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Cai L, He Q, Luo H, Gui X, Wei L, Lu Y, Liu J, Sun A. Is depression in patients with temporal lobe epilepsy related to hippocampal sclerosis? A meta-analysis. Clin Neurol Neurosurg 2023; 225:107602. [PMID: 36689793 DOI: 10.1016/j.clineuro.2023.107602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To systematically evaluate the association between hippocampal sclerosis (HS) and depression in patients with temporal lobe epilepsy (TLE) through a meta-analysis. METHODS Chinese and English databases, such as the China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals (VIP), WanFang, the Chinese Biomedical Literature Service System (SinoMed), PubMed and the Web of Science, were searched. RESULTS Two evaluators independently screened the literature, extracted data and evaluated the risk of bias in the included studies in accordance with the inclusion and exclusion criteria. RevMan 5.1 was used to analyze the data. A total of 786 patients with epilepsy were included in the study, including 82 depressive patients with HS and 64 depressive patients without HS. The results showed that the TLE patients with HS were more likely to develop depression than those without HS (odds ratio (OR)= 2.14, 95% confidence interval (CI) [1.45, 3.16], Z = 3.85, p = 0.0001). CONCLUSION HS can be considered a high-risk factor for depression in patients with TLE, and the correlation is significant. However, the sample size included in the study was small; additional high-quality studies are needed in the future.
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Affiliation(s)
- Lun Cai
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
| | - Qianchao He
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
| | - Huazheng Luo
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
| | - Xiongbin Gui
- Department of Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Liping Wei
- Department of Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
| | - Yongjing Lu
- Department of Nuclear Medicine, Guangxi Minzu Hospital, Nanning 530001, PR China
| | - Jie Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
| | - Anna Sun
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China
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Martín-Suárez S, Abiega O, Ricobaraza A, Hernandez-Alcoceba R, Encinas JM. Alterations of the Hippocampal Neurogenic Niche in a Mouse Model of Dravet Syndrome. Front Cell Dev Biol 2020; 8:654. [PMID: 32793597 PMCID: PMC7385077 DOI: 10.3389/fcell.2020.00654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/01/2020] [Indexed: 01/24/2023] Open
Abstract
Hippocampal neurogenesis, the process by which neural stem cells (NSCs) continuously generate new neurons in the dentate gyrus (DG) of most mammals including humans, is chiefly regulated by neuronal activity. Thus, severe alterations have been found in samples from epilepsy patients and in the hippocampal neurogenic niche in mouse models of epilepsy. Reactive-like and gliogenic NSCs plus aberrant newborn neurons with altered migration, morphology, and functional properties are induced by seizures in experimental models of temporal lobe epilepsy. Hippocampal neurogenesis participates in memory and learning and in the control of anxiety and stress. It has been therefore hypothesized that part of the cognitive symptoms associated with epilepsy could be promoted by impaired hippocampal neurogenesis. We here analyze for the first time the alterations of the neurogenic niche in a novel mouse model of Dravet syndrome (DS), a genetic encephalopathy with severe epilepsy in infancy and multiple neurological comorbidities. Scn1aWT/A1783V mice, hereafter referred to as DS, carrying a heterozygous and clinically relevant SCN1A mutation (A1783V) recapitulate the disease at the genetic and phenotypic levels. We demonstrate that in the neurogenic niche of young adult DS mice there are fewer NSCs, they have impaired cell division and bear reactive-like morphology. In addition, there is significant aberrant neurogenesis. Newborn immature neurons migrate abnormally, and several morphological features are drastically changed. Thus, this study shows for the first time important modifications in hippocampal neurogenesis in DS and opens venues for further research on this topic.
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Affiliation(s)
- Soraya Martín-Suárez
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Oihane Abiega
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Ana Ricobaraza
- Gene Therapy Program CIMA, IdiSNA, Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
| | - Rubén Hernandez-Alcoceba
- Gene Therapy Program CIMA, IdiSNA, Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
| | - Juan Manuel Encinas
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain.,Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain
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Stefanatou M, Gatzonis S, Peskostas A, Paraskevas G, Koutroumanidis M. Drug-responsive versus drug-refractory mesial temporal lobe epilepsy: a single-center prospective outcome study. Postgrad Med 2019; 131:479-485. [PMID: 31513436 DOI: 10.1080/00325481.2019.1663126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives: To evaluate clinical, electrophysiological, and neuroradiological factors which correlate with the prognosis in patients with mesial temporal lobe epilepsy (MTLE). Methods: This was a single-center prospective outcome study in patients with MTLE. The patients' family history, clinical characteristics, neurophysiological data (electroencephalography - EEG), neuroimaging, antiepileptic therapy, and outcome were collected and analyzed. The population was divided into four groups depending on the frequency of the seizures when they attended their last follow up. All variables and outcome measures were compared between the four groups. Results: In total 83 consecutive patients were included within the four groups. Group 1 (seizure-free) consisted of 7 patients, (9%), Group 2 (rare seizures) consisted of 15 patients (18%), Group 3 (often seizures) consisted of 30 patients (36%), and Group 4 (very often seizures) consisted of 31 patients (37%). The groups did not differ significantly in demographic characteristics. There was a strong positive correlation between resistance to therapy and sleep activation on EEG (p = 0.005), occurrence of focal to bilateral seizures (p = 0.007), automatisms (p = 0.004), and the number of previously used antiepileptic drugs (AEDs) (p = 0.002). There was no association between febrile convulsions (FC), hippocampal sclerosis (HS), and the outcome that was found. Conclusion: MTLE is a heterogeneous syndrome. Establishing the factors responsible for, and associated with, drug resistance is important for optimal management and treatment, as early identification of drug resistance should then ensure a timely referral for surgical treatment is made. This prospective study shows that sleep activation on EEG, ictal automatisms, occurrence of focal to bilateral tonic-clonic seizures, and increased number of tried AEDs are negative prognostic factors.
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Affiliation(s)
- Maria Stefanatou
- 1st Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece.,Department of Clinical Neurophysiology and Epilepsies, Guy's and St. Thomas' NHS Foundation Trust , London , UK
| | - Stylianos Gatzonis
- 1st Department of Neurosurgery, Epilepsy Centre, National and Kapodistrian University of Athens, "Evangelismos" Hospital , Athens , Greece
| | - Antonis Peskostas
- Department of Statistics and Insurance Science, University of Piraeus , Piraeus , Greece
| | - George Paraskevas
- 1st Department of Neurology, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece
| | - Michael Koutroumanidis
- Department of Clinical Neurophysiology and Epilepsies, Guy's and St. Thomas' NHS Foundation Trust , London , UK
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Muro-García T, Martín-Suárez S, Espinosa N, Valcárcel-Martín R, Marinas A, Zaldumbide L, Galbarriatu L, Sierra A, Fuentealba P, Encinas JM. Reactive Disruption of the Hippocampal Neurogenic Niche After Induction of Seizures by Injection of Kainic Acid in the Amygdala. Front Cell Dev Biol 2019; 7:158. [PMID: 31482091 PMCID: PMC6710991 DOI: 10.3389/fcell.2019.00158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/29/2019] [Indexed: 01/22/2023] Open
Abstract
Adult neurogenesis persists in the adult hippocampus due to the presence of multipotent neural stem cells (NSCs). Hippocampal neurogenesis is involved in a range of cognitive functions and is tightly regulated by neuronal activity. NSCs respond promptly to physiological and pathological stimuli altering their neurogenic and gliogenic potential. In a mouse model of mesial temporal lobe epilepsy (MTLE), seizures triggered by the intrahippocampal injection of the glutamate receptor agonist kainic acid (KA) induce NSCs to convert into reactive NSCs (React-NSCs) which stop producing new neurons and ultimately generate reactive astrocytes thus contributing to the development of hippocampal sclerosis and abolishing neurogenesis. We herein show how seizures triggered by the injection of KA in the amygdala, an alternative model of MTLE which allows parallel experimental manipulation in the dentate gyrus, also trigger the induction of React-NSCs and provoke the disruption of the neurogenic niche resulting in impaired neurogenesis. These results highlight the sensitivity of NSCs to the surrounding neuronal circuit activity and demonstrate that the induction of React-NSCs and the disruption of the neurogenic niche are not due to the direct effect of KA in the hippocampus. These results also suggest that neurogenesis might be lost in the hippocampus of patients with MTLE. Indeed we provide results from human MTLE samples absence of cell proliferation, of neural stem cell-like cells and of neurogenesis.
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Affiliation(s)
- Teresa Muro-García
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Soraya Martín-Suárez
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Nelson Espinosa
- Departamento de Psiquiatría, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto Valcárcel-Martín
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Ainhoa Marinas
- Epilepsy Unit, University Hospital of Cruces, Bilbao, Spain
| | | | | | - Amanda Sierra
- Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,Laboratory of Glial Cell Biology, Achucarro Basque Center for Neuroscience, Leioa, Spain.,IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain
| | - Pablo Fuentealba
- Departamento de Psiquiatría, Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Manuel Encinas
- The Neural Stem Cell and Neurogenesis Laboratory, Achucarro Basque Center for Neuroscience, Leioa, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain.,IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain
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Bjørke AB, Nome CG, Falk RS, Gjerstad L, Taubøll E, Heuser K. Evaluation of long-term antiepileptic drug use in patients with temporal lobe epilepsy: Assessment of risk factors for drug resistance and polypharmacy. Seizure 2018; 61:63-70. [PMID: 30099235 DOI: 10.1016/j.seizure.2018.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 06/12/2018] [Accepted: 07/14/2018] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate risk factors for drug resistance and polypharmacy in patients with temporal lobe epilepsy. METHODS Patients with temporal lobe epilepsy, treated for more than 5 years, completed questionnaires on antiepileptic drug use and effect. Logistic regression models were used for analysis of risk factors. RESULTS Of 135 patients included in the study, 65% were classified as drug resistant and 41% identified as using polypharmacy. Poor effects associated with first-choice antiepileptic drug were reported by 59% of the patients, and 70% reported poor effects of second-line treatment. The most frequently used first-generation antiepileptic drugs had a similar mean effect to those of second-generation. Univariate regression analyses showed a significant association between drug resistance and mesial temporal sclerosis, seizure onset below 18 years, and lack of family history of epilepsy. However, multivariate regression analysis showed no association with any demographic or clinical features. Unsuccessful treatment with the first antiepileptic drug increased the risk of drug resistance by 18 times, and the risk of poor effect from the second antiepileptic drug by 9 times. Disease duration was associated with annual risk for drug resistance of 7% and for polypharmacy of 5%. CONCLUSIONS A poor effect from initial pharmacotherapy is the only early risk factor for drug resistance found in this study. Long disease duration increases the risk of drug resistance and polypharmacy. Second-generation antiepileptic drugs provide no additional effect for poor responders to first-generation drugs.
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Affiliation(s)
- Agnes Balint Bjørke
- Department of Neurology, Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Department of Neurology, Division of Neurology, Rheumatology and Habilitation, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
| | - Cecilie Gjessing Nome
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
| | - Leif Gjerstad
- Department of Neurology, Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Erik Taubøll
- Department of Neurology, Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Kjell Heuser
- Department of Neurology, Division of Clinical Neuroscience, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
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Sideman N, Chaitanya G, He X, Doucet G, Kim NY, Sperling MR, Sharan AD, Tracy JI. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy. Epilepsy Behav 2018; 81:70-78. [PMID: 29499551 DOI: 10.1016/j.yebeh.2018.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/12/2018] [Accepted: 01/23/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. METHODS A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. RESULTS Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. SIGNIFICANCE Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several different phenotypes, varying according to side of seizure onset and the specific mesial structures involved. There is good correspondence between task LI activation and FC patterns in the setting of LTLE, suggesting that reliable visual episodic memory reorganization may require both a shift in nodal activation and a change in nodal connectivity with mesial temporal structures involved in memory.
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Affiliation(s)
- Noah Sideman
- Thomas Jefferson University, Department of Neurology, United States
| | - Ganne Chaitanya
- Thomas Jefferson University, Department of Neurology, United States
| | - Xiaosong He
- Thomas Jefferson University, Department of Neurology, United States
| | - Gaelle Doucet
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, United States
| | - Na Young Kim
- Thomas Jefferson University, Department of Neurology, United States
| | | | - Ashwini D Sharan
- Thomas Jefferson University, Department of Neurosurgery, United States
| | - Joseph I Tracy
- Thomas Jefferson University, Department of Neurology, United States.
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Oishi S, Zalucki O, Premarathne S, Wood SA, Piper M. USP9X deletion elevates the density of oligodendrocytes within the postnatal dentate gyrus. NEUROGENESIS 2016; 3:e1235524. [PMID: 27830160 DOI: 10.1080/23262133.2016.1235524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 12/27/2022]
Abstract
Neural stem cells (NSCs) within the adult hippocampal dentate gyrus reside in the subgranular zone (SGZ). A dynamic network of signaling mechanisms controls the balance between the maintenance of NSC identity, and their subsequent differentiation into dentate granule neurons. Recently, the ubiquitin-specific protease 9 X-linked (USP9X) was shown to be important for hippocampal morphogenesis, as mice lacking this gene exhibited a higher proportion of proliferating NSCs, yet a decrease in neuronal numbers, within the postnatal dentate gyrus. Here we reveal that Usp9x-deficiency results in the upregulation of numerous oligodendrocytic and myelin-associated genes within the postnatal hippocampus. Moreover, cell counts reveal a significant increase in oligodendrocyte precursor cells and mature oligodendrocytes per unit volume of the mutant dentate gyrus. Collectively, these findings indicate that USP9X may regulate NSC lineage determination within the postnatal SGZ.
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Affiliation(s)
- Sabrina Oishi
- The School of Biomedical Sciences, The University of Queensland , Brisbane, Queensland, Australia
| | - Oressia Zalucki
- The School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Susitha Premarathne
- The Eskitis Institute for Drug Discovery, Griffith University , Brisbane, Queensland, Australia
| | - Stephen A Wood
- The Eskitis Institute for Drug Discovery, Griffith University , Brisbane, Queensland, Australia
| | - Michael Piper
- The School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
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Kuzmanovski I, Cvetkovska E, Babunovska M, Kiteva Trencevska G, Kuzmanovska B, Boshkovski B, Isjanovska R. Seizure outcome following medical treatment of mesial temporal lobe epilepsy: Clinical phenotypes and prognostic factors. Clin Neurol Neurosurg 2016; 144:91-5. [DOI: 10.1016/j.clineuro.2016.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/20/2016] [Accepted: 03/08/2016] [Indexed: 01/03/2023]
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Neuronal hyperactivity accelerates depletion of neural stem cells and impairs hippocampal neurogenesis. Cell Stem Cell 2016; 16:488-503. [PMID: 25957904 DOI: 10.1016/j.stem.2015.04.003] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 12/02/2014] [Accepted: 04/06/2015] [Indexed: 11/20/2022]
Abstract
Adult hippocampal neurogenesis is believed to maintain a range of cognitive functions, many of which decline with age. We recently reported that radial neural stem cells (rNSCs) in the hippocampus undergo activation-dependent conversion into astrocytes, a mechanism that over time contributes to a reduction in the rNSC population. Here, we injected low and high levels of kainic acid (KA) in the dentate gyrus to assess whether neuronal hyperexcitation, a hallmark of epileptic disorders, could accelerate this conversion. At low levels of KA, generating epileptiform activity without seizures, we indeed found increased rNSC activation and conversion into astrocytes. At high levels, generating sustained epileptic seizures, however, we find that rNSCs divide symmetrically and that both mother and daughter cells convert into reactive astrocytes. Our results demonstrate that a threshold response for neuronal hyperexcitation provokes a dramatic shift in rNSC function, which impairs adult hippocampal neurogenesis in the long term.
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Coan AC, Campos BM, Beltramini GC, Yasuda CL, Covolan RJM, Cendes F. Distinct functional and structural MRI abnormalities in mesial temporal lobe epilepsy with and without hippocampal sclerosis. Epilepsia 2014; 55:1187-96. [PMID: 24903633 DOI: 10.1111/epi.12670] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to investigate patterns of electroencephalography-correlated functional MRI (EEG-fMRI) and subtle structural abnormalities in patients with mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (MTLE-HS) or normal MRI (MTLE-NL). METHODS We evaluated EEG-fMRI acquisition of the 25 patients with diagnosis of MTLE who had interictal epileptiform discharges (IEDs) in the intra-MRI EEG: 13 MTLE-HS and 12 MTLE-NL. fMRI was performed using echo-planar images in a 3T MRI coupled with EEG acquired with 64 MRI-compatible electrodes. In the first level analyses, the time of the IEDs ipsilateral to the epileptogenic zone was used as the paradigm, and four contrasts maps were built according to the variation of the hemodynamic response function (HRF) peaks (0, +3, +5, and +7 s). Second level group analyses were performed combining the contrast maps of MTLE-HS or MTLE-NL patients with each different HRF obtained at the first level. Areas of gray matter atrophy were evaluated with voxel-based morphometry (VBM) in both groups. RESULTS MTLE-HS and MTLE-NL had IED-related positive BOLD (posBOLD) detected in the ipsilateral anterior temporal lobe and insula. However, only MTLE-HS had significant posBOLD on contralateral hippocampus and anterior cingulate, whereas MTLE-NL had areas of posBOLD on ipsilateral frontal lobe. Both groups had significant IED-related negBOLD responses in areas of the default mode network (DMN), such as posterior cingulate and precuneus. There was no overlap of both posBOLD and negBOLD and areas of atrophy detected by VBM. SIGNIFICANCE Similar IEDs have different patterns of hemodynamic responses in sub-groups of MTLE. In both MTLE-HS and MTLE-NL, there is a possible suppression of the DMN related to IEDs, as demonstrated by the negBOLD in these areas. The brain areas involved in the interictal related hemodynamic network are not the regions with the most significant gray matter atrophy in MTLE with or without MRI signs of HS.
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Affiliation(s)
- Ana C Coan
- Department of Neurology, Neuroimaging Laboratory, University of Campinas, Campinas, São Paulo, Brazil
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11
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Sanchez-Gistau V, Sugranyes G, Baillés E, Carreño M, Donaire A, Bargalló N, Pintor L. Is major depressive disorder specifically associated with mesial temporal sclerosis? Epilepsia 2012; 53:386-92. [PMID: 22220776 DOI: 10.1111/j.1528-1167.2011.03373.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Whether a specific lesion such as mesial temporal sclerosis (MTS) increases the risk for a mood disorder in epilepsy remains subject to debate. Despite evidence of limbic system involvement in the genesis of emotional symptoms, recent studies fail to support an association between depression and MTS. We aimed to clarify this controversial issue by overcoming prior methodologic limitations, hypothesizing that rates of major depressive disorder (MDD) would be higher in patients with MTS. METHODS Three hundred eight patients with focal epilepsy (International League Against Epilepsy [ILAE] criteria), were classified into three groups on the basis of neuroimaging findings: MTS, a lesion different from MTS, or absence of lesion. Patients were assessed using the Structured Interview for DSM-IV axis I psychiatric disorders (SCID-I), by a psychiatrist blinded to epilepsy subtype. The Spanish version of the Hospital Anxiety and Depression Scale (HADS) was also administered. A complete logistic regression analysis was performed to investigate the association between MTS and MDD. KEY FINDINGS MTS increased the likelihood of a lifetime MDD by nearly 2.5. No other current or "postseizure onset" lifetime Axis I DSM-IV psychiatric disorder was associated with MTS. Female gender, primary education, comorbid anxiety disorders, and antidepressant treatment were also associated with an increased risk of MDD. Marriage was found to be a protective factor for MDD. SIGNIFICANCE Our results support a specific association between MTS and lifetime "postseizure onset," MDD. The lack of association with current depression is in line with the hypothesis that the link between MTS and depression is more of a chronic than a state-dependent condition.
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Affiliation(s)
- Vanessa Sanchez-Gistau
- Department of Child and Adolescent Psychiatry, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.
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Heuser K, Hoddevik EH, Taubøll E, Gjerstad L, Indahl U, Kaczmarek L, Berg PR, Lien S, Nagelhus EA, Ottersen OP. Temporal Lobe Epilepsy and Matrix Metalloproteinase 9: A tempting relation but negative genetic association. Seizure 2010; 19:335-8. [DOI: 10.1016/j.seizure.2010.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 05/03/2010] [Accepted: 05/07/2010] [Indexed: 01/26/2023] Open
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13
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Heuser K, Nagelhus EA, Taubøll E, Indahl U, Berg PR, Lien S, Nakken S, Gjerstad L, Ottersen OP. Variants of the genes encoding AQP4 and Kir4.1 are associated with subgroups of patients with temporal lobe epilepsy. Epilepsy Res 2009; 88:55-64. [PMID: 19864112 DOI: 10.1016/j.eplepsyres.2009.09.023] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Revised: 09/09/2009] [Accepted: 09/25/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The etiopathogenesis of temporal lobe epilepsy (TLE) and its subgroups - mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and TLE with antecedent febrile seizures (TLE-FS) - is poorly understood. It has been proposed that the water channel aquaporin-4 (AQP4) and the potassium channel Kir4.1 (KCNJ10 gene) act in concert to regulate extracellular K(+) homeostasis and that functional alterations of these channels influence neuronal excitability. The current study was designed to identify variants of the AQP4 and KCNJ10 genes associated with TLE and subgroups of this condition. MATERIAL AND METHODS We included 218 Norwegian patients with TLE and 181 ethnically matched healthy controls. An association study was established in which all TLE patients were compared with healthy controls. Additionally, subgroups of 56 MTLE-HS patients were compared with 162 TLE patients without HS, and 102 TLE-FS patients were compared with 105 TLE without FS. RESULTS We found eight single SNPs, seven in KCNJ10 and one between KCNJ10 and KCNJ9, associated with TLE-FS (nominal p-values from 0.009 to 0.041). Seven of the SNPs segregate into one large haplotype block expanding from KCNJ10 to KCNJ9, including the region interposed those genes. One haplotype was overrepresented in the TLE-FS cases (nominal p-value 0.014). These results were confirmed by explorative multivariate analysis indicating that a combination of SNPs from KCNJ10, the region between KCNJ10 and KCNJ9, and the AQP4 gene is associated with TLE-FS. For the TLE cohort as a whole, explorative multivariate analysis indicated a combination of SNPs from the KCNJ10 and AQP4 genes in association with TLE. CONCLUSION Variations in the AQP4 and the KCNJ10/KCNJ9 region are likely to be associated with TLE, particularly TLE-FS, supporting the suggestion that perturbations of water and K(+) transport are involved in the etiopathogenesis of TLE.
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Affiliation(s)
- Kjell Heuser
- Department of Neurology, Rikshospitalet University Hospital, Oslo, Norway.
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