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Zhang Q, Li J, He Y, Yang F, Xu Q, Larivière S, Bernhardt BC, Liao W, Lu G, Zhang Z. Atypical functional connectivity hierarchy in Rolandic epilepsy. Commun Biol 2023; 6:704. [PMID: 37429897 DOI: 10.1038/s42003-023-05075-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 06/26/2023] [Indexed: 07/12/2023] Open
Abstract
Functional connectivity hierarchy is an important principle in the process of brain functional organization and an important feature reflecting brain development. However, atypical brain network hierarchy organization in Rolandic epilepsy have not been systematically investigated. We examined connectivity alteration with age and its relation to epileptic incidence, cognition, or underlying genetic factors in 162 cases of Rolandic epilepsy and 117 typically developing children, by measuring fMRI multi-axis functional connectivity gradients. Rolandic epilepsy is characterized by contracting and slowing expansion of the functional connectivity gradients, highlighting the atypical age-related change of the connectivity hierarchy in segregation properties. The gradient alterations are relevant to seizure incidence, cognition, and connectivity deficit, and development-associated genetic basis. Collectively, our approach provides converging evidence for atypical connectivity hierarchy as a system-level substrate of Rolandic epilepsy, suggesting this is a disorder of information processing across multiple functional domains, and established a framework for large-scale brain hierarchical research.
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Affiliation(s)
- Qirui Zhang
- Department of Diagnostic Radiology, Jinling Hospital, the First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, China
- Department of Diagnostic Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Yan He
- Department of Neurology, Children's Hospital of Nanjing Medical University, Nanjing, 210002, China
| | - Fang Yang
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
| | - Qiang Xu
- Department of Diagnostic Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China
- College of Automation Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, 210002, China
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Guangming Lu
- Department of Diagnostic Radiology, Jinling Hospital, the First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, China.
- Department of Diagnostic Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China.
| | - Zhiqiang Zhang
- Department of Diagnostic Radiology, Jinling Hospital, the First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, China.
- Department of Diagnostic Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China.
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Xu F, Xu Y, Wang Y, Niu K, Li Y, Wang P, Li Y, Sun J, Chen Q, Wang X. Language-related brain areas in childhood epilepsy with centrotemporal spikes studied with MEG. Clin Neurophysiol 2023; 152:11-21. [PMID: 37257319 DOI: 10.1016/j.clinph.2023.05.005] [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: 12/19/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Children with self-limited epilepsy with centrotemporal spikes (SeLECTS) typically indicate cognitive impairment with widespread speech impairment. We explored how epilepsy affects language-related brain areas and areas in their vicinity. METHODS Twenty-two children with SeLECTS and declined verbal comprehension (DVC), 21 with SeLECTS and normal verbal comprehension (NVC), and 23 healthy controls (HCs) underwent high-sampling magnetoencephalography recordings. According to a previous study, 24 language-related regions of interest were selected bilaterally, and the relative spectral power was estimated using a minimum norm estimate. RESULTS The highest mean power spectral density was observed in the delta band for the DVC group, in the theta band for the NVC group, and in the alpha band for HCs within language-specific brain regions. The distinctions between the DVC and NVC groups in the delta and theta frequency bands were primarily concentrated in the right linguistic brain area. CONCLUSIONS Children with SeLECTS may have developmental problems in language-related brain areas, with different developmental levels observed in the DVC, NVC, and HC groups. The DVC group could have inferior speech comprehension due to a more significant number of seizures and more left-sided spike locations. SIGNIFICANCE Children having SeLECTS showed impaired brain maturation, leading to associated language impairment.
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Affiliation(s)
- Fengyuan Xu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Xu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yingfan Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Kai Niu
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yihan Li
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Pengfei Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yanzhang Li
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jintao Sun
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qiqi Chen
- Country MEG Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoshan Wang
- Country Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
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Hageter J, Starkey J, Horstick EJ. Thalamic regulation of a visual critical period and motor behavior. Cell Rep 2023; 42:112287. [PMID: 36952349 PMCID: PMC10514242 DOI: 10.1016/j.celrep.2023.112287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/02/2023] [Accepted: 03/03/2023] [Indexed: 03/24/2023] Open
Abstract
During the visual critical period (CP), sensory experience refines the structure and function of visual circuits. The basis of this plasticity was long thought to be limited to cortical circuits, but recently described thalamic plasticity challenges this dogma and demonstrates greater complexity underlying visual plasticity. Yet how visual experience modulates thalamic neurons or how the thalamus modulates CP timing is incompletely understood. Using a larval zebrafish, thalamus-centric ocular dominance model, we show functional changes in the thalamus and a role of inhibitory signaling to establish CP timing using a combination of functional imaging, optogenetics, and pharmacology. Hemisphere-specific changes in genetically defined thalamic neurons correlate with changes in visuomotor behavior, establishing a role of thalamic plasticity in modulating motor performance. Our work demonstrates that visual plasticity is broadly conserved and that visual experience leads to neuron-level functional changes in the thalamus that require inhibitory signaling to establish critical period timing.
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Affiliation(s)
- John Hageter
- Department of Biology, West Virginia University, Morgantown, WV 26506, USA
| | - Jacob Starkey
- Department of Biology, West Virginia University, Morgantown, WV 26506, USA
| | - Eric J Horstick
- Department of Biology, West Virginia University, Morgantown, WV 26506, USA; Department of Neuroscience, West Virginia University, Morgantown, WV 26506, USA.
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Delayed brain development of Rolandic epilepsy profiled by deep learning-based neuroanatomic imaging. Eur Radiol 2021; 31:9628-9637. [PMID: 34018056 DOI: 10.1007/s00330-021-08048-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/30/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Although Rolandic epilepsy (RE) has been regarded as a brain developmental disorder, neuroimaging studies have not yet ascertained whether RE has brain developmental delay. This study employed deep learning-based neuroanatomic biomarker to measure the changed feature of "brain age" in RE. METHODS The study constructed a 3D-CNN brain age prediction model through 1155 cases of typically developing children's morphometric brain MRI from open-source datasets and further applied to a local dataset of 167 RE patients and 107 typically developing children. The brain-predicted age difference was measured to quantitatively estimate brain age changes in RE and further investigated the relevancies with cognitive and clinical variables. RESULTS The brain age estimation network model presented a good performance for brain age prediction in typically developing children. The children with RE showed a 0.45-year delay of brain age by contrast with typically developing children. Delayed brain age was associated with neuroanatomic changes in the Rolandic regions and also associated with cognitive dysfunction of attention. CONCLUSION This study provided neuroimaging evidence to support the notion that RE has delayed brain development. KEY POINTS • The children with Rolandic epilepsy showed imaging phenotypes of delayed brain development with increased GM volume and decreased WM volume in the Rolandic regions. • The children with Rolandic epilepsy had a 0.45-year delay of brain-predicted age by comparing with typically developing children, using 3D-CNN-based brain age prediction model. • The delayed brain age was associated with morphometric changes in the Rolandic regions and attentional deficit in Rolandic epilepsy.
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Armangue T, Spatola M, Vlagea A, Mattozzi S, Cárceles-Cordon M, Martinez-Heras E, Llufriu S, Muchart J, Erro ME, Abraira L, Moris G, Monros-Giménez L, Corral-Corral Í, Montejo C, Toledo M, Bataller L, Secondi G, Ariño H, Martínez-Hernández E, Juan M, Marcos MA, Alsina L, Saiz A, Rosenfeld MR, Graus F, Dalmau J. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. Lancet Neurol 2018; 17:760-772. [PMID: 30049614 DOI: 10.1016/s1474-4422(18)30244-8] [Citation(s) in RCA: 346] [Impact Index Per Article: 57.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/04/2018] [Accepted: 06/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Herpes simplex encephalitis can trigger autoimmune encephalitis that leads to neurological worsening. We aimed to assess the frequency, symptoms, risk factors, and outcomes of this complication. METHODS We did a prospective observational study and retrospective analysis. In the prospective observational part of this study, we included patients with herpes simplex encephalitis diagnosed by neurologists, paediatricians, or infectious disease specialists in 19 secondary and tertiary Spanish centres (Cohort A). Outpatient follow-up was at 2, 6, and 12 months from onset of herpes simplex encephalitis. We studied another group of patients retrospectively, when they developed autoimmune encephalitis after herpes simplex encephalitis (Cohort B). We compared demographics and clinical features of patients who developed autoimmune encephalitis with those who did not, and in patients who developed autoimmune encephalitis we compared these features by age group (patients ≤4 years compared with patients >4 years). We also used multivariable binary logistic regression models to assess risk factors for autoimmune encephalitis after herpes simplex encephalitis. FINDINGS Between Jan 1, 2014, and Oct 31, 2017, 54 patients with herpes simplex encephalitis were recruited to Cohort A, and 51 were included in the analysis (median age 50 years [IQR 5-68]). At onset of herpes simplex encephalitis, none of the 51 patients had antibodies to neuronal antigens; during follow-up, 14 (27%) patients developed autoimmune encephalitis and all 14 (100%) had neuronal antibodies (nine [64%] had NMDA receptor [NMDAR] antibodies and five [36%] had other antibodies) at or before onset of symptoms. The other 37 patients did not develop autoimmune encephalitis, although 11 (30%) developed antibodies (n=3 to NMDAR, n=8 to unknown antigens; p<0·001). Antibody detection within 3 weeks of herpes simplex encephalitis was a risk factor for autoimmune encephalitis (odds ratio [OR] 11·5, 95% CI 2·7-48·8; p<0·001). Between Oct 7, 2011, and Oct 31, 2017, there were 48 patients in Cohort B with new-onset or worsening neurological symptoms not caused by herpes simplex virus reactivation (median age 8·8 years [IQR 1·1-44·2]; n=27 male); 44 (92%) patients had antibody-confirmed autoimmune encephalitis (34 had NMDAR antibodies and ten had other antibodies). In both cohorts (n=58 patients with antibody-confirmed autoimmune encephalitis), patients older than 4 years frequently presented with psychosis (18 [58%] of 31; younger children not assessable). Compared with patients older than 4 years, patients aged 4 years or younger (n=27) were more likely to have shorter intervals between onset of herpes simplex encephalitis and onset of autoimmune encephalitis (median 26 days [IQR 24-32] vs 43 days [25-54]; p=0·0073), choreoathetosis (27 [100%] of 27 vs 0 of 31; p<0·001), decreased level of consciousness (26 [96%] of 27 vs seven [23%] of 31; p<0·001), NMDAR antibodies (24 [89%] of 27 vs 19 [61%] of 31; p=0·033), and worse outcome at 1 year (median modified Rankin Scale 4 [IQR 4-4] vs 2 [2-3]; p<0·0010; seizures 12 [63%] of 19 vs three [13%] of 23; p=0·001). INTERPRETATION The results of our prospective study show that autoimmune encephalitis occurred in 27% of patients with herpes simplex encephalitis. It was associated with development of neuronal antibodies and usually presented within 2 months after treatment of herpes simplex encephalitis; the symptoms were age-dependent, and the neurological outcome was worse in young children. Prompt diagnosis is important because patients, primarily those older than 4 years, can respond to immunotherapy. FUNDING Mutua Madrileña Foundation, Fondation de l'Université de Lausanne et Centre Hospitalier Universitaire Vaudois, Instituto Carlos III, CIBERER, National Institutes of Health, Generalitat de Catalunya, Fundació CELLEX.
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Affiliation(s)
- Thaís Armangue
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Pediatric Neuroimmunology Unit, Neurology Department, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Marianna Spatola
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; University of Lausanne, Lausanne, Switzerland
| | - Alexandru Vlagea
- Immunology Department, Centre of Biomedical Diagnosis, Hospital Clínic, University of Barcelona, Barcelona, Spain; Functional Unit of Clinical Immunology, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Simone Mattozzi
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Section of Child Neuropsychiatry, Department of Medical Surgical and Experimental Medicine, University of Sassari (Sassari), Italy
| | - Marc Cárceles-Cordon
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Eloy Martinez-Heras
- Laboratory of Advanced Imaging in Neuroimmunological Diseases (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Sara Llufriu
- Laboratory of Advanced Imaging in Neuroimmunological Diseases (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Muchart
- Department of Radiology, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - María Elena Erro
- Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Laura Abraira
- Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
| | - German Moris
- Department of Neurology, Hospital Central de Asturias, Oviedo, Spain
| | - Luis Monros-Giménez
- Department of Neurology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Carmen Montejo
- Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Manuel Toledo
- Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Luis Bataller
- Department of Neurology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Gabriela Secondi
- Pediatric Neuroimmunology Unit, Neurology Department, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Helena Ariño
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Eugenia Martínez-Hernández
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Manel Juan
- Immunology Department, Centre of Biomedical Diagnosis, Hospital Clínic, University of Barcelona, Barcelona, Spain; Functional Unit of Clinical Immunology, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Maria Angeles Marcos
- Microbiology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Laia Alsina
- Functional Unit of Clinical Immunology, Research Institute of Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Albert Saiz
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Myrna R Rosenfeld
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Department of Neurology, University of Pennsylvania, PA, USA
| | - Francesc Graus
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Josep Dalmau
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain; Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain; Department of Neurology, University of Pennsylvania, PA, USA; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
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Ogawa C, Kidokoro H, Fukasawa T, Yamamoto H, Ishihara N, Ito Y, Sakaguchi Y, Okai Y, Ohno A, Nakata T, Azuma Y, Hattori A, Kubota T, Tsuji T, Hirakawa A, Kawai H, Natsume J. Cytotoxic edema at onset in West syndrome of unknown etiology: A longitudinal diffusion tensor imaging study. Epilepsia 2018; 59:440-448. [PMID: 29315514 DOI: 10.1111/epi.13988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To clarify longitudinal changes in white matter microstructures from the onset of disease in patients with West syndrome (WS) of unknown etiology. METHODS Diffusion tensor imaging (DTI) was prospectively performed at onset and at 12 and 24 months old in 17 children with WS of unknown etiology. DTI was analyzed using tract-based spatial statistics (TBSS) and tract-specific analysis (TSA) of 13 fiber tracts, and fractional anisotropy (FA) and mean diffusivity (MD) were compared with those of 42 age-matched controls. Correlations of FA and MD with developmental quotient (DQ) at age 24 months were analyzed. Multiple comparisons were adjusted for using the false discovery rate (q-value). RESULTS TBSS analysis at onset showed higher FA and lower MD in the corpus callosum and brainstem in patients. TSA showed lower MD in bilateral uncinate fasciculi (UF) (right: q < 0.001; left: q = 0.03) at onset in patients. TBSS showed a negative correlation between FA at onset and DQ in the right frontal lobe, whereas FA at 24 months old exhibited a positive correlation with DQ in the diffuse white matter. MD for bilateral UF at 24 months old on TSA correlated positively with DQ (q = 0.04, both). SIGNIFICANCE These findings may indicate the existence of cytotoxic edema in the immature white matter and dorsal brainstem at onset, and subsequent alterations in the diffuse white matter in WS of unknown etiology. Microstructural development in the UF might play important roles in cognitive development in WS.
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Affiliation(s)
- Chikako Ogawa
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | | | - Hiroyuki Yamamoto
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoko Ishihara
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuji Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoko Sakaguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Okai
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsuko Ohno
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiko Nakata
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiteru Azuma
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayako Hattori
- Department of Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tetsuo Kubota
- Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
| | - Takeshi Tsuji
- Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
| | - Akihiro Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisashi Kawai
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Brain and Mind Research Center, Nagoya University, Nagoya, Japan.,Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Childhood absence epilepsy and benign epilepsy with centro-temporal spikes: a narrative review analysis. World J Pediatr 2017; 13:106-111. [PMID: 28101769 DOI: 10.1007/s12519-017-0006-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/01/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recent studies have shown a possible coexistence of absence seizures with other forms of epilepsy. The purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS) in pediatric epileptic patients. DATA SOURCES A PubMed systematic search indexed for MEDLINE, PubMed and EMBASE was undertaken to identify studies in children including articles written between 1996 and 2015. Retrospective studies, meta-analysis and case reports were included. The list of references of all the relevant articles was also studied. The date of our last search was December 2015. RESULTS Review of the literature revealed 19 cases, 8 females and 11 males, reporting a consecutive or contemporary coexistence of CAE and BECTS within the same patients. Patient's age ranged between 4 and 12 years. Three out of 19 patients presented concomitant features of both syndromes, whereas 16 patients experienced the two syndromes at different times. CONCLUSIONS BECTS and CAE may be pathophysiologically related, and the two epileptic phenotypes may indicate a neurobiological continuum. Further studies are needed to elucidate a probable genetic or functional link between partial and primarily generalized electro-clinical patterns in idiopathic childhood epilepsies.
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Wilmshurst JM, Berg AT, Lagae L, Newton CR, Cross JH. The challenges and innovations for therapy in children with epilepsy. Nat Rev Neurol 2014; 10:249-60. [PMID: 24709890 DOI: 10.1038/nrneurol.2014.58] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Major advances have been made in the diagnosis, evaluation and management of children with epilepsy over the past 15 years. There has been a marked increase in genetic diagnoses of a number of key childhood-onset epilepsy syndromes, such as Dravet syndrome, which has been linked to mutations in the SCN1A gene. The reorganization and reclassification of epilepsies, devised by the International League Against Epilepsy, has stimulated specialists to reassess their diagnostic practices; however, many studies have not addressed the global issues in treating children with epilepsy-specifically, the challenges of diagnosis through to optimal, and appropriate, therapeutic management. Also, Class I evidence-based data that are needed as a foundation for the development of treatment guidelines worldwide are lacking. Epilepsy is common, and the impact of this disease crosses age ranges and should be managed at all levels of care from community to quaternary care. In this Review, existing data and new therapeutic management approaches are discussed with the aim of highlighting the incidence of standard practices that may not be based on clinical evidence.
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Affiliation(s)
- Jo M Wilmshurst
- Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch 7700, South Africa
| | - Anne T Berg
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL 60611, USA
| | - Lieven Lagae
- Department of Pediatric Neurology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Charles R Newton
- Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute, PO Box 230, Kilifi 80108, Kenya
| | - J Helen Cross
- UCL Institute of Child Health, 4/5 Long Yard, London WC1N 3LU, UK
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