1
|
Berl MM, Koop JI, Ailion A, Bearden DJ, Boyer K, Cooper CM, Decrow AM, Duong PH, Espe-Pfeifer P, Gabriel M, Hodges E, Marshall DF, McNally KA, Molnar AE, Olsen EK, Ono KE, Patrick KE, Paul BM, Romain J, Sepeta LN, Stilp RLH, Wilkening GN, Zaccariello M, Zelko F, Perry MS. Leveraging expertise and optimizing clinical research: Initial success of a pediatric epilepsy surgery collaborative. Epilepsia 2023. [PMID: 36897767 DOI: 10.1111/epi.17579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE Improve data-driven research to inform clinical decision-making with pediatric epilepsy surgery patients by expanding the Pediatric Epilepsy Research Consortium Epilepsy Surgery (PERC-Surgery) Workgroup to include neuropsychological data. This article reports on the process and initial success of this effort and characterizes the cognitive functioning of the largest multi-site pediatric epilepsy surgery cohort in the United States. METHODS Pediatric neuropsychologists from 18 institutions completed surveys regarding neuropsychological practice and the impact of involvement in the collaborative. Neuropsychological data were entered through an online database. Descriptive analyses examined the survey responses and cognitive functioning of the cohort. Statistical analyses examined which patients were evaluated and if composite scores differed by domain, demographics, measures used, or epilepsy characteristics. RESULTS Positive impact of participation was evident by attendance, survey responses, and the neuropsychological data entry of 534 presurgical epilepsy patients. This cohort, ages 6 months to 21 years, were majority White and non-Hispanic, and more likely to have private insurance. Mean intelligence quotient (IQ) scores were below to low average, with weaknesses in working memory and processing speed. Full-scale IQ (FSIQ) was lowest for patients with younger age at seizure onset, daily seizures, and magnetic resonance imaging (MRI) abnormalities. SIGNIFICANCE We established a collaborative network and fundamental infrastructure to address questions outlined by the Epilepsy Research Benchmarks. There is a wide range in the age and IQ of patients considered for pediatric epilepsy surgery, yet it appears that social determinants of health impact access to care. Consistent with other national cohorts, this US cohort has a downward shift in IQ associated with seizure severity.
Collapse
Affiliation(s)
- Madison M Berl
- Department of Neuropsychology, Departments of Psychiatry and Behavioral Sciences, Children's Research Institute, Children's National Hospital, George Washington University, Washington, DC, USA
| | - Jennifer I Koop
- Pediatric Neuropsychology, Children's Wisconsin, Medical College of Wisconsin Department of Neurology, Milwaukee, Wisconsin, USA
| | - Alyssa Ailion
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Donald J Bearden
- Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Katrina Boyer
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Crystal M Cooper
- Neurosciences Center, Cook Children's Medical Center, Jane and John Justin Institute for Mind Health, Fort Worth, Texas, USA
| | - Amanda M Decrow
- Division of Pediatric Psychology and Neuropsychology, Atrium Health Levine Children's Hospital, Charlotte, North Carolina, USA
| | - Priscilla H Duong
- Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Patricia Espe-Pfeifer
- Department of Psychiatry & Pediatrics, University of Iowa Hospitals and Clinics, Ames, Iowa, USA
| | - Marsha Gabriel
- Neurosciences Center, Cook Children's Medical Center, Jane and John Justin Institute for Mind Health, Fort Worth, Texas, USA
| | - Elise Hodges
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - David F Marshall
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Kelly A McNally
- Department of Pediatric Psychology and Neuropsychology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Andrew E Molnar
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Emily K Olsen
- Department of Pediatric Psychology, Oregon Health and Science University, Portland, Oregon, USA
| | - Kim E Ono
- Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kristina E Patrick
- Department of Neurology, Department of Neurosciences, Seattle Children's Hospital, University of Washington, Seattle, Washington, United States
| | - Brianna M Paul
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | | | - Leigh N Sepeta
- Department of Neuropsychology, Departments of Psychiatry and Behavioral Sciences, Children's Research Institute, Children's National Hospital, George Washington University, Washington, DC, USA
| | - Rebecca L H Stilp
- Department of Pediatric Neurosurgery, Norton Neuroscience Institute, Louisville, Kentucky, USA
| | - Greta N Wilkening
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Michael Zaccariello
- Department of Psychiatry and Psychology, Division of Neurocognitive Disorders, Mayo Clinic, Rochester, Minnesota, USA
| | - Frank Zelko
- Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - M Scott Perry
- Neurosciences Center, Cook Children's Medical Center, Jane and John Justin Institute for Mind Health, Fort Worth, Texas, USA
| | | |
Collapse
|
2
|
Lalani SJ, Reyes A, Kaestner E, Stark SM, Stark CEL, Lee D, Kansal L, Shih JJ, Smith CN, Paul BM, McDonald CR. Impaired Behavioral Pattern Separation in Refractory Temporal Lobe Epilepsy and Mild Cognitive Impairment. J Int Neuropsychol Soc 2022; 28:550-562. [PMID: 34078506 PMCID: PMC8965747 DOI: 10.1017/s1355617721000734] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Episodic memory impairment and hippocampal pathology are hallmark features of both temporal lobe epilepsy (TLE) and amnestic mild cognitive impairment (aMCI). Pattern separation (PS), which enables the distinction between similar but unique experiences, is thought to contribute to successful encoding and retrieval of episodic memories. Impaired PS has been proposed as a potential mechanism underling episodic memory impairment in aMCI, but this association is less established in TLE. In this study, we examined behavioral PS in patients with TLE and explored whether profiles of performance in TLE are similar to aMCI. METHOD Patients with TLE, aMCI, and age-matched, healthy controls (HCs) completed a modified recognition task that relies on PS for the discrimination of highly similar lure items, the Mnemonic Similarity Task (MST). Group differences were evaluated and relationships between clinical characteristics, California Verbal Learning Test-Second Edition scores, and MST performance were tested in the TLE group. RESULTS Patients with TLE and aMCI demonstrated poorer PS performance relative to the HCs, but performance did not differ between the two patient groups. Neither the side of seizure focus nor having hippocampal sclerosis affected performance in TLE. However, TLE patients with clinically defined memory impairment showed the poorest performance. CONCLUSION Memory performance on a task that relies on PS was disrupted to a similar extent in TLE and aMCI. The MST could provide a clinically useful tool for measuring hippocampus-dependent memory impairments in TLE and other neurological disorders associated with hippocampal damage.
Collapse
Affiliation(s)
- Sanam J Lalani
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Anny Reyes
- San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Shauna M Stark
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Craig E L Stark
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - David Lee
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Leena Kansal
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Jerry J Shih
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Christine N Smith
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Carrie R McDonald
- San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| |
Collapse
|
3
|
Kaestner E, Stasenko A, Ben-Haim S, Shih J, Paul BM, McDonald CR. The importance of basal-temporal white matter to pre- and post-surgical naming ability in temporal lobe epilepsy. Neuroimage Clin 2022; 34:102963. [PMID: 35220106 PMCID: PMC8888987 DOI: 10.1016/j.nicl.2022.102963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Emerging research highlights the importance of basal-temporal cortex, centered on the fusiform gyrus, to both pre-surgical naming ability and post-surgical naming outcomes in temporal lobe epilepsy (TLE). In this study, we investigate whether integrity of the white matter network that interconnects this basal region to the distributed language network affects naming ability and risk for post-surgical naming decline. METHODS Patients with drug-resistant TLE were recruited from two epilepsy centers in a prospective longitudinal study. The pre-surgical dataset included 50 healthy controls, 47 left TLE (L-TLE), and 41 right TLE (R-TLE) patients. All participants completed pre-surgical T1- and diffusion-weighted MRI (dMRI), as well as neuropsychological tests of auditory and visual naming. Nineteen L-TLE and 18 R-TLE patients underwent anterior temporal lobectomy (ATL) and also completed post-surgical neuropsychological testing. Pre-surgical fractional anisotropy (FA) of the white matter directly beneath the fusiform neocortex (i.e., superficial white matter; SWM) and of deep white matter tracts with connections to the basal-temporal cortex [inferior longitudinal fasciculus (ILF) and inferior frontal occipital fasciculus (IFOF)] was calculated. Clinical variables, hippocampal volume, and FA of each white matter tract or region were examined in linear regressions with naming scores, or change in naming scores, as the primary outcomes. RESULTS Pre-surgically, higher FA in the bilateral ILF, bilateral IFOF, and left fusiform SWM was associated with better visual and auditory naming scores (all ps < 0.05 with FDR correction). In L-TLE, higher pre-surgical FA was also associated with less naming decline post-surgically, but results varied across tracts. When including only patients with typical language dominance, only integrity of the right fusiform SWM was associated with less visual naming decline (p = .0018). DISCUSSION Although a broad network of white matter network matter may contribute to naming ability pre-surgically, the reserve capacity of the contralateral (right) fusiform SWM may be important for mitigating visual naming decline following ATL in L-TLE. This shows that the study of the structural network interconnecting the basal-temporal region to the wider language network has implications for understanding both pre- and post-surgical naming in TLE.
Collapse
Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Alena Stasenko
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharona Ben-Haim
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Jerry Shih
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California -San Francisco, San Francisco, CA, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| |
Collapse
|
4
|
Balachandra AR, Kaestner E, Bahrami N, Reyes A, Lalani S, Macari AC, Paul BM, Bonilha L, McDonald CR. Clinical utility of structural connectomics in predicting memory in temporal lobe epilepsy. Neurology 2020; 94:e2424-e2435. [PMID: 32358221 PMCID: PMC7455364 DOI: 10.1212/wnl.0000000000009457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the predictive power of white matter neuronal networks (i.e., structural connectomes [SCs]) in discriminating memory-impaired patients with temporal lobe epilepsy (TLE) from those with normal memory. METHODS T1- and diffusion MRI (dMRI), clinical variables, and neuropsychological measures of verbal memory were available for 81 patients with TLE. Prediction of memory impairment was performed with a tree-based classifier (XGBoost) for 4 models: (1) a clinical model including demographic and clinical features, (2) a hippocampal volume (HCV) model, (3) a tract model including 5 temporal lobe white matter association tracts derived from a dMRI atlas, and (4) an SC model based on dMRI. SCs were derived by extracting cortical-cortical connections from a temporal lobe subnetwork with probabilistic tractography. Principal component (PC) analysis was then applied to reduce the dimensionality of the SC, yielding 10 PCs. Multimodal models were also tested combining SCs and tracts with HCV. Each model was trained on 48 patients from 1 epilepsy center and tested on 33 patients from a different center. RESULTS Multimodal models that included the SC + HCV model yielded the highest classification accuracy (81%; 0.90 sensitivity; 0.67 specificity), outperforming the clinical model (61%; p < 0.001) and HCV model (66%; p < 0.001). In addition, the unimodal SC model (76% accuracy) and tract model (73% accuracy) outperformed the clinical model (p < 0.001) and HCV model (p < 0.001) for classifying patients with TLE with and without memory impairment. Furthermore, the SC identified that short-range temporal-temporal connections were important contributors to memory performance. CONCLUSION SCs and tract-based models are stronger predictors of memory impairment in TLE than HCVs and clinical variables. However, SCs may provide additional information about local cortical-cortical connectivity contributing to memory that is not captured in large association tracts.
Collapse
Affiliation(s)
- Akshara R Balachandra
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Naeim Bahrami
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Sanam Lalani
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anna Christina Macari
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Brianna M Paul
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Leonardo Bonilha
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA.
| |
Collapse
|
5
|
Reyes A, Lalani SJ, Kaestner E, Hooper K, Chen A, Macari AC, Paul BM, Hermann BP, McDonald CR. The impact of cerebrovascular risk factors on postoperative memory decline in patients with left temporal lobe epilepsy. Epilepsy Behav 2020; 102:106558. [PMID: 31733568 PMCID: PMC6962533 DOI: 10.1016/j.yebeh.2019.106558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/10/2019] [Accepted: 09/10/2019] [Indexed: 12/24/2022]
Abstract
Cerebrovascular risk factors (CVRFs) and comorbid cardiovascular and metabolic disease have been linked to accelerated cognitive aging and dementia in the general population; however, the contribution of these comorbidities to the risk of post anterior temporal lobectomy (ATL) memory decline has been unexamined. We explored the effects of CVRFs on postoperative verbal memory decline in a cohort of 22 patients with left temporal lobe epilepsy (LTLE) who completed pre- and one-year postsurgical neuropsychological testing. Diagnoses of interest included preoperative cardiovascular and metabolic disorders, as well as CVRFs [pulse pressure proxy, body mass index (BMI), and fasting glucose]. Twenty-three percent of patients had a history of cardiovascular disease, 9% of metabolic disorders, and 38% had a BMI indicating overweight or obese status. Higher preoperative BMI and glucose were associated with greater decline in verbal memory. The association between BMI and memory decline remained significant after controlling for age and left hippocampal volume. These findings suggest that modifiable health-related risk factors, including CVRFs, may impact the risk of postoperative cognitive decline, and that BMI in particular could be an important factor to consider and/or target for intervention early in clinical care to protect cognitive health.
Collapse
Affiliation(s)
- Anny Reyes
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Sanam J Lalani
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Kiera Hooper
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Austin Chen
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Anna Christina Macari
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA; UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA
| | - Bruce P Hermann
- Matthews Neuropsychology Section, University of Wisconsin, USA
| | - Carrie R McDonald
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| |
Collapse
|
6
|
Kaestner E, Balachandra AR, Bahrami N, Reyes A, Lalani SJ, Macari AC, Voets NL, Drane DL, Paul BM, Bonilha L, McDonald CR. The white matter connectome as an individualized biomarker of language impairment in temporal lobe epilepsy. Neuroimage Clin 2019; 25:102125. [PMID: 31927128 PMCID: PMC6953962 DOI: 10.1016/j.nicl.2019.102125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The distributed white matter network underlying language leads to difficulties in extracting clinically meaningful summaries of neural alterations leading to language impairment. Here we determine the predictive ability of the structural connectome (SC), compared with global measures of white matter tract microstructure and clinical data, to discriminate language impaired patients with temporal lobe epilepsy (TLE) from TLE patients without language impairment. METHODS T1- and diffusion-MRI, clinical variables (CVs), and neuropsychological measures of naming and verbal fluency were available for 82 TLE patients. Prediction of language impairment was performed using a robust tree-based classifier (XGBoost) for three models: (1) a CV-model which included demographic and epilepsy-related clinical features, (2) an atlas-based tract-model, including four frontotemporal white matter association tracts implicated in language (i.e., the bilateral arcuate fasciculus, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus), and (3) a SC-model based on diffusion MRI. For the association tracts, mean fractional anisotropy was calculated as a measure of white matter microstructure for each tract using a diffusion tensor atlas (i.e., AtlasTrack). The SC-model used measurement of cortical-cortical connections arising from a temporal lobe subnetwork derived using probabilistic tractography. Dimensionality reduction of the SC was performed with principal components analysis (PCA). Each model was trained on 49 patients from one epilepsy center and tested on 33 patients from a different center (i.e., an independent dataset). Randomization was performed to test the stability of the results. RESULTS The SC-model yielded a greater area under the curve (AUC; .73) and accuracy (79%) compared to both the tract-model (AUC: .54, p < .001; accuracy: 70%, p < .001) and the CV-model (AUC: .59, p < .001; accuracy: 64%, p < .001). Within the SC-model, lateral temporal connections had the highest importance to model performance, including connections similar to language association tracts such as links between the superior temporal gyrus to pars opercularis. However, in addition to these connections many additional connections that were widely distributed, bilateral and interhemispheric in nature were identified as contributing to SC-model performance. CONCLUSION The SC revealed a white matter network contributing to language impairment that was widely distributed, bilateral, and lateral temporal in nature. The distributed network underlying language may be why the SC-model has an advantage in identifying sub-components of the complex fiber networks most relevant for aspects of language performance.
Collapse
Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Naeim Bahrami
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Sanam J Lalani
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Anna Christina Macari
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Natalie L Voets
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Daniel L Drane
- Departments of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington, Seattle, WA, USA
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Leonardo Bonilha
- Medical University of South Carolina, Department of Neurology, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| |
Collapse
|
7
|
Balter S, Lin G, Leyden KM, Paul BM, McDonald CR. Neuroimaging correlates of language network impairment and reorganization in temporal lobe epilepsy. Brain Lang 2019; 193:31-44. [PMID: 27393391 PMCID: PMC5215985 DOI: 10.1016/j.bandl.2016.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/27/2016] [Accepted: 06/15/2016] [Indexed: 06/02/2023]
Abstract
Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.
Collapse
Affiliation(s)
- S Balter
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - G Lin
- Palo Alto University, Palo Alto, CA, United States
| | - K M Leyden
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States
| | - B M Paul
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - C R McDonald
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States; Department of Psychiatry, University of California, San Diego, CA, United States.
| |
Collapse
|
8
|
Chang YHA, Marshall A, Bahrami N, Mathur K, Javadi SS, Reyes A, Hegde M, Shih JJ, Paul BM, Hagler DJ, McDonald CR. Differential sensitivity of structural, diffusion, and resting-state functional MRI for detecting brain alterations and verbal memory impairment in temporal lobe epilepsy. Epilepsia 2019; 60:935-947. [PMID: 31020649 DOI: 10.1111/epi.14736] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Temporal lobe epilepsy (TLE) is known to affect large-scale gray and white matter networks, and these network changes likely contribute to the verbal memory impairments observed in many patients. In this study, we investigate multimodal imaging patterns of brain alterations in TLE and evaluate the sensitivity of different imaging measures to verbal memory impairment. METHODS Diffusion tensor imaging (DTI), volumetric magnetic resonance imaging (vMRI), and resting-state functional MRI (rs-fMRI) were evaluated in 46 patients with TLE and 33 healthy controls to measure patterns of microstructural, structural, and functional alterations, respectively. These measurements were obtained within the white matter directly beneath neocortex (ie, superficial white matter [SWM]) for DTI and across neocortex for vMRI and rs-fMRI. The degree to which imaging alterations within left medial temporal lobe/posterior cingulate (LMT/PC) and left lateral temporal regions were associated with verbal memory performance was evaluated. RESULTS Patients with left TLE and right TLE both demonstrated pronounced microstructural alterations (ie, decreased fractional anisotropy [FA] and increased mean diffusivity [MD]) spanning the entire frontal and temporolimbic SWM, which were highly lateralized to the ipsilateral hemisphere. Conversely, reductions in cortical thickness in vMRI and alterations in the magnitude of the rs-fMRI response were less pronounced and less lateralized than the microstructural changes. Both stepwise regression and mediation analyses further revealed that FA and MD within SWM in LMT/PC regions were the most robust predictors of verbal memory, and that these associations were independent of left hippocampal volume. SIGNIFICANCE These findings suggest that microstructural loss within the SWM is pronounced in patients with TLE, and injury to the SWM within the LMT/PC region plays a critical role in verbal memory impairment.
Collapse
Affiliation(s)
- Yu-Hsuan A Chang
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Anisa Marshall
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Naeim Bahrami
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Kushagra Mathur
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Sogol S Javadi
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Manu Hegde
- Department of Neurology, University of California, San Francisco, California.,UCSF Comprehensive Epilepsy Center, San Francisco, California
| | - Jerry J Shih
- Department of Neurosciences, University of California, San Diego, California.,UCSD Comprehensive Epilepsy Center, San Diego, California
| | - Brianna M Paul
- Department of Neurology, University of California, San Francisco, California.,UCSF Comprehensive Epilepsy Center, San Francisco, California
| | - Donald J Hagler
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,Department of Radiology, University of California, San Diego, California
| | - Carrie R McDonald
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California.,UCSD Comprehensive Epilepsy Center, San Diego, California
| |
Collapse
|
9
|
Reyes A, Kaestner E, Bahrami N, Balachandra A, Hegde M, Paul BM, Hermann B, McDonald CR. Cognitive phenotypes in temporal lobe epilepsy are associated with distinct patterns of white matter network abnormalities. Neurology 2019; 92:e1957-e1968. [PMID: 30918094 DOI: 10.1212/wnl.0000000000007370] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/31/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To identify distinct cognitive phenotypes in temporal lobe epilepsy (TLE) and evaluate patterns of white matter (WM) network alterations associated with each phenotype. METHODS Seventy patients with TLE were characterized into 4 distinct cognitive phenotypes based on patterns of impairment in language and verbal memory measures (language and memory impaired, memory impaired only, language impaired only, no impairment). Diffusion tensor imaging was obtained in all patients and in 46 healthy controls (HC). Fractional anisotropy (FA) and mean diffusivity (MD) of the WM directly beneath neocortex (i.e., superficial WM [SWM]) and of deep WM tracts associated with memory and language were calculated for each phenotype. Regional and network-based SWM analyses were performed across phenotypes. RESULTS The language and memory impaired group and the memory impaired group showed distinct patterns of microstructural abnormalities in SWM relative to HC. In addition, the language and memory impaired group showed widespread alterations in WM tracts and altered global SWM network topology. Patients with isolated language impairment exhibited poor network structure within perisylvian cortex, despite relatively intact global SWM network structure, whereas patients with no impairment appeared similar to HC across all measures. CONCLUSIONS These findings demonstrate a differential pattern of WM microstructural abnormalities across distinct cognitive phenotypes in TLE that can be appreciated at both the regional and network levels. These findings not only help to unravel the underlying neurobiology associated with cognitive impairment in TLE, but they could also aid in establishing cognitive taxonomies or in the prediction of cognitive course in TLE.
Collapse
Affiliation(s)
- Anny Reyes
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Erik Kaestner
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Naeim Bahrami
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Akshara Balachandra
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Manu Hegde
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Brianna M Paul
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Bruce Hermann
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA
| | - Carrie R McDonald
- From the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R.); Center for Multimodal Imaging and Genetics (A.R., E.K., N.B., A.B., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; Department of Neurology (M.H., B.M.P.), University of California, San Francisco; UCSF Comprehensive Epilepsy Center (M.H., B.M.P.), San Francisco; Matthews Neuropsychology Section (B.H.), University of Wisconsin-Madison; and UCSD Comprehensive Epilepsy Center (C.R.M.), San Diego, CA.
| |
Collapse
|
10
|
Ehrlich T, Reyes A, Paul BM, Uttarwar V, Hartman S, Mathur K, Chang YHA, Hegde M, Shih JJ, McDonald CR. Beyond depression: The impact of executive functioning on quality of life in patients with temporal lobe epilepsy. Epilepsy Res 2018; 149:30-36. [PMID: 30468945 DOI: 10.1016/j.eplepsyres.2018.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/14/2018] [Accepted: 11/12/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Individuals with temporal lobe epilepsy (TLE) often experience diminished quality of life (QoL). Although comorbid depression is one of the most recognized predictors of poor QoL in TLE, impairments in verbal memory (VM) and executive functioning (EF), have also been identified as risk factors, independent of other biological and psychosocial factors. In this study, we examine the contribution of depression, VM, and EF to QoL in 52 well-characterized medically-refractory TLE patients. METHODS Quality of life was assessed with the Quality of Life in Epilepsy (QOLIE-31) questionnaire and depression symptomatology was evaluated with the Beck Depression Inventory-II (BDI-II). Tests of VM included the California Verbal Learning Test-Second Edition and the Wechsler Memory Scale-Third Edition, Logical Memory and Verbal Paired Associates subtests. Tests of EF included the D-KEFS Category Switching and Color Word Interference Tests, and the Trail Making Test. Using these measures, a principal component (PC) was derived for VM and for EF. Hierarchical multiple linear regression analysis was used to evaluate the unique contributions of BDI-II Score, VM PC, and EF PC to the QOLIE-31 Total Score, while controlling for important clinical and demographic variables. Post-hoc analyses were also performed to examine the contribution of each variable to specific QOLIE subscales. RESULTS Of the clinical variables, only number of antiepileptic drugs contributed to QOLIE scores. As expected, severity of depressive symptoms was the most significant predictor of QOLIE Total Score, explaining 43.4% of the variance in total QoL. The VM PC did not contribute to the QOLIE Total Score. Rather, our EF PC emerged as an important predictor of QoL, explaining an additional 5% of the variance, after controlling for clinical variables, depression severity, and VM performance. SIGNIFICANCE These findings suggest that a combination of clinical, affective, and cognitive factors influence QoL in patients with TLE. Designing interventions with careful attention to depression and EF may be needed to optimize QoL in patients with refractory TLE and potentially other epilepsy syndromes.
Collapse
Affiliation(s)
- Tobin Ehrlich
- Palo Alto University, 1971 Arastradero Drive, Palo Alto, CA 94304, USA
| | - Anny Reyes
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Brianna M Paul
- UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA; Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - Vedang Uttarwar
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Stephen Hartman
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Kushagra Mathur
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Yu-Hsuan A Chang
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Manu Hegde
- UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA
| | - Jerry J Shih
- UCSD Comphrensive Epilepsy Center, San Diego, CA, USA
| | - Carrie R McDonald
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; UCSD Comphrensive Epilepsy Center, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| |
Collapse
|
11
|
Martin-Brevet S, Rodríguez-Herreros B, Nielsen JA, Moreau C, Modenato C, Maillard AM, Pain A, Richetin S, Jønch AE, Qureshi AY, Zürcher NR, Conus P, Chung WK, Sherr EH, Spiro JE, Kherif F, Beckmann JS, Hadjikhani N, Reymond A, Buckner RL, Draganski B, Jacquemont S, Arveiler B, Baujat G, Sloan-Béna F, Belfiore M, Bonneau D, Bouquillon S, Boute O, Brusco A, Busa T, Caberg JH, Campion D, Colombert V, Cordier MP, David A, Debray FG, Delrue MA, Doco-Fenzy M, Dunkhase-Heinl U, Edery P, Fagerberg C, Faivre L, Forzano F, Genevieve D, Gérard M, Giachino D, Guichet A, Guillin O, Héron D, Isidor B, Jacquette A, Jaillard S, Journel H, Keren B, Lacombe D, Lebon S, Le Caignec C, Lemaître MP, Lespinasse J, Mathieu-Dramart M, Mercier S, Mignot C, Missirian C, Petit F, Pilekær Sørensen K, Pinson L, Plessis G, Prieur F, Rooryck-Thambo C, Rossi M, Sanlaville D, Schlott Kristiansen B, Schluth-Bolard C, Till M, Van Haelst M, Van Maldergem L, Alupay H, Aaronson B, Ackerman S, Ankenman K, Anwar A, Atwell C, Bowe A, Beaudet AL, Benedetti M, Berg J, Berman J, Berry LN, Bibb AL, Blaskey L, Brennan J, Brewton CM, Buckner R, Bukshpun P, Burko J, Cali P, Cerban B, Chang Y, Cheong M, Chow V, Chu Z, Chudnovskaya D, Cornew L, Dale C, Dell J, Dempsey AG, Deschamps T, Earl R, Edgar J, Elgin J, Olson JE, Evans YL, Findlay A, Fischbach GD, Fisk C, Fregeau B, Gaetz B, Gaetz L, Garza S, Gerdts J, Glenn O, Gobuty SE, Golembski R, Greenup M, Heiken K, Hines K, Hinkley L, Jackson FI, Jenkins J, Jeremy RJ, Johnson K, Kanne SM, Kessler S, Khan SY, Ku M, Kuschner E, Laakman AL, Lam P, Lasala MW, Lee H, LaGuerre K, Levy S, Cavanagh AL, Llorens AV, Campe KL, Luks TL, Marco EJ, Martin S, Martin AJ, Marzano G, Masson C, McGovern KE, McNally Keehn R, Miller DT, Miller FK, Moss TJ, Murray R, Nagarajan SS, Nowell KP, Owen J, Paal AM, Packer A, Page PZ, Paul BM, Peters A, Peterson D, Poduri A, Pojman NJ, Porche K, Proud MB, Qasmieh S, Ramocki MB, Reilly B, Roberts TP, Shaw D, Sinha T, Smith-Packard B, Gallagher AS, Swarnakar V, Thieu T, Triantafallou C, Vaughan R, Wakahiro M, Wallace A, Ward T, Wenegrat J, Wolken A. Quantifying the Effects of 16p11.2 Copy Number Variants on Brain Structure: A Multisite Genetic-First Study. Biol Psychiatry 2018; 84:253-264. [PMID: 29778275 DOI: 10.1016/j.biopsych.2018.02.1176] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/01/2018] [Accepted: 02/24/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND 16p11.2 breakpoint 4 to 5 copy number variants (CNVs) increase the risk for developing autism spectrum disorder, schizophrenia, and language and cognitive impairment. In this multisite study, we aimed to quantify the effect of 16p11.2 CNVs on brain structure. METHODS Using voxel- and surface-based brain morphometric methods, we analyzed structural magnetic resonance imaging collected at seven sites from 78 individuals with a deletion, 71 individuals with a duplication, and 212 individuals without a CNV. RESULTS Beyond the 16p11.2-related mirror effect on global brain morphometry, we observe regional mirror differences in the insula (deletion > control > duplication). Other regions are preferentially affected by either the deletion or the duplication: the calcarine cortex and transverse temporal gyrus (deletion > control; Cohen's d > 1), the superior and middle temporal gyri (deletion < control; Cohen's d < -1), and the caudate and hippocampus (control > duplication; -0.5 > Cohen's d > -1). Measures of cognition, language, and social responsiveness and the presence of psychiatric diagnoses do not influence these results. CONCLUSIONS The global and regional effects on brain morphometry due to 16p11.2 CNVs generalize across site, computational method, age, and sex. Effect sizes on neuroimaging and cognitive traits are comparable. Findings partially overlap with results of meta-analyses performed across psychiatric disorders. However, the lack of correlation between morphometric and clinical measures suggests that CNV-associated brain changes contribute to clinical manifestations but require additional factors for the development of the disorder. These findings highlight the power of genetic risk factors as a complement to studying groups defined by behavioral criteria.
Collapse
Affiliation(s)
- Sandra Martin-Brevet
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Laboratoire de Recherche en Neuroimagerie, Département des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Borja Rodríguez-Herreros
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; CHU Sainte-Justine Research Center, Université de Montréal, Montréal, Quebec, Canada
| | - Jared A Nielsen
- Department of Psychology, Harvard University, Cambridge, Massachusetts; Center for Brain Science, Harvard University, Cambridge, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Clara Moreau
- CHU Sainte-Justine Research Center, Université de Montréal, Montréal, Quebec, Canada
| | - Claudia Modenato
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Laboratoire de Recherche en Neuroimagerie, Département des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Anne M Maillard
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Centre Cantonal Autisme, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Aurélie Pain
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Centre Cantonal Autisme, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Sonia Richetin
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Aia E Jønch
- CHU Sainte-Justine Research Center, Université de Montréal, Montréal, Quebec, Canada; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Abid Y Qureshi
- Center for Brain Science, Harvard University, Cambridge, Massachusetts; Department of Neurology, University of Kansas Medical Center, Kansas City, KS
| | - Nicole R Zürcher
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | | | | | - Wendy K Chung
- Simons Foundation, New York, New York; Departments of Pediatrics and Medicine, Columbia University, New York, New York
| | - Elliott H Sherr
- Department of Neurology, Department of Pediatrics, and Weill Institute for Neurosciences, University of California, San Francisco, California
| | | | - Ferath Kherif
- Laboratoire de Recherche en Neuroimagerie, Département des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Jacques S Beckmann
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Nouchine Hadjikhani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Alexandre Reymond
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Randy L Buckner
- Department of Psychology, Harvard University, Cambridge, Massachusetts; Center for Brain Science, Harvard University, Cambridge, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Bogdan Draganski
- Laboratoire de Recherche en Neuroimagerie, Département des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sébastien Jacquemont
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; CHU Sainte-Justine Research Center, Université de Montréal, Montréal, Quebec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Reyes A, Paul BM, Marshall A, Chang YHA, Bahrami N, Kansal L, Iragui VJ, Tecoma ES, Gollan TH, McDonald CR. Does bilingualism increase brain or cognitive reserve in patients with temporal lobe epilepsy? Epilepsia 2018; 59:1037-1047. [PMID: 29658987 DOI: 10.1111/epi.14072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Bilingual healthy adults have been shown to exhibit an advantage in executive functioning (EF) that is associated with microstructural changes in white matter (WM) networks. Patients with temporal lobe epilepsy (TLE) often show EF deficits that are associated with WM compromise. In this study, we investigate whether bilingualism can increase cognitive reserve and/or brain reserve in bilingual patients with TLE, mitigating EF impairment and WM compromise. METHODS Diffusion tensor imaging was obtained in 19 bilingual and 26 monolingual patients with TLE, 12 bilingual healthy controls (HC), and 21 monolingual HC. Fractional anisotropy (FA) and mean diffusivity (MD) were calculated for the uncinate fasciculus (Unc) and cingulum (Cing), superior frontostriatal tract (SFS), and inferior frontostriatal tract (IFS). Measures of EF included Trail Making Test-B (TMT-B) and Delis-Kaplan Executive Function System Color-Word Inhibition/Switching. Analyses of covariance were conducted to compare FA and MD of the Unc, Cing, SFS, and IFS and EF performance across groups. RESULTS In bilingual patients, FA was lower in the ipsilateral Cing and Unc compared to all other groups. For both patient groups, MD of the ipsilateral Unc was higher relative to HC. Despite more pronounced reductions in WM integrity, bilingual patients performed similarly to monolingual TLE and both HC groups on EF measures. By contrast, monolingual patients performed worse than HC on TMT-B. In addition, differences in group means between bilingual and monolingual patients on TMT-B approached significance when controlling for the extent of WM damage (P = .071; d = 0.62), suggesting a tendency toward higher performance for bilingual patients. SIGNIFICANCE Despite poorer integrity of regional frontal lobe WM, bilingual patients performed similarly to monolingual patients and HC on EF measures. These findings align with studies suggesting that bilingualism may provide a protective factor for individuals with neurological disease, potentially through reorganization of EF networks that promote greater cognitive reserve.
Collapse
Affiliation(s)
- Anny Reyes
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,University of California, San Francisco Comprehensive Epilepsy Center, San Francisco, CA, USA
| | - Anisa Marshall
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Yu-Hsuan A Chang
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Naeim Bahrami
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA
| | - Leena Kansal
- University of California, San Diego Comprehensive Epilepsy Center, San Diego, CA, USA
| | - Vicente J Iragui
- University of California, San Diego Comprehensive Epilepsy Center, San Diego, CA, USA
| | - Evelyn S Tecoma
- University of California, San Diego Comprehensive Epilepsy Center, San Diego, CA, USA
| | - Tamar H Gollan
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Carrie R McDonald
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| |
Collapse
|
13
|
Chang YHA, Kemmotsu N, Leyden KM, Kucukboyaci NE, Iragui VJ, Tecoma ES, Kansal L, Norman MA, Compton R, Ehrlich TJ, Uttarwar VS, Reyes A, Paul BM, McDonald CR. Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy. Brain Lang 2017; 170:82-92. [PMID: 28432987 PMCID: PMC5507363 DOI: 10.1016/j.bandl.2017.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/09/2017] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for each imaging modality and a principal component (PC) was derived from language measures. Correlations were performed among imaging measures, as well as to the language PC. In controls, better language performance was associated with stronger left-lateralized temporo-parietal and temporo-occipital activations. In LTLE, better language performance was associated with stronger right-lateralized inferior frontal, temporo-parietal, and temporo-occipital activations. These right-lateralized activations in LTLE were associated with right-lateralized arcuate fasciculus fractional anisotropy. These data suggest that interhemispheric language reorganization in LTLE is associated with alterations to perisylvian white matter. These concurrent structural and functional shifts from left to right may help to mitigate language impairment in LTLE.
Collapse
Affiliation(s)
- Yu-Hsuan A Chang
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Nobuko Kemmotsu
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Kelly M Leyden
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - N Erkut Kucukboyaci
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Vicente J Iragui
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Evelyn S Tecoma
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Leena Kansal
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Marc A Norman
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Rachelle Compton
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Tobin J Ehrlich
- Palo Alto University, 1971 Arastradero Drive, Palo Alto, CA 94304, USA.
| | - Vedang S Uttarwar
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA; UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA.
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| |
Collapse
|
14
|
Loi RQ, Leyden KM, Balachandra A, Uttarwar V, Hagler DJ, Paul BM, Dale AM, White NS, McDonald CR. Restriction spectrum imaging reveals decreased neurite density in patients with temporal lobe epilepsy. Epilepsia 2016; 57:1897-1906. [PMID: 27735051 DOI: 10.1111/epi.13570] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Diffusion tensor imaging (DTI) has become a popular tool for delineating the location and extent of white matter injury in temporal lobe epilepsy (TLE). However, DTI yields nonspecific measures that are confounded by changes occurring within both the intracellular and extracellular environments. This study investigated whether an advanced diffusion method, restriction spectrum imaging (RSI) could provide a more robust measure of white matter injury in TLE relative to DTI due to RSI's ability to separate intraaxonal diffusion (i.e., neurite density; ND) from diffusion associated with extraaxonal factors (e.g., inflammation; crossing fibers). METHODS RSI and DTI scans were obtained on 21 patients with TLE and 11 age-matched controls. RSI-derived maps of ND, isotropic-hindered (IH) and isotropic-free (IF) water, and crossing fibers (CFs) were compared to DTI-derived fractional anisotropy (FA) maps. Voxelwise and tract-based analyses were performed comparing patients with TLE to controls on each diffusion metric. RESULTS Reductions in FA were seen primarily in frontotemporal white matter in TLE, and they were most pronounced proximal to the seizure focus. Reductions in ND corresponded to those seen in the FA maps; however, ND reductions were greater in magnitude, more lateralized to the epileptogenic hemisphere, and showed a broader pattern. Increases in IF/IH and effects from CFs also contributed to reduced FA in the ipsilateral parahippocampal cingulum and fornix, with decreases in IH extending into extratemporal regions. Reduced ND of the uncinate fasciculus was associated with longer disease duration, whereas FA was not associated with any clinical variables. SIGNIFICANCE RSI may provide a more specific measure of white matter pathology in TLE, distinguishing regions primarily affected by axonal/myelin loss from those where CFs and increases in extracellular water also play a role. By providing a more specific measure of axonal/myelin loss, RSI-derived ND may better reflect overall white matter burden in epilepsy.
Collapse
Affiliation(s)
- Richard Q Loi
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A
| | - Kelly M Leyden
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A
| | - Akshara Balachandra
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A
| | - Vedang Uttarwar
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A
| | - Donald J Hagler
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A.,Department of Radiology, University of California, San Diego, La Jolla, California, U.S.A
| | - Brianna M Paul
- Department of Neurology, University of California, San Francisco, California, U.S.A.,UCSF Comprehensive Epilepsy Center, University of California, San Francisco, California, U.S.A
| | - Anders M Dale
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A.,Department of Radiology, University of California, San Diego, La Jolla, California, U.S.A
| | - Nathan S White
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A.,Department of Radiology, University of California, San Diego, La Jolla, California, U.S.A
| | - Carrie R McDonald
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, California, U.S.A.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, U.S.A
| |
Collapse
|
15
|
Fine EM, Delis DC, Paul BM, Filoteo JV. Reduced verbal fluency for proper names in nondemented patients with Parkinson's disease: a quantitative and qualitative analysis. J Clin Exp Neuropsychol 2010; 33:226-33. [PMID: 20936559 DOI: 10.1080/13803395.2010.507185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There has been an increasing interest within neuropsychology in comparing verbal fluency for different grammatical classes (e.g., verb generation vs. noun generation) in neurological populations, including Parkinson's disease (PD). However, to our knowledge, few studies have compared verbal fluency for common nouns and proper names in PD. Common nouns and proper names differ in terms of their semantic characteristics, as categories of common nouns are organized hierarchically based on semantics, while categories of proper nouns lack a well-defined semantic organization. In addition, there is accumulating evidence that the retrieval of these distinct grammatical classes are subserved by somewhat distinct neural systems. Given that verbal fluency deficits are among the first impairments to emerge in PD, and that such deficits are predictors of future cognitive decline, it is important to examine all aspects of verbal fluency in this population. For the current study, we compared the performance of a group of 32 nondemented PD patients with 32 healthy participants (HP) on verbal fluency tasks for common nouns (animals) and proper names (boys' first names). A significant interaction between verbal fluency task and diagnostic status emerged, as the PD group performed significantly worse on only the proper name fluency task. This finding may reflect the absence of well-defined semantic organization that structures the verbal search for first names, thus placing a greater onus on strategic or "executive" verbal retrieval processes.
Collapse
Affiliation(s)
- Eric M Fine
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
| | | | | | | |
Collapse
|
16
|
Paul BM, Snyder AZ, Haist F, Raichle ME, Bellugi U, Stiles J. Amygdala response to faces parallels social behavior in Williams syndrome. Soc Cogn Affect Neurosci 2009; 4:278-85. [PMID: 19633063 PMCID: PMC2728637 DOI: 10.1093/scan/nsp023] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 06/21/2009] [Indexed: 11/14/2022] Open
Abstract
Individuals with Williams syndrome (WS), a genetically determined disorder, show relatively strong face-processing abilities despite poor visuospatial skills and depressed intellectual function. Interestingly, beginning early in childhood they also show an unusually high level of interest in face-to-face social interaction. We employed functional magnetic resonance imaging (fMRI) to investigate physiological responses in face-sensitive brain regions, including ventral occipito-temporal cortex and the amygdala, in this unique genetic disorder. Participants included 17 individuals with WS, 17 age- and gender-matched healthy adults (chronological age-matched controls, CA) and 17 typically developing 8- to 9-year-old children (developmental age controls, DA). While engaged in a face discrimination task, WS participants failed to recruit the amygdala, unlike both CA and DA controls. WS fMRI responses in ventral occipito-temporal cortex, however, were comparable to those of DA controls. Given the integral role of the amygdala in social behavior, the failure of WS participants to recruit this region during face processing may be a neural correlate of the abnormally high sociability that characterizes this disorder.
Collapse
Affiliation(s)
- Brianna M Paul
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA.
| | | | | | | | | | | |
Collapse
|
17
|
Nair SB, Mukundan G, Paul BM, Ramachandran L, Gopinathan KK, Joseph S. Chromosome 12;15 rearrangements in patients with recurrent miscarriage. Indian J Hum Genet 2006. [DOI: 10.4103/0971-6866.29857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
18
|
Paul BM, Elvevåg B, Bokat CE, Weinberger DR, Goldberg TE. Levels of processing effects on recognition memory in patients with schizophrenia. Schizophr Res 2005; 74:101-10. [PMID: 15694759 DOI: 10.1016/j.schres.2004.05.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Revised: 05/11/2004] [Accepted: 05/12/2004] [Indexed: 10/26/2022]
Abstract
This study sought to characterize the performance of patients with schizophrenia, as compared with healthy participants, on a memory task that required encoding of items to different depths. Participants included 21 individuals with schizophrenia and 26 healthy controls. During the encoding phase of the study, participants processed successively presented words in two ways: perceptually (by making a decision as to whether the letter "a" was present in the word) or semantically (by making a living/nonliving decision for each word). During the recognition phase of the study, participants were presented with a list of words containing items that had been presented during the encoding phase (during either the letter decision task or the semantic decision task), as well as items that had not been seen before (foils). Though patients with schizophrenia performed more poorly overall on the recognition task, recognition was facilitated by semantic encoding to an equivalent degree in both groups. In other words, while significant main effects were present for group and encoding, no groupxencoding condition was present. This result is consistent with previous findings of a lack of qualitative differences in performance on learning and memory tasks between patients with schizophrenia and healthy controls. It also suggests that strategies that place constraints on the encoding processes used by patients may help improve the efficiency with which they learn and remember information.
Collapse
Affiliation(s)
- Brianna M Paul
- Clinical Brain Disorders Branch, National Institute of Mental Health, 10 Center Drive, MSC 1379, Bethesda MD 20892, USA
| | | | | | | | | |
Collapse
|
19
|
|
20
|
Abstract
Individuals with Williams syndrome (WMS) show an interesting dissociation of ability within the visuospatial domain, particularly between face perception and other visuospatial tasks. In this population, using tasks matched for stimuli, required response, and difficulty (for controls) is critical when comparing performance across these areas. We compared WMS individuals with a sample of typically developing 8- and 9-year-old children, and with a sample of adults, closer to the WMS participants in chronological age, in order to investigate performance across two precisely matched perceptual tasks, one assessing face processing and the other assessing proficiency in processing stimuli location. The pattern of performance seen in WMS, but not in controls, implicates a specific deficit of dorsal stream functioning in this syndrome.
Collapse
Affiliation(s)
- Brianna M Paul
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, USA
| | | | | | | | | |
Collapse
|