1
|
Kimura N, Takahashi Y, Usui N, Matsuda K, Otani H, Kasai Y, Kondo A, Imai K, Takita J. Neuropsychological outcome after frontal surgery for pediatric-onset epilepsy with focal cortical dysplasia in adolescent and young adult. Epilepsy Behav 2024; 153:109687. [PMID: 38368791 DOI: 10.1016/j.yebeh.2024.109687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE We investigated neuropsychological outcome in patients with pharmacoresistant pediatric-onset epilepsy caused by focal cortical dysplasia (FCD), who underwent frontal lobe resection during adolescence and young adulthood. METHODS Twenty-seven patients were studied, comprising 15 patients who underwent language-dominant side resection (LDR) and 12 patients who had languagenondominant side resection (n-LDR). We evaluated intelligence (language function, arithmetic ability, working memory, processing speed, visuo-spatial reasoning), executive function, and memory in these patients before and two years after resection surgery. We analyzed the relationship between neuropsychological outcome and resected regions (side of language dominance and location). RESULTS Although 75% of the patients showed improvement or no change in individual neuropsychological tests after surgical intervention, 25% showed decline. The cognitive tests that showed improvement or decline varied between LDR and n-LDR. In patients who had LDR, decline was observed in Vocabulary and Phonemic Fluency (both 5/15 patients), especially after resection of ventrolateral frontal cortex, and improvement was observed in WCST-Category (7/14 patients), Block Design (6/15 patients), Digit Symbol (4/15 patients), and Delayed Recall (3/9 patients). In patients who underwent n-LDR, improvement was observed in Vocabulary (3/12 patients), but decline was observed in Block Design (2/9 patients), and WCST-Category (2/9 patients) after resection of dorsolateral frontal cortex; and Arithmetic (3/10 patients) declined after resection of dorsolateral frontal cortex or ventrolateral frontal cortex. General Memory (3/8 patients), Visual Memory (3/8 patients), Delayed Recall (3/8 patients), Verbal Memory (2/9 patients), and Digit Symbol (3/12 patients) also declined after n-LDR. CONCLUSION Postoperative changes in cognitive function varied depending on the location and side of the resection. For precise presurgical prediction of neuropsychological outcome after surgery, further prospective studies are needed to accumulate data of cognitive changes in relation to the resection site.
Collapse
Affiliation(s)
- Nobusuke Kimura
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Naniwa Ikuno Hospital, Daikoku 1-10-3, Naniwa-ku, Oosaka 556-0014, Japan.
| | - Yukitoshi Takahashi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Department of Pediatrics, Gifu University School of Medicine, Japan; School of Pharmaceutical Sciences, University of Shizuoka, Japan.
| | - Naotaka Usui
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Kazumi Matsuda
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Hideyuki Otani
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Yoshinobu Kasai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Akihiko Kondo
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Katsumi Imai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Junko Takita
- Kyoto University, Shogoin Kawahara-cho 53, Sakyo-ku, Kyoto 606-8507, Japan.
| |
Collapse
|
2
|
Arrotta K, Swanson SJ, Janecek JK, Hamberger MJ, Barr WB, Baxendale S, McDonald CR, Reyes A, Hermann BP, Busch RM. Application of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) to frontal lobe epilepsy using multicenter data. Epilepsy Behav 2023; 148:109471. [PMID: 37866248 DOI: 10.1016/j.yebeh.2023.109471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 10/24/2023]
Abstract
RATIONALE The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) was recently introduced as a consensus-based, empirically-driven taxonomy of cognitive disorders in epilepsy and has been effectively applied to patients with temporal lobe epilepsy (TLE). The purpose of this study was to apply the IC-CoDE to patients with frontal lobe epilepsy (FLE) using national multicenter data. METHODS Neuropsychological data of 455 patients with FLE aged 16 years or older were available across four US-based sites. First, we examined test-specific impairment rates across sites using two impairment thresholds (1.0 and 1.5 standard deviations below the normative mean). Following the proposed IC-CoDE guidelines, patterns of domain impairment were determined based on commonly used tests within five cognitive domains (language, memory, executive functioning, attention/processing speed, and visuospatial ability) to construct phenotypes. Impairment rates and distributions across phenotypes were then compared with those found in patients with TLE for which the IC-CoDE classification was initially validated. RESULTS The highest rates of impairment were found among tests of naming, verbal fluency, speeded sequencing and set-shifting, and complex figure copy. The following IC-CoDE phenotype distributions were observed using the two different threshold cutoffs: 23-40% cognitively intact, 24-29% single domain impairment, 13-20% bi-domain impairment, and 18-33% generalized impairment. Language was the most common single domain impairment (68% for both thresholds) followed by attention and processing speed (15-18%). Overall, patients with FLE reported higher rates of cognitive impairment compared with patients with TLE. CONCLUSIONS These results demonstrate the applicability of the IC-CoDE to epilepsy syndromes outside of TLE. Findings indicated generally stable and reproducible phenotypes across multiple epilepsy centers in the U.S. with diverse sample characteristics and varied neuropsychological test batteries. Findings also highlight opportunities for further refinement of the IC-CoDE guidelines as the application expands.
Collapse
Affiliation(s)
- Kayela Arrotta
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Sara J Swanson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julie K Janecek
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - William B Barr
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, CA, USA
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, CA, USA
| | - Bruce P Hermann
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robyn M Busch
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
3
|
Ljunggren S, Winblad S, Samuelsson H, Malmgren K. Decision-making under ambiguity after frontal lobe resection for epilepsy. Epilepsy Behav 2023; 142:109215. [PMID: 37075512 DOI: 10.1016/j.yebeh.2023.109215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Decision-making is crucial to daily life and can impact our society as well as economic conditions. Although the frontal lobes have been identified as important for decision-making, this capacity has only been studied to a limited extent in frontal lobe epilepsy and not at all after frontal lobe resection (FLR) for epilepsy. This study aimed to explore decision-making under ambiguity after FLR for epilepsy. METHODS Fourteen patients having undergone FLR for epilepsy completed the Iowa Gambling Task (IGT) which is a widely used tool to measure decision-making under ambiguity. Iowa Gambling Task scores included in the analysis were: total net score, separate scores from five blocks across the test, and a change score (last block of IGT minus first block). A group of healthy controls (n = 30) was used as a comparison. Associations between IGT and standardized neuropsychological methods for assessment of executive functions, self-rating questionnaires of mental health, fatigue, and behavior linked to frontal lobe dysfunction were also investigated. RESULTS The patient group performed inferior to controls at the final block of the IGT (p =.001).A group difference in IGT change scores was found (p =.005), reflectingthe absence of a positive change in performance over time for the FLR group compared to the control group. Correlations with tests of executive functions as well as self-rating scales were mainly statistically nonsignificant. CONCLUSIONS This study shows that patients having undergone FLR for epilepsy have difficulties with decision-making under ambiguity. The performance illustrated a failure to learn throughout the task. Executive as well as emotional deficits may impact decision-making processes in this patient group and need to be considered in further studies. Prospective studies with larger cohorts are needed.
Collapse
Affiliation(s)
- Sofia Ljunggren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Blå Stråket 7, SE-413 45 Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Stefan Winblad
- Department of Psychology, Gothenburg University, Box 500, SE-405 30 Gothenburg, Sweden.
| | - Hans Samuelsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Blå Stråket 7, SE-413 45 Gothenburg, Sweden; Department of Psychology, Gothenburg University, Box 500, SE-405 30 Gothenburg, Sweden.
| | - Kristina Malmgren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Blå Stråket 7, SE-413 45 Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| |
Collapse
|
4
|
Caciagli L, Paquola C, He X, Vollmar C, Centeno M, Wandschneider B, Braun U, Trimmel K, Vos SB, Sidhu MK, Thompson PJ, Baxendale S, Winston GP, Duncan JS, Bassett DS, Koepp MJ, Bernhardt BC. Disorganization of language and working memory systems in frontal versus temporal lobe epilepsy. Brain 2022; 146:935-953. [PMID: 35511160 PMCID: PMC9976988 DOI: 10.1093/brain/awac150] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/28/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is a common comorbidity of epilepsy and adversely impacts people with both frontal lobe (FLE) and temporal lobe (TLE) epilepsy. While its neural substrates have been investigated extensively in TLE, functional imaging studies in FLE are scarce. In this study, we profiled the neural processes underlying cognitive impairment in FLE and directly compared FLE and TLE to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE and 52 controls) using neuropsychological tests and four functional MRI tasks probing expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-seizure medication load. We devised a multiscale approach to map brain activation and deactivation during cognition and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects across established motifs of functional brain organization: (i) canonical resting-state functional systems; and (ii) the principal functional connectivity gradient, which encodes a continuous transition of regional connectivity profiles, anchoring lower-level sensory and transmodal brain areas at the opposite ends of a spectrum. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, as well as reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. The imaging signatures of dysfunction in FLE are broadly similar to those in TLE, but some patterns are syndrome-specific: altered default-mode deactivation is more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands is more marked in TLE. Functional abnormalities in FLE and TLE appear overall modulated by disease load. On balance, our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies and sheds light on system behaviour that may be amenable to future remediation strategies.
Collapse
Affiliation(s)
- Lorenzo Caciagli
- Correspondence to: Lorenzo Caciagli, MD, PhD Department of Bioengineering University of Pennsylvania, 240 Skirkanich Hall 210 South 33rd Street, Philadelphia, PA 19104, USA E-mail: ;
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Christian Vollmar
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Maria Centeno
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Epilepsy Unit, Hospital Clínic de Barcelona, IDIBAPS, 08036 Barcelona, Spain
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Urs Braun
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karin Trimmel
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Centre for Medical Image Computing, University College London, London, UK,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Meneka K Sidhu
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Medicine, Division of Neurology, Queen’s University, Kingston, Ontario, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Dani S Bassett
- Correspondence may also be addressed to: Dani S. Bassett, PhD E-mail:
| | | | | |
Collapse
|
5
|
Rodriguez-Cruces R, Royer J, Larivière S, Bassett DS, Caciagli L, Bernhardt BC. Multimodal connectome biomarkers of cognitive and affective dysfunction in the common epilepsies. Netw Neurosci 2022; 6:320-338. [PMID: 35733426 PMCID: PMC9208009 DOI: 10.1162/netn_a_00237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/02/2022] [Indexed: 11/05/2022] Open
Abstract
Epilepsy is one of the most common chronic neurological conditions, traditionally defined as a disorder of recurrent seizures. Cognitive and affective dysfunction are increasingly recognized as core disease dimensions and can affect patient well-being, sometimes more than the seizures themselves. Connectome-based approaches hold immense promise for revealing mechanisms that contribute to dysfunction and to identify biomarkers. Our review discusses emerging multimodal neuroimaging and connectomics studies that highlight network substrates of cognitive/affective dysfunction in the common epilepsies. We first discuss work in drug-resistant epilepsy syndromes, that is, temporal lobe epilepsy, related to mesiotemporal sclerosis (TLE), and extratemporal epilepsy (ETE), related to malformations of cortical development. While these are traditionally conceptualized as ‘focal’ epilepsies, many patients present with broad structural and functional anomalies. Moreover, the extent of distributed changes contributes to difficulties in multiple cognitive domains as well as affective-behavioral challenges. We also review work in idiopathic generalized epilepsy (IGE), a subset of generalized epilepsy syndromes that involve subcortico-cortical circuits. Overall, neuroimaging and network neuroscience studies point to both shared and syndrome-specific connectome signatures of dysfunction across TLE, ETE, and IGE. Lastly, we point to current gaps in the literature and formulate recommendations for future research. Epilepsy is increasingly recognized as a network disorder characterized by recurrent seizures as well as broad-ranging cognitive difficulties and affective dysfunction. Our manuscript reviews recent literature highlighting brain network substrates of cognitive and affective dysfunction in common epilepsy syndromes, namely temporal lobe epilepsy secondary to mesiotemporal sclerosis, extratemporal epilepsy secondary to malformations of cortical development, and idiopathic generalized epilepsy syndromes arising from subcortico-cortical pathophysiology. We discuss prior work that has indicated both shared and distinct brain network signatures of cognitive and affective dysfunction across the epilepsy spectrum, improves our knowledge of structure-function links and interindividual heterogeneity, and ultimately aids screening and monitoring of therapeutic strategies.
Collapse
Affiliation(s)
- Raul Rodriguez-Cruces
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Jessica Royer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Sara Larivière
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Dani S. Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104 USA
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104 USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104 USA
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom
| | - Boris C. Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
6
|
Nitta N, Usui N, Kondo A, Tottori T, Terada K, Kasai Y, Takahashi Y, Nozaki K, Inoue Y. Neuropsychological outcomes after frontal lobectomy to treat intractable epilepsy. Epilepsy Behav 2021; 123:108240. [PMID: 34375803 DOI: 10.1016/j.yebeh.2021.108240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/14/2021] [Accepted: 07/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Frontal lobectomy is often used as a surgical treatment for frontal lobe epilepsy, especially when a large epileptogenic zone in the frontal lobe is inferred from preoperative evaluation. The frontal lobe is important for cognitive functions such as executive functions and verbal fluency, but the neuropsychological outcome after a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex has not been studied thoroughly. In the present study, we evaluated neuropsychological outcomes after patients with frontal lobe epilepsy received a frontal or prefrontal lobectomy. METHODS We retrospectively reviewed the data of patients with frontal lobe epilepsy who underwent a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex at 16 years or older from October 2004 to December 2014, with a minimum postoperative follow-up of 24 months. We analyzed and compared neuropsychological outcomes, including executive functions, verbal fluency, intelligence, and memory, before and after the operation. RESULTS Eighteen patients were 16 years or older and underwent pre- and postoperative (2 years after the operation) neuropsychological evaluations. Patients showed significant deterioration only on the Benton Visual Retention Test. Performance on tests of frontal lobe functions, such as executive function and verbal fluency, showed no significant deterioration. CONCLUSIONS Overall cognitive performance, including functions widely thought to depend on the frontal lobe, is stable after a frontal or prefrontal lobectomy to treat frontal lobe epilepsy.
Collapse
Affiliation(s)
- Naoki Nitta
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Department of Neurosurgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Naotaka Usui
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Akihiko Kondo
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan
| | - Takayasu Tottori
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Kiyohito Terada
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Yoshinobu Kasai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Yukitoshi Takahashi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga 520-2192, Japan.
| | - Yushi Inoue
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| |
Collapse
|
7
|
Moguilner S, Birba A, Fino D, Isoardi R, Huetagoyena C, Otoya R, Tirapu V, Cremaschi F, Sedeño L, Ibáñez A, García AM. Multimodal neurocognitive markers of frontal lobe epilepsy: Insights from ecological text processing. Neuroimage 2021; 235:117998. [PMID: 33789131 PMCID: PMC8272524 DOI: 10.1016/j.neuroimage.2021.117998] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 01/07/2023] Open
Abstract
The pressing call to detect sensitive cognitive markers of frontal lobe epilepsy (FLE) remains poorly addressed. Standard frameworks prove nosologically unspecific (as they reveal deficits that also emerge across other epilepsy subtypes), possess low ecological validity, and are rarely supported by multimodal neuroimaging assessments. To bridge these gaps, we examined naturalistic action and non-action text comprehension, combined with structural and functional connectivity measures, in 19 FLE patients, 19 healthy controls, and 20 posterior cortex epilepsy (PCE) patients. Our analyses integrated inferential statistics and data-driven machine-learning classifiers. FLE patients were selectively and specifically impaired in action comprehension, irrespective of their neuropsychological profile. These deficits selectively and specifically correlated with (a) reduced integrity of the anterior thalamic radiation, a subcortical structure underlying motoric and action-language processing as well as epileptic seizure spread in this subtype; and (b) hypoconnectivity between the primary motor cortex and the left-parietal/supramarginal regions, two putative substrates of action-language comprehension. Moreover, machine-learning classifiers based on the above neurocognitive measures yielded 75% accuracy rates in discriminating individual FLE patients from both controls and PCE patients. Briefly, action-text assessments, combined with structural and functional connectivity measures, seem to capture ecological cognitive deficits that are specific to FLE, opening new avenues for discriminatory characterizations among epilepsy types.
Collapse
Affiliation(s)
- Sebastian Moguilner
- Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina
| | - Agustina Birba
- University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Daniel Fino
- Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Fundación Argentina para el Desarrollo en Salud, Mendoza, Argentina
| | - Roberto Isoardi
- Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina
| | - Celeste Huetagoyena
- Neuromed, Clinical Neuroscience, Mendoza, Argentina; Universidad Católica Argentina
| | - Raúl Otoya
- Neuromed, Clinical Neuroscience, Mendoza, Argentina
| | - Viviana Tirapu
- Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Neuromed, Clinical Neuroscience, Mendoza, Argentina
| | - Fabián Cremaschi
- Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Neuroscience Department of the School of Medicine, National University of Cuyo, Mendoza, Argentina; Santa Isabel de Hungría Hospital, Mendoza, Argentina
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Agustín Ibáñez
- Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Adolfo M García
- Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.
| |
Collapse
|
8
|
Karami M, Mehvari Habibabadi J, Nilipour R, Barekatain M, Gaillard WD, Soltanian-Zadeh H. Presurgical Language Mapping in Patients With Intractable Epilepsy: A Review Study. Basic Clin Neurosci 2021; 12:163-176. [PMID: 34925713 PMCID: PMC8672671 DOI: 10.32598/bcn.12.2.2053.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/10/2020] [Accepted: 11/08/2020] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION about 20% to 30% of patients with epilepsy are diagnosed with drug-resistant epilepsy and one third of these are candidates for epilepsy surgery. Surgical resection of the epileptogenic tissue is a well-established method for treating patients with intractable focal epilepsy. Determining language laterality and locality is an important part of a comprehensive epilepsy program before surgery. Functional Magnetic Resonance Imaging (fMRI) has been increasingly employed as a non-invasive alternative method for the Wada test and cortical stimulation. Sensitive and accurate language tasks are essential for any reliable fMRI mapping. METHODS The present study reviews the methods of presurgical fMRI language mapping and their dedicated fMRI tasks, specifically for patients with epilepsy. RESULTS Different language tasks including verbal fluency are used in fMRI to determine language laterality and locality in different languages such as Persian. there are some considerations including the language materials and technical protocols for task design that all presurgical teams should take into consideration. CONCLUSION Accurate presurgical language mapping is very important to preserve patients language after surgery. This review was the first part of a project for designing standard tasks in Persian to help precise presurgical evaluation and in Iranian PWFIE.
Collapse
Affiliation(s)
- Mahdieh Karami
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | | | - Reza Nilipour
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Majid Barekatain
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - William D. Gaillard
- Center for Neuroscience and Behavioral Health, Children’s National Medical Center, George Washington University, Washington, D.C. USA
| | - Hamid Soltanian-Zadeh
- Departments of Communication, School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Radiology and Research Administration, Henry Ford Health System, Detroit, MI, USA
| |
Collapse
|
9
|
Larivière S, Bernasconi A, Bernasconi N, Bernhardt BC. Connectome biomarkers of drug-resistant epilepsy. Epilepsia 2020; 62:6-24. [PMID: 33236784 DOI: 10.1111/epi.16753] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
Drug-resistant epilepsy (DRE) considerably affects patient health, cognition, and well-being, and disproportionally contributes to the overall burden of epilepsy. The most common DRE syndromes are temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal epilepsy related to cortical malformations. Both syndromes have been traditionally considered as "focal," and most patients benefit from brain surgery for long-term seizure control. However, increasing evidence indicates that many DRE patients also present with widespread structural and functional network disruptions. These anomalies have been suggested to relate to cognitive impairment and prognosis, highlighting their importance for patient management. The advent of multimodal neuroimaging and formal methods to quantify complex systems has offered unprecedented ability to profile structural and functional brain networks in DRE patients. Here, we performed a systematic review on existing DRE network biomarker candidates and their contribution to three key application areas: (1) modeling of cognitive impairments, (2) localization of the surgical target, and (3) prediction of clinical and cognitive outcomes after surgery. Although network biomarkers hold promise for a range of clinical applications, translation of neuroimaging biomarkers to the patient's bedside has been challenged by a lack of clinical and prospective studies. We therefore close by highlighting conceptual and methodological strategies to improve the evaluation and accessibility of network biomarkers, and ultimately guide clinically actionable decisions.
Collapse
Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
10
|
El Wafa HEA, Ghobashy SAEL, Hamza AM. A comparative study of executive functions among children with attention deficit and hyperactivity disorder and those with learning disabilities. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00071-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Both ADHD and learning disorders have been found to be associated with executive dysfunctions; the executive functions’ (EFs) construct generally involves a series of components—planning, cognitive flexibility, inhibition, attention control, and verbal and visuo-spatial working memory—that work independently in many ways but are closely related. There were no significant studies comparing both disorders and excluding the drug’s effects on executive functions. In our study, we used BDEFS-CA to assess executive functions among a sample of 340 children divided in to four groups: group 1 (100 children), ADHD only; group II (80 children), LD only; group III (60 children), combined ADHD and LD; and group IV (100 children), control group. We included children aged from 6 to 13 of both sexes of average IQ and all had to be drug naive with no sensory impairment or disabling neurological disorder and after their parents’ consent.
Results
The results showed that there was significant higher affection of the five executive functions domains in the first three groups more than the fourth control group. Furthermore, the self-restraint (response-inhibition) executive dysfunction was the most commonly affected EF in group I while time management EF and self-regulation and problem solving EF were the most commonly affected EF in the LD group.
Conclusions
Complete executive function profile assessment should be done for children diagnosed with ADHD or learning disability and EF intervention program should be included in the management plan for better outcomes mainly self-restraint EF in case of ADHD and problem solving and self-organization EF in case of learning disabilities
Collapse
|
11
|
Giovagnoli AR, Tallarita GM, Parente A, Pastori C, de Curtis M. The understanding of mental states and the cognitive phenotype of frontal lobe epilepsy. Epilepsia 2020; 61:747-757. [PMID: 32124981 DOI: 10.1111/epi.16457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Previous studies of frontal lobe epilepsy (FLE) have documented different impairments of theory of mind (ToM), while the study of frontal lobe (FL) lesion without seizures has produced inconsistent results. Given the role played by the FLs in ToM, we evaluated this and other functions in patients with FLE with and without FL lesions. The main objective was to clarify the salience of ToM impairment in the cognitive pattern of FLE and its capacity to discriminate these patients from healthy subjects. The effects of FL lesions on ToM were also explored. METHODS Seventy-five adult patients with FLE (40 cases with FL lesions) were compared with 42 healthy controls. The Faux Pas Task (FPT) and other neuropsychological tests were utilized to assess ToM, reasoning, language, memory, praxis, attention, and executive abilities. RESULTS The patients obtained lower z scores for the FPT than for other tests. The ToM, Executive, and Verbal factors discriminated patients from healthy subjects. The patients with or without FL lesion showed significant impairments in recognizing and understanding others' epistemic and affective mental states, but adequate capacity to exclude inexistent mental states was retained. In comparison with controls, the patients with FL lesions obtained lower scores for lexical, memory, praxis, attention, and executive functions, whereas those without lesion only showed attention and initiative deficits. Schooling was the major predictor of ToM, whereas the capacity to exclude inexistent mental states was related to seizure onset age and epilepsy duration. Other cognitive functions were related to schooling, age, or FLE laterality. SIGNIFICANCE Impaired understanding of real mental states is a specific, salient, and discriminating cognitive aspect of FLE. Poor education is a risk factor for ToM deficit, whereas the clinical variables and FL lesions have no impact. These results suggest that impaired ToM may be a marker of FLE neurobehavioral phenotype.
Collapse
Affiliation(s)
- Anna Rita Giovagnoli
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giulia Maria Tallarita
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Annalisa Parente
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pastori
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marco de Curtis
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| |
Collapse
|
12
|
Bremm FJ, Hendriks MPH, Bien CG, Grewe P. Pre- and postoperative verbal memory and executive functioning in frontal versus temporal lobe epilepsy. Epilepsy Behav 2019; 101:106538. [PMID: 31678807 DOI: 10.1016/j.yebeh.2019.106538] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 01/26/2023]
Abstract
There is accumulating evidence for considerable overlap in preoperatively affected cognitive functions in patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE). The current study investigated whether it is possible to differentiate between patients with FLE and TLE prior to surgery, based on measures of verbal memory and executive functioning. Furthermore, the postoperative cognitive development was compared. Pre- and postoperative data from 109 patients with FLE and 194 patients with TLE were retrospectively analyzed. Preoperatively, there were no differences in verbal memory, and postoperatively, no distinctive cognitive change was found between patients with FLE and TLE. However, patients with FLE performed worse on a cognitive switching task. Notably, irrespective of localization, patients with a presumed epileptogenic area in the language-dominant hemisphere performed worse than patients with seizures that originated in the nonlanguage-dominant hemisphere on measures of verbal memory, both pre- and postoperatively. In sum, the results suggest that verbal memory scores may be less valuable for differentiation between TLE and FLE, while measures of executive functioning may help identify patients with FLE. Additionally, rather than the localization, epilepsy lateralization critically impacts the evaluation of verbal memory functioning in both TLE and FLE. The results are discussed in light of the current frameworks of functional disturbances in epileptic networks.
Collapse
Affiliation(s)
- Florian J Bremm
- Epilepsy-Center Bethel, Krankenhaus Mara, Maraweg 17-21, 33617 Bielefeld, Germany; Radboud University, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, Montessorilaan 3, 6525 HR Nijmegen, the Netherlands.
| | - Marc P H Hendriks
- Radboud University, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, Montessorilaan 3, 6525 HR Nijmegen, the Netherlands; Academic Centre of Epileptology, Kempenhaeghe, Heeze Sterkselseweg 65, 5590 AB Heeze, the Netherlands.
| | - Christian G Bien
- Epilepsy-Center Bethel, Krankenhaus Mara, Maraweg 17-21, 33617 Bielefeld, Germany.
| | - Philip Grewe
- Epilepsy-Center Bethel, Krankenhaus Mara, Maraweg 17-21, 33617 Bielefeld, Germany.
| |
Collapse
|
13
|
van den Berg L, de Weerd A, Reuvekamp M, Hagebeuk E, van der Meere J. Working memory in pediatric frontal lobe epilepsy. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:101-110. [PMID: 31092008 DOI: 10.1080/21622965.2019.1611431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Thirty-two children with frontal lobe epilepsy (FLE) were assessed using different working memory measures. In addition, parents and teachers completed the working memory scale of the Behavioral Rating Inventory of Executive Functioning (BRIEF) to assess the children's "daily life behavior." Results suggested minimal working memory deficits as assessed with performance-based measures. However, the BRIEF showed more working memory deficits suggesting that, on a daily life level, working memory problems seem to be associated with FLE. We discuss why the results of the performance-based measures are not consistent with results of the BRIEF.HighlightsParents as well as teachers report working memory dysfunction in daily life to the same extent.Performance based measures show minimal deficits of working memory.Correlation between working memory tasks and proxy measures are low.
Collapse
Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | | | | | - Jaap van der Meere
- Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
| |
Collapse
|
14
|
The neuropsychological profile of parietal and occipital lobe epilepsy. Epilepsy Behav 2019; 94:137-143. [PMID: 30909077 DOI: 10.1016/j.yebeh.2019.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 12/20/2022]
Abstract
Despite the extensive body of research in clinical neurology on the functional organization of posterior cortices, parietal and occipital lobe epilepsy (PLE and OLE) have not as yet received the attention afforded frontal and temporal lobe epilepsy (FLE and TLE), perhaps due to their low prevalence. Posterior epilepsies however, represent a challenge for epileptology in general and neuropsychological differential diagnosis in particular. Our main purpose was to examine the likely existence of a pattern of cognitive dysfunction characterizing patients suffering from seizures with a parietal and/or occipital ictal onset. We hypothesized that such patients would present difficulties in the visuospatial and visuoconstructive domains, since spatial analysis and synthesis is an inherent feature of posterior cortical systems. Participants were 14 patients with epilepsy and 14 healthy controls matched for demographic characteristics (gender, age, and education level). We used an extensive battery of neuropsychological tests to assess auditory-verbal memory and learning, episodic memory, attention and working memory, verbal abilities, haptic perception, arithmetic abilities, and executive functions. Special attention was given to visuospatial abilities. Depression and anxiety symptoms were assessed through a self-administered questionnaire. Nonparametric (Mann-Whitney U test) statistical tests were conducted. We found that patients with epilepsy performed significantly worse in visuoconstruction, verbal, and executive functions compared to their healthy matches. Finally, we interpret our findings from the perspective of Luria of mental functions organized into functional systems and the current trends in epileptology to view epilepsy as a system (network) problem.
Collapse
|
15
|
Drane DL, Pedersen NP. Knowledge of language function and underlying neural networks gained from focal seizures and epilepsy surgery. BRAIN AND LANGUAGE 2019; 189:20-33. [PMID: 30615986 PMCID: PMC7183240 DOI: 10.1016/j.bandl.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 09/05/2018] [Accepted: 12/19/2018] [Indexed: 05/09/2023]
Abstract
The effects of epilepsy and its treatments have contributed significantly to language models. The setting of epilepsy surgery, which allows for careful pre- and postsurgical evaluation of patients with cognitive testing and neuroimaging, has produced a wealth of language findings. Moreover, a new wave of surgical interventions, including stereotactic laser ablation and radio frequency ablation, have contributed new insights and corrections to language models as they can make extremely precise, focal lesions. This review covers the common language deficits observed in focal dyscognitive seizure syndromes. It also addresses the effects of surgical interventions on language, and highlights insights gained from unique epilepsy assessment methods (e.g., cortical stimulation mapping, Wada evaluation). Emergent findings are covered including a lack of involvement of the hippocampus in confrontation word retrieval, possible roles for key white matter tracts in language, and the often-overlooked basal temporal language area. The relationship between language and semantic memory networks is also explored, with brief consideration given to the prevailing models of semantic processing, including the amodal Hub and distributed, multi-modal processing models.
Collapse
Affiliation(s)
- Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA.
| | - Nigel P Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
16
|
Profile of neuropsychological impairment in Sleep-related Hypermotor Epilepsy. Sleep Med 2018; 48:8-15. [DOI: 10.1016/j.sleep.2018.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/03/2018] [Accepted: 03/14/2018] [Indexed: 11/21/2022]
|
17
|
Kamenskiy IS, Kaymovskiy IL, Gersamiya AG, Vavilina IS. [Cognitive impairment. The effects of seizures?]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:50-54. [PMID: 29213039 DOI: 10.17116/jnevro20171179250-54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review discusses articles on cognitive impairments developing after one or more convulsive seizures. Cognitive disorders seem to be frequent complications of epilepsy. According to recent clinical studies, the intensity of cognitive declines depends on a frequency and severity of seizures. However, presence of an epileptic focus does not always indicate an increase in cognitive impairments. An effect of a single convulsive seizure on cognitive functions at this stage is uncertain. According to some data, cognitive impairments after a single generalized seizures develop only in specific clinical syndromes, on the other hand, they are influenced by the emotional state of the subject. This problem remains relevant today. Further work is needed in this direction.
Collapse
Affiliation(s)
| | | | - A G Gersamiya
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | | |
Collapse
|
18
|
Busch RM, Floden DP, Ferguson L, Mahmoud S, Mullane A, Jones S, Jehi L, Bingaman W, Najm IM. Neuropsychological outcome following frontal lobectomy for pharmacoresistant epilepsy in adults. Neurology 2017; 88:692-700. [PMID: 28087827 DOI: 10.1212/wnl.0000000000003611] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/18/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy. METHODS Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning. Objective methods were used to assess meaningful change across a wide range of abilities and to identify factors associated with neuropsychological decline following frontal lobectomy. Detailed postoperative neuroimaging analysis was conducted to characterize region, extent, and volume of resection. RESULTS Forty-eight percent of patients did not demonstrate meaningful postoperative declines in cognition and an additional 42% demonstrated decline in 1 or 2 cognitive domains. When cognitive decline was observed, it usually occurred on measures of intelligence, visuomotor processing speed, or executive functioning. Side and site of resection were unrelated to cognitive outcome, but played a role in decline of contralateral manual dexterity following supplementary motor area resection. Higher preoperative ability, older age at surgery, absence of a malformation of cortical development on MRI, and poor seizure outcome were related to cognitive decline on some measures, but had poor sensitivity in identifying at-risk patients. CONCLUSIONS The vast majority of patients who undergo frontal lobectomy for treatment of pharmacoresistant epilepsy demonstrate good cognitive and motor outcomes.
Collapse
Affiliation(s)
- Robyn M Busch
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH.
| | - Darlene P Floden
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Lisa Ferguson
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Shamseldeen Mahmoud
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Audrina Mullane
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Stephen Jones
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Lara Jehi
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - William Bingaman
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| | - Imad M Najm
- From the Epilepsy Center (R.M.B., L.F., S.J., L.J., W.B., I.M.N.), Psychiatry & Psychology (R.M.B., D.P.F., L.F., A.M.), Center for Neurological Restoration (D.P.F.), and Diagnostic Radiology (S.M., S.J.), Neurological Institute, Cleveland Clinic, OH
| |
Collapse
|
19
|
|
20
|
Scicchitano F, van Rijn CM, van Luijtelaar G. Unilateral and Bilateral Cortical Resection: Effects on Spike-Wave Discharges in a Genetic Absence Epilepsy Model. PLoS One 2015; 10:e0133594. [PMID: 26262879 PMCID: PMC4532477 DOI: 10.1371/journal.pone.0133594] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 06/29/2015] [Indexed: 12/28/2022] Open
Abstract
Research Question Recent discoveries have challenged the traditional view that the thalamus is the primary source driving spike-and-wave discharges (SWDs). At odds, SWDs in genetic absence models have a cortical focal origin in the deep layers of the perioral region of the somatosensory cortex. The present study examines the effect of unilateral and bilateral surgical resection of the assumed focal cortical region on the occurrence of SWDs in anesthetized WAG/Rij rats, a well described and validated genetic absence model. Methods Male WAG/Rij rats were used: 9 in the resected and 6 in the control group. EEG recordings were made before and after craniectomy, after unilateral and after bilateral removal of the focal region. Results SWDs decreased after unilateral cortical resection, while SWDs were no longer noticed after bilateral resection. This was also the case when the resected areas were restricted to layers I-IV with layers V and VI intact. Conclusions These results suggest that SWDs are completely abolished after bilateral removal of the focal region, most likely by interference with an intracortical columnar circuit. The evidence suggests that absence epilepsy is a network type of epilepsy since interference with only the local cortical network abolishes all seizures.
Collapse
Affiliation(s)
- Francesca Scicchitano
- Department of Health Science, School of Medicine and Surgery, University “Magna Graecia” of Catanzaro, Viale Europa—Germaneto, 88100, Catanzaro, Italy
| | - Clementina M. van Rijn
- Department of Biological Psychology, Donders Centre for Cognition, Donders Institution of Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Gilles van Luijtelaar
- Department of Biological Psychology, Donders Centre for Cognition, Donders Institution of Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- * E-mail:
| |
Collapse
|
21
|
Ljunggren S, Andersson-Roswall L, Rydenhag B, Samuelsson H, Malmgren K. Cognitive outcome two years after frontal lobe resection for epilepsy – A prospective longitudinal study. Seizure 2015. [DOI: 10.1016/j.seizure.2015.05.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
22
|
Robb Swan A, Nichols S, Drake A, Angeles A, Diwakar M, Song T, Lee RR, Huang MX. Magnetoencephalography Slow-Wave Detection in Patients with Mild Traumatic Brain Injury and Ongoing Symptoms Correlated with Long-Term Neuropsychological Outcome. J Neurotrauma 2015; 32:1510-21. [PMID: 25808909 DOI: 10.1089/neu.2014.3654] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mild traumatic brain injury (mTBI) is common in the United States, accounting for as many as 75-80% of all TBIs. It is recognized as a significant public health concern, but there are ongoing controversies regarding the etiology of persistent symptoms post-mTBI. This constellation of nonspecific symptoms is referred to as postconcussive syndrome (PCS). The present study combined results from magnetoencephalography (MEG) and cognitive assessment to examine group differences and relationships between brain activity and cognitive performance in 31 military and civilian individuals with a history of mTBI+PCS and 33 matched healthy control subjects. An operator-free analysis was used for MEG data to increase reliability of the technique. Subjects completed a comprehensive neuropsychological assessment, and measures of abnormal slow-wave activity from MEG were collected. Results demonstrated significant group differences on measures of executive functioning and processing speed. In addition, significant correlations between slow-wave activity on MEG and patterns of cognitive functioning were found in cortical areas, consistent with cognitive impairments on exams. Results provide more objective evidence that there may be subtle changes to the neurobiological integrity of the brain that can be detected by MEG. Further, these findings suggest that these abnormalities are associated with cognitive outcomes and may account, at least in part, for long-term PCS in those who have sustained an mTBI.
Collapse
Affiliation(s)
- Ashley Robb Swan
- 1 Research Services, VA San Diego Healthcare System , San Diego, California.,3 Department of Radiology, University of California , San Diego, San Diego, California
| | - Sharon Nichols
- 4 Department of Neuroscience, University of California , San Diego, San Diego, California
| | - Angela Drake
- 5 Department of Community Health, National University , San Diego, California
| | - AnneMarie Angeles
- 1 Research Services, VA San Diego Healthcare System , San Diego, California.,3 Department of Radiology, University of California , San Diego, San Diego, California
| | - Mithun Diwakar
- 3 Department of Radiology, University of California , San Diego, San Diego, California
| | - Tao Song
- 3 Department of Radiology, University of California , San Diego, San Diego, California
| | - Roland R Lee
- 1 Research Services, VA San Diego Healthcare System , San Diego, California.,2 Radiology Services, VA San Diego Healthcare System , San Diego, California.,3 Department of Radiology, University of California , San Diego, San Diego, California
| | - Ming-Xiong Huang
- 1 Research Services, VA San Diego Healthcare System , San Diego, California.,2 Radiology Services, VA San Diego Healthcare System , San Diego, California.,3 Department of Radiology, University of California , San Diego, San Diego, California
| |
Collapse
|
23
|
van Diessen E, Zweiphenning WJEM, Jansen FE, Stam CJ, Braun KPJ, Otte WM. Brain Network Organization in Focal Epilepsy: A Systematic Review and Meta-Analysis. PLoS One 2014; 9:e114606. [PMID: 25493432 PMCID: PMC4262431 DOI: 10.1371/journal.pone.0114606] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 11/12/2014] [Indexed: 12/17/2022] Open
Abstract
Normal brain functioning is presumed to depend upon interacting regions within large-scale neuronal networks. Increasing evidence exists that interictal network alterations in focal epilepsy are associated with cognitive and behavioral deficits. Nevertheless, the reported network alterations are inconclusive and prone to low statistical power due to small sample sizes as well as modest effect sizes. We therefore systematically reviewed the existing literature and conducted a meta-analysis to characterize the changes in whole-brain interictal focal epilepsy networks at sufficient power levels. We focused on the two most commonly used metrics in whole-brain networks: average path length and average clustering coefficient. Twelve studies were included that reported whole-brain network average path length and average clustering coefficient characteristics in patients and controls. The overall group difference, quantified as the standardized mean average path length difference between epilepsy and control groups, corresponded to a significantly increased average path length of 0.29 (95% confidence interval (CI): 0.12 to 0.45, p = 0.0007) in the epilepsy group. This suggests a less integrated interictal whole-brain network. Similarly, a significantly increased standardized mean average clustering coefficient of 0.35 (CI: 0.05 to 0.65, p = 0.02) was found in the epilepsy group in comparison with controls, pointing towards a more segregated interictal network. Sub-analyses revealed similar results for functional and structural networks in terms of effect size and directionality for both metrics. In addition, we found individual network studies to be prone to low power due to the relatively small group differences in average path length and average clustering coefficient in combination with small sample sizes. The pooled network characteristics support the hypothesis that focal epilepsy has widespread detrimental effects, that is, reduced integration and increased segregation, on whole brain interictal network organization, which may relate to the co-morbid cognitive and behavioral impairments often reported in patients with focal epilepsy.
Collapse
Affiliation(s)
- Eric van Diessen
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- * E-mail:
| | | | - Floor E. Jansen
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis J. Stam
- Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Kees P. J. Braun
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem M. Otte
- Department of Pediatric Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Biomedical MR Imaging and Spectroscopy Group, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
24
|
Verbal Fluency in Focal Epilepsy: A Systematic Review and Meta-analysis. Neuropsychol Rev 2014; 24:200-18. [DOI: 10.1007/s11065-014-9255-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
|
25
|
Predictors of decline in verbal fluency after frontal lobe epilepsy surgery. Epilepsy Behav 2013; 27:326-9. [PMID: 23524470 DOI: 10.1016/j.yebeh.2013.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 02/14/2013] [Accepted: 02/16/2013] [Indexed: 11/21/2022]
Abstract
Few studies have focused on language changes following frontal lobe epilepsy (FLE) surgery. The aim of the current study is to quantify the role of resection location and size in verbal fluency decline after FLE surgery and to examine its predictors. A retrospective chart review identified 36 adult patients who underwent FLE surgery. Verbal fluency was assessed using the Controlled Oral Word Association Test (COWAT). Nine (25%) of the patients had significant decline. Binary logistic regression incorporating side of resection and preoperative COWAT score significantly predicted decline and accounted for 25% of the variance. A trend was also noted for decliners to have higher postoperative seizure recurrence (p=0.067). There was no effect of size of resection. Patients undergoing FLE surgery are at risk of verbal fluency decline, especially if they have a high presurgical verbal fluency score, undergo a frontal lobe resection in the language dominant hemisphere, and have poor seizure outcome.
Collapse
|
26
|
Lazow SP, Thadani VM, Gilbert KL, Morse RP, Bujarski KA, Kulandaivel K, Roth RM, Scott RC, Roberts DW, Jobst BC. Outcome of frontal lobe epilepsy surgery. Epilepsia 2012; 53:1746-55. [DOI: 10.1111/j.1528-1167.2012.03582.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Dulay MF, Busch RM. Prediction of neuropsychological outcome after resection of temporal and extratemporal seizure foci. Neurosurg Focus 2012; 32:E4. [DOI: 10.3171/2012.1.focus11340] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Resection of seizure foci is an effective treatment for the control of medically intractable epilepsy. However, cognitive morbidity can occur as a result of surgical intervention. This morbidity is dependent on several factors, including location and extent of resection, disease characteristics, patient demographic characteristics, and functional status of the tissue to be resected. In this review article, the authors provide a summary of the neurocognitive outcomes of epilepsy surgery with an emphasis on presurgical predictors of postsurgical cognitive decline.
Collapse
Affiliation(s)
- Mario F. Dulay
- 1Comprehensive Epilepsy Program and Department of Neurosurgery, The Methodist Hospital Neurological Institute, Houston, Texas; and
| | - Robyn M. Busch
- 2Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
28
|
Chieffo D, Lettori D, Contaldo I, Perrino F, Graziano A, Palermo C, Mittica A, Tamburrini G, Battaglia D, Di Rocco C, Guzzetta F. Surgery of children with frontal lobe lesional epilepsy: neuropsychological study. Brain Dev 2011; 33:310-5. [PMID: 20619982 DOI: 10.1016/j.braindev.2010.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 06/07/2010] [Accepted: 06/08/2010] [Indexed: 11/27/2022]
Abstract
AIM OF THE STUDY was to provide new data about the evolution of neuropsychological findings in patients with lesional frontal lobe epilepsy (FLE) operated on with lesion excision. PATIENTS AND METHODS Twelve patients with lesional FLE underwent full clinical examination including neurological, neuropsychological and developmental assessments, high-resolution magnetic resonance imaging (MRI), ictal and interictal prolonged EEG monitoring and evaluation of seizure semeiology before and after surgery. The mean follow-up duration was 2 years and 10 months (range=14 months-7 years). Another group of lesional temporal lobe epilepsy, matched for the age at surgery and side of surgery, was likewise studied in order to compare neuropsychological patterns and to try to find out specific features in frontal lobe epilepsy evolution. RESULTS All patients resulted seizure free at outcome except one belonging to Engel's class II. Before surgery general intelligence was similar in FLE as well as in TLE group. Executive functions and motor coordination were frequently affected in FLE whereas patients with TLE often presented with deficits in naming, visual memory and visuo-spatial attention. After surgery there was a frequent decline of IQ in FLE group together with a slight deterioration, especially of executive functions in some patients. An improvement of behaviour was often observed in both groups. CONCLUSIONS As already reported in literature, neuropsychological pre-surgical data confirms the involvement of attention and executive functions in lesional FLE. No significant neuropsychological improvement was produced by surgery that determined in some cases a slight decline of general intelligence and specific frontal abilities. Yet, generally behaviour improved and seizures were controlled.
Collapse
Affiliation(s)
- Daniela Chieffo
- Child Neurology and Psychiatry Unit, Catholic University, Largo Gemelli 8, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
|
30
|
Abstract
INTRODUCTION Cognitive disorders are common in patients with epilepsy. Their aetiology is multifactorial, being affected by the type and location of the epileptogenic lesion, epileptic syndrome, type of seizures, age of onset, frequency and severity. Timely diagnosis and treatment can help to reduce their impact on the patient's quality of life. RESULTS The most significant cognitive deficits are associated with focal epilepsy, although some, usually mild, neuropsychological disorders can be found in idiopathic generalized epilepsy. The use of antiepileptic drugs (AEDs) can cause additional neuropsychological disorders that are of particular concern in learning-age children and elderly patients with cognitive disorders before the start of treatment. Recent studies have raised the concern that the use of some AEDs during pregnancy may cause cognitive disorders in the child exposed to them in utero. Cognitive disorders can also present as a complication of surgery for refractory epilepsy. Some risk factors for significant memory loss after surgery for temporal lobe epilepsy have been described. They include intervention in the dominant hemisphere, good preoperative function and poor functional reserve in the contralateral hippocampus. CONCLUSIONS The heterogeneity of different types of epilepsy makes case-control studies difficult; however, thanks to the growing interest in the neuropsychological deficits associated with epilepsy, we now know some factors that could lead to the appearance of these disorders and their prognosis. Special care must be taken to detect cognitive side effects associated with AEDs, which seem to be more common with classic than with new AEDs, and in those patients receiving polytherapy. Neuropsychological assessment should be routinely performed before epilepsy surgery to predict possible postsurgical cognitive deficits.
Collapse
|
31
|
Neuropsychological disturbances in frontal lobe epilepsy due to mutated nicotinic receptors. Epilepsy Behav 2009; 14:354-9. [PMID: 19059498 DOI: 10.1016/j.yebeh.2008.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 11/14/2008] [Indexed: 11/23/2022]
Abstract
Mutations in nicotinic receptor subunits have been identified in some families with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). Normal intelligence has currently been considered the rule, although anecdotal cases with intellectual disability have been reported. We aimed to evaluate the frequency and degree of neuropsychological disorders in ADNFLE associated with nicotinic receptor mutations by testing 11 subjects from four families with a comprehensive neuropsychological assessment. General intellectual function was below the normal range in 45% of the subjects. All were abnormal in one or more executive task. Memory was either more affected than executive functions or equally affected in two thirds of subjects, suggesting a frontotemporal pattern of cognitive impairment. Cognitive dysfunction appears to be an integral part of the broad phenotype of ADNFLE with nicotinic receptor mutations, a fact that has been underestimated until now. The cognitive disorder affects executive functions as well as memory in most subjects.
Collapse
|
32
|
Neurocognitive and behavioral functioning in frontal lobe epilepsy: a review. Epilepsy Behav 2009; 14:19-26. [PMID: 18926928 DOI: 10.1016/j.yebeh.2008.09.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 09/10/2008] [Accepted: 09/16/2008] [Indexed: 11/23/2022]
Abstract
Frontal lobe epilepsy (FLE) is a seizure disorder with a lower prevalence than temporal lobe epilepsy (TLE). Despite its consequences on cognitive and emotional well-being, the neuropsychology of FLE has not been well studied. By contrast, TLE has been studied meticulously, leading to a relevant understanding of memory and the functional characteristics of the temporal and limbic circuits. The neuropsychological studies on FLE report deficits in motor coordination and planning, reduced attention span, and difficulties in response inhibition in complex cognitive tasks. This review aims to illustrate the most relevant neurocognitive dimensions, psychiatric comorbidity, and postoperative neuropsychological outcome of FLE. Methodological suggestions for future research are also included by critically reviewing the existing literature.
Collapse
|
33
|
Wagstaff GF, Wheatcroft J, Cole JC, Brunas-Wagstaff J, Blackmore V, Pilkington A. Some cognitive and neuropsychological aspects of social inhibition and facilitation. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/09541440701469749] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Silvestri R, Gagliano A, Calarese T, Aricò I, Cedro C, Condurso R, Germanò E, Vita G, Tortorella G. Ictal and interictal EEG abnormalities in ADHD children recorded over night by video-polysomnography. Epilepsy Res 2007; 75:130-7. [PMID: 17588723 DOI: 10.1016/j.eplepsyres.2007.05.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Revised: 04/07/2007] [Accepted: 05/04/2007] [Indexed: 10/23/2022]
Abstract
In this paper we explore the prevalence of ictal and interictal epileptiform discharges (IEDs) and sleep disorders in ADHD children referred to a sleep clinic for all night video-PSG. Forty-two ADHD outpatients (35 males and 7 females) underwent video-PSG and a behavioural/neuropsychological assessment. Spearman correlation coefficients (p<0.05 criterion level) were used to assess the association between cognitive, behavioural, clinical (co-morbidity), sleep (sleep efficiency) and EEG (seizures, IEDs, localization of IEDs foci) variables. Sleep disorders were found in 86% of ADHD children; among these, 26% had RLS. 53.1% of ADHD children had IEDs (28.2% centro-temporal spikes, 12.5% frontal spikes, 9.3% temporal-occipital spikes and 2.3% generalized S-W). Nocturnal seizures were recorded in three patients: two with atypical interictal rolandic spikes and one with left frontal slow abnormalities. A significant relationship (p<0.05) emerges between nocturnal seizures and WISC-R IQ score and visual-spatial memory test and between some cognitive variables and interictal rolandic spikes. High levels of inattention, impulsivity/hyperactivity and oppositional behaviours were related (p<0.01 or 0.05) with Restless Leg Syndrome diagnosis. In conclusion, ADHD is a condition often associated with EEG epileptiform abnormalities. Seizures/IEDs presence seems to play a role on cognitive abilities, conversely sleep disorders have a stronger impact on behavioural rather than cognitive indicators.
Collapse
Affiliation(s)
- Rosalia Silvestri
- Sleep Medicine Centre, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|