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Meng X, Deng K, Huang B, Lin X, Wu Y, Tao W, Lin C, Yang Y, Chen F. Classification of temporal lobe epilepsy based on neuropsychological tests and exploration of its underlying neurobiology. Front Hum Neurosci 2023; 17:1100683. [PMID: 37397855 PMCID: PMC10307531 DOI: 10.3389/fnhum.2023.1100683] [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: 11/17/2022] [Accepted: 05/09/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To assist improving long-term postoperative seizure-free rate, we aimed to use machine learning algorithms based on neuropsychological data to differentiate temporal lobe epilepsy (TLE) from extratemporal lobe epilepsy (extraTLE), as well as explore the relationship between magnetic resonance imaging (MRI) and neuropsychological tests. Methods Twenty-three patients with TLE and 23 patients with extraTLE underwent neuropsychological tests and MRI scans before surgery. The least absolute shrinkage and selection operator were firstly employed for feature selection, and a machine learning approach with neuropsychological tests was employed to classify TLE using leave-one-out cross-validation. A generalized linear model was used to analyze the relationship between brain alterations and neuropsychological tests. Results We found that logistic regression with the selected neuropsychological tests generated classification accuracies of 87.0%, with an area under the receiver operating characteristic curve (AUC) of 0.89. Three neuropsychological tests were acquired as significant neuropsychological signatures for the diagnosis of TLE. We also found that the Right-Left Orientation Test difference was related to the superior temporal and the banks of the superior temporal sulcus (bankssts). The Conditional Association Learning Test (CALT) was associated with the cortical thickness difference in the lateral orbitofrontal area between the two groups, and the Component Verbal Fluency Test was associated with the cortical thickness difference in the lateral occipital cortex between the two groups. Conclusion These results showed that machine learning-based classification with the selected neuropsychological data can successfully classify TLE with high accuracy compared to previous studies, which could provide kind of warning sign for surgery candidate of TLE patients. In addition, understanding the mechanism of cognitive behavior by neuroimaging information could assist doctors in the presurgical evaluation of TLE.
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Affiliation(s)
- Xianghong Meng
- Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
| | - Kan Deng
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- MSC Clinical and Technical Solutions, Philips Healthcare, Guangzhou, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Xiaoyi Lin
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yingtong Wu
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Wei Tao
- Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
| | - Chuxuan Lin
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yang Yang
- Department of Radiology, Suining Central Hospital, Suining, China
| | - Fuyong Chen
- Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
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Hoxhaj P, Habiya SK, Sayabugari R, Balaji R, Xavier R, Ahmad A, Khanam M, Kachhadia MP, Patel T, Abdin ZU, Haider A, Nazir Z. Investigating the Impact of Epilepsy on Cognitive Function: A Narrative Review. Cureus 2023; 15:e41223. [PMID: 37525802 PMCID: PMC10387362 DOI: 10.7759/cureus.41223] [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] [Accepted: 06/28/2023] [Indexed: 08/02/2023] Open
Abstract
It has been noted that people who have epilepsy have an increased propensity for cognitive dysfunction. We explored 25 relevant articles on PubMed and Cochrane Library after implementing inclusion criteria. Different factors have been postulated and studied that may cause cognitive dysfunction in these patients; structural brain abnormalities, polypharmacy of antiepileptic medication, and neuropsychiatric disorders are the most common causes. Cognitive assessments such as Montreal Cognitive Assessment (MOCA) and Mini-Mental State Exam (MMSE) are the mainstay tools used to diagnose the degree of cognitive decline, and alterations in EEG (electroencephalogram) parameters have also been noted in people with cognitive decline. The mechanisms and treatments for cognitive decline are still being studied, while attention has also been directed toward preventive and predictive methods. Early detection and treatment of cognitive impairment can help minimize its impact on the patient's quality of life. Regular cognitive assessments are essential for epileptic patients, particularly those on multiple antiepileptic drugs. While proper management of epilepsy and related comorbidities would reduce cognitive decline and improve the overall quality of life for people with epilepsy.
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Affiliation(s)
- Pranvera Hoxhaj
- Medicine, University of Medicine, Tirana, Tirana, ALB
- Obstetrics and Gynaecology, Scher & Kerenyi MDS, New York, USA
| | - Sana K Habiya
- Internal Medicine, Indian Institute of Medical Science and Research, Jalna, IND
- Public Health, Northeastern Illinois University, Chicago, USA
| | | | - Roghan Balaji
- Neurology, Ponjesly Super Speciality Hospital, Nagercoil, IND
- Neurology, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, IND
| | - Roshni Xavier
- Internal Medicine, Rajagiri Hospital, Aluva, IND
- Internal Medicine, Carewell Hospital, Malappuram, IND
| | - Arghal Ahmad
- Internal Medicine, Ziauddin University, Karachi, PAK
| | | | | | - Tirath Patel
- Internal Medicine, American University of Antigua, St John, ATG
| | - Zain U Abdin
- Internal Medicine, District Head Quarter Hospital, Faisalabad, PAK
| | - Ali Haider
- Internal Medicine, Quetta Institute of Medical Sciences, Quetta, PAK
| | - Zahra Nazir
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Dedeoglu Ö, Altaş H, Yılmaz D, Gürkaş E, Gülleroğlu B, Ekşioğlu S, Çıtak Kurt N. Corpus callosum thickness: A predictive factor for the first drug efficiency of self-limited epilepsy with centrotemporal spikes (selects)? Epilepsy Res 2023; 190:107072. [PMID: 36628885 DOI: 10.1016/j.eplepsyres.2022.107072] [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: 07/07/2022] [Revised: 12/07/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the existence of a possible linkage between the thickness of corpus callosum (CC) regions and the first antiepileptic drug response in patients with Selects. MATERIALS AND METHODS CC thickness of 68 patients with Selects and 42 healthy controls between 4 and 12 years of age were measured using brain magnetic resonance imaging (MRI). Clinical and EEG features of newly diagnosed Selects patients were recorded. Patients were divided into two groups: good-response (patients without seizures within 24 weeks) and poor-response (patients with ≥ 1 seizure within 24 weeks). Thickness of CC was compared between patients (good-response and poor-response groups).and healthy controls. RESULTS The thicknesses of genu and isthmus were significantly reduced in the Selects group than healthy controls. Isthmus and splenium were significantly thinner in poor responders than those in the good-response group (p = 0.005 and p < 0.001, respectively). The total number of seizures was negatively correlated with the thickness of the body, isthmus, and splenium (p < 0.001). There was no significant difference in CC thickness of the children with and without electrical status epilepticus in sleep (ESES). The thickness of the isthmus and splenium were significantly thinner in patients receiving ≥ 2 antiepileptic drugs (p = 0.002 and p = 0.001, respectively). CONCLUSIONS Our study highlights the notable differences in areas of CC in Selects patients. These changes may help uncover the underlying cause of seizure recurrence and antiepileptic drug (AED) response. Different thinner parts of CC may be a protective mechanism to prevent seizure spread to other brain regions. CC thickness can be used as a new radiologic biomarker for predicting first AED response and seizure recurrence in Selects patients.
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Affiliation(s)
- Özge Dedeoglu
- Department of Pediatric Neurology, Ankara State Hospital, Ankara, Turkey.
| | - Hilal Altaş
- Department of Pediatric Neurology, Ankara State Hospital, Ankara, Turkey
| | - Deniz Yılmaz
- Department of Pediatric Neurology, Ankara State Hospital, Ankara, Turkey.
| | - Esra Gürkaş
- Department of Pediatric Neurology, Ankara State Hospital, Ankara, Turkey.
| | - Başak Gülleroğlu
- Department of Pediatric Radiology, Ankara State Hospital, Ankara, Turkey.
| | - Seçil Ekşioğlu
- Department of Pediatric Radiology, Ankara State Hospital, Ankara, Turkey.
| | - Neşe Çıtak Kurt
- Department of Pediatric Neurology, Ankara State Hospital, Ankara, Turkey.
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Laurent A, Artiges E, Mellerio C, Boutin-Watine M, Landré E, Semah F, Chassoux F. Metabolic correlates of cognitive impairment in mesial temporal lobe epilepsy. Epilepsy Behav 2020; 105:106948. [PMID: 32062107 DOI: 10.1016/j.yebeh.2020.106948] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/07/2020] [Accepted: 01/24/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The purpose of the study was to determine the correlations between brain metabolism and cognitive impairment in patients with drug-resistant mesial temporal lobe epilepsy (MTLE). METHODS [18F]-FluoroDeoxyGlucose positron emission tomography ([18F]-FDG-PET) and neuropsychological assessment were performed in 97 patients with MTLE (53 females, 15-56 years old, mean: 31.6 years, standard deviation (SD) = 10.4) with unilateral hippocampal sclerosis (HS, 49 left). We compared brain metabolism and gray matter volume (GMV) between patients with cognitive impairment (intelligence quotient (IQ) and memory index <80) and patients with normal cognition, using statistical parametric mapping (SPM), in the whole population then in right and left HS (RHS, LHS) separately. RESULTS Intelligence quotient (40-121, mean: 83.7 ± 16.9) and memory index (45-133, mean: 80.7 ± 19.3) were impaired in 43% and 51% of the patients, respectively, similarly in RHS and LHS. We did not find any correlations between IQ and clinical factors related to epilepsy; however, there was a significant correlation between low memory index and early age of onset in LHS (p = 0.021), and widespread epileptogenic zone in the whole population (p = 0.033). Impaired IQ correlated with extratemporal hypometabolism, involving frontoparietal networks implicated in the default mode network (DMN), predominantly in the midline cortices. Metabolic asymmetry regarding HS lateralization included the precuneus (pC) in LHS and the anterior cingulate cortex (ACC) in RHS, both areas corresponding to key nodes of the DMN. Memory index correlated with the same frontoparietal networks as for IQ, with an additional involvement of the temporal lobes, which was ipsilateral in RHS and contralateral in LHS. A diffuse decrease of GMV including the ipsilateral hippocampus correlated with cognitive impairment; however, the structural alterations did not match with the hypometabolic areas. CONCLUSIONS Cognitive impairment in MTLE correlates with extratemporal hypometabolism, involving the mesial frontoparietal networks implicated in the DMN and suggesting a disconnection with the affected hippocampus. Asymmetric alterations of connectivity may sustain the predominant ACC and pC metabolic decrease in patients with cognitive impairment.
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Affiliation(s)
- Agathe Laurent
- Epilepsy Unit, Department of Neurosurgery, GHU Paris Sainte-Anne, 75014 Paris, France
| | - Eric Artiges
- INSERM U1000 "Neuroimaging and Psychiatry,", Paris Sud University-Paris Saclay University, Psychiatry Department, 91G16 Orsay, France
| | - Charles Mellerio
- Department of Neuroradiology, GHU Paris Sainte-Anne, 75014 Paris, France
| | - Magali Boutin-Watine
- Epilepsy Unit, Department of Neurosurgery, GHU Paris Sainte-Anne, 75014 Paris, France
| | - Elisabeth Landré
- Epilepsy Unit, Department of Neurosurgery, GHU Paris Sainte-Anne, 75014 Paris, France
| | - Franck Semah
- Department of Nuclear Medicine and INSERM U1171, CHU Lille, F-59000 Lille, France
| | - Francine Chassoux
- Epilepsy Unit, Department of Neurosurgery, GHU Paris Sainte-Anne, 75014 Paris, France; Nuclear Medicine Department, SHFJ, Orsay, France; University Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, 91401, France.
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Allone C, Bonanno L, Lo Buono V, Corallo F, Palmeri R, Micchia K, Pollicino P, Bramanti A, Marino S. Neuropsychological assessment and clinical evaluation in temporal lobe epilepsy with associated cortical dysplasia. J Clin Neurosci 2020; 72:146-150. [PMID: 31918906 DOI: 10.1016/j.jocn.2019.12.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Temporal Lobe Epilepsy (TLE) is a chronic neurological disorder, often associated to cognitive deficits. Focal cortical dysplasia (FCD), frequently associated to high risk of epilepsy, can lead to abnormalities in cognition. The aim of this study was to explore neuropsychological performance and to identify potential risk factors for cognitive impairment in TLE subjects with associated FCD. Our sample was composed by 46 TLE patients with FCD (37.76 ± 12.60 years; 29 females and 16 males) and 44 healthy controls (41.05 ± 9.74 years; 25 females and 19 males). All subjects performed a neuropsychological battery associated to a measurement of depression and anxiety. Results showed a poor performance of all domains of cognitive functioning and identified age of epilepsy onset as potential risk factor of cognitive impairment. These findings support the importance to focus on cognitive impairment in TLE patients with FCD to better clarify the impact of epilepsy features and FCD in therapeutic and everyday management.
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Affiliation(s)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | | | | | - Katia Micchia
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | | | - Alessia Bramanti
- Institute of Applied Science and Intelligent Systems "ISASI Eduardo Caianiello", CNR, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy; Department of Biomedical Sciences and Morphological and Fuctional Imaging, University of Messina, Messina, Italy
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Boutzoukas EM, Crutcher J, Somoza E, Sepeta LN, You X, Gaillard WD, Wallace GL, Berl MM. Cortical thickness in childhood left focal epilepsy: Thinning beyond the seizure focus. Epilepsy Behav 2020; 102:106825. [PMID: 31816479 PMCID: PMC6962541 DOI: 10.1016/j.yebeh.2019.106825] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/20/2019] [Accepted: 11/24/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Structural brain differences are found in adults and children with epilepsy, yet pediatric samples have been heterogeneous regarding seizure type, magnetic resonance imaging (MRI) findings, and hemisphere of seizure focus. This study examines whether cortical thickness and surface area differ between children with left-hemisphere focal epilepsy (LHE) and age-matched typically developing (TD) peers. We examined whether age differentially moderated cortical thickness between groups and if cortical thickness was associated with duration of epilepsy, seizure frequency, or neuropsychological functioning. METHODS Thirty-five children with LHE and 35 TD children completed neuropsychological testing and 3T MR imaging. Neuropsychological measures included general intelligence and executive functioning. All MRIs were normal. Surface-based morphometric processing and analyses were conducted using FreeSurfer 6.0. Regression analyses compared age by cortical thickness differences between groups. Correlational analyses examined associations between cortical thickness in these areas with neuropsychological functioning or epilepsy characteristics. RESULTS Left-hemisphere focal epilepsy displayed decreased cortical thickness bilaterally compared to TD controls across 6 brain regions but no differences in surface area. Moderation analyses revealed quadratic relationships between age and cortical thickness for left frontoparietal-cingulate and right superior frontal regions. Higher performance intelligence quotient (IQ) (PIQ) and verbal IQ (VIQ) and fewer parent reported executive function problems were associated with greater cortical thickness in TD children. SIGNIFICANCE Children with LHE displayed thinner cortex extending beyond the hemisphere of seizure focus. The nonlinear pattern of cortical thickness across age occurring in TD children is not evident in the same manner in children with LHE. These differences in cortical thickness patterns were greatest in children 8-12 years old. Greater cortical thickness was associated with higher IQ and fewer executive control problems in daily activities in TD children. Thus, differences in cortical thickness in the absence of differences in surface area, suggest cortical thickness may be a sensitive proxy of subtle neuroanatomical changes that are related to neuropsychological functioning.
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Affiliation(s)
- Emanuel M Boutzoukas
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA
| | - Jason Crutcher
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA
| | - Eduardo Somoza
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA
| | - Leigh N Sepeta
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA
| | - Xiaozhen You
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics and Neurology, The George Washington University, Washington, DC, USA
| | - William D Gaillard
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics and Neurology, The George Washington University, Washington, DC, USA
| | - Gregory L Wallace
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA; Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, DC, USA
| | - Madison M Berl
- Comprehensive Pediatric Epilepsy Program, Children's National Medical Center, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, USA.
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Oyegbile TO, VanMeter JW, Motamedi G, Zecavati N, Santos C, Lee Earn Chun C, Gaillard WD, Hermann B. Executive dysfunction is associated with an altered executive control network in pediatric temporal lobe epilepsy. Epilepsy Behav 2018; 86:145-152. [PMID: 30001910 PMCID: PMC7395827 DOI: 10.1016/j.yebeh.2018.04.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 04/12/2018] [Accepted: 04/29/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Children with temporal lobe epilepsy (TLE) exhibit executive dysfunction on traditional neuropsychological tests. However, there is limited evidence of neural network alterations associated with this clinical executive dysfunction. The objective of this study was to characterize working memory deficits in children with TLE via activation of the executive control network on functional magnetic resonance imaging (fMRI) and determine the relationships to fMRI behavioral findings and traditional neuropsychological tests. EXPERIMENTAL DESIGN Functional magnetic resonance imaging was conducted on 17 children with TLE and 18 healthy control participants (age 8-16 years) while they performed the N-back task in order to assess activation of the executive control network. N-back accuracy, N-back reaction time, and traditional neuropsychological tests (Delis-Kaplan Executive Function System [D-KEFS] color-word interference and card-sort test) were also assessed. PRINCIPAL OBSERVATIONS Children with TLE exhibited executive dysfunction on D-KEFS testing, reduced N-back accuracy, and increased N-back reaction time compared with healthy controls; D-KEFS and N-back behavioral findings were significantly correlated. Children with TLE also exhibited significant reduction in activation of the frontal lobe within the executive control network compared to healthy controls. These alterations were significantly correlated with N-back behavioral findings and D-KEFS testing. CONCLUSIONS Children with TLE exhibit executive dysfunction, which correlates with executive control network alterations. This lends validity to the theory that the executive control network contributes to working memory function. The findings also indicate that children with TLE have network alterations in nontemporal brain regions.
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Affiliation(s)
| | | | | | | | - Cesar Santos
- Georgetown University Medical Center, Washington, D.C
| | | | - William D. Gaillard
- Georgetown University Medical Center, Washington, D.C.,Children’s National Medical Center, Washington, DC
| | - Bruce Hermann
- University of Wisconsin School of Medicine and Public Health, Madison, WI
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Allone C, Lo Buono V, Corallo F, Pisani LR, Pollicino P, Bramanti P, Marino S. Neuroimaging and cognitive functions in temporal lobe epilepsy: A review of the literature. J Neurol Sci 2017; 381:7-15. [DOI: 10.1016/j.jns.2017.08.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 02/05/2023]
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Liu X, Liao Y, Wang X, Zou D, Luo C, Jian C, Wu Y. MicroRNA expression profiles in chronic epilepsy rats and neuroprotection from seizures by targeting miR-344a. Neuropsychiatr Dis Treat 2017; 13:2037-2044. [PMID: 28814872 PMCID: PMC5546815 DOI: 10.2147/ndt.s141062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
MicroRNA (miRNA) is believed to play a crucial role in the cause and treatment of epilepsy by controlling gene expression. However, it is still unclear how miRNA profiles change after multiple prolonged seizures and aggravation of brain injury in chronic epilepsy (CE). To investigate the role of miRNA in epilepsy, we utilized the CE rat models with pentylenetetrazol (PTZ) and miRNA profiles in the hippocampus. miRNA profiles were characterized using miRNA microarray analysis and were compared with the rats in the sham group, which received 0.9% physiological saline treatment at the same dose. Four up-regulated miRNAs (miR-139-3p, -770-5p, -127-5p, -331-3p) and 5 down-regulated miRNAs (miR-802-5p, -380-5p, -183-5p, -547-5p, -344a/-344a-5p) were found in the CE rats (fold change >1.5, P<0.05). Three of the dysregulated miRNAs were validated by quantitative real-time polymerase chain reaction, which revealed an outcome consistent with the initial results of the miRNA microarray analyses. Then, miR-344a agomir was intracerebroventricularly injected and followed by PTZ induction of CE models to investigate the effect of miR-344a in chronic neocortical epileptogenesis. After miRNA-344a agomir and scramble treatment, results showed a restoration of seizure behavior and a reduction in neuron damage in the cortex in miRNA-334a agomir treated rats. These data suggest that miRNA-344a might have a small modulatory effect on seizure-induced apoptosis signaling pathways in the cortex.
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Affiliation(s)
- Xixia Liu
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University.,Department of Rehabilitation, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuhan Liao
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Xiuxiu Wang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Donghua Zou
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Chun Luo
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Chongdong Jian
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Yuan Wu
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
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10
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Hellwig S, Gutmann V, Trimble MR, van Elst LT. Cerebellar volume is linked to cognitive function in temporal lobe epilepsy: a quantitative MRI study. Epilepsy Behav 2013; 28:156-62. [PMID: 23747499 DOI: 10.1016/j.yebeh.2013.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/17/2013] [Accepted: 04/29/2013] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Chronic intractable temporal lobe epilepsy (TLE) is associated with certain comorbidities including cognitive impairment. A less common condition among patients with TLE is intermittent explosive disorder (IED), a specific form of aggressive behavior that has been linked to low intelligence and structural pathology in the amygdala. We aimed to identify other neuroanatomical substrates of both cognitive dysfunction and IED in patients with TLE, with special focus on the cerebellum, a brain region known to participate in functional networks involved in neuropsychological and affective processes. METHODS Magnetic resonance imaging-based volumetric data from 60 patients with temporal lobe epilepsy (36 with and 24 without IED) were evaluated. Cerebellar, hippocampal, and total brain volumes were processed separately. In a total of 50 patients, the relationship between volumetric measurements and clinical and neuropsychological data (full-scale, verbal, and performance intelligence quotients) was analyzed. RESULTS Intermittent explosive disorder in patients with TLE was not significantly linked to any of the regional volumes analyzed. However, cognitive performance showed a significant association both with total brain volume and cerebellar volume measurements, whereby the left cerebellar volume showed the strongest association. A deviation from normal cerebellar volumes was related to lower intelligence. Of note, left cerebellar volume was influenced by age and duration of epilepsy. Hippocampal volumes had a minor influence on cognitive parameters. CONCLUSION Our findings suggest that cerebellar volume is not linked to IED in patients with TLE but is significantly associated with cognitive dysfunction. Our findings support recent hypotheses proposing that the cerebellum has a relevant functional topography.
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Affiliation(s)
- Sabine Hellwig
- Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany.
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11
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Evaluation of corpus callosum morphometry in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Surg Radiol Anat 2013; 36:47-54. [PMID: 23771402 DOI: 10.1007/s00276-013-1144-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 05/27/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of the study was to evaluate the effects of mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) on corpus callosum (CC) morphometry in large and pathologically proven MTLE-HS patients. METHODS We measured certain CC dimensions in 103 patients and 33 healthy controls using in vivo magnetic resonance imaging. In particular, we compared the two groups in relation to the clinical (localization of the HS, duration of epilepsy, frequency of seizures and length of seizures) and demographical (age, gender, handedness) features. Students' t test, two-way ANOVA and Spearman test were used for statistical analysis. RESULTS There was no significant difference between CC morphometry with respect to age and handedness among patients. The differences between the genders, however, were significant favouring longer diameters in males. We found significant decrease in the dimensions of the genu, body, isthmus and splenium of the CC in the MTLE-HS group, but there was no reduction in the size of the rostrum. CONCLUSIONS This general reduction in the size of the CC except for the rostrum was thought to be the result of cortical atrophy secondary to the disease. Concerning the preserved rostral part of the CC, it was thought that the fibers of the frontal lobe pass through different pathways than the tracts in the rostrum.
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Braakman HMH, van der Kruijs SJM, Vaessen MJ, Jansen JFA, Debeij-van Hall MHJA, Vles JSH, Aldenkamp AP, Backes WH, Hofman PAM. Microstructural and functional MRI studies of cognitive impairment in epilepsy. Epilepsia 2012; 53:1690-9. [PMID: 22889330 DOI: 10.1111/j.1528-1167.2012.03624.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cognitive impairment is the most common comorbidity in children with epilepsy, but its pathophysiology and predisposing conditions remain unknown. Clinical epilepsy characteristics are not conclusive in determining cognitive outcome. Because many children with epilepsy do not have macrostructural magnetic resonance imaging (MRI) abnormalities, the underlying substrate for cognitive impairment may be found at the microstructural or functional level. In the last two decades, new MRI techniques have been developed that have the potential to visualize microstructural or functional abnormalities associated with cognitive impairment. These include volumetric MRI, voxel-based morphometry (VBM), diffusion tensor imaging (DTI), MR spectroscopy (MRS), and functional MRI (fMRI). All of these techniques have shed new light on various aspects associated with, or underlying, cognitive impairment, although their use in epilepsy has been limited and focused mostly on adults. Therefore, in this review, the use of all these different MRI techniques to unravel cognitive impairment in epilepsy is discussed both in adults and children with epilepsy. Volumetric MRI and VBM have revealed significant volume losses in the area of the seizure focus as well as in distant areas. DTI adds evidence of loss of integrity of connections from the seizure focus to distant areas as well as between distant areas. MRS and fMRI have shown impaired function both in the area of the seizure focus as well as in distant structures. For this review we have compiled and compared findings from the various techniques to conclude that cognitive impairment in epilepsy results from a network disorder in which the (micro)structures as well as the functionality can be disturbed.
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Affiliation(s)
- Hilde M H Braakman
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Venturin GT, Greggio S, Marinowic DR, Zanirati G, Cammarota M, Machado DC, DaCosta JC. Bone marrow mononuclear cells reduce seizure frequency and improve cognitive outcome in chronic epileptic rats. Life Sci 2011; 89:229-34. [PMID: 21718708 DOI: 10.1016/j.lfs.2011.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 05/10/2011] [Accepted: 06/03/2011] [Indexed: 11/27/2022]
Abstract
AIMS Epilepsy affects 0.5-1% of the world's population, and approximately a third of these patients are refractory to current medication. Given their ability to proliferate, differentiate and regenerate tissues, stem cells could restore neural circuits lost during the course of the disease and reestablish the physiological excitability of neurons. This study verified the therapeutic potential of bone marrow mononuclear cells (BMMCs) on seizure control and cognitive impairment caused by experimentally induced epilepsy. MAIN METHODS Status epilepticus (SE) was induced by lithium-pilocarpine injection and controlled with diazepam 90 min after SE onset. Lithium-pilocarpine-treated rats were intravenously transplanted 22 days after SE with BMMCs obtained from enhanced green fluorescent protein (eGFP) transgenic C57BL/6 mice. Control epileptic animals were given an equivalent volume of saline or fibroblast injections. Animals were video-monitored for the presence of spontaneous recurrent seizures prior to and following the cell administration procedure. In addition, rats underwent cognitive evaluation using a Morris water maze. KEY FINDINGS Our data show that BMMCs reduced the frequency of seizures and improved the learning and long-term spatial memory impairments of epileptic rats. EGFP-positive cells were detected in the brains of transplanted animals by PCR analysis. SIGNIFICANCE The positive behavioral effects observed in our study indicate that BMMCs could represent a promising therapeutic option in the management of chronic temporal lobe epilepsy.
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Affiliation(s)
- Gianina Teribele Venturin
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Pulsipher DT, Dabbs K, Tuchsherer V, Sheth RD, Koehn MA, Hermann BP, Seidenberg M. Thalamofrontal neurodevelopment in new-onset pediatric idiopathic generalized epilepsy. Neurology 2011; 76:28-33. [PMID: 21205692 DOI: 10.1212/wnl.0b013e318203e8f3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Quantitative MRI techniques have demonstrated thalamocortical abnormalities in idiopathic generalized epilepsy (IGE). However, there are few studies examining IGE early in its course and the neurodevelopmental course of this region is not adequately defined. OBJECTIVE We examined the 2-year developmental course of the thalamus and frontal lobes in pediatric new-onset IGE (i.e., within 12 months of diagnosis). METHODS We performed whole-brain MRI in 22 patients with new-onset IGE and 36 age-matched healthy controls. MRI was repeated 24 months after baseline MRI. Quantitative volumetrics were used to examine thalamic and frontal lobe volumes. RESULTS The IGE group showed significant differences in thalamic volume within 1 year of seizure onset (baseline) and went on to show thalamic volume loss at a significantly faster rate than healthy control children over the 2-year interval. The control group also showed a significantly greater increase in frontal white matter expansion than the IGE group. In contrast, frontal lobe gray matter volume differences were moderate at baseline and persisted over time, indicating similar developmental trajectories with differences early in the disease process that are maintained. CONCLUSIONS Brain tissue abnormalities in thalamic and frontal regions can be identified very early in the course of IGE and an abnormal trajectory of growth continues over a 2-year interval.
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Affiliation(s)
- D T Pulsipher
- Rosalind Franklin University of Medicine & Science, Department of Psychology, 3333 Green Bay Road, North Chicago, IL 60064, USA.
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Abstract
Cognitive Prognosis in Chronic Temporal Lobe Epilepsy. Hermann BP, Seidenberg M, Dow C, Jones J, Rutecki P, Bhattacharya A, Bell B. Ann Neurol 2006;60:80–87. Objective First, to determine whether patients with chronic temporal lobe epilepsy have a different cognitive trajectory compared to control subjects over a prospective 4-year interval; second, to determine the proportion of patients who exhibit abnormal cognitive change and their profile of demographic, clinical epilepsy, and baseline quantitative magnetic resonance imaging characteristics; and third, to determine the most vulnerable cognitive domains. Methods Participants with chronic temporal lobe epilepsy ( N = 46) attending a tertiary referral clinic and healthy control subjects ( N = 65) underwent neuropsychological assessment and reevaluation 4 years later. Analysis of test–retest patterns identified individual patients with adverse cognition outcomes. Results The prospective cognitive trajectory of patients with chronic temporal lobe epilepsy differs from age- and sex-matched healthy control subjects. Lack of practice effects is common, but frank adverse cognitive outcomes are observed in a subset of patients (20%–25%), particularly in vulnerable cognitive domains that include memory. Cognitive declines are associated with a profile of abnormalities in baseline quantitative magnetic resonance volumetrics, lower baseline intellectual capacity, as well as longer duration of epilepsy and older chronological age. Interpretation Cognitive prognosis is poor for a subset of patients characterized by chronicity of epilepsy, older age, lower intellectual ability, and more baseline abnormalities in quantitative magnetic resonance volumetrics.
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The effect of seizures on working memory and executive functioning performance. Epilepsy Behav 2010; 17:412-9. [PMID: 20153981 DOI: 10.1016/j.yebeh.2010.01.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 12/28/2009] [Accepted: 01/08/2010] [Indexed: 11/24/2022]
Abstract
The aim of this study was to assess whether duration of seizure disorder and lifetime seizure load are associated with deficits in higher cognitive functions in patients with temporal lobe epilepsy (TLE) (N=207) or psychogenic nonepileptic seizures (PNES) (N=216). Multivariate regression analyses revealed that age at onset, duration, and group assignment were significant predictors of neuropsychological performance (all P<or=0.02), with group having a moderating relationship. Univariate analyses revealed different patterns of predictor effects on cognitive functioning within each diagnostic group. An impairment index was calculated for each individual, and univariate analyses revealed that age at TLE but not PNES onset was the only significant predictor of impairment (b=-0.005, P<0.001). The results suggest that earlier age at seizure onset, longer duration, and higher lifetime seizure frequency affect cognitive functioning in both the TLE and PNES groups, but differently within each group. These results have implications for early diagnosis and intervention in both groups.
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Hermann BP, Lin JJ, Jones JE, Seidenberg M. The emerging architecture of neuropsychological impairment in epilepsy. Neurol Clin 2009; 27:881-907. [PMID: 19853214 PMCID: PMC2811050 DOI: 10.1016/j.ncl.2009.08.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A new literature is now under way, one linking cognitive abnormalities directly to indices of structural, functional, metabolic, and other neurobiologic markers of cerebral integrity, independent of their association with clinical epilepsy characteristics. These trends are reviewed in this article. The focus is on temporal lobe epilepsy (TLE) as a model with which to address the core points because this form of localization-related epilepsy has been very carefully studied from both a cognitive and imaging standpoint. Some pertinent historical issues are touched on first, followed by more detailed reviews of the cognitive and neuroimaging abnormalities that have been found in TLE, followed by an overview of studies examining direct structure-function relationships in TLE and other epilepsies.
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Affiliation(s)
- Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, 600 North Highland Avenue, Madison, WI 53792, USA.
| | - Jack J Lin
- Department of Neurology, University of California-Irvine, Irvine, CA 92697, USA
| | - Jana E Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, 600 North Highland Avenue, Madison, WI 53792, USA
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin School of Medicine and Science, 3333 N. Green Bay Road, North Chicago, IL 60064, USA
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Pulsipher DT, Seidenberg M, Guidotti L, Tuchscherer VN, Morton J, Sheth RD, Hermann B. Thalamofrontal circuitry and executive dysfunction in recent-onset juvenile myoclonic epilepsy. Epilepsia 2009; 50:1210-9. [PMID: 19183226 DOI: 10.1111/j.1528-1167.2008.01952.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Thalamofrontal abnormalities have been identified in chronic primary generalized epilepsy, specifically in juvenile myoclonic epilepsy (JME). These regions also underlie executive functioning, although their relationship has yet to be examined in JME. This study examined the relationship between thalamic and frontal volumes and executive function in recent-onset JME compared to healthy control subjects and recent-onset benign childhood epilepsy with centrotemporal spikes (BCECTS), a syndrome not typically associated with thalamocortical or executive dysfunction. METHODS Twenty children with recent-onset JME were compared to 51 healthy controls and 12 children with BCECTS using quantitative magnetic resonance imaging (MRI) and measures of executive abilities. Quantitative thalamic and frontal volumes were obtained through semi-automated software. Subtests from the Delis-Kaplan Executive Function System (D-KEFS) and the Behavior Rating Inventory of Executive Function (BRIEF) were used to measure executive function. RESULTS Executive functions were impaired in JME subjects compared to control and BCECTS subjects. Subjects with JME had significantly smaller thalamic volumes and more frontal cerebrospinal fluid (CSF) than control and BCECTS subjects. Thalamic and frontal volumes were significantly related to executive functioning in the JME group, but not in the other two groups. DISCUSSION Children with JME have significant executive dysfunction associated with significantly smaller thalami and more frontal CSF. Children with recent-onset BCECTS do not display the same pattern. Frontal and thalamic volumes appear to mediate the relationship between executive functioning and brain structure in JME.
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Affiliation(s)
- Dalin T Pulsipher
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA.
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Lee SA, Kim CH, Kang SY, No YJ, Kang JK, Lee JK. The lateralizing value of IQ in mesiotemporal epilepsy: Differences between patients with unitemporal and bitemporal epileptiform discharges. Seizure 2008; 17:604-10. [DOI: 10.1016/j.seizure.2008.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2007] [Revised: 02/15/2008] [Accepted: 02/29/2008] [Indexed: 10/22/2022] Open
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McDonald CR. The use of neuroimaging to study behavior in patients with epilepsy. Epilepsy Behav 2008; 12:600-11. [PMID: 18078790 PMCID: PMC2702661 DOI: 10.1016/j.yebeh.2007.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 10/31/2007] [Indexed: 10/22/2022]
Abstract
Structural and functional neuroimaging continues to play an increasing role in the presurgical evaluation of patients with epilepsy. In addition to its value in localizing the epileptogenic zone and eloquent cortex, neuroimaging is contributing to our understanding of mood comorbidity in epilepsy. Although the vast majority of research has focused on patients with temporal lobe epilepsy (TLE), neuroimaging studies of patients with extratemporal epilepsy and primary generalized epilepsy are increasing in number. In this review, structural and functional imaging modalities that have received considerable research attention in recent years are reviewed, and their strengths and limitations for understanding behavior in epilepsy are assessed. In addition, advances in multimodal imaging are discussed along with their potential application to the presurgical evaluation of patients with seizure disorders.
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Affiliation(s)
- Carrie R. McDonald
- Department of Psychiatry, University of California, San Diego, Multimodal Imaging Laboratory, University of California, San Diego
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McDonald CR, Hagler DJ, Ahmadi ME, Tecoma E, Iragui V, Gharapetian L, Dale AM, Halgren E. Regional neocortical thinning in mesial temporal lobe epilepsy. Epilepsia 2008; 49:794-803. [PMID: 18266751 DOI: 10.1111/j.1528-1167.2008.01539.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the nature and extent of regional cortical thinning in patients with mesial temporal lobe epilepsy (MTLE). METHODS High-resolution volumetric MRIs were obtained on 21 patients with MTLE and 21 controls. Mean cortical thickness was measured within regions of interest and point-by-point across the neocortex using cortical reconstruction and parcellation software. RESULTS Bilateral thinning was observed within frontal and lateral temporal regions in MTLE patients relative to controls. The most striking finding was bilateral cortical thinning in the precentral gyrus and immediately adjacent paracentral region and pars opercularis of the inferior frontal gyrus, extending to the orbital region. Within the temporal lobe, bilateral thinning was observed in Heschl's gyrus only. Ipsilateral only thinning was observed in the superior and middle temporal gyri, as well as in the medial orbital cortex. Greater asymmetries in cortical thickness were observed in medial temporal cortex in patients relative to controls. Individual subject analyses revealed that this asymmetry reflected significant ipsilateral thinning of medial temporal cortex in 33% of patients, whereas it reflected ipsilateral thickening in 20% of MTLEs. DISCUSSION Patients with MTLE show widespread, bilateral pathology in neocortical regions that is not appreciated on standard imaging. Future studies are needed that elucidate the clinical implications of neocortical thinning in MTLE.
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Affiliation(s)
- Carrie R McDonald
- Department of Psychiatry, and Multimodal Imaging Laboratory, University of California, San Diego, CA 92093-0841, USA.
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Van Paesschen W, Porke K, Fannes K, Vandenberghe R, Palmini A, Van Laere K, Dupont P. Cognitive Deficits during Status Epilepticus and Time Course of Recovery: A Case Report. Epilepsia 2007; 48:1979-83. [PMID: 17561953 DOI: 10.1111/j.1528-1167.2007.01157.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe a young woman with progressive cognitive and neurological deficits during a parietal lobe status epilepticus (SE). Ictal FDG-PET showed left parietal lobe hypermetabolism and frontal lobe hypometabolism with concomitant EEG slowing. Cognitive and neurological deficits fully reversed more than 1 year after seizure remission, and were associated with normalization of FDG-PET and EEG. Our findings suggest that ictal hypometabolism and EEG delta activity at a distance from the epileptic focus were seizure-related phenomena, possibly representing inhibition in seizure propagation pathways, which could be responsible for the epileptic encephalopathy.
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Affiliation(s)
- Wim Van Paesschen
- Department of Neurology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium.
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Weber B, Luders E, Faber J, Richter S, Quesada CM, Urbach H, Thompson PM, Toga AW, Elger CE, Helmstaedter C. Distinct regional atrophy in the corpus callosum of patients with temporal lobe epilepsy. Brain 2007; 130:3149-54. [PMID: 17728360 PMCID: PMC2770440 DOI: 10.1093/brain/awm186] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We analysed the influence of mesial temporal lobe epilepsy on the thickness of the corpus callosum (CC) in a large sample of well-characterized patients (n = 96) and healthy controls (n = 28). In particular, we investigated whether callosal structures are differentially affected depending on the affected hemisphere and age of epilepsy onset. Overall, we observed that epilepsy is associated with a decreased thickness in posterior callosal regions. Patients with an early onset, especially patients with left onset, additionally exhibited a smaller callosal thickness in more anterior and midbody regions. These findings may reflect non-specific as well as specific effects of temporal lobe epilepsy on CC development and interhemispheric connectivity.
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Affiliation(s)
- Bernd Weber
- Department of Epileptology, University of Bonn, Germany.
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Daley M, Levitt J, Siddarth P, Mormino E, Hojatkashani C, Gurbani S, Shields WD, Sankar R, Toga A, Caplan R. Frontal and temporal volumes in children with epilepsy. Epilepsy Behav 2007; 10:470-6. [PMID: 17382595 DOI: 10.1016/j.yebeh.2007.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 01/14/2007] [Accepted: 02/14/2007] [Indexed: 10/23/2022]
Abstract
This study examined if children with cryptogenic epilepsy and complex partial seizures (CPS) have smaller total brain, frontal, and temporal lobe volumes than normal children and how this is related to seizure, cognitive, psychiatric, and demographic variables. Forty-four children with CPS and 38 normal children, aged 5-16 years, underwent brain MRI scans at 1.5 T. Tissue was segmented, and total brain, frontal lobe, frontal parcellation, and temporal lobe volumes were computed. Other than significantly larger temporal lobe white matter volumes in the CPS group, there were no significant differences in brain volumes between the CPS and normal groups. Earlier onset, longer duration of illness, younger chronological age, and presence of a psychiatric diagnosis were significantly related to smaller frontotemporal volumes in subjects with CPS. Although these findings suggest that CPS might affect development of the temporal and frontal regions, we are unable to rule out the possibility that smaller frontotemporal volumes might predispose children to CPS. These findings highlight the need to control for seizure, cognitive, psychiatric, and demographic variables in studies of frontotemporal volumes in pediatric CPS.
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Affiliation(s)
- Melita Daley
- Department of Psychiatry, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095-1759, USA.
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