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Shariff E, Nazish S, Zafar A, Shahid R, Aljaafari D, Soltan NM, Farhan AM, Alkhamis FA, AlShurem M, Basheir OFH, Alshamrani F, Albakr AI, Al Ghamdi O, AlSulaiman AA, Al Abdali M. Characteristics of Stroke-related Seizures and their Predictive Factors: A Tertiary Care Center Experience. Ann Afr Med 2024; 23:285-290. [PMID: 39034547 DOI: 10.4103/aam.aam_15_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/07/2023] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND PURPOSE Various risk factors have been described in the literature that increase the risk of seizures associated with stroke. This study was aimed to determine the occurrence rate of poststroke seizures (PSSs) and the associated risk factors in Arab population. MATERIALS AND METHODS Study included all stroke patients aged >18 years with a minimum follow-up of 24 months following stroke to identify seizure occurrence. Patient's hospital records for all admissions and clinic visits were reviewed. Seizures were classified into early PSS if they occur within 1 week of stroke, and late PSS if they occur after 1 week of stroke. RESULTS Out of 594 patients, 380 were males. Seizure occurrence was higher in anterior circulation infarctions (94.8%, P < 0.05), cortical location (80.5%, P < 0.05), large artery atherosclerosis (63.8%, P < 0.05), lower activated partial thromboplastin time (APTT) (P = 0.0007), patients with ischemic heart disease (IHD) (P = 0.01), and those who underwent craniotomy (P = 0.001). Nonhigh-density lipoprotein cholesterol was inversely related to PSS (P = 0.01). Higher stroke severity (89%) and confusion (67%) at the time of presentation were independently related to PSS. CONCLUSIONS Eighty-two (13.8%) patients had PSS. Greater stroke severity at presentation with altered sensorium was independent risk factors for the development of PSS. Patients with underlying IHD, lower APTT, and undergoing neurosurgical intervention require vigilant monitoring for PSS.
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Affiliation(s)
- Erum Shariff
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saima Nazish
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Azra Zafar
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rizwana Shahid
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Danah Aljaafari
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nehad Mahmoud Soltan
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Mohamed Farhan
- Department of General Courses, College of Applied Studies and Community Service, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahd A Alkhamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed AlShurem
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Foziah Alshamrani
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Aishah Ibrahim Albakr
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omar Al Ghamdi
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulla A AlSulaiman
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Majed Al Abdali
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Aljafen BN, Alneseyan R, Muayqil T, Alkhateeb MO, Aldosari MM, Alsermani A, Alnakhli L, Althomali R, Alnami R, Alqahtani R, Ibrahim L, Babtain F. Evaluating the prevalence and risk factors for depression in patients with temporal lobe epilepsy with hippocampal sclerosis: A cross-sectional multicenter study. Epilepsy Behav 2024; 154:109782. [PMID: 38636108 DOI: 10.1016/j.yebeh.2024.109782] [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: 01/05/2024] [Revised: 03/12/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Epilepsy frequently accompanies Major Depressive Disorder (MDD). Notably, people with temporal lobe epilepsy and hippocampal sclerosis may face an increased susceptibility to MDD, as evidence indicates the involvement of the limbic system in the development of emotional symptoms. OBJECTIVES To determine the prevalence and predictors of depression in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and compare them to those of other epilepsy types. METHODS A sample of 293 epilepsy patients, including 159 non-TLE-HS and 134 TLE-HS, were recruited from three hospitals. Of these, 215 completed a two-section electronic survey. The first section collected demographic and epilepsy data, while the second used the Arabic version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). RESULTS Of 215 patients, 104 (48%) had TLE-HS-38 with right TLE-HS (37%), 56 with left TLE-HS (54%), and 10 with bilateral TLE-HS (10%). The prevalence and severity of depression was assessed with an NDDI-E score of 15 or higher identified 35 patients (16%) with MDD. Valproic acid and lamotrigine were associated with higher NDDI-E scores. No such associations were found for levetiracetam or carbamazepine. Polytherapy in TLE-HS showed a significant correlation with daily poor concentration. CONCLUSION We explored the differences in depression prevalence between TLE-HS and other epilepsy types and concluded they are minimal but slightly higher in TLE-HS. Predictors of depression such as seizure frequency and disease duration influenced MDD prevalence in TLE-HS. Lamotrigine and valproate were linked to higher NDDI-E scores.
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Affiliation(s)
- Bandar N Aljafen
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Ruwa Alneseyan
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Taim Muayqil
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mashael O Alkhateeb
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Alfasial University, Riyadh, Saudi Arabia
| | - Mubarak M Aldosari
- Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Aya Alsermani
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Lujain Alnakhli
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Renad Althomali
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Razan Alnami
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Ruba Alqahtani
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Lama Ibrahim
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Fawzi Babtain
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Eskandrani A, Almusallam E, Alenizi A, Asiri S, Bamogaddam F, Alhameed M, Aldosari MM. Health related quality of life in a Saudi population of patients with epilepsy. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2023; 28:234-242. [PMID: 37844939 PMCID: PMC10827025 DOI: 10.17712/nsj.2023.4.20230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/08/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To assess the quality of life for epilepsy patients in Saudi Arabia. Epilepsy, one of the most prevalent chronic neurological conditions in the world, frequently results in a low quality of life. METHODS This cross-sectional study analyzed data between September 2020 and September 2021 from 102 adult patients with epilepsy in outpatient clinics department of Epilepsy Program at King Fahad Medical City compared it to 108 healthy controls during the same study period. Sociodemographics and clinical data were gathered using the Arabic version of the Rand 36-Item Short Form Survey (SF-36) questionnaire and the Quality of Life in Epilepsy Inventory (QOLIE-31). RESULTS Patients with epilepsy had lower SF-36 scores when compared to the control for role limitation due to physical health, role limitations due to emotional health, and general health. The QOLIE-31 revealed that gender was associated with energy/fatigue (p=0.028), medication effect (p=0.016), and social function (p=0.003); only social functioning showed a significant association (p=0.023) with employment. CONCLUSION Quality of life for patients with epilepsy was found to be significantly impacted in Saudi Arabia. Certain factors found in this study differentiate it from data that has already been released. This might be due to Arab differences in family support as well as cultural and religious beliefs.
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Affiliation(s)
- Alaa Eskandrani
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Eman Almusallam
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Asmaa Alenizi
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Safiyyah Asiri
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Fawziah Bamogaddam
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Majed Alhameed
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
| | - Mubarak M. Aldosari
- From Epilepsy Department, National Neuroscience Institution, King Fahd Medical City, Riyadh, Saudi Arabia. Riyadh, Kingdom of Saudi Arabia
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Patrikelis P, Messinis L, Kimiskidis V, Gatzonis S. Neuropsychology of epilepsy surgery and theory-based practice: an opinion review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:835-843. [PMID: 37793405 PMCID: PMC10550352 DOI: 10.1055/s-0043-1770349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/15/2023] [Indexed: 10/06/2023]
Abstract
The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.
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Affiliation(s)
- Panayiotis Patrikelis
- University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
- Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
| | - Lambros Messinis
- Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
- University Hospital of Patras, School of Medicine, Neuropsychology Section, Departments of Neurology and Psychiatry, Patras, Greece.
| | - Vasileios Kimiskidis
- Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, 1st Department of Neurology, Thessaloniki, Greece.
| | - Stylianos Gatzonis
- University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
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Asadi-Pooya AA, Farazdaghi M, Asadi-Pooya H, Fazelian K. Attention deficit hyperactivity disorder in patients with seizures: Functional seizures vs. epilepsy. J Clin Neurosci 2023; 115:20-23. [PMID: 37459827 DOI: 10.1016/j.jocn.2023.07.010] [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: 04/23/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND We investigated the rates of positive screening for attention deficit-hyperactivity disorder (ADHD) in adults with seizures [i.e., focal epilepsy vs. idiopathic generalized epilepsy (IGE) vs. functional seizures (FS)]. We hypothesized that the rates of positive screening for ADHD are different between these three groups of patients. METHODS This was a cross sectional study. Patients, 19 to 55 years of age, with a diagnosis of IGE, focal epilepsy or FS were investigated at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Shiraz, Iran, from September 2022 until January 2023 and during their follow-up visits. We used the validated Persian version of Adult ADHD Self-Report Scale (ASRS v1.1)15 to investigate and screen for ADHD in these patients. RESULTS Forty patients with focal epilepsy, 40 with IGE, and 40 with FS were included. Attention deficit-hyperactivity disorder (ADHD) screening was positive in 35% of patients with FS, in 30% of those with focal epilepsy (compared with FS, p = 0.633), and in 10% of patients with IGE (compared with FS, p = 0.007). CONCLUSION Adult patients with functional seizures and those with focal epilepsy are at a high risk of self-reporting experiences that could be characteristic of ADHD. Screening tools [e.g., Adult ADHD Self-Report Scale (ASRS v1.1)] are useful to help clinicians address seizure comorbidities such as ADHD. However, a clinical diagnosis of ADHD should be ascertained in a patient with positive screening.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Mohsen Farazdaghi
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hanieh Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khatereh Fazelian
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Yu H, Gao J, Chang RSK, Mak W, Thach TQ, Cheung RTF. Inhibitory dysfunction may cause prospective memory impairment in temporal lobe epilepsy (TLE) patients: an event-related potential study. Front Hum Neurosci 2023; 17:1006744. [PMID: 37565055 PMCID: PMC10410078 DOI: 10.3389/fnhum.2023.1006744] [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: 07/29/2022] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Prospective memory (PM) is the ability to remember future intentions, and PM function is closely related to independence in daily life, particularly in patients with temporal lobe epilepsy (TLE). As PM involves various cognitive components of attention, working memory, inhibition and other executive functions, this study investigated how TLE may affect PM components and the underlying neural mechanisms. Methods Sixty-four subjects were recruited, including 20 refractory TLE patients, 18 well-controlled TLE patients and 26 age-matched healthy controls. A set of neuropsychological tests was administered to assess specific brain functions. An event-related potential (ERP) task was used to further explore how PM and its components would be differentially affected in the two TLE types. Results Our findings revealed that: (1) refractory TLE patients scored lower than the healthy controls in the digit span, Verbal Fluency Test and Symbol Digit Modalities Test; (2) refractory TLE patients exhibited impaired PM performance and reduced prospective positivity amplitudes over the frontal, central and parietal regions in ERP experiments when compared to the healthy controls; and (3) decreased P3 amplitudes in the nogo trials were observed over the frontal-central sites in refractory but not in well-controlled TLE patients. Discussion To our knowledge, this is the first ERP study on PM that has specifically identified PM impairment in refractory but not in well-controlled TLE patients. Our finding of double dissociation in PM components suggests that inhibition dysfunction may be the main reason for PM deficit in refractory TLE patients. The present results have clinical implications for neuropsychological rehabilitation in TLE patients.
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Affiliation(s)
- Hemei Yu
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Junling Gao
- Centre of Buddhist Studies, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Windsor Mak
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Thuan-Quoc Thach
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Raymond Tak Fai Cheung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
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Shen Z, Pu S, Cao X, Tang M, Wang S, Bai D, Jiang G. Bioinformatics and network pharmacology analysis of drug targets and mechanisms related to the comorbidity of epilepsy and migraine. Epilepsy Res 2023; 189:107066. [PMID: 36571905 DOI: 10.1016/j.eplepsyres.2022.107066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/04/2022] [Accepted: 12/11/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The present study aimed to explore the mechanisms underlying the comorbidity of epilepsy and migraine, identify potential common targets for drug intervention, and provide insight into new avenues for disease prevention and treatment using an integrated bioinformatic and network pharmacology approach. METHODS Disease targets in epilepsy and migraine were screened using the DisGeNET database to identify intersecting gene targets. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEEG) enrichment analyses were then performed using the WebGestalt database. Furthermore, the STRING database was used to construct a protein-protein interaction (PPI) network, and Cytoscape software was used to analyze the protein molecular signals at the intersection of epilepsy and migraine. The Drugbank database was used to identify common targets for antiepileptic drugs in epilepsy and migraine to further analyze the disease-gene-target-drug interaction network. Finally, molecular docking simulations were performed to verify the hypothesis that migraine and epilepsy share common diseases and drug targets. RESULTS A total of 178 common targets for epilepsy and migraine were identified using the DisGeNET database, and the 24 genes most related to the diseases were screened using the Score_gda gene scoring system. GO enrichment analysis indicated that common targets were mainly enriched in biological processes and molecular functions, including membrane potential regulation, inorganic ion transmembrane transport, axonal signaling, and ion channel activity. KEGG pathway enrichment analysis indicated that the mechanism of action might be related to neuroactive ligand receptors, AGE-RAGE, cAMP, and VEGF signaling pathways. The PPI network construction and analysis results showed that the PPI grid had 23 central nodes and 24 connected edges, with an average node degree of 2.09 and an average clustering coefficient of 0.384. The 10 genes with potentially important roles in epilepsy and migraine were CACNA1A, KCNQ2, KCNA1, SCN1A, PRRT2, SCN8A, KCNQ3, SCN2A, GRIN2A, and GABRG2. Drugbank database results indicated that antiepileptic drugs, including lamotrigine, topiramate, valproic acid, carbamazepine, gabapentin, and perampanel, also had common targets with migraine. The three most important targets exhibited strong binding affinity with drugs in the molecular docking simulations. CONCLUSION Our systematic and comprehensive analyses of disease-gene-target-drug interaction networks identified several biological processes and molecular functions common to migraine and epilepsy, most of which were related to neuroactive ligand-receptor interactions. These data provide a new theoretical basis and reference for the clinical treatment of comorbid epilepsy and migraine and may aid in the development of novel pharmacological strategies.
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Affiliation(s)
- Ziyi Shen
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China
| | - Shengxiong Pu
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China
| | - Xing Cao
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China
| | - Ming Tang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China
| | - Shenglin Wang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China
| | - Dazhang Bai
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China.
| | - Guohui Jiang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College; Institute of Neurological Diseases, North Sichuan Medical College, Nanchong 637000, China.
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Chauvière L. Early cognitive comorbidities before disease onset: A common symptom towards prevention of related brain diseases? Heliyon 2022; 8:e12259. [PMID: 36590531 PMCID: PMC9800323 DOI: 10.1016/j.heliyon.2022.e12259] [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: 08/08/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Brain diseases are very heterogeneous; however they also display multiple common risk factors and comorbidities. With a paucity of disease-modifying therapies, prevention became a health priority. Towards prevention, one strategy is to focus on similar symptoms of brain diseases occurring before disease onset. Cognitive deficits are a promising candidate as they occur across brain diseases before disease onset. Based on recent research, this review highlights the similarity of brain diseases and discusses how early cognitive deficits can be exploited to tackle disease prevention. After briefly introducing common risk factors, I review common comorbidities across brain diseases, with a focus on cognitive deficits before disease onset, reporting both experimental and clinical findings. Next, I describe network abnormalities associated with early cognitive deficits and discuss how these abnormalities can be targeted to prevent disease onset. A scenario on brain disease etiology with the idea that early cognitive deficits may constitute a common symptom of brain diseases is proposed.
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Chen J, Ye H, Zhang J, Li A, Ni Y. Pathogenesis of seizures and epilepsy after stroke. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-021-00068-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
AbstractStroke is the most frequent cause of secondary epilepsy in the elderly. The incidence of cerebral stroke is increasing with the extension of life expectancy, and the prevalence of post-stroke epilepsy (PSE) is rising. There are various seizure types after stroke, and the occurrence of epilepsy is closely related to the type and location of stroke. Moreover, the clinical treatment of post-stroke epilepsy is difficult, which increases the risk of disability and death, and affects the prognosis and quality of life of patients. Now seizure and epilepsy after stroke is more and more get the attention of the medical profession, has been more and more researchers have devoted to seizures after stroke and PSE clinical and basic research, and hope to get a scientific and unified guideline, to give timely and effective treatment, but the exact pathophysiologic mechanism has not yet formed a unified conclusion. It has been found that ion channels, neurotransmitters, proliferation of glial cells, genetics and other factors are involved in the occurrence and development of PSE. In this review, we discuss the pathogenesis of early-onset epileptic seizures and late-onset epilepsy after stroke, in order to provide a basis for clinicians to understand the disease, and expect to provide ideas for future exploration.
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Bragatti JA. Forced Normalization Revisited: New Concepts About a Paradoxical Phenomenon. Front Integr Neurosci 2021; 15:736248. [PMID: 34512281 PMCID: PMC8429494 DOI: 10.3389/fnint.2021.736248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
The phenomenon of Forced Normalization (FN) was first described by Landolt in 1953, who described the disappearance of epileptiform discharges in the EEG of patients with epilepsy, concomitant with the development of psychotic symptoms. Later, Tellenbach coined the term “alternative psychosis” referring specifically to the alternation between clinical phenomena. Finally, in 1991, Wolf observed a degenerative process involved in the phenomenon, which he called “paradoxical normalization.” Initially, FN was explained through experimental models in animals and the demonstration of the kindling phenomenon, in its electrical and pharmacological subdivisions. At this stage of research on the epileptic phenomenon, repetitive electrical stimuli applied to susceptible regions of the brain (hippocampus and amygdala) were considered to explain the pathophysiological basis of temporal lobe epileptogenesis. Likewise, through pharmacological manipulation, especially of dopaminergic circuits, psychiatric comorbidities began to find their basic mechanisms. With the development of new imaging techniques (EEG/fMRI), studies in the area started to focus on the functional connectivity (FC) of different brain regions with specific neuronal networks, which govern emotions. Thus, a series of evidence was produced relating the occurrence of epileptic discharges in the limbic system and their consequent coactivation and deactivation of these resting-state networks. However, there are still many controversies regarding the basic mechanisms of network alterations related to emotional control, which will need to be studied with a more homogeneous methodology, in order to try to explain this interesting neuropsychiatric phenomenon with greater accuracy.
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Affiliation(s)
- José Augusto Bragatti
- Clinical Neurophysiology Unit, Service of Neurology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Lin CH, Lin WD, Chou IC, Lee IC, Hong SY. Is Preterm Birth a Risk Factor for Subsequent Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder in Children with Febrile Seizure?-A Retrospective Study. Life (Basel) 2021; 11:life11080854. [PMID: 34440598 PMCID: PMC8398685 DOI: 10.3390/life11080854] [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: 07/05/2021] [Revised: 08/07/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
Febrile seizure (FS) is the most prevalent childhood seizure; it is significantly related to subsequent epilepsy and has possible links to childhood neurodevelopmental disorders. Separately, premature births are believed to increase the risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Therefore, this study investigated whether preterm birth is a risk factor for subsequent epilepsy, ASD, and ADHD in children with FS. We retrospectively collected data for children aged < 5 years with FS from 1 January 2005, to 31 December 2013. We divided these children into two groups-the premature birth group and the full-term group-and compared their incidence rates of epilepsy, ASD and ADHD. The data of 426 patients with history of febrile convulsion were retrospectively collected. The premature birth group (FS+/preterm+) had 108 patients and the full-term group (FS+/preterm-) had 318 patients. The overall epilepsy risk in the FS+/preterm+ group was higher than in the FS+/preterm- group (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.14-5.58; p = 0.02). The overall risk of ADHD in the FS+/preterm+ group was higher than that in the FS+/preterm- group (OR, 6.41; 95% CI, 3.39-12.09; p = 0.0001). In addition, children with FS+/preterm+ had 16.9 times (95% CI, 4.79-59.7; p = 0.0001) higher odds of having ASD compared with those with FS+/preterm-. Preterm birth may be a risk factor for subsequent epilepsy, ASD and ADHD in children with FS.
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Affiliation(s)
- Chien-Heng Lin
- Division of Pediatrics Pulmonology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
- Department of Biomedical Imaging and Radiological Science, College of Medicine, China Medical University, Taichung 404327, Taiwan
| | - Wei-De Lin
- Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan;
| | - I-Ching Chou
- Division of Pediatrics Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
| | - Inn-Chi Lee
- Department of Pediatrics, Chung Shan Medical University Hospital and Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan;
| | - Syuan-Yu Hong
- Division of Pediatrics Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
- Department of Medicine, School of Medicine, China Medical University, Taichung 404328, Taiwan
- Institute of Biomedicine, School of Medicine, China Medical University, Taichung 404328, Taiwan
- Correspondence:
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12
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Idris Z, Zakaria Z, Halim SA, Razak SA, Ghani ARI, Abdullah JM. Disconnecting surgery at alveus and cornu ammonis of hippocampus, amygdala superficialis, and amygdala medial nuclei for epilepsy associated with attention deficit hyperactivity disorder. Childs Nerv Syst 2021; 37:1797-1802. [PMID: 32949261 DOI: 10.1007/s00381-020-04893-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
The neural basis for epilepsy and attention deficit hyperactivity disorder (ADHD) is currently incompletely known. We reported a young girl with both epilepsy and ADHD, who had a calcified lesion in the right basolateral amygdalo-hippocampal region extending to the ventral striatum. The child underwent disconnecting surgery and biopsy of the lesion. Fascinatingly, the child's behavior changed immediately after the surgery from inattentive and impulsive to nearly normal behavior experiencing no more breakthrough seizures since after 3 years of surgery. The Schaltenbrand Wahren Brain Atlas revealed alveus, cornu ammonis, amygdala superficialis, and medium as the disconnected region in this surgery.
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Affiliation(s)
- Zamzuri Idris
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia. .,Brain And Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia. .,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia.
| | - Zaitun Zakaria
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Brain And Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia
| | - Sanihah Abdul Halim
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia.,Neurology Unit, Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Salmi Abd Razak
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia.,Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Abdul Rahman Izaini Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Brain And Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Brain And Behaviour Cluster, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150, Kota Bharu, Kelantan, Malaysia
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13
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Banerjee S, Dong M, Lee MH, O'Hara N, Juhasz C, Asano E, Jeong JW. Deep Relational Reasoning for the Prediction of Language Impairment and Postoperative Seizure Outcome Using Preoperative DWI Connectome Data of Children With Focal Epilepsy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:793-804. [PMID: 33166251 PMCID: PMC8544001 DOI: 10.1109/tmi.2020.3036933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Prolonged seizures in children with focal epilepsy (FE) may impair language functions and often reoccur after surgical intervention. This study is aimed at developing a novel deep relational reasoning network to investigate whether conventional diffusion-weighted imaging connectome analysis can be improved when predicting expressive and receptive scores of preoperative language impairments and classifying postoperative seizure outcomes (seizure freedom or recurrence) in individual FE children. To deeply reason the dependencies of axonal connections that are sparsely distributed in the whole brain, this study proposes the "dilated CNN + RN", a dilated convolutional neural network (CNN) combined with a relation network (RN). The performance of the dilated CNN + RN was evaluated using whole brain connectome data from 51 FE children. It was found that when compared with other state-of-the-art algorithms, the dilated CNN + RN led to an average improvement of 90.2% and 97.3% in predicting expressive and receptive language scores, and 2.2% and 4% improvement in classifying seizure freedom and seizure recurrence, respectively. These improvements were independent of the prefixed connectome densities. Also, the dilated CNN + RN could provide an explainable artificial intelligence (AI) model by computing gradient-based regression/classification activation maps. This mapping analysis revealed left superior-medial frontal cortex, bilateral hippocampi, and cerebellum as crucial hubs, facilitating important connections that were most predictive of language function and seizure refractoriness after surgery.
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14
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Sair A, Şair YB, Saracoğlu İ, Sevincok L, Akyol A. The relation of major depression, OCD, personality disorders and affective temperaments with Temporal lobe epilepsy. Epilepsy Res 2021; 171:106565. [PMID: 33535159 DOI: 10.1016/j.eplepsyres.2021.106565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/22/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In patients with temporal lobe epilepsy (TLE), studies demonstrate frequent comorbidity with mood disorders, personality disorders (especially obsessive-compulsive disorder) and major depression, but there are conflicting findings. This study aimed to investigate psychiatric comorbidities and affective temperament among TLE patients and to explore the relationships between obsessive compulsive disorder, other personality disorders, major depression and affective temperament in order to clarify the mediator effect of TLE in these relationships. METHODS Thirty patients with TLE and 30 healthy volunteers were included. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), Hamilton Anxiety (HAM-A) scale, Hamilton Depression (HAM-D) scale, Beck Suicidal Ideation Scale (BSSI) and Yale Brown Obsession Compulsion Scale (YBOCS) were applied and evaluated by a psychiatrist. Additionally, all individuals completed The Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). RESULTS Patients with temporal lobe epilepsy had higher scores in TEMPS-A, HAM-A, HAM-D, YBOCS and BSSI. Major depression, obsessive compulsive disorder and dependent and antisocial personality disorders were prevalent in patients. With respect to affective temperaments, depressive, cyclothymic and anxious temperaments were associated with obsessive compulsive disorder comorbidity; whereas, depressive and anxious temperaments were found to be associated with major depression comorbidity in patients with TLE. Furthermore, cluster A and cluster C personality disorders were associated with affective temperaments in patients with TLE. Affective temperaments had no correlation with illness duration, seizure frequency, depression severity and suicidal thoughts, but obsessions and compulsions. Suicidal thoughts were associated with obsessions and compulsions. CONCLUSION Affective temperaments are core personality traits with biological background and they may provide a foundation for psychiatric disorders, especially mood disorders. Considering that TLE originates from abnormalities in brain circuitry, it may form a basis for psychiatric disorders. Therefore, psychiatric evaluation to determine comorbidities may be beneficial to increase the quality of life of patients with TLE.
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Affiliation(s)
- Ahmet Sair
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Yaşan Bilge Şair
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - İrem Saracoğlu
- Residant at Psychiatry Department, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Levent Sevincok
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Ali Akyol
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
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15
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Anderson DE, Madhavan D, Swaminathan A. Global brain network dynamics predict therapeutic responsiveness to cannabidiol treatment for refractory epilepsy. Brain Commun 2020; 2:fcaa140. [PMID: 33376981 PMCID: PMC7751013 DOI: 10.1093/braincomms/fcaa140] [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: 12/10/2019] [Revised: 06/29/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022] Open
Abstract
Refractory epilepsy is a chronic brain network disorder characterized by unresponsiveness to multiple (>2) anti-epileptic drugs. Cannabidiol, a non-psychotropic neuroactive substance, is an emerging anti-epileptic treatment that was recently approved by the US Food and Drug Administration for the treatment of refractory epilepsy, especially Lennox Gastaut syndrome and Dravet syndrome. Here, we evaluated associations between global brain network dynamics and related changes and responsiveness to cannabidiol therapy using a combination of electroencephalography phase coherence and graph theoretical analyses. Refractory epilepsy patients with Lennox Gastaut syndrome or Dravet syndrome underwent serial electroencephalography testing prior to and during cannabidiol treatment. Patients showing greater than 70% seizure frequency reduction were classified as treatment responders for the purposes of this study. We calculated inter-electrode electroencephalography phase coherence in delta (1–3 Hz), theta (4–7 Hz), alpha (8–12 Hz) and beta (13–30 Hz) frequency bands. Graph theoretical analysis of brain network dynamics was extracted from phase coherence to evaluate measures of network integration (i.e. characteristic path length, global efficiency and degree) and segregation (i.e. modularity and transitivity). We found that responders, relative to non-responders, showed increased network integration—as indexed by relatively higher global efficiency and lower degree—and increased network segregation—as indexed by relatively higher modularity—exclusively in the beta-frequency band. We also found that larger cannabidiol dosages were associated with increased network integration—as indexed by higher global efficiency with increasing dose—and increased network segregation—as indexed by lower transitivity with increasing dose—in the delta, theta and alpha frequency bands. In summary, we demonstrate novel effects of cannabidiol on brain network dynamics with important implications for the treatment of refractory epilepsy and, possibly, across broader research applications in the future.
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Affiliation(s)
- David E Anderson
- Department of Ophthalmology & Visual Sciences, University of Nebraska Medical Center, Omaha, NE 68198-5540, USA
| | - Deepak Madhavan
- Department of Pediatric Neurology, Boys Town National Research Hospital, Omaha, NE 68198-8440, USA
| | - Arun Swaminathan
- Department of Neurological Sciences, University of Nebraska Medical Center, Boys Town, NE 68010, USA
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16
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Singh AK, Singh SK, Nandi MK, Mishra G, Maurya A, Rai A, Rai GK, Awasthi R, Sharma B, Kulkarni GT. Berberine: A Plant-derived Alkaloid with Therapeutic Potential to Combat Alzheimer's disease. Cent Nerv Syst Agents Med Chem 2020; 19:154-170. [PMID: 31429696 DOI: 10.2174/1871524919666190820160053] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/29/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Berberine (a protoberberine isoquinoline alkaloid) has shown promising pharmacological activities, including analgesic, anti-inflammatory, anticancer, antidiabetic, anti-hyperlipidemic, cardioprotective, memory enhancement, antidepressant, antioxidant, anti-nociceptive, antimicrobial, anti- HIV and cholesterol-lowering effects. It is used in the treatment of the neurodegenerative disorder. It has strong evidence to serve as a potent phytoconstituent in the treatment of various neurodegenerative disorders such as AD. It limits the extracellular amyloid plaques and intracellular neurofibrillary tangles. It has also lipid-glucose lowering ability, hence can be used as a protective agent in atherosclerosis and AD. However, more detailed investigations along with safety assessment of berberine are warranted to clarify its role in limiting various risk factors and AD-related pathologies. This review highlights the pharmacological basis to control oxidative stress, neuroinflammation and protective effect of berberine in AD, which will benefit to the biological scientists in understanding and exploring the new vistas of berberine in combating Alzheimer's disease.
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Affiliation(s)
- Anurag K Singh
- Centre of Experimental Medicine & Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Santosh K Singh
- Centre of Experimental Medicine & Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India
| | - Manmath K Nandi
- Institute of Medical Sciences, Faculty of Ayurveda, Department of medicinal chemistry, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Gaurav Mishra
- Institute of Medical Sciences, Faculty of Ayurveda, Department of medicinal chemistry, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Anand Maurya
- Institute of Medical Sciences, Faculty of Ayurveda, Department of medicinal chemistry, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Arati Rai
- Hygia Institute of Pharmaceutical Education & Research, Lucknow-226020, Uttar Pradesh, India
| | - Gopal K Rai
- Department of Pharmaceutical Engineering & Technology, Indian Institute of Technology (Banaras Hindu University), Varanasi-221005, Uttar Pradesh, India
| | - Rajendra Awasthi
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
| | - Bhupesh Sharma
- Department of Pharmacology, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
| | - Giriraj T Kulkarni
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
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17
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Gonzalez LM, Wrennall JA. A neuropsychological model for the pre-surgical evaluation of children with focal-onset epilepsy: An integrated approach. Seizure 2020; 77:29-39. [DOI: 10.1016/j.seizure.2018.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/28/2018] [Accepted: 12/17/2018] [Indexed: 12/20/2022] Open
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18
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Nogueira MH, Pimentel da Silva LR, Vasques Moreira JC, de Rezende TJR, Zanão TA, de Campos BM, Yasuda CL, Cendes F. Major Depressive Disorder Associated With Reduced Cortical Thickness in Women With Temporal Lobe Epilepsy. Front Neurol 2020; 10:1398. [PMID: 32010051 PMCID: PMC6979005 DOI: 10.3389/fneur.2019.01398] [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: 06/23/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Major Depressive Disorder (MDD) is highly prevalent in patients with mesial temporal lobe epilepsy (MTLE), especially in women, carrying significant morbidity. This study aimed to investigate the cortical thickness (CT) abnormalities associated with MDD in women with MTLE and hippocampal atrophy (HA). Also, we investigated the impact of MDD upon the volumes of the hippocampus and amygdala in these patients. Methods: We included 50 women with MTLE and HA (20 left, LMTLE; 30 right, RMTLE), 41 healthy women in the control group, and 15 women with MDD without epilepsy. MTLE patients were subdivided into three groups: MTLE-without-MDD (23 MTLE patients without MDD), MTLE-mild-MDD (nine MTLE patients with mild symptoms of MDD), and MTLE-severe-MDD (18 MTLE patients with moderate to severe symptoms of MDD). The five groups were balanced for age (p = 0.56). All participants had high-resolution 3D T1-weighted images in a 3T scanner. We used FreeSurfer 6.0 for volumetry and CT parcellation. All participants were submitted to a clinical psychological evaluation through the Structured Clinical Interview for DSM-IV (SCID-IV) and completed the Beck Depression Inventory (BDI-II). Results: We identified a smaller ipsilateral amygdala volume (p = 0.04) in the MTLE-severe-MDD group when compared to the control group. Our results presented a reduced ipsilateral lateral orbitofrontal cortex (p = 0.02) in the MTLE-severe-MDD in comparison to the MTLE-mild-MDD group. We also identified a thinner ipsilateral fusiform gyrus (p < 0.01) in the MTLE-severe-MDD compared to both MTLE-without-MDD and control groups. A reduced CT of the contralateral superior frontal gyrus (p = 0.02) was observed in the MTLE-severe-MDD in comparison to the MTLE-mild-MDD group. Conclusions: The identification of areas with reduced CT and atrophy of the ipsilateral amygdala in women with MTLE and MDD suggest that the cortical thinning in the network of the paralimbic system is related to the co-occurrence and intensity of depressive symptoms in this group.
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Affiliation(s)
- Mateus Henrique Nogueira
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Luciana Ramalho Pimentel da Silva
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - José Carlos Vasques Moreira
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Thiago Junqueira Ribeiro de Rezende
- The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil.,Laboratory of Medical Physics, University of Campinas - UNICAMP, Campinas, Brazil
| | - Tamires Araújo Zanão
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
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19
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Normalization of EEG in depression after antidepressant treatment with sertraline? A preliminary report. J Affect Disord 2019; 259:67-72. [PMID: 31437703 DOI: 10.1016/j.jad.2019.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND MDD patients with abnormal EEG patterns seem more likely to be non-responsive to the antidepressants escitalopram and venlafaxine, but not sertraline, than patients without EEG abnormalities. This finding suggests that patients with both MDD and abnormal EEGs may differentially respond to antidepressant treatment. In the current study, we investigated whether depressed patients with an abnormal EEG show a normalization of the EEG related to antidepressant treatment and response and whether such effect is drug specific, and whether having had early life stress (ELS) increases the chance of abnormal activity. METHODS Baseline and week 8 EEGs and depression symptoms were extracted from a large multicenter study (iSPOT-D, n = 1008) where depressed patients were randomized to escitalopram, sertraline, or venlafaxine-XR treatment. We calculated Odds Ratios of EEG normalization and depression response in patients with an abnormal EEG at baseline, comparing sertraline versus other antidepressants. RESULTS Fifty seven patients with abnormal EEGs were included. EEGs did not normalize significantly more with sertraline compared to other antidepressants (OR = 1.9, p = .280). However, patients with a normalized EEG taking sertraline were 5.2 times more likely to respond than subjects taking other antidepressants (p = .019). ELS was not significantly related to abnormal activity. LIMITATIONS Neurophysiological recordings were limited in time (two times 2-minute EEGs) and statistical power (n = 57 abnormal EEGs). CONCLUSIONS Response rates in patients with normalized EEG taking sertraline were significantly larger than in subjects treated with escitalopram/venlafaxine. This adds to personalized medicine and suggests a possible drug repurposing for sertraline.
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20
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Bermeo-Ovalle A. Psychiatric comorbidities go untreated in patients with epilepsy: Ignorance or denial? Epilepsy Behav 2019; 98:306-308. [PMID: 30600177 DOI: 10.1016/j.yebeh.2018.11.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 11/21/2018] [Indexed: 01/16/2023]
Abstract
Psychiatric comorbidities are common in patients with epilepsy (PWE). Depression and anxiety are the most prevalent of these comorbidities and are associated with worse quality of life. Several screening tools are available to identify and follow up these conditions. However, time constrains in outpatient clinic visits and limited access to mental healthcare professionals discourage clinicians to use them. This paper discusses the advantage and limitations of screening tools and makes a compelling argument for neurologists to take an active role in the diagnosis and treatment of common psychiatric comorbidities in PWE. This article is part of the Special Issue "Obstacles of Treatment of Psychiatric Comorbidities in Epilepsy".
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Affiliation(s)
- Adriana Bermeo-Ovalle
- Rush University Medical Center, Department of Neurological Sciences, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America; Laboratory of Electroencephalography, 1725 West Harrison Street, Suite 885, Chicago, IL 60612, United States of America.
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21
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Calle‐López Y, Ladino LD, Benjumea‐Cuartas V, Castrillón‐Velilla DM, Téllez‐Zenteno JF, Wolf P. Forced normalization: A systematic review. Epilepsia 2019; 60:1610-1618. [DOI: 10.1111/epi.16276] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/07/2019] [Accepted: 06/09/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Yamile Calle‐López
- Epilepsy Program Pablo Tobón Uribe Hospital NeuroclinicaUniversity of Antioquia Medellín Colombia
| | - Lady Diana Ladino
- Epilepsy Program Pablo Tobón Uribe Hospital NeuroclinicaUniversity of Antioquia Medellín Colombia
| | | | | | | | - Peter Wolf
- Danish Epilepsy Centre Dianalund Denmark
- Postgraduate Program in Medical Sciences Santa Catarina Federal University Florianópolis Brazil
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22
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Bektaş G, Tekin U, Yıldız EP, Aydınlı N, Çalışkan M, Özmen M. Autism spectrum disorder and attention-deficit/hyperactivity disorder-related symptoms in benign childhood epilepsy with centrotemporal spikes: A prospective case-control study. Epilepsy Behav 2019; 95:61-64. [PMID: 31026784 DOI: 10.1016/j.yebeh.2019.03.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/24/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Benign childhood epilepsy with centrotemporal spikes (BECTS), one of the most common idiopathic epilepsy syndromes in children, has been associated with neuropsychological problems. PURPOSE The objective of this study was to investigate the frequency of symptoms related to comorbid neurodevelopmental disorders, the autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children with typical BECTS, and to identify corresponding risk factors. METHODS Children and adolescents with typical BECTS aged 6-16 years were included in the study period from January 1, 2017, to December 31, 2017. Children with atypical presentations of BECTS, other neurological disorders, and preexisting neuropsychiatric disorders were excluded. The ASD and ADHD were assessed by the Social Communication Questionnaire (SCQ) and the Turgay Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), respectively. Patients' scores were compared with those of healthy subjects. Correlation analyses were performed to evaluate the association between the age at seizure onset, the total number of seizures and the SCQ and T-DSM-IV-S scores. RESULTS Fifty-eight children with BECTS and 60 healthy children participated in the study. The total SCQ score, the SCQ reciprocal social interaction score, and the SCQ communication score significantly differed between children with BECTS and the control group (p = 0.001, p < 0.001, p = 0.001, respectively). The total ADHD score was significantly different between patients and controls (p < 0.001). A significant difference was observed between patients and controls in terms of the T-DSM-IV-S hyperactivity-impulsivity score and the T-DSM-IV-S inattention score (p = 0.012, p < 0.001, respectively). The age at seizure onset was significantly correlated with the total SCQ score (p = 0.03). The Spearman's correlation coefficient was 0.352 for the total SCQ score, indicating a positive association between the age at seizure onset and the total SCQ score. CONCLUSION Children with typical BECTS may have an increased risk of suffering from symptoms of ASD and ADHD. Children with late onset of seizures may be more likely to develop neuropsychological disturbances regarding ASD and ADHD.
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Affiliation(s)
- Gonca Bektaş
- Division of Pediatric Neurology, Department of Pediatrics, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
| | - Uğur Tekin
- Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Edibe Pembegül Yıldız
- Division of Pediatric Neurology, Department of Pediatrics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Nur Aydınlı
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Çalışkan
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Meral Özmen
- Department of Pediatric Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Abstract
INTRODUCTION Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients, but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis, and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy, and their psychometric properties are discussed but the NDDI-E is the most practical and cost-effective. Challenges in diagnosing depression in epilepsy are discussed including reasons for the atypical features of mood disorders in epilepsy. Psychological treatments and/or SSRIs are indicated, but the level of evidence is still low. Even if there is no reason to hypothesise that internationally accepted guidelines of treatment of depression outside epilepsy may not be valid, rigorous studies are needed in order to have proper outcome measures. Epilepsy centers should have well-defined care pathways for depression in order to provide access to mental health support when needed.
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Affiliation(s)
- Marco Mula
- a Institute of Medical and Biomedical Education , St George's University of London and The Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust , London , UK
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Clinical and electroencephalographic correlates of psychiatric features in children with frontal lobe epilepsy. Epilepsy Behav 2019; 92:283-289. [PMID: 30731294 DOI: 10.1016/j.yebeh.2019.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Frontal lobe epilepsy (FLE) is often associated with psychiatric features, although the factors predisposing to the concurrence of these conditions have yet to be determined, especially in younger children. We aimed at defining possible clinical and electroencephalography (EEG) features that may enhance the psychiatric risk in pediatric FLE. METHOD We performed a structured psychiatric assessment of 59 children with FLE, using both categorical and dimensional approaches, correlated psychopathology with epilepsy data, and cognitive development. RESULTS About 1/3 of patients with FLE displayed intellectual disability (ID), and more than 2/3 displayed psychiatric disorders, including depression, disruptive behaviors, anxiety, and bipolar/psychotic disorders. Psychiatric dimensions such as impulse control problems, attentional deficits, social problems, and aggressive behaviors were frequent features of FLE. Intellectual disability was associated with an earlier onset of psychiatric disorders and more frequent disruptive behavior disorders and aggressiveness. Long-standing epilepsy and bilateral or anterior frontal EEG abnormalities also increased the risk of psychopathology. Finally, right-hemisphere lesions were associated with disruptive behavior disorders, fast EEG rhythms with attention/memory problems, and phases of seizure remission with impulse control problems. CONCLUSIONS Clinical and EEG markers of increased psychopathological risk may help in defining consistent at-risk subgroups within FLE and improving early diagnosis, prognosis, and treatment. Categorical and dimensional approaches to psychiatric diagnosis may generate new research hypotheses and support the investigation of the complex pathophysiological bases shared by different neurodevelopmental disturbances.
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Imaging correlates of behavioral impairments: An experimental PET study in the rat pilocarpine epilepsy model. Neurobiol Dis 2018; 118:9-21. [DOI: 10.1016/j.nbd.2018.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/05/2018] [Accepted: 06/12/2018] [Indexed: 01/04/2023] Open
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Fitzgerald PJ, Watson BO. Gamma oscillations as a biomarker for major depression: an emerging topic. Transl Psychiatry 2018; 8:177. [PMID: 30181587 PMCID: PMC6123432 DOI: 10.1038/s41398-018-0239-y] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/05/2018] [Indexed: 01/16/2023] Open
Abstract
Identifying biomarkers for major depression is of high importance for improving diagnosis and treatment of this common and debilitating neuropsychiatric disorder, as the field seeks to move toward both personalized and more effective treatments. Here we focus on electroencephalography (EEG) or direct scalp voltage recordings as such a biomarker, with an emphasis on gamma and high gamma oscillations (or "rhythms"). In the last several decades, alpha and theta band rhythms have been found to provide information on depressive state as well as recovery, but the gamma band is less well characterized with respect to depression. We summarize some key findings on gamma rhythms (especially their amplitude) as a biomarker or endophenotype for major depression. These studies suggest: (1) under certain conditions gamma rhythms can distinguish subjects with major depression from healthy controls, (2) gamma may distinguish bipolar disorder from unipolar depression, (3) various pharmacological and non-pharmacological treatments that counteract depression also alter gamma, (4) animal models of depression-like behavior show gamma abnormalities, with changes in gamma associated with therapeutic recovery. The most informative approaches in the future may combine profiles of gamma band power across the brain to assess ratios of activity across regions. Overall we have good evidence to suggest that gamma rhythms may provide objective information on major depressive disease status, but we will need further work to better define the precise measures to follow.
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Affiliation(s)
- Paul J Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109-5720, USA
| | - Brendon O Watson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109-5720, USA.
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Chen C, Chen D, Xue H, Liu X, Zhang T, Tang S, Li W, Xu X. IDGenetics: a comprehensive database for genes and mutations of intellectual disability related disorders. Neurosci Lett 2018; 685:96-101. [PMID: 30144540 DOI: 10.1016/j.neulet.2018.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/22/2018] [Accepted: 08/21/2018] [Indexed: 11/19/2022]
Abstract
Intellectual disability (ID) is one of the most prevalent chronic developmental brain disorders or phenotype of syndromic ID, affecting nearly 1-2% of the general population worldwide. Over recent decades, tremendous effort and high-throughput platforms have been devised to explore the complex heterogeneity, numerous genes and variants have been associated with the ID, especially de novo mutations and copy number variants. An organized resource containing the increasing genetic data is imperative to assist ID research. In this study, the integrative and annotated intellectual disability database has been developed, named 'IDGenetics', which contains known information about ID, including 815 genes and 17102 variants associated with 918 clinical diseases (3001 clinical phenotype) collected from 3822 publications and ID-related databases. Furthermore, in-depth data mining was performed to obtain an understanding of each entry, including functional annotation, gene/disease/phenotype network establishment and overlap analysis focusing on comorbidity. 1478 candidate genes (483 high-confidence and 995 low-confidence) were collected and prioritized by adopting the annotations of 12 functional prediction tools and algorithm. In addition, IDGenetics database provides concise search methods, convenient browsing functions, intuitive graphical displays and constantly updated features. IDGenetics will be a valuable and integrative resource for deciphering the genetic and functional architecture of ID and the improvement of clinical diagnosis, intervention and treatment.
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Affiliation(s)
- Chong Chen
- Key Laboratory of Birth Defects, Department of Genetics, Wenzhou Central Hospital, Wenzhou, 325000, China
| | - Denghui Chen
- Key Laboratory of Medical Genetics, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325035, China
| | - Huangqi Xue
- Key Laboratory of Medical Genetics, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325035, China
| | - Xinting Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tao Zhang
- Institute of Genomic Medicine, Wenzhou Medical University, Wenzhou, 325035, China
| | - Shaohua Tang
- Key Laboratory of Birth Defects, Department of Genetics, Wenzhou Central Hospital, Wenzhou, 325000, China; Key Laboratory of Medical Genetics, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wei Li
- Key Laboratory of Medical Genetics, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Xueqin Xu
- Key Laboratory of Birth Defects, Department of Genetics, Wenzhou Central Hospital, Wenzhou, 325000, China.
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Paudel YN, Shaikh MF, Shah S, Kumari Y, Othman I. Role of inflammation in epilepsy and neurobehavioral comorbidities: Implication for therapy. Eur J Pharmacol 2018; 837:145-155. [PMID: 30125565 DOI: 10.1016/j.ejphar.2018.08.020] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 02/07/2023]
Abstract
Epilepsy is a devastating condition affecting around 70 million people worldwide. Moreover, the quality of life of people with epilepsy (PWE) is worsened by a series of comorbidities. The neurobehavioral comorbidities discussed herein share a reciprocal and complex relationship with epilepsy, which ultimately complicates the treatment process in PWE. Understanding the mechanistic pathway by which these comorbidities are associated with epilepsy might be instrumental in developing therapeutic interventions. Inflammatory cytokine signaling in the brain regulates important brain functions including neurotransmitter metabolism, neuroendocrine function, synaptic plasticity, dopaminergic transmission, the kynurenine pathway, and affects neurogenesis as well as the neural circuitry of moods. In this review, we hypothesize that the complex relationship between epilepsy and its related comorbidities (cognitive impairment, depression, anxiety, autism, and schizophrenia) can be unraveled through the inflammatory mechanism that plays a prominent role in all these individual conditions. An ample amount of evidence is available reporting the role of inflammation in epilepsy and all individual comorbid condition but their complex relationship with epilepsy has not yet been explored through the prospective of inflammatory pathway. Our review suggests that epilepsy and its neurobehavioral comorbidities are associated with elevated levels of several key inflammatory markers. This review also sheds light on the mechanistic association between epilepsy and its neurobehavioral comorbidities. Moreover, we analyzed several anti-inflammatory therapies available for epilepsy and its neurobehavioral comorbidities. We suggest, these anti-inflammatory therapies might be a possible intervention and could be a promising strategy for preventing epileptogenesis and its related neurobehavioral comorbidities.
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Affiliation(s)
- Yam Nath Paudel
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Mohd Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.
| | - Sadia Shah
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - Yatinesh Kumari
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Iekhsan Othman
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
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Godoy LD, Rossignoli MT, Delfino-Pereira P, Garcia-Cairasco N, de Lima Umeoka EH. A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications. Front Behav Neurosci 2018; 12:127. [PMID: 30034327 PMCID: PMC6043787 DOI: 10.3389/fnbeh.2018.00127] [Citation(s) in RCA: 334] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022] Open
Abstract
Stress is recognized as an important issue in basic and clinical neuroscience research, based upon the founding historical studies by Walter Canon and Hans Selye in the past century, when the concept of stress emerged in a biological and adaptive perspective. A lot of research after that period has expanded the knowledge in the stress field. Since then, it was discovered that the response to stressful stimuli is elaborated and triggered by the, now known, stress system, which integrates a wide diversity of brain structures that, collectively, are able to detect events and interpret them as real or potential threats. However, different types of stressors engage different brain networks, requiring a fine-tuned functional neuroanatomical processing. This integration of information from the stressor itself may result in a rapid activation of the Sympathetic-Adreno-Medullar (SAM) axis and the Hypothalamus-Pituitary-Adrenal (HPA) axis, the two major components involved in the stress response. The complexity of the stress response is not restricted to neuroanatomy or to SAM and HPA axes mediators, but also diverge according to timing and duration of stressor exposure, as well as its short- and/or long-term consequences. The identification of neuronal circuits of stress, as well as their interaction with mediator molecules over time is critical, not only for understanding the physiological stress responses, but also to understand their implications on mental health.
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Affiliation(s)
- Lívea Dornela Godoy
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Matheus Teixeira Rossignoli
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Polianna Delfino-Pereira
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Norberto Garcia-Cairasco
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Eduardo Henrique de Lima Umeoka
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
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30
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Asadi-Pooya AA. Yield of EEG monitoring in children with developmental disabilities is high. Epilepsy Behav 2018; 84:105-106. [PMID: 29758444 DOI: 10.1016/j.yebeh.2018.04.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/03/2018] [Accepted: 04/28/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE The purpose of this study was to investigate the yield of a 2-hour electroencephalography (EEG) monitoring (awake and sleep) in children with developmental disabilities and without any clinically apparent seizures. METHODS In this retrospective study, I investigated all children below 9 years of age who had developmental disabilities and were referred to Shiraz Comprehensive Epilepsy center for electroencephalographic investigation from June 2017 until January 2018. Exclusion criteria included any past history of neonatal seizures, febrile or afebrile seizures, and parental suspicion for seizures. We systematically obtained a brief clinical history and performed a 2-hour, awake and asleep EEG monitoring for all patients. RESULTS Thirty-two patients (23 males and 9 females) met all the inclusion and exclusion criteria; mean age (±standard deviation) was 4.1 (±2.1) years. Nineteen patients (59%) had an abnormal EEG: 15 patients (47%) had epileptiform discharges, and four children had abnormal background activity with no epileptiform discharges. CONCLUSION Considering the high diagnostic yield of an awake and asleep EEG monitoring, as it was observed in the current study, this test on a screening basis can be reasonably justified in all children with developmental disabilities.
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Affiliation(s)
- Ali A Asadi-Pooya
- Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
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Li Z, Song Y, Xiao G, Gao F, Xu S, Wang M, Zhang Y, Guo F, Liu J, Xia Y, Cai X. Bio-electrochemical microelectrode arrays for glutamate and electrophysiology detection in hippocampus of temporal lobe epileptic rats. Anal Biochem 2018; 550:123-131. [PMID: 29723519 DOI: 10.1016/j.ab.2018.04.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 04/21/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
Temporal Lobe Epilepsy (TLE) is a chronic neurological disorder, characterized by sudden, repeated and transient central nervous system dysfunction. For better understanding of TLE, bio-nanomodified microelectrode arrays (MEA) are designed, for the achievement of high-quality simultaneous detection of glutamate signals (Glu) and multi-channel electrophysiological signals including action potentials (spikes) and local field potentials (LFPs). The MEA was fabricated by Micro-Electro-Mechanical System fabrication technology and all recording sites were modified with platinum black nano-particles, the average impedance decreased by nearly 90 times. Additionally, glutamate oxidase was also modified for the detection of Glu. The average sensitivity of the electrode in Glu solution was 1.999 ± 0.032 × 10-2pA/μM·μm2(n = 3) and linearity was R = 0.9986, with a good selectivity of 97.82% for glutamate and effective blocking of other interferents. In the in-vivo experiments, the MEA was subjected in hippocampus to electrophysiology and Glu concentration detection. During seizures, the fire rate of spikes increases, and the interspike interval is concentrated within 30 ms. The amplitude of LFPs increases by 3 times and the power increases. The Glu level (4.22 μM, n = 4) was obviously higher than normal rats (2.24 μM, n = 4). The MEA probe provides an advanced tool for the detection of dual-mode signals in the research of neurological diseases.
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Affiliation(s)
- Ziyue Li
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Yilin Song
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Guihua Xiao
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Fei Gao
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Shengwei Xu
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Mixia Wang
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Yu Zhang
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China
| | - Fengru Guo
- University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jie Liu
- University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yang Xia
- University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xinxia Cai
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 10090, China.
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