1
|
Peplow P, Martinez B. MicroRNAs as potential biomarkers in temporal lobe epilepsy and mesial temporal lobe epilepsy. Neural Regen Res 2023; 18:716-726. [DOI: 10.4103/1673-5374.354510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
2
|
You J, Huang H, Chan CTY, Li L. Pathological Targets for Treating Temporal Lobe Epilepsy: Discoveries From Microscale to Macroscale. Front Neurol 2022; 12:779558. [PMID: 35069411 PMCID: PMC8777077 DOI: 10.3389/fneur.2021.779558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is one of the most common and severe types of epilepsy, characterized by intractable, recurrent, and pharmacoresistant seizures. Histopathology of TLE is mostly investigated through observing hippocampal sclerosis (HS) in adults, which provides a robust means to analyze the related histopathological lesions. However, most pathological processes underlying the formation of these lesions remain elusive, as they are difficult to detect and observe. In recent years, significant efforts have been put in elucidating the pathophysiological pathways contributing to TLE epileptogenesis. In this review, we aimed to address the new and unrecognized neuropathological discoveries within the last 5 years, focusing on gene expression (miRNA and DNA methylation), neuronal peptides (neuropeptide Y), cellular metabolism (mitochondria and ion transport), cellular structure (microtubule and extracellular matrix), and tissue-level abnormalities (enlarged amygdala). Herein, we describe a range of biochemical mechanisms and their implication for epileptogenesis. Furthermore, we discuss their potential role as a target for TLE prevention and treatment. This review article summarizes the latest neuropathological discoveries at the molecular, cellular, and tissue levels involving both animal and patient studies, aiming to explore epileptogenesis and highlight new potential targets in the diagnosis and treatment of TLE.
Collapse
Affiliation(s)
- Jing You
- Department of Biomedical Engineering, University of North Texas, Denton, TX, United States
| | - Haiyan Huang
- Department of Nutrition and Food Science, Texas Women University, Denton, TX, United States
| | - Clement T Y Chan
- Department of Biomedical Engineering, University of North Texas, Denton, TX, United States
| | - Lin Li
- Department of Biomedical Engineering, University of North Texas, Denton, TX, United States.,Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
3
|
Andrade-Machado R, Benjumea Cuartas V, Muhammad IK. Recognition of interictal and ictal discharges on EEG. Focal vs generalized epilepsy. Epilepsy Behav 2021; 117:107830. [PMID: 33639439 DOI: 10.1016/j.yebeh.2021.107830] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The differentiation between focal and generalized epilepsies based on clinical and electroencephalographic features is difficult and sometimes confusing. OBJECTIVE To review the EEG findings in patients with focal epilepsy. METHODS An extensive literature review was done. We used the following Pubmed and Medline descriptors alone and in different combinations for database searching: focal, partial, epilepsy, electroencephalographic findings, and EEG. Additional filters included review, original articles, and language limited to Spanish and English. Using the above criteria, a total of 69 articles showed the interictal and ictal EEG findings in focal epilepsy. DEVELOPMENT Focal epileptiform discharges and persistence of focal abnormalities, characterize the interictal EEG findings in focal epilepsies. To distinguish SBS from primary generalized spike waves are required to note: (a) a lead-in time of at least 2 s, (b) the morphology of the focal triggering spikes clearly differ from that of the bisynchronous epileptiform paroxysms, and (c) the morphology of triggering spikes resemble that of other focal spikes from the same region. Focal and Generalized Epilepsy can coexist. Delayed Lateralization on EEG with inconclusive onset and bizarre semiology confusing semiology should not be confused with generalized onset seizures with focal evolution. CONCLUSIONS A close attention to localization and morphology of epileptiform discharges, the correct interpretation of secondary bilateral synchrony, and provocative maneuvers help to correctly identify the EEG findings leading to diagnose focal epilepsies. The presence of generalized epileptiform activity does not rule out the existence of a focal epilepsy.
Collapse
|
4
|
Phuong TH, Houot M, Méré M, Denos M, Samson S, Dupont S. Cognitive impairment in temporal lobe epilepsy: contributions of lesion, localization and lateralization. J Neurol 2020; 268:1443-1452. [PMID: 33216221 DOI: 10.1007/s00415-020-10307-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive impairment is an important comorbidity of refractory temporal lobe epilepsy (TLE). We aimed to explore the impact of (i) specific lesions, such as dysembryoplastic neuroepithelial tumor (DNET), dysplasia, or hippocampal sclerosis, (ii) focus localization (medial versus lateral) and (iii) focus lateralization (right versus left) on the neuropsychological profile of refractory TLE adult patients. METHODS We examined the neuropsychological characteristics of 312 adults with refractory TLE: 100 patients without hippocampal sclerosis (HS) and 212 with HS. Scores on tests of intelligence (Global IQ, Verbal IQ and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions and language abilities were analyzed. RESULTS Three main factors influenced the neuropsychological profile of refractory TLE patients: (i) the lesion, patients with HS obtaining poorer cognitive performances than patients without HS and specifically DNET patients performing better than patients with HS, (ii) the focus side, that seems only relevant for verbal memory abilities which are affected in left but not right TLE patients and (iii) the localization of seizure focus, patients with medial TLE exhibiting lower memory performances than patients with lateral TLE. CONCLUSION Lesion, localization and lateralization are major contributors of the cognitive impairment depicted in TLE. Hippocampal sclerosis appears as the main contributor.
Collapse
Affiliation(s)
- Thanh Ha Phuong
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Neurology Unit, Hôpital Bach Mai, Hanoi, Vietnam
| | - Marion Houot
- Clinical Investigation Centre, Institut du Cerveau Et de La Moelle Épinière (ICM), Pitié-Salpêtrière Hospital Paris, Paris, France.,Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Méré
- Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marisa Denos
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Séverine Samson
- Univ. Lille, ULR 4072-PSITEC-Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
| | - Sophie Dupont
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Université Paris Sorbonne, Paris, France. .,Centre de Recherche de l'Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France.
| |
Collapse
|
5
|
Chauvière L. Update on temporal lobe‐dependent information processing, in health and disease. Eur J Neurosci 2019; 51:2159-2204. [DOI: 10.1111/ejn.14594] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/06/2019] [Accepted: 09/27/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Laëtitia Chauvière
- INSERM U1266 Institut de Psychiatrie et de Neurosciences de Paris (IPNP) Paris France
| |
Collapse
|
6
|
Jarero-Basulto JJ, Gasca-Martínez Y, Rivera-Cervantes MC, Ureña-Guerrero ME, Feria-Velasco AI, Beas-Zarate C. Interactions Between Epilepsy and Plasticity. Pharmaceuticals (Basel) 2018; 11:ph11010017. [PMID: 29414852 PMCID: PMC5874713 DOI: 10.3390/ph11010017] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/01/2018] [Accepted: 02/06/2018] [Indexed: 02/06/2023] Open
Abstract
Undoubtedly, one of the most interesting topics in the field of neuroscience is the ability of the central nervous system to respond to different stimuli (normal or pathological) by modifying its structure and function, either transiently or permanently, by generating neural cells and new connections in a process known as neuroplasticity. According to the large amount of evidence reported in the literature, many stimuli, such as environmental pressures, changes in the internal dynamic steady state of the organism and even injuries or illnesses (e.g., epilepsy) may induce neuroplasticity. Epilepsy and neuroplasticity seem to be closely related, as the two processes could positively affect one another. Thus, in this review, we analysed some neuroplastic changes triggered in the hippocampus in response to seizure-induced neuronal damage and how these changes could lead to the establishment of temporal lobe epilepsy, the most common type of focal human epilepsy.
Collapse
Affiliation(s)
- José J Jarero-Basulto
- Cellular Neurobiology Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| | - Yadira Gasca-Martínez
- Cellular Neurobiology Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| | - Martha C Rivera-Cervantes
- Cellular Neurobiology Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| | - Mónica E Ureña-Guerrero
- Neurotransmission Biology Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| | - Alfredo I Feria-Velasco
- Cellular Neurobiology Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| | - Carlos Beas-Zarate
- Development and Neural Regeneration Laboratory, Cell and Molecular Biology Department, CUCBA, University of Guadalajara, 45220 Zapopan, Jalisco, Mexico.
| |
Collapse
|
7
|
Chaudhari RM, Dash D, Ramanujam B, Rana MK, Appukuttan R, Sharma A, Kunwar Y, Tejaniya G, Padma V, Chandra SP, Tripathi M. Evaluation of Ictal Consciousness in Temporal and Extra Temporal Epilepsy: Observations from a Tertiary Care Hospital in India. J Epilepsy Res 2017; 6:93-96. [PMID: 28101481 PMCID: PMC5206106 DOI: 10.14581/jer.16017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/25/2016] [Indexed: 11/09/2022] Open
Abstract
Background and Purpose Differences in consciousness during seizures depend on the location of the seizure onset. Methods The present study evaluates ictal consciousness using the ictal consciousness inventory (ICI) in drug refractory mesial temporal (MTLE), neocortical temporal (NTLE) and extra temporal epilepsy (ETLE). This was a cross sectional cohort study with 45 patients with mesial temporal epilepsy, 47 with extra temporal and 11 patients with neocortical temporal epilepsy. The ICI a 20 item questionnaire was used to calculate the scores for level (L, question 1–10) and content (C, question 11–20) of consciousness. Results The patients in mesial temporal group had higher ICI-L scores, p = 0.0129 as compared to the extra temporal group, but no difference was observed in the content of consciousness. The ICI-L and C scores were not different in the mesial temporal and the neocortical temporal group (p = 0.53 and 0.65) respectively. Conclusions Patients with mesial temporal epilepsy had a higher level of consciousness than the extra temporal group but there was no difference in the content. Also there was no difference in the level and content of consciousness between mesial and the neocortical temporal group.
Collapse
Affiliation(s)
- Rima M Chaudhari
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Deepa Dash
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Bhargavi Ramanujam
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Manit K Rana
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Renjith Appukuttan
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Anubha Sharma
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Yuvraj Kunwar
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Gaurav Tejaniya
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Vasantha Padma
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| | - Sarat P Chandra
- Department of Neurosurgery, All India Institute of Medical sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical sciences, New Delhi, India
| |
Collapse
|
8
|
Hippocampography Guides Consistent Mesial Resections in Neocortical Temporal Lobe Epilepsy. EPILEPSY RESEARCH AND TREATMENT 2016; 2016:3581358. [PMID: 27703809 PMCID: PMC5039275 DOI: 10.1155/2016/3581358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 06/27/2016] [Accepted: 08/14/2016] [Indexed: 11/28/2022]
Abstract
Background. The optimal surgery in lesional neocortical temporal lobe epilepsy is unknown. Hippocampal electrocorticography maximizes seizure freedom by identifying normal-appearing epileptogenic tissue for resection and minimizes neuropsychological deficit by limiting resection to demonstrably epileptogenic tissue. We examined whether standardized hippocampal electrocorticography (hippocampography) guides resection for more consistent hippocampectomy than unguided resection in conventional electrocorticography focused on the lesion. Methods. Retrospective chart reviews any kind of electrocorticography (including hippocampography) as part of combined lesionectomy, anterolateral temporal lobectomy, and hippocampectomy over 8 years . Patients were divided into mesial (i.e., hippocampography) and lateral electrocorticography groups. Primary outcome was deviation from mean hippocampectomy length. Results. Of 26 patients, fourteen underwent hippocampography-guided mesial temporal resection. Hippocampography was associated with 2.6 times more consistent resection. The range of hippocampal resection was 0.7 cm in the mesial group and 1.8 cm in the lateral group (p = 0.01). 86% of mesial group versus 42% of lateral group patients achieved seizure freedom (p = 0.02). Conclusions. By rationally tailoring excision to demonstrably epileptogenic tissue, hippocampography significantly reduces resection variability for more consistent hippocampectomy than unguided resection in conventional electrocorticography. More consistent hippocampal resection may avoid overresection, which poses greater neuropsychological risk, and underresection, which jeopardizes postoperative seizure freedom.
Collapse
|