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Lee S, Kim H, Kim JH, So M, Kim JB, Kim DJ. Heart rate variability as a preictal marker for determining the laterality of seizure onset zone in frontal lobe epilepsy. Front Neurosci 2024; 18:1373837. [PMID: 38784087 PMCID: PMC11114103 DOI: 10.3389/fnins.2024.1373837] [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: 01/23/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
Determining the laterality of the seizure onset zone is challenging in frontal lobe epilepsy (FLE) due to the rapid propagation of epileptic discharges to the contralateral hemisphere. There is hemispheric lateralization of autonomic control, and heart rate is modulated by interactions between the sympathetic and parasympathetic nervous systems. Based on this notion, the laterality of seizure foci in FLE might be determined using heart rate variability (HRV) parameters. We explored preictal markers for differentiating the laterality of seizure foci in FLE using HRV parameters. Twelve patients with FLE (6 right FLE and 6 left FLE) were included in the analyzes. A total of 551 (460 left FLE and 91 right FLE) 1-min epoch electrocardiography data were used for HRV analysis. We found that most HRV parameters differed between the left and right FLE groups. Among the machine learning algorithms applied in this study, the light gradient boosting machine was the most accurate, with an AUC value of 0.983 and a classification accuracy of 0.961. Our findings suggest that HRV parameter-based laterality determination models can be convenient and effective tools in clinical settings. Considering that heart rate can be easily measured in real time with a wearable device, our proposed method can be applied to a closed-loop device as a real-time monitoring tool for determining the side of stimulation.
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Affiliation(s)
- Seho Lee
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Hayom Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Hyung Kim
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Mingyeong So
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung Bin Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong-Joo Kim
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- NeuroTx, Co., Ltd., Seoul, Republic of Korea
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Park JW, Okamoto LE, Kim SH, Lee CN, Park KW, Baek SH, Sung JH, Jeon N, Koh SB, Gamboa A, Shibao CA, Diedrich A, Kim BJ, Biaggioni I. Sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson's disease. Clin Auton Res 2024; 34:269-279. [PMID: 38652421 DOI: 10.1007/s10286-024-01031-6] [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: 12/11/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The specific characteristics of autonomic involvement in patients with early Parkinson's disease (PD) are unclear. This study aimed to evaluate the characteristics of autonomic dysfunction in drug-naïve patients with early-stage PD without orthostatic hypotension (OH) by analyzing Valsalva maneuver (VM) parameters. METHODS We retrospectively analyzed drug-naïve patients without orthostatic hypotension (n = 61) and controls (n = 20). The patients were subcategorized into early PD (n = 35) and mid-PD (n = 26) groups on the basis of the Hoehn and Yahr staging. VM parameters, including changes in systolic blood pressure at late phase 2 (∆SBPVM2), ∆HRVM3, Valsalva ratio (VR), pressure recovery time, adrenergic baroreflex sensitivity, and vagal baroreflex sensitivity, were assessed. RESULTS In the early PD group, ∆SBPVM2, a marker of sympathetic function, was significantly lower compared with that in controls (risk ratio = 0.95, P = 0.027). Receiver operating characteristic (ROC) curve analysis showed an optimal cut-off value of -10 mmHg for ∆SBPVM2 [P = 0.002, area under the curve (AUC): 0.737]. VR exhibited an inverse relationship with Unified Parkinson's Disease Rating Scale Part 3 scores in the multivariable regression analysis (VR: P = 0.038, β = -28.61), whereas age showed a positive relationship (age: P = 0.027, β = 0.35). CONCLUSION The ∆BPVM2 parameter of the VM may help detect autonomic nervous system involvement in early-PD without OH. Our results suggest that sympathetic dysfunction is an early manifestation of autonomic dysfunction in patients with PD.
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Affiliation(s)
- Jin-Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Luis E Okamoto
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sung-Hwan Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Chan-Nyoung Lee
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Kun Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Namjoon Jeon
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Alfredo Gamboa
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cyndya A Shibao
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - André Diedrich
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea.
- BK21 FOUR R&E Center for Learning Health Systems, Graduate School, Korea University, Seoul, Republic of Korea, Seoul, Korea.
| | - Italo Biaggioni
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Kim K, Kim H, Kong J, Kim JB. Enhanced functional connectivity in the reward circuitry in healthy adults with weekend catch-up sleep. Hum Brain Mapp 2023; 44:4927-4937. [PMID: 37466297 PMCID: PMC10472906 DOI: 10.1002/hbm.26429] [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: 12/18/2022] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
We aimed to identify structural and functional changes in healthy adults with catch-up sleep (CUS), we applied seed-based functional connectivity (FC) analysis using resting-state functional magnetic resonance imaging (MRI). We hypothesized that deficits in reward processing could be a fundamental mechanism underlying the motivation of taking CUS. Then, 55 healthy adults voluntarily (34 with CUS and 21 without CUS) participated in this study. Voxel-based morphometry was performed to explore region of gray matter volume (GMV) difference between CUS and non-CUS groups. Between-group comparison of FC was then carried out using resting-state functional MRI analysis seeding at the region of volume difference. Moreover, the region of volume difference and the strength of FC were correlated with scores of questionnaires for reward-seeking behavior and clinical variables. CUS group had a higher reward-seeking tendency, and increased GMV in the bilateral nucleus accumbens and right superior frontal gyrus relative to non-CUS group. FC analysis seeding at the bilateral accumbens revealed increases of FC in the bilateral medial prefrontal cortex in CUS group compared to non-CUS group. The questionnaire scores reflecting the reward-seeking tendency were correlated with the FC strength between bilateral accumbens and medial prefrontal cortex. Our results indicate that CUS is associated with reward-seeking tendency and increased GMV and FC in regions responsible for reward network. Our findings suggest that enhanced reward network could be the crucial mechanism underlying taking CUS and might be implicated in the detrimental effects of circadian misalignment.
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Affiliation(s)
- Keun‐Tae Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Hayom Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Jooheon Kong
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
| | - Jung Bin Kim
- Department of NeurologyKorea University Anam Hospital, Korea University College of MedicineSeoulRepublic of Korea
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Xiang Q, Li M, Wen J, Ren F, Yang Z, Jiang X, Chen Y. The bioactivity and applications of pomegranate peel extract: A review. J Food Biochem 2022; 46:e14105. [PMID: 35128669 DOI: 10.1111/jfbc.14105] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 12/13/2022]
Abstract
Pomegranate peel (PP) is a by-product in the processing of pomegranate products, which is usually discarded as a waste. However, a large number of researches have shown that pomegranate peel extract (PPE) is rich in a variety of phenolic substances, among which ellagic acid (EA), as one of the main active components, has significant biological activities, such as anti-oxidation, anti-tumor, anti-inflammatory, neuroprotection, anti-viral, and anti-bacterial. We analyzed the mechanism of EA's biological activity, and discussed its application in the food industry, for instance, food preservation, food additives, and functional foods. Combined with the research status of PPE, we discussed the limitations and development potential of PPE, in order to provide theoretical reference and scientific basis for the development and utilization of pomegranate by-products. PRACTICAL APPLICATIONS: Pomegranate peel (PP), the inedible part of the fruit, is usually treated as waste. In recent years, researchers have been committed to exploring various bioactive ingredients in PP and exploring its potential benefits to human health, which has far-reaching significance. In this paper, the chemical constituents of polyphenols in PP were reviewed, mainly focusing on the biological activity and mechanism of ellagic acid (EA). We reviewed the applications and invention patents of pomegranate peel extract (PPE) in food field, including food preservation, food additive, and functional foods, providing reference for the recycling and reuse of PP.
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Affiliation(s)
- Qiwen Xiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Meifeng Li
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiayu Wen
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fajian Ren
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhou Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xingyue Jiang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Chen
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Distinct roles of right temporoparietal cortex in pentagon copying test. Brain Imaging Behav 2022; 16:1528-1537. [PMID: 35083712 DOI: 10.1007/s11682-021-00607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 11/02/2022]
Abstract
Pentagon Copying Test (PCT) is commonly used to assess visuospatial deficits, but the neural substrates underlying pentagon copying are not well understood. The Qualitative Scoring Pentagon Test (QSPT), an optimized scoring system, classifies five categories of errors patients make in pentagons copying and grades them depending on the errors' severity. To determine the strategic brain regions involved in the PCT, we applied the QSPT system to evaluate the visuospatial impairment of 136 acute ischemic stroke patients on the PCT and used Support Vector Regression Lesion-Symptom Mapping to investigate relevant brain regions. The total QSPT score was correlated with the right supramarginal gyrus. The angle number errors and closure errors were principally associated with lesions of the posterior temporoparietal cortex, including the right middle occipital gyrus and middle temporal gyrus, while the intersection errors and rotation errors were related to the more anterior part of the right temporoparietal lobe with the additional frontal cortex. In conclusion, the right temporoparietal cortex is the strategic region for pentagon copying tasks. The angle number and closure represent the visuospatial processing of within-object features, while intersection and rotation require between-object manipulation. The posterior-anterior distinction in the right temporoparietal region underlies the differences of within-object and between-object processing.
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