportunities presented by greater understanding of the oscillatory basis of WM function and dysfunction in epilepsy, including potential targets for neuromodulation.
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Affiliation(s)
- Olivia N. Arski
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Julia M. Young
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
| | - Mary-Lou Smith
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - George M. Ibrahim
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Öztoprak Ü, Yayici Köken Ö, Aksoy E, Yüksel D. Spike-Wave Index Assessment and Electro-Clinical Correlation in Patients with Encephalopathy Associated with Epileptic State During Slow Sleep (ESES / CSWS); Single-Center Experience. Epilepsy Res 2021; 170:106549. [PMID: 33450525 DOI: 10.1016/j.eplepsyres.2021.106549] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/06/2020] [Accepted: 12/30/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE This study aimed to describe the electroclinical spectrum and neurocognitive outcome in children with epileptic encephalopathy with status epilepticus during sleep (ESES) according to the EEG patterns. METHODS Records of 48 (19 males, 29 females) patients with ESES/CSWS syndrome were retrospectively evaluated for data on sleep and awake EEGs, psychometric tests, and brain MRI. Patients with a spike-wave index (SWI) of at least 50 % in the NREM sleep EEG were included in the study. Electrophysiologic findings were separated into two groups based on SWI: SWI>85-100 % (typical ESES) and SWI < 85 % (atypical ESES). The neurocognitive prognosis was also evaluated in two groups; favorable and unfavorable. RESULTS The median age at the onset of ESES was 6 years and 5 months and ranged from 3 to 13 years. The median duration of follow-up after the ESES diagnosis was 57 months (range 24-150 months). Etiology was evaluated in three groups: symptomatic/structural, idiopathic, and unknown (cryptogenic). Twenty-seven (56.25 %) patients had atypical ESES patterns and 21 patients (43.75 %) had typical ESES patterns. Twenty-eight patients (58.3 %) had cognitive deterioration. Long term neurocognitive outcome was unfavorable in half of the patients. Symptomatic/structural etiology was more common in patients with unfavorable (p < 0.001) outcomes. The median age at the diagnosis of ESES (p < 0.001) was significantly earlier in the patients with unfavorable neurocognitive outcomes. The longer duration of ESES(p < 0.001), and the longer time between the onset of epilepsy and ESES (p = 0.039) was significantly associated with unfavorable outcomes. We found that patients with typical ESES had a higher risk for poor neurocognitive outcomes than patients with atypical ESES (OR: 31.096 [1.565-617.696]). CONCLUSION The long-term outcome of ESES is exceedingly variable. An unfavorable neurocognitive outcome seems to be related to ESES with a long-duration and early-onset epileptic activity, SWI ≥ 85 %, and etiology.
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Affiliation(s)
- Ülkühan Öztoprak
- University of Health Sciences, Dr. Sami Ulus Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey.
| | - Özlem Yayici Köken
- Ankara City Hospital, Children's Hospital, Department of Pediatric Neurology, Ankara, Turkey.
| | - Erhan Aksoy
- University of Health Sciences, Dr. Sami Ulus Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey.
| | - Deniz Yüksel
- University of Health Sciences, Dr. Sami Ulus Training and Research Hospital, Department of Pediatric Neurology, Ankara, Turkey.
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Chawla T, Chaudhry N, Puri V. Cognitive Dysfunction in Juvenile Myoclonic Epilepsy (JME) - A Tertiary Care Center Study. Ann Indian Acad Neurol 2021; 24:40-50. [PMID: 33911378 PMCID: PMC8061499 DOI: 10.4103/aian.aian_663_19] [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: 12/11/2019] [Revised: 12/25/2019] [Accepted: 12/30/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND AIM Epilepsy often leads to cognitive impairment. Idiopathic generalized epilepsy as a group is considered to be benign in terms of its effects on cognition. Though, neuropsychological testing reveals subtle frontal impairment in patients with juvenile myoclonic epilepsy (JME). The aim of this study is to evaluate cognitive dysfunction in patients with JME. METHOD We compared 50 JME patients and 50 age and sex matched healthy controls above 12 years of age on various cognitive tests which included Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Executive Interview (EXIT), PGI Memory Scale (PGIMS), Clock Drawing Test (CDT), Cube copying test (CCT), and Nahor Benson Test (NBT). We correlated the cognitive dysfunction with education level, age of onset, duration of epilepsy, electroencephalogram (EEG) abnormalities, treatment, and seizure control status. RESULTS JME patients performed significantly worse on MMSE (P = 0.001), PGI MS (P value = 0.001), FAB (P =.001), EXIT (P =.001), CDT (P =.02), and CCT (P =.001) when compared to the controls. JME patients had impaired attention, verbal fluency, design fluency, verbal memory, visual memory, conceptualization, set shifting, mental flexibility, response inhibition, and visuospatial functions. Cognitive dysfunction correlated with education level, duration of epilepsy and EEG abnormality. No correlation was seen with seizure frequency or type of antiepileptic therapy. CONCLUSIONS JME patients demonstrate both frontal and parietooccipital lobe dysfunction. Hence detailed higher mental function tests supplemented by functional neuroimaging studies should be done in JME patients for their comprehensive management. This would also enhance our knowledge about the pathogenesis of JME.
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Affiliation(s)
- Tanushree Chawla
- Department of Neurology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Neera Chaudhry
- Department of Neurology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Vinod Puri
- Department of Neurology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
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Modulation of locomotor behaviors by location-specific epileptic spiking and seizures. Epilepsy Behav 2021; 114:107652. [PMID: 33309429 PMCID: PMC8450922 DOI: 10.1016/j.yebeh.2020.107652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Epilepsy is a debilitating neurological condition characterized by spontaneous seizures as well as significant comorbid behavioral abnormalities. In addition to seizures, epileptic patients exhibit interictal spikes far more frequently than seizures, often, but not always observed in the same brain areas. The exact relationship between spiking and seizures as well as their respective effects on behavior are not well understood. In fact, spiking without overt seizures is seen in various psychiatric conditions including attention-deficit hyperactivity disorder. METHODS In order to study the effects of spiking and seizures on behavior in an epileptic animal model, we used long-term video-electroencephalography recordings at six cortical recording sites together with behavioral activity monitoring. Animals received unilateral injections of tetanus toxin into either the somatosensory or motor cortex. RESULTS Somatosensory cortex-injected animals developed progressive spiking ipsilateral to the injection site, while those receiving the injection into the motor cortex developed mostly contralateral spiking and spontaneous seizures. Animals with spiking but no seizures displayed a hyperactive phenotype, while animals with both spiking and seizures displayed a hypoactive phenotype. Not all spikes were equivalent as spike location strongly correlated with distinct locomotor behaviors including ambulatory distance, vertical movements, and rotatory movement. CONCLUSIONS Together, our results demonstrate relationships between brain region-specific spiking, seizures, and behaviors in rodents that could translate into a better understanding for patients with epileptic behavioral comorbidities and other neuropsychiatric disorders.
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Quon RJ, Meisenhelter S, Adamovich-Zeitlin RH, Song Y, Steimel SA, Camp EJ, Testorf ME, MacKenzie TA, Gross RE, Lega BC, Sperling MR, Kahana MJ, Jobst BC. Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy. Epilepsia 2020; 62:481-491. [PMID: 33332586 DOI: 10.1111/epi.16792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study was undertaken to evaluate the influence that subject-specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy. METHODS One hundred fifty subjects with intracranial electrodes performed multiple sessions of a free recall memory task; this standardized task controlled for subject attention levels. We utilized a dominance analysis to rank the importance of subject-specific factors based on their relative influence on IED rates. Linear mixed-effects models were employed to comprehensively examine factors with highly ranked importance. RESULTS Antiseizure medication (ASM) status, time of testing, and seizure onset zone (SOZ) location were the highest-ranking factors in terms of their impact on IED rates. The average IED rate of electrodes in SOZs was 34% higher than the average IED rate of electrodes outside of SOZs (non-SOZ; p < .001). However, non-SOZ electrodes had similar IED rates regardless of the subject's SOZ location (p = .99). Subjects on older generation (p < .001) and combined generation (p < .001) ASM regimens had significantly lower IED rates relative to the group taking no ASMs; newer generation ASM regimens demonstrated a nonsignificant association with IED rates (p = .13). Of the ASMs included in this study, the following ASMs were associated with significant reductions in IED rates: levetiracetam (p < .001), carbamazepine (p < .001), lacosamide (p = .03), zonisamide (p = .01), lamotrigine (p = .03), phenytoin (p = .03), and topiramate (p = .01). We observed a nonsignificant association between time of testing and IED rates (morning-afternoon p = .15, morning-evening p = .85, afternoon-evening p = .26). SIGNIFICANCE The current study ranks the relative influence that subject-specific factors have on IED rates and highlights the importance of considering certain factors, such as SOZ location and ASM status, when analyzing IEDs for clinical or research purposes.
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Affiliation(s)
- Robert J Quon
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Stephen Meisenhelter
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | | | - Yinchen Song
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Sarah A Steimel
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Edward J Camp
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Markus E Testorf
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Thayer School of Engineering at Dartmouth College, Hanover, New Hampshire, USA
| | - Todd A MacKenzie
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Dartmouth Institute, Dartmouth College, Hanover, New Hampshire, USA
| | - Robert E Gross
- Department of Neurosurgery, Emory University, Atlanta, Georgia, USA
| | - Bradley C Lega
- Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA
| | - Michael R Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael J Kahana
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbara C Jobst
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Storz S, Wilhelm I, Critelli H, Feldmann M, Ramirez A, Ramantani G, Huber R, Bölsterli BK. Sleep-dependent memory consolidation in children with self-limited focal epilepsies. Epilepsy Behav 2020; 113:107513. [PMID: 33129045 DOI: 10.1016/j.yebeh.2020.107513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Children with self-limited focal epilepsies of childhood (SLFE) are known to show impaired memory functions, particularly in the verbal domain. Interictal epileptiform discharges (IED) in these epilepsies are more pronounced in nonrapid eye movement (NREM) sleep. Nonrapid eye movement sleep is crucial for consolidation of newly-encoded memories. Therefore, we hypothesize that sleep-dependent memory consolidation is altered in relation to IED in children with SLFE. METHODS We conducted a prospective case-control study. We applied a verbal (word pair) and a visuospatial (two-dimensional [2D] object location) learning task, both previously shown to benefit from sleep in terms of memory consolidation. Learning took place in the evening, and retrieval was tested in the morning after a night of sleep. Electroencephalogram (EEG) was recorded across night. After sleep-stage scoring, the spike-wave index (SWI) was assessed at the beginning and the end of sleep. Fourteen patients with SLFE (age: 5.5 to 11.6 years) were compared with 15 healthy controls (age: 6.8 to 9.1 years) examined in a previous study. RESULTS In contrast to healthy controls (mean: +12.9% recalled word pairs, p = .003, standard deviation (SD) = 12.4%), patients did not show overnight performance gains in the verbal memory task (mean: +6.4% recalled word pairs, p > .05, SD = 17.3) Neither patients nor controls showed significant overnight changes in visuospatial task performance. Spike-wave index was negatively correlated with recall performance in the verbal but not in the visuospatial task. SIGNIFICANCE We found evidence for impaired overnight improvement of performance in children with SLFE in a verbal learning task, with high SWI rates predicting low recall performance. We speculate that spike-waves hamper long-term memory consolidation by interfering with NREM sleep.
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Affiliation(s)
- Sarah Storz
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Ines Wilhelm
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit (TPU), University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Hanne Critelli
- Department of Neurology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Maria Feldmann
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Ana Ramirez
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Georgia Ramantani
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Neurology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Reto Huber
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Bigna K Bölsterli
- Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Neurology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
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Developmental Language Disorder: Wake and Sleep Epileptiform Discharges and Co-morbid Neurodevelopmental Disorders. Brain Sci 2020; 10:brainsci10120910. [PMID: 33256068 PMCID: PMC7760604 DOI: 10.3390/brainsci10120910] [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: 09/21/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022] Open
Abstract
Developmental language disorder (DLD) is frequently associated with other developmental diseases and may lead to a handicap through adolescence or adulthood. The aim of our retrospective study was to characterize DLD subgroups, their etiological factors and clinical comorbidities, and the role of epileptiform discharges in wake and sleep recordings. Fifty-five children (42 male, mean age 6.2 ± 1.4 years, range 4-9 years) were included in the present study and underwent phoniatric, psychologic, neurologic, as well as wake and nocturnal electroencephalography (EEG) or polysomnography (PSG) examinations. A receptive form of DLD was determined in 34 children (63.0%), and an expressive form was found in 20 children (37.0%). Poor cooperation in one child did not permit exact classification. DLD children with the receptive form had significantly lower mean phonemic hearing (79.1% ± 10.9) in comparison with those with the expressive form (89.7% ± 6.2, p < 0.001). A high amount of perinatal risk factors was found in both groups (50.9%) as well as comorbid developmental diseases. Developmental motor coordination disorder was diagnosed in 33 children (61.1%), and attention deficit or hyperactivity disorder was diagnosed in 39 children (70.9%). Almost one half of DLD children (49.1%) showed abnormalities on the wake EEG; epileptiform discharges were found in 20 children (36.4%). Nocturnal EEG and PSG recordings showed enhanced epileptiform discharges, and they were found in 30 children (55.6%, p = 0.01). The wake EEG showed focal discharges predominantly in the temporal or temporo-parieto-occipital regions bilaterally, while in the sleep recordings, focal activity was shifted to the fronto-temporo-central areas (p < 0.001). Almost all epileptiform discharges appeared in non-rapid eye movement (NREM) sleep. A close connection was found between DLD and perinatal risk factors, as well as neurodevelopmental disorders. Epileptiform discharges showed an enhancement in nocturnal sleep, and the distribution of focal discharges changed.
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Ahmed GK, Darwish AM, Khalifa H, Khashbah MA. Evaluation of psychiatric comorbidity in attention-deficit hyperactivity disorder with epilepsy: A case-control study. Epilepsy Res 2020; 169:106505. [PMID: 33302225 DOI: 10.1016/j.eplepsyres.2020.106505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder caused by structural and functional brain abnormalities as well as genetic and environmental factors. ADHD symptoms are commonly observed in individuals with epilepsy. A few studies have reported a pattern of behavioral problems in children with combined epilepsy and ADHD. We aimed to evaluate comorbid behavioral problems and mental health concerns among children with epilepsy with ADHD and without ADHD including autism spectrum disorder, anxiety, depression, somatic problems, oppositional defiant disorder, and conduct disorder. METHODS A total of 100 children aged between 6 and 11 years were recruited and categorized into 1 of 5 groups (20 child/group): (1) epilepsy, (2) epilepsy with ADHD, (3) ADHD with electroencephalogram (EEG) changes, (4) ADHD without EEG changes, and (5) healthy control. The scales used in our study included the Childhood Autism Spectrum Test (CAST) to screen autism spectrum conditions and related social and communication conditions, Conners' Parent Rating Scale (CPRS) to assess ADHD and other comorbid behavioral and social-emotional difficulties, and Children Behavior Checklist (CBCL) to evaluate behavior problems. RESULTS The CAST scale score showed no significant difference among the studied groups. Regarding the Conners-3 scale, the combined type of ADHD was predominant in the ADHD with EEG changes group and the ADHD with epilepsy group, while hyperactive ADHD was predominant in the ADHD without EEG changes group. The ADHD with EEG changes group and the ADHD with epilepsy group had equally high clinical rating scores for CBCL in internalizing and externalizing problems. There was a significant difference in the profile of all Diagnostic and Statistical Manual of Mental Disorders (DSM-5) scales of CBCL among the studied groups. CONCLUSION This is the first study to use EEG in patients with ADHD in comparison with epilepsy. ADHD with epilepsy is closely related to ADHD with EEG changes regarding psychiatric comorbidity in terms of anxiety, depression, somatic problems, oppositional defiance problems, and conduct problems.
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Affiliation(s)
- Gellan K Ahmed
- Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
| | - Alaa M Darwish
- Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt
| | - Hossam Khalifa
- Department of Neurology and Psychiatry, Assiut University, 71516 Assiut, Egypt
| | - Mohamed A Khashbah
- Department of Economics, Neuroeconomics and Finance, Claremont Graduate University, CA, 91711, United States
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van den Munckhof B, Gefferie SR, van Noort SAM, van Teeseling HC, Schijvens MP, Smit W, Teunissen NW, Plate JDJ, Huiskamp GJM, Leijten FSS, Braun KPJ, Jansen FE, Bölsterli BK. Sleep slow-wave homeostasis and cognitive functioning in children with electrical status epilepticus in sleep. Sleep 2020; 43:5831237. [PMID: 32374855 DOI: 10.1093/sleep/zsaa088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/03/2020] [Indexed: 01/13/2023] Open
Abstract
STUDY OBJECTIVES Encephalopathy with electrical status epilepticus in sleep (ESES) is characterized by non-rapid eye movement (non-REM)-sleep-induced epileptiform activity and acquired cognitive deficits. The synaptic homeostasis hypothesis describes the process of daytime synaptic potentiation balanced by synaptic downscaling in non-REM-sleep and is considered crucial to retain an efficient cortical network. We aimed to study the overnight decline of slow waves, an indirect marker of synaptic downscaling, in patients with ESES and explore whether altered downscaling relates to neurodevelopmental and behavioral problems. METHODS Retrospective study of patients with ESES with at least one whole-night electroencephalogram (EEG) and neuropsychological assessment (NPA) within 4 months. Slow waves in the first and last hour of non-REM-sleep were analyzed. Differences in slow-wave slope (SWS) and overnight slope course between the epileptic focus and non-focus electrodes and relations to neurodevelopment and behavior were analyzed. RESULTS A total of 29 patients with 44 EEG ~ NPA combinations were included. Mean SWS decreased from 357 to 327 µV/s (-8%, p < 0.001) across the night and the overnight decrease was less pronounced in epileptic focus than in non-focus electrodes (-5.6% vs. -8.7%, p = 0.003). We found no relation between SWS and neurodevelopmental test results in cross-sectional and longitudinal analyses. Patients with behavioral problems showed less SWS decline than patients without and the difference was most striking in the epileptic focus (-0.9% vs. -8.8%, p = 0.006). CONCLUSIONS Slow-wave homeostasis-a marker of synaptic homeostasis-is disturbed by epileptiform activity in ESES. Behavioral problems, but not neurodevelopmental test results, were related to severity of this disturbance.
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Affiliation(s)
- Bart van den Munckhof
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Silvano R Gefferie
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Suus A M van Noort
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Heleen C van Teeseling
- Department of Pediatric Neuropsychology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mischa P Schijvens
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - William Smit
- Department of Clinical Neurophysiology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nico W Teunissen
- Department of Clinical Neurophysiology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Joost D J Plate
- Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert Jan M Huiskamp
- Department of Clinical Neurophysiology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Frans S S Leijten
- Department of Clinical Neurophysiology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kees P J Braun
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Floor E Jansen
- Department of Pediatric Neurology, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bigna K Bölsterli
- Division of Clinical Neurophysiology, Department of Neurology, University Children's Hospital Zurich, Zurich, Switzerland
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Rocha PL, Barros AK, Silva WS, Sousa GC, Sousa P, da Silva AM. Classification of the interictal state with hypsarrhythmia from Zika Virus Congenital Syndrome and of the ictal state from epilepsy in childhood without hypsarrhythmia in EEGs using entropy measures. Comput Biol Med 2020; 126:104014. [DOI: 10.1016/j.compbiomed.2020.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
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Horvath AA, Csernus EA, Lality S, Kaminski RM, Kamondi A. Inhibiting Epileptiform Activity in Cognitive Disorders: Possibilities for a Novel Therapeutic Approach. Front Neurosci 2020; 14:557416. [PMID: 33177974 PMCID: PMC7593384 DOI: 10.3389/fnins.2020.557416] [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: 04/30/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment is a common and seriously debilitating symptom of various mental and neurological disorders including autism, attention deficit hyperactivity disorder, multiple sclerosis, epilepsy, and neurodegenerative diseases, like Alzheimer's disease. In these conditions, high prevalence of epileptiform activity emerges as a common pathophysiological hallmark. Growing body of evidence suggests that this discrete but abnormal activity might have a long-term negative impact on cognitive performance due to neuronal circuitries' remodeling, altered sleep structure, pathological hippocampo-cortical coupling, and even progressive neuronal loss. In animal models, epileptiform activity was shown to enhance the formation of pathological amyloid and tau proteins that in turn trigger network hyperexcitability. Abolishing epileptiform discharges might slow down the cognitive deterioration. These findings might provide basis for therapeutic use of antiepileptic drugs in neurodegenerative cognitive disorders. The aim of our review is to describe the data on the prevalence of epileptiform activity in various cognitive disorders, to summarize the current knowledge of the mechanisms of epileptic activity in relation to cognitive impairment, and to explore the utility of antiepileptic drugs in the therapy of cognitive disorders. We also propose future directions for drug development and novel therapeutic interventions targeting epileptiform discharges in these disorders.
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Affiliation(s)
- Andras Attila Horvath
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
- Department of Neurology, National Institute of Clinical Neurosciences, Budapest, Hungary
| | | | - Sara Lality
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Rafal M. Kaminski
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Anita Kamondi
- Department of Neurology, National Institute of Clinical Neurosciences, Budapest, Hungary
- Department of Neurology, Semmelweis University, Budapest, Hungary
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Serrano-Reyes M, García-Vilchis B, Reyes-Chapero R, Cáceres-Chávez VA, Tapia D, Galarraga E, Bargas J. Spontaneous Activity of Neuronal Ensembles in Mouse Motor Cortex: Changes after GABAergic Blockade. Neuroscience 2020; 446:304-322. [PMID: 32860933 DOI: 10.1016/j.neuroscience.2020.08.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/02/2020] [Accepted: 08/18/2020] [Indexed: 01/12/2023]
Abstract
The mouse motor cortex exhibits spontaneous activity in the form of temporal sequences of neuronal ensembles in vitro without the need of tissue stimulation. These neuronal ensembles are defined as groups of neurons with a strong correlation between its firing patterns, generating what appears to be a predetermined neural conduction mode that needs study. Each ensemble is commonly accompanied by one or more parvalbumin expressing neurons (PV+) or fast spiking interneurons. Many of these interneurons have functional connections between them, helping to form a circuit configuration similar to a small-world network. However, rich club metrics show that most connected neurons are neurons not expressing parvalbumin, mainly pyramidal neurons (PV-) suggesting feed-forward propagation through pyramidal cells. Ensembles with PV+ neurons are connected to these hubs. When ligand-gated fast GABAergic transmission is blocked, temporal sequences of ensembles collapse into a unique synchronous and recurrent ensemble, showing the need of inhibition for coding cortical spontaneous activity. This new ensemble has a duration and electrophysiological characteristics of brief recurrent interictal epileptiform discharges (IEDs) composed by the coactivity of both PV- and PV+ neurons, demonstrating that GABA transmission impedes its occurrence. Synchronous ensembles are clearly divided into two clusters one of them lasting longer and mainly composed by PV+ neurons. Because an ictal-like event was not recorded after several minutes of IEDs recording, it is inferred that an external stimulus and/or fast GABA transmission are necessary for its appearance, making this preparation ideal to study both the neuronal machinery to encode cortical spontaneous activity and its transformation into brief non-ictal epileptiform discharges.
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Affiliation(s)
- Miguel Serrano-Reyes
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - Brisa García-Vilchis
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - Rosa Reyes-Chapero
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | | | - Dagoberto Tapia
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - Elvira Galarraga
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - José Bargas
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, México City 04510, Mexico.
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Zhang T, Shi Q, Li Y, Gao Y, Sun J, Miao A, Wu C, Chen Q, Hu Z, Guo H, Wang X. Frequency-Dependent Interictal Neuromagnetic Activities in Children With Benign Epilepsy With Centrotemporal Spikes: A Magnetoencephalography (MEG) Study. Front Hum Neurosci 2020; 14:264. [PMID: 32742261 PMCID: PMC7365040 DOI: 10.3389/fnhum.2020.00264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/12/2020] [Indexed: 01/02/2023] Open
Abstract
Objective: This study aimed to investigate interictal neuromagnetic activities in the low- to high-frequency ranges in patients with benign epilepsy with centrotemporal spikes (BECTS), especially those without interictal epileptiform discharges (IEDs). Methods: We studied 21 clinically-diagnosed BECTS patients and 11 age-matched healthy controls (HC) using high-sampling magnetoencephalography (MEG). Neuromagnetic sources were assessed with accumulated source imaging (ASI). The MEG data were analyzed in seven frequency bands. The MEG recordings distinguished BECTS without IEDs (n = 10) from those with IEDs (n = 11) and HC (n = 11). Results: At 1–4 Hz, the neuromagnetic activities in healthy subjects tended to locate at the precuneus/posterior cingulate, while those of the BECTS patients without IEDs tended to locate at the medial frontal cortex (MFC) compared to BECTS patients with IEDs. The MEG source imaging at 30–80 Hz revealed that BECTS patients without IEDs had higher occurrences of interictal brain activity in the medial temporal lobe (MTL) compared to controls and the brain activity strength seemed to be weaker. There was a significant correlation between the source strength of the interictal gamma oscillations of BECTS patients without IEDs and the duration of epilepsy. Conclusions: IEDs might disrupt the default mode network (DMN). Aberrant brain activities in BECTS patients without IEDs were associated with cognitive areas of the brain. The strength of gamma oscillations in the chronic epilepsy state reflected the duration of BECTS. Significance: MEG could reveal the aberrant neural activities in BECTS patients during the interictal period, and such abnormality is frequency-dependent. Gamma oscillations could be used to identify BECTS patients without IEDs.
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Affiliation(s)
- Tingting Zhang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Qi Shi
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yihan Li
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Gao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jintao Sun
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Ailiang Miao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Caiyun Wu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Qiqi Chen
- MEG Center, Nanjing Brain Hospital, Nanjing, China
| | - Zheng Hu
- Department of Neurology, Nanjing Children's Hospital, Nanjing, China
| | - Hu Guo
- Department of Neurology, Nanjing Children's Hospital, Nanjing, China
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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Unravelling the Role of Glycogen Synthase Kinase-3 in Alzheimer's Disease-Related Epileptic Seizures. Int J Mol Sci 2020; 21:ijms21103676. [PMID: 32456185 PMCID: PMC7279454 DOI: 10.3390/ijms21103676] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 12/21/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common form of dementia. An increasing body of evidence describes an elevated incidence of epilepsy in patients with AD, and many transgenic animal models of AD also exhibit seizures and susceptibility to epilepsy. However, the biological mechanisms that underlie the occurrence of seizure or increased susceptibility to seizures in AD is unknown. Glycogen synthase kinase-3 (GSK-3) is a serine/threonine kinase that regulates various cellular signaling pathways, and plays a crucial role in the pathogenesis of AD. It has been suggested that GSK-3 might be a key factor that drives epileptogenesis in AD by interacting with the pathological hallmarks of AD, amyloid precursor protein (APP) and tau. Furthermore, seizures may also contribute to the progression of AD through GSK-3. In this way, GSK-3 might be involved in initiating a vicious cycle between AD and seizures. This review aims to summarise the possible role of GSK-3 in the link between AD and seizures. Understanding the role of GSK-3 in AD-associated seizures and epilepsy may help researchers develop new therapeutic approach that can manage seizure and epilepsy in AD patients as well as decelerate the progression of AD.
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Lambert I, Tramoni-Negre E, Lagarde S, Roehri N, Giusiano B, Trebuchon-Da Fonseca A, Carron R, Benar CG, Felician O, Bartolomei F. Hippocampal Interictal Spikes during Sleep Impact Long-Term Memory Consolidation. Ann Neurol 2020; 87:976-987. [PMID: 32279329 DOI: 10.1002/ana.25744] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 03/11/2020] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Non-rapid eye movement (NREM) sleep is supposed to play a key role in long-term memory consolidation transferring information from hippocampus to neocortex. However, sleep also activates epileptic activities in medial temporal regions. This study investigated whether interictal hippocampal spikes during sleep would impair long-term memory consolidation. METHOD We prospectively measured visual and verbal memory performance in 20 patients with epilepsy investigated with stereoelectroencephalography (SEEG) at immediate, 30-minute, and 1-week delays, and studied the correlations between interictal hippocampal spike frequency during waking and the first cycle of NREM sleep and memory performance, taking into account the number of seizures occurring during the consolidation period and other possible confounding factors, such as age and epilepsy duration. RESULTS Retention of verbal memory over 1 week was negatively correlated with hippocampal spike frequency during sleep, whereas no significant correlation was found with hippocampal interictal spikes during waking. No significant result was found for visual memory. Regression tree analysis showed that the number of seizures was the first factor that impaired the verbal memory retention between 30 minutes and 1 week. When the number of seizures was below 5, spike frequency during sleep higher than 13 minutes was associated with impaired memory retention over 1 week. INTERPRETATION Our results show that activation of interictal spikes in the hippocampus during sleep and seizures specifically impair long-term memory consolidation. We hypothesize that hippocampal interictal spikes during sleep interrupt hippocampal-neocortical transfer of information. ANN NEUROL 2020;87:976-987.
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Affiliation(s)
- Isabelle Lambert
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Eve Tramoni-Negre
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Neurology Neuropsychology, Marseille, France
| | - Stanislas Lagarde
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Nicolas Roehri
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Bernard Giusiano
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Public Health Department, Marseille, France
| | - Agnès Trebuchon-Da Fonseca
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Romain Carron
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Functional and Stereotactic Neurosurgery, Marseille, France
| | | | - Olivier Felician
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Neurology Neuropsychology, Marseille, France
| | - Fabrice Bartolomei
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
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