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Van Vrekhem T, Miatton M, Hemelsoet D, Van Hijfte L, Dekeyser C, De Zaeytijd J, Van Driessche V, Van Hoecke H, Maes L, Laureys G. Cognitive outcomes in Susac syndrome: A 2-year neuropsychological follow-up study. Eur J Neurol 2024; 31:e16186. [PMID: 38308420 DOI: 10.1111/ene.16186] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND AND PURPOSE Susac syndrome (SuS) is a rare, autoimmune, neurological disease characterized by a clinical triad of branch retinal artery occlusion, sensorineural hearing loss and encephalopathy. Neuropsychological functioning in SuS is little researched and the prevalence, nature, and evolution over time of cognitive deficits in SuS remain unclear. This study aimed to better understand the long-term neuropsychological outcomes of patients with SuS. METHODS Thirteen patients with SuS (mean [SD] age 39.5 [11.1] years) were enrolled at the Ghent University Hospital by their treating neurologist. The cognitive functioning and emotional well-being of each patient was evaluated by means of a thorough neuropsychological test battery at baseline and after 2 years. Follow-up testing after 2 years was performed in 11 patients (mean [SD] age 42.2 [11.5] years). RESULTS Patients showed normal neuropsychological test results at a group level, both at baseline and follow-up testing. Significant improvements over time were found for information processing speed, verbal recognition, and semantic and phonological fluency. Individual test results showed interindividual variability at baseline, with most impairments being in attention, executive functioning and language, which improved after a 2-year period. In addition, patients reported significantly lower mental and physical well-being, both at baseline and follow-up testing. CONCLUSIONS Our results suggest that neuropsychological dysfunction in SuS is limited at a group level and improves over time. Nonetheless, individual test results reveal interindividual variability, making cognitive screening essential. Furthermore, a high psycho-emotional burden of the disease was reported, for which screening and follow-up are necessary.
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Affiliation(s)
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Julie De Zaeytijd
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | | | - Helen Van Hoecke
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Leen Maes
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Guy Laureys
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
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Van Oeckel V, Poppe L, Deforche B, Brondeel R, Miatton M, Verloigne M. Associations of habitual sedentary time with executive functioning and short-term memory in 7th and 8th grade adolescents. BMC Public Health 2024; 24:495. [PMID: 38365719 PMCID: PMC10870470 DOI: 10.1186/s12889-024-18014-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND While there is increasing evidence for negative physical health consequences of high volumes of sedentary time and prolonged sedentary time in adolescents, the association with cognition is less clear. This study investigated the association of volumes of habitual sedentary time and prolonged sedentary time with executive functions and short-term memory in adolescents. METHODS This study has a cross-sectional observational study design. Volumes of sedentary time and prolonged sedentary time (accumulated sedentary time spent in bouts of ≥ 30 min) were measured using the Axivity AX3 accelerometer. Six cognitive functions (spatial and verbal short-term memory; and working memory, visuospatial working memory, response inhibition and planning as executive functions) were measured using six validated cognitive assessments. Data were analysed using generalised linear models. RESULTS Data of 119 adolescents were analysed (49% boys, 13.4 ± 0.6 year). No evidence for an association of volumes of sedentary time and prolonged sedentary time with spatial and verbal short-term memory, working memory, and visuospatial working memory was found. Volumes of sedentary time and prolonged sedentary time were significantly related to planning. One hour more sedentary time or prolonged sedentary time per day was associated with respectively on average 17.7% (95% C.I.: 3.5-29.7%) and 12.1% (95% C.I.: 3.9-19.6%) lower scores on the planning task. CONCLUSIONS No evidence was found for an association of volumes of habitual sedentary time and prolonged sedentary time with short-term memory and executive functions, except for planning. Furthermore, the context of sedentary activities could be an important confounder in the association of sedentary time and prolonged sedentary time with cognition among adolescents. Future research should therefore collect data on the context of sedentary activities. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov in January 2020 (NCT04327414; released on March 11, 2020).
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Affiliation(s)
- Veerle Van Oeckel
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Louise Poppe
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Ruben Brondeel
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Department of Head and Skin, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Criel Y, Boon C, Depuydt E, Stalpaert J, Huysman E, Miatton M, Santens P, van Mierlo P, De Letter M. Aging and sex effects on phoneme perception: An exploratory mismatch negativity and P300 investigation. Int J Psychophysiol 2023:S0167-8760(23)00451-8. [PMID: 37301445 DOI: 10.1016/j.ijpsycho.2023.06.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND & AIMS The mismatch negativity (MMN) and P300 event-related potentials (ERPs) have been studied in relation to phoneme discrimination and categorization, respectively. Although the effects of aging and sex on pure-tone perception have been widely investigated using these ERPs, evidence relating to phoneme perception is scarce. The current study aimed to provide insight into the effects of aging and sex on phoneme discrimination and categorization, as measured through the MMN and P300. METHOD An inattentive and attentive oddball paradigm containing a phonemic articulation place contrast were administered during EEG registration in sixty healthy individuals (thirty males and females), of which an equal number of young (20-39 years), middle-aged (40-59 years) and elderly (60+ years) subjects were included. The amplitude, onset latency and topographical distribution of the MMN and P300 effect, as well as the amplitude of the P1-N1-P2 complex were, analyzed for age group and sex differences. RESULTS With respect to aging, elderly subjects demonstrated a reduced MMN and P300 amplitude compared to the young group, whereas the scalp distribution of both components was unaffected. No aging effects on the P1-N1-P2 complex were found. In elderly individuals, the P300 was found to be delayed compared to the young group, while no such effect on MMN latency could be observed. No differences in MMN and P300 measures could be observed between males and females. CONCLUSION Differential effects of aging were found on the MMN and P300, specifically in terms of latency, in relation to phoneme perception. In contrast, sex was found to scarcely affect both processes.
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Affiliation(s)
- Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Claire Boon
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Emma Depuydt
- Medical Imaging and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Eline Huysman
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Pieter van Mierlo
- Medical Imaging and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Dekeyser C, Vanhoorne A, Hemelsoet D, Van Hijfte L, De Zaeytijd J, Van Driessche V, Van Hoecke H, Miatton M, Van Vrekhem T, Maes L, Laureys G. Atypical clinical and novel radiological findings in Susac syndrome: Experience from a large monocentric cohort. J Neuroimmunol 2023; 376:578032. [PMID: 36736020 DOI: 10.1016/j.jneuroim.2023.578032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/03/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
Susac syndrome (SuS) is a rare immune-mediated endotheliopathy that affects the brain, retina and inner ear and is characterised by the variable clinical triad of encephalopathy, visual and vestibulocochlear dysfunction. Here, we present clinical and paraclinical data of 19 SuS patients followed at Ghent University Hospital and highlight some atypical clinical and novel radiological findings. Our findings suggest that spinal involvement expands the clinical phenotype of SuS. We further introduce dark blood sequences as a more sensitive technique to detect radiological disease activity in SuS. Our data add to the current understanding of the diagnosis, monitoring and treatment of SuS.
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Affiliation(s)
- Cathérine Dekeyser
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Alexander Vanhoorne
- Department of Neurology, AZ Groeninge, President Kennedylaan 4, Kortrijk, Belgium.
| | - Dimitri Hemelsoet
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Liesbeth Van Hijfte
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Julie De Zaeytijd
- Department of Ophthalmology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Veroniek Van Driessche
- Department of Radiology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Helen Van Hoecke
- Department of Otorhinolaryngology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Tineke Van Vrekhem
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Leen Maes
- Department of Otorhinolaryngology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium; Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, Ghent, Belgium.
| | - Guy Laureys
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
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Carrette S, Boon P, Klooster D, Van Dycke A, Carrette E, Miatton M, Raedt R, Delbeke J, Meurs A, Vonck K. Continuous theta burst stimulation for drug-resistant epilepsy. Front Neurosci 2022; 16:885905. [PMID: 36061598 PMCID: PMC9433314 DOI: 10.3389/fnins.2022.885905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionRepetitive transcranial magnetic stimulation (rTMS) may have anti-epileptic effects, especially in patients with neocortical lesions. Initial clinical trials demonstrated that the duration of the seizure reducing effect is relatively short-lived. In the context of a chronic condition like epilepsy, theta burst stimulation (TBS) may represent a potential solution in optimizing treatment practicality and durability as it was demonstrated to be associated with longer-lasting after-effects. TBS has been studied extensively in diverse neuropsychiatric conditions, but a therapeutic TBS protocol has not previously been applied in epilepsy patients.Materials and methodsWe performed a prospective open-label pilot study of 4-day accelerated continuous TBS (cTBS) treatment in patients with neocortical drug-resistant epilepsy (DRE). A treatment session consisted of 5 cTBS trains, each comprising 600 pulses presented in 50 Hz triplet bursts every 200 ms, delivered at 10-min intertrain-intervals, targeted over the epileptic focus (EF) using a neuronavigation-guided figure-of-8 coil. Safety and feasibility, and seizure frequency were assessed as primary and secondary endpoints, respectively, over a 4-week baseline period, a 1-week treatment period and a 7-week follow-up period, using adverse event logging, electro-encephalography, cognitive, and psychological questionnaires and a seizure diary kept by the patients and/or caregivers.ResultsSeven subjects (4M:3F; median age 48, interquartile ranges 25) underwent the treatment protocol. Adverse events were reported in all subjects but were mild and transient. No clinical or electrographic seizures were evoked during or immediately following stimulation. No deterioration was found in cognition nor in psycho-emotional well-being following treatment. Treatment burden was acceptable, but seems to depend on clinical effect, duration of ongoing effect and stimulation site. Median weekly seizure frequency and ratio of seizure-free weeks did not change significantly in this small patient cohort.ConclusionWe report the results of the first ever trial of cTBS as a treatment for neocortical DRE. A 4-day accelerated cTBS protocol over the EF appears safe and feasible. Although the design and sample size of this open-label pilot study is unfit to reliably identify a therapeutic effect, results encourage further exploration of cTBS as an anti-epileptic treatment and potential optimization compared to conventional rTMS in a dedicated randomized controlled trial. (clinicaltrials.gov: NCT02635633).
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Affiliation(s)
- Sofie Carrette
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
- *Correspondence: Sofie Carrette,
| | - Paul Boon
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Debby Klooster
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | | | - Evelien Carrette
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marijke Miatton
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Robrecht Raedt
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Jean Delbeke
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Alfred Meurs
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Kristl Vonck
- Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
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Huygelier H, Schraepen B, Miatton M, Welkenhuyzen L, Michiels K, Note E, Lafosse C, Thielen H, Lemmens R, Bruffaerts R, Demeyere N, Gillebert CR. The Dutch Oxford Cognitive Screen (OCS-NL): psychometric properties in Flemish stroke survivors. Neurol Sci 2022; 43:6349-6358. [DOI: 10.1007/s10072-022-06314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
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Stalpaert J, Standaert S, D’Helft L, Miatton M, Sieben A, Van Langenhove T, Duyck W, van Mierlo P, De Letter M. Therapy-Induced Electrophysiological Changes in Primary Progressive Aphasia: A Preliminary Study. Front Hum Neurosci 2022; 16:766866. [PMID: 35431838 PMCID: PMC9008202 DOI: 10.3389/fnhum.2022.766866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
AimsThis preliminary study aimed to investigate therapy-induced electrophysiological changes in persons with primary progressive aphasia (PPA). The investigated event-related potential (ERP) components associated with language processing were the mismatch negativity, P300, N400, and P600.MethodsA linguistic ERP test battery and standardized language assessment were administered in four patients with PPA of which two received speech-language therapy (SLT) and two did not receive therapy. The battery was administered twice with approximately 6 months in between in each patient. The results of the follow-up assessments were compared to the results of the initial assessments.ResultsAlthough the results of the behavioral language assessment remained relatively stable between the initial and follow-up assessments, changes in the mean amplitudes, onset latencies, and duration of the ERP components were found in the four patients. In the two patients that did not receive SLT, an increased delay in 50% and a decreased mean amplitude in 25% of the measured ERP components were found. The electrophysiological changes found in the patients that received SLT were variable. Interestingly, the mismatch negativity and the N400 effect elicited by the categorical priming paradigm were less delayed and had an increased mean amplitude at the follow-up assessment in the patient with the non-fluent variant who received SLT. In this patient, the P600 component was absent at the initial assessment but present at the follow-up assessment.ConclusionAlthough no clear patterns in electrophysiological changes between patients who received SLT and patients who did not receive SLT were found by our preliminary study, it seems like the SLT induced improvements or compensation mechanisms in some specific language comprehension processes in the patient with the NFV. The results of this study are still preliminary because only four heterogeneous patients were included. Future studies should include larger patient groups of the three clinical variants because the therapy-induced electrophysiological changes might differ depending on the clinical variant and the underlying pathology.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- *Correspondence: Jara Stalpaert,
| | | | - Lien D’Helft
- Logopediepraktijk Bieke Van Waeyenberghe, Lievegem, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Anne Sieben
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Wouter Duyck
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Mertens A, Gadeyne S, Lescrauwaet E, Carrette E, Meurs A, De Herdt V, Dewaele F, Raedt R, Miatton M, Boon P, Vonck K. The potential of invasive and non-invasive vagus nerve stimulation to improve verbal memory performance in epilepsy patients. Sci Rep 2022; 12:1984. [PMID: 35132096 PMCID: PMC8821667 DOI: 10.1038/s41598-022-05842-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/11/2022] [Indexed: 12/30/2022] Open
Abstract
It has been demonstrated that acute vagus nerve stimulation (VNS) improves word recognition memory in epilepsy patients. Transcutaneous auricular vagus nerve stimulation (taVNS) has gained interest as a non-invasive alternative to improve cognition. In this prospective randomized cross-over study, we investigated the effect of both invasive VNS and taVNS on verbal memory performance in 15 patients with drug-resistant epilepsy. All patients conducted a word recognition memory paradigm in 3 conditions: VNS ON, VNS OFF and taVNS (3-period 3-treatment cross-over study design). For each condition, patients memorized 21 highlighted words from text paragraphs. Afterwards, the intervention was delivered for 30 s. Immediate recall and delayed recognition scores were obtained for each condition. This memory paradigm was repeated after 6 weeks of VNS therapy in 2 conditions: VNS ON and VNS OFF (2-period 2-treatment cross-over study design). Acute VNS and taVNS did not improve verbal memory performance. Immediate recall and delayed recognition scores were significantly improved after 6 weeks of VNS treatment irrespective of the acute intervention. We can conclude that the previously described positive effects of invasive VNS on verbal memory performance could not be replicated with invasive VNS and taVNS. An improved verbal memory performance was seen after 6 weeks of VNS treatment, suggesting that longer and more repetitive stimulation of the vagal pathway is required to modulate verbal memory performance.Clinical trial registration number: NCT05031208.
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Affiliation(s)
- Ann Mertens
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium.
| | - Stefanie Gadeyne
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Emma Lescrauwaet
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Evelien Carrette
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Alfred Meurs
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Veerle De Herdt
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Frank Dewaele
- Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium
| | - Robrecht Raedt
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Marijke Miatton
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
| | - Paul Boon
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Kristl Vonck
- Department of Neurology, 4BRAIN Research Group, Ghent University Hospital, 9000, Ghent, Belgium
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Stalpaert J, Cocquyt EM, Miatton M, Sieben A, Van Langenhove T, van Mierlo P, De Letter M. A case series of verbal semantic processing in primary progressive aphasia: Evidence from the N400 effect. Int J Lang Commun Disord 2021; 56:1165-1189. [PMID: 34357662 DOI: 10.1111/1460-6984.12658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The semantic variant of primary progressive aphasia (PPA) is typically associated with a loss of semantic knowledge. Research on the semantic processing in the other clinical variants of PPA is, however, rather sparse and limited to off-line behavioural studies. AIMS This study aimed to investigate verbal semantic processing in patients with the three variants of PPA by the event-related potential technique. The presence, latency, amplitude and/or topographic distribution of the N400 effect may be helpful in the diagnosis of PPA and its clinical variants and it provides temporal information about semantic processing (disturbances) in the three variants of PPA. METHODS & PROCEDURES The N400 effect was studied by a categorical word-priming paradigm and a semantic-anomaly paradigm at sentence level in eight persons with PPA(-plus) and 30 age-matched healthy controls. The mean amplitudes and onset latencies of the N400 effect were compared between each patient and the control group by two methods that are applicable in clinical practice, namely visual inspection and Z-scores. OUTCOMES & RESULTS The N400 effect elicited by the categorical-priming paradigm was only present in the two patients with the non-fluent variant of PPA. This effect was absent in the two patients with the semantic variant(-plus), two patients with the logopenic variant(-plus), one patient with the non-fluent variant-plus, and the patient with PPA not otherwise specified. The results of the N400 effect elicited by the semantic-anomaly task at the sentence level were variable, but differences in the presence, mean amplitudes, onset latencies and/or topographic distributions of the effect were found in all patients with PPA(-plus) in comparison with the control group. CONCLUSIONS & IMPLICATIONS The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. Furthermore, our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context in patients with the three variants of PPA. These findings might help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant. WHAT THIS PAPER ADDS What is already known on the subject The semantic variant of PPA is characterized by an impaired object knowledge and single-word comprehension and these functions are relatively spared in the non-fluent and logopenic variants following the guidelines of Gorno-Tempini et al. (2011). Research on the semantic processing in patients with the non-fluent and logopenic variant is, however, rather sparse and limited to off-line behavioural studies. Only four group studies investigated verbal semantic processing by the N400 effect, and these studies indicate disturbances in the three variants of PPA. What this paper adds to existing knowledge Our results indicate the presence of difficulties with retrieving stored semantic knowledge or semantic integration of a word in the preceding context during a semantic-priming paradigm in patients with the semantic and logopenic variants of PPA and during a semantic-anomaly task at the sentence level in patients with the three variants of PPA. What are the potential or actual clinical implications of this work? The results of our study showed that the evaluation of the N400 effect might have an added value in the diagnostic process of PPA in general and in the differentiation of patients with the non-fluent variant from patients with the logopenic and semantic variants. The evaluation of the N400 effect might also help the speech-language pathologist in determining individualized therapy goals and indicate that it might be helpful to focus on verbal semantic processing in language therapy in patients with the three variants of PPA and not only in patients with the semantic variant.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Anne Sieben
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Kestens K, Degeest S, Miatton M, Keppler H. Visual and Verbal Working Memory and Processing Speed Across the Adult Lifespan: The Effect of Age, Sex, Educational Level, Awakeness, and Hearing Sensitivity. Front Psychol 2021; 12:668828. [PMID: 34721133 PMCID: PMC8551836 DOI: 10.3389/fpsyg.2021.668828] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To strengthen future methodological choices regarding the measurement of cognition within the field of audiology, the current study aimed to examine the effect of, among other things, hearing sensitivity on the backward corsi tapping task (i.e., visual working memory and processing speed) and the letter-number sequencing task (i.e., verbal working memory and processing speed). Design and Study Sample: The backward corsi tapping task and the letter-number sequencing task were administered to 184 participants, aged between 18 and 69 years. The effect of age, sex, educational level, awakeness, and hearing sensitivity on verbal and visual working memory and processing speed was assessed using stepwise multiple regression analyses. Results: For all outcome variables, a decrease in performance was observed with increasing age. For visual and verbal working memory, males outperformed females, whereas no clear sex effect was observed for visual and verbal processing speed. Hearing sensitivity had only a significant impact on visual processing speed. Conclusion: The importance to evaluate cognitive construct validity within audiological research was highlighted. Further research should focus on investigating the associations between speech understanding on the one hand and the backward corsi tapping task and letter-number sequencing task on the other hand.
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Affiliation(s)
- Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium
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11
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Kestens K, Degeest S, Miatton M, Keppler H. An Auditory Stroop Test to Implement in Cognitive Hearing Sciences: Development and Normative Data. Int J Psychol Res (Medellin) 2021; 14:37-51. [PMID: 35096355 PMCID: PMC8794330 DOI: 10.21500/20112084.5118] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/17/2021] [Accepted: 04/13/2021] [Indexed: 12/22/2022] Open
Abstract
Objective: This study developed and gained insight in an auditory Stroop test, implementable in cognitive hearing sciences. Methods: An auditory Stroop test was developed and performed in 178 participants, aged between 18 and 69 years. This Auditory Stroop test consisted of two tests: Stroop-tones and Stroop-words whereby the pitch of pure-tones and spoken words (i.e., the words high and low) had to be identified by high or low, respectively. An interference score was calculated as a measure of verbal executive functioning. Regression models were conducted to examine the effect of age, sex, education, awakeness, hearing, as well as visual and verbal working memory, and processing speed on the auditory Stroop scores. Normative data were obtained per age decade. Results: Compared to the visual counterparts, the auditory Stroop outcomes were better predicted by verbal working memory and processing speed. A trend was observed showing a decrease in performances with increasing age. No other participant-related variables had a significant relationship with the auditory Stroop test. Conclusion: This auditory Stroop test was considered a good test for measuring executive functioning using auditory stimuli. Implementing this auditory Stroop test within cognitive hearing sciences will contribute to unravel the auditory-cognitive perspective of speech understanding.
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Affiliation(s)
- Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium. Ghent University Ghent Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium. Ghent University Ghent Belgium
| | - Marijke Miatton
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium. Ghent University Ghent Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium. Ghent University Ghent Belgium.,Department of Oto-rhino-laryngology, Ghent University Hospital, Ghent, Belgium. Ghent University Hospital Ghent Belgium
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12
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Stalpaert J, Miatton M, Sieben A, Van Langenhove T, van Mierlo P, De Letter M. The Electrophysiological Correlates of Phoneme Perception in Primary Progressive Aphasia: A Preliminary Case Series. Front Hum Neurosci 2021; 15:618549. [PMID: 34149376 PMCID: PMC8206281 DOI: 10.3389/fnhum.2021.618549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/30/2021] [Indexed: 12/03/2022] Open
Abstract
Aims: This study aimed to investigate phoneme perception in patients with primary progressive aphasia (PPA) by using the event-related potential (ERP) technique. These ERP components might contribute to the diagnostic process of PPA and its clinical variants (NFV: nonfluent variant, SV: semantic variant, LV: logopenic variant) and reveal insights about phoneme perception processes in these patients. Method: Phoneme discrimination and categorization processes were investigated by the mismatch negativity (MMN) and P300 in eight persons with early- and late-stage PPA (3 NFV, 2 LV, 2 SV, and 1 PPA-NOS; not otherwise specified) and 30 age-matched healthy adults. The mean amplitude, the onset latency, and the topographic distribution of both components in each patient were compared to the results of the control group. Results: The MMN was absent or the onset latency of the MMN was delayed in the patients with the NFV, LV, and PPA-NOS in comparison to the control group. In contrast, no differences in mean amplitudes and onset latencies of the MMN were found between the patients with the SV and the control group. Concerning the P300, variable results were found in the patients with the NFV, SV, and PPA-NOS, but the P300 of both patients with the LV was delayed and prolonged with increased mean amplitude in comparison to the control group. Conclusion: In this preliminary study, phoneme discrimination deficits were found in the patients with the NFV and LV, and variable deficits in phoneme categorization processes were found in all patients with PPA. In clinical practice, the MMN might be valuable to differentiate the SV from the NFV and the LV and the P300 to differentiate the LV from the NFV and the SV. Further research in larger and independent patient groups is required to investigate the applicability of these components in the diagnostic process and to determine the nature of these speech perception deficits in the clinical variants of PPA.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Anne Sieben
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Pieter van Mierlo
- Department of Electronics and Information Systems, Medical Image and Signal Processing Group, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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13
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Loret G, Miatton M, Vingerhoets G, Poppe B, Hemelsoet D. A long-term neuropsychological evaluation in Fabry disease. Acta Neurol Belg 2021; 121:191-197. [PMID: 32915382 DOI: 10.1007/s13760-020-01484-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/24/2020] [Indexed: 02/02/2023]
Abstract
Fabry disease (FD) is a X-linked multi-systemic metabolic disorder with mainly renal, cardiac and neurological dysfunction. The neuropsychological impact is still unclear, with previous study results ranging from disturbance of speed of information processing and executive functions to a normal cognitive profile. The aim of our study was to gain further insight into the neuropsychological involvement of FD. Patients with genetically proven FD were enrolled at the Ghent University Hospital by their treating neurologist. We evaluated the cognitive status of each patient by a thorough neuropsychological test battery and these exact same neuropsychological assessments were repeated after a follow-up period of 2-4 years and at a second follow-up moment 1-4 years after the first follow-up. Thirteen patients with FD were included (8 female) with mean age of 41.5 years (SD ± 13.9) at baseline. All patients had normal neuropsychological test results on the subtests included in the cognitive battery at baseline, according to age-, gender- and education matched normative data. At the first follow-up moment (2-4 years after baseline), six patients were included (3 male), mean age 45.3 years. At the second follow-up (1-4 years after first follow-up), four patients (2 male) were included, with mean age 45 years. Both at the first and second follow-up moments, all patients obtained normal scores on the subtests. The cognitive functioning appeared to be in the normal range at baseline and did not decline over a follow-up period of 3-8 years, suggesting that cognition in FD patients may be well-preserved in time.
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14
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Stalpaert J, Cocquyt EM, Criel Y, Segers L, Miatton M, Van Langenhove T, van Mierlo P, De Letter M. Language and Speech Markers of Primary Progressive Aphasia: A Systematic Review. Am J Speech Lang Pathol 2020; 29:2206-2225. [PMID: 32810414 DOI: 10.1044/2020_ajslp-20-00008] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This systematic review aimed to establish language and speech markers to support the clinical diagnosis of primary progressive aphasia (PPA) and its clinical phenotypes. Our first objective was to identify behavioral language and speech markers of early-stage PPA. Our second objective was to identify the electrophysiological correlates of the language and speech characteristics in PPA. Method The databases MEDLINE, Web of Science, and Embase were searched for relevant articles. To identify behavioral markers, the initial subjective complaints and the language and speech deficits detected during the initial diagnostic evaluation were summarized for PPA in general and each clinical variant according to the 2011 consensus diagnostic criteria (nonfluent variant [NFV], semantic variant, and logopenic variant [LV]). To identify electrophysiological markers, the studies in which event-related potentials (ERPs) were elicited by a language or speech paradigm in patients with PPA were included. Results In total, 114 relevant studies were identified, including 110 behavioral studies and only four electrophysiological studies. This review suggests that patients with the semantic variant could be accurately differentiated from the NFV and LV in the initial stages based on the consensus criteria. Nonetheless, the early differentiation between the NFV and LV is not straightforward. In the four electrophysiological studies, differences in the latency, amplitude, and topographical distribution of the semantic N400 component were found between patients with PPA and healthy controls. Conclusions To accurately differentiate the NFV from the LV, it could be important to assess the language and speech degeneration by more specific assessments and by more objective diagnostic methods that offer insights into the language-related processes. Electrophysiological markers of PPA were not identified in this review due to the low number of studies that investigated language-related ERPs. More controlled ERP studies in larger patient cohorts are needed to investigate the diagnostic applicability of language-related ERPs in PPA. Supplemental Material https://doi.org/10.23641/asha.12798080.
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Affiliation(s)
- Jara Stalpaert
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | - Yana Criel
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Lieselot Segers
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | | | | | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Department of Electronics and Information Systems, Ghent University, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Belgium
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15
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Mertens A, Naert L, Miatton M, Poppa T, Carrette E, Gadeyne S, Raedt R, Boon P, Vonck K. Transcutaneous Vagus Nerve Stimulation Does Not Affect Verbal Memory Performance in Healthy Volunteers. Front Psychol 2020; 11:551. [PMID: 32351421 PMCID: PMC7174665 DOI: 10.3389/fpsyg.2020.00551] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/09/2020] [Indexed: 01/05/2023] Open
Abstract
Introduction Invasive vagus nerve stimulation (VNS) improves word recognition memory in patients with epilepsy. Recent studies with transcutaneous VNS (tVNS) have also shown positive effects on various subdomains of cognitive functioning in healthy volunteers. In this randomized, controlled, crossover study, we investigated the effect of tVNS on a word recognition memory paradigm in healthy volunteers to further investigate the potential of tVNS in the treatment of cognitive disorders. Methods We included 41 healthy participants aged between 18 and 30 years (young age group) and 24 healthy participants aged between 45 and 80 years (older age group). Each participant completed a word recognition memory paradigm during three different conditions: true tVNS, sham, and control. During true tVNS, stimulation was delivered at the cymba conchae. Sham stimulation was delivered by stimulating the earlobe. In the control condition, no stimulation was given. In each condition, participants were asked to remember highlighted words from three test paragraphs. Accuracy scores were calculated for immediate recall after each test paragraph and for delayed recognition at the end of the paradigm. We hypothesized that highlighted words from paragraphs in the true tVNS condition would be more accurately recalled and/or recognized compared to highlighted words from paragraphs in the sham or control condition. Results In this randomized study, tVNS did not affect the accuracy scores for immediate recall or delayed recognition in both age groups. The younger group showed significantly higher accuracy scores than the older group. The accuracy scores improved over time, and the most recently learned words were better recognized. Participants rated true tVNS as significantly more painful; however, pain was not found to affect accuracy scores. Conclusion In this study, tVNS did not affect verbal memory performance in healthy volunteers. Our results could not replicate the positive effects of invasive VNS on word recognition memory in epilepsy patients. Future research with the aim of improving cognitive function should focus on the rational identification of optimized and individualized stimulation settings primarily in patients with cognitive deficits.
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Affiliation(s)
- Ann Mertens
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Lien Naert
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Tasha Poppa
- Ghent Experimental Psychiatry (GHEP) Lab, Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Evelien Carrette
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Stefanie Gadeyne
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Robrecht Raedt
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Paul Boon
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
| | - Kristl Vonck
- 4Brain, Department of Neurology, Institute for Neuroscience, Ghent University Hospital, Ghent, Belgium
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16
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Santens P, Vanschoenbeek G, Miatton M, De Letter M. The moral brain and moral behaviour in patients with Parkinson's disease: a review of the literature. Acta Neurol Belg 2018; 118:387-393. [PMID: 30014443 DOI: 10.1007/s13760-018-0986-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 07/11/2018] [Indexed: 01/05/2023]
Abstract
Morality is a complex and versatile concept that necessitates the integrated activity of multiple interacting networks in the brain. Numerous cortical and subcortical areas, many of which are implicated in either emotional and cognitive control or Theory of Mind, are involved in the processing of moral behaviour. Different methods have been used to investigate various aspects of morality, which has lead to confusing and sometimes opposing results. Emotional, cognitive and personality changes have long been recognized in Parkinson's disease (PD) patients, suggesting a potential impact on moral aspects of behaviour in daily living situations. Alterations in social cognition have been described in all stages of PD but these are rather directly related to PD pathology and not to dopaminergic or DBS treatment. There are no convincing data supporting the hypothesis that dopaminergic treatment or deep brain stimulation of the STN per se interfere with morality in PD patients, although subgroups of patients may display socially unacceptable behaviour. Research in social cognition in PD patients is a fascinating topic that needs further attention in view of the impact on quality of life for PD patients and their caregivers.
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Affiliation(s)
- Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, 13K12, 9000, Ghent, Belgium.
| | - Giel Vanschoenbeek
- Department of Neurology, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, 13K12, 9000, Ghent, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10, 13K12, 9000, Ghent, Belgium
| | - Miet De Letter
- Department of Speech, Language and Hearing Sciences, Ghent University, Corneel Heymanslaan 10, 2P1, 9000, Ghent, Belgium
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17
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Sieben A, Van Mossevelde S, Wauters E, Engelborghs S, van der Zee J, Van Langenhove T, Santens P, Praet M, Boon P, Miatton M, Van Hoecke S, Vandenbulcke M, Vandenberghe R, Cras P, Cruts M, De Deyn PP, Van Broeckhoven C, Martin JJ. Extended FTLD pedigree segregating a Belgian GRN-null mutation: neuropathological heterogeneity in one family. Alzheimers Res Ther 2018; 10:7. [PMID: 29370838 PMCID: PMC6389176 DOI: 10.1186/s13195-017-0334-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND In this paper, we describe the clinical and neuropathological findings of nine members of the Belgian progranulin gene (GRN) founder family. In this family, the loss-of-function mutation IVS1 + 5G > C was identified in 2006. In 2007, a clinical description of the mutation carriers was published that revealed the clinical heterogeneity among IVS1 + 5G > C carriers. We report our comparison of our data with the published clinical and neuropathological characteristics of other GRN mutations as well as other frontotemporal lobar degeneration (FTLD) syndromes, and we present a review of the literature. METHODS For each case, standardized sampling and staining were performed to identify proteinopathies, cerebrovascular disease, and hippocampal sclerosis. RESULTS The neuropathological substrate in the studied family was compatible in all cases with transactive response DNA-binding protein (TDP) proteinopathy type A, as expected. Additionally, most of the cases presented also with primary age-related tauopathy (PART) or mild Alzheimer's disease (AD) neuropathological changes, and one case had extensive Lewy body pathology. An additional finding was the presence of cerebral small vessel changes in every patient in this family. CONCLUSIONS Our data show not only that the IVS1 + 5G > C mutation has an exclusive association with FTLD-TDP type A proteinopathy but also that other proteinopathies can occur and should be looked for. Because the penetrance rate of the clinical phenotype of carriers of GRN mutations is age-dependent, further research is required to investigate the role of co-occurring age-related pathologies such as AD, PART, and cerebral small vessel disease.
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Affiliation(s)
- Anne Sieben
- Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior, University of Antwerp, Universiteitsplein 1, B-2160, Antwerp, Belgium.,Department of Neurology, Ghent University Hospital, Ghent, Belgium.,Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium
| | - Sara Van Mossevelde
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Netwerk Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.,Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| | - Eline Wauters
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Sebastiaan Engelborghs
- Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior, University of Antwerp, Universiteitsplein 1, B-2160, Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Netwerk Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Julie van der Zee
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Tim Van Langenhove
- Department of Neurology, Ghent University Hospital, Ghent, Belgium.,Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Marleen Praet
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Paul Boon
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Marijke Miatton
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Sofie Van Hoecke
- Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Old Age Psychiatry and Memory Clinic, University Hospitals Leuven, Leuven, Belgium
| | - Rik Vandenberghe
- Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Cras
- Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior, University of Antwerp, Universiteitsplein 1, B-2160, Antwerp, Belgium.,Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| | - Marc Cruts
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium.,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Peter Paul De Deyn
- Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior, University of Antwerp, Universiteitsplein 1, B-2160, Antwerp, Belgium.,Department of Neurology and Memory Clinic, Hospital Netwerk Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.,Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Center for Molecular Neurology, VIB , Universiteitsplein 1, B-2610, Antwerp, Belgium. .,Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
| | - Jean-Jacques Martin
- Institute Born-Bunge, Neuropathology and Laboratory of Neurochemistry and Behavior, University of Antwerp, Universiteitsplein 1, B-2160, Antwerp, Belgium.
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18
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Vogt VL, Äikiä M, Del Barrio A, Boon P, Borbély C, Bran E, Braun K, Carette E, Clark M, Cross JH, Dimova P, Fabo D, Foroglou N, Francione S, Gersamia A, Gil-Nagel A, Guekht A, Harrison S, Hecimovic H, Heminghyt E, Hirsch E, Javurkova A, Kälviäinen R, Kavan N, Kelemen A, Kimiskidis VK, Kirschner M, Kleitz C, Kobulashvili T, Kosmidis MH, Kurtish SY, Lesourd M, Ljunggren S, Lossius MI, Malmgren K, Mameniskiené R, Martin-Sanfilippo P, Marusic P, Miatton M, Özkara Ç, Pelle F, Rubboli G, Rudebeck S, Ryvlin P, van Schooneveld M, Schmid E, Schmidt PM, Seeck M, Steinhoff BJ, Shavel-Jessop S, Tarta-Arsene O, Trinka E, Viggedal G, Wendling AS, Witt JA, Helmstaedter C. Current standards of neuropsychological assessment in epilepsy surgery centers across Europe. Epilepsia 2017; 58:343-355. [PMID: 28067423 DOI: 10.1111/epi.13646] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
Abstract
We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.
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Affiliation(s)
- Viola Lara Vogt
- Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany
| | - Marja Äikiä
- Epilepsy Center/Neurocenter, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Antonio Del Barrio
- Department of Neurology, Epilepsy Program, Hospital Ruber International, Madrid, Spain
| | - Paul Boon
- Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium
| | - Csaba Borbély
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Ema Bran
- Department of Clinical Neurosciences, Pediatric Neurology Clinic, Carol Davila University of Medicine, Bucharest, Romania.,Alexandu Obregia Clinical Psychiatric Hospital, Pediatric Neurology Clinic, Bucharest, Romania
| | - Kees Braun
- Department of Child Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Evelien Carette
- Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium
| | - Maria Clark
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Judith Helen Cross
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Petia Dimova
- Clinic of Child Neurology, St Naum University Hospital of Neurology and Psychiatry, Sofia, Bulgaria
| | - Daniel Fabo
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | | | - Stefano Francione
- Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Anna Gersamia
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.,Department of Neurology and Neurosurgery of the Russian National Research Medical University, Moscow, Russia
| | - Antonio Gil-Nagel
- Department of Neurology, Epilepsy Program, Hospital Ruber International, Madrid, Spain
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.,Department of Neurology and Neurosurgery of the Russian National Research Medical University, Moscow, Russia
| | - Sue Harrison
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Hrvoje Hecimovic
- Department of Neurology, Zagreb Epilepsy Center, University Hospital, Zagreb, Croatia
| | - Einar Heminghyt
- National Center for Epilepsy (SSE), Oslo University Hospital, Oslo, Norway
| | | | - Alena Javurkova
- 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic
| | | | - Nicole Kavan
- EEG & Epilepsy Unit, Hospital of Geneva & Functional Neurology and Neurosurgery Program, University Hospitals of Geneva and Lausanne, Geneva, Switzerland
| | - Anna Kelemen
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | | | - Margarita Kirschner
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Teia Kobulashvili
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Selin Yagci Kurtish
- Division of Clinical Electro-Neurophysiology, Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mathieu Lesourd
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland
| | - Sofia Ljunggren
- Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | | | - Kristina Malmgren
- Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ruta Mameniskiené
- Faculty of Medicine, Clinic of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania.,Department of Neurology, Vilnius University Hospital Santariškių klinikos, Vilnius, Lithuania
| | - Patricia Martin-Sanfilippo
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Petr Marusic
- 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Marijke Miatton
- Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium
| | - Çiğdem Özkara
- Division of Clinical Electro-Neurophysiology, Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Federica Pelle
- Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy
| | - Guido Rubboli
- Danish Epilepsy Center, Filadelfia/University of Copenhagen, EEMA (European Epilepsy Monitoring Unit Association), Dianalund, Denmark.,Epilepsy Institute, IDEE, Lyon, France
| | - Sarah Rudebeck
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.,Epilepsy Institute, IDEE, Lyon, France
| | - Monique van Schooneveld
- Department of Pediatric Psychology, Sector of Neuropsychology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Elisabeth Schmid
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Margitta Seeck
- EEG & Epilepsy Unit, Hospital of Geneva & Functional Neurology and Neurosurgery Program, University Hospitals of Geneva and Lausanne, Geneva, Switzerland
| | | | - Sara Shavel-Jessop
- University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom
| | - Oana Tarta-Arsene
- Department of Clinical Neurosciences, Pediatric Neurology Clinic, Carol Davila University of Medicine, Bucharest, Romania.,Alexandu Obregia Clinical Psychiatric Hospital, Pediatric Neurology Clinic, Bucharest, Romania
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gerd Viggedal
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Juri-Alexander Witt
- Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany
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Sarrechia I, Miatton M, De Wolf D, François K, Gewillig M, Meyns B, Vingerhoets G. Neurocognitive development and behaviour in school-aged children after surgery for univentricular or biventricular congenital heart disease. Eur J Cardiothorac Surg 2015; 49:167-74. [DOI: 10.1093/ejcts/ezv029] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/14/2015] [Indexed: 11/14/2022] Open
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Vonck K, Raedt R, Naulaerts J, De Vogelaere F, Thiery E, Van Roost D, Aldenkamp B, Miatton M, Boon P. Vagus nerve stimulation…25 years later! What do we know about the effects on cognition? Neurosci Biobehav Rev 2014; 45:63-71. [DOI: 10.1016/j.neubiorev.2014.05.005] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 05/02/2014] [Accepted: 05/13/2014] [Indexed: 01/09/2023]
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Sarrechia I, Miatton M, De Wolf D, François K, Vingerhoets G. Neurobehavioural functioning in school-aged children with a corrected septal heart defect. Acta Cardiol 2013; 68:23-30. [PMID: 23457906 DOI: 10.1080/ac.68.1.2959628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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
OBJECTIVE This cross-sectional study assesses neurobehavioural consequences after surgical treatment for acyanotic congenital heart defect at the age of 5 to 12 years. METHODS AND RESULTS Fifteen school-aged children who underwent surgical intervention for a septal heart defect were examined with the short form Wechsler Intelligence Scale for Children-third Edition, Dutch Version (WISC-III-NL), and a neuropsychological assessment with the Nepsy. Performances were compared to a matched healthy control group. Parents completed the Child Behaviour Checklist and were interviewed to rate the child's cognitive and emotional functioning. Children older than eight years filled out a self-perception questionnaire. Analyses revealed significant differences between the study groups on several cognitive and behavioural domains. Estimated intelligence scores were in the average range. Domains of attention and fine motor skills, and the subtest level of language abilities, elicited significant group differences, with less favourable outcomes for the patient group. Parents of patients reported more withdrawn behaviour, social difficulties, thought problems, attentional shortcomings and lower competence for activities. These parents also indicated poor problem solving skills in everyday activities. CONCLUSIONS Surgical patients displayed subtle neuropsychological difficulties concerning language and fine motor skills. Behavioural difficulties were common. Future research should address risk factors for adverse neurobehavioural manifestations in this patient group.
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Affiliation(s)
- Iemke Sarrechia
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- Head, Neck and Nerve System, Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Daniël De Wolf
- Paediatric Cardiology, Department of Paediatrics, Ghent University, Ghent, Belgium
| | - Katrien François
- Paediatric Cardiac Surgery, Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium
| | - Guy Vingerhoets
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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22
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Vonck K, Sprengers M, Carrette E, Dauwe I, Miatton M, Meurs A, Goossens L, DE Herdt V, Achten R, Thiery E, Raedt R, VAN Roost D, Boon P. A decade of experience with deep brain stimulation for patients with refractory medial temporal lobe epilepsy. Int J Neural Syst 2012; 23:1250034. [PMID: 23273130 DOI: 10.1142/s0129065712500347] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this study, we present long-term results from patients with medial temporal lobe (MTL) epilepsy treated with deep brain stimulation (DBS). Since 2001, 11 patients (8M) with refractory MTL epilepsy underwent MTL DBS. When unilateral DBS failed to decrease seizures by > 90%, a switch to bilateral MTL DBS was proposed. After a mean follow-up of 8.5 years (range: 67-120 months), 6/11 patients had a ≥ 90% seizure frequency reduction with 3/6 seizure-free for > 3 years; three patients had a 40%-70% reduction and two had a < 30% reduction. In 3/5 patients switching to bilateral DBS further improved outcome. Uni- or bilateral MTL DBS did not affect neuropsychological functioning. This open study with an extended long-term follow-up demonstrates maintained efficacy of DBS for MTL epilepsy. In more than half of the patients, a seizure frequency reduction of at least 90% was reached. Bilateral MTL DBS may herald superior efficacy in unilateral MTL epilepsy.
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Affiliation(s)
- Kristl Vonck
- Department of Neurology, Reference Center for Refractory Epilepsy, Gent, Belgium.
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Abstract
AIM To describe the parental view of the cognitive skills of their child with a surgically corrected congenital heart disease (CHD) and compare it to objectified cognitive measures in children with CHD 6-12 years postoperatively. METHODS Parents completed a questionnaire on several cognitive functions of their child. Children with CHD and healthy controls (n=86, aged 8 years 8 months +/- 1 year 6 months) underwent an abbreviated IQ-testing and a neurodevelopmental assessment. RESULTS Parents of the children with CHD more frequently indicated lower sustained attention (p<0.05), lower divided attention (p<0.001), more problems with memory and learning skills (p<0.05), and deficient gross motor functioning (p<0.01) compared to the parents of healthy controls. Intellectual and neuropsychological assessment revealed a lower estimated full-scale IQ (p<0.01), worse sensorimotor functioning (p<0.001), and lower performances on language (p<0.001), attention/executive functioning (p<0.05), and memory (p<0.05) in the CHD-group. Several items of the questionnaire were significant predictors for worse neurodevelopmental outcome. CONCLUSION Overall, the objective and subjective measures on cognitive functioning are in agreement and indicate the presence of neurocognitive deficits in children with CHD. This study endorses the accuracy and usefulness of a parental questionnaire to report on the cognitive functioning of the child and urges the investigation of neurocognitive functioning in children with CHD at follow-up.
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Affiliation(s)
- Marijke Miatton
- Laboratory for Neuropsychology, Department of Internal Medicine, Ghent University, Ghent, Belgium.
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Abstract
OBJECTIVE We sought to combine parental and child reports in order to describe the behavior, self-perception, and emotional profile of children with a surgically corrected congenital heart disease (CHD). METHODS Forty-three children with a surgically corrected CHD were selected and compared to an age- and sex-matched healthy group. The parents of the CHD children completed a behavior rating scale, the Child Behavior Checklist. Children 8 years and older (n = 23) completed a self-report questionnaire concerning perceived competence, their anxiety level, and feelings of depression. RESULTS Compared to parents of healthy children, those of CHD children report significantly lower school results (p < .01), more school problems in general (p < .01), and a higher percentage of their children repeated a school year (p < .01). They also reported more social (p < .01) and attention problems (p < .01) and more aggressive behavior (p < .05). On self-perception and state anxiety questionnaires, no significant differences were found between the patient group and the healthy group. On a depression scale, however, children with a surgically corrected CHD reported more depressive feelings than healthy controls (p < .01). CONCLUSION Parents of children with CHD rate their child's school competence to be weaker than healthy peers, they report more attention and social problems and more aggressive behavior. Children themselves did not report differences on perceived competence or anxiety but they do indicate more depressive symptoms than healthy peers.
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Affiliation(s)
- Marijke Miatton
- Laboratory for Neuropsychology, Department of Internal Medicine, Reference Centre for Refractory Epilepsy, Ghent University, Ghent, Belgium.
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Miatton M, De Wolf D, François K, Thiery E, Vingerhoets G. Neuropsychological performance in school-aged children with surgically corrected congenital heart disease. J Pediatr 2007; 151:73-8, 78.e1. [PMID: 17586194 DOI: 10.1016/j.jpeds.2007.02.020] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [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: 08/22/2006] [Revised: 12/21/2006] [Accepted: 02/05/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE As surgical management of children with congenital heart disease (CHD) advanced, developmental outcome became the main focus of contemporary research. In this study, we specify the cognitive profile of children with CHD, 6 to 12 years postoperatively. STUDY DESIGN Patients with CHD (n = 43, mean age 8 years, 8 months) and healthy controls (n = 43, mean age 8 years, 11 months), were examined with an abbreviated intelligence scale (Wechsler Intelligence Scale for Children-3rd edition, Dutch version) and a developmental neuropsychological assessment battery (NEPSY [a developmental NEuroPSYchological assessment]). RESULTS We identified significantly lower scores for the CHD group on Estimated Full Scale IQ (P < .01). Neuropsychological assessment revealed lower scores for the CHD group on the cognitive domains of Sensorimotor Functioning (P < .001), Language (P < .001), Attention and Executive Functioning (P < .05), and Memory (P < .05). Children with CHD displayed more impulsive test behavior than healthy peers. No differences on IQ or cognitive domains were found between the cyanotic and the acyanotic CHD group. CONCLUSIONS Six to 12 years postoperatively, children with CHD display a neuropsychological profile with mainly mild motor deficits and subtle difficulties with language tasks. Attention/executive functioning and memory also appear involved but to a lesser degree. Long-term follow-up of children with surgically corrected CHD, even when hemodynamically successful, is warranted, as they are at risk for neurodevelopmental delay at school age.
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Affiliation(s)
- Marijke Miatton
- Laboratory for Neuropsychology, Department of Internal Medicine, Ghent University, Ghent, Belgium.
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Miatton M, De Wolf D, François K, Thiery E, Vingerhoets G. Intellectual, neuropsychological, and behavioral functioning in children with tetralogy of Fallot. J Thorac Cardiovasc Surg 2007; 133:449-55. [PMID: 17258582 DOI: 10.1016/j.jtcvs.2006.10.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [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: 08/22/2006] [Revised: 09/29/2006] [Accepted: 10/10/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although it is known that pediatric cardiac surgery holds risks for later development, few studies investigated the long-term development in children with tetralogy of Fallot. The purpose of this study was to define their intellectual capacities, neuropsychological profile, and behavioral functioning 6 to 12 years postoperatively. METHODS Patients (n = 18; age, 8 years, 3 months +/- 1 year, 6 months) were examined with a short-form intelligence scale (Wechsler Intelligence Scale for Children, 3rd edition, Dutch version) and a neuropsychological assessment battery (NEPSY). Their parents completed a behavioral questionnaire. The patient group was compared with an acyanotic congenital heart disease group and a healthy control group. RESULTS No significant differences between the patient group and the acyanotic group emerged. Compared with the healthy control group, children with tetralogy of Fallot showed significantly lower scores on the estimated Full Scale IQ (P < .05) and on the NEPSY domains Language (P < .01) and Sensorimotor Functioning (P < .01). Also, the subtests Tower (P < .05), Memory for Names (P < .05), Narrative Memory (P < .05), and Design Copy (P < .05) elicited group differences. Parental reports revealed significantly higher scores on attention problems (P < .05) and the total problem scale (P < .05), as well as significantly lower school performances than those of healthy peers (P < .01). CONCLUSIONS In children with tetralogy of Fallot, we identified a lower estimated full-scale intelligence than in healthy peers and a neuropsychological profile characterized by primarily mild motor deficits and difficulties with language tasks. Parents of the children with tetralogy of Fallot indicated attention problems and rated the child's school competencies to be lower than in healthy control subjects.
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Affiliation(s)
- Marijke Miatton
- Laboratory for Neuropsychology, Department of Internal Medicine, Ghent University, Ghent, Belgium.
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Miatton M, De Wolf D, François K, Thiery E, Vingerhoets G. Neurocognitive consequences of surgically corrected congenital heart defects: A review. Neuropsychol Rev 2006; 16:65-85. [PMID: 16960756 DOI: 10.1007/s11065-006-9005-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Accepted: 03/31/2006] [Indexed: 10/24/2022]
Abstract
With advances in surgical procedures, neuropsychological assessment after congenital heart defects and pre, peri- and/or postoperative predictors of adverse outcome has become an important focus in research. We aim to summarize neuropsychological sequelae associated with different types of congenital heart defects, critically review the methodology used in more than 20 empirical studies that were retrieved from biomedical electronic search engines, and identify possible directions for future research. Despite the lack of adequate control groups and long-term studies, there seem to be some cognitive deficits. The largest group of children with isolated congenital heart defects present with normal intellectual capacities. However, they tend to show language deficits and motor dysfunction. Although performances on memory tasks are good, unambiguous conclusions concerning their attentional and executive functioning are still lacking. Serious behavioral problems are not an issue. In addition to a detailed description of the (neuro) psychological consequences of pediatric cardiac surgery, an overview of the predictors of the cognitive defects is provided.
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Affiliation(s)
- M Miatton
- Laboratory for Neuropsychology, Department of Internal Medicine, Ghent University, De Pintelaan 185, 4 K 3, B-9000, Ghent, Belgium.
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Vingerhoets G, Miatton M, Vonck K, Seurinck R, Boon P. Memory performance during the intracarotid amobarbital procedure and neuropsychological assessment in medial temporal lobe epilepsy: the limits of material specificity. Epilepsy Behav 2006; 8:422-8. [PMID: 16412696 DOI: 10.1016/j.yebeh.2005.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 10/14/2005] [Revised: 11/20/2005] [Accepted: 11/25/2005] [Indexed: 12/01/2022]
Abstract
We investigated the relationship between material-specific memory performance elicited during the Wada test, or intracarotid amobarbital procedure (IAP), and classic neuropsychological assessment in 89 surgical candidates with refractory medial temporal lobe epilepsy (MTLE). The neuropsychological battery included measures of simple and complex verbal and visual memory, whereas the IAP material consisted of verbal and dually encodable stimuli. Neuropsychological testing revealed that reduced verbal memory performance was associated with left-sided MTLE, whereas visual memory tasks revealed no differences between patients with left-sided and right-sided MTLE. During IAP, memory performance was worse with the ipsilesional hemisphere, regardless of lesion side. Most importantly, performance on verbal memory tests was significantly, but moderately, correlated with left hemispheric IAP performance, indicating that memory tasks using verbal material are a valid marker of left hemispheric integrity in left language-dominant MTLE patients and significantly predict left hemispheric memory performance during IAP. In contrast, performance on classic visual memory tests is unrelated to right hemispheric IAP performance, suggesting that the currently used visual memory stimuli do not reflect right hemispheric sensitivity.
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Affiliation(s)
- G Vingerhoets
- Laboratory for Neuropsychology, Ghent University, Ghent, Belgium.
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Abstract
OBJECTIVES This study aimed to investigate whether different types of memory stimulus provide different information during the Wada or intracarotid amytal procedure (IAP) in patients with refractory medial temporal lobe epilepsy (MTLE). METHODS Eighty nine surgical candidates with documented MTLE and selected for left hemispheric language dominance underwent memory assessment with verbal and dually encodable stimuli during a presurgical IAP. RESULTS The overall IAP memory performance with the left hemisphere is significantly better than with the right hemisphere regardless of lesion side. This can be explained by the left hemispheric advantage of encoding all stimuli, whereas the right hemisphere has only limited resources to encode verbal stimuli. More importantly, it appeared that dually encodable items remain more readily recognised following injection ipsilateral to the lesion, whereas verbal items are always better recognised following right hemisphere injection regardless of lesion side. CONCLUSIONS Verbal IAP stimuli show left hemispheric sensitivity in left language dominant MTLE patients. The dually encodable items of the IAP appear lesion sensitive.
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Affiliation(s)
- G Vingerhoets
- Laboratory for Neuropsychology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium.
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Della Vedova B, Sirianni F, Lazzi C, Miatton M, Perossa R, Giuliani C. UTILIZZO DI UN TEST in vitro PER LA SORVEGLIANZA DELLA TUBERCOLOSI LATENTE NEGLI OPERATORI SANITARI. Microbiol Med 2005. [DOI: 10.4081/mm.2005.3684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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31
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Vonck K, Boon P, Goossens L, Dedeurwaerdere S, Claeys P, Gossiaux F, Van Hese P, De Smedt T, Raedt R, Achten E, Deblaere K, Thieleman A, Vandemaele P, Thiery E, Vingerhoets G, Miatton M, Caemaert J, Van Roost D, Baert E, Michielsen G, Dewaele F, Van Laere K, Thadani V, Robertson D, Williamson P. Neurostimulation for refractory epilepsy. Acta Neurol Belg 2003; 103:213-7. [PMID: 15008506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Neurostimulation is an emerging treatment for refractory epilepsy. To date the precise mechanism of action remains to be elucidated. Better insight in the mechanism of action may identify seizure types or syndromes that respond to such a treatment and may guide the search for optimal stimulation parameters and finally improve clinical efficacy. In the past ten years some progress has been made through neurophysiological, neuroanatomical, neurochemical and cerebral blood flow studies in patients and animals undergoing vagus nerve stimulation (VNS). Interesting results have been found in VNS-treated patients that underwent evoked potential measurements, cerebrospinal fluid investigation, neuropsychological testing and PET, SPECT and fMRI testing. Desynchronisation of abnormal synchronous epileptic activity is one of the hypotheses on the mode of action that might primarily be responsible for an anti-seizure effect. There is however increasing evidence from research and clinical observation that VNS might establish a true and long-term anti-epileptic effect. It has been shown that VNS influences neurotransmission in the brain and provokes long-term changes in cerebral blood flow in areas crucial for epileptogenesis such as the thalamus and medial temporal lobe structures. Deep brain stimulation (DBS) for epilepsy has regained interest. Central nervous system structures known to play a key role in the epileptogenic network such as the thalamus and subthalamic nucleus have been targeted. Another approach is to target the ictal onset zone such as the medial temporal lobe. At Ghent University Hospital 10 patients have been treated with long-term amygdalohippocampal DBS. Several hypotheses have been raised for the mechanism of action of DBS for refractory seizures. Seizure reduction may be due to a microlesion caused by electrode insertion or by provoking a reversible functional lesion due to the effect of electrical current on hyperexcitable tissue. Neurophysiological techniques such as evoked potentials monitoring and intraoperative single unit potential recordings may guide correct electrode placement, individual DBS titration and elucidation of the mechanims of action of DBS for epilepsy.
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Affiliation(s)
- Kristl Vonck
- Reference Center for Refractory Epilepsy and Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Gent, Belgium
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Abstract
OBJECTIVE To investigate the cognitive profile of patients with idiopathic Parkinson's disease and to determine the demographic and medical variables that contribute to the cognitive outcome. DESIGN Retrospective cohort analysis. METHODS 100 patients with idiopathic Parkinson's disease were given a neuropsychological test battery investigating attention, memory, and visuospatial and executive functions. Test performance was compared against normative data, and linear regression determined significant predictors of cognitive impairment from a set of demographic and disease course variables. RESULTS Frontal-type cognitive dysfunction was widespread in patients with advanced Parkinson's disease. Attention and memory were mildly to moderately impaired, whereas visuospatial function showed only subtle impairment. Older age and tremor at onset were significant predictors of poor cognitive performance. CONCLUSIONS The observed cognitive impairment in patients with advanced Parkinson's disease is more than expected for normal aging. Although in apparent contrast with most previous research, reporting a greater risk of cognitive dysfunction in Parkinson's disease patients with predominant akinesia/rigidity, tremor at onset may be a marker for more widespread brain pathology that contributes to an increased risk of cognitive impairment.
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Affiliation(s)
- G Vingerhoets
- Laboratory for Neuropsychology, Ghent University, Ghent, Belgium.
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