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Korbmacher M, van der Meer D, Beck D, de Lange AMG, Eikefjord E, Lundervold A, Andreassen OA, Westlye LT, Maximov II. Brain asymmetries from mid- to late life and hemispheric brain age. Nat Commun 2024; 15:956. [PMID: 38302499 PMCID: PMC10834516 DOI: 10.1038/s41467-024-45282-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Abstract
The human brain demonstrates structural and functional asymmetries which have implications for ageing and mental and neurological disease development. We used a set of magnetic resonance imaging (MRI) metrics derived from structural and diffusion MRI data in N=48,040 UK Biobank participants to evaluate age-related differences in brain asymmetry. Most regional grey and white matter metrics presented asymmetry, which were higher later in life. Informed by these results, we conducted hemispheric brain age (HBA) predictions from left/right multimodal MRI metrics. HBA was concordant to conventional brain age predictions, using metrics from both hemispheres, but offers a supplemental general marker of brain asymmetry when setting left/right HBA into relationship with each other. In contrast to WM brain asymmetries, left/right discrepancies in HBA are lower at higher ages. Our findings outline various sex-specific differences, particularly important for brain age estimates, and the value of further investigating the role of brain asymmetries in brain ageing and disease development.
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Affiliation(s)
- Max Korbmacher
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
- Mohn Medical Imaging and Visualization Centre (MMIV), Bergen, Norway.
| | - Dennis van der Meer
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Dani Beck
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Eli Eikefjord
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
- Mohn Medical Imaging and Visualization Centre (MMIV), Bergen, Norway
| | - Arvid Lundervold
- Mohn Medical Imaging and Visualization Centre (MMIV), Bergen, Norway
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Ole A Andreassen
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ivan I Maximov
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
- NORMENT Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
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Zhao X, Zhou Y, Li Y, Huang S, Zhu H, Zhou Z, Zhu S, Zhu W. The asymmetry of glymphatic system dysfunction in patients with temporal lobe epilepsy: A DTI-ALPS study. J Neuroradiol 2023; 50:562-567. [PMID: 37301366 DOI: 10.1016/j.neurad.2023.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE While the occurrence of glymphatic system dysfunction has been observed in temporal lobe epilepsy (TLE), the potential asymmetry of this system has yet to be investigated in the TLE context. We aimed to investigate the glymphatic system function in both hemispheres and to analyze asymmetric features of the glymphatic system in TLE patients using diffusion tensor image analysis along the perivascular space (DTI-ALPS) method. MATERIALS AND METHODS 43 patients (left TLE (LTLE), n = 20; right TLE (RTLE), n = 23) and 39 healthy controls (HC) were enrolled in this study. The DTI-ALPS index was calculated for the left (left ALPS index) and right (right ALPS index) hemispheres respectively. An asymmetry index (AI) was calculated by AI = (Right - Left)/ [(Right + Left)/2] to represent the asymmetric pattern. Independent two sample t-test, two-sample paired t-test or one-way ANOVA with Bonferroni correction were conducted to compare the differences in ALPS indices and AI among the groups. RESULTS Both left ALPS index (p = 0.040) and right ALPS index (p = 0.001) of RTLE patients were significantly decreased, while only left ALPS index of LTLE patients (p = 0.005) was reduced. Compared to contralateral ALPS index, the ipsilateral ALPS index was significantly decreased in TLE (p = 0.008) and RTLE (p = 0.009) patients. Leftward asymmetry of the glymphatic system was found in HC (p = 0.045) and RTLE (p = 0.009) patients. The LTLE patients presented reduced asymmetric traits when compared to RTLE patients (p = 0.029). CONCLUSION The TLE patients exhibited altered ALPS indices, which could be triggered by glymphatic system dysfunction. Altered ALPS indices were more severe in ipsilateral than in the contralateral hemisphere. Moreover, LTLE and RTLE patients exhibited different change patterns of the glymphatic system. In addition, glymphatic system function presented asymmetric patterns in both normal adult brain and RTLE patients.
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Affiliation(s)
- Xu Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanhao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongquan Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Zhou
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zanao TA, Seitz‐Holland J, O'Donnell LJ, Zhang F, Rathi Y, Lopes TM, Pimentel‐Silva LR, Yassuda CL, Makris N, Shenton ME, Bouix S, Lyall AE, Cendes F. Exploring the impact of hippocampal sclerosis on white matter tracts and memory in individuals with mesial temporal lobe epilepsy. Epilepsia Open 2023; 8:1111-1122. [PMID: 37469213 PMCID: PMC10472386 DOI: 10.1002/epi4.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 07/14/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVE To investigate how the presence/side of hippocampal sclerosis (HS) are related to the white matter structure of cingulum bundle (CB), arcuate fasciculus (AF), and inferior longitudinal fasciculus (ILF) in mesial temporal lobe epilepsy (MTLE). METHODS We acquired diffusion-weighted magnetic resonance imaging (MRI) from 86 healthy and 71 individuals with MTLE (22 righ-HS; right-HS, 34 left-HS; left-HS, and 15 nonlesional MTLE). We utilized two-tensor tractography and fiber clustering to compare fractional anisotropy (FA) of each side/tract between groups. Additionally, we examined the association between FA and nonverbal (WMS-R) and verbal (WMS-R, RAVLT codification) memory performance for MTLE individuals. RESULTS White matter abnormalities depended on the side and presence of HS. The left-HS demonstrated widespread abnormalities for all tracts, the right-HS showed lower FA for ipsilateral tracts and the nonlesional MTLE group did not differ from healthy individuals. Results indicate no differences in verbal/nonverbal memory performance between the groups, but trend-level associations between higher FA of visual memory and the left CB (r = 0.286, P = 0.018), verbal memory (RAVLT) and -left CB (r = 0.335, P = 0.005), -right CB (r = 0.286, P = 0.016), and -left AF (r = 0.287, P = 0.017). SIGNIFICANCE Our results highlight that the presence and side of HS are crucial to understand the pathophysiology of MTLE. Specifically, left-sided HS seems to be related to widespread bilateral white matter abnormalities. Future longitudinal studies should focus on developing diagnostic and treatment strategies dependent on HS's presence/side.
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Affiliation(s)
- Tamires A. Zanao
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | - Johanna Seitz‐Holland
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Lauren J. O'Donnell
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fan Zhang
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Tátila M. Lopes
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | | | - Clarissa L. Yassuda
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Sylvain Bouix
- Département de génie logiciel et TI, École de technologie supérieureUniversité du QuébecMontrealQuebecCanada
| | - Amanda E. Lyall
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fernando Cendes
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
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Wang G, Liu X, Zhang M, Wang K, Liu C, Chen Y, Wu W, Zhao H, Xiao B, Wan L, Long L. Structural and functional changes of the cerebellum in temporal lobe epilepsy. Front Neurol 2023; 14:1213224. [PMID: 37602268 PMCID: PMC10435757 DOI: 10.3389/fneur.2023.1213224] [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: 04/27/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Aims This study aimed to comprehensively explore the cerebellar structural and functional changes in temporal lobe epilepsy (TLE) and its association with clinical information. Methods The SUIT toolbox was utilized to perform cerebellar volume and diffusion analysis. In addition, we extracted the average diffusion values of cerebellar peduncle tracts to investigate microstructure alterations. Seed-based whole-brain analysis was used to investigate cerebellar-cerebral functional connectivity (FC). Subgroup analyses were performed to identify the cerebellar participation in TLE with/without hippocampal sclerosis (HS)/focal-to-bilateral tonic-clonic seizure (FBTCS) and TLE with different lateralization. Results TLE showed widespread gray matter atrophy in bilateral crusII, VIIb, VIIIb, left crusI, and left VIIIa. Both voxel and tract analysis observed diffusion abnormalities in cerebellar afferent peduncles. Reduced FC between the right crus II and the left parahippocampal cortex was found in TLE. Additionally, TLE showed increased FCs between left lobules VI-VIII and cortical nodes of the dorsal attention and visual networks. Across all patients, decreased FC was associated with poorer cognitive function, while increased FCs appeared to reflect compensatory effects. The cerebellar structural changes were mainly observed in HS and FBTCS subgroups and were regardless of seizure lateralization, while cerebellar-cerebral FC alterations were similar in all subgroups. Conclusion TLE exhibited microstructural changes in the cerebellum, mainly related to HS and FBTCS. In addition, altered cerebellar-cerebral functional connectivity is associated with common cognitive alterations in TLE.
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Affiliation(s)
- Ge Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Xianghe Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Min Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Kangrun Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Chaorong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Yayu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Haiting Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
| | - Lily Wan
- Department of Anatomy and Neurobiology, Central South University Xiangya Medical School, Changsha, Hunan, China
| | - Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Epileptic Disease of Hunan Province, Central South University, Changsha, China
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Zhang Y, Liu Z, Dou W, Wei J, Lv Y, Hou B, You H, Feng F. Study of the microstructure of brain white matter in medial temporal lobe epilepsy based on diffusion tensor imaging. Brain Behav 2023; 13:e2919. [PMID: 36880299 PMCID: PMC10097073 DOI: 10.1002/brb3.2919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES To compare the white matter (WM) asymmetry in left and right medial temporal lobe epilepsy (mTLE) with and without hippocampal sclerosis (HS+, HS-) and assess the correlation of preoperative asymmetry and the dynamics of WM fibers with surgical outcomes. MATERIALS AND METHODS Preoperative MRI scans were collected from 58 mTLE patients (40 HS+, 18 HS-); 15 (11 HS+, 4 HS-) then underwent postoperative MRI scans. DTI parameters, including the fractional anisotropy (FA), mean diffusion coefficient (MD), axial diffusion coefficient (AD), and radial diffusion coefficient (RD), were extracted from 20 paired WM tracts by PANDA based on the JHU WM tractography atlas. The bilateral cerebral parameters and the pre- to postoperative changes in the DTI parameters of specific fiber tracts were compared. The asymmetry indexes (AIs) of paired fibers were also analyzed. RESULTS There were fewer asymmetrical WM fibers in HS- patients than in HS+ patients. The pattern of WM asymmetry differed between left and right mTLE patients. Differences in the FA AI of the inferior fronto-occipital fasciculus and inferior longitudinal fasciculus (ILF) were found in left HS+ patients with different surgical outcomes. All mTLE patients exhibited decreases in FA and increases in MD and RD in specific ipsilateral WM fibers. In International League Against Epilepsy (ILAE) grade 1 patients, the MD values in the ipsilateral CGH increased over time, whereas the RD values in the ipsilateral ILF and the AD values in the ipsilateral ILF and UNC decreased. In ILAE grade 2-5 patients, the FA values in the ipsilateral cingulate gyrus part of the cingulum (CGC) increased over time. CONCLUSION The WM tract asymmetry was more extensive in HS+ patients than in HS- patients. The preoperative WM fiber AIs in left HS+ patients may be useful for surgical prognosis. Additionally, pre- to postoperative changes in WM fibers may help predict surgical outcomes.
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Affiliation(s)
- Yiwei Zhang
- Department of Radiology, Peking University First Hospital, Beijing, China.,Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhaoxi Liu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wanchen Dou
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Juan Wei
- GE Healthcare, MR Research China, Beijing, China
| | - Yuelei Lv
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Radiology, Beijing CHAO-YANG Hospital, Capital Medical University, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,State Key Laboratory of Difficult, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Li C, Cai HB, Zhao X, Xi XC, Zhou Q, Luo HY, Tang ZP, Kang HC, Kirsch HE. What Is Different about Teratoma-Associated Anti-LGI1 Encephalitis? A Long-Term Clinical and Neuroimaging Case Series. Eur Neurol 2022; 85:437-445. [PMID: 35896086 DOI: 10.1159/000524974] [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: 01/11/2022] [Accepted: 04/30/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is clinically heterogeneous, especially at presentation, and though it is sometimes found in association with tumor, this is by no means the rule. METHODS Clinical data for 10 patients with anti-LGI1 encephalitis were collected including one case with teratoma and nine cases without and compared for clinical characteristics. Microscopic pathological examination and immunohistochemical assay of the LGI1 antibody were performed on teratoma tissue obtained by laparoscopic oophorocystectomy. RESULTS In our teratoma-associated anti-LGI1 encephalitis case, teratoma pathology was characterized by mostly thyroid tissue and immunohistochemical assay confirmed positive nuclear staining of LGI1 in some tumor cells. The anti-LGl1 patient with teratoma was similar to the non-teratoma cases in many ways: age at onset (average 47.3 in non-teratoma cases); percent presenting with rapidly progressive dementia (67% of non-teratoma cases) and psychiatric symptoms (33%); hyponatremia (78%); normal cerebrospinal fluid results except for positive LGI1 antibody (78%); bilateral hippocampal hyperintensity on magnetic resonance imaging (44%); diffuse slow waves on electroencephalography (33%); good response to immunotherapy (67%); and mild residual cognitive deficit (22%). Her chronic anxiety and presentation with status epilepticus were the biggest differences compared with the non-teratoma cases. CONCLUSION In our series, anti-LGI1 encephalitis included common clinical features in our series: rapidly progressive dementia, faciobrachial dystonic seizures, behavioral disorders, hyponatremia, hippocampal hyperintensity on magnetic resonance imaging, and residual cognitive deficit. We observed some differences (chronic anxiety and status epilepticus) in our case with teratoma, but a larger accumulation of cases is needed to improve our knowledge base.
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Affiliation(s)
- Cun Li
- Department of Neurology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Bin Cai
- Department of Neurology, Department of Pneumology, No. 9 Hospital of Wuhan City, Wuhan, China
| | - Xu Zhao
- Department of Radiology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin-Cong Xi
- Department of Radiology and Intervention, No. 6 Hospital of Shanghai City, Shanghai, China
| | - Qing Zhou
- Department of Neurology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui-Ya Luo
- Department of Pathophysiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhou-Ping Tang
- Department of Neurology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui-Cong Kang
- Department of Neurology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heidi E Kirsch
- Department of Neurology and Radiology & Biomedical Imaging, Epilepsy Center, University of California, San Francisco, California, USA
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Mohammad SA, Nashaat NH, Okba AAMB, Kilany A, Abdel-Rahman AS, Abd-Elhamed AM, Abdelraouf ER. Asymmetry Matters: Diffusion Tensor Tractography of the Uncinate Fasciculus in Children with Verbal Memory Deficits. AJNR Am J Neuroradiol 2022; 43:1042-1047. [PMID: 35680160 DOI: 10.3174/ajnr.a7535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Verbal declarative memory performance relies on frontotemporal connectivity. The uncinate fasciculus is a major association tract connecting the frontal and temporal lobes. Hemispheric asymmetries contribute to various cognitive and neurobehavioral abilities. Here we investigated microstructural alterations and hemispheric asymmetry of the uncinate fasciculus and their possible correlation to memory performance of children with learning disorders attributed to verbal memory deficits. MATERIALS AND METHODS Two groups of right-handed children with learning disorders attributed to verbal memory deficits and typically developing children (n = 20 and 22, respectively) underwent DTI on a 1.5T scanner. Tractography of the uncinate fasciculus in both hemispheres was performed, and fractional anisotropy and diffusivity indices (radial diffusivity, axial diffusivity, and trace) were obtained. The asymmetry index was calculated. Verbal memory was assessed using subsets of the Stanford Binet Intelligence Scale, 4th edition, a dyslexia assessment test, and the Illinois test of Psycholinguistic Abilities. Correlation between diffusion metrics and verbal memory performance was investigated in the learning disorders group. Also, hemispheric differences in each group were tested, and between-group comparisons were performed. RESULTS Children with learning disorders showed absence of the normal left-greater-than-right asymmetry of fractional anisotropy and the normal right-greater-than-left asymmetry of radial diffusivity seen in typically developing children. Correlation with verbal memory subsets revealed that the higher the fractional anisotropy and asymmetry index, the better the rapid naming performance (P <.05) was. CONCLUSIONS These findings demonstrated microstructural aberrations with reduction of hemispheric asymmetry of the uncinate fasciculus, which could disrupt the normal frontotemporal connectivity in children with learning disorders attributed to verbal memory deficits. This outcome gives more understanding of pathologic mechanisms underlying this disorder.
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Affiliation(s)
- S A Mohammad
- From the Department of Diagnostic and Interventional Radiology and Molecular Imaging (S.A.M., A.A.M.B.O., A.S.A.-R., A.M.A.-E.), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - N H Nashaat
- Research on Children with Special Needs Department (N.H.N., A.K., E.R.A.), Medical Research Division, National Research Centre, Cairo, Egypt
| | - A A M B Okba
- From the Department of Diagnostic and Interventional Radiology and Molecular Imaging (S.A.M., A.A.M.B.O., A.S.A.-R., A.M.A.-E.), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - A Kilany
- Research on Children with Special Needs Department (N.H.N., A.K., E.R.A.), Medical Research Division, National Research Centre, Cairo, Egypt
| | - A S Abdel-Rahman
- From the Department of Diagnostic and Interventional Radiology and Molecular Imaging (S.A.M., A.A.M.B.O., A.S.A.-R., A.M.A.-E.), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - A M Abd-Elhamed
- From the Department of Diagnostic and Interventional Radiology and Molecular Imaging (S.A.M., A.A.M.B.O., A.S.A.-R., A.M.A.-E.), Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - E R Abdelraouf
- Research on Children with Special Needs Department (N.H.N., A.K., E.R.A.), Medical Research Division, National Research Centre, Cairo, Egypt
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Zhao X, Kang H, Zhou Z, Hu Y, Li J, Li S, Li J, Zhu W. Interhemispheric functional connectivity asymmetry is distinctly affected in left and right mesial temporal lobe epilepsy. Brain Behav 2022; 12:e2484. [PMID: 35166072 PMCID: PMC8933759 DOI: 10.1002/brb3.2484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The differences of functional connectivity (FC) and functional asymmetry between left and right mesial temporal lobe epilepsy with hippocampal sclerosis (LMTLE and RMTLE) have not been completely clarified yet. The purpose of the present study is to investigate the FC changes and the FC asymmetric patterns of MTLE, and to compare the differences in FC and functional asymmetry between LMTLE and RMTLE. METHODS In total, 12 LMTLE, 11 RMTLE patients, and 23 healthy controls (HC) were included. Region of interest (ROI)-based analysis was used to evaluate FC. The right functional connectivity (rFC) and left functional connectivity (lFC) of each ROI were calculated. Asymmetry index (AI) was calculated based on the following formula: AI=100×(rFC-lFC)/[(rFC+lFC)/2]${\rm{AI\ }} = {\rm{\ }}100{\rm{\ }} \times {\rm{\ }}( {{\rm{rFC}} - {\rm{lFC}}} )/[ {( {{\rm{rFC}} + {\rm{lFC}}} )/2} ]$ . Paired t-test and univariate analysis of variance were used to analyze FC asymmetry. Linear correlation analysis was performed between significant FC changes and lateralized ROIs and epilepsy onset age and duration. RESULTS LMTLE and RMTLE patients showed different patterns of alteration in FC and functional asymmetry when compared with controls. RMTLE presented more extensive FC abnormalities than LMTLE. Regions in ipsilateral temporal lobe presented as central regions of abnormalities in both patient groups. In addition, the asymmetric characteristics of FC were reduced in MTLE compared with HC, with even more pronounced reduction for RMTLE group. Meanwhile, ROIs presented FC AI differences among the three groups were mostly involving left temporal lobe (L_hippo, L_amyg, L_TP, L_aMTG, and L_pTFusC). No correlation was found between significant FC changes and lateralized ROIs and epilepsy onset age and duration. CONCLUSION The FC and asymmetric features of MTLE are altered and involve both the temporal lobe and extra-temporal lobe. Furthermore, the altered FC and asymmetric features were distinctly affected in LMTLE and RMTLE compared to controls.
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Affiliation(s)
- Xu Zhao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huicong Kang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Zhou
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shihui Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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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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Tung H, Lin WH, Lan TH, Hsieh PF, Chiang MC, Lin YY, Peng SJ. Network reorganization during verbal fluency task in fronto-temporal epilepsy: A functional near-infrared spectroscopy study. J Psychiatr Res 2021; 138:541-549. [PMID: 33990025 DOI: 10.1016/j.jpsychires.2021.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/25/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
This is the first study to use functional near-infrared spectroscopy (fNIRS) to investigate how the lateralization of the epileptogenic zone affects the reconfiguration of task-related network patterns. Eleven left fronto-temporal epilepsy (L-FTE) and 11 right fronto-temporal epilepsy (R-FTE), as well as 22 age- and gender-matched controls, were enrolled. Signals from 52-channel fNIRS were recorded while the subject was undertaking verbal fluency tasks (VFTs), which included categorical (CFT) and letter (LFT) fluency tasks. Three analytic methods were used to study the network topology: network-based analysis, hub identification, and proportional threshold to select the top 20% strongest connections for both graph theory parameters and clinical correlation. Performance of CFT is accomplished primarily using the ventral pathway, and bilateral ventral pathways are augmented in fronto-temporal epilepsy patients by strengthening the inter-hemispheric connections, especially for R-FTE. LFT mainly employed the dorsal pathway, and further prioritized the left dorsal pathway in strengthening intra-hemispheric connections in fronto-temporal epilepsy, especially L-FTE. The top 20% of the strongest connections only present differences in CFT network compared with the controls. R-FTE increased inter-hemispheric network density, while L-FTE decreased inter-hemispheric average characteristic path length. Accumulative seizure burden only affects L-FTE network. Better LFT performance and longer educational years seem to promote left fronto-temporal networks, and decreased the demand from RR intra-hemispheric connectivity in L-FTE. LFT scores in R-FTE are maintained by preserved RR intra-hemispheric networks. However, CFT scores and educational years seem to have no effect on the CFT network topology in both FTE.
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Affiliation(s)
- Hsin Tung
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taiwan; Center of Faculty Development, Taichung Veterans General Hospital, Taiwan; Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Peiyuan F Hsieh
- Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taiwan
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Yang Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Association of hypometabolic extension of 18F-FDG PET with diffusion tensor imaging indices in mesial temporal lobe epilepsy with hippocampal sclerosis. Seizure 2021; 88:130-137. [PMID: 33878604 DOI: 10.1016/j.seizure.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To assess the association between hypometabolic extension of 18F-fluorodeoxyglucose positron emission tomography and diffusion tensor imaging indices, including mean diffusivity (MD) and fractional anisotropy (FA), in hippocampal sclerosis (HS). METHODS Thirty-six unilateral HS were retrospectively selected and stratified into two groups: broad and localized hypometabolic groups (hypometabolism beyond [n = 26] and within the temporal lobe [n = 10]). Forty-one pairs of gray matter (GM) regions of interest (ROIs) were segmented using FreeSurfer software. The GM ROIs were applied to MD maps, and median MD values within each ROI were compared between hemispheres ipsilateral and contralateral to HS using a mixed effect model. Tract-Based Spatial Statistics (TBSS) was used to evaluate FA of white matter (WM) tracts between hemispheres ipsilateral and contralateral to HS. Disease laterality was controlled for. RESULTS The MD values in the thalamus, caudate, hippocampus, amygdala, superior frontal gyrus, middle and inferior temporal gyrus, temporal pole, and isthmus cingulate gyrus were significantly higher in the HS side than the contralateral side for the broad hypometabolic group. Those in the amygdala and superior temporal sulcus were significantly higher in the HS side than the contralateral side for the localized group. The TBSS analyses showed significantly decreased FA in the WM tracts of the temporal and frontal lobes for the broad hypometabolic group, while no tracts showed significant differences for the localized group. CONCLUSION The hypometabolic extension for HS was associated with the abnormalities of MD and FA in GM and WM, respectively, with more widespread microstructural alterations for broad hypometabolic HS.
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