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Wen S, Zhang H, Huang K, Wei X, Yang K, Wang Q, Feng L. Impaired orienting function detected through eye movements in patients with temporal lobe epilepsy. Front Neurosci 2023; 17:1290959. [PMID: 38188032 PMCID: PMC10770870 DOI: 10.3389/fnins.2023.1290959] [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: 09/08/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Objective Patients with temporal lobe epilepsy (TLE) often exhibit attention function impairment. The orienting network is the subsystem of the attention network that has not been fully studied. In this study, we used eye-tracking technology with an attention network test (ANT)-based task to assess the orienting function of TLE patients, aiming to characterize their eye movement patterns. Methods A total of 37 TLE patients and 29 healthy controls (HCs) completed the ANT task based on eye-tracking technology. Orienting function damage was mainly assessed by the ANT orienting effect. Eye movement metrics, such as mean first goal-directed saccade latency (MGSL), total saccades, and saccade amplitudes, were compared between groups. Results The TLE patients had a significantly lower ANT orienting effect (HC, 54.05 ± 34.05; TLE, 32.29 ± 39.54) and lower eye-tracking orienting effect (HC, 116.98 ± 56.59; TLE, 86.72 ± 59.10) than those of the HCs. The larger orienting effects indicate that orienting responses are faster when receiving a spatial cue compared with a center cue. In the spatial cue condition, compared with HCs, the TLE group showed a longer first goal-directed saccade latency (HC, 76.77 ± 58.87 ms; TLE, 115.14 ± 59.15 ms), more total saccades (HC, 28.46 ± 12.30; TLE, 36.69 ± 15.13), and larger saccade amplitudes (HC, 0.75° ± 0.60°; TLE, 1.36° ± 0.89°). Furthermore, there was a positive correlation of the orienting-effect score between the ANT task and eye-tracking metrics (r = 0.58, p < 0.05). Conclusion We innovatively developed a new detection method using eye-tracking technology in combination with an ANT-based task to detect the orienting function in TLE patients. The current research demonstrated that TLE patients had a significant orienting dysfunction with a specific saccade pattern characterized by a longer first goal-directed saccade latency, more total saccades, and larger saccade amplitudes. These oculomotor metrics are likely to be a better indicator of orienting function and may potentially be used for behavioral-based interventions and long-term cognition monitoring in TLE patients.
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Affiliation(s)
- Shirui Wen
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huangyemin Zhang
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
- University of Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaojie Wei
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
- University of Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
| | - Ke Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Quan Wang
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
- Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of Chinese Academy of Sciences, Xi'an, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Orhan Varoglu A, Avarisli A, Keskin H, Garipbas N. Comparing neuropsychological functioning in Turkish patients with right and left temporal lobe epilepsy. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38015648 DOI: 10.1080/23279095.2023.2286504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
We compared neuropsychiatric evaluations in temporal lobe epilepsy according to the lateralized hemisphere. Forty-one (68.3%) left-sided temporal lobe epilepsy (LTLE) were compared to 19 right-sided temporal lobe epilepsy (RTLE) (31.7%) (p < 0.001). RTLE mean age was 37 (22-46) years, and LTLE mean age 38 was (30-42). RTLE disease duration was 10 (6-20) years, and LTLE was 22 (10-33) (p < 0.013). Gender (man/woman) for RTLE was 7/12, and for LTLE was 18/23. LTLE scored poorer on the Wechsler Memory Scale (WMS)-III's Mental Control Months-error, WMS-V's "Forward Number Range" and "Backward Number Range" than RTLE (p < 0.017, p < 0.023, p < 0.004). There were differences between hemispheres for "Number of Items Remembered with a Hint" and "Total number of Recalled Items" (WMS-IV) (p < 0.038, p < 0.045). LTLE had lower scores in the Verbal Fluency -K-A-S letters words and WAIS (Wechsler Adult Intelligence Scale) similarity than RTLE (p < 0.019, p < 0.024, p < 0.033, p < 0.026). Oktem and Boston-number of Self-Named Items Tests were poorer in LTLE than RTLE (p < 0.05, p < 0.043). Mental Control Months-error (WMS-III), "Total Number of Recalled Items", "Number of Items Remembered with Hint" (WMS-IV), forward and backward number range (WMS-V), Oktem, Verbal Fluency -K,-A,-S letters words, WAIS similarity, and Boston-number of Self-Named Items tests, can help identify lateralization, particularly in LTLE.
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Affiliation(s)
- Asuman Orhan Varoglu
- Department of Neurology, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
| | - Aysenur Avarisli
- Department of Neurology, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
| | - Havva Keskin
- Department of Internal Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul,Turkey
| | - Nilay Garipbas
- Department of Psychiatry, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
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Pellinen J, Pardoe H, Sillau S, Barnard S, French J, Knowlton R, Lowenstein D, Cascino GD, Glynn S, Jackson G, Szaflarski J, Morrison C, Meador KJ, Kuzniecky R. Later onset focal epilepsy with roots in childhood: Evidence from early learning difficulty and brain volumes in the Human Epilepsy Project. Epilepsia 2023; 64:2761-2770. [PMID: 37517050 DOI: 10.1111/epi.17727] [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: 06/15/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Visual assessment of magnetic resonance imaging (MRI) from the Human Epilepsy Project 1 (HEP1) found 18% of participants had atrophic brain changes relative to age without known etiology. Here, we identify the underlying factors related to brain volume differences in people with focal epilepsy enrolled in HEP1. METHODS Enrollment data for participants with complete records and brain MRIs were analyzed, including 391 participants aged 12-60 years. HEP1 excluded developmental or cognitive delay with intelligence quotient <70, and participants reported any formal learning disability diagnoses, repeated grades, and remediation. Prediagnostic seizures were quantified by semiology, frequency, and duration. T1-weighted brain MRIs were analyzed using Sequence Adaptive Multimodal Segmentation (FreeSurfer v7.2), from which a brain tissue volume to intracranial volume ratio was derived and compared to clinically relevant participant characteristics. RESULTS Brain tissue volume changes observable on visual analyses were quantified, and a brain tissue volume to intracranial volume ratio was derived to compare with clinically relevant variables. Learning difficulties were associated with decreased brain tissue volume to intracranial volume, with a ratio reduction of .005 for each learning difficulty reported (95% confidence interval [CI] = -.007 to -.002, p = .0003). Each 10-year increase in age at MRI was associated with a ratio reduction of .006 (95% CI = -.007 to -.005, p < .0001). For male participants, the ratio was .011 less than for female participants (95% CI = -.014 to -.007, p < .0001). There were no effects from seizures, employment, education, seizure semiology, or temporal lobe electroencephalographic abnormalities. SIGNIFICANCE This study shows lower brain tissue volume to intracranial volume in people with newly treated focal epilepsy and learning difficulties, suggesting developmental factors are an important marker of brain pathology related to neuroanatomical changes in focal epilepsy. Like the general population, there were also independent associations between brain volume, age, and sex in the study population.
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Affiliation(s)
- Jacob Pellinen
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Heath Pardoe
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Stefan Sillau
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Jacqueline French
- New York University Comprehensive Epilepsy Center, New York, New York, USA
| | - Robert Knowlton
- University of California, San Francisco, San Francisco, California, USA
| | - Daniel Lowenstein
- University of California, San Francisco, San Francisco, California, USA
| | | | - Simon Glynn
- University of Michigan, Ann Arbor, Michigan, USA
| | - Graeme Jackson
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | | | - Chris Morrison
- New York University Comprehensive Epilepsy Center, New York, New York, USA
| | - Kimford J Meador
- Stanford University Neuroscience Health Center, Palo Alto, California, USA
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