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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: 6] [Impact Index Per Article: 6.0] [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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Su TY, Tang Y, Choi JY, Hu S, Sakaie K, Murakami H, Jones S, Blümcke I, Najm I, Ma D, Wang ZI. Evaluating whole-brain tissue-property changes in MRI-negative pharmacoresistant focal epilepsies using MR fingerprinting. Epilepsia 2023; 64:430-442. [PMID: 36507762 PMCID: PMC10107443 DOI: 10.1111/epi.17488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We aim to quantify whole-brain tissue-property changes in patients with magnetic resonance imaging (MRI)-negative pharmacoresistant focal epilepsy by three-dimensional (3D) magnetic resonance fingerprinting (MRF). METHODS We included 30 patients with pharmacoresistant focal epilepsy and negative MRI by official radiology report, as well as 40 age- and gender-matched healthy controls (HCs). MRF scans were obtained with 1 mm3 isotropic resolution. Quantitative T1 and T2 relaxometry maps were reconstructed from MRF and registered to the Montreal Neurological Institute (MNI) space. A two-sample t test was performed in Functional Magnetic Resonance Imaging of the Brain (FMRIB) Software Library (FSL) to evaluate significant abnormalities in patients comparing to HCs, with correction by the threshold-free cluster enhancement (TFCE) method. Subgroups analyses were performed for extra-temporal epilepsy/temporal epilepsy (ETLE/TLE), and for those with/without subtle abnormalities detected by morphometric analysis program (MAP), to investigate each subgroup's pattern of MRF changes. Correlation analyses were performed between the mean MRF values in each significant cluster and seizure-related clinical variables. RESULTS Compared to HCs, patients exhibited significant group-level T1 increase ipsilateral to the epileptic origin, in the mesial temporal gray matter (GM) and white matter (WM), temporal pole GM, orbitofrontal GM, hippocampus, and amygdala, with scattered clusters in the neocortical temporal and insular GM. No significant T2 changes were detected. The ETLE subgroup showed a T1-increase pattern similar to the overall cohort, with additional involvement of the ipsilateral anterior cingulate GM. The subgroup of MAP+ patients also showed a T1-increase pattern similar to the overall cohort, with additional cluster in the ipsilateral lateral orbitofrontal GM. Higher T1 was associated with younger seizure-onset age, longer epilepsy duration, and higher seizure frequency. SIGNIFICANCE MRF revealed group-level T1 increase in limbic/paralimbic structures ipsilateral to the epileptic origin, in patients with pharmacoresistant focal epilepsy and no apparent lesions on MRI, suggesting that these regions may be commonly affected by seizures in the epileptic brain. The significant association between T1 increase and higher seizure burden may reflect progressive tissue damage.
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Affiliation(s)
- Ting-Yu Su
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yingying Tang
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Joon Yul Choi
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Siyuan Hu
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ken Sakaie
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Stephen Jones
- Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ingmar Blümcke
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
- Neuropathology, University of Erlangen, Erlangen, Germany
| | - Imad Najm
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Dan Ma
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
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Berl M. Honoring Steven Schachter. Epilepsy Behav 2022; 137:108792. [PMID: 36463033 DOI: 10.1016/j.yebeh.2022.108792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Madison Berl
- Pediatric Neuropsychologist, Children's National Hospital, 111 Michigan Avenue, NW, Washington, DC 20010, United States.
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Wang F, Lai Y, Pan Y, Li H, Liu Q, Sun B. A systematic review of brain morphometry related to deep brain stimulation outcome in Parkinson's disease. NPJ Parkinsons Dis 2022; 8:130. [PMID: 36224189 PMCID: PMC9556527 DOI: 10.1038/s41531-022-00403-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
While the efficacy of deep brain stimulation (DBS) is well-established in Parkinson’s Disease (PD), the benefit of DBS varies across patients. Using imaging features for outcome prediction offers potential in improving effectiveness, whereas the value of presurgical brain morphometry, derived from the routinely used imaging modality in surgical planning, remains under-explored. This review provides a comprehensive investigation of links between DBS outcomes and brain morphometry features in PD. We systematically searched PubMed and Embase databases and retrieved 793 articles, of which 25 met inclusion criteria and were reviewed in detail. A majority of studies (24/25), including 1253 of 1316 patients, focused on the outcome of DBS targeting the subthalamic nucleus (STN), while five studies included 57 patients receiving globus pallidus internus (GPi) DBS. Accumulated evidence showed that the atrophy of motor cortex and thalamus were associated with poor motor improvement, other structures such as the lateral-occipital cortex and anterior cingulate were also reported to correlated with motor outcome. Regarding non-motor outcomes, decreased volume of the hippocampus was reported to correlate with poor cognitive outcomes. Structures such as the thalamus, nucleus accumbens, and nucleus of basalis of Meynert were also reported to correlate with cognitive functions. Caudal middle frontal cortex was reported to have an impact on postsurgical psychiatric changes. Collectively, the findings of this review emphasize the utility of brain morphometry in outcome prediction of DBS for PD. Future efforts are needed to validate the findings and demonstrate the feasibility of brain morphometry in larger cohorts.
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Affiliation(s)
- Fengting Wang
- grid.16821.3c0000 0004 0368 8293Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijie Lai
- grid.16821.3c0000 0004 0368 8293Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Pan
- grid.16821.3c0000 0004 0368 8293Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyang Li
- grid.16821.3c0000 0004 0368 8293Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qimin Liu
- grid.152326.10000 0001 2264 7217Department of Psychology and Human Development, Vanderbilt University, Nashville, USA
| | - Bomin Sun
- grid.16821.3c0000 0004 0368 8293Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Pulli EP, Silver E, Kumpulainen V, Copeland A, Merisaari H, Saunavaara J, Parkkola R, Lähdesmäki T, Saukko E, Nolvi S, Kataja EL, Korja R, Karlsson L, Karlsson H, Tuulari JJ. Feasibility of FreeSurfer Processing for T1-Weighted Brain Images of 5-Year-Olds: Semiautomated Protocol of FinnBrain Neuroimaging Lab. Front Neurosci 2022; 16:874062. [PMID: 35585923 PMCID: PMC9108497 DOI: 10.3389/fnins.2022.874062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 02/03/2023] Open
Abstract
Pediatric neuroimaging is a quickly developing field that still faces important methodological challenges. Pediatric images usually have more motion artifact than adult images. The artifact can cause visible errors in brain segmentation, and one way to address it is to manually edit the segmented images. Variability in editing and quality control protocols may complicate comparisons between studies. In this article, we describe in detail the semiautomated segmentation and quality control protocol of structural brain images that was used in FinnBrain Birth Cohort Study and relies on the well-established FreeSurfer v6.0 and ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium tools. The participants were typically developing 5-year-olds [n = 134, 5.34 (SD 0.06) years, 62 girls]. Following a dichotomous quality rating scale for inclusion and exclusion of images, we explored the quality on a region of interest level to exclude all regions with major segmentation errors. The effects of manual edits on cortical thickness values were relatively minor: less than 2% in all regions. Supplementary Material cover registration and additional edit options in FreeSurfer and comparison to the computational anatomy toolbox (CAT12). Overall, we conclude that despite minor imperfections FreeSurfer can be reliably used to segment cortical metrics from T1-weighted images of 5-year-old children with appropriate quality assessment in place. However, custom templates may be needed to optimize the results for the subcortical areas. Through visual assessment on a level of individual regions of interest, our semiautomated segmentation protocol is hopefully helpful for investigators working with similar data sets, and for ensuring high quality pediatric neuroimaging data.
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Affiliation(s)
- Elmo P. Pulli
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- *Correspondence: Elmo P. Pulli, ; orcid.org/0000-0003-3871-8563
| | - Eero Silver
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Venla Kumpulainen
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Anni Copeland
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Harri Merisaari
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Radiology, University of Turku, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Riikka Korja
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Jetro J. Tuulari
- Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Matuz-Budai T, Lábadi B, Kohn E, Matuz A, Zsidó AN, Inhóf O, Kállai J, Szolcsányi T, Perlaki G, Orsi G, Nagy SA, Janszky J, Darnai G. Individual differences in the experience of body ownership are related to cortical thickness. Sci Rep 2022; 12:808. [PMID: 35039541 PMCID: PMC8764083 DOI: 10.1038/s41598-021-04720-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2022] Open
Abstract
The widely used rubber hand illusion (RHI) paradigm provides insight into how the brain manages conflicting multisensory information regarding bodily self-consciousness. Previous functional neuroimaging studies have revealed that the feeling of body ownership is linked to activity in the premotor cortex, the intraparietal areas, the occipitotemporal cortex, and the insula. The current study investigated whether the individual differences in the sensation of body ownership over a rubber hand, as measured by subjective report and the proprioceptive drift, are associated with structural brain differences in terms of cortical thickness in 67 healthy young adults. We found that individual differences measured by the subjective report of body ownership are associated with the cortical thickness in the somatosensory regions, the temporo-parietal junction, the intraparietal areas, and the occipitotemporal cortex, while the proprioceptive drift is linked to the premotor area and the anterior cingulate cortex. These results are in line with functional neuroimaging studies indicating that these areas are indeed involved in processes such as cognitive-affective perspective taking, visual processing of the body, and the experience of body ownership and bodily awareness. Consequently, these individual differences in the sensation of body ownership are pronounced in both functional and structural differences.
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Affiliation(s)
- Timea Matuz-Budai
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary.
| | - Beatrix Lábadi
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - Eszter Kohn
- Institute of Philosophy and Art Theory, University of Pécs, Pécs, Hungary
| | - András Matuz
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - András Norbert Zsidó
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - Orsolya Inhóf
- Institute of Psychology, University of Pécs, 6 Ifjúság str., Pécs, 7624, Hungary
| | - János Kállai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Szolcsányi
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
| | - Gergely Orsi
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Szilvia Anett Nagy
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Darnai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- MTA-PTE, Clinical Neuroscience MR Research Group, Pécs, Hungary
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Hung A, Morningstar M, Mattson WI, Saygin ZM, Nelson EE. Atypical age-related changes in the structure of the mentalizing network in children with refractory focal epilepsy. Epilepsy Res 2021; 175:106701. [PMID: 34182239 DOI: 10.1016/j.eplepsyres.2021.106701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/11/2021] [Accepted: 06/21/2021] [Indexed: 11/24/2022]
Abstract
Refractory focal epilepsy (rFE) is commonly comorbid with impaired social functioning, which significantly reduces quality of life. Previous research has identified a mentalizing network in the brain-composed of the anterior temporal cortex, medial prefrontal cortex (mPFC), posterior temporal sulcus (pSTS), and temporoparietal junction-that is thought to play a critical role in social cognition. In typically-developing (TD) youth, this network undergoes a protracted developmental process with cortical thinning and white matter expansion occurring across adolescence. Because epilepsy is associated with both social dysfunction and irregular neural development, we investigated whether gray and white matter in the mentalizing network differed between youth with rFE (n = 22) and TD youth (n = 41) aged 8-21 years. Older age was associated with reduced cortical thickness in the bilateral mPFC in TD youth, but not in rFE youth. Compared to TD youth, rFE youth had greater white matter density in the right pSTS. Our findings suggest that rFE youth show atypical patterns of cortical thickness and white matter density in regions of the brain that are typically associated with social information processing, potentially as a result of ongoing seizures, comorbid conditions, or other illness-related factors. These results encourage future research to examine whether such variations in neural structure are predictive of specific social deficits in rFE youth.
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Affiliation(s)
- Andy Hung
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital. 431 South 18th Street, 3rd Floor, Columbus, OH, 43205, United States.
| | - Michele Morningstar
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital. 431 South 18th Street, 3rd Floor, Columbus, OH, 43205, United States; Department of Pediatrics, Ohio State University College of Medicine. 370 West 9th Avenue, Columbus, OH, 43210, United States; Department of Psychology, Queen's University. Humphrey Hall, 62 Arch Street, Kingston, OH, K7L 3N6, Canada.
| | - Whitney I Mattson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital. 431 South 18th Street, 3rd Floor, Columbus, OH, 43205, United States.
| | - Zeynep M Saygin
- Department of Psychology, Ohio State University College of Arts and Sciences. 225 Psychology Building, 1835 Neil Avenue, Columbus, OH, 43210, United States.
| | - Eric E Nelson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital. 431 South 18th Street, 3rd Floor, Columbus, OH, 43205, United States; Department of Pediatrics, Ohio State University College of Medicine. 370 West 9th Avenue, Columbus, OH, 43210, United States.
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Kenchaiah R, Satishchandra P, Bhargava Goutham K, Dawn BR, Sain J, Kulanthaivelu K, Mundlamuri RC, Asranna A, Sinha S. Cortical-Subcortical morphometric signature of hot water epilepsy patients. Epilepsy Res 2020; 167:106436. [PMID: 32846313 DOI: 10.1016/j.eplepsyres.2020.106436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/20/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cortical and subcortical grey matter (GM) morphometric changes have been demonstrated Temporal Lobe Epilepsy (TLE) or Idiopathic Generalized Epilepsies (IGE). Hot Water Epilepsy (HWE) has not hitherto been studied in these perspectives. PURPOSE To investigate the cortical and subcortical grey matter in subjects with HWE in terms of thickness, volume, and surface area using Surface-Based Morphometry (SBM). To assess relationships of SBM-derived metrics with clinical variables. MATERIALS AND METHODS Ninety-nine people with HWE and 50 age-matched healthy controls underwent high resolution volumetric MRI brain. These were processed with FreeSurfer to obtain SBM parameters i:e cortical thickness, cortical volume, and Cortical surface area. Volumes of seven subcortical GM structures (hippocampus, globus pallidus, nucleus ambiguous(NA), caudate nucleus, putamen, thalamus, and amygdala) were computed. Intergroup morphometric differences and their correlation with epilepsy-specific clinical variables were calculated. RESULTS SBM revealed a global reduction in bihemispheric cortical thickness and left hemispheric cortical volume. Besides, a regional difference in the morphometric measures was noted in temporo-limbic, parietal, pre-cuneus, and the cingulate region. Reduced volume of thalami and left caudate alongside an increased volume of the bilateral amygdala, bilateral nucleus ambiguous (NA), right caudate, and putamen was the other cardinal observation. CONCLUSION HWE subjects show alterations in the morphometry of the cortical ribbon and the subcortical grey matter. The temporal semiology, 'reflex nature' pathophysiology correlates involvement of temporo-limbic structures/somatosensory cortex, while the involvement of structures like pre-cuneus, posterior cingulate, and frontal regions are in agreement with functional networks related loss of awareness. That bilateral amygdala swelling occurs in HWE is a novel observation and may signal that it could be a distinct variant of Mesial TLE.
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Affiliation(s)
- Raghavendra Kenchaiah
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - P Satishchandra
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - K Bhargava Goutham
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India; Departments of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Bharath Rose Dawn
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Jitender Sain
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Karthik Kulanthaivelu
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | | | - Ajay Asranna
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Sanjib Sinha
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India.
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