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Zhao Y, Lin J, Qi X, Cao D, Zhu F, Chen L, Tan Z, Mo T, Zeng H. To explore the potential mechanisms of cognitive impairment in children with MRI-negative pharmacoresistant epilepsy due to focal cortical dysplasia: A pilot study from gray matter structure view. Heliyon 2024; 10:e26609. [PMID: 38404806 PMCID: PMC10884915 DOI: 10.1016/j.heliyon.2024.e26609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 01/22/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024] Open
Abstract
Objectives To investigate the characteristics of brain structure in children with focal cortical dysplasia (FCD)-induced pharmacoresistant epilepsy, and explore the potential mechanisms of cognitive impairment from the view of gray matter alteration. Methods 25 pharmacoresistant pediatric patients with pathologically confirmed focal cortical dysplasia (FCD), and 25 gender-matched healthy controls were included in this study. 3.0T MRI data and intelligence tests using the Wechsler Intelligence Scale for Children-Forth Edition (WISC-IV) were generated for all subjects. Voxel-based morphometry (VBM)-diffeomorphic anatomical registration through exponentiated lie algebra (DARTEL) and surface-based morphometry (SBM) analyses were performed to analyze gray matter volume and cortical structure. Two-sample t-tests were used to compare the differences in gray matter volume (P<0.05, FWE) and cortical thickness (P<0.001, FWE) between the two groups. Also, the Spearman rank correlation analyses were employed to determine the relationship between structural alterations and neuropsychological results. Results The WISC-IV scores of the FCD group were significantly lower than those of the HC group in terms of full-scale intelligence quotient (FSIQ), verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI) (all P<0.01). Compared with the HC group, in the FCD group, the gray matter volume (GMV) reduced significantly in the left cerebellum_8, cerebellum_Crus2, and bilateral thalamus (P<0.05, FWE); the GMV increased in the bilateral medial frontal gyrus, right precuneus, and left inferior temporal gyrus (P<0.05, FWE), and the cortical thickness increased in the bilateral frontal, parietal, and temporal areas (P<0.001, FWE). Correlation analyses showed that the age of seizure onset had positive correlations with the WISC-IV scores significantly. Meanwhile, the cortex thicknesses of the left pars opercularis gyrus, left middle temporal gyrus, and right inferior temporal gyrus had negative correlations with the WISC-IV scores significantly. Conclusion FCD patients showed subtle structural abnormalities in multiple brain regions, with significant involvement of the primary visual cortex and language function cortex. And we also demonstrated a crucial correlation between gray matter structural alteration and cognitive impairment.
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Affiliation(s)
- Yilin Zhao
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China
| | - Jieqiong Lin
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Xinxin Qi
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
- China Medical University, Shenyang, China
| | - Dezhi Cao
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Fengjun Zhu
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Li Chen
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Zeshi Tan
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Tong Mo
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Hongwu Zeng
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
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Wang K, Xie F, Liu C, Wang G, Zhang M, He J, Tan L, Tang H, Chen F, Xiao B, Song Y, Long L. Shared functional network abnormality in patients with temporal lobe epilepsy and their siblings. CNS Neurosci Ther 2023; 29:1109-1119. [PMID: 36647843 PMCID: PMC10018100 DOI: 10.1111/cns.14087] [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: 07/21/2022] [Revised: 12/07/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023] Open
Abstract
AIM Temporal lobe epilepsy is a neurological network disease in which genetics played a greater role than previously appreciated. This study aimed to explore shared functional network abnormalities in patients with sporadic temporal lobe epilepsy and their unaffected siblings. METHODS Fifty-eight patients with sporadic temporal lobe epilepsy, 13 unaffected siblings, and 30 healthy controls participated in this cross-sectional study. We examined the task-based whole-brain functional network topology and the effective functional connectivity between networks identified by group-independent component analysis. RESULTS We observed increased global efficiency, decreased clustering coefficiency, and decreased small-worldness in patients and siblings (p < 0.05, false discovery rate-corrected). The effective network connectivity from the ventral attention network to the limbic system was impaired (p < 0.001, false discovery rate-corrected). These features had higher prevalence in unaffected siblings than in normal population and was not correlated with disease burden. In addition, topological abnormalities had a high intraclass correlation between patients and their siblings. CONCLUSION Patients with temporal lobe epilepsy and their unaffected siblings showed shared topological functional disturbance and the effective functional network connectivity impairment. These abnormalities may contribute to the pathogenesis that promotes the susceptibility of seizures and language decline in temporal lobe epilepsy.
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Affiliation(s)
- Kangrun Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Epileptic disease of Hunan Province, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fangfang Xie
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Chaorong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ge Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Min Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jialinzi He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Langzi Tan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Haiyun Tang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Fenghua Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Epileptic disease of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yanmin Song
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Epileptic disease of Hunan Province, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Potemkina EG, Salomatina TA, Andreev EV, Abramov KB, Bannikova VD, Dengina NO, Nezdorovina VG, Zabrodskaya YM, Samochernykh KA, Odintsova GV. [MR morphometry in epileptology: progress and perspectives]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2023; 87:113-119. [PMID: 37325834 DOI: 10.17116/neiro202387031113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Morphometric MRI analysis improves neuroimaging of structural changes in epilepsy. OBJECTIVE To investigate diagnostic potential of MR brain morphometry in neurosurgical epileptology. MATERIAL AND METHODS An interdisciplinary working group reviewed the studies devoted to MR morphometry in epileptology as a part of state assignment No. 056-00119-22-00. Study subject was trials of MR-morphometry in epilepsy. Searching for literature data was conducted in international and national databases between 2017 and 2022 using certain keywords. Final analysis included 36 publications. RESULTS Currently, MR brain morphometry allows measurement of cortical volume and thickness, surface area and depth of furrows, as well as analysis of cortical tortuosity and fractal changes. In neurosurgical epileptology, MR-morphometry has the greatest diagnostic value in MR-negative epilepsy. This method simplifies preoperative diagnosis and reduces costs. CONCLUSION Morphometry in neurosurgical epileptology is an additional method for verifying the epileptogenic zone. Automated programs simplify application of this method.
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Affiliation(s)
- E G Potemkina
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - T A Salomatina
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - E V Andreev
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - K B Abramov
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - V D Bannikova
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - N O Dengina
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - V G Nezdorovina
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - Yu M Zabrodskaya
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - K A Samochernykh
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
| | - G V Odintsova
- Almazov National Medical Research Centre, Polenov Neurosurgery Research Institute, St. Petersburg, Russia
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Brain Diffusion Weighted Imaging Study of Mongolian Idiopathic Epilepsy. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6978116. [PMID: 36478789 PMCID: PMC9722273 DOI: 10.1155/2022/6978116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
Objective To evaluate the effectiveness of diffusion-weighted imaging in the assessment of idiopathic epilepsy in Mongolian. Methods One hundred Mongolian idiopathic epilepsy patients were enrolled as the observation group and 100 healthy Mongolian volunteers as the control group. All the subjects underwent routine MRI, diffusion kurtosis imaging (DKI), and intra-voxel incoherent motion (IVIM) examination on a 3.0 T scanner. Mean kurtosis (MK), mean diffusivity (MD), fractional anisotropy (FA), true water molecular diffusion coefficient (D), mean diffusion coefficient (MD), pseudo-diffusion coefficient (D∗), and perfusion fraction (f) of each region of interest in the brain were measured. Count data were expressed as rates, and the chi-square test was performed for comparison between groups. Measurement data were first assessed by a normality test, and the t test for independent samples was performed for comparison between groups if they met the normal distribution; for non-normal distribution, the Mann-Whitney U test was performed for comparison between groups. A ROC curve analysis was performed to test the effectiveness of each parameter. Results MK values of the hippocampus, thalamus, and white matter of the temporal lobe in the observation group were significantly higher than those in the control group, while D and F values were significantly lower (all P < 0.05). ROC curve analysis showed that MK, D, and F values of the hippocampus, thalamus, and white matter of the temporal lobe had moderate to good diagnostic efficacy for idiopathic epilepsy (AUC = 0.617-0.749, all P < 0.001). Conclusion DKI and IVIM can more accurately represent the abnormal changes of brain tissue in patients with epilepsy, and it may have important implications for the clinical diagnosis of Mongolian epileptic patients.
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Wang G, Wu W, Xu Y, Yang Z, Xiao B, Long L. Imaging Genetics in Epilepsy: Current Knowledge and New Perspectives. Front Mol Neurosci 2022; 15:891621. [PMID: 35706428 PMCID: PMC9189397 DOI: 10.3389/fnmol.2022.891621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/06/2022] [Indexed: 12/11/2022] Open
Abstract
Epilepsy is a neurological network disease with genetics playing a much greater role than was previously appreciated. Unfortunately, the relationship between genetic basis and imaging phenotype is by no means simple. Imaging genetics integrates multidimensional datasets within a unified framework, providing a unique opportunity to pursue a global vision for epilepsy. This review delineates the current knowledge of underlying genetic mechanisms for brain networks in different epilepsy syndromes, particularly from a neural developmental perspective. Further, endophenotypes and their potential value are discussed. Finally, we highlight current challenges and provide perspectives for the future development of imaging genetics in epilepsy.
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Affiliation(s)
- Ge Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yuchen Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhuanyi Yang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
- *Correspondence: Lili Long
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Microstructural features of the cerebral cortex: Implications for predicting epilepsy relapse after drug withdrawal. Brain Res 2020; 1751:147200. [PMID: 33166509 DOI: 10.1016/j.brainres.2020.147200] [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: 08/02/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023]
Abstract
A considerable portion of patients with well-controlled seizures and visually normal brain structures experience seizure recurrence after anti-seizure medication is withdrawn. Microstructural abnormalities of the cortex may play an essential role in epilepsy relapse. Patients with idiopathic/cryptogenic epilepsy were registered. At the follow-up endpoint, 18 patients with relapse (PR+ group), 20 patients without relapse (PR- group), and 30 healthy controls were included. High-resolution T1-weighted images were obtained at the time of drug withdrawal. Microstructural features including cortical thickness, surface area, cortical volume and mean curvature in 68 cortical areas were calculated. A general linear model was applied to investigate intergroup differences, and then post hoc analysis was performed. Additionally, factor analysis was conducted to extract components from imaging measures showing a difference between PR- and PR+ groups, and independent associations between components and epilepsy relapse were assessed using a logistic regression model. Cortical thickness of the left paracentral lobule, left temporal pole and right superior frontal gyrus; surface area of the bilateral lingual gyrus and bilateral pericalcarine cortex; and cortical volume of the bilateral pericalcarine cortex had significant intergroup differences (false discovery rate correction, P < 0.05). All measures, except for cortical thickness of the left temporal pole, showed differences between PR- and PR+ groups. Two dominant components were extracted from these measures, and both were independently associated with epilepsy relapse. In conclusion, epilepsy patients with relapse presented distinct microstructural features of cortex at the time of drug withdrawal, which may serve as a potential biomarker for predicting seizure recurrence.
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Caciagli L, Wandschneider B, Centeno M, Vollmar C, Vos SB, Trimmel K, Long L, Xiao F, Lowe AJ, Sidhu MK, Thompson PJ, Winston GP, Duncan JS, Koepp MJ. Motor hyperactivation during cognitive tasks: An endophenotype of juvenile myoclonic epilepsy. Epilepsia 2020; 61:1438-1452. [PMID: 32584424 PMCID: PMC7681252 DOI: 10.1111/epi.16575] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/17/2020] [Accepted: 05/17/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Juvenile myoclonic epilepsy (JME) is the most common genetic generalized epilepsy syndrome. Myoclonus may relate to motor system hyperexcitability and can be provoked by cognitive activities. To aid genetic mapping in complex neuropsychiatric disorders, recent research has utilized imaging intermediate phenotypes (endophenotypes). Here, we aimed to (a) characterize activation profiles of the motor system during different cognitive tasks in patients with JME and their unaffected siblings, and (b) validate those as endophenotypes of JME. METHODS This prospective cross-sectional investigation included 32 patients with JME, 12 unaffected siblings, and 26 controls, comparable for age, sex, handedness, language laterality, neuropsychological performance, and anxiety and depression scores. We investigated patterns of motor system activation during episodic memory encoding and verb generation functional magnetic resonance imaging (fMRI) tasks. RESULTS During both tasks, patients and unaffected siblings showed increased activation of motor system areas compared to controls. Effects were more prominent during memory encoding, which entailed hand motion via joystick responses. Subgroup analyses identified stronger activation of the motor cortex in JME patients with ongoing seizures compared to seizure-free patients. Receiver-operating characteristic curves, based on measures of motor activation, accurately discriminated both patients with JME and their siblings from healthy controls (area under the curve: 0.75 and 0.77, for JME and a combined patient-sibling group against controls, respectively; P < .005). SIGNIFICANCE Motor system hyperactivation represents a cognitive, domain-independent endophenotype of JME. We propose measures of motor system activation as quantitative traits for future genetic imaging studies in this syndrome.
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Affiliation(s)
- Lorenzo Caciagli
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
| | - Britta Wandschneider
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
| | - Maria Centeno
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Epilepsy UnitHospital Clínic de BarcelonaBarcelonaSpain
| | - Christian Vollmar
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Department of NeurologyLudwig‐Maximilians‐UniversitätMunichGermany
| | - Sjoerd B. Vos
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Centre for Medical Image ComputingUniversity College LondonLondonUK
- Neuroradiological Academic UnitUCL Queen Square Institute of NeurologyLondonUK
| | - Karin Trimmel
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Department of NeurologyMedical University of ViennaViennaAustria
| | - Lili Long
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Department of NeurologyXiangya Hospital of Central South UniversityChangshaChina
| | - Fenglai Xiao
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduChina
| | - Alexander J. Lowe
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
| | - Meneka K. Sidhu
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
| | - Pamela J. Thompson
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
| | - Gavin P. Winston
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
- Department of NeurologyQueen's UniversityKingstonONCanada
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
| | - Matthias J. Koepp
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyChalfont St PeterBuckinghamshireUK
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Yaakub SN, Tangwiriyasakul C, Abela E, Koutroumanidis M, Elwes RDC, Barker GJ, Richardson MP. Heritability of alpha and sensorimotor network changes in temporal lobe epilepsy. Ann Clin Transl Neurol 2020; 7:667-676. [PMID: 32333640 PMCID: PMC7261746 DOI: 10.1002/acn3.51032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Electroencephalography (EEG) features in the alpha band have been shown to differ between people with epilepsy and healthy controls. Here, in a group of patients with mesial temporal lobe epilepsy (mTLE), we seek to confirm these EEG features, and using simultaneous functional magnetic resonance imaging, we investigate whether brain networks related to the alpha rhythm differ between patients and healthy controls. Additionally, we investigate whether alpha abnormalities are found as an inherited endophenotype in asymptomatic relatives. METHODS We acquired scalp EEG and simultaneous EEG and functional magnetic resonance imaging in 24 unrelated patients with unilateral mTLE, 23 asymptomatic first-degree relatives of patients with mTLE, and 32 healthy controls. We compared peak alpha power and frequency from electroencephalographic data in patients and relatives to healthy controls. We identified brain networks associated with alpha oscillations and compared these networks in patients and relatives to healthy controls. RESULTS Patients had significantly reduced peak alpha frequency (PAF) across all parietal and occipital electrodes. Asymptomatic relatives also had significantly reduced PAF over 14 of 17 parietal and occipital electrodes. Both patients and asymptomatic relatives showed a combination of increased activation and a failure of deactivation in relation to alpha oscillations compared to healthy controls in the sensorimotor network. INTERPRETATION Genetic factors may contribute to the shift in PAF and alterations in brain networks related to alpha oscillations. These may not entirely be a consequence of anti-epileptic drugs, seizures or hippocampal sclerosis and deserve further investigation as mechanistic contributors to mTLE.
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Affiliation(s)
- Siti N Yaakub
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK.,School of Biomedical Engineering & Imaging Sciences, King's College London & Guy's and St Thomas' PET Centre, King's College London, London, UK
| | - Chayanin Tangwiriyasakul
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Eugenio Abela
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK.,Department of Clinical Neurophysiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Michalis Koutroumanidis
- Department of Clinical Neurophysiology and Epilepsies, Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, London, UK
| | - Robert D C Elwes
- Department of Clinical Neurophysiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark P Richardson
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK.,Department of Clinical Neurophysiology, King's College Hospital NHS Foundation Trust, London, UK
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Long L, Galovic M, Chen Y, Postma T, Vos SB, Xiao F, Wu W, Song Y, Huang S, Koepp M, Xiao B. Shared hippocampal abnormalities in sporadic temporal lobe epilepsy patients and their siblings. Epilepsia 2020; 61:735-746. [PMID: 32196657 DOI: 10.1111/epi.16477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the shared familial contribution to hippocampal and extrahippocampal morphological abnormalities in patients with sporadic temporal lobe epilepsy (TLE) and their unaffected siblings. METHODS We collected clinical, electrophysiological, and T1-weighted magnetic resonance imaging (MRI) data of 18 sporadic patients with TLE without lesions other than hippocampal sclerosis (12 right, 6 left), their 18 unaffected full siblings, and 18 matched healthy volunteers. We compared between-group differences in cortical thickness and volumes of five subcortical areas (hippocampus, amygdala, thalamus, putamen, and pallidum). We determined the subregional extent of hippocampal abnormalities using surface shape analysis. All our imaging results were corrected for multiple comparisons using random field theory. RESULTS We detected smaller hippocampal volumes in patients (right TLE: median right hippocampus 1.92 mL, interquartile range [IQR] 1.39-2.62, P < .001; left TLE: left hippocampus 2.05 mL, IQR 1.99-2.33, P = .01) and their unaffected siblings (right hippocampus 2.65 mL, IQR 2.32-2.80, P < .001; left hippocampus 2.39 mL, IQR 2.18-2.53, P < .001) compared to healthy controls (right hippocampus 2.94 mL, IQR 2.77-3.24; left hippocampus 2.71 mL, IQR 2.37-2.89). Surface shape analysis showed that patients with TLE had bilateral subregional atrophy in both hippocampi (right > left). Similar but less-pronounced subregional atrophy was detected in the right hippocampus of unaffected siblings. Patients with TLE had reduced cortical thickness in bilateral premotor/prefrontal cortices and the right precentral gyrus. Siblings did not show abnormalities in cortical or subcortical areas other than the hippocampus. SIGNIFICANCE Our results demonstrate a shared vulnerability of the hippocampus in both patients with TLE and their unaffected siblings, pointing to a contribution of familial factors to hippocampal atrophy. This neuroimaging trait could represent an endophenotype of TLE, which might precede the onset of epilepsy in some individuals.
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Affiliation(s)
- Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Yayu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tjardo Postma
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Centre for Medical Image Computing, University College London, London, UK
| | - Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yanmin Song
- Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Matthias Koepp
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Tan L, Chen Y, Wu W, Liu C, Fu Y, He J, Zhang M, Wang G, Wang K, Long H, Xiao W, Xiao B, Long L. Impaired Cognitive Abilities in Siblings of Patients with Temporal Lobe Epilepsy. Neuropsychiatr Dis Treat 2020; 16:3071-3079. [PMID: 33363375 PMCID: PMC7752648 DOI: 10.2147/ndt.s258074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Patients with temporal lobe epilepsy (TLE) are at high risk of cognitive impairment. In addition to persistent seizures and antiepileptic drugs (AEDs), genetic factors also play an important role in the progression of cognitive deficits in TLE patients. Defining a cognitive endophenotype for TLE can provide information on the risk of cognitive impairment in patients. This study investigated the cognitive endophenotype of TLE by comparing neuropsychological function between patients with TLE, their unaffected siblings, and healthy control subjects. PATIENTS AND METHODS A total of 46 patients with TLE, 26 siblings, and 33 control subjects were recruited. Cognitive function (ie, general cognition, short- and long-term memory, attention, visuospatial and executive functions, and working memory) was assessed with a battery of neuropsychological tests. Differences between groups were evaluated by analysis of covariance, with age and years of education as covariates. The Kruskal-Wallis test was used to evaluate data that did not satisfy the homogeneity of variance assumption. Pairwise comparisons were adjusted by Bonferroni correction, with a significance threshold of P<0.05. RESULTS Patients with TLE showed deficits in the information test (P<0.001), arithmetic test (P=0.003), digit symbol substitution test (P=0.001), block design test (BDT; P=0.005), and backward digit span test (P=0.001) and took a longer time to complete the Hayling test Part A (P=0.011) compared to controls. Left TLE patients tended to have worse executive function test scores than right TLE patients. The siblings of TLE patients showed deficits in the BDT (P=0.006, Bonferroni-corrected) relative to controls. CONCLUSION Patients with TLE exhibit cognitive impairment. Executive function is worse in patients with left TLE than in those with right TLE. Siblings show impaired visuospatial function relative to controls. Thus, cognitive deficits in TLE patients have a genetic component and are independent of seizures or AED use.
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Affiliation(s)
- Langzi Tan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yayu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Chaorong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yujiao Fu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jialinzi He
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Min Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Ge Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Kangrun Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Hongyu Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wenbiao Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
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Chauvière L. Potential causes of cognitive alterations in temporal lobe epilepsy. Behav Brain Res 2020; 378:112310. [DOI: 10.1016/j.bbr.2019.112310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
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Yaakub SN, Barker GJ, Carr SJ, Abela E, Koutroumanidis M, Elwes RDC, Richardson MP. Abnormal temporal lobe morphology in asymptomatic relatives of patients with hippocampal sclerosis: A replication study. Epilepsia 2019; 60:e1-e5. [PMID: 30324623 PMCID: PMC6334277 DOI: 10.1111/epi.14575] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 12/25/2022]
Abstract
We investigated gray and white matter morphology in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE+HS) and first-degree asymptomatic relatives of patients with mTLE+HS. Using T1-weighted magnetic resonance imaging (MRI), we sought to replicate previously reported findings of structural surface abnormalities of the anterior temporal lobe in asymptomatic relatives of patients with mTLE+HS in an independent cohort. We performed whole-brain MRI in 19 patients with mTLE+HS, 14 first-degree asymptomatic relatives of mTLE+HS patients, and 32 healthy control participants. Structural alterations in patients and relatives compared to controls were assessed using automated hippocampal volumetry and cortical surface-based morphometry. We replicated previously reported cortical surface area contractions in the ipsilateral anterior temporal lobe in both patients and relatives compared to healthy controls, with asymptomatic relatives showing similar but less extensive changes than patients. These findings suggest morphologic abnormality in asymptomatic relatives of mTLE+HS patients, suggesting an inherited brain structure endophenotype.
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Affiliation(s)
- Siti Nurbaya Yaakub
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Gareth J. Barker
- Department of NeuroimagingInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Sarah J. Carr
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Eugenio Abela
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
| | - Michalis Koutroumanidis
- Department of Clinical Neurophysiology and EpilepsiesGuy’s and St. Thomas’ NHS Foundation TrustLondonUK
| | | | - Mark P. Richardson
- Department of Basic & Clinical NeuroscienceInstitute of Psychiatry, Psychology & NeuroscienceKing’s College LondonLondonUK
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