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Sabadell V, Trébuchon A, Alario FX. An exploration of anomia rehabilitation in drug-resistant temporal lobe epilepsy. Epilepsy Behav Rep 2024; 27:100681. [PMID: 38881885 PMCID: PMC11178986 DOI: 10.1016/j.ebr.2024.100681] [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: 02/28/2024] [Revised: 05/15/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts quality of life. Despite these observations, language rehabilitation is still understudied in LTLE. We assessed the effect of a four-week rehabilitation on four drug-resistant LTLE patients after their surgery. The anomia rehabilitation was based on cognitive descriptions of word finding deficits in LTLE. Its primary ingredients were psycholinguistic tasks and a psychoeducation approach to help patients cope with daily communication issues. We repeatedly assessed naming skills for trained and untrained words, before and during the therapy using an A-B design with follow-up and replication. Subjective anomia complaint and standardized language assessments were also collected. We demonstrated the effectiveness of the rehabilitation program for trained words despite the persistence of seizures. Furthermore, encouraging results were observed for untrained items. Variable changes in anomia complaint were observed. One patient who conducted the protocol as self-rehabilitation responded similarly to the others, despite the different manner of intervention. These results open promising avenues for helping epileptic patients suffering from anomia. For example, this post-operative program could easily be adapted to be conducted preoperatively.
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Affiliation(s)
| | - Agnès Trébuchon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
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Islam T, Islam R, Basak M, Roy AD, Arman MA, Paul S, Shandra O, Ali SR. Performance investigation of epilepsy detection from noisy EEG signals using base-2-meta stacking classifier. Sci Rep 2024; 14:10792. [PMID: 38734752 PMCID: PMC11088643 DOI: 10.1038/s41598-024-61338-2] [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: 01/17/2024] [Accepted: 05/04/2024] [Indexed: 05/13/2024] Open
Abstract
Epilepsy is a chronic neurological disease, characterized by spontaneous, unprovoked, recurrent seizures that may lead to long-term disability and premature death. Despite significant efforts made to improve epilepsy detection clinically and pre-clinically, the pervasive presence of noise in EEG signals continues to pose substantial challenges to their effective application. In addition, discriminant features for epilepsy detection have not been investigated yet. The objective of this study is to develop a hybrid model for epilepsy detection from noisy and fragmented EEG signals. We hypothesized that a hybrid model could surpass existing single models in epilepsy detection. Our approach involves manual noise rejection and a novel statistical channel selection technique to detect epilepsy even from noisy EEG signals. Our proposed Base-2-Meta stacking classifier achieved notable accuracy (0.98 ± 0.05), precision (0.98 ± 0.07), recall (0.98 ± 0.05), and F1 score (0.98 ± 0.04) even with noisy 5-s segmented EEG signals. Application of our approach to the specific problem like detection of epilepsy from noisy and fragmented EEG data reveals a performance that is not only superior to others, but also is translationally relevant, highlighting its potential application in a clinic setting, where EEG signals are often noisy or scanty. Our proposed metric DF-A (Discriminant feature-accuracy), for the first time, identified the most discriminant feature with models that give A accuracy or above (A = 95 used in this study). This groundbreaking approach allows for detecting discriminant features and can be used as potential electrographic biomarkers in epilepsy detection research. Moreover, our study introduces innovative insights into the understanding of these features, epilepsy detection, and cross-validation, markedly improving epilepsy detection in ways previously unavailable.
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Affiliation(s)
- Torikul Islam
- Department of Biomedical Engineering (BME), New Jersey Institute of Technology, Newark, NJ, USA.
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh.
| | - Redwanul Islam
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh
| | - Monisha Basak
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh
| | - Amit Dutta Roy
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh
| | - Md Adil Arman
- Department of Biomedical Engineering (BME), Florida International University, Miami, FL, USA
| | - Samanta Paul
- Department of Biomedical Engineering (BME), University of Cincinnati, Cincinnati, OH, USA
| | - Oleksii Shandra
- Department of Biomedical Engineering (BME), Florida International University, Miami, FL, USA
| | - Sk Rahat Ali
- Department of Biomedical Engineering (BME), Khulna University of Engineering & Technology, Khulna, 9230, Bangladesh
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Englot DJ. Chronicles of Change: The Shrinking Brain in Epilepsy. Epilepsy Curr 2024; 24:159-161. [PMID: 38898902 PMCID: PMC11185202 DOI: 10.1177/15357597241228475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Identification of Different MRI Atrophy Progression Trajectories in Epilepsy by Subtype and Stage Inference Xiao F, Caciagli L, Wandschneider B, Sone D, Young AL, Vos SB, Winston GP, Zhang Y, Liu W, An D, Kanber B, Zhou D, Sander JW, Thom M, Duncan JS, Alexander DC, Galovic M, Koepp MJ. Brain . 2023;146(11):4702-4716. doi:10.1093/brain/awad284 Artificial intelligence (AI)-based tools are widely employed, but their use for diagnosis and prognosis of neurological disorders is still evolving. Here we analyse a cross-sectional multicentre structural MRI dataset of 696 people with epilepsy and 118 control subjects. We use an innovative machine-learning algorithm, Subtype and Stage Inference, to develop a novel data-driven disease taxonomy, whereby epilepsy subtypes correspond to distinct patterns of spatiotemporal progression of brain atrophy. In a discovery cohort of 814 individuals, we identify two subtypes common to focal and idiopathic generalized epilepsies, characterized by progression of grey matter atrophy driven by the cortex or the basal ganglia. A third subtype, only detected in focal epilepsies, was characterized by hippocampal atrophy. We corroborate external validity via an independent cohort of 254 people and confirm that the basal ganglia subtype is associated with the most severe epilepsy. Our findings suggest fundamental processes underlying the progression of epilepsy-related brain atrophy. We deliver a novel MRI- and AI-guided epilepsy taxonomy, which could be used for individualized prognostics and targeted therapeutics.
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Affiliation(s)
- Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center
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Feng Y, Diego KS, Dong Z, Wick ZC, Page-Harley L, Page-Harley V, Schnipper J, Lamsifer SI, Pennington ZT, Vetere LM, Philipsberg PA, Soler I, Jurkowski A, Rosado CJ, Khan NN, Cai DJ, Shuman T. Distinct changes to hippocampal and medial entorhinal circuits emerge across the progression of cognitive deficits in epilepsy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.12.584697. [PMID: 38559224 PMCID: PMC10979962 DOI: 10.1101/2024.03.12.584697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Temporal lobe epilepsy (TLE) causes pervasive and progressive memory impairments, yet the specific circuit changes that drive these deficits remain unclear. To investigate how hippocampal-entorhinal dysfunction contributes to progressive memory deficits in epilepsy, we performed simultaneous in vivo electrophysiology in hippocampus (HPC) and medial entorhinal cortex (MEC) of control and epileptic mice 3 or 8 weeks after pilocarpine-induced status epilepticus (Pilo-SE). We found that HPC synchronization deficits (including reduced theta power, coherence, and altered interneuron spike timing) emerged within 3 weeks of Pilo-SE, aligning with early-onset, relatively subtle memory deficits. In contrast, abnormal synchronization within MEC and between HPC-MEC emerged later, by 8 weeks after Pilo-SE, when spatial memory impairment was more severe. Furthermore, a distinct subpopulation of MEC layer 3 excitatory neurons (active at theta troughs) was specifically impaired in epileptic mice. Together, these findings suggest that hippocampal-entorhinal circuit dysfunction accumulates and shifts as cognitive impairment progresses in TLE.
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Affiliation(s)
- Yu Feng
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Zhe Dong
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | | | | | | | | | | | - Ivan Soler
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Nadia N Khan
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Denise J Cai
- Icahn School of Medicine at Mount Sinai, New York, NY
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Pang X, Liang X, Chang W, Lv Z, Zhao J, Wu P, Li X, Wei W, Zheng J. The role of the thalamus in modular functional networks in temporal lobe epilepsy with cognitive impairment. CNS Neurosci Ther 2024; 30:e14345. [PMID: 37424152 PMCID: PMC10848054 DOI: 10.1111/cns.14345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/04/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE Cognitive deficit is common in patients with temporal lobe epilepsy (TLE). Here, we aimed to investigate the modular architecture of functional networks associated with distinct cognitive states in TLE patients together with the role of the thalamus in modular networks. METHODS Resting-state functional magnetic resonance imaging scans were acquired from 53 TLE patients and 37 matched healthy controls. All patients received the Montreal Cognitive Assessment test and accordingly were divided into TLE patients with normal cognition (TLE-CN, n = 35) and TLE patients with cognitive impairment (TLE-CI, n = 18) groups. The modular properties of functional networks were calculated and compared including global modularity Q, modular segregation index, intramodular connections, and intermodular connections. Thalamic subdivisions corresponding to the modular networks were generated by applying a 'winner-take-all' strategy before analyzing the modular properties (participation coefficient and within-module degree z-score) of each thalamic subdivision to assess the contribution of the thalamus to modular functional networks. Relationships between network properties and cognitive performance were then further explored. RESULTS Both TLE-CN and TLE-CI patients showed lower global modularity, as well as lower modular segregation index values for the ventral attention network and the default mode network. However, different patterns of intramodular and intermodular connections existed for different cognitive states. In addition, both TLE-CN and TLE-CI patients exhibited anomalous modular properties of functional thalamic subdivisions, with TLE-CI patients presenting a broader range of abnormalities. Cognitive performance in TLE-CI patients was not related to the modular properties of functional network but rather to the modular properties of functional thalamic subdivisions. CONCLUSIONS The thalamus plays a prominent role in modular networks and potentially represents a key neural mechanism underlying cognitive impairment in TLE.
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Affiliation(s)
- Xiaomin Pang
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Xiulin Liang
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Weiwei Chang
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Zongxia Lv
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Jingyuan Zhao
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Peirong Wu
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Xinrong Li
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Wutong Wei
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
| | - Jinou Zheng
- Department of NeurologyGuangxi Medical University First Affiliated HospitalNanningChina
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Cairós-González M, Verche E, Hernández S, Alonso MÁ. Cognitive flexibility impairment in temporal lobe epilepsy: The impact of epileptic foci lateralization on executive functions. Epilepsy Behav 2024; 151:109587. [PMID: 38159506 DOI: 10.1016/j.yebeh.2023.109587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Temporal Lobe Epilepsy (TLE) has been associated with memory impairments, which are typically linked to hippocampal and mesial temporal cortex lesions. Considering the presence of extensive bidirectional frontotemporal connections, it can be hypothesized that executive dysfunction in TLE is modulated by the lateralization of the epileptic foci. MATERIAL AND METHODS A comprehensive neuropsychological executive functions protocol was administered to 63 participants, including 42 individuals with temporal lobe epilepsy (20 with right-TLE and 22 with left-TLE) and 21 healthy controls aged 20-49. RESULTS The results indicate that TLE patients exhibit poorer executive performance compared to healthy controls in working memory (F(2,60) = 4.18, p <.01), planning (F(2,60) = 4.71, p <.05), set shifting (F(2,60) = 10.1, p <.001), phonetic verbal fluency (F(2,60) = 11.71, p <.01) and semantic verbal fluency (F(2,60) = 9.61, p <.001. No significant differences were found in cognitive inhibition. Furthermore, right-TLE patients showed lower performance than left-TLE in set shifting (F(1,61) = 6.45, p <.05), while no significant differences were observed in working memory, planning, inhibition, and verbal fluency. CONCLUSIONS This research emphasize the importance of considering the lateralization of the temporal lobe focus to achieve a more accurate neuropsychological characterization. The cognitive differences between left and right TLE patients highlight the need for individualized approaches in their treatment and care.
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Affiliation(s)
- Mariana Cairós-González
- Faculty of Health Sciences, Valencian International University, Pintor Sorolla St., 21, 46002, Valencia, Spain.
| | - Emilio Verche
- Department of Psychobiology and Methodology in Behavioural Sciences, University Complutense de Madrid, Rector Royo Villanova St., 1, 28040, Madrid, Spain
| | - Sergio Hernández
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology and Language Therapy, University of La Laguna, Campus de Guajara, 456, 38200, San Cristóbal de La Laguna, Spain
| | - María Ángeles Alonso
- Department of Cognitive Psychology, Social and Organizational Faculty of Psychology and Language Therapy, University of La Laguna, Campus de Guajara, 456, 38200, San Cristóbal de La Laguna, Spain
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Bingaman N, Ferguson L, Thompson N, Reyes A, McDonald CR, Hermann BP, Arrotta K, Busch RM. The relationship between mood and anxiety and cognitive phenotypes in adults with pharmacoresistant temporal lobe epilepsy. Epilepsia 2023; 64:3331-3341. [PMID: 37814399 DOI: 10.1111/epi.17795] [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: 08/22/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Patients with temporal lobe epilepsy (TLE) are often at a high risk for cognitive and psychiatric comorbidities. Several cognitive phenotypes have been identified in TLE, but it is unclear how phenotypes relate to psychiatric comorbidities, such as anxiety and depression. This observational study investigated the relationship between cognitive phenotypes and psychiatric symptomatology in TLE. METHODS A total of 826 adults (age = 40.3, 55% female) with pharmacoresistant TLE completed a neuropsychological evaluation that included at least two measures from five cognitive domains to derive International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) cognitive phenotypes (i.e., intact, single-domain impairment, bi-domain impairment, generalized impairment). Participants also completed screening measures for depression and anxiety. Psychiatric history and medication data were extracted from electronic health records. Multivariable proportional odds logistic regression models examined the relationship between IC-CoDE phenotypes and psychiatric variables after controlling for relevant covariates. RESULTS Patients with elevated depressive symptoms had a greater odds of demonstrating increasingly worse cognitive phenotypes than patients without significant depressive symptomatology (odds ratio [OR] = 1.123-1.993, all corrected p's < .05). Number of psychotropic (OR = 1.584, p < .05) and anti-seizure medications (OR = 1.507, p < .001), use of anti-seizure medications with mood-worsening effects (OR = 1.748, p = .005), and history of a psychiatric diagnosis (OR = 1.928, p < .05) also increased the odds of a more severe cognitive phenotype, while anxiety symptoms were unrelated. SIGNIFICANCE This study demonstrates that psychiatric factors are not only associated with function in specific cognitive domains but also with the pattern and extent of deficits across cognitive domains. Results suggest that depressive symptoms and medications are strongly related to cognitive phenotype in adults with TLE and support the inclusion of these factors as diagnostic modifiers for cognitive phenotypes in future work. Longitudinal studies that incorporate neuroimaging findings are warranted to further our understanding of the complex relationships between cognition, mood, and seizures and to determine whether non-pharmacologic treatment of mood symptoms alters cognitive phenotype.
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Affiliation(s)
- Nolan Bingaman
- Department of Psychology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Lisa Ferguson
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Ohio, Cleveland, USA
| | - Nicolas Thompson
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anny Reyes
- Department of Radiation Medicine and Applied Sciences and Psychiatry, University of California, San Diego, California, USA
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences and Psychiatry, University of California, San Diego, California, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kayela Arrotta
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Ohio, Cleveland, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robyn M Busch
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Ohio, Cleveland, USA
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Silva AB, Leonard MK, Oganian Y, D’Esopo E, Krish D, Kopald B, Tran EB, Chang EF, Kleen JK. Interictal epileptiform discharges contribute to word-finding difficulty in epilepsy through multiple cognitive mechanisms. Epilepsia 2023; 64:3266-3278. [PMID: 37753856 PMCID: PMC10841419 DOI: 10.1111/epi.17781] [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: 04/25/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE Cognitive impairment often impacts quality of life in epilepsy even if seizures are controlled. Word-finding difficulty is particularly prevalent and often attributed to etiological (static, baseline) circuit alterations. We sought to determine whether interictal discharges convey significant superimposed contributions to word-finding difficulty in patients, and if so, through which cognitive mechanism(s). METHODS Twenty-three patients undergoing intracranial monitoring for drug-resistant epilepsy participated in multiple tasks involving word production (auditory naming, short-term verbal free recall, repetition) to probe word-finding difficulty across different cognitive domains. We compared behavioral performance between trials with versus without interictal discharges across six major brain areas and adjusted for intersubject differences using mixed-effects models. We also evaluated for subjective word-finding difficulties through retrospective chart review. RESULTS Subjective word-finding difficulty was reported by the majority (79%) of studied patients preoperatively. During intracranial recordings, interictal epileptiform discharges (IEDs) in the medial temporal lobe were associated with long-term lexicosemantic memory impairments as indexed by auditory naming (p = .009), in addition to their established impact on short-term verbal memory as indexed by free recall (p = .004). Interictal discharges involving the lateral temporal cortex and lateral frontal cortex were associated with delayed reaction time in the auditory naming task (p = .016 and p = .018), as well as phonological working memory impairments as indexed by repetition reaction time (p = .002). Effects of IEDs across anatomical regions were strongly dependent on their precise timing within the task. SIGNIFICANCE IEDs appear to act through multiple cognitive mechanisms to form a convergent basis for the debilitating clinical word-finding difficulty reported by patients with epilepsy. This was particularly notable for medial temporal spikes, which are quite common in adult focal epilepsy. In parallel with the treatment of seizures, the modulation of interictal discharges through emerging pharmacological means and neurostimulation approaches may be an opportunity to help address devastating memory and language impairments in epilepsy.
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Affiliation(s)
- Alexander B. Silva
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Medical Scientist Training Program, University of California, San Francisco, CA, USA
- University of California, Berkeley - University of California, San Francisco Graduate Program in Bioengineering, Berkeley, CA, USA
| | - Matthew K. Leonard
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Emma D’Esopo
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Devon Krish
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brandon Kopald
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Edwina B. Tran
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Edward F. Chang
- Department of Neurosurgery, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
- University of California, Berkeley - University of California, San Francisco Graduate Program in Bioengineering, Berkeley, CA, USA
| | - Jonathan K. Kleen
- Department of Neurology, Weill Institute of Neurosciences, University of California San Francisco, San Francisco, CA, USA
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Karpychev V, Malyutina S, Zhuravleva A, Bronov O, Kuzin V, Marinets A, Dragoy O. Disruptions in modular structure and network integration of language-related network predict language performance in temporal lobe epilepsy: Evidence from graph-based analysis. Epilepsy Behav 2023; 147:109407. [PMID: 37688840 DOI: 10.1016/j.yebeh.2023.109407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/03/2023] [Accepted: 08/19/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is a network disorder that alters the total organization of the language-related network. Task-based functional magnetic resonance imaging (fMRI) aimed at functional connectivity is a direct method to investigate how the network is reorganized. However, such studies are scarce and represented mostly by the resting-state analysis of the individual connections between regions. To fill this gap, we used a graph-based analysis, which allows us to cover the total language-related network changes, such as disruptions in an integration/segregation balance, during a language task in TLE. METHODS We collected task-based fMRI data with sentence completion from 19 healthy controls and 28 people with left TLE. Using graph-based analysis, we estimated how the language-related network segregated into modules and tested whether they differed between groups. We evaluated the total network integration and the integration within modules. To assess intermodular integration, we considered the number and location of connector hubs-regions with high connectivity. RESULTS The language-related network was differently segregated during language processing in the groups. While healthy controls showed a module consisting of left perisylvian regions, people with TLE exhibited a bilateral module formed by the anterior language-related areas and a module in the left temporal lobe, reflecting hyperconnectivity within the epileptic focus. As a consequence of this reorganization, there was a statistical tendency that the dominance of the intramodular integration over the total network integration was greater in TLE, which predicted language performance. The increase in the number of connector hubs in the right hemisphere, in turn, was compensatory in TLE. SIGNIFICANCE Our study provides insights into the reorganization of the language-related network in TLE, revealing specific network changes in segregation and integration. It confirms reduced global connectivity and compensation across the healthy hemisphere, commonly observed in epilepsy. These findings advance the understanding of the network-based reorganizational processes underlying language processing in TLE.
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Affiliation(s)
- Victor Karpychev
- Center for Language and Brain, HSE University, Moscow, Russian Federation.
| | - Svetlana Malyutina
- Center for Language and Brain, HSE University, Moscow, Russian Federation
| | - Anna Zhuravleva
- Center for Language and Brain, HSE University, Moscow, Russian Federation
| | - Oleg Bronov
- National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russian Federation
| | - Vasiliy Kuzin
- National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russian Federation
| | - Aleksei Marinets
- National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russian Federation
| | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russian Federation; Institute of Linguistics, Russian Academy of Sciences, Moscow, Russian Federation
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10
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Xi Y, Lan Z, Chen Y, Zhang Q, Wu Z, Li G. Patients with epilepsy without cognitive impairment show altered brain networks in multiple frequency bands in an audiovisual integration task. Neurophysiol Clin 2023; 53:102888. [PMID: 37660635 DOI: 10.1016/j.neucli.2023.102888] [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: 02/20/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES Comorbid cognitive and behavioral deficits are often observed in patients with epilepsy. It is not clear whether the brain networks of patients with epilepsy without cognitive decline differs from that of healthy controls in different frequency bands in the task-state. The purpose of our study was to explore whether epilepsy affects the structure of brain networks associated with cognitive processing, even when patients with epilepsy do not have cognitive impairment. METHODS We designed an audiovisual discrimination task and recorded electroencephalogram (EEG) data from healthy controls and patients with epilepsy. We established constructed time-varying brain networks across the delta, theta, alpha, and beta bands on the task-state EEG data during audiovisual integration processing. RESULTS The results showed changes in the structure of the brain networks in the theta, alpha, and beta bands in patients with epilepsy who had no cognitive deficit. No significant difference in the connectivity strength, clustering coefficient, characteristic path length, or global efficiency was noted between patients and healthy controls. Moreover, the structure of brain networks in patients showed no correlation with the behavioral performance. CONCLUSION The repeated abnormal firing of neurons in the brain of patients with epilepsy may inhibit it from optimizing networks into more efficient structures. Epilepsy might affect decision-making ability by damaging the neural activity in the beta band and preventing its correlation with decision-making behaviors.
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Affiliation(s)
- Yang Xi
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China.
| | - Zhu Lan
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Ying Chen
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Qiushi Zhang
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Zhenyu Wu
- Department of Orthopedics of Affiliated Hospital of Beihua University, Beihua University, Jilin 132012, P.R. China
| | - Guangjian Li
- Department of Neurology of First Affiliated Hospital of Jilin University, Jilin University, Changchun 130022, P.R. China
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Peter Binding L, Neal Taylor P, O'Keeffe AG, Giampiccolo D, Fleury M, Xiao F, Caciagli L, de Tisi J, Winston GP, Miserocchi A, McEvoy A, Duncan JS, Vos SB. The impact of temporal lobe epilepsy surgery on picture naming and its relationship to network metric change. Neuroimage Clin 2023; 38:103444. [PMID: 37300974 PMCID: PMC10300575 DOI: 10.1016/j.nicl.2023.103444] [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: 03/08/2023] [Revised: 05/04/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Anterior temporal lobe resection (ATLR) is a successful treatment for medically-refractory temporal lobe epilepsy (TLE). In the language-dominant hemisphere, 30%- 50% of individuals experience a naming decline which can impact upon daily life. Measures of structural networks are associated with language performance pre-operatively. It is unclear if analysis of network measures may predict post-operative decline. METHODS White matter fibre tractography was performed on preoperative diffusion MRI of 44 left lateralised and left resection individuals with TLE to reconstruct the preoperative structural network. Resection masks, drawn on co-registered pre- and post-operative T1-weighted MRI scans, were used as exclusion regions on pre-operative tractography to estimate the post-operative network. Changes in graph theory metrics, cortical strength, betweenness centrality, and clustering coefficient were generated by comparing the estimated pre- and post-operative networks. These were thresholded based on the presence of the connection in each patient, ranging from 75% to 100% in steps of 5%. The average graph theory metric across thresholds was taken. We incorporated leave-one-out cross-validation with smoothly clipped absolute deviation (SCAD) least absolute shrinkage and selection operator (LASSO) feature selection and a support vector classifier to assess graph theory metrics on picture naming decline. Picture naming was assessed via the Graded Naming Test preoperatively and at 3 and 12 months post-operatively and the outcome was classified using the reliable change index (RCI) to identify clinically significant decline. The best feature combination and model was selected using the area under the curve (AUC). The sensitivity, specificity and F1-score were also reported. Permutation testing was performed to assess the machine learning model and selected regions difference significance. RESULTS A combination of clinical and graph theory metrics were able to classify outcome of picture naming at 3 months with an AUC of 0.84. At 12 months, change in strength to cortical regions was best able to correctly classify outcome with an AUC of 0.86. Longitudinal analysis revealed that betweenness centrality was the best metric to identify patients who declined at 3 months, who will then continue to experience decline from 3 to 12 months. Both models were significantly higher AUC values than a random classifier. CONCLUSION Our results suggest that inferred changes of network integrity were able to correctly classify picture naming decline after ATLR. These measures may be used to prospectively to identify patients who are at risk of picture naming decline after surgery and could potentially be utilised to assist tailoring the resection in order to prevent this decline.
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Affiliation(s)
- Lawrence Peter Binding
- Centre for Medical Image Computing, Department of Computer Science, UCL, London, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.
| | - Peter Neal Taylor
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; CNNP lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University, United Kingdom
| | - Aidan G O'Keeffe
- School of Mathematical Sciences, University of Nottingham, United Kingdom; Institute of Epidemiology and Healthcare, UCL, London WC1E 6BT, United Kingdom
| | - Davide Giampiccolo
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom; Department of Neurosurgery, Institute of Neurosciences, Cleveland Clinic London, United Kingdom
| | - Marine Fleury
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom
| | - Lorenzo Caciagli
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jane de Tisi
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine, Division of Neurology, Queens University, Kingston, Canada
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - Andrew McEvoy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom
| | - Sjoerd B Vos
- Centre for Medical Image Computing, Department of Computer Science, UCL, London, United Kingdom; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Microscopy, Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
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Smetana RM, Batchala PP, Lee BG, Albataineh T, Broshek DK, Fountain NB, Abbas S, Quigg M. Multifocal hypometabolic correlates to deficits of verbal memory in mesial temporal lobe epilepsy. Epilepsy Behav 2023; 143:109244. [PMID: 37192585 DOI: 10.1016/j.yebeh.2023.109244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Neuropsychological research on mesial temporal lobe epilepsy (MTLE) often highlights material-specific memory deficits, but a lesion-focused model may not accurately reflect the underlying networks that support episodic memory in these patients. Our study evaluated the pathophysiology behind verbal learning/memory deficits as revealed by hypometabolism quantified through 18-fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS This retrospective study included thirty presurgical patients with intractable unilateral MTLE who underwent interictal FDG-PET and verbal memory assessment (12 females, mean age: 38.73 years). Fluorodeoxyglucose-positron emission tomography mapping was performed with voxel-based mapping of glucose utilization to a database of age-matched controls to derive regional Z-scores. Neuropsychological outcome variables included scores on learning and recall trials of two distinct verbal memory measures validated for use in epilepsy research. Pearson's correlations evaluated relationships between clinical variables and verbal memory. Linear regression was used to relate regional hypometabolism and verbal memory assessment. Post hoc analyses assessed areas of FDG-PET hypometabolism (threshold Z ≤ -1.645 below mean) where verbal memory was impaired. RESULTS Verbal memory deficits correlated with hypometabolism in limbic structures ipsilateral to language dominance but also correlated with hypometabolism in networks involving the ipsilateral perisylvian cortex and contralateral limbic and nonlimbic structures. DISCUSSION We conclude that traditional models of verbal memory may not adequately capture cognitive deficits in a broader sample of patients with MTLE. This study has important implications for epilepsy surgery protocols that use neuropsychological data and FDG-PET to draw conclusions about surgical risks.
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Affiliation(s)
- Racheal M Smetana
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Bern G Lee
- Department of Neuropsychology, Ochsner Health, Baton Rouge, LA, USA.
| | - Tamer Albataineh
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Donna K Broshek
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Nathan B Fountain
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
| | - Salma Abbas
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Mark Quigg
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
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Binding LP, Dasgupta D, Taylor PN, Thompson PJ, O'Keeffe AG, de Tisi J, McEvoy AW, Miserocchi A, Winston GP, Duncan JS, Vos SB. Contribution of White Matter Fiber Bundle Damage to Language Change After Surgery for Temporal Lobe Epilepsy. Neurology 2023; 100:e1621-e1633. [PMID: 36750386 PMCID: PMC10103113 DOI: 10.1212/wnl.0000000000206862] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/12/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In medically refractory temporal lobe epilepsy (TLE), 30%-50% of patients experience substantial language decline after resection in the language-dominant hemisphere. In this study, we investigated the contribution of white matter fiber bundle damage to language change at 3 and 12 months after surgery. METHODS We studied 127 patients who underwent TLE surgery from 2010 to 2019. Neuropsychological testing included picture naming, semantic fluency, and phonemic verbal fluency, performed preoperatively and 3 and 12 months postoperatively. Outcome was assessed using reliable change index (RCI; clinically significant decline) and change across timepoints (postoperative scores minus preoperative scores). Functional MRI was used to determine language lateralization. The arcuate fasciculus (AF), inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus, middle longitudinal fasciculus (MLF), and uncinate fasciculus were mapped using diffusion MRI probabilistic tractography. Resection masks, drawn comparing coregistered preoperative and postoperative T1 MRI scans, were used as exclusion regions on preoperative tractography to estimate the percentage of preoperative tracts transected in surgery. Chi-squared assessments evaluated the occurrence of RCI-determined language decline. Independent sample t tests and MM-estimator robust regressions were used to assess the impact of clinical factors and fiber transection on RCI and change outcomes, respectively. RESULTS Language-dominant and language-nondominant resections were treated separately for picture naming because postoperative outcomes were significantly different between these groups. In language-dominant hemisphere resections, greater surgical damage to the AF and IFOF was related to RCI decline at 3 months. Damage to the inferior frontal subfasciculus of the IFOF was related to change at 3 months. In language-nondominant hemisphere resections, increased MLF resection was associated with RCI decline at 3 months, and damage to the anterior subfasciculus was related to change at 3 months. Language-dominant and language-nondominant resections were treated as 1 cohort for semantic and phonemic fluency because there were no significant differences in postoperative decline between these groups. Postoperative seizure freedom was associated with an absence of significant language decline 12 months after surgery for semantic fluency. DISCUSSION We demonstrate a relationship between fiber transection and naming decline after temporal lobe resection. Individualized surgical planning to spare white matter fiber bundles could help to preserve language function after surgery.
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Affiliation(s)
- Lawrence Peter Binding
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia.
| | - Debayan Dasgupta
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Peter Neal Taylor
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Pamela Jane Thompson
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Aidan G O'Keeffe
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Jane de Tisi
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Andrew William McEvoy
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Anna Miserocchi
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Gavin P Winston
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - John S Duncan
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Sjoerd B Vos
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
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He M, Kolesar TA, Goertzen AL, Ng MC, Ko JH. Do Epilepsy Patients with Cognitive Impairment Have Alzheimer's Disease-like Brain Metabolism? Biomedicines 2023; 11:biomedicines11041108. [PMID: 37189726 DOI: 10.3390/biomedicines11041108] [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: 03/15/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Although not classically considered together, there is emerging evidence that Alzheimer's disease (AD) and epilepsy share a number of features and that each disease predisposes patients to developing the other. Using machine learning, we have previously developed an automated fluorodeoxyglucose positron emission tomography (FDG-PET) reading program (i.e., MAD), and demonstrated good sensitivity (84%) and specificity (95%) for differentiating AD patients versus healthy controls. In this retrospective chart review study, we investigated if epilepsy patients with/without mild cognitive symptoms also show AD-like metabolic patterns determined by the MAD algorithm. Scans from a total of 20 patients with epilepsy were included in this study. Because AD diagnoses are made late in life, only patients aged ≥40 years were considered. For the cognitively impaired patients, four of six were identified as MAD+ (i.e., the FDG-PET image is classified as AD-like by the MAD algorithm), while none of the five cognitively normal patients was identified as MAD+ (χ2 = 8.148, p = 0.017). These results potentially suggest the usability of FDG-PET in prognosticating later dementia development in non-demented epilepsy patients, especially when combined with machine learning algorithms. A longitudinal follow-up study is warranted to assess the effectiveness of this approach.
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Affiliation(s)
- Michael He
- Undergraduate Medical Education, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| | - Tiffany A Kolesar
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB R3E 3J7, Canada
| | - Andrew L Goertzen
- Section of Nuclear Medicine, Department of Radiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Graduate Program in Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
| | - Marcus C Ng
- Graduate Program in Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
- Section of Neurology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Neuroscience Research Program, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB R3E 3J7, Canada
- Graduate Program in Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
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15
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Kitchigina V, Shubina L. Oscillations in the dentate gyrus as a tool for the performance of the hippocampal functions: Healthy and epileptic brain. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110759. [PMID: 37003419 DOI: 10.1016/j.pnpbp.2023.110759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
The dentate gyrus (DG) is part of the hippocampal formation and is essential for important cognitive processes such as navigation and memory. The oscillatory activity of the DG network is believed to play a critical role in cognition. DG circuits generate theta, beta, and gamma rhythms, which participate in the specific information processing performed by DG neurons. In the temporal lobe epilepsy (TLE), cognitive abilities are impaired, which may be due to drastic alterations in the DG structure and network activity during epileptogenesis. The theta rhythm and theta coherence are especially vulnerable in dentate circuits; disturbances in DG theta oscillations and their coherence may be responsible for general cognitive impairments observed during epileptogenesis. Some researchers suggested that the vulnerability of DG mossy cells is a key factor in the genesis of TLE, but others did not support this hypothesis. The aim of the review is not only to present the current state of the art in this field of research but to help pave the way for future investigations by highlighting the gaps in our knowledge to completely appreciate the role of DG rhythms in brain functions. Disturbances in oscillatory activity of the DG during TLE development may be a diagnostic marker in the treatment of this disease.
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Affiliation(s)
- Valentina Kitchigina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region 142290, Russia.
| | - Liubov Shubina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow region 142290, Russia
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Hammers DB, Miranda M, Abildskov TJ, Tate DF, Wilde EA, Spencer RJ. Consideration of different scoring approaches for a verbal incidental learning measure from the WAIS-IV using hippocampal volumes. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:43-53. [PMID: 33882772 DOI: 10.1080/23279095.2021.1909592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: While Spencer's verbal incidental learning (IL) task-from Vocabulary and Similarities subtests of the WAIS-has been validated relative to traditional memory measures and Alzheimer's disease (AD) pathology, the effectiveness of the particular scoring method used has not been assessed relative to alternative scoring weightings. The purpose of this study was to compare original and alternative scoring methods of this IL task by using an AD biomarker-benchmark to arrive at an optimal approach. Methods: Fifty-five memory-clinic patients aged 59-87 received neuropsychological assessment, measures of IL, and quantitative brain imaging. Partial correlation coefficients with total hippocampal volume-controlling for age, sex, and intracranial volume-were assessed across several IL scoring methods, and partial correlations with measures of memory were examined to evaluate convergent validity.Results: IL scoring methods maximizing the contribution of paired-associate-recall-performance were significantly correlated with both hippocampal volumes and traditional memory measures, whereas discrimination-emphasized scoring methods were not.Conclusions: IL scoring methods emphasizing memory paired-associate recall appeared to be preferable to those emphasizing memory discrimination. Administration of the IL- Similarities subtest alone, without IL- Vocabulary, may strike a balance between strength of relationships with both hippocampal volumes and standard memory measures, while also limiting administration time.
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Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Michelle Miranda
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Tracy J Abildskov
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA
| | - David F Tate
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA.,George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elisabeth A Wilde
- Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City, UT, USA.,George E. Whalen Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Psychiatry, Neuropsychology Section, Michigan Medicine, Ann Arbor, MI, USA
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17
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D'Aprano F, Malpas CB, Roberts S, Saling MM. Vague retellings of personal narratives in temporal lobe epilepsy. Seizure 2022; 107:177-185. [PMID: 36631304 DOI: 10.1016/j.seizure.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Aside from deficits identified in single-word level retrieval, individuals with temporal lobe epilepsy (TLE) exhibit clinical oddities, such as circumstantiality in their language production. Circumstantiality refers to the use of language which is pedantic, repetitive, and overly detailed. This becomes particularly evident when elicitation tasks impose minimal structure, or when impersonal narratives are retold over consecutive occasions. Personal reminiscence is highly specific and localised in time, placing unique demands on cognitive-linguistic systems. It is hypothesised that the nature of this elicitation paradigm will produce a unique psycholinguistic phenotype in those with TLE. Among controls there is a compression of output for impersonal narratives, meaning that they use fewer words over less time and are more fluent. The opposite effect is observed when personal narratives are retold. METHODS To investigate the micro- and macrolinguistic processes underpinning personal discourse production in TLE, we examined the elicited language output of 15 surgically naïve individuals with TLE and 14 healthy controls. Participants were asked to recall and re-tell an autobiographical memory on four immediately consecutive occasions, representing an alternative unstructured elicitation. Following transcription and coding of output, a detailed multi-level discourse analysis of output volume, fluency, cohesion, and coherence was conducted. RESULTS As anticipated, a distinctly different pattern emerged in TLE when compared with controls who did not compress their output volume across repetitions but instead produced greater novelty, and a more coherent and refined account over time. Individuals with TLE consistently told a less distinct story across repetitions, with disturbances in fluency, cohesion, and coherence. CONCLUSION This reflects a reduced capacity to produce a coherent mental representation, in all likelihood related to the neurolinguistic demands of recalling and retelling specific personal events.
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Affiliation(s)
- Fiore D'Aprano
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia.
| | - Charles B Malpas
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Stefanie Roberts
- Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Michael M Saling
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Clinical Neuropsychology, The Austin Hospital, Australia.
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18
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Executive Functioning and Social Skills in Children with Epileptic Seizures and Non-Epileptic Seizures. Epilepsy Res 2022; 188:107051. [DOI: 10.1016/j.eplepsyres.2022.107051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
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19
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Fleury M, Buck S, Binding LP, Caciagli L, Vos SB, Winston GP, Thompson P, Koepp MJ, Duncan JS, Sidhu MK. Episodic memory network connectivity in temporal lobe epilepsy. Epilepsia 2022; 63:2597-2622. [PMID: 35848050 PMCID: PMC9804196 DOI: 10.1111/epi.17370] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) affects brain networks and is associated with impairment of episodic memory. Temporal and extratemporal reorganization of memory functions is described in functional magnetic resonance imaging (fMRI) studies. Functional reorganizations have been shown at the local activation level, but network-level alterations have been underinvestigated. We aim to investigate the functional anatomy of memory networks using memory fMRI and determine how this relates to memory function in TLE. METHODS Ninety patients with unilateral TLE (43 left) and 29 controls performed a memory-encoding fMRI paradigm of faces and words with subsequent out-of-scanner recognition test. Subsequent memory event-related contrasts of words and faces remembered were generated. Psychophysiological interaction analysis investigated task-associated changes in functional connectivity seeding from the mesial temporal lobes (MTLs). Correlations between changes in functional connectivity and clinical memory scores, epilepsy duration, age at epilepsy onset, and seizure frequency were investigated, and between connectivity supportive of better memory and disease burden. Connectivity differences between controls and TLE, and between TLE with and without hippocampal sclerosis, were explored using these confounds as regressors of no interest. RESULTS Compared to controls, TLE patients showed widespread decreased connectivity between bilateral MTLs and frontal lobes, and increased local connectivity between the anterior MTLs bilaterally. Increased intrinsic connectivity within the bilateral MTLs correlated with better out-of-scanner memory performance in both left and right TLE. Longer epilepsy duration and higher seizure frequency were associated with decreased connectivity between bilateral MTLs and left/right orbitofrontal cortex (OFC) and insula, connections supportive of memory functions. TLE due to hippocampal sclerosis was associated with greater connectivity disruption within the MTL and extratemporally. SIGNIFICANCE Connectivity analyses showed that TLE is associated with temporal and extratemporal memory network reorganization. Increased bilateral functional connectivity within the MTL and connectivity to OFC and insula are efficient, and are disrupted by greater disease burden.
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Affiliation(s)
- Marine Fleury
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Sarah Buck
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Lawrence P. Binding
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of Computer Science, Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Sjoerd B. Vos
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Neuroradiological Academic Unit, University College London Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Gavin P. Winston
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Division of Neurology, Department of MedicineQueen's UniversityKingstonOntarioCanada
| | - Pamela J. Thompson
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Matthias J. Koepp
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Meneka K. Sidhu
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
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20
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Kandeda AK, Nodeina S, Mabou ST. An aqueous extract of Syzygium cumini protects against kainate-induced status epilepticus and amnesia: evidence for antioxidant and anti-inflammatory intervention. Metab Brain Dis 2022; 37:2581-2602. [PMID: 35916986 DOI: 10.1007/s11011-022-01052-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/12/2022] [Indexed: 10/16/2022]
Abstract
Temporal lobe epilepsy is the most common drug-resistant epilepsy. To cure epilepsy, drugs must target the mechanisms at the origin of seizures. Thus, the present investigation aimed to evaluate the antiepileptic- and anti-amnesic-like effects of an aqueous extract of Syzygium cumini against kainate-induced status epilepticus in mice, and possible mechanisms of action. Mice were divided into 7 groups and treated as follows: normal group or kainate group received po distilled water (10 mL/kg), four test groups received Syzygium cumini (28.8, 72, 144, and 288 mg/kg, po), and the positive control group treated intraperitoneally (ip) with sodium valproate (300 mg/kg). An extra group of normal mice was treated with piracetam (200 mg/kg, po). Treatments were administered 60 min before the induction of status epilepticus with kainate (15 mg/kg, ip), and continued daily throughout behavioral testing. Twenty-four hours after the induction, T-maze and Morris water maze tasks were successively performed. The animals were then sacrificed and some markers of oxidative stress and neuroinflammation were estimated in the hippocampus. The extract significantly prevented status epilepticus and mortality. In the T-maze, the aqueous extract markedly increased the time spent and the number of entries in the discriminated arm. In the Morris water maze, the extract significantly increased the time spent in the target quadrant during the retention phase. Furthermore, the aqueous extract induced a significant reduction of oxidative stress and neuroinflammation. These results suggest that the aqueous extract of Syzygium cumini has antiepileptic- and anti-amnesic-like effects, likely mediated in part by antioxidant and anti-inflammatory activities.
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Affiliation(s)
- Antoine Kavaye Kandeda
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon.
- Department of Animal Biology and Physiology, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon.
| | - Saleh Nodeina
- Department of Biological Sciences, Faculty of Science, University of Ngaoundéré, P.O. Box 454, Ngaoundéré, Cameroon
| | - Symphorien Talom Mabou
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
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21
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Levan A, Fegter O, Gale SD. Social Skills Differences in Children with Epilepsy and Nonepileptic Seizures. JOURNAL OF PEDIATRIC EPILEPSY 2022. [DOI: 10.1055/s-0042-1750303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractResearch has shown that children experiencing epileptic seizures (ES) or non-ESs (NES) exhibit cognitive and behavioral deficits, but no research has examined social skills differences between the two groups. A better understanding of social skills differences between these two groups might allow for the development of more targeted interventions. The purpose of this study was to examine social skills differences between children with ES and children with NES, using the Social Skills Improvement Scale (SSIS). A total of 43 children were recruited from the epilepsy monitoring units at Phoenix Children's Hospital and Primary Children's Medical Center. The epilepsy group consisted of 28 participants (50% female, mean age at testing = 11.79, standard deviation [SD] = 3.12), and the NES group consisted of 15 participants (67% female; mean age at testing = 12.62, SD = 3.33). Parents and children completed the SSIS Rating Scales. No group differences were found between children with ES and children with NES on social skills measures. However, children in both groups rated their social skills as being in the average range, while parents of children in both groups rated their children's social skills as being in the below average range. Limitations to this study and directions for future research are discussed.
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Affiliation(s)
- Ashley Levan
- Department of Psychology, St. Louis Children's Hospital, St. Louis, Missouri, United States
| | - Ollie Fegter
- Department of Psychology, Brigham Young University, Provo, Utah, United States
| | - Shawn D. Gale
- Department of Psychology, Brigham Young University, Provo, Utah, United States
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States
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22
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Cole ER, Grogan DP, Laxpati NG, Fernandez AM, Skelton HM, Isbaine F, Gutekunst CA, Gross RE. Evidence supporting deep brain stimulation of the medial septum in the treatment of temporal lobe epilepsy. Epilepsia 2022; 63:2192-2213. [PMID: 35698897 DOI: 10.1111/epi.17326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/28/2022]
Abstract
Electrical brain stimulation has become an essential treatment option for more than one third of epilepsy patients who are resistant to pharmacological therapy and are not candidates for surgical resection. However, currently approved stimulation paradigms achieve only moderate success, on average providing approximately 75% reduction in seizure frequency and extended periods of seizure freedom in nearly 20% of patients. Outcomes from electrical stimulation may be improved through the identification of novel anatomical targets, particularly those with significant anatomical and functional connectivity to the epileptogenic zone. Multiple studies have investigated the medial septal nucleus (i.e., medial septum) as such a target for the treatment of mesial temporal lobe epilepsy. The medial septum is a small midline nucleus that provides a critical functional role in modulating the hippocampal theta rhythm, a 4-7-Hz electrophysiological oscillation mechanistically associated with memory and higher order cognition in both rodents and humans. Elevated theta oscillations are thought to represent a seizure-resistant network activity state, suggesting that electrical neuromodulation of the medial septum and restoration of theta-rhythmic physiology may not only reduce seizure frequency, but also restore cognitive comorbidities associated with mesial temporal lobe epilepsy. Here, we review the anatomical and physiological function of the septohippocampal network, evidence for seizure-resistant effects of the theta rhythm, and the results of stimulation experiments across both rodent and human studies, to argue that deep brain stimulation of the medial septum holds potential to provide an effective neuromodulation treatment for mesial temporal lobe epilepsy. We conclude by discussing the considerations necessary for further evaluating this treatment paradigm with a clinical trial.
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Affiliation(s)
- Eric R Cole
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | | | - Nealen G Laxpati
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Alejandra M Fernandez
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Henry M Skelton
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Faical Isbaine
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Claire-Anne Gutekunst
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert E Gross
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.,Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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23
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Binding LP, Dasgupta D, Giampiccolo D, Duncan JS, Vos SB. Structure and function of language networks in temporal lobe epilepsy. Epilepsia 2022; 63:1025-1040. [PMID: 35184291 PMCID: PMC9773900 DOI: 10.1111/epi.17204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Individuals with temporal lobe epilepsy (TLE) may have significant language deficits. Language capabilities may further decline following temporal lobe resections. The language network, comprising dispersed gray matter regions interconnected with white matter fibers, may be atypical in individuals with TLE. This review explores the structural changes to the language network and the functional reorganization of language abilities in TLE. We discuss the importance of detailed reporting of patient's characteristics, such as, left- and right-sided focal epilepsies as well as lesional and nonlesional pathological subtypes. These factors can affect the healthy functioning of gray and/or white matter. Dysfunction of white matter and displacement of gray matter function could concurrently impact their ability, in turn, producing an interactive effect on typical language organization and function. Surgical intervention can result in impairment of function if the resection includes parts of this structure-function network that are critical to language. In addition, impairment may occur if language function has been reorganized and is included in a resection. Conversely, resection of an epileptogenic zone may be associated with recovery of cortical function and thus improvement in language function. We explore the abnormality of functional regions in a clinically applicable framework and highlight the differences in the underlying language network. Avoidance of language decline following surgical intervention may depend on tailored resections to avoid critical areas of gray matter and their white matter connections. Further work is required to elucidate the plasticity of the language network in TLE and to identify sub-types of language representation, both of which will be useful in planning surgery to spare language function.
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Affiliation(s)
- Lawrence P. Binding
- Department of Computer ScienceCentre for Medical Image ComputingUniversity College LondonLondonUK
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Debayan Dasgupta
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Victor Horsley Department of NeurosurgeryNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Davide Giampiccolo
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Victor Horsley Department of NeurosurgeryNational Hospital for Neurology and NeurosurgeryLondonUK
- Institute of NeuroscienceCleveland Clinic LondonLondonUK
- Department of NeurosurgeryVerona University HospitalUniversity of VeronaVeronaItaly
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Sjoerd B. Vos
- Department of Computer ScienceCentre for Medical Image ComputingUniversity College LondonLondonUK
- Neuroradiological Academic UnitUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Centre for Microscopy, Characterisation, and AnalysisThe University of Western AustraliaNedlandsWestern AustraliaAustralia
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24
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Halder T, Michl P, Flanagin V, Schenk T. Impaired Emotion Processing and Panic Disorder After Left Anterior Temporal Lobectomy: A Case Report of Successful Psychotherapeutic Intervention. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Background
Over the last decades, brain surgery became a more frequently applied treatment for temporal lobe epilepsy (TLE). Despite its success, several studies found de-novo post-operative psychiatric symptoms in TLE surgery patients. Cognitive behavioural therapy is effective to treat brain healthy psychiatric patients but might not be translatable to patients with resections in emotion regulating networks as these areas seem to be essentially involved in successful psychotherapeutic treatment.
Methods
Here we report the case of a female patient with medically refractory medial temporal lobe epilepsy resulting in left anterior temporal lobectomy at age 35. Post operation she did not show adequate fearful response but at the same time manifested symptoms of a severe panic disorder. We investigated if this patient, despite lesions in emotion-behaviour brain circuits, can benefit from cognitive behavioural therapy.
Results
The intervention, customized to the specific resources and difficulties of the patient, was effective in stopping panic attacks and improving social functioning.
Conclusions
This case shows that MTL brain surgery patients may benefit from CBT and demonstrates the important and if yet still somewhat mysterious role of the amygdala in emotion regulation processes.
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25
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Banjac S, Roger E, Cousin E, Mosca C, Minotti L, Krainik A, Kahane P, Baciu M. Mapping of Language-and-Memory Networks in Patients With Temporal Lobe Epilepsy by Using the GE2REC Protocol. Front Hum Neurosci 2022; 15:752138. [PMID: 35069148 PMCID: PMC8772037 DOI: 10.3389/fnhum.2021.752138] [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] [Received: 08/02/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Preoperative mapping of language and declarative memory functions in temporal lobe epilepsy (TLE) patients is essential since they frequently encounter deterioration of these functions and show variable degrees of cerebral reorganization. Due to growing evidence on language and declarative memory interdependence at a neural and neuropsychological level, we propose the GE2REC protocol for interactive language-and-memory network (LMN) mapping. GE2REC consists of three inter-related tasks, sentence generation with implicit encoding (GE) and two recollection (2REC) memory tasks: recognition and recall. This protocol has previously been validated in healthy participants, and in this study, we showed that it also maps the LMN in the left TLE (N = 18). Compared to healthy controls (N = 19), left TLE (LTLE) showed widespread inter- and intra-hemispheric reorganization of the LMN through reduced activity of regions engaged in the integration and the coordination of this meta-network. We also illustrated how this protocol could be implemented in clinical practice individually by presenting two case studies of LTLE patients who underwent efficient surgery and became seizure-free but showed different cognitive outcomes. This protocol can be advantageous for clinical practice because it (a) is short and easy to perform; (b) allows brain mapping of essential cognitive functions, even at an individual level; (c) engages language-and-memory interaction allowing to evaluate the integrative processes within the LMN; (d) provides a more comprehensive assessment by including both verbal and visual modalities, as well as various language and memory processes. Based on the available postsurgical data, we presented preliminary results obtained with this protocol in LTLE patients that could potentially inform the clinical practice. This implies the necessity to further validate the potential of GE2REC for neurosurgical planning, along with two directions, guiding resection and describing LMN neuroplasticity at an individual level.
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Affiliation(s)
- Sonja Banjac
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
| | - Elise Roger
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
| | - Emilie Cousin
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
- Université Grenoble Alpes, UMS IRMaGe CHU Grenoble, Grenoble, France
| | - Chrystèle Mosca
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Lorella Minotti
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Alexandre Krainik
- Université Grenoble Alpes, UMS IRMaGe CHU Grenoble, Grenoble, France
| | - Philippe Kahane
- Université Grenoble Alpes, Grenoble Institute of Neuroscience ‘Synchronisation et modulation des réseaux neuronaux dans l’épilepsie’ & Neurology Department, Grenoble, France
| | - Monica Baciu
- Université Grenoble Alpes, CNRS LPNC UMR 5105, Grenoble, France
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26
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Abstract
Purinergic signaling is increasingly recognized to play a role during the generation of hyperexcitable networks in the brain. Among the purinergic receptors, the ionotropic ATP-gated P2X7 receptor has attracted particular attention as a possible drug target for epilepsy. P2X7 receptor expression is increased in the brain of experimental models of epilepsy and in patients and, P2X7 receptor antagonism modulates seizure severity and epilepsy development. To date, studies analyzing the role of the P2X7 receptor during epilepsy have mainly focused on temporal lobe epilepsy, the most common form of acquired epilepsy in adults which is particularly prone to drug refractoriness.Animal models of seizures and epilepsy are an essential tool in the identification of novel anticonvulsive and antiepileptogenic drug targets and much data demonstrating a role for the P2X7 receptor during epilepsy have been obtained by using these models. The aim of the present book chapter is to provide a detailed description of two commonly used mouse models of temporal lobe epilepsy, which are the intra-amygdala kainic acid model of status epilepticus and the controlled cortical impact model of traumatic brain injury. This chapter concludes with a brief description of how these models can be used to investigate the impact of targeting the P2X7 receptor on acute seizures, epilepsy development and established epilepsy .
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Affiliation(s)
- Mariana Alves
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Laura de Diego-Garcia
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Tobias Engel
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.
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27
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Chee K, Razmara A, Geller AS, Harris WB, Restrepo D, Thompson JA, Kramer DR. The role of the piriform cortex in temporal lobe epilepsy: A current literature review. Front Neurol 2022; 13:1042887. [PMID: 36479052 PMCID: PMC9720270 DOI: 10.3389/fneur.2022.1042887] [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: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
Temporal lobe epilepsy is the most common form of focal epilepsy and can have various detrimental consequences within many neurologic domains. Recent evidence suggests that the piriform cortex may also be implicated in seizure physiology. The piriform cortex is a primary component of the olfactory network and is located at the junction of the frontal and temporal lobes, wrapping around the entorhinal sulcus. Similar to the hippocampus, it is a tri-layered allocortical structure, with connections to many adjacent regions including the orbitofrontal cortex, amygdala, peri- and entorhinal cortices, and insula. Both animal and human studies have implicated the piriform cortex as a critical node in the temporal lobe epilepsy network. It has additionally been shown that resection of greater than half of the piriform cortex may significantly increase the odds of achieving seizure freedom. Laser interstitial thermal therapy has also been shown to be an effective treatment strategy with recent evidence hinting that ablation of the piriform cortex may be important for seizure control as well. We propose that sampling piriform cortex in intracranial stereoelectroencephalography (sEEG) procedures with the use of a temporal pole or amygdalar electrode would be beneficial for further understanding the role of the piriform cortex in temporal lobe epilepsy.
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Affiliation(s)
- Keanu Chee
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ashkaun Razmara
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Aaron S Geller
- Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - William B Harris
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Diego Restrepo
- Department of Developmental and Cell Biology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - John A Thompson
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Daniel R Kramer
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Missing links: The functional unification of language and memory (L∪M). Neurosci Biobehav Rev 2021; 133:104489. [PMID: 34929226 DOI: 10.1016/j.neubiorev.2021.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/14/2021] [Accepted: 12/07/2021] [Indexed: 10/19/2022]
Abstract
The field of neurocognition is currently undergoing a significant change of perspective. Traditional neurocognitive models evolved into an integrative and dynamic vision of cognitive functioning. Dynamic integration assumes an interaction between cognitive domains traditionally considered to be distinct. Language and declarative memory are regarded as separate functions supported by different neural systems. However, they also share anatomical structures (notably, the inferior frontal gyrus, the supplementary motor area, the superior and middle temporal gyrus, and the hippocampal complex) and cognitive processes (such as semantic and working memory) that merge to endorse our quintessential daily lives. We propose a new model, "L∪M" (i.e., Language/union/Memory), that considers these two functions interactively. We fractionated language and declarative memory into three fundamental dimensions or systems ("Receiver-Transmitter", "Controller-Manager" and "Transformer-Associative" Systems), that communicate reciprocally. We formalized their interactions at the brain level with a connectivity-based approach. This new taxonomy overcomes the modular view of cognitive functioning and reconciles functional specialization with plasticity in neurological disorders.
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Deficits in Behavioral and Neuronal Pattern Separation in Temporal Lobe Epilepsy. J Neurosci 2021; 41:9669-9686. [PMID: 34620720 PMCID: PMC8612476 DOI: 10.1523/jneurosci.2439-20.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 09/09/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
In temporal lobe epilepsy, the ability of the dentate gyrus to limit excitatory cortical input to the hippocampus breaks down, leading to seizures. The dentate gyrus is also thought to help discriminate between similar memories by performing pattern separation, but whether epilepsy leads to a breakdown in this neural computation, and thus to mnemonic discrimination impairments, remains unknown. Here we show that temporal lobe epilepsy is characterized by behavioral deficits in mnemonic discrimination tasks, in both humans (females and males) and mice (C57Bl6 males, systemic low-dose kainate model). Using a recently developed assay in brain slices of the same epileptic mice, we reveal a decreased ability of the dentate gyrus to perform certain forms of pattern separation. This is because of a subset of granule cells with abnormal bursting that can develop independently of early EEG abnormalities. Overall, our results linking physiology, computation, and cognition in the same mice advance our understanding of episodic memory mechanisms and their dysfunction in epilepsy.SIGNIFICANCE STATEMENT People with temporal lobe epilepsy (TLE) often have learning and memory impairments, sometimes occurring earlier than the first seizure, but those symptoms and their biological underpinnings are poorly understood. We focused on the dentate gyrus, a brain region that is critical to avoid confusion between similar memories and is anatomically disorganized in TLE. We show that both humans and mice with TLE experience confusion between similar situations. This impairment coincides with a failure of the dentate gyrus to disambiguate similar input signals because of pathologic bursting in a subset of neurons. Our work bridges seizure-oriented and memory-oriented views of the dentate gyrus function, suggests a mechanism for cognitive symptoms in TLE, and supports a long-standing hypothesis of episodic memory theories.
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Lv Z, Chen Z, Ye W, Pang X, Nie L, Chang W, Long Q, Zheng J. Disruption in Surface-Based Functional Connectivity in the Right Posterior Hippocampal CA3 Subfield: A Probable Neural Basis of Visuospatial Working Memory Impairment in Patients With Right Temporal Lobe Epilepsy. Front Neurol 2021; 12:735689. [PMID: 34712198 PMCID: PMC8545809 DOI: 10.3389/fneur.2021.735689] [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: 07/03/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Visuospatial working memory (VSWM) impairment is common in patients with right temporal lobe epilepsy (rTLE). The posterior hippocampus is critical for spatial memory, but the contributions of the different subfields to VSWM deficits remain unclear. Forty-six rTLE patients and 42 healthy controls (HCs) were recruited. Resting-state fMRI (rsfMRI) and structural MRI scans were administered, followed by a VSWM_Nback test. The right posterior hippocampus was automatically segmented, and the surface-based functional connectivity (SBFC) of the subiculum (Sub), CA1, CA3, dentate gyrus (DG), hippocampal tail, and right entorhinal cortex (EC) were compared between groups. Correlation analysis was performed between the altered SBFC and VSWM_Nback scores for rTLE patients. The results showed that rTLE patients underperformed in the VSWM_Nback test, with longer mean reaction time of accurate response (ACCmeanRT) in 0back and 2back condition, lower hit rate (HR) and higher false alarm rate (FAR) in 2back condition. Compared with HCs, the rCA3 in the rTLE group exhibited decreased SBFC with inferior parietal cortex (IPC), temporal lateral cortex (TLC), and posterior visual cortex (PVC) in the right hemisphere as well as the bilateral dorsolateral prefrontal cortex (DLPFC). The SBFC of the rEC and right anterior cingulate cortex (rACC) increased in the rTLE group. Within the rTLE group, the decreased SBFC of the rCA3-rIPC and rCA3-rLTC were correlated with worse VSWM performance. Therefore, the decreased SBFC of the rCA3-rIPC and rCA3-rLTC might be the critical aberrant FC pattern reflecting VSWM impairment in rTLE patients. The mechanism might involve functional disruption between the core subsystem and the medial temporal subsystem of the default mode network (DMN).
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Affiliation(s)
- Zongxia Lv
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zirong Chen
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Ye
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liluo Nie
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiwei Chang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qijia Long
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Recall and Self-Relevance of Emotional Words Predict Subjective Self-Evaluation of Cognition in Patients with MTLE with or without Depressive Symptoms. Brain Sci 2021; 11:brainsci11111402. [PMID: 34827401 PMCID: PMC8615735 DOI: 10.3390/brainsci11111402] [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] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/04/2021] [Accepted: 10/19/2021] [Indexed: 01/10/2023] Open
Abstract
We examined whether word processing is associated with subjective self-evaluation of cognition in patients with mesial temporal lobe epilepsy (MTLE) as a function of their depressive symptoms. MTLE patients with (MTLE +d, N = 28) or without (MTLE -d, N = 11) depression were compared to pair-matched healthy control participants on free recall and self-relevance ratings of emotionally valenced words. Correlation and hierarchical analyses were conducted to investigate whether the subjective self-evaluation of cognition in MTLE patients is predicted by the negative emotional bias reflected in task performance. MTLE +d patients endorsed as self-relevant fewer positive words and more negative words than the MTLE -d patients and healthy participants. They also self-evaluated their cognition poorer than the MTLE -d patients. Analyses indicated that recall and self-endorsement of emotional words predicted both self-evaluation of cognition as well as epilepsy duration. Our findings indicate that negative self-relevance emotional bias is observed in MTLE patients and is predictive of subjective self-evaluation of cognition. Application of brief behavioral tasks probing emotional functions could be valuable for clinical research and practice in the patients with MTLE.
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An inventory of basic research in temporal lobe epilepsy. Rev Neurol (Paris) 2021; 177:1069-1081. [PMID: 34176659 DOI: 10.1016/j.neurol.2021.02.390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 12/25/2022]
Abstract
Temporal lobe epilepsy is a severe neurological disease, characterized by seizure occurrence and invalidating cognitive co-morbidities, which affects up to 1% of the adults. Roughly one third of the patients are resistant to any conventional pharmacological treatments. The last option in that case is the surgical removal of the epileptic focus, with no guarantee for clinical symptom alleviation. This state of affairs requests the identification of cellular or molecular targets for novel therapeutic approaches with limited side effects. Here we review some generalities about the disease as well as some of the most recent discoveries about the cellular and molecular mechanisms of TLE, and the latest perspectives for novel treatments.
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Banjac S, Roger E, Pichat C, Cousin E, Mosca C, Lamalle L, Krainik A, Kahane P, Baciu M. Reconfiguration dynamics of a language-and-memory network in healthy participants and patients with temporal lobe epilepsy. Neuroimage Clin 2021; 31:102702. [PMID: 34090125 PMCID: PMC8186554 DOI: 10.1016/j.nicl.2021.102702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/21/2021] [Accepted: 05/14/2021] [Indexed: 12/03/2022]
Abstract
Current theoretical frameworks suggest that human behaviors are based on strong and complex interactions between cognitive processes such as those underlying language and memory functions in normal and neurological populations. We were interested in assessing the dynamic cerebral substrate of such interaction between language and declarative memory, as the composite function, in healthy controls (HC, N = 19) and patients with temporal lobe epilepsy (TLE, N = 16). Our assumption was that the language and declarative memory integration is based on a language-and-memory network (LMN) that is dynamic and reconfigures according to task demands and brain status. Therefore, we explored two types of LMN dynamics, a state reconfiguration (intrinsic resting-state compared to extrinsic state assessed with a sentence recall task) and a reorganization of state reconfiguration (TLE compared to HC). The dynamics was evaluated in terms of segregation (community or module detection) and integration (connector hubs). In HC, the level of segregation was the same in both states and the mechanism of LMN state reconfiguration was shown through module change of key language and declarative memory regions with integrative roles. In TLE patients, the reorganization of LMN state reconfiguration was reflected in segregation increase and extrinsic modules that were based on shorter-distance connections. While lateral and mesial temporal regions enabled state reconfiguration in HC, these regions showed reduced flexibility in TLE. We discuss our results in a connectomic perspective and propose a dynamic model of language and declarative memory functioning. We claim that complex and interactive cognitive functions, such as language and declarative memory, should be investigated dynamically, considering the interaction between cognitive networks.
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Affiliation(s)
- Sonja Banjac
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Elise Roger
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Cédric Pichat
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France; Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Chrystèle Mosca
- Neurology Department, Grenoble Hospital, Univ. Grenoble Alpes, 38000 Grenoble, France
| | - Laurent Lamalle
- Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Alexandre Krainik
- Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, 38000 Grenoble, France
| | - Philippe Kahane
- Neurology Department, Grenoble Hospital, Univ. Grenoble Alpes, 38000 Grenoble, France
| | - Monica Baciu
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, 38000 Grenoble, France.
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Sollfrank T, Kohnen O, Hilfiker P, Kegel LC, Jokeit H, Brugger P, Loertscher ML, Rey A, Mersch D, Sternagel J, Weber M, Grunwald T. The Effects of Dynamic and Static Emotional Facial Expressions of Humans and Their Avatars on the EEG: An ERP and ERD/ERS Study. Front Neurosci 2021; 15:651044. [PMID: 33967681 PMCID: PMC8100234 DOI: 10.3389/fnins.2021.651044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine whether the cortical processing of emotional faces is modulated by the computerization of face stimuli ("avatars") in a group of 25 healthy participants. Subjects were passively viewing 128 static and dynamic facial expressions of female and male actors and their respective avatars in neutral or fearful conditions. Event-related potentials (ERPs), as well as alpha and theta event-related synchronization and desynchronization (ERD/ERS), were derived from the EEG that was recorded during the task. All ERP features, except for the very early N100, differed in their response to avatar and actor faces. Whereas the N170 showed differences only for the neutral avatar condition, later potentials (N300 and LPP) differed in both emotional conditions (neutral and fear) and the presented agents (actor and avatar). In addition, we found that the avatar faces elicited significantly stronger reactions than the actor face for theta and alpha oscillations. Especially theta EEG frequencies responded specifically to visual emotional stimulation and were revealed to be sensitive to the emotional content of the face, whereas alpha frequency was modulated by all the stimulus types. We can conclude that the computerized avatar faces affect both, ERP components and ERD/ERS and evoke neural effects that are different from the ones elicited by real faces. This was true, although the avatars were replicas of the human faces and contained similar characteristics in their expression.
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Affiliation(s)
| | | | | | - Lorena C. Kegel
- Swiss Epilepsy Center, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Hennric Jokeit
- Swiss Epilepsy Center, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Peter Brugger
- Valens Rehabilitation Centre, Valens, Switzerland
- Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Miriam L. Loertscher
- Institute for the Performing Arts and Film, Zurich University of the Arts, Zurich, Switzerland
| | - Anton Rey
- Institute for the Performing Arts and Film, Zurich University of the Arts, Zurich, Switzerland
| | - Dieter Mersch
- Institute for Critical Theory, Zurich University of the Arts, Zurich, Switzerland
| | - Joerg Sternagel
- Institute for Critical Theory, Zurich University of the Arts, Zurich, Switzerland
| | - Michel Weber
- Institute for the Performing Arts and Film, Zurich University of the Arts, Zurich, Switzerland
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Bjørke AB, Østby Y, Grahl SG, Larsson PG, Olsen KB, Johansen Nævra MC, Ringstad GA, Bjørnerud A, Gjerstad L, Taubøll E, Heuser K. Cognition in adult patients with newly diagnosed non-lesional temporal lobe epilepsy. Epilepsy Behav 2021; 116:107771. [PMID: 33545650 DOI: 10.1016/j.yebeh.2021.107771] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate whether cognitive performance is affected in newly diagnosed temporal lobe epilepsy (TLE) and to determine the most vulnerable cognitive domains. METHODS In this baseline longitudinal study, differences in memory and non-memory cognitive functions were assessed using comprehensive neuropsychological test batteries in 21 adult patients with newly diagnosed non-lesional TLE and individually matched controls. In addition, the analyses included ratings of self-perceived emotional status. RESULTS The patients performed more poorly than the control group regarding delayed visual memory (p = 0.013) and executive function tasks related to switching (Trail Making Test and verbal fluency shifting; p = 0.025 and p = 0.03, respectively). We found no differences in verbal learning and memory, attention/working memory/processing speed, and other executive functions. SIGNIFICANCE Our results show that patients with TLE often have specific cognitive deficits at time of diagnosis, even in the absence of structural brain abnormalities. This supports the hypothesis that memory dysfunction is linked to an underlying pathology rather than to the effect of recurrent seizures, long-term use of anti-seizure medication, or other epilepsy-related factors. As certain executive functions are affected at an early stage, the pathology may involve brain regions beyond the temporal lobe and may comprise larger brain networks. These results indicate the need for greater awareness of cognition at the time of diagnosis of TLE and before initiation of treatment, and integration of neuropsychological assessment into early routine clinical care.
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Affiliation(s)
- Agnes Balint Bjørke
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Neurology, Division of Neurology, Rheumatology and Habilitation, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ylva Østby
- Institute of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Simon Gevert Grahl
- Institute of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Pål Gunnar Larsson
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ketil Berg Olsen
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Marianne C Johansen Nævra
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Geir Andre Ringstad
- Department of Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Atle Bjørnerud
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Leif Gjerstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Taubøll
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjell Heuser
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Zingerone Targets Status Epilepticus by Blocking Hippocampal Neurodegeneration via Regulation of Redox Imbalance, Inflammation and Apoptosis. Pharmaceuticals (Basel) 2021; 14:ph14020146. [PMID: 33670383 PMCID: PMC7918711 DOI: 10.3390/ph14020146] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/23/2022] Open
Abstract
Epilepsy is an intricate neurological disease where the neurons are severely affected, leading to the mortality of millions worldwide. Status epilepticus (SE), induced by lithium chloride (LiCl) and pilocarpine, is the most accepted model for epilepsy. The current work aims to unravel the mechanisms underlying the anti-epileptic efficacy of zingerone (an active ingredient of ginger), which has beneficial pharmacological activities on seizure-induced behavioral, histological, neurochemical, and molecular patterns in mice. Zingerone restored cognitive function by diminishing seizure activity, escape latency, and subsequent hippocampal damage manifested in histology. Seizures are associated with local inflammation, redox imbalance, and neural loss, confirmed by the present study of SE, and was attenuated by zingerone treatment. Nuclear factor-kappa B and its downstream signaling molecules (TNF-α, IL-1β, IL-6, NO, MPO) were activated in the LiCl-and-pilocarpine-induced group leading to inflammatory signaling, which was substantially ameliorated by zingerone treatment. The intrinsic apoptotic process was triggered subsequent to SE, as demonstrated by augmentation of cleaved caspase-3, downregulation of Bcl-2. However, zingerone treatment downregulated caspase-3 and upregulated Bcl-2, increasing cell survival and decreasing hippocampal neural death, deciphering involvement of apoptosis in SE. Therefore, zingerone plays an essential role in neuroprotection, probably by precluding oxidative stress, inflammation, and obstructing the mitochondrial pathway of apoptosis.
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Ives-Deliperi V, Butler JT. Mechanisms of cognitive impairment in temporal lobe epilepsy: A systematic review of resting-state functional connectivity studies. Epilepsy Behav 2021; 115:107686. [PMID: 33360743 DOI: 10.1016/j.yebeh.2020.107686] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 12/22/2022]
Abstract
Temporal lobe epilepsy is the most common form of focal epilepsy and related cognitive dysfunction impacts significantly on quality of life in patients. Identifying the mechanisms of such impairment would assist in the management and treatment of patients. The study of perturbations in resting-state networks could shed light on this subject. The aim of this systematic review was to synthesize findings on the relationship between aberrant resting-state functional connectivity and cognitive performance in patients with TLE. Literature searches were conducted on Scopus and PubMed electronic databases and 17 relevant articles were extracted, all of which studied the association between resting-state functional connectivity (RSFC) and cognition in adults with TLE. Study findings were synthesized according to methods used to analyze resting-state data, cognitive domains tested, and neuropsychology tasks administered. Results show that increased RSFC in the primary epileptogenic hippocampus, and reduced intra-hemispheric RSFC, are associated with weaker memory performance. In left TLE, memory impairment may be compensated for by bilateral hippocampal connectivity, which is also predictive of better postoperative memory outcomes. In right TLE, memory loss may be compensated for by increased connectivity between the contralateral hippocampus and inferior frontal gyrus. There is also tentative evidence that working memory dysfunction is related to reduced RSFC between the medial frontal-insular parietal network and the medial temporal network, executive dysfunction is related to reduced RSFC between frontal and parietal lobes, and between the frontal lobe and subcortical regions and that language dysfunction is related to reduced RSFC within the left fronto-temporal language network. Multicenter studies could refute or support these findings by enrolling large samples of patients and employing multivariate regression analysis to control for the effects of anatomical disruption, interictal discharges, seizure frequency, medication, and mood. Systematic review registration: PROSPERO: 191323.
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Affiliation(s)
- Victoria Ives-Deliperi
- Neuroscience Institute, Division of Neurosurgery, University of Cape Town, South Africa.
| | - James T Butler
- Division of Neurology, Department of Medicine, University of Cape Town, South Africa
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Elbanhawy I, Fahmy EM, Sharaf S, Ismail RS, Elmehdawy K. Association between serum apolipoprotein E and cognitive functions in Egyptian patients with temporal lobe epilepsy. Acta Neurol Belg 2021; 121:161-166. [PMID: 31197659 DOI: 10.1007/s13760-019-01167-7] [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: 05/29/2018] [Accepted: 06/06/2019] [Indexed: 10/26/2022]
Abstract
Memory, cognition and visuospatial aspects of temporal lobe epilepsy (TLE) have not been fully analyzed yet. From among the huge growing population of circulating apoproteins analyzed in TLE, apolipoprotein E (APOE) was discovered; however, its role in TLE has not been fully elucidated yet. This study was designed to investigate the relation between the serum level of APOE and cognition in TLE patients. Sixty-five subjects (35 TLE patients and 30 healthy matched controls) were included. Evaluation of cognitive functions was done using Addenbrooke's Cognitive Examination Revised (ACE-R) scale. Serum APOE level was measured by ELISA. The mean total score, memory and visuospatial scores of ACE-R were significantly lower in TLE patients compared to healthy subjects. The mean total score and memory score of ACE-R were significantly lower in seizures originating from mesial temporal lobe (MTL) and left temporal lobe seizures. Serum APOE levels were significantly higher in TLE patients compared to healthy subjects. Serum APOE levels significantly negatively correlated with total score, memory, and visuospatial ability scores of ACE-R. Serum APOE was significantly higher in MTL seizures compared to lateral lobe seizures and in left temporal lobe seizures compared to right temporal seizures. Memory and visuospatial aspects were significantly affected in TLE patients. So, the serum APOE level can possibly contribute to cognitive dysfunction in such patients.
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Dilcher R, Malpas CB, Walterfang M, Kwan P, O'Brien TJ, Velakoulis D, Vivash L. Cognitive profiles in patients with epileptic and nonepileptic seizures evaluated using a brief cognitive assessment tool. Epilepsy Behav 2021; 115:107643. [PMID: 33317941 DOI: 10.1016/j.yebeh.2020.107643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is a need for the development of brief tools to screen for cognitive impairments in epilepsy patients in order to prioritize and direct formal comprehensive cognitive testing. Yet, shorter cognitive screening tools are limited in their breadth of cognitive domains or have not been intensively studied on an epilepsy population. This study used a brief cognitive screening tool in order to compare cognitive profiles between patients with epilepsy and those with nonepileptic seizures. METHODS Patients admitted to the Royal Melbourne Hospital video-EEG monitoring unit between 2005 and 2017 were included. Patients were categorized according to seizure etiology (epileptic, psychogenic or other nonepileptic seizures), epilepsy syndrome (focal or generalized; temporal lobe (TLE) or extra-temporal lobe epilepsy (ETLE)), seizure frequency, and anti-seizure medications (ASMs). Attention, visuoconstructional, memory, executive, and language functioning were assessed with the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG). General linear mixed models were computed to investigate cognitive profiles according to diagnostic group and other clinicodemographic variables. RESULTS 800 patients were included in the analysis (61% female and 39 % male, median age 36 years). Patients with both epileptic seizures and psychogenic seizures (n = 25) had the lowest total scores on NUCOG, followed by patients with epileptic seizures (n = 411), psychogenic seizures (n = 185), and nonepileptic seizures (n = 179, p = 0.002). Specifically, patients with epileptic seizures performed worse than those with nonepileptic seizures in the executive, language, and memory domain, and had lower language domain scores than those with psychogenic seizures. Patients with bilateral TLE had poorer performance than those with unilateral TLE, particularly for memory function. Specific ASMs and polypharmacy but not seizure frequency had a negative effect on cognition (p < 0.001). NUCOG scores did not differ between focal and generalized epilepsies, or between TLE and ETLE. CONCLUSION The NUCOG differentiated cognitive profiles in patients with uncontrolled seizures due to different etiologies. Bilateral TLE and medication adversely affected cognitive performance, and overall patients with epilepsy performed worse than those with nonepileptic seizures. These results provide further evidence for sensitivity of the NUCOG for detecting cognitive impairment in patients with seizure disorders.
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Affiliation(s)
- Roxane Dilcher
- Melbourne Brain Centre, The Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia; Department of Neuroscience, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Charles B Malpas
- Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia; Clinical Outcomes Research Unit (CORe), Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, VIC, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne and North Western Mental Health, Melbourne, VIC, Australia
| | - Patrick Kwan
- Melbourne Brain Centre, The Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Terence J O'Brien
- Melbourne Brain Centre, The Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia
| | - Dennis Velakoulis
- Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Lucy Vivash
- Melbourne Brain Centre, The Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Neuroscience, Central Clinical School, Alfred Health, Monash University, Melbourne, VIC, Australia.
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Henin S, Turk-Browne NB, Friedman D, Liu A, Dugan P, Flinker A, Doyle W, Devinsky O, Melloni L. Learning hierarchical sequence representations across human cortex and hippocampus. SCIENCE ADVANCES 2021; 7:eabc4530. [PMID: 33608265 PMCID: PMC7895424 DOI: 10.1126/sciadv.abc4530] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/07/2021] [Indexed: 05/03/2023]
Abstract
Sensory input arrives in continuous sequences that humans experience as segmented units, e.g., words and events. The brain's ability to discover regularities is called statistical learning. Structure can be represented at multiple levels, including transitional probabilities, ordinal position, and identity of units. To investigate sequence encoding in cortex and hippocampus, we recorded from intracranial electrodes in human subjects as they were exposed to auditory and visual sequences containing temporal regularities. We find neural tracking of regularities within minutes, with characteristic profiles across brain areas. Early processing tracked lower-level features (e.g., syllables) and learned units (e.g., words), while later processing tracked only learned units. Learning rapidly shaped neural representations, with a gradient of complexity from early brain areas encoding transitional probability, to associative regions and hippocampus encoding ordinal position and identity of units. These findings indicate the existence of multiple, parallel computational systems for sequence learning across hierarchically organized cortico-hippocampal circuits.
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Affiliation(s)
- Simon Henin
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA.
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | | | - Daniel Friedman
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Anli Liu
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Patricia Dugan
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Adeen Flinker
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Werner Doyle
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Orrin Devinsky
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Lucia Melloni
- New York University Comprehensive Epilepsy Center, 223 34th Street, New York, NY 10016, USA.
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
- Department of Neuroscience, Max Planck Institute for Empirical Aesthetics, Grüneburgweg 14, 60322 Frankfurt am Main, Germany
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González HFJ, Narasimhan S, Johnson GW, Wills KE, Haas KF, Konrad PE, Chang C, Morgan VL, Rubinov M, Englot DJ. Role of the Nucleus Basalis as a Key Network Node in Temporal Lobe Epilepsy. Neurology 2021; 96:e1334-e1346. [PMID: 33441453 DOI: 10.1212/wnl.0000000000011523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine whether the nucleus basalis of Meynert (NBM) may be a key network structure of altered functional connectivity in temporal lobe epilepsy (TLE), we examined fMRI with network-based analyses. METHODS We acquired resting-state fMRI in 40 adults with TLE and 40 matched healthy control participants. We calculated functional connectivity of NBM and used multiple complementary network-based analyses to explore the importance of NBM in TLE networks without biasing our results by our approach. We compared patients to controls and examined associations of network properties with disease metrics and neurocognitive testing. RESULTS We observed marked decreases in connectivity between NBM and the rest of the brain in patients with TLE (0.91 ± 0.88, mean ± SD) vs controls (1.96 ± 1.13, p < 0.001, t test). Larger decreases in connectivity between NBM and fronto-parietal-insular regions were associated with higher frequency of consciousness-impairing seizures (r = -0.41, p = 0.008, Pearson). A core network of altered nodes in TLE included NBM ipsilateral to the epileptogenic side and bilateral limbic structures. Furthermore, normal community affiliation of ipsilateral NBM was lost in patients, and this structure displayed the most altered clustering coefficient of any node examined (3.46 ± 1.17 in controls vs 2.23 ± 0.93 in patients). Abnormal connectivity between NBM and subcortical arousal community was associated with modest neurocognitive deficits. Finally, a logistic regression model incorporating connectivity properties of ipsilateral NBM successfully distinguished patients from control datasets with moderately high accuracy (78%). CONCLUSIONS These results suggest that while NBM is rarely studied in epilepsy, it may be one of the most perturbed network nodes in TLE, contributing to widespread neural effects in this disabling disorder.
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Affiliation(s)
- Hernán F J González
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA.
| | - Saramati Narasimhan
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Graham W Johnson
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Kristin E Wills
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Kevin F Haas
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Peter E Konrad
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Catie Chang
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Victoria L Morgan
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Mikail Rubinov
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
| | - Dario J Englot
- From the Departments of Biomedical Engineering (H.F.J.G., G.W.J., P.E.K., C.C., V.L.M., M.R., D.J.E.) and Electrical Engineering and Computer Science (C.C., V.L.M., M.R., D.J.E.), Vanderbilt University; Departments of Neurological Surgery (S.N., K.E.W., P.E.K., D.J.E.), Radiology and Radiological Sciences (V.L.M., D.J.E.), and Neurology (K.F.H.) and Vanderbilt University Institute of Imaging Science (H.F.J.G., S.N., G.W.J., K.E.W., C.C., V.L.M., D.J.E.), Vanderbilt University Medical Center, Nashville, TN; and Department of Psychology (M.R.), Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA
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Keni RR, Radhakrishnan A. Using McGurk effect to detect speech-perceptional abnormalities in refractory epilepsy. Epilepsy Behav 2021; 114:107600. [PMID: 33248941 DOI: 10.1016/j.yebeh.2020.107600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/19/2020] [Accepted: 10/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND McGurk effect is a perceptual phenomenon that demonstrates an interaction between hearing and vision in speech perception. A wide range of neuropsychological deficits have been described in people with long-standing epilepsy, which affect multimodal integration in speech perception and hence refractory epilepsy patients are ideal for testing the McGurk effect. MATERIALS AND METHODS We studied the McGurk effect in 50 patients diagnosed with medically refractory left or right hemispheric epilepsy based on clinical, radiological, and electrophysiological data. RESULTS The McGurk effect was better perceived (p = 0.006) in patients with left hemispheric epilepsy (n = 12, 71%) compared to right (n = 5, 29%). The other factors which compromised the perception of the McGurk effect were impairments in visual memory (p = 0.041), facial emotion recognition (p = 0.001), and lip-reading (p = 0.006). Perception of the McGurk effect reduced significantly (p = 0.006) when the epilepsy duration was 10 years or beyond. CONCLUSION The McGurk effect can be used in refractory epilepsy patients, to detect subtle abnormalities in speech perception, before significant irreversible speech and language dysfunction become evident.
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Affiliation(s)
- Ravish R Keni
- R. Madhavan Nayar Centre for Comprehensive Epilepsy Care, Department of Neurology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Ashalatha Radhakrishnan
- R. Madhavan Nayar Centre for Comprehensive Epilepsy Care, Department of Neurology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Kerala, India.
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Leeman-Markowski BA, Adams J, Martin SP, Devinsky O, Meador KJ. Methylphenidate for attention problems in epilepsy patients: Safety and efficacy. Epilepsy Behav 2020; 115:107627. [PMID: 33360744 PMCID: PMC7884102 DOI: 10.1016/j.yebeh.2020.107627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
Children with attention deficit hyperactivity disorder (ADHD) have an increased risk of seizures, and children with epilepsy have an increased prevalence of ADHD. Adults with epilepsy often have varying degrees of attentional dysfunction due to multiple factors, including anti-seizure medications, frequent seizures, interictal discharges, underlying lesions, and psychiatric comorbidities. Currently, there are no approved medications for the treatment of epilepsy-related attentional dysfunction. Methylphenidate (MPH) is a stimulant, FDA-approved for the treatment of ADHD, and often used for ADHD in the setting of pediatric epilepsy. Large database and registry studies indicate safety of MPH in children with ADHD and epilepsy, with no significant effect on seizure frequency. Small single-dose and open-label studies suggest efficacy of MPH in adults with epilepsy-related attention deficits. Methylphenidate represents a possible treatment for attentional dysfunction due to epilepsy, but large, randomized, placebo-controlled, double-blinded studies are needed.
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Affiliation(s)
- Beth A. Leeman-Markowski
- Research Service, VA New York Harbor Healthcare System, 423 E. 23rd St., New York, NY, US 10010,Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY, US 10016,Corresponding author, Beth A. Leeman-Markowski,
| | - Jesse Adams
- Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305-5723, United States.
| | - Samantha P. Martin
- Research Service, VA New York Harbor Healthcare System, 423 E. 23rd St., New York, NY, US 10010,Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY, US 10016
| | - Orrin Devinsky
- Comprehensive Epilepsy Center, Department of Neurology, New York University Langone Health, 223 E. 34th St., New York, NY 10016, United States; Department of Neurosurgery, New York University Langone Health, 660 1st Ave. #5, New York, NY 10016, United States; Department of Psychiatry, New York University Langone Health, 550 1st Ave., New York, NY 10016, United States.
| | - Kimford J. Meador
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, 213 Quarry Road, MC 5979 (room 2856), Palo Alto, CA, US 94304-5979
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Sanjari Moghaddam H, Rahmani F, Aarabi MH, Nazem-Zadeh MR, Davoodi-Bojd E, Soltanian-Zadeh H. White matter microstructural differences between right and left mesial temporal lobe epilepsy. Acta Neurol Belg 2020; 120:1323-1331. [PMID: 30635771 DOI: 10.1007/s13760-019-01074-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/05/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Mesial temporal lobe epilepsy (mTLE) is a chronic focal epileptic disorder characterized by recalcitrant seizures often necessitating surgical intervention. Identifying the laterality of seizure focus is crucial for pre-surgical planning. We implemented diffusion MRI (DMRI) connectometry to identify differences in white matter connectivity in patients with left and right mTLE relative to healthy control subjects. METHOD We enrolled 12 patients with right mTLE, 12 patients with left mTLE, and 12 age/sex matched healthy controls (HCs). We used DMRI connectometry to identify local connectivity patterns of white matter tracts, based on quantitative anisotropy (QA). We compared QA of white matter to reconstruct tracts with significant difference in connectivity between patients and HCs and then between patients with left and right mTLE. RESULTS Right mTLE patients show higher anisotropy in left inferior longitudinal fasciculus (ILF) and forceps minor and lower QA in genu of corpus callosum (CC), bilateral corticospinal tracts (CSTs), and bilateral middle cerebellar peduncles (MCPs) compared to HCs. Left mTLE patients show higher anisotropy in genu of CC, bilateral CSTs, and right MCP and decreased anisotropy in forceps minor compared to HCs. Compared to patients with right mTLE, left mTLE patients showed increased and decreased connectivity in some major tracts. CONCLUSIONS Our study showed the pattern of microstructural disintegrity in mTLE patients relative to HCs. We demonstrated that left and right mTLE patients have discrepant alternations in their white matter microstructure. These results may indicate that left and right mTLE have different underlying pathologic mechanisms.
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Affiliation(s)
| | - Farzaneh Rahmani
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad-Reza Nazem-Zadeh
- Research Center for Science and Technology in Medicine (RCSTIM), Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Davoodi-Bojd
- Image Analysis Laboratory, Departments of Radiology and Research Administration, Henry Ford Health System, One Ford Place, 2F, Detroit, MI, 48202, USA
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, North Kargar Ave., Tehran, Iran.
- Image Analysis Laboratory, Departments of Radiology and Research Administration, Henry Ford Health System, One Ford Place, 2F, Detroit, MI, 48202, USA.
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Phuong TH, Houot M, Méré M, Denos M, Samson S, Dupont S. Cognitive impairment in temporal lobe epilepsy: contributions of lesion, localization and lateralization. J Neurol 2020; 268:1443-1452. [PMID: 33216221 DOI: 10.1007/s00415-020-10307-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive impairment is an important comorbidity of refractory temporal lobe epilepsy (TLE). We aimed to explore the impact of (i) specific lesions, such as dysembryoplastic neuroepithelial tumor (DNET), dysplasia, or hippocampal sclerosis, (ii) focus localization (medial versus lateral) and (iii) focus lateralization (right versus left) on the neuropsychological profile of refractory TLE adult patients. METHODS We examined the neuropsychological characteristics of 312 adults with refractory TLE: 100 patients without hippocampal sclerosis (HS) and 212 with HS. Scores on tests of intelligence (Global IQ, Verbal IQ and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions and language abilities were analyzed. RESULTS Three main factors influenced the neuropsychological profile of refractory TLE patients: (i) the lesion, patients with HS obtaining poorer cognitive performances than patients without HS and specifically DNET patients performing better than patients with HS, (ii) the focus side, that seems only relevant for verbal memory abilities which are affected in left but not right TLE patients and (iii) the localization of seizure focus, patients with medial TLE exhibiting lower memory performances than patients with lateral TLE. CONCLUSION Lesion, localization and lateralization are major contributors of the cognitive impairment depicted in TLE. Hippocampal sclerosis appears as the main contributor.
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Affiliation(s)
- Thanh Ha Phuong
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Neurology Unit, Hôpital Bach Mai, Hanoi, Vietnam
| | - Marion Houot
- Clinical Investigation Centre, Institut du Cerveau Et de La Moelle Épinière (ICM), Pitié-Salpêtrière Hospital Paris, Paris, France.,Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Méré
- Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marisa Denos
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Séverine Samson
- Univ. Lille, ULR 4072-PSITEC-Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
| | - Sophie Dupont
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Université Paris Sorbonne, Paris, France. .,Centre de Recherche de l'Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France.
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Hwang BY, Mampre D, Penn R, Anderson WS, Kang J, Kamath V. Olfactory Testing in Temporal Lobe Epilepsy: a Systematic Review. Curr Neurol Neurosci Rep 2020; 20:65. [PMID: 33169232 DOI: 10.1007/s11910-020-01083-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Olfactory testing is a potentially safe, cost-effective, bedside evaluation tool for diagnosis, monitoring, and risk assessment for surgery in temporal lobe epilepsy (TLE) patients, but testing methods and relevant olfactory domains are not standardized. We conducted a systematic review to evaluate olfactory tests in TLE and summarize the results of the literature. RECENT FINDINGS Olfactory tests varied significantly in odorant administration tools and devices, target odorants, evaluation timing, and grading scales. The Smell Threshold Test and University of Pennsylvania Smell Identification Test were the most validated single-domain tests for odor detection and odor identification, respectively. For multi-domain tests, Odor Memory/Discrimination Test and the Sniffin' Sticks test were the most validated. Results of olfactory tests in TLE are presented by domain. Rigorous validation, standardization, and comparative analysis of existing olfactory tests by domain is urgently needed to establish the utility and efficacy of olfactory testing in TLE.
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Affiliation(s)
- Brian Y Hwang
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA.
| | - David Mampre
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Rachel Penn
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - William S Anderson
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Joon Kang
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Krueger JN, Wilmot JH, Teratani-Ota Y, Puhger KR, Nemes SE, Crestani AP, Lafreniere MM, Wiltgen BJ. Amnesia for context fear is caused by widespread disruption of hippocampal activity. Neurobiol Learn Mem 2020; 175:107295. [PMID: 32822864 PMCID: PMC8562570 DOI: 10.1016/j.nlm.2020.107295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 12/26/2022]
Abstract
The hippocampus plays an essential role in the formation and retrieval of episodic memories in humans and contextual memories in animals. However, amnesia is not always observed when this structure is compromised. To determine why this is the case, we compared the effects of several different circuit manipulations on memory retrieval and hippocampal activity. Mice were first trained on context fear conditioning and then optogenetic and chemogenetic tools were used to alter activity during memory retrieval. We found that retrieval was only impaired when manipulations caused widespread changes (increases or decreases) in hippocampal activity. Widespread increases occurred when pyramidal cells were excited and widespread decreases were found when GABAergic neurons were stimulated. Direct hyperpolarization of excitatory neurons only moderately reduced activity and did not produce amnesia. Surprisingly, widespread decreases in hippocampal activity did not prevent retrieval if they occurred gradually prior to testing. This suggests that intact brain regions can express contextual memories if they are given adequate time to compensate for the loss of the hippocampus.
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Affiliation(s)
- Jamie N Krueger
- Center for Neuroscience, University of California Davis, 1544 Newton Ct., Davis, CA 95618, United States.
| | - Jacob H Wilmot
- Department of Psychology, University of California Davis, 135 Young Hall, Davis, CA 95616, United States.
| | - Yusuke Teratani-Ota
- Department of Psychology, University of California Davis, 135 Young Hall, Davis, CA 95616, United States.
| | - Kyle R Puhger
- Department of Psychology, University of California Davis, 135 Young Hall, Davis, CA 95616, United States.
| | - Sonya E Nemes
- Center for Neuroscience, University of California Davis, 1544 Newton Ct., Davis, CA 95618, United States.
| | - Ana P Crestani
- Department of Psychology, University of California Davis, 135 Young Hall, Davis, CA 95616, United States.
| | - Marrisa M Lafreniere
- Center for Neuroscience, University of California Davis, 1544 Newton Ct., Davis, CA 95618, United States.
| | - Brian J Wiltgen
- Center for Neuroscience, University of California Davis, 1544 Newton Ct., Davis, CA 95618, United States; Department of Psychology, University of California Davis, 135 Young Hall, Davis, CA 95616, United States.
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48
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Masoudian N, Moradpour M, Samaei A, Ehsani F, Ziari A. Assessment of cognitive functions and related risk factors in Iranian patients with generalized epilepsy as compared to patients with non-epileptic neurological disorders. CURRENT JOURNAL OF NEUROLOGY 2020; 19:167-172. [PMID: 38011428 PMCID: PMC8236431 DOI: 10.18502/cjn.v19i4.5543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/27/2020] [Indexed: 11/27/2022]
Abstract
Background: The cognitive impairment in patients with generalized epilepsy may affect their social efficiency and quality of life (QOL). The aim of this study is to determine the cognitive dysfunction and related risk factors in patients with generalized epilepsy as compared to patients with non-epileptic neurological disorders. Methods: In the present descriptive cross-sectional study, the cognitive function was assessed by Montreal Cognitive Assessment (MoCA) test in 62 patients with generalized epilepsy and also 62 patients with non-epileptic neurological diseases who referred to the Neurology Clinic, Semnan University of Medical Sciences, Semnan, Iran. The relationship between cognitive impairment and related risk factors was also investigated. The data were analyzed by SPSS software. Results: The mean score of MoCA in the patients with generalized epilepsy and the control group was 22.80 ± 4.14 and 26.48 ± 2.85, respectively (P < 0.050). The results indicated significantly lower MoCA scores in the epileptic group rather than the non-epileptic one (P < 0.001). Moreover, there was a significant relationship between MoCA score and age, education level, living place, the dose and rate of medicines, and the number of seizures in patients with epilepsy (P < 0.001). Gender and the duration of disease had no significant effects on the cognitive impairment of patients with epilepsy (P > 0.05). Conclusion: Patients with epilepsy had a significant cognitive impairment as compared to the patients with non-epileptic neurological disorders. Age, education level, living place, the dose and rate of medicines, and the number of seizures were the risk factors of cognitive impairment in the patients with epilepsy, while duration of disease and gender had no effects on the intensity of cognitive deficits.
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Affiliation(s)
- Nooshin Masoudian
- Department of Internal Medicine, School of Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Miad Moradpour
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Afshin Samaei
- Department of Internal Medicine, School of Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Abbas Ziari
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
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Levetiracetam Reduced the Basal Excitability of the Dentate Gyrus without Restoring Impaired Synaptic Plasticity in Rats with Temporal Lobe Epilepsy. Brain Sci 2020; 10:brainsci10090634. [PMID: 32933015 PMCID: PMC7565946 DOI: 10.3390/brainsci10090634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
Temporal lobe epilepsy (TLE), the most common type of focal epilepsy, affects learning and memory; these effects are thought to emerge from changes in synaptic plasticity. Levetiracetam (LEV) is a widely used antiepileptic drug that is also associated with the reversal of cognitive dysfunction. The long-lasting effect of LEV treatment and its participation in synaptic plasticity have not been explored in early chronic epilepsy. Therefore, through the measurement of evoked field potentials, this study aimed to comprehensively identify the alterations in the excitability and the short-term (depression/facilitation) and long-term synaptic plasticity (long-term potentiation, LTP) of the dentate gyrus of the hippocampus in a lithium–pilocarpine rat model of TLE, as well as their possible restoration by LEV (1 week; 300 mg/kg/day). TLE increased the population spike (PS) amplitude (input/output curve); interestingly, LEV treatment partially reduced this hyperexcitability. Furthermore, TLE augmented synaptic depression, suppressed paired-pulse facilitation, and reduced PS-LTP; however, LEV did not alleviate such alterations. Conversely, the excitatory postsynaptic potential (EPSP)-LTP of TLE rats was comparable to that of control rats and was decreased by LEV. LEV caused a long-lasting attenuation of basal hyperexcitability but did not restore impaired synaptic plasticity in the early chronic phase of TLE.
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50
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Singh TB, Aisikaer A, He C, Wu Y, Chen H, Ni H, Song Y, Yin J. The Assessment of Brain Functional Changes in the Temporal Lobe Epilepsy Patient with Cognitive Impairment by Resting-state Functional Magnetic Resonance Imaging. J Clin Imaging Sci 2020; 10:50. [PMID: 32874755 PMCID: PMC7451150 DOI: 10.25259/jcis_55_2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The objective of the study was to detect functional changes in the brain of cognitive impairment-temporal lobe epilepsy (CI-TLE) patient and to sort out the possible mechanism involved in CI in CI-TLE patients using resting-state functional magnetic resonance imaging (RS-fMRI). Material and Methods Fifty-eight TLE cases were included, which was divided into 44 TLE patients without CI (cognitive not impairment [CNI]-TLE) and 14 TLE patients with CI (CI-TLE). The normal control (NC) group consisted of 40 participants. RS-fMRI data preprocessing was carried out in statistical parametric mapping (SPM) software. The data were realigned, coregistered, normalized, and finally smoothened and then were taken for amplitude of low-frequency fluctuation (ALFF) calculation in RS-fMRI data analysis toolkit (REST) software. For data analysis, voxel-wise two-sample t-test was carried out between TLE group and NC group; CI-TLE group and cognitive not impairment-TLE (CNI-TLE) group in SPM software, a cluster >10 voxels and P < 0.01 was considered to be significant. Results Compared to NC, the TLE patients showed increased ALFF activation mostly in parahippocampal gyrus (PG), frontal lobe, midbrain, pons, insula, inferior temporal gyrus, and anterior cingulate gyrus (ACG) while decreased ALFF value was seen in posterior cingulate gyrus, cuneus, cerebellum posterior lobe, inferior parietal lobule (IPL), and superior temporal gyrus. Compared to CNI-TLE, CI-TLE patients showed increased ALFF in middle temporal gyrus (MTG), cuneus, ACG, IPL, middle frontal gyrus (MFG), superior frontal gyrus (SFG), cerebellum posterior lobe, and decreased ALFF cluster in the corpus callosum and MFG. Conclusion Between TLE and NC, we found increased ALFF activation in PG, frontal lobe, thalamus, insula, midbrain, and pons in TLE patient. Between CI and CNI TLE, area of executive control network and default model network, especially in MTG, ACG, IPL, MFG, and SFG, had increased ALFF value in CI-TLE patient. Activation of these areas should be because of the decompensation mechanism.
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Affiliation(s)
| | - Aikedan Aisikaer
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Che He
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Yalin Wu
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Hong Chen
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Hongyan Ni
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Yijun Song
- Department of Radiology, Tianjin Medical University General Hospital, Heping, Tianjin
| | - Jianzhong Yin
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
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