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Tsalouchidou PE, Hoffmann J, Strehlau S, Linka L, Belke M, Habermehl L, Schulze M, Kemmling A, Menzler K, Knake S. Morphometric magnetic resonance imaging (MRI) postprocessing in MRI-negative patients with first unprovoked seizure. Epilepsia 2024; 65:1107-1114. [PMID: 38305932 DOI: 10.1111/epi.17909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The aim of the study was to evaluate the benefits of morphometric magnetic resonance imaging (MRI) postprocessing in patients presenting with a first seizure and negative MRI results and to investigate these findings in the context of the clinical and electroencephalographic data, seizure recurrence rates, and epilepsy diagnosis in these patients. METHODS We retrospectively reviewed 97 MRI scans of patients with first unprovoked epileptic seizure and no evidence of epileptogenic lesion on clinical routine MRI. Morphometric Analysis Program (MAP; v2018), automated postprocessing software, was used to identify subtle, potentially epileptogenic lesions in the three-dimensional T1-weighted MRI data. The resulting probability maps were examined together with the conventional MRI images by a reviewer who remained blinded to the patients' clinical and electroencephalographical data. Clinical data were prospectively collected between February 2018 and May 2023. RESULTS Among the apparently MRI-negative patients, a total of 18 of 97 (18.6%) showed cortical changes suggestive of focal cortical dysplasia. Within the population with positive MAP findings (MAP+), seizure recurrence rates were 61.1% and 66.7% at 1 and 2 years after the first unprovoked seizure, respectively. Conversely, patients with negative MAP findings (MAP-) had lower seizure recurrence rates of 27.8% and 34.2% at 1 and 2 years after the first unprovoked seizure, respectively. Patients with MAP+ findings were significantly more likely to be diagnosed with epilepsy than those patients with MAP- findings (χ2 [1, n = 97] = 14.820, p < .001, odds ratio = 21.371, 95% CI = 2.710-168.531) during a mean follow-up time of 22.51 months (SD = 16.7 months, range = 1-61 months). SIGNIFICANCE MRI postprocessing can be a valuable tool for detecting subtle epileptogenic lesions in patients with a first seizure and negative MRI results. Patients with first seizure and MAP+ findings had high seizure recurrence rates, meeting the criteria for beginning epilepsy.
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Affiliation(s)
- Panagiota-Eleni Tsalouchidou
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Johanna Hoffmann
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Sascha Strehlau
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Louise Linka
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Marcus Belke
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
| | - Lena Habermehl
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Maximilian Schulze
- Department of Neuroradiology, Philipps University Marburg, Marburg, Germany
| | - André Kemmling
- Department of Neuroradiology, Philipps University Marburg, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
- Core Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
- Core Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
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Javadzadeh Y, Santos A, Aquilino MS, Mylvaganam S, Urban K, Carlen PL. Cannabidiol Exerts Anticonvulsant Effects Alone and in Combination with Δ 9-THC through the 5-HT1A Receptor in the Neocortex of Mice. Cells 2024; 13:466. [PMID: 38534310 DOI: 10.3390/cells13060466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Cannabinoids have shown potential in drug-resistant epilepsy treatment; however, we lack knowledge on which cannabinoid(s) to use, dosing, and their pharmacological targets. This study investigated (i) the anticonvulsant effect of Cannabidiol (CBD) alone and (ii) in combination with Delta-9 Tetrahydrocannabinol (Δ9-THC), as well as (iii) the serotonin (5-HT)1A receptor's role in CBD's mechanism of action. Seizure activity, induced by 4-aminopyridine, was measured by extracellular field recordings in cortex layer 2/3 of mouse brain slices. The anticonvulsant effect of 10, 30, and 100 µM CBD alone and combined with Δ9-THC was evaluated. To examine CBD's mechanism of action, slices were pre-treated with a 5-HT1A receptor antagonist before CBD's effect was evaluated. An amount of ≥30 µM CBD alone exerted significant anticonvulsant effects while 10 µM CBD did not. However, 10 µM CBD combined with low-dose Δ9-THC (20:3 ratio) displayed significantly greater anticonvulsant effects than either phytocannabinoid alone. Furthermore, blocking 5-HT1A receptors before CBD application significantly abolished CBD's effects. Thus, our results demonstrate the efficacy of low-dose CBD and Δ9-THC combined and that CBD exerts its effects, at least in part, through 5-HT1A receptors. These results could address drug-resistance while providing insight into CBD's mechanism of action, laying the groundwork for further testing of cannabinoids as anticonvulsants.
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Affiliation(s)
- Yasaman Javadzadeh
- Krembil Research Institute, University Health Network, Toronto, ON M5S 0T8, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Alexandra Santos
- Krembil Research Institute, University Health Network, Toronto, ON M5S 0T8, Canada
| | - Mark S Aquilino
- Krembil Research Institute, University Health Network, Toronto, ON M5S 0T8, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Shanthini Mylvaganam
- Krembil Research Institute, University Health Network, Toronto, ON M5S 0T8, Canada
| | | | - Peter L Carlen
- Krembil Research Institute, University Health Network, Toronto, ON M5S 0T8, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Medicine (Neurology), University Health Network, Toronto, ON M5G 2C4, Canada
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3
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Lang M, Colby S, Ashby-Padial C, Bapna M, Jaimes C, Rincon SP, Buch K. An imaging review of the hippocampus and its common pathologies. J Neuroimaging 2024; 34:5-25. [PMID: 37872430 DOI: 10.1111/jon.13165] [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: 06/29/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
The hippocampus is a complex structure located in the mesial temporal lobe that plays a critical role in cognitive and memory-related processes. The hippocampal formation consists of the dentate gyrus, hippocampus proper, and subiculum, and its importance in the neural circuitry makes it a key anatomic structure to evaluate in neuroimaging studies. Advancements in imaging techniques now allow detailed assessment of hippocampus internal architecture and signal features that has improved identification and characterization of hippocampal abnormalities. This review aims to summarize the neuroimaging features of the hippocampus and its common pathologies. It provides an overview of the hippocampal anatomy on magnetic resonance imaging and discusses how various imaging techniques can be used to assess the hippocampus. The review explores neuroimaging findings related to hippocampal variants (incomplete hippocampal inversion, sulcal remnant and choroidal fissure cysts), and pathologies of neoplastic (astrocytoma and glioma, ganglioglioma, dysembryoplastic neuroepithelial tumor, multinodular and vacuolating neuronal tumor, and metastasis), epileptic (mesial temporal sclerosis and focal cortical dysplasia), neurodegenerative (Alzheimer's disease, progressive primary aphasia, and frontotemporal dementia), infectious (Herpes simplex virus and limbic encephalitis), vascular (ischemic stroke, arteriovenous malformation, and cerebral cavernous malformations), and toxic-metabolic (transient global amnesia and opioid-associated amnestic syndrome) etiologies.
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Affiliation(s)
- Min Lang
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Samantha Colby
- Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah, USA
| | | | - Monika Bapna
- School of Medicine, Georgetown University, Washington, DC, USA
| | - Camilo Jaimes
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Sandra P Rincon
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Karen Buch
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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4
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Marinowic DR, Zanirati GG, Xavier FAC, Varella FJ, Azevedo SPDC, Ghilardi IM, Pereira-Neto NG, Koff MAE, Paglioli E, Palmini A, Abreu JG, Machado DC, da Costa JC. WNT pathway in focal cortical dysplasia compared to perilesional nonlesional tissue in refractory epilepsies. BMC Neurol 2023; 23:338. [PMID: 37749503 PMCID: PMC10521408 DOI: 10.1186/s12883-023-03394-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 09/15/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Focal cortical dysplasia (FCD) is a malformation of cortical development that causes medical refractory seizures, and one of the main treatments may be surgical resection of the affected area of the brain. People affected by FCD may present with seizures of variable severity since childhood. Despite many medical treatments available, only surgery can offer cure. The pathophysiology of the disease is not yet understood; however, it is known that several gene alterations may play a role. The WNT/β-catenin pathway is closely related to the control and balance of cell proliferation and differentiation in the central nervous system. The aim of this study was to explore genes related to the WNT/β-catenin pathway in lesional and perilesional brain tissue in patients with FCD type II. METHODS Dysplastic and perilesional tissue from the primary dysplastic lesion of patients with FCD type IIa were obtained from two patients who underwent surgical treatment. The analysis of the relative expression of genes was performed by a qRT-PCR array (super array) containing 84 genes related to the WNT pathway. RESULTS Our results suggest the existence of molecular alteration in some genes of the WNT pathway in tissue with dysplastic lesions and of perilesional tissue. We call this tissue of normal-appearing adjacent cortex (NAAC). Of all genes analyzed, a large number of genes show similar behavior between injured, perilesional and control tissues. However, some genes have similar characteristics between the perilesional and lesional tissue and are different from the control brain tissue, presenting the perilesional tissue as a molecularly altered material. CONCLUSION Our results suggest that the perilesional area after surgical resection of tissue with cortical dysplasia presents molecular changes that may play a role in the recurrence of seizures in these patients. The perilesional tissue should receive expanded attention beyond the somatic mutations described and associated with FCD, such as mTOR, for example, to new signaling pathways that may play a crucial role in seizure recurrence.
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Affiliation(s)
- Daniel R Marinowic
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
- Graduate Program in Medicine and Health Sciences, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
- Graduate Program in Medicine, Pediatrics and Child Health, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
- Graduate Program in Biomedical Gerontology, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Gabriele G Zanirati
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine, Pediatrics and Child Health, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando A C Xavier
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine and Health Sciences, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fábio Jean Varella
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine, Pediatrics and Child Health, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Sofia Prates da Cunha Azevedo
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Isadora Machado Ghilardi
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine, Pediatrics and Child Health, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Normando G Pereira-Neto
- Epilepsy Surgery Program, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco Antônio Eduardo Koff
- Epilepsy Surgery Program, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eliseu Paglioli
- Epilepsy Surgery Program, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Palmini
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Epilepsy Surgery Program, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - José Garcia Abreu
- Biomedical Science Institute - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Denise C Machado
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine and Health Sciences, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaderson C da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Medicine and Health Sciences, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, Medical School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Mohsin SN, Grezenko H, Khan S, Eshete FD, Shrestha S, Kamran M, Affaf M, Jama A, Gasim RW, Zubaer Ahmad D, Yadav I, Arif S, K C A, Khaliq AS. Bridging Development and Disruption: Comprehensive Insights into Focal Cortical Dysplasia and Epileptic Management. Cureus 2023; 15:e45996. [PMID: 37900524 PMCID: PMC10601976 DOI: 10.7759/cureus.45996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Focal cortical dysplasia (FCD) is a prominent neurological disorder characterized by disruptions in localized brain cell organization and development. This narrative review delineates the multi-faceted nature of FCD, emphasizing its correlation with drug-resistant epilepsy, predominantly in children and young adults. We explore the historical context of FCD, highlighting its indispensable role in shaping our comprehension of epilepsy and cortical anomalies. The clinical spectrum of FCD is broad, encompassing diverse seizure patterns, cognitive impairments, and associated neuropsychiatric disorders. We underscore the importance of differential diagnosis, with techniques ranging from electroencephalogram (EEG) interpretations to microscopic evaluations, and discuss advanced diagnostic modalities, such as the 3T magnetic resonance imaging (MRI) epilepsy protocols. Therapeutically, while anti-seizure medications are often first-line interventions, surgically refractory cases necessitate more invasive procedures, underscoring the importance of individualized treatment. Furthermore, the review touches upon the prognostic aspects of FCD, highlighting the importance of personalized care regimens, and provides insights into emerging therapeutic avenues, including the potential of the mammalian target of rapamycin (mTOR) pathway. Conclusively, this review accentuates the complex relationship between brain development and epileptogenicity inherent to FCD and underscores the promise of future research in enhancing patient outcomes.
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Affiliation(s)
| | - Han Grezenko
- Translational Neuroscience, Barrow Neurological Institute, Phoenix, USA
| | - Saadia Khan
- Community Medicine, Khyber Girls Medical College, Peshawar, PAK
| | | | - Shraddha Shrestha
- Internal Medicine, Nepal Korea Friendship Municipality Hospital, Bhaktapur, NPL
| | | | - Maryam Affaf
- Internal Medicine, Women's Medical and Dental College, Abbottabad, PAK
| | - Ayat Jama
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Rayan W Gasim
- Internal Medicine, University of Khartoum, Khartoum, SDN
| | | | - Indresh Yadav
- Internal Medicine, Samar Hospital and Research Center Pvt. Ltd., Janakpur, NPL
- Internal Medicine, Community Based Medical College, Mymensingh, BGD
| | - Sidra Arif
- Urology, Jinnah Postgraduate Medical Center, Karachi, PAK
| | - Anil K C
- Medicine and Surgery, Patan Academy of Health Sciences, Kathmandu, NPL
- Internal Medicine and Neurology, California Institute of Behavioral Neurosciences & Psychology, California, USA
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6
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Chikara RK, Jahromi S, Tamilia E, Madsen JR, Stufflebeam SM, Pearl PL, Papadelis C. Electromagnetic source imaging predicts surgical outcome in children with focal cortical dysplasia. Clin Neurophysiol 2023; 153:88-101. [PMID: 37473485 PMCID: PMC10528204 DOI: 10.1016/j.clinph.2023.06.015] [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: 02/14/2023] [Revised: 05/25/2023] [Accepted: 06/15/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of electromagnetic source imaging (EMSI) in localizing spikes and predict surgical outcome in children with drug resistant epilepsy (DRE) due to focal cortical dysplasia (FCD). METHODS We retrospectively analyzed magnetoencephalography (MEG) and high-density (HD-EEG) data from 23 children with FCD-associated DRE who underwent intracranial EEG and surgery. We localized spikes using equivalent current dipole (ECD) fitting, dipole clustering, and dynamical statistical parametric mapping (dSPM) on EMSI, electric source imaging (ESI), and magnetic source imaging (MSI). We calculated the distance from the seizure onset zone (DSOZ) and resection (DRES). We estimated receiver operating characteristic (ROC) curves with Youden's index (J) to predict outcome. RESULTS EMSI presented shorter DSOZ (15.18 ± 9.06 mm) and DRES (8.56 ± 6.24 mm) compared to ESI (DSOZ: 25.04 ± 16.20 mm, p < 0.009; DRES: 18.88 ± 17.30 mm, p < 0.03) and MSI (DSOZ: 23.37 ± 8.98 mm, p < 0.03; DRES: 15.51 ± 10.11 mm, p < 0.02) for clustering in patients with good outcome. Clustering showed shorter DSOZ and DRES compared to ECD fitting and dSPM (p < 0.05). EMSI had higher performance as outcome predictor (J = 70.63%) compared to ESI (J = 41.27%) and MSI (J = 33.33%) for clustering. CONCLUSIONS EMSI provides superior localization and improved predictive performance than individual modalities. SIGNIFICANCE EMSI can help the surgical planning and facilitate the localization of epileptogenic foci.
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Affiliation(s)
- Rupesh Kumar Chikara
- Jane and John Justin Institute for Mind Health, Neuroscience Research, Cook Children's Health Care System, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Saeed Jahromi
- Jane and John Justin Institute for Mind Health, Neuroscience Research, Cook Children's Health Care System, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Eleonora Tamilia
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph R Madsen
- Division of Epilepsy Surgery, Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Steve M Stufflebeam
- Athinoula Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Phillip L Pearl
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Christos Papadelis
- Jane and John Justin Institute for Mind Health, Neuroscience Research, Cook Children's Health Care System, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA; School of Medicine, Texas Christian University, Fort Worth, TX, USA.
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7
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Jiménez-Murillo D, Castro-Ospina AE, Duque-Muñoz L, Martínez-Vargas JD, Suárez-Revelo JX, Vélez-Arango JM, de la Iglesia-Vayá M. Automatic Detection of Focal Cortical Dysplasia Using MRI: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:7072. [PMID: 37631608 PMCID: PMC10458261 DOI: 10.3390/s23167072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Focal cortical dysplasia (FCD) is a congenital brain malformation that is closely associated with epilepsy. Early and accurate diagnosis is essential for effectively treating and managing FCD. Magnetic resonance imaging (MRI)-one of the most commonly used non-invasive neuroimaging methods for evaluating the structure of the brain-is often implemented along with automatic methods to diagnose FCD. In this review, we define three categories for FCD identification based on MRI: visual, semi-automatic, and fully automatic methods. By conducting a systematic review following the PRISMA statement, we identified 65 relevant papers that have contributed to our understanding of automatic FCD identification techniques. The results of this review present a comprehensive overview of the current state-of-the-art in the field of automatic FCD identification and highlight the progress made and challenges ahead in developing reliable, efficient methods for automatic FCD diagnosis using MRI images. Future developments in this area will most likely lead to the integration of these automatic identification tools into medical image-viewing software, providing neurologists and radiologists with enhanced diagnostic capabilities. Moreover, new MRI sequences and higher-field-strength scanners will offer improved resolution and anatomical detail for precise FCD characterization. This review summarizes the current state of automatic FCD identification, thereby contributing to a deeper understanding and the advancement of FCD diagnosis and management.
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Affiliation(s)
- David Jiménez-Murillo
- Grupo de investigación Máquinas Inteligentes y Reconocimiento de Patrones, Instituto Tecnológico Metropolitano, Medellín 050013, Colombia; (D.J.-M.); (L.D.-M.)
| | - Andrés Eduardo Castro-Ospina
- Grupo de investigación Máquinas Inteligentes y Reconocimiento de Patrones, Instituto Tecnológico Metropolitano, Medellín 050013, Colombia; (D.J.-M.); (L.D.-M.)
| | - Leonardo Duque-Muñoz
- Grupo de investigación Máquinas Inteligentes y Reconocimiento de Patrones, Instituto Tecnológico Metropolitano, Medellín 050013, Colombia; (D.J.-M.); (L.D.-M.)
| | | | - Jazmín Ximena Suárez-Revelo
- Grupo de Investigación en Imágenes Médicas SURA, Ayudas Diagnósticas SURA, Carrera 48 # 26-50, Piso 2, Medellín 050021, Colombia; (J.X.S.-R.); (J.M.V.-A.)
| | - Jorge Mario Vélez-Arango
- Grupo de Investigación en Imágenes Médicas SURA, Ayudas Diagnósticas SURA, Carrera 48 # 26-50, Piso 2, Medellín 050021, Colombia; (J.X.S.-R.); (J.M.V.-A.)
| | - Maria de la Iglesia-Vayá
- Biomedical Imaging Unit FISABIO-CIPF, Foundation for the Promotion of the Research in Healthcare and Biomedicine (FISABIO), Avda. de Catalunya, 21, 46020 Valencia, Spain;
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM-G23), 28029 Madrid, Spain
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8
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Aquiles A, Fiordelisio T, Luna-Munguia H, Concha L. Altered functional connectivity and network excitability in a model of cortical dysplasia. Sci Rep 2023; 13:12335. [PMID: 37518675 PMCID: PMC10387479 DOI: 10.1038/s41598-023-38717-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
Focal cortical dysplasias (FCDs) are malformations of cortical development that often result in medically refractory epilepsy, with a greater incidence in the pediatric population. The relationship between the disturbed cortical morphology and epileptogenic activity of FCDs remains unclear. We used the BCNU (carmustine 1-3-bis-chloroethyl-nitrosourea) animal model of cortical dysplasia to evaluate neuronal and laminar alterations and how these result in altered activity of intracortical networks in early life. We corroborated the previously reported morphological anomalies characteristic of the BCNU model, comprising slightly larger and rounder neurons and abnormal cortical lamination. Next, the neuronal activity of live cortical slices was evaluated through large field-of-view calcium imaging as well as the neuronal response to a stimulus that leads to cortical hyperexcitability (pilocarpine). Examination of the joint activity of neuronal calcium time series allowed us to identify intracortical communication patterns and their response to pilocarpine. The baseline power density distribution of neurons in the cortex of BCNU-treated animals was different from that of control animals, with the former showing no modulation after stimulus. Moreover, the intracortical communication pattern differed between the two groups, with cortexes from BCNU-treated animals displaying decreased inter-layer connectivity as compared to control animals. Our results indicate that the altered anatomical organization of the cortex of BCNU-treated rats translates into altered functional networks that respond abnormally to a hyperexcitable stimulus and highlight the role of network dysfunction in the pathophysiology of cortical dysplasia.
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Affiliation(s)
- A Aquiles
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Campus Juriquilla, Querétaro, Querétaro, Mexico
| | - T Fiordelisio
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Laboratorio Nacional de Soluciones Biomiméticas para Diagnóstico y Terapia LaNSBioDyT, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - H Luna-Munguia
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Campus Juriquilla, Querétaro, Querétaro, Mexico
| | - L Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Campus Juriquilla, Querétaro, Querétaro, Mexico.
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9
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Bizzotto S. The human brain through the lens of somatic mosaicism. Front Neurosci 2023; 17:1172469. [PMID: 37250426 PMCID: PMC10213359 DOI: 10.3389/fnins.2023.1172469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Every cell in the human brain possesses a unique genome that is the product of the accumulation of somatic mutations starting from the first postzygotic cell division and continuing throughout life. Somatic mosaicism in the human brain has been the focus of several recent efforts that took advantage of key technological innovations to start elucidating brain development, aging and disease directly in human tissue. On one side, somatic mutation occurring in progenitor cells has been used as a natural barcoding system to address cell phylogenies of clone formation and cell segregation in the brain lineage. On the other side, analyses of mutation rates and patterns in the genome of brain cells have revealed mechanisms of brain aging and disorder predisposition. In addition to the study of somatic mosaicism in the normal human brain, the contribution of somatic mutation has been investigated in both developmental neuropsychiatric and neurodegenerative disorders. This review starts with a methodological perspective on the study of somatic mosaicism to then cover the most recent findings in brain development and aging, and ends with the role of somatic mutations in brain disease. Thus, this review underlies what we have learned and what is still possible to discover by looking at somatic mosaicism in the brain genome.
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Villaseñor PJ, Cortés-Servín D, Pérez-Moriel A, Aquiles A, Luna-Munguía H, Ramirez-Manzanares A, Coronado-Leija R, Larriva-Sahd J, Concha L. Multi-tensor diffusion abnormalities of gray matter in an animal model of cortical dysplasia. Front Neurol 2023; 14:1124282. [PMID: 37342776 PMCID: PMC10278582 DOI: 10.3389/fneur.2023.1124282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/18/2023] [Indexed: 06/23/2023] Open
Abstract
Focal cortical dysplasias are a type of malformations of cortical development that are a common cause of drug-resistant focal epilepsy. Surgical treatment is a viable option for some of these patients, with their outcome being highly related to complete surgical resection of lesions visible in magnetic resonance imaging (MRI). However, subtle lesions often go undetected on conventional imaging. Several methods to analyze MRI have been proposed, with the common goal of rendering subtle cortical lesions visible. However, most image-processing methods are targeted to detect the macroscopic characteristics of cortical dysplasias, which do not always correspond to the microstructural disarrangement of these cortical malformations. Quantitative analysis of diffusion-weighted MRI (dMRI) enables the inference of tissue characteristics, and novel methods provide valuable microstructural features of complex tissue, including gray matter. We investigated the ability of advanced dMRI descriptors to detect diffusion abnormalities in an animal model of cortical dysplasia. For this purpose, we induced cortical dysplasia in 18 animals that were scanned at 30 postnatal days (along with 19 control animals). We obtained multi-shell dMRI, to which we fitted single and multi-tensor representations. Quantitative dMRI parameters derived from these methods were queried using a curvilinear coordinate system to sample the cortical mantle, providing inter-subject anatomical correspondence. We found region- and layer-specific diffusion abnormalities in experimental animals. Moreover, we were able to distinguish diffusion abnormalities related to altered intra-cortical tangential fibers from those associated with radial cortical fibers. Histological examinations revealed myelo-architectural abnormalities that explain the alterations observed through dMRI. The methods for dMRI acquisition and analysis used here are available in clinical settings and our work shows their clinical relevance to detect subtle cortical dysplasias through analysis of their microstructural properties.
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Affiliation(s)
- Paulina J. Villaseñor
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
| | - David Cortés-Servín
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
| | | | - Ana Aquiles
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
| | - Hiram Luna-Munguía
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
| | | | - Ricardo Coronado-Leija
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, United States
| | - Jorge Larriva-Sahd
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México Campus Juriquilla, Querétaro, Mexico
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11
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Fountain C, Ghuman H, Paldino M, Tamber M, Panigrahy A, Modo M. Acquisition and Analysis of Excised Neocortex from Pediatric Patients with Focal Cortical Dysplasia Using Mesoscale Diffusion MRI. Diagnostics (Basel) 2023; 13:1529. [PMID: 37174921 PMCID: PMC10177920 DOI: 10.3390/diagnostics13091529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/01/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
Non-invasive classification of focal cortical dysplasia (FCD) subtypes remains challenging from a radiology perspective. Quantitative imaging biomarkers (QIBs) have the potential to distinguish subtypes that lack pathognomonic features and might help in defining the extent of abnormal connectivity associated with each FCD subtype. A key motivation of diagnostic imaging is to improve the localization of a "lesion" that can guide the surgical resection of affected tissue, which is thought to cause seizures. Conversely, surgical resections to eliminate or reduce seizures provided unique opportunities to develop magnetic resonance imaging (MRI)-based QIBs by affording long scan times to evaluate multiple contrast mechanisms at the mesoscale (0.5 mm isotropic voxel dimensions). Using ex vivo hybrid diffusion tensor imaging on a 9.4 T MRI scanner, the grey to white matter ratio of scalar indices was lower in the resected middle temporal gyrus (MTG) of two neuropathologically confirmed cases of FCD compared to non-diseased control postmortem fixed temporal lobes. In contrast, fractional anisotropy was increased within FCD and also adjacent white matter tracts. Connectivity (streamlines/mm3) in the MTG was higher in FCD, suggesting that an altered connectivity at the lesion locus can potentially provide a tangible QIB to distinguish and characterize FCD abnormalities. However, as illustrated here, a major challenge for a robust tractographical comparison lies in the considerable differences in the ex vivo processing of bioptic and postmortem samples. Mesoscale diffusion MRI has the potential to better define and characterize epileptic tissues obtained from surgical resection to advance our understanding of disease etiology and treatment.
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Affiliation(s)
- Chandler Fountain
- Department of Radiology and Medical Imaging, University of Virginia Health System, 1215 Lee St, Chartlottesville, VA 22903, USA
| | - Harmanvir Ghuman
- Department of Bioengineering, University of Pittsburgh, 302 Benedum Hall, 3700 O’Hara Street, Pititsburgh, PA 15260, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, 450 Technology Drive, Suite 300, Pittsburgh, PA 15219, USA
| | - Michael Paldino
- Department of Radiology, University of Pittsburgh, PUH Suite E204, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Mandeep Tamber
- Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, Suite B 400, Pittsburgh, PA 15213, USA
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh, PUH Suite E204, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Michel Modo
- Department of Bioengineering, University of Pittsburgh, 302 Benedum Hall, 3700 O’Hara Street, Pititsburgh, PA 15260, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, 450 Technology Drive, Suite 300, Pittsburgh, PA 15219, USA
- Department of Radiology, University of Pittsburgh, PUH Suite E204, 200 Lothrop Street, Pittsburgh, PA 15213, USA
- Centre for the Neural Basis of Behavior, University of Pittsburgh and Carnegie Mellon University, 4074 Biomedical Science Tower 3, Pittsburgh, PA 15261, USA
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12
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Berry BM, Miller LR, Berns M, Kucewicz M. The Possibility of Eidetic Memory in a Patient Report of Epileptogenic Zone in Right Temporo-Parietal-Occipital Cortex. Life (Basel) 2023; 13:956. [PMID: 37109485 PMCID: PMC10145536 DOI: 10.3390/life13040956] [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: 02/20/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
Eidetic memory has been reported in children and in patients with synesthesia but is otherwise thought to be a rare phenomenon. Presented herein is a patient with right-sided language dominance, as proven via multiple functional imaging and neuropsychometric methods, who has a seizure onset zone in the right temporo-parietal-occipital cortex. This patient's medically refractory epilepsy and thus hyperactive cortex could possibly contribute to near eidetic ability with paired-associates learning tasks (in both short-term and long-term retention). There are reports of epilepsy negatively affecting memory, but as far as the authors are aware to date, there is limited evidence of any lesion enhancing cognitive functions (whether through direct lesion or via compensatory mechanism) that would be localized to a seizure onset zone in the dominant temporo-parietal-occipital junction.
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Affiliation(s)
- Brent M. Berry
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, USA
- Neurology Department, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA
- VA Medical Center, 1 Veterans Drive, Minneapolis, MN 55417, USA
- Mayo Clinic, Department of Neurology, Department of Sleep Medicine, Department of Physiology & Biomedical Engineering, 200 First St. SW, Rochester, MN 55905, USA
- BioTechMed Center, Brain & Mind Electrophysiology Lab, Department of Multimedia Systems, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-233 Gdańsk, Poland
| | - Laura R. Miller
- Mayo Clinic, Department of Neurology, Department of Sleep Medicine, Department of Physiology & Biomedical Engineering, 200 First St. SW, Rochester, MN 55905, USA
| | - Meaghan Berns
- University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, USA
- Neurology Department, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA
| | - Michal Kucewicz
- Mayo Clinic, Department of Neurology, Department of Sleep Medicine, Department of Physiology & Biomedical Engineering, 200 First St. SW, Rochester, MN 55905, USA
- BioTechMed Center, Brain & Mind Electrophysiology Lab, Department of Multimedia Systems, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-233 Gdańsk, Poland
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13
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Chokote E, Ngarka L, Takoeta EO, Kengni HNT, Nfor LN, Mengnjo MK, Mendo EL, Djeutcheu F, Yepnjio FN, Tatah GY, Mbassi HDA, Njamnshi AK. A rare case of drug sensitive adult‐onset temporal lobe epilepsy due to a focal cortical dysplasia revealed by ictal coughing: First report in sub‐Saharan Africa. Clin Case Rep 2023; 11:e7093. [PMID: 36992669 PMCID: PMC10041363 DOI: 10.1002/ccr3.7093] [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: 04/05/2022] [Revised: 08/30/2022] [Accepted: 02/25/2023] [Indexed: 03/30/2023] Open
Abstract
This case suggests that clinicians should consider seizures as a differential diagnosis of paroxystic cough with loss of consciousness. Focal cortical dysplasia should equally be screened for with magnetic resonance imaging (MRI) scans even in adults with epilepsy in sub‐Saharan Africa. This case suggests that clinicians should consider seizures as a differential diagnosis of paroxystic cough with loss of consciousness. Focal cortical dysplasia should equally be screened for with Magnetic Resonance Imaging (MRI) scans even in adults with epilepsy in sub‐Saharan Africa.
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Affiliation(s)
- Eric‐Samuel Chokote
- Department of NeurologyJordan Medical ServicesYaoundéCameroon
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
| | - Leonard Ngarka
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of Neurology Yaoundé Central HospitalYaoundéCameroon
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
| | | | - Hermann Nestor Tsague Kengni
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
- Department of CardiologyJordan Medical ServicesYaoundéCameroon
| | - Leonard N. Nfor
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of Neurology Yaoundé Central HospitalYaoundéCameroon
| | - Michel K. Mengnjo
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of Neurology Yaoundé Central HospitalYaoundéCameroon
| | - Edwige Laure Mendo
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of NeurologyEbolowa Regional HospitalEbolowaCameroon
| | | | | | - Godwin Y. Tatah
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of Neurology Yaoundé Central HospitalYaoundéCameroon
- Department of NeurologyCH Saint‐NazaireSaint‐NazaireFrance
| | - Hubert Désiré Awa Mbassi
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
- Chantal Biya FoundationMCCYaoundéCameroon
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN)YaoundéCameroon
- Brain Research Africa Initiative (BRAIN)GenevaSwitzerland
- Department of Neurology Yaoundé Central HospitalYaoundéCameroon
- Faculty of Medicine and Biomedical SciencesThe University of Yaoundé IYaoundéCameroon
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14
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Tsalouchidou PE, Zoellner JP, Kirscht A, Mueller CJ, Nimsky C, Schulze M, Hattingen E, Chatzis G, Freiman TM, Strzelczyk A, Fuest S, Menzler K, Rosenow F, Knake S. Temporal encephaloceles and coexisting epileptogenic lesions. Epilepsia Open 2023; 8:113-124. [PMID: 36408781 PMCID: PMC9977755 DOI: 10.1002/epi4.12674] [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: 08/31/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study was performed to identify coexisting structural lesions in patients with epilepsy and known temporal encephaloceles (TEs). METHODS Forty-seven structural magnetic resonance imaging (MRI) scans of patients with epilepsy and radiologically diagnosed TEs were retrospectively reviewed visually and using an automated postprocessing software, the Morphometric Analysis Program v2018 (MAP18), to depict additional subtle, potentially epileptogenic lesions in the 3D T1-weighted MRI data. All imaging findings were evaluated in the context of clinical and electroencephalographical findings. RESULTS The study population consisted of 47 epilepsy patients (38.3% female, n = 18). The median age at the time of the scan was 40 years (range 12-81 years). Twenty-one out of 47 MRI scans (44.7%) showed coexisting lesions in the initial MRI evaluation; in 38.3% (n = 18) of patients, those lesions were considered probably epileptogenic. After postprocessing, probable epileptogenic lesions were identified in 53.2% (n = 25) of patients. Malformations of cortical development had initially been reported in 17.0% (n = 8) of patients with TEs, which increased to 38.3% (n = 18) after postprocessing. TEs and other epileptogenic lesions were considered equally epileptogenic in 21.3% (n = 10) of the cases in the initial MR reports and 25.5% (n = 12) of the cases after postprocessing. SIGNIFICANCE Temporal encephaloceles are a potential cause of MRI-negative temporal lobe epilepsy. According to our data, TEs can occur with other lesions, suggesting that increased awareness is also required in patients with lesional epilepsy. TEs may not always be epileptogenic; hence, their occurrence with other structural pathologies may influence the presurgical evaluation and surgical approach. Finally, TEs can be associated with malformations of cortical development, which may indicate a common developmental etiology of those lesions.
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Affiliation(s)
| | - Johann Philipp Zoellner
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | - Annika Kirscht
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Christina Julia Mueller
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Christopher Nimsky
- Department of Neurosurgery, Philipps University Marburg, Marburg, Germany
| | - Maximilian Schulze
- Division of Neuroradiology, Philipps University Marburg, Marburg, Germany
| | - Elke Hattingen
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany.,Department of Neuroradiology, Goethe University, Frankfurt, Germany
| | - Georgios Chatzis
- Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, Marburg, Germany
| | | | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | - Sven Fuest
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany.,Core Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, Marburg, Germany.,Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt, Germany.,Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany.,Core Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
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15
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Baria E, Giordano F, Guerrini R, Caporalini C, Buccoliero AM, Cicchi R, Pavone FS. Dysplasia and tumor discrimination in brain tissues by combined fluorescence, Raman, and diffuse reflectance spectroscopies. BIOMEDICAL OPTICS EXPRESS 2023; 14:1256-1275. [PMID: 36950232 PMCID: PMC10026567 DOI: 10.1364/boe.477035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 06/18/2023]
Abstract
Identification of neoplastic and dysplastic brain tissues is of paramount importance for improving the outcomes of neurosurgical procedures. This study explores the combined application of fluorescence, Raman and diffuse reflectance spectroscopies for the detection and classification of brain tumor and cortical dysplasia with a label-free modality. Multivariate analysis was performed to evaluate classification accuracies of these techniques-employed both in individual and multimodal configuration-obtaining high sensitivity and specificity. In particular, the proposed multimodal approach allowed discriminating tumor/dysplastic tissues against control tissue with 91%/86% sensitivity and 100%/100% specificity, respectively, whereas tumor from dysplastic tissues were discriminated with 89% sensitivity and 86% specificity. Hence, multimodal optical spectroscopy allows reliably differentiating these pathologies using a non-invasive, label-free approach that is faster than the gold standard technique and does not require any tissue processing, offering the potential for the clinical translation of the technology.
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Affiliation(s)
- Enrico Baria
- National Institute of Optics, National Research Council, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
- European Laboratory for Non-Linear Spectroscopy, University of Florence, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
| | - Flavio Giordano
- Division of Neurosurgery, Department of Neuroscience I, "A. Meyer" Children's Hospital, Viale Gaetano Pieraccini 24, Florence 50141, Italy
| | - Renzo Guerrini
- Division of Neurosurgery, Department of Neuroscience I, "A. Meyer" Children's Hospital, Viale Gaetano Pieraccini 24, Florence 50141, Italy
| | - Chiara Caporalini
- Division of Pathology, Department of Critical Care Medicine and Surgery, University of Florence, Viale Giovanni Battista Morgagni 85, Florence 50134, Italy
| | - Anna Maria Buccoliero
- Division of Pathology, Department of Critical Care Medicine and Surgery, University of Florence, Viale Giovanni Battista Morgagni 85, Florence 50134, Italy
| | - Riccardo Cicchi
- National Institute of Optics, National Research Council, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
- European Laboratory for Non-Linear Spectroscopy, University of Florence, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
| | - Francesco Saverio Pavone
- National Institute of Optics, National Research Council, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
- European Laboratory for Non-Linear Spectroscopy, University of Florence, Via Nello Carrara 1, Sesto Fiorentino 50019, Italy
- Department of Physics and Astrophysics, University of Florence, Via Sansone 1, Sesto Fiorentino 50019, Italy
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16
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Jadav D, Gupta V, Khera S, Meshram V. Focal Cortical Dysplasia with hippocampal sclerosis. AUTOPSY AND CASE REPORTS 2023; 13:e2023420. [PMID: 36741591 PMCID: PMC9886384 DOI: 10.4322/acr.2023.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/02/2023] [Indexed: 02/07/2023] Open
Abstract
Focal Cortical Dysplasia (FCD) is a group of focal developmental malformations of the cerebral cortex cytoarchitecture. FCD usually manifests as medically intractable epilepsy, especially in young children. Live patients are diagnosed by radiological examination such as magnetic resonance imaging (MRI), fluorodeoxyglucose positron emission tomography (FDG PET), magnetoencephalography (MEG), diffusion-tensor imaging (DTI), and intracranial electroencephalogram (EEG). While some cases can be missed by radiological examination, they are usually diagnosed on the histopathological examination of the surgically removed specimens of medically intractable epilepsy patients. We report a case of a young girl with cerebral palsy, mental retardation, and seizure disorder who died in her sleep. The deceased was diagnosed with FCD type III with hippocampal sclerosis on histopathological examination at autopsy. H & E stain and NeuN immunohistochemistry neuronal cell marker were used to demonstrate the findings of FCD.
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Affiliation(s)
- Devendra Jadav
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Jodhpur, Rajasthan, India
| | - Vaibhav Gupta
- Vardhman Mahavir Medical College and Safdarjung Hospital, Department of Forensic Medicine and Toxicology, New Delhi, India
| | - Sudeep Khera
- All India Institute of Medical Sciences, Department of Pathology and Lab Medicine, Jodhpur, Rajasthan, India
| | - Vikas Meshram
- All India Institute of Medical Sciences, Department of Forensic Medicine and Toxicology, Jodhpur, Rajasthan, India
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17
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Sharma D, Tripathi M, Doddamani R, Sharma MC, Lalwani S, Sarat Chandra P, Banerjee Dixit A, Banerjee J. Correlation of age at seizure onset with GABA A receptor subunit and chloride Co-transporter configuration in Focal cortical dysplasia (FCD). Neurosci Lett 2023; 796:137065. [PMID: 36638954 DOI: 10.1016/j.neulet.2023.137065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
Focal cortical dysplasia (FCD) represents a group of malformations of cortical development, which are speculated to be related to early developmental defects in the cerebral cortex. According to dysmature cerebral development hypothesis of FCD altered GABAA receptor function is known to contribute to abnormal neuronal network. Here, we studied the possible association between age at seizure onset in FCD with the subunit configuration of GABAA receptors in resected brain specimens obtained from patients with FCD. We observed a significantly higher ratio of α4/α1 subunit-containing GABAA receptors in patients with early onset (EO) FCD as compared to those with late onset (LO) FCD as is seen during the course of development where α4-containing GABAA receptors expression is high as compared to α1-containing GABAA receptors expression. Likewise, the influx to efflux chloride co-transporter expression of NKCC1/KCC2 was also increased in patients with EO FCD as seen during brain development. In addition, we observed that the ratio of GABA/Glutamate neurotransmitters was lower in patients with EO FCD as compared to that in patients with LO FCD. Our findings suggest altered configuration of GABAA receptors in FCD which could be contributing to aberrant depolarizing GABAergic activity. In particular, we observed a correlation of age at seizure onset in FCD with subunit configuration of GABAA receptors, levels of NKCC1/KCC2 and the ratio of GABA/Glutamate neurotransmitters such that the patients with EO FCD exhibited a more critically modulated GABAergic network.
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Affiliation(s)
- Devina Sharma
- 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
| | - Ramesh Doddamani
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - M C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Lalwani
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Aparna Banerjee Dixit
- Dr. B.R Ambedkar Center for Biomedical Research, University of Delhi, New Delhi, India
| | - Jyotirmoy Banerjee
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India.
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18
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Developing Novel Experimental Models of m-TORopathic Epilepsy and Related Neuropathologies: Translational Insights from Zebrafish. Int J Mol Sci 2023; 24:ijms24021530. [PMID: 36675042 PMCID: PMC9866103 DOI: 10.3390/ijms24021530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
The mammalian target of rapamycin (mTOR) is an important molecular regulator of cell growth and proliferation. Brain mTOR activity plays a crucial role in synaptic plasticity, cell development, migration and proliferation, as well as memory storage, protein synthesis, autophagy, ion channel expression and axonal regeneration. Aberrant mTOR signaling causes a diverse group of neurological disorders, termed 'mTORopathies'. Typically arising from mutations within the mTOR signaling pathway, these disorders are characterized by cortical malformations and other neuromorphological abnormalities that usually co-occur with severe, often treatment-resistant, epilepsy. Here, we discuss recent advances and current challenges in developing experimental models of mTOR-dependent epilepsy and other related mTORopathies, including using zebrafish models for studying these disorders, as well as outline future directions of research in this field.
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19
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Santos MV, Garcia CAB, Hamad APA, Costa UT, Sakamoto AC, Dos Santos AC, Machado HR. Clinical and Surgical Approach for Cerebral Cortical Dysplasia. Adv Tech Stand Neurosurg 2023; 48:327-354. [PMID: 37770690 DOI: 10.1007/978-3-031-36785-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The present article describes pathophysiological and clinical aspects of congenital malformations of the cerebral tissue (cortex and white matter) that cause epilepsy and very frequently require surgical treatment. A particular emphasis is given to focal cortical dysplasias, the most common pathology among these epilepsy-related malformations. Specific radiological and surgical features are also highlighted, so a thorough overview of cortical dysplasias is provided.
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Affiliation(s)
- Marcelo Volpon Santos
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil.
- Department of Surgery and Anantomy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.
| | - Camila Araujo Bernardino Garcia
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Ana Paula Andrade Hamad
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Ursula Thome Costa
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Americo Ceiki Sakamoto
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio Carlos Dos Santos
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
| | - Helio Rubens Machado
- Center for Pediatric Epilepsy Surgery (CIREP), Ribeirão Preto Medical School, University Hospital, University of São Paulo, São Paulo, SP, Brazil
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20
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Shamim D, Nwabueze O, Uysal U. Beyond Resection: Neuromodulation and Minimally Invasive Epilepsy Surgery. Noro Psikiyatr Ars 2022; 59:S81-S90. [PMID: 36578991 PMCID: PMC9767135 DOI: 10.29399/npa.28181] [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: 03/26/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Epilepsy is a common neurological disease impacting both patients and healthcare systems. Approximately one third of patients have drug-resistant epilepsy (DRE) and are candidates for surgical options. However, only a small percentage undergo surgical treatment due to factors such as patient misconception/fear of surgery, healthcare disparities in epilepsy care, complex presurgical evaluation, primary care knowledge gap, and lack of systemic structures to allow effective coordination between referring physician and surgical epilepsy centers. Resective surgical treatments are superior to medication management for DRE patients in terms of seizure outcomes but may be less palatable to patients. There have been major advancements in minimally invasive surgeries (MIS) and neuromodulation techniques that may allay these concerns. Both epilepsy MIS and neuromodulation have shown promising seizure outcomes while minimizing complications. Minimally invasive methods include Laser Interstitial Thermal Therapy (LITT), RadioFrequency Ablation (RFA), Stereotactic RadioSurgery (SRS). Neuromodulation methods, which are more palliative, include Vagus Nerve Stimulation (VNS), Deep Brain Stimulation (DBS), and Responsive Neurostimulation System (RNS). This review will discuss the role of these techniques in varied epilepsy subtypes, their effectiveness in improving seizure control, and adverse outcomes.
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Affiliation(s)
- Daniah Shamim
- University of Kansas Medical Center, Department of Neurology, Kansas City, KS, USA
| | - Obiefuna Nwabueze
- University of Kansas Medical Center, Department of Neurology, Kansas City, KS, USA
| | - Utku Uysal
- University of Kansas Medical Center, Department of Neurology, Kansas City, KS, USA,Correspondence Address: Utku Uysal, MS University of Kansas School of Medicine 4000 Cambridge Street Mailstop 1065 Kansas City, KS 66160, USA • E-mail:
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21
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Primary Cilia Dysfunction in Neurodevelopmental Disorders beyond Ciliopathies. J Dev Biol 2022; 10:jdb10040054. [PMID: 36547476 PMCID: PMC9782889 DOI: 10.3390/jdb10040054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Primary cilia are specialized, microtubule-based structures projecting from the surface of most mammalian cells. These organelles are thought to primarily act as signaling hubs and sensors, receiving and integrating extracellular cues. Several important signaling pathways are regulated through the primary cilium including Sonic Hedgehog (Shh) and Wnt signaling. Therefore, it is no surprise that mutated genes encoding defective proteins that affect primary cilia function or structure are responsible for a group of disorders collectively termed ciliopathies. The severe neurologic abnormalities observed in several ciliopathies have prompted examination of primary cilia structure and function in other brain disorders. Recently, neuronal primary cilia defects were observed in monogenic neurodevelopmental disorders that were not traditionally considered ciliopathies. The molecular mechanisms of how these genetic mutations cause primary cilia defects and how these defects contribute to the neurologic manifestations of these disorders remain poorly understood. In this review we will discuss monogenic neurodevelopmental disorders that exhibit cilia deficits and summarize findings from studies exploring the role of primary cilia in the brain to shed light into how these deficits could contribute to neurologic abnormalities.
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22
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Madhamanchi K, Madhamanchi P, Jayalakshmi S, Panigrahi M, Patil A, Phanithi PB. Endoplasmic reticulum stress and unfolded protein accumulation correlate to seizure recurrence in focal cortical dysplasia patients. Cell Stress Chaperones 2022; 27:633-643. [PMID: 36258150 PMCID: PMC9672265 DOI: 10.1007/s12192-022-01301-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 01/25/2023] Open
Abstract
Epileptic seizures occur due to an imbalance between excitatory and inhibitory neurosignals. The excitotoxic insults promote the accumulation of reactive oxygen species (ROS), unfolded proteins (UFP) aggregation, and sometimes even cell death. The epileptic brain samples in our study showed significant changes in the quantity of UFP accumulation. This part explored the efficiency of ER stress and autophagy responses at neutralizing the UFP using resected epileptic brain tissue samples. Meanwhile, we regularly observed these patients' post-surgical clinical data to find the recurrence of seizures. According to International League against Epilepsy (ILAE) suggestions, we classified the patients (n = 26) as class 1 (completely seizure-free), class 2 (less frequent seizures or auras), and class 3 (auras with < 3 seizures per year). The classification helped us understand the reason for variations in the UFP accumulation in patient samples. We have observed the protein levels of ER chaperone, glucose-regulated protein 78 kDa (GRP78/BiP), inositol-requiring enzyme 1α (IRE1α), X box-binding protein 1 s (XBP1s), eukaryotic translation initiation factor 2α (peIF2α), C/EBP homologous protein (CHOP), NADPH oxidase (NOX2), and autophagy proteins like BECLIN1, ATG 7, 12, 5, 16, p62, and LC3. Our results suggested that ER stress response limitation may contribute to seizure recurrence in epilepsy patients, particularly in classes 2 and 3. In addition, we have observed significant upregulation of ER stress-dependent apoptosis initiation factor CHOP in these patients. These results indicate that understanding the ER stress response pattern infers the possibility of post-surgical outcomes in focal cortical dysplasia (FCD) patients.
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Affiliation(s)
- Kishore Madhamanchi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
| | - Pradeep Madhamanchi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
- Govt. Degree College for Men, Srikakulam District, Andhra Pradesh, 532001, India
| | - Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Manas Panigrahi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Anuja Patil
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Prakash Babu Phanithi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India.
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23
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Nguyen LH, Bordey A. Current Review in Basic Science: Animal Models of Focal Cortical Dysplasia and Epilepsy. Epilepsy Curr 2022; 22:234-240. [PMID: 36187145 PMCID: PMC9483763 DOI: 10.1177/15357597221098230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Focal cortical dysplasia (FCD) is a malformation of cortical development that is a prevalent cause of intractable epilepsy in children. Of the three FCD subtypes, understanding the etiology and pathogenesis of FCD type II has seen the most progress owing to the recent advances in identifying gene mutations along the mTOR signaling pathway as a frequent cause of this disorder. Accordingly, numerous animal models of FCD type II based on genetic manipulation of the mTOR signaling pathway have emerged to investigate the mechanisms of epileptogenesis and novel therapeutics for epilepsy. These include transgenic and in utero electroporation-based animal models. Here, we review the histopathological and electroclinical features of existing FCD type II animal models and discuss the scientific and technical considerations, clinical applications, and limitations of current models. We also highlight other models of FCD based on early life acquired factors.
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Affiliation(s)
- Lena H. Nguyen
- Departments of Neurosurgery and Cellular & Molecular
Physiology, Yale University School of
Medicine, New Haven, CT, USA
| | - Angélique Bordey
- Departments of Neurosurgery and Cellular & Molecular
Physiology, Yale University School of
Medicine, New Haven, CT, USA
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24
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Schaaf ZA, Tat L, Cannizzaro N, Panoutsopoulos AA, Green R, Rülicke T, Hippenmeyer S, Zarbalis KS. WDFY3 mutation alters laminar position and morphology of cortical neurons. Mol Autism 2022; 13:27. [PMID: 35733184 PMCID: PMC9219247 DOI: 10.1186/s13229-022-00508-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Proper cerebral cortical development depends on the tightly orchestrated migration of newly born neurons from the inner ventricular and subventricular zones to the outer cortical plate. Any disturbance in this process during prenatal stages may lead to neuronal migration disorders (NMDs), which can vary in extent from focal to global. Furthermore, NMDs show a substantial comorbidity with other neurodevelopmental disorders, notably autism spectrum disorders (ASDs). Our previous work demonstrated focal neuronal migration defects in mice carrying loss-of-function alleles of the recognized autism risk gene WDFY3. However, the cellular origins of these defects in Wdfy3 mutant mice remain elusive and uncovering it will provide critical insight into WDFY3-dependent disease pathology. METHODS Here, in an effort to untangle the origins of NMDs in Wdfy3lacZ mice, we employed mosaic analysis with double markers (MADM). MADM technology enabled us to genetically distinctly track and phenotypically analyze mutant and wild-type cells concomitantly in vivo using immunofluorescent techniques. RESULTS We revealed a cell autonomous requirement of WDFY3 for accurate laminar positioning of cortical projection neurons and elimination of mispositioned cells during early postnatal life. In addition, we identified significant deviations in dendritic arborization, as well as synaptic density and morphology between wild type, heterozygous, and homozygous Wdfy3 mutant neurons in Wdfy3-MADM reporter mice at postnatal stages. LIMITATIONS While Wdfy3 mutant mice have provided valuable insight into prenatal aspects of ASD pathology that remain inaccessible to investigation in humans, like most animal models, they do not a perfectly replicate all aspects of human ASD biology. The lack of human data makes it indeterminate whether morphological deviations described here apply to ASD patients or some of the other neurodevelopmental conditions associated with WDFY3 mutation. CONCLUSIONS Our genetic approach revealed several cell autonomous requirements of WDFY3 in neuronal development that could underlie the pathogenic mechanisms of WDFY3-related neurodevelopmental conditions. The results are also consistent with findings in other ASD animal models and patients and suggest an important role for WDFY3 in regulating neuronal function and interconnectivity in postnatal life.
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Affiliation(s)
- Zachary A Schaaf
- University of California at Davis, Department of Pathology and Laboratory Medicine, Sacramento, CA, 95817, USA
- Shriners Hospitals for Children Northern California, Sacramento, CA, 95817, USA
| | - Lyvin Tat
- University of California at Davis, Department of Pathology and Laboratory Medicine, Sacramento, CA, 95817, USA
| | - Noemi Cannizzaro
- University of California at Davis, Department of Pathology and Laboratory Medicine, Sacramento, CA, 95817, USA
| | - Alexios A Panoutsopoulos
- Shriners Hospitals for Children Northern California, Sacramento, CA, 95817, USA
- University of California at Davis, Department of Physiology and Membrane Biology, Sacramento, CA, 95817, USA
| | - Ralph Green
- University of California at Davis, Department of Pathology and Laboratory Medicine, Sacramento, CA, 95817, USA
| | - Thomas Rülicke
- Department of Biomedical Sciences, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - Simon Hippenmeyer
- Institute of Science and Technology Austria, Am Campus 1, 3400, Klosterneuburg, Austria
| | - Konstantinos S Zarbalis
- University of California at Davis, Department of Pathology and Laboratory Medicine, Sacramento, CA, 95817, USA.
- Shriners Hospitals for Children Northern California, Sacramento, CA, 95817, USA.
- UC Davis MIND Institute, Sacramento, CA, 95817, USA.
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25
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Mo J, Zhang J, Hu W, Shao X, Sang L, Zheng Z, Zhang C, Wang Y, Wang X, Liu C, Zhao B, Zhang K. Neuroimaging gradient alterations and epileptogenic prediction in focal cortical dysplasia Ⅲa. J Neural Eng 2022; 19. [PMID: 35405671 DOI: 10.1088/1741-2552/ac6628] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/10/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Focal cortical dysplasia Type Ⅲa (FCD Ⅲa) is a highly prevalent temporal lobe epilepsy but the seizure outcomes are not satisfactory after epilepsy surgery. Hence, quantitative neuroimaging, epileptogenic alterations, as well as their values in guiding surgery are worth exploring. METHODS We examined 69 patients with pathologically verified FCD Ⅲa using multimodal neuroimaging and stereoelectroencephalography (SEEG). Among them, 18 received postoperative imaging which showed the extent of surgical resection and 9 underwent SEEG implantation. We also explored neuroimaging gradient alterations along with the distance to the temporal pole. Subsequently, the machine learning regression model was employed to predict whole-brain epileptogenicity. Lastly, the correlation between neuroimaging or epileptogenicity and surgical cavities was assessed. RESULTS FCD Ⅲa displayed neuroimaging gradient alterations on the temporal neocortex, morphology-signal intensity decoupling, low similarity of intra-morphological features and high similarity of intra-signal intensity features. The support vector regression model was successfully applied at the whole-brain level to calculate the continuous epileptogenic value at each vertex (mean-squared error = 13.8 ± 9.8). CONCLUSION Our study investigated the neuroimaging gradient alterations and epileptogenicity of FCD Ⅲa, along with their potential values in guiding suitable resection range and in predicting postoperative seizure outcomes. The conclusions from this study may facilitate an accurate presurgical examination of FCD Ⅲa. However, further investigation including a larger cohort is necessary to confirm the results.
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Affiliation(s)
- Jiajie Mo
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Jianguo Zhang
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Wenhan Hu
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Xiaoqiu Shao
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Lin Sang
- Peking University First Hospital Fengtai Hospital, No. 99 South 4th Fengtai Road, Fengtai District, Beijing, 100070, CHINA
| | - Zhong Zheng
- Peking University First Hospital Fengtai Hospital, No. 99 South 4th Fengtai Road, Fengtai District, Beijing, 100070, CHINA
| | - Chao Zhang
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Yao Wang
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Xiu Wang
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Chang Liu
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
| | - Baotian Zhao
- Beijing Tiantan Hospital, , Beijing, 100070, CHINA
| | - Kai Zhang
- Beijing Tiantan Hospital, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, CHINA
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26
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Cwetsch AW, Ziogas I, Narducci R, Savardi A, Bolla M, Pinto B, Perlini LE, Bassani S, Passafaro M, Cancedda L. A rat model of a focal mosaic expression of PCDH19 replicates human brain developmental abnormalities and behaviors. Brain Commun 2022; 4:fcac091. [PMID: 35528232 PMCID: PMC9070467 DOI: 10.1093/braincomms/fcac091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/04/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022] Open
Abstract
Protocadherin 19 gene-related epilepsy or protocadherin 19 clustering epilepsy is an infantile-onset epilepsy syndrome characterized by psychiatric (including autism-related), sensory, and cognitive impairment of varying degrees. Protocadherin 19 clustering epilepsy is caused by X-linked protocadherin 19 protein loss of function. Due to random X-chromosome inactivation, protocadherin 19 clustering epilepsy-affected females present a mosaic population of healthy and protocadherin 19-mutant cells. Unfortunately, to date, no current mouse model can fully recapitulate both the brain histological and behavioural deficits present in people with protocadherin 19 clustering epilepsy. Thus, the search for a proper understanding of the disease and possible future treatment is hampered. By inducing a focal mosaicism of protocadherin 19 expression using in utero electroporation in rats, we found here that protocadherin 19 signalling in specific brain areas is implicated in neuronal migration, heat-induced epileptic seizures, core/comorbid behaviours related to autism and cognitive function.
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Affiliation(s)
- Andrzej W Cwetsch
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Università degli Studi di Genova, Via Balbi, 5, 16126 Genova, Italy
- Instituto de Biotecnologia y Biomedicina (BIOTECMED), Universidad de Valencia, 46100 Burjassot, Spain
| | - Ilias Ziogas
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Università degli Studi di Genova, Via Balbi, 5, 16126 Genova, Italy
| | - Roberto Narducci
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
| | - Annalisa Savardi
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Dulbecco Telethon Institute, Italy
| | - Maria Bolla
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Università degli Studi di Genova, Via Balbi, 5, 16126 Genova, Italy
| | - Bruno Pinto
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Bio@SNS, Scuola Normale Superiore, Piazza dei Cavalieri 7, 56126, Pisa, Italy
| | - Laura E Perlini
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
| | | | | | - Laura Cancedda
- Brain Development and Disease Laboratory, Istituto Italiano di Tecnologia, via Morego, 30, 16163 Genova, Italy
- Dulbecco Telethon Institute, Italy
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27
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NPRL2 Inhibition of mTORC1 Controls Sodium Channel Expression and Brain Amino Acid Homeostasis. eNeuro 2022; 9:ENEURO.0317-21.2022. [PMID: 35165201 PMCID: PMC8896560 DOI: 10.1523/eneuro.0317-21.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/19/2022] Open
Abstract
Genetic mutations in nitrogen permease regulator-like 2 (NPRL2) are associated with a wide spectrum of familial focal epilepsies, autism, and sudden unexpected death of epileptics (SUDEP), but the mechanisms by which NPRL2 contributes to these effects are not well known. NPRL2 is a requisite subunit of the GAP activity toward Rags 1 (GATOR1) complex, which functions as a negative regulator of mammalian target of rapamycin complex 1 (mTORC1) kinase when intracellular amino acids are low. Here, we show that loss of NPRL2 expression in mouse excitatory glutamatergic neurons causes seizures before death, consistent with SUDEP in humans with epilepsy. Additionally, the absence of NPRL2 expression increases mTORC1-dependent signal transduction and significantly alters amino acid homeostasis in the brain. Loss of NPRL2 reduces dendritic branching and increases the strength of electrically stimulated action potentials (APs) in neurons. The increased AP strength is consistent with elevated expression of epilepsy-linked, voltage-gated sodium channels in the NPRL2-deficient brain. Targeted deletion of NPRL2 in primary neurons increases the expression of sodium channel Scn1A, whereas treatment with the pharmacological mTORC1 inhibitor called rapamycin prevents Scn1A upregulation. These studies demonstrate a novel role of NPRL2 and mTORC1 signaling in the regulation of sodium channels, which can contribute to seizures and early lethality.
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28
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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.
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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
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29
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Ali R, Gollwitzer S, Reindl C, Hamer H, Coras R, Blümcke I, Buchfelder M, Hastreiter P, Rampp S. Phase-Amplitude Coupling measures for determination of the epileptic network: A methodological comparison. J Neurosci Methods 2022; 370:109484. [DOI: 10.1016/j.jneumeth.2022.109484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/29/2021] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
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30
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Sollee J, Tang L, Igiraneza AB, Xiao B, Bai HX, Yang L. Artificial Intelligence for Medical Image Analysis in Epilepsy. Epilepsy Res 2022; 182:106861. [DOI: 10.1016/j.eplepsyres.2022.106861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/18/2021] [Accepted: 01/16/2022] [Indexed: 11/16/2022]
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31
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Nguyen LH, Xu Y, Mahadeo T, Zhang L, Lin TV, Born HA, Anderson AE, Bordey A. Expression of 4E-BP1 in juvenile mice alleviates mTOR-induced neuronal dysfunction and epilepsy. Brain 2021; 145:1310-1325. [PMID: 34849602 DOI: 10.1093/brain/awab390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Hyperactivation of the mechanistic target of rapamycin (mTOR) pathway during fetal neurodevelopment alters neuron structure and function, leading to focal malformation of cortical development (FMCD) and intractable epilepsy. Recent evidence suggests a role for dysregulated cap-dependent translation downstream of mTOR in the formation of FMCD and seizures. However, it is unknown whether modifying translation once the developmental pathologies are established can reverse neuronal abnormalities and seizures. Addressing these issues is crucial with regards to therapeutics since these neurodevelopmental disorders are predominantly diagnosed during childhood, when patients present with symptoms. Here, we report increased phosphorylation of the mTOR effector and translational repressor, 4E-BP1, in patient FMCD tissue and in a mouse model of FMCD. Using temporally regulated conditional gene expression systems, we found that expression of a constitutively active form of 4E-BP1 that resists phosphorylation by mTOR in juvenile mice reduced neuronal cytomegaly and corrected several neuronal electrophysiological alterations, including depolarized resting membrane potential, irregular firing pattern, and aberrant expression of HCN4 channels. Further, 4E-BP1 expression in juvenile FMCD mice after epilepsy onset resulted in improved cortical spectral activity and decreased spontaneous seizure frequency in adults. Overall, our study uncovered a remarkable plasticity of the juvenile brain that facilitates novel therapeutic opportunities to treat FMCD-related epilepsy during childhood with potentially long-lasting effects in adults.
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Affiliation(s)
- Lena H Nguyen
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Youfen Xu
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Travorn Mahadeo
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Longbo Zhang
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Tiffany V Lin
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Heather A Born
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Anne E Anderson
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Angélique Bordey
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
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32
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Swanson LC, Ahmed R. Epilepsy Syndromes: Current Classifications and Future Directions. Neurosurg Clin N Am 2021; 33:113-134. [PMID: 34801136 DOI: 10.1016/j.nec.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This review describes the clinical presentations and treatment options for commonly recognized epilepsy syndromes in the pediatric age group, based on the 2017 International League Against Epilepsy classification. Structural epilepsies that are amenable to surgical intervention are discussed. Lastly, emerging technologies are reviewed that are expanding our knowledge of underlying epilepsy pathologies and will guide future syndromic classification systems including genetic testing and tissue repositories.
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Affiliation(s)
- Laura C Swanson
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave. #18, Chicago, IL 60611, USA
| | - Raheel Ahmed
- Department of Neurosurgery, University of Wisconsin-Madison School of Medicine and Public Health, 1675 Highland Avenue #0002, Madison, WI 53705, USA.
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33
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Laohathai C, Ebersole JS, Mosher JC, Bagić AI, Sumida A, Von Allmen G, Funke ME. Practical Fundamentals of Clinical MEG Interpretation in Epilepsy. Front Neurol 2021; 12:722986. [PMID: 34721261 PMCID: PMC8551575 DOI: 10.3389/fneur.2021.722986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Magnetoencephalography (MEG) is a neurophysiologic test that offers a functional localization of epileptic sources in patients considered for epilepsy surgery. The understanding of clinical MEG concepts, and the interpretation of these clinical studies, are very involving processes that demand both clinical and procedural expertise. One of the major obstacles in acquiring necessary proficiency is the scarcity of fundamental clinical literature. To fill this knowledge gap, this review aims to explain the basic practical concepts of clinical MEG relevant to epilepsy with an emphasis on single equivalent dipole (sECD), which is one the most clinically validated and ubiquitously used source localization method, and illustrate and explain the regional topology and source dynamics relevant for clinical interpretation of MEG-EEG.
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Affiliation(s)
- Christopher Laohathai
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
- Department of Neurology, Saint Louis University, Saint Louis, MO, United States
| | - John S. Ebersole
- Northeast Regional Epilepsy Group, Atlantic Health Neuroscience Institute, Summit, NJ, United States
| | - John C. Mosher
- Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Anto I. Bagić
- University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), Department of Neurology, University of Pittsburgh Medical Center, Pittsburg, PA, United States
| | - Ai Sumida
- Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Gretchen Von Allmen
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Michael E. Funke
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School at UTHealth, Houston, TX, United States
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Niyas S, Chethana Vaisali S, Show I, Chandrika T, Vinayagamani S, Kesavadas C, Rajan J. Segmentation of focal cortical dysplasia lesions from magnetic resonance images using 3D convolutional neural networks. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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35
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Saute RL, Peixoto-Santos JE, Velasco TR, Leite JP. Improving surgical outcome with electric source imaging and high field magnetic resonance imaging. Seizure 2021; 90:145-154. [PMID: 33608134 DOI: 10.1016/j.seizure.2021.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 12/14/2022] Open
Abstract
While most patients with focal epilepsy present with clear structural abnormalities on standard, 1.5 or 3 T MRI, some patients are MRI-negative. For those, quantitative MRI techniques, such as volumetry, voxel-based morphometry, and relaxation time measurements can aid in finding the epileptogenic focus. High-field MRI, just recently approved for clinical use by the FDA, increases the resolution and, in several publications, was shown to improve the detection of focal cortical dysplasias and mild cortical malformations. For those cases without any tissue abnormality in neuroimaging, even at 7 T, scalp EEG alone is insufficient to delimitate the epileptogenic zone. They may benefit from the use of high-density EEG, in which the increased number of electrodes helps improve spatial sampling. The spatial resolution of even low-density EEG can benefit from electric source imaging techniques, which map the source of the recorded abnormal activity, such as interictal epileptiform discharges, focal slowing, and ictal rhythm. These EEG techniques help localize the irritative, functional deficit, and seizure-onset zone, to better estimate the epileptogenic zone. Combining those technologies allows several drug-resistant cases to be submitted to surgery, increasing the odds of seizure freedom and providing a must needed hope for patients with epilepsy.
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Affiliation(s)
- Ricardo Lutzky Saute
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - Jose Eduardo Peixoto-Santos
- Discipline of Neuroscience, Department of Neurology and Neurosurgery, Paulista School of Medicine, Unifesp, Brazil
| | - Tonicarlo R Velasco
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - Joao Pereira Leite
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Brazil.
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36
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Srivastava A, Kumar K, Banerjee J, Tripathi M, Dubey V, Sharma D, Yadav N, Sharma MC, Lalwani S, Doddamani R, Chandra PS, Dixit AB. Transcriptomic profiling of high- and low-spiking regions reveals novel epileptogenic mechanisms in focal cortical dysplasia type II patients. Mol Brain 2021; 14:120. [PMID: 34301297 PMCID: PMC8305866 DOI: 10.1186/s13041-021-00832-4] [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: 03/21/2021] [Accepted: 07/14/2021] [Indexed: 11/15/2022] Open
Abstract
Focal cortical dysplasia (FCD) is a malformation of the cerebral cortex with poorly-defined epileptogenic zones (EZs), and poor surgical outcome in FCD is associated with inaccurate localization of the EZ. Hence, identifying novel epileptogenic markers to aid in the localization of EZ in patients with FCD is very much needed. High-throughput gene expression studies of FCD samples have the potential to uncover molecular changes underlying the epileptogenic process and identify novel markers for delineating the EZ. For this purpose, we, for the first time performed RNA sequencing of surgically resected paired tissue samples obtained from electrocorticographically graded high (MAX) and low spiking (MIN) regions of FCD type II patients and autopsy controls. We identified significant changes in the MAX samples of the FCD type II patients when compared to non-epileptic controls, but not in the case of MIN samples. We found significant enrichment for myelination, oligodendrocyte development and differentiation, neuronal and axon ensheathment, phospholipid metabolism, cell adhesion and cytoskeleton, semaphorins, and ion channels in the MAX region. Through the integration of both MAX vs non-epileptic control and MAX vs MIN RNA sequencing (RNA Seq) data, PLP1, PLLP, UGT8, KLK6, SOX10, MOG, MAG, MOBP, ANLN, ERMN, SPP1, CLDN11, TNC, GPR37, SLC12A2, ABCA2, ABCA8, ASPA, P2RX7, CERS2, MAP4K4, TF, CTGF, Semaphorins, Opalin, FGFs, CALB2, and TNC were identified as potential key regulators of multiple pathways related to FCD type II pathology. We have identified novel epileptogenic marker elements that may contribute to epileptogenicity in patients with FCD and could be possible markers for the localization of EZ.
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Affiliation(s)
| | - Krishan Kumar
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India
| | | | | | - Vivek Dubey
- Department of Biophysics, AIIMS, New Delhi, India
| | - Devina Sharma
- Department of Neurosurgery, AIIMS, New Delhi, 110029, India
| | - Nitin Yadav
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India
| | - M C Sharma
- Department of Pathology, AIIMS, New Delhi, India
| | - Sanjeev Lalwani
- Department of Forensic Medicine and Toxicology, AIIMS, New Delhi, India
| | | | - P Sarat Chandra
- Department of Neurosurgery, AIIMS, New Delhi, 110029, India.
| | - Aparna Banerjee Dixit
- Dr B R Ambedkar Centre for Biomedical Research, University of Delhi, Delhi, 110007, India.
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Bartoňová M, Bartoň M, Říha P, Vojtíšek L, Brázdil M, Rektor I. The benefit of the diffusion kurtosis imaging in presurgical evaluation in patients with focal MR-negative epilepsy. Sci Rep 2021; 11:14208. [PMID: 34244544 PMCID: PMC8270902 DOI: 10.1038/s41598-021-92804-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
The effectivity of diffusion-weighted MRI methods in detecting the epileptogenic zone (EZ) was tested. Patients with refractory epilepsy (N=25) who subsequently underwent resective surgery were recruited. First, the extent of white matter (WM) asymmetry from mean kurtosis (MK) was calculated in order to detect the lobe with the strongest impairment. Second, a newly developed metric was used, reflecting a selection of brain areas with concurrently increased mean Diffusivity, reduced fractional Anisotropy, and reduced mean Kurtosis (iDrArK). A two-step EZ detection was performed as (1) lobe-specific detection, (2) iDrArK voxel-wise detection (with a possible lobe-specific restriction if the result of the first step was significant in a given subject). The method results were compared with the surgery resection zones. From the whole cohort (N=25), the numbers of patients with significant results were: 10 patients in lobe detection and 9 patients in EZ detection. From these subsets of patients with significant results, the impaired lobe was successfully detected with 100% accuracy; the EZ was successfully detected with 89% accuracy. The detection of the EZ using iDrArK was substantially more successful when compared with solo diffusional parameters (or their pairwise combinations). For a subgroup with significant results from step one (N=10), iDrArK without lobe restriction achieved 37.5% accuracy; lobe-restricted iDrArK achieved 100% accuracy. The study shows the plausibility of MK for detecting widespread WM changes and the benefit of combining different diffusional voxel-wise parameters.
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Affiliation(s)
- Michaela Bartoňová
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Brno Epilepsy Center, Full member of the European Reference Network (ERN) EpiCARE, First Department of Neurology, St. Anne′s University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Bartoň
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Pavel Říha
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Brno Epilepsy Center, Full member of the European Reference Network (ERN) EpiCARE, First Department of Neurology, St. Anne′s University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lubomír Vojtíšek
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Milan Brázdil
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Brno Epilepsy Center, Full member of the European Reference Network (ERN) EpiCARE, First Department of Neurology, St. Anne′s University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- grid.10267.320000 0001 2194 0956Central European Institute of Technology (CEITEC), Multimodal and Functional Neuroimaging Research Group, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Brno Epilepsy Center, Full member of the European Reference Network (ERN) EpiCARE, First Department of Neurology, St. Anne′s University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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38
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Narayana S, Gibbs SK, Fulton SP, McGregor AL, Mudigoudar B, Weatherspoon SE, Boop FA, Wheless JW. Clinical Utility of Transcranial Magnetic Stimulation (TMS) in the Presurgical Evaluation of Motor, Speech, and Language Functions in Young Children With Refractory Epilepsy or Brain Tumor: Preliminary Evidence. Front Neurol 2021; 12:650830. [PMID: 34093397 PMCID: PMC8170483 DOI: 10.3389/fneur.2021.650830] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
Accurate presurgical mapping of motor, speech, and language cortices, while crucial for neurosurgical planning and minimizing post-operative functional deficits, is challenging in young children with neurological disease. In such children, both invasive (cortical stimulation mapping) and non-invasive functional mapping imaging methods (MEG, fMRI) have limited success, often leading to delayed surgery or adverse post-surgical outcomes. We therefore examined the clinical utility of transcranial magnetic stimulation (TMS) in young children who require functional mapping. In a retrospective chart review of TMS studies performed on children with refractory epilepsy or a brain tumor, at our institution, we identified 47 mapping sessions in 36 children 3 years of age or younger, in whom upper and lower extremity motor mapping was attempted; and 13 children 5–6 years old in whom language mapping, using a naming paradigm, was attempted. The primary hand motor cortex was identified in at least one hemisphere in 33 of 36 patients, and in both hemispheres in 27 children. In 17 children, primary leg motor cortex was also successfully identified. The language cortices in temporal regions were successfully mapped in 11 of 13 patients, and in six of them language cortices in frontal regions were also mapped, with most children (n = 5) showing right hemisphere dominance for expressive language. Ten children had a seizure that was consistent with their clinical semiology during or immediately following TMS, none of which required intervention or impeded completion of mapping. Using TMS, both normal motor, speech, and language developmental patterns and apparent disease induced reorganization were demonstrated in this young cohort. The successful localization of motor, speech, and language cortices in young children improved the understanding of the risk-benefit ratio prior to surgery and facilitated surgical planning aimed at preserving motor, speech, and language functions. Post-operatively, motor function was preserved or improved in nine out of 11 children who underwent surgery, as was language function in all seven children who had surgery for lesions near eloquent cortices. We provide feasibility data that TMS is a safe, reliable, and effective tool to map eloquent cortices in young children.
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Affiliation(s)
- Shalini Narayana
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Savannah K Gibbs
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Stephen P Fulton
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Amy Lee McGregor
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Basanagoud Mudigoudar
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Sarah E Weatherspoon
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Frederick A Boop
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Semmes Murphey Neurologic and Spine Institute, Memphis, TN, United States.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States
| | - James W Wheless
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
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González-Ortiz S, Medrano S, Capellades J, Vilas M, Mestre A, Serrano L, Conesa G, Pérez-Enríquez C, Arumi M, Bargalló N, Delgado-Martinez I, Rocamora R. Voxel-based morphometry for the evaluation of patients with pharmacoresistant epilepsy with apparently normal MRI. J Neuroimaging 2021; 31:560-568. [PMID: 33817887 DOI: 10.1111/jon.12849] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI) is essential in the diagnosis of pharmacoresistant epilepsy (PRE), because patients with lesions detected by MRI have a better prognosis after surgery. Focal cortical dysplasia (FCD) is one of the most frequent etiologies of PRE but can be difficult to identify by MRI. Voxel-based morphometric analysis programs, like the Morphometric Analysis Program (MAP), have been developed to help improve MRI detection. Our objective was to evaluate the clinical usefulness of MAP in patients with PRE and an apparently normal MRI. METHODS We studied 70 patients with focal PRE and a nonlesional MRI. The 3DT1 sequence was processed with MAP, obtaining three z-score maps. Patients were classified as MAP+ if one or more z-score maps showed a suspicious area of brightness, and MAP- if the z-score maps did not show any suspicious areas. For MAP+ cases, a second-look MRI was performed with a dedicated inspection based on the MAP findings. The MAP results were correlated with the epileptogenic zone. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS Thirty-one percent of patients were classified as MAP+ and 69% were MAP-. Results showed a sensitivity of 0.57, specificity of 0.8, PPV of 0.91, and NPV of 0.35. In 19% of patients, an FCD was found in the second-look MRI after MAP. CONCLUSIONS MAP was helpful in the detection of lesions in PRE patients with a nonlesional MRI, which could have important repercussions for the clinical management and postoperative prognosis of these patients.
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Affiliation(s)
- Sofía González-Ortiz
- Radiology Department, Hospital del Mar, Barcelona, Spain.,Epilpsy Reserach Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | | | | | - Marta Vilas
- Radiology Department, Hospital del Mar, Barcelona, Spain
| | - Antoni Mestre
- Nuclear Medicine Department, Hospital Trueta, Girona, Spain
| | - Laura Serrano
- Neurosurgery Department, Hospital del Mar, Barcelona, Spain
| | - Gerardo Conesa
- Neurosurgery Department, Hospital del Mar, Barcelona, Spain.,Epilpsy Reserach Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Carmen Pérez-Enríquez
- Neurology Department, Hospital del Mar, Barcelona, Spain.,Epilpsy Reserach Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Montserrat Arumi
- Anatomic Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Nuria Bargalló
- Centre de Diagnosi per la Imatge, Hospital Clínic, Barcelona, Spain
| | - Ignacio Delgado-Martinez
- Neurosurgery Department, Hospital del Mar, Barcelona, Spain.,Epilpsy Reserach Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Rodrigo Rocamora
- Neurology Department, Hospital del Mar, Barcelona, Spain.,Epilpsy Reserach Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
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40
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De Vito A, Mankad K, Pujar S, Chari A, Ippolito D, D’Arco F. Narrative review of epilepsy: getting the most out of your neuroimaging. Transl Pediatr 2021; 10:1078-1099. [PMID: 34012857 PMCID: PMC8107872 DOI: 10.21037/tp-20-261] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Neuroimaging represents an important step in the evaluation of pediatric epilepsy. The crucial role of brain imaging in the diagnosis, follow-up and presurgical assessment of patients with epilepsy is noted and has to be familiar to all neuroradiologists and trainees approaching pediatric brain imaging. Morphological qualitative imaging shows the majority of cerebral lesions/alterations underlying focal epilepsy and can highlight some features which are useful in the differential diagnosis of the different types of epilepsy. Recent advances in MRI acquisitions including diffusion-weighted imaging (DWI), post-acquisition image processing techniques, and quantification of imaging data are increasing the accuracy of lesion detection during the last decades. Functional MRI (fMRI) can be really useful and helps to identify cortical eloquent areas that are essential for language, motor function, and memory, and diffusion tensor imaging (DTI) can reveal white matter tracts that are vital for these functions, thus reducing the risk of epilepsy surgery causing new morbidities. Also positron emission tomography (PET), single photon emission computed tomography (SPECT), simultaneous electroencephalogram (EEG) and fMRI, and electrical and magnetic source imaging can be used to assess the exact localization of epileptic foci and help in the design of intracranial EEG recording strategies. The main role of these "hybrid" techniques is to obtain quantitative and qualitative informations, a necessary step to evaluate and demonstrate the complex relationship between abnormal structural and functional data and to manage a "patient-tailored" surgical approach in epileptic patients.
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Affiliation(s)
- Andrea De Vito
- Department of Neuroradiology, H. S. Gerardo Monza, Monza, Italy
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Suresh Pujar
- Department of Neurology, Great Ormond Street Hospital for Children, London, UK
| | - Aswin Chari
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK
| | | | - Felice D’Arco
- Department of Radiology, Great Ormond Street Hospital, London, UK
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Khalilov VS, Kholin AA, Gazdieva KS, Kislyakov AN, Zavadenko NN. [Features of the neuroradiological picture of ganglioglioma on the example of 20 clinical cases]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:90-98. [PMID: 33340303 DOI: 10.17116/jnevro202012011190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the images obtained during pre-surgical neuroimaging in patients with gangliomas for the presence of specific signs and verification of the neoplastic process. MATERIAL AND METHODS The results of presurgical MRI (3.0, 1.5 Tesla) of 20 patients with gangliomas were analyzed to identify specific signs of a neuronal-glial tumor and verify the neoplastic process based on the results obtained and a review of the literature. In addition to high-resolution MRI (HR MRI), various protocol modifications were applied to patients with epileptogenic pathological substrates of unclear etiology, including tractography (DTI) and contrast-free MR perfusion (ASL). In 5 cases, a multi-modal study was performed that combined the results of CT, routine MRI, HR MRI, functional MRI (fMRI) in various combinations and PET CT. RESULTS AND CONCLUSION In 17 cases, patients underwent epileptic surgery. Three patients without epilepsy were operated on for a tumor diagnosed by radiological examination. In all 20 cases, gangliogliomas were verified, including 1 anaplastic, 1 infantile desmoplastic, and another patient had histological samples showing signs of a composite tumor. Combination with FCD IIIb was observed in 3 cases. Two patients had a double pathology (cases of tumors combination with lissencephaly and neuronal heterotopia) and another had a composite neuronal-glial tumor. In 15 cases, gangliogliomas showed neuroradiological features typical for dysembryoplastic neuroepithelial tumor (DNT) such as multicystic, nodular, and diffuse (dysplastic) described in the literature. In addition, in 9 cases, they had significant signs of neoplastic process such as contrast enhancement, continued growth and remodeling of the underlying bone. Verification of the neoplastic process based on the results of neuroradiological studies was difficult in 6 cases. In 2 cases, it was not possible to confirm the presence of neoplasm by radiological methods, and in 1 patient, the verification of the tumor during differential diagnosis took more than 8 years. The most common differential diagnosis was performed with DNT and FCD type IIb, which have a number of similar neuroradiological features.
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Affiliation(s)
- V S Khalilov
- Central Children Clinical Hospital of Federal Medical-Biological Agency, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Kholin
- Pirogov Russian National Research Medical University, Moscow, Russia.,Russian Children Clinical Hospital, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Kh Sh Gazdieva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - N N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
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42
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Feng C, Zhao H, Li Y, Cheng Z, Wen J. Improved detection of focal cortical dysplasia in normal-appearing FLAIR images using a Bayesian classifier. Med Phys 2020; 48:912-925. [PMID: 33283293 DOI: 10.1002/mp.14646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Focal cortical dysplasia (FCD) is a malformation of cortical development that often causes pharmacologically intractable epilepsy. However, FCD lesions are frequently characterized by minor structural abnormalities that can easily go unrecognized, making diagnosis difficult. Therefore, many epileptic patients have had pathologically confirmed FCD lesions that appeared normal in pre-surgical fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) studies. Such lesions are called "FLAIR-negative." This study aimed to improve the detection of histopathologically verified FCD in a sample of patients without visually appreciable lesions. METHODS The technique first extracts a series of features from a FLAIR image. Then, three naive Bayesian classifiers with probability (NBCP) are trained based on different numbers of feature maps to classify voxels as lesional or healthy voxels and assign the lesions a probability of correct classification. This method classifies the three-dimensional (3D) images of all patients using leave-one-out cross-validation (LOOCV). Finally, the 3D lesion probability map, including epileptogenic lesions, is obtained by removing false-positive voxel outliers using the morphological method. The performance of the NBCP was assessed for quantitative analysis by specificity, accuracy, recall, precision, and Dice coefficient in subject-wise, lesion-wise, and voxel-wise manners. RESULTS The best detection results were obtained by using four features: cortical thickness, symmetry, K-means, and modified texture energy. There were eight lesions in seven patients. The subject-wise sensitivity of the proposed method was 85.71% (6/7). Seven out of eight lesions were detected, so the lesion-wise sensitivity was 87.50% (7/8). No significant differences in effectiveness were found between automated lesion detection using four features and lesion detection using manual segmentation, as voxels were quantitatively analyzed in terms of specificity (mean ± SD = 99.64 ± 0.13), accuracy (mean ± SD = 99.62 ± 0.14), recall (mean ± SD = 73.27 ± 26.11), precision (mean ± SD = 11.93 ± 8.16), and Dice coefficient (mean ± SD = 22.82 ± 15.57). CONCLUSION We developed a novel automatic voxel-based method to improve the detection of FCD FLAIR-negative lesions. To the best of our knowledge, this study is the first to detect FCD lesions that appear normal in pre-surgical 3D high-resolution FLAIR images alone with a limited number of radiomics features. We optimized the algorithm and selected the best prior probability to improve the detection. For non-temporal lobe epilepsy (non-TLE) patients, lesions could be accurately located, although there were still false-positive areas.
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Affiliation(s)
- Cuixia Feng
- Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Hulin Zhao
- The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Yueer Li
- Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Zhibiao Cheng
- Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Junhai Wen
- Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China
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Increased expression of Fragile X mental retardation protein in malformative lesions of patients with focal cortical dysplasia. Neuroreport 2020; 31:1036-1041. [PMID: 32833881 DOI: 10.1097/wnr.0000000000001517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Focal cortical dysplasia (FCD) accounts for nearly half of all cases of medically refractory epilepsy in the pediatric and adult patient populations. This neurological disorder stems from localized malformations in cortical brain tissue due to impaired neuronal proliferation, differentiation, and migration patterns. Recent studies in animal models have highlighted the potential role of the Fragile X mental retardation protein (FMRP) levels in FCD. The purpose of this study was to investigate the status of FMRP activation in cortical brain tissues surgically resected from patients with FCD. In parallel, this study also investigated protein levels within the PI3K/AKT/mTOR and canonical Wnt signaling pathways. METHODS Pathologic tissue from malformative lesions of FCD patients with medically refractory epilepsy was compared to relatively normal control non-epileptic tissue from patients with intracranial neoplasms. A series of western blotting assays were performed to assess key proteins in the PI3K/AKT/mTOR, canonical Wnt signaling pathways, and FMRP. RESULTS There was suppression of S235/236-phosphorylated S6, GSK3α, and GSK3β protein levels in samples derived from FCD patients, compared to non-epileptic controls. FCD samples also had significantly greater levels of total and S499-phosphorylated FMRP. CONCLUSION These findings support our hypothesis that malformative lesions associated with FCD are characterized by high levels of FMRP activation along with dysregulation of both PI3K/AKT/mTOR and canonical Wnt signaling. These novel clinical findings extend previous work in animal models, further suggesting a potential unforeseen role of GSK3α and GSK3β in the pathophysiology of FCD and refractory epilepsy.
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Dusak A, Hafizoglu D, Kilic SS, Yazıcı Z. Central nervous system variations and abnormalities in anhidrotic ectodermal dysplasia (AED): neuroimaging findings. Acta Radiol 2020; 61:1377-1387. [PMID: 32000505 DOI: 10.1177/0284185120901510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anhidrotic ectodermal dysplasia (AED) is a rare, mostly X-linked recessive genodermatosis, characterized by congenital defects of ectodermal derivative structures as the central nervous system (CNS) is primarily ectodermal in origin. PURPOSE To evaluate CNS variations and abnormalities in AED. MATERIAL AND METHODS A retrospective analysis was made of the neurological and neuroimaging findings of 17 children (12 boys, 5 girls; median age = 8 years; age range = 2-14 years) diagnosed with AED in our pediatric clinics during 2008-2016. The pattern of CNS variation and abnormalities were evaluated by comparing of these findings with an age- and gender-matched healthy control group with no family history. RESULTS Of the 17 AED cases identified on the basis of neuroimaging findings, 6 (35.3%) were seen to be normal. Associated CNS variation and abnormalities including cavum septum pellucidum (35.3%), callosal dysgenesis (11.8%), prominent Virchow-Robin spaces (64.7%), cortical sulcal dilation (41.1%), mega cisterna magna (35.3%), focal cortical dysplasia (11.8%), and delayed myelination (58.8%) were observed in 11 (64.7%) children with AED. CONCLUSION AED suggests a spectrum of CNS variation and abnormalities, presenting with neurological and neuroimaging findings, demonstrated in the embryonic surface- and neuro-ectoderm derived structures. The results of this study suggest that CNS variation and abnormalities might be associated with AED.
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Affiliation(s)
- Abdurrahim Dusak
- Department of Radiology, Uludag University, School of Medicine, Bursa, Turkey
| | - Demet Hafizoglu
- Department of Pediatrics, Uludag University, School of Medicine, Bursa, Turkey
| | - Sara Sebnem Kilic
- Department of Pediatrics, Uludag University, School of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University, School of Medicine, Bursa, Turkey
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Chen SD, Pan HY, Huang JB, Liu XP, Li JH, Ho CJ, Tsai MH, Yang JL, Chen SF, Chen NC, Chuang YC. Circulating MicroRNAs from Serum Exosomes May Serve as a Putative Biomarker in the Diagnosis and Treatment of Patients with Focal Cortical Dysplasia. Cells 2020; 9:cells9081867. [PMID: 32785072 PMCID: PMC7465068 DOI: 10.3390/cells9081867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 12/12/2022] Open
Abstract
Focal cortical dysplasia (FCD) is a congenital malformation of cortical development where the cortical neurons located in the brain area fail to migrate in the proper formation. Epilepsy, particularly medically refractory epilepsy, is the most common clinical presentation for all types of FCD. This study aimed to explore the expression change of circulating miRNAs in patients with FCD from serum exosomes. A total of nine patients with FCD and four healthy volunteers were enrolled in this study. The serum exosomes were isolated from the peripheral blood of the subjects. Transmission electron microscopy (TEM) was used to identify the exosomes. Both exosomal markers and neuronal markers were detected by Western blotting analysis to prove that we could obtain central nervous system-derived exosomes from the circulation. The expression profiles of circulating exosomal miRNAs were assessed using next-generation sequencing analysis (NGS). We obtained a total of 107 miRNAs with dominant fold change (>2-fold) from both the annotated 5p-arm and 3p-arm of 2780 mature miRNAs. Based on the integrated platform of HMDD v3.2, miRway DB and DIANA-miRPath v3.0 online tools, and confirmed by MiRBase analysis, four potentially predicted miRNAs from serum exosomes in patients with FCD were identified, including miR194-2-5p, miR15a-5p, miR-132-3p, and miR-145-5p. All four miRNAs presented upregulated expression in patients with FCD compared with controls. Through Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and pathway category of four target miRNAs, we found eight possible signaling pathways that may be related to FCD. Among them, we suggest that the mTOR signaling pathway, PI3K-Akt signaling pathway, p53 signaling pathway, and cell cycle regulation and TGF-beta signaling pathway are high-risk pathways that play a crucial role in the pathogenesis of FCD and refractory epilepsy. Our results suggest that the circulating miRNAs from exosomes may provide a potential biomarker for diagnostic, prognostic, and therapeutic adjuncts in patients with FCD and refractory epilepsy.
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Affiliation(s)
- Shang-Der Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
- Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (X.-P.L.); (J.-H.L.); (J.-L.Y.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (H.-Y.P.); (J.-B.H.)
| | - Jyun-Bin Huang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (H.-Y.P.); (J.-B.H.)
| | - Xuan-Ping Liu
- Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (X.-P.L.); (J.-H.L.); (J.-L.Y.)
| | - Jie-Hau Li
- Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (X.-P.L.); (J.-H.L.); (J.-L.Y.)
| | - Chen-Jui Ho
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
| | - Meng-Han Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Jenq-Lin Yang
- Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (X.-P.L.); (J.-H.L.); (J.-L.Y.)
| | - Shu-Fang Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
| | - Nai-Ching Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
| | - Yao-Chung Chuang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (S.-D.C.); (C.-J.H.); (M.-H.T.); (S.-F.C.); (N.-C.C.)
- Institute for Translation Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (X.-P.L.); (J.-H.L.); (J.-L.Y.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Biological Science, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
- Correspondence:
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Maiworm M, Nöth U, Hattingen E, Steinmetz H, Knake S, Rosenow F, Deichmann R, Wagner M, Gracien RM. Improved Visualization of Focal Cortical Dysplasia With Surface-Based Multiparametric Quantitative MRI. Front Neurosci 2020; 14:622. [PMID: 32612511 PMCID: PMC7308728 DOI: 10.3389/fnins.2020.00622] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023] Open
Abstract
Purpose In the clinical routine, detection of focal cortical dysplasia (FCD) by visual inspection is challenging. Still, information about the presence and location of FCD is highly relevant for prognostication and treatment decisions. Therefore, this study aimed to develop, describe and test a method for the calculation of synthetic anatomies using multiparametric quantitative MRI (qMRI) data and surface-based analysis, which allows for an improved visualization of FCD. Materials and Methods Quantitative T1-, T2- and PD-maps and conventional clinical datasets of patients with FCD and epilepsy were acquired. Tissue segmentation and delineation of the border between white matter and cortex was performed. In order to detect blurring at this border, a surface-based calculation of the standard deviation of each quantitative parameter (T1, T2, and PD) was performed across the cortex and the neighboring white matter for each cortical vertex. The resulting standard deviations combined with measures of the cortical thickness were used to enhance the signal of conventional FLAIR-datasets. The resulting synthetically enhanced FLAIR-anatomies were compared with conventional MRI-data utilizing regions of interest based analysis techniques. Results The synthetically enhanced FLAIR-anatomies showed higher signal levels than conventional FLAIR-data at the FCD sites (p = 0.005). In addition, the enhanced FLAIR-anatomies exhibited higher signal levels at the FCD sites than in the corresponding contralateral regions (p = 0.005). However, false positive findings occurred, so careful comparison with conventional datasets is mandatory. Conclusion Synthetically enhanced FLAIR-anatomies resulting from surface-based multiparametric qMRI-analyses have the potential to improve the visualization of FCD and, accordingly, the treatment of the respective patients.
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Affiliation(s)
- Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt, Germany.,Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Susanne Knake
- Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany.,Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Felix Rosenow
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany.,Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
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Sungura RE, Spitsbergen JM, Mpolya EA, Sauli E, Vianney JM. The neuroimaging magnitude of pediatric brain atrophy in northern Tanzania. Pan Afr Med J 2020; 36:25. [PMID: 32774602 PMCID: PMC7388640 DOI: 10.11604/pamj.2020.36.25.22515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The loss of parenchymal brain volume per normative age comparison is a distinctive feature of brain atrophy. While the condition is the most prevalent to elderly, it has also been observed in pediatric ages. Various causes such as trauma, infection, and malnutrition have been reported to trigger the loss of brain tissues volume. Despite this literature based knowledge of risk factors, the magnitude of brain atrophy in pediatric age group is scantly addressed in most developing countries including Tanzania. The current study aims to understand the magnitude of brain atrophy in children residing in Northern Zone, Tanzania. Methods A cross-sectional hospital survey was performed in which 455 children who were presented with various brain pathologies from the year 2013 to 2019 and whose brains examined by Computerized tomography (CT)-Scanners were recruited in the study. The brain statuses were examined using three linear radiological methods including the measure of sulcal-width, Evans index, and lateral ventricular body width. Results Results showed a significant number of atrophied brains among children in Northern Tanzania and that the condition was observed to have a 1:1 male to female ratio. The prevalence of pediatric brain atrophy was found to be 16.04%. Conclusion The cortical subtype of brain atrophy presented as the most prevalent type of brain volume loss. The findings of this study suggest existence of considerable trends of brain atrophy in children which need special attention and mitigation plans.
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Affiliation(s)
- Richard Erasto Sungura
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela-African Institution of Science and Technology, Arusha, Tanzania
| | - John Martin Spitsbergen
- Department of Biological Sciences, Western Michigan University, Michigan, United State of America
| | - Emmanuel Abraham Mpolya
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela-African Institution of Science and Technology, Arusha, Tanzania.,Department of Biological Sciences, Western Michigan University, Michigan, United State of America
| | - Elingarami Sauli
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela-African Institution of Science and Technology, Arusha, Tanzania
| | - John-Mary Vianney
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela-African Institution of Science and Technology, Arusha, Tanzania
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Sepúlveda MM, Rojas GM, Faure E, Pardo CR, Las Heras F, Okuma C, Cordovez J, de la Iglesia-Vayá M, Molina-Mateo J, Gálvez M. Visual analysis of automated segmentation in the diagnosis of focal cortical dysplasias with magnetic resonance imaging. Epilepsy Behav 2020; 102:106684. [PMID: 31778880 DOI: 10.1016/j.yebeh.2019.106684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/12/2019] [Accepted: 11/02/2019] [Indexed: 01/19/2023]
Abstract
Focal cortical dysplasias (FCDs) are a frequent cause of epilepsy. It has been reported that up to 40% of them cannot be visualized with conventional magnetic resonance imaging (MRI). The main objective of this work was to evaluate by means of a retrospective descriptive observational study whether the automated brain segmentation is useful for detecting FCD. One hundred and fifty-five patients, who underwent surgery between the years 2009 and 2016, were reviewed. Twenty patients with FCD confirmed by histology and a preoperative segmentation study, with ages ranging from 3 to 43 years (14 men), were analyzed. Three expert neuroradiologists visually analyzed conventional and advanced MRI with automated segmentation. They were classified into positive and negative concerning visualization of FCD by consensus. Of the 20 patients evaluated with conventional MRI, 12 were positive for FCD. Of the negative studies for FCD with conventional MRI, 2 (25%) were positive when they were analyzed with automated segmentation. In 13 of the 20 patients (with positive segmentation for FCD), cortical thickening was observed in 5 (38.5%), while pseudothickening was observed in the rest of patients (8, 61.5%) in the anatomical region of the brain corresponding to the dysplasia. This work demonstrated that automated brain segmentation helps to increase detection of FCDs that are unable to be visualized in conventional MRI images.
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Affiliation(s)
| | - Gonzalo M Rojas
- Laboratory for Advanced Medical Image Processing, Department of Radiology, Clínica las Condes, Santiago, Chile; Health Innovation Center, Clínica las Condes, Santiago, Chile; Advanced Center for Epilepsy, Clínica la Condes, Santiago, Chile.
| | - Evelyng Faure
- Department of Radiology, Clínica las Condes, Santiago, Chile; Advanced Center for Epilepsy, Clínica la Condes, Santiago, Chile
| | - Claudio R Pardo
- Department of Radiology, Clínica las Condes, Santiago, Chile
| | - Facundo Las Heras
- Department of Pathological Anatomy, Clínica las Condes, Santiago, Chile
| | - Cecilia Okuma
- Department of Radiology, Clínica las Condes, Santiago, Chile
| | - Jorge Cordovez
- Department of Radiology, Clínica las Condes, Santiago, Chile
| | - María de la Iglesia-Vayá
- Regional Ministry of Health in Valencia Region, Valencia, Spain; Join Unit FISABIO-CIPF, Valencia, Spain
| | - José Molina-Mateo
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Marcelo Gálvez
- Department of Radiology, Clínica las Condes, Santiago, Chile; Health Innovation Center, Clínica las Condes, Santiago, Chile; Advanced Center for Epilepsy, Clínica la Condes, Santiago, Chile; Academic Direction, Clinica Las Condes, Santiago, Chile
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49
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Automated detection of focal cortical dysplasia using a deep convolutional neural network. Comput Med Imaging Graph 2020; 79:101662. [DOI: 10.1016/j.compmedimag.2019.101662] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 07/12/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
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50
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Marinowic DR, Majolo F, Zanirati GG, Plentz I, Neto EP, Palmini ALF, Machado DC, Da Costa JC. Analysis of genes involved in cell proliferation, adhesion, and control of apoptosis during embryonic neurogenesis in Induced Pluripotent Stem Cells (iPSCs) from patients with Focal Cortical Dysplasia. Brain Res Bull 2019; 155:112-118. [PMID: 31816405 DOI: 10.1016/j.brainresbull.2019.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
Focal cortical dysplasia (FCD) is a malformation of cortical development which is strongly associated with drug-refractory epilepsy. Certain studies have demonstrated an increase in mTOR signaling in patients with FCD on the basis of observation of phosphorylated molecules. The aim of the present study was to verify the differences in genes involved in cell proliferation, adhesion, and control of apoptosis during embryonic neurogenesis in iPSCs derived from the Focal Cortical Dysplasia. Fibroblasts were obtained from the skin biopsies of patients with FCD (n = 2) and controls (n = 2). iPSCs were generated by exposing the fibroblasts to viral vectors that contained the Yamanaka factors (OCT4, SOX2, KLF4, and c-MYC genes) responsible for promoving cell reprogramation. The fibroblasts and iPSCs were tested during different phases of neurodifferentiation for migration capacity and expression of the genes involved in the PI3K pathway. Fibroblasts of patients with FCD migrated with greater intensity during the first two time points of analyses. iPSCs did not exhibit any difference in cell migration between the groups. Fibroblasts, brain tissue, and iPSCs of the patients with FCD exhibited a significant reduction in the relative expression values of 4EBP-1. During neurodevelopment, the iPSCs from patients with FCD exhibited a reduction in the expression of cIAP-1, cIAP-2, PI3K, β-Catenin and 4EBP-1 gene. We suggest that the differences observed in the migration potential of adult cells and in the gene expression related to the fundamental processes involved in normal brain development during the neurodifferentiation process might be associated with cortical alteration in the patients with FCD.
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Affiliation(s)
- Daniel Rodrigo Marinowic
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda Majolo
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriele Goulart Zanirati
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine, Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ismael Plentz
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine, Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eliseu Paglioli Neto
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Epilepsy Surgery Program of São Lucas Hospital of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - André Luís Fernandes Palmini
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Epilepsy Surgery Program of São Lucas Hospital of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Denise Cantarelli Machado
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaderson Costa Da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine, Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil; School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
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