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Paul D, Dixit AB, Srivastava A, Banerjee J, Tripathi M, Suman P, Doddamani R, Lalwani S, Siraj F, Sharma MC, Chandra PS, Singh RK. Altered expression of activating transcription factor 3 in the hippocampus of patients with mesial temporal lobe epilepsy-hippocampal sclerosis (MTLE-HS). Int J Neurosci 2024; 134:267-273. [PMID: 35822277 DOI: 10.1080/00207454.2022.2100777] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
Aim of the study: Activating Transforming factor 3 (ATF3) is a stress induced gene and closely associated with neuro-inflammation while Transforming growth Factor Beta (TGFβ) signalling is also reported to be involved in neuro-inflammation and hyper-excitability associated with drug resistant epilepsy. Animal model studies indicate the involvement of ATF3 and TGFβ receptors to promote epileptogenesis. Human studies also show that TGFβ signalling is activated in MTLE-HS. However, lack of studies on ATF3 and TGFβRI expression in MTLE-HS patients exists. We hypothesize that ATF3 and TGFβRI might be expressed in hippocampi of patients with MTLE-HS and playing role in epileptogenesis. Materials & methods: Protein expression of ATF3 and TGFβRI was performed by western blotting. Localisation of ATF3 was performed by immunohistochemistry and immunoflorescence. Results: Protein expression of ATF3 and TGFβRI was significantly up-regulated in hippocampi of patients as compared to controls. Also ATF3 IR was significantly expressed in hippocampi of patients and ATF3 was expressed predominantly in cytoplasm as compared to nucleus. No correlation was found between ATF3 expression and epilepsy duration and seizure frequency. Conclusions: ATF3 and TGFβRI are both important players in neuro-inflammation and might potentiate epileptogenesis in these patients.
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Affiliation(s)
- Debasmita Paul
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Aparna Banerjee Dixit
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, New Delhi, India
| | - Arpna Srivastava
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Jyotirmoy Banerjee
- Department of Biophysics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Priya Suman
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, New Delhi, India
| | - Ramesh Doddamani
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sanjeev Lalwani
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Fouzia Siraj
- National Institute of Pathology, Safdarjung Hospital campus, New Delhi, India
| | - Mehar Chand Sharma
- Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rajesh Kumar Singh
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Wang Z, Guo J, van 't Klooster M, Hoogteijling S, Jacobs J, Zijlmans M. Prognostic Value of Complete Resection of the High-Frequency Oscillation Area in Intracranial EEG: A Systematic Review and Meta-Analysis. Neurology 2024; 102:e209216. [PMID: 38560817 DOI: 10.1212/wnl.0000000000209216] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES High-frequency oscillations (HFOs; ripples 80-250 Hz; fast ripples [FRs] 250-500 Hz) recorded with intracranial electrodes generated excitement and debate about their potential to localize epileptogenic foci. We performed a systematic review and meta-analysis on the prognostic value of complete resection of the HFOs-area (crHFOs-area) for epilepsy surgical outcome in intracranial EEG (iEEG) accessing multiple subgroups. METHODS We searched PubMed, Embase, and Web of Science for original research from inception to October 27, 2022. We defined favorable surgical outcome (FSO) as Engel class I, International League Against Epilepsy class 1, or seizure-free status. The prognostic value of crHFOs-area for FSO was assessed by (1) the pooled FSO proportion after crHFOs-area; (2) FSO for crHFOs-area vs without crHFOs-area; and (3) the predictive performance. We defined high combined prognostic value as FSO proportion >80% + FSO crHFOs-area >without crHFOs-area + area under the curve (AUC) >0.75 and examined this for the clinical subgroups (study design, age, diagnostic type, HFOs-identification method, HFOs-rate thresholding, and iEEG state). Temporal lobe epilepsy (TLE) was compared with extra-TLE through dichotomous variable analysis. Individual patient analysis was performed for sex, affected hemisphere, MRI findings, surgery location, and pathology. RESULTS Of 1,387 studies screened, 31 studies (703 patients) met our eligibility criteria. Twenty-seven studies (602 patients) analyzed FRs and 20 studies (424 patients) ripples. Pooled FSO proportion after crHFOs-area was 81% (95% CI 76%-86%) for FRs and 82% (73%-89%) for ripples. Patients with crHFOs-area achieved more often FSO than those without crHFOs-area (FRs odds ratio [OR] 6.38, 4.03-10.09, p < 0.001; ripples 4.04, 2.32-7.04, p < 0.001). The pooled AUCs were 0.81 (0.77-0.84) for FRs and 0.76 (0.72-0.79) for ripples. Combined prognostic value was high in 10 subgroups: retrospective, children, long-term iEEG, threshold (FRs and ripples) and automated detection and interictal (FRs). FSO after complete resection of FRs-area (crFRs-area) was achieved less often in people with TLE than extra-TLE (OR 0.37, 0.15-0.89, p = 0.006). Individual patient analyses showed that crFRs-area was seen more in patients with FSO with than without MRI lesions (p = 0.02 after multiple correction). DISCUSSION Complete resection of the brain area with HFOs is associated with good postsurgical outcome. Its prognostic value holds, especially for FRs, for various subgroups. The use of HFOs for extra-TLE patients requires further evidence.
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Affiliation(s)
- Ziyi Wang
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
| | - Jiaojiao Guo
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
| | - Maryse van 't Klooster
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
| | - Sem Hoogteijling
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
| | - Julia Jacobs
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
| | - Maeike Zijlmans
- From the Department of Neurology and Neurosurgery (Z.W., J.G., M.v.t.K., S.H., M.Z.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, the Netherlands; Department of Pediatrics (J.J.), University of Calgary, Alberta Children's Hospital, Calgary, Canada; and Stichting Epilepsie Instellingen Nederland (SEIN) (M.Z.), Heemstede, the Netherlands
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Datta AN. A video case vignette: Hypermotor activity, ictal aggression, and bolting in an adolescent with an anteromedial temporal lesion. Epileptic Disord 2024; 26:236-239. [PMID: 37971030 DOI: 10.1002/epd2.20176] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
Content available: Video.
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Affiliation(s)
- Anita N Datta
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Joplin S, Gascoigne M, Barton B, Webster R, Gill D, Lawson J, Mandalis A, Sabaz M, McLean S, Gonzalez L, Smith ML, Lah S. Repeat testing enhances long-term verbal memory in children with epilepsy. Child Neuropsychol 2024; 30:425-443. [PMID: 37144751 DOI: 10.1080/09297049.2023.2205633] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/14/2023] [Indexed: 05/06/2023]
Abstract
To (i) determine whether accelerated long-term forgetting (ALF) can be found using standardized verbal memory test materials in children with genetic generalized epilepsy (GGE) and temporal lobe epilepsy (TLE), and (ii) to establish whether ALF is impacted by executive skills and repeat testing over long delays. One hundred and twenty-three children aged 8 to 16, (28 with GGE, 23 with TLE, and 72 typically developing; TD) completed a battery of standardized tests assessing executive functioning and memory for two stories. Stories were recalled immediately and after a 30-min delay. To examine whether repeat testing impacts long-term forgetting, one story was tested via free recall at 1-day and 2-weeks, and the other at 2-weeks only. Recognition was then tested for both stories at 2-weeks. Children with epilepsy recalled fewer story details, both immediately and after 30-min relative to TD children. Compared to TD children, the GGE group, but not the TLE group, showed ALF, having significantly poorer recall of the story tested only at the longest delay. Poor executive skills were significantly correlated with ALF for children with epilepsy. Standard story memory materials can detect ALF in children with epilepsy when administered over long delays. Our findings suggest that (i) ALF is related to poor executive skills in children with epilepsy, and (ii) repeated testing may ameliorate ALF in some children.
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Affiliation(s)
- Samantha Joplin
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Michael Gascoigne
- School of Psychology and Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Belinda Barton
- Faculty of Health, Discipline of Psychology, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Richard Webster
- TY Nelson Department of Neurology, Kids Neuroscience Centre, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Deepak Gill
- TY Nelson Department of Neurology, Kids Neuroscience Centre, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - John Lawson
- Department of Neurology SCHN, School of Women and Children's Health, UNSW, Randwick, NSW, Australia
| | - Anna Mandalis
- Department of Psychology, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Mark Sabaz
- Department of Psychology, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Samantha McLean
- TY Nelson Department of Neurology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Linda Gonzalez
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Mary-Lou Smith
- Department of Psychology, University of Toronto Mississauga and Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Suncica Lah
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
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Gooley S, Perucca P, Tubb C, Hildebrand MS, Berkovic SF. Somatic mosaicism in focal epilepsies. Curr Opin Neurol 2024; 37:105-114. [PMID: 38235675 DOI: 10.1097/wco.0000000000001244] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE OF REVIEW Over the past decade, it has become clear that brain somatic mosaicism is an important contributor to many focal epilepsies. The number of cases and the range of underlying pathologies with somatic mosaicism are rapidly increasing. This growth in somatic variant discovery is revealing dysfunction in distinct molecular pathways in different focal epilepsies. RECENT FINDINGS We briefly summarize the current diagnostic yield of pathogenic somatic variants across all types of focal epilepsy where somatic mosaicism has been implicated and outline the specific molecular pathways affected by these variants. We will highlight the recent findings that have increased diagnostic yields such as the discovery of pathogenic somatic variants in novel genes, and new techniques that allow the discovery of somatic variants at much lower variant allele fractions. SUMMARY A major focus will be on the emerging evidence that somatic mosaicism may contribute to some of the more common focal epilepsies such as temporal lobe epilepsy with hippocampal sclerosis, which could lead to it being re-conceptualized as a genetic disorder.
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Affiliation(s)
- Samuel Gooley
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
| | - Piero Perucca
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
- Department of Neuroscience, Central Clinical School, Monash University
- Department of Neurology, Alfred Health, Melbourne
- Department of Neurology, The Royal Melbourne Hospital
| | - Caitlin Tubb
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Neuroscience Group, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Samuel F Berkovic
- Epilepsy Research Centre, Department of Medicine, University of Melbourne
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg
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Häussler U, Neres J, Vandenplas C, Eykens C, Kadiu I, Schramm C, Fleurance R, Stanley P, Godard P, de Mot L, van Eyll J, Knobeloch KP, Haas CA, Dedeurwaerdere S. Downregulation of Ubiquitin-Specific Protease 15 (USP15) Does Not Provide Therapeutic Benefit in Experimental Mesial Temporal Lobe Epilepsy. Mol Neurobiol 2024; 61:2367-2389. [PMID: 37874479 PMCID: PMC10973041 DOI: 10.1007/s12035-023-03692-2] [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: 07/11/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
Structural epilepsies display complex immune activation signatures. However, it is unclear which neuroinflammatory pathways drive pathobiology. Transcriptome studies of brain resections from mesial temporal lobe epilepsy (mTLE) patients revealed a dysregulation of transforming growth factor β, interferon α/β, and nuclear factor erythroid 2-related factor 2 pathways. Since these pathways are regulated by ubiquitin-specific proteases (USP), in particular USP15, we hypothesized that USP15 blockade may provide therapeutic relief in treatment-resistant epilepsies. For validation, transgenic mice which either constitutively or inducibly lack Usp15 gene expression underwent intrahippocampal kainate injections to induce mTLE. We show that the severity of status epilepticus is unaltered in mice constitutively lacking Usp15 compared to wild types. Cell death, reactive gliosis, and changes in the inflammatory transcriptome were pronounced at 4 days after kainate injection. However, these brain inflammation signatures did not differ between genotypes. Likewise, induced deletion of Usp15 in chronic epilepsy did not affect seizure generation, cell death, gliosis, or the transcriptome. Concordantly, siRNA-mediated knockdown of Usp15 in a microglial cell line did not impact inflammatory responses in the form of cytokine release. Our data show that a lack of USP15 is insufficient to modulate the expression of relevant neuroinflammatory pathways in an mTLE mouse model and do not support targeting USP15 as a therapeutic approach for pharmacoresistant epilepsy.
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Affiliation(s)
- Ute Häussler
- Experimental Epilepsy Research, Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
- BrainLinks-BrainTools Center, University of Freiburg, Georges-Koehler-Allee 201, 79110, Freiburg, Germany.
| | - João Neres
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Catherine Vandenplas
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Caroline Eykens
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Irena Kadiu
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Carolin Schramm
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Renaud Fleurance
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Phil Stanley
- Early Development Statistics, UCB Celltech, 208 Bath Road, Slough, Berkshire, SL1 3WE, UK
| | - Patrice Godard
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Laurane de Mot
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Jonathan van Eyll
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Klaus-Peter Knobeloch
- Institute for Neuropathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
- CIBSS - Centre for Integrative Biological Signalling Studies, Freiburg, Germany.
| | - Carola A Haas
- Experimental Epilepsy Research, Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
- BrainLinks-BrainTools Center, University of Freiburg, Georges-Koehler-Allee 201, 79110, Freiburg, Germany
- Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany
- Bernstein Center Freiburg, University of Freiburg, Hansastr. 9a, 79104, Freiburg, Germany
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Wen F, Tan Z, Huang D, Xiang J. Molecular mechanism analyses of post-traumatic epilepsy and hereditary epilepsy based on 10× single-cell transcriptome sequencing technology. CNS Neurosci Ther 2024; 30:e14702. [PMID: 38572804 PMCID: PMC10993349 DOI: 10.1111/cns.14702] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Single-cell RNA sequencing analysis has been usually conducted on post-traumatic epilepsy (PET) and hereditary epilepsy (HE) patients; however, the transcriptome of patients with traumatic temporal lobe epilepsy has rarely been studied. MATERIALS AND METHODS Hippocampus tissues isolated from one patient with PTE and one patient with HE were used in the present study. Single cell isolates were prepared and captured using a 10× Genomics Chromium Single-Cell 3' kit (V3) according to the manufacturer's instructions. The libraries were sequenced on an Illumina NovaSeq 6000 sequencing system. Raw data were processed, and the cells were filtered and classified using the Seurat R package. Uniform Manifold Approximation and Projection was used for visualization. Differentially expressed genes (DEGs) were identified based on a p-value ≤0.01 and log fold change (FC) ≥0.25. Gene Ontology (GO, http://geneontology.org/) and KEGG (Kyoto Encyclopedia of Genes and Genomes, www.genome.jp/kegg) analyses were performed on the DEGs for enrichment analysis. RESULTS The reads obtained from the 10× genomic platform for PTE and HE were 39.56 M and 30.08 M, respectively. The Q30 score of the RNA reads was >91.6%. After filtering, 7479 PTE cells and 9357 HE cells remained for further study. More than 96.4% of the reads were mapped to GRCh38/GRCm38. The cells were differentially distributed in two groups, with higher numbers of oligodendrocytes (6522 vs. 2532) and astrocytes (133 vs. 52), and lower numbers of microglial cells (2242 vs. 3811), and neurons (3 vs. 203) present in the HE group than in the PTE group. The DEGs in four cell clusters were identified, with 25 being in oligodendrocytes (13 upregulated and 12 downregulated), 87 in microglia cells (42 upregulated and 45 downregulated), 222 in astrocytes (115 upregulated and 107 downregulated), and 393 in neurons (305 upregulated and 88 downregulated). The genes MTND1P23 (downregulated), XIST (downregulated), and RPS4Y1 (upregulated) were commonly expressed in all four cell clusters. The DEGs in microglial cells and astrocytes were enriched in the IL-17 signaling pathway. CONCLUSION Our study explored differences in cells found in a patient with PE compared to a patient with HE, and the transcriptome in the different cells was analyzed for the first time. Studying inflammatory and immune functions might be the best approach for investigating traumatic temporal lobe epilepsy in neurons.
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Affiliation(s)
- Fang Wen
- Department of NeurologyThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Zhigang Tan
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Dezhi Huang
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Jun Xiang
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
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de Almeida JP, Castro BM, Passarelli V, Chaim KT, Castro-Lima H, Listik C, Jorge CL, Valerio R, Arantes PR, Amaro E, Pipek LZ, Castro LH. Left-sided epileptiform activity influences language lateralization in right mesial temporal sclerosis. Epilepsia Open 2024; 9:626-634. [PMID: 38217377 PMCID: PMC10984302 DOI: 10.1002/epi4.12897] [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: 02/11/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE To investigate the association between left epileptiform activity and language laterality indices (LI) in patients with right mesial temporal sclerosis (MTS). METHODS Twenty-two patients with right MTS and 22 healthy subjects underwent fMRI scanning while performing a language task. LI was calculated in multiple regions of interest (ROI). Data on the presence of left epileptiform abnormalities were obtained during prolonged video-EEG monitoring. RESULTS After correction for multiple comparisons, LI was reduced in the middle temporal gyrus in the left interictal epileptiform discharges (IED+) group, compared with the left IED- group (p < 0.05). SIGNIFICANCE Using a responsive reading naming fMRI paradigm, right MTS patients who presented left temporal interictal epileptiform abnormalities on video-EEG showed decreased LI in the middle temporal gyrus, indicating decreased left middle temporal gyrus activation, increased right middle temporal gyrus activation or a combination of both, demonstrative of language network reorganization, specially in the MTG, in this patient population. PLAIN LANGUAGE SUMMARY This research studied 22 patients with right mesial temporal sclerosis (a specific type of epilepsy) comparing them to 22 healthy individuals. Participants were asked to perform a language task while undergoing a special brain imaging technique (fMRI). The findings showed that patients with epilepsy displayed a change in the area of the brain typically responsible for language processing. This suggests that their brains may have adapted due to their condition, altering the way language is processed.
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Affiliation(s)
- Juliana Passos de Almeida
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Bettina Martins Castro
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Valmir Passarelli
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Khallil Taverna Chaim
- LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Humberto Castro-Lima
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Clarice Listik
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Carmen Lisa Jorge
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Rosa Valerio
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Paula Ricci Arantes
- LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Edson Amaro
- LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Leonardo Zumerkorn Pipek
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Luiz H Castro
- Department of Neurology, Epilepsy Program, Clinical Hospital, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
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Aljishi A, Sherman BE, Huberdeau DM, Obaid S, Khan K, Lamsam L, Zibly Z, Sivaraju A, Turk-Browne NB, Damisah EC. Statistical learning in epilepsy: Behavioral and anatomical mechanisms in the human brain. Epilepsia 2024; 65:753-765. [PMID: 38116686 PMCID: PMC10948305 DOI: 10.1111/epi.17871] [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: 10/15/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe (MTL) in the healthy brain. This leads to the hypothesis that statistical learning (SL) may be impaired in patients with epilepsy (PWE) involving the temporal lobe, and that this impairment could contribute to their varied memory deficits. In turn, studies done in collaboration with PWE, that evaluate the necessity of MTL circuitry through disease and causal perturbations, provide an opportunity to advance basic understanding of SL. METHODS We implemented behavioral testing, volumetric analysis of the MTL substructures, and direct electrical brain stimulation to examine SL across a cohort of 61 PWE and 28 healthy controls. RESULTS We found that behavioral performance in an SL task was negatively associated with seizure frequency irrespective of seizure origin. The volume of hippocampal subfields CA1 and CA2/3 correlated with SL performance, suggesting a more specific role of the hippocampus. Transient direct electrical stimulation of the hippocampus disrupted SL. Furthermore, the relationship between SL and seizure frequency was selective, as behavioral performance in an episodic memory task was not impacted by seizure frequency. SIGNIFICANCE Overall, these results suggest that SL may be hippocampally dependent and that the SL task could serve as a clinically useful behavioral assay of seizure frequency that may complement existing approaches such as seizure diaries. Simple and short SL tasks may thus provide patient-centered endpoints for evaluating the efficacy of novel treatments in epilepsy.
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Affiliation(s)
- Ayman Aljishi
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, 37240, USA
| | - Brynn E. Sherman
- Department of Psychology, Yale University, New Haven, CT 06520, USA
| | | | - Sami Obaid
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Kamren Khan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Layton Lamsam
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Zion Zibly
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Adithya Sivaraju
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Nicholas B. Turk-Browne
- Department of Psychology, Yale University, New Haven, CT 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
| | - Eyiyemisi C. Damisah
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
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10
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Li Y, Ran Y, Yao M, Chen Q. Altered static and dynamic functional connectivity of the default mode network across epilepsy subtypes in children: A resting-state fMRI study. Neurobiol Dis 2024; 192:106425. [PMID: 38296113 DOI: 10.1016/j.nbd.2024.106425] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/08/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Epilepsy is a chronic neurologic disorder characterized by abnormal functioning of brain networks, making it a complex research topic. Recent advancements in neuroimaging technology offer an effective approach to unraveling the intricacies of the human brain. Within different types of epilepsy, there is growing recognition regarding ongoing changes in the default mode network (DMN). However, little is known about the shared and distinct alterations of static functional connectivity (sFC) and dynamic functional connectivity (dFC) in DMN among epileptic subtypes, especially in children with epilepsy. METHODS Here, 110 children with epilepsy at a single center, including idiopathic generalized epilepsy (IGE), frontal lobe epilepsy (FLE), temporal lobe epilepsy (TLE), and parietal lobe epilepsy (PLE), as well as 84 healthy controls (HC) underwent resting-state functional magnetic resonance imaging (fMRI) scan. We investigated both sFC and dFC between groups of the DMN. RESULTS Decreased static and dynamic connectivity within the DMN subsystem were shared by all subtypes. In each epilepsy subtype, children with epilepsy displayed significant and distinct patterns of DMN connectivity compared to the control group: the IGE group showed reduced interhemispheric connectivity, the FLE group consistently demonstrated disturbances in frontal region connectivity, the TLE group exhibited significant disruptions in hippocampal connectivity, and the PLE group displayed a notable decrease in parietal-temporal connectivity within the DMN. Some state-specific FC disruptions (decreased dFC) were observed in each epilepsy subtype that cannot detect by sFC. To determine their uniqueness within specific subtypes, bootstrapping methods were employed and found the significant results (IGE: between PCC and bilateral precuneus, FLE: between right middle frontal gyrus and bilateral middle temporal gyrus, TLE: between left Hippocampus and right fusiform, PLE: between left angular and cingulate cortex). Furthermore, only children with IGE exhibited dynamic features associated with clinical variables. CONCLUSIONS Our findings highlight both shared and distinct FC alterations within the DMN in children with different types of epilepsy. Furthermore, our work provides a novel perspective on the functional alterations in the DMN of pediatric patients, suggesting that combined sFC and dFC analysis can provide valuable insights for deepening our understanding of the neuronal mechanism underlying epilepsy in children.
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Affiliation(s)
- Yongxin Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
| | - Yun Ran
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Maohua Yao
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Qian Chen
- Department of Pediatric Neurosurgery, Shenzhen Children's Hospital, Shenzhen, China
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11
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Latreille V, Avigdor T, Thomas J, Crane J, Sziklas V, Jones-Gotman M, Frauscher B. Scalp and hippocampal sleep correlates of memory function in drug-resistant temporal lobe epilepsy. Sleep 2024; 47:zsad228. [PMID: 37658793 PMCID: PMC10851866 DOI: 10.1093/sleep/zsad228] [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: 04/24/2023] [Revised: 07/22/2023] [Indexed: 09/05/2023] Open
Abstract
Seminal animal studies demonstrated the role of sleep oscillations such as cortical slow waves, thalamocortical spindles, and hippocampal ripples in memory consolidation. In humans, whether ripples are involved in sleep-related memory processes is less clear. Here, we explored the interactions between sleep oscillations (measured as traits) and general episodic memory abilities in 26 adults with drug-resistant temporal lobe epilepsy who performed scalp-intracranial electroencephalographic recordings and neuropsychological testing, including two analogous hippocampal-dependent verbal and nonverbal memory tasks. We explored the relationships between hemispheric scalp (spindles, slow waves) and hippocampal physiological and pathological oscillations (spindles, slow waves, ripples, and epileptic spikes) and material-specific memory function. To differentiate physiological from pathological ripples, we used multiple unbiased data-driven clustering approaches. At the individual level, we found material-specific cerebral lateralization effects (left-verbal memory, right-nonverbal memory) for all scalp spindles (rs > 0.51, ps < 0.01) and fast spindles (rs > 0.61, ps < 0.002). Hippocampal epileptic spikes and short pathological ripples, but not physiological oscillations, were negatively (rs > -0.59, ps < 0.01) associated with verbal learning and retention scores, with left lateralizing and antero-posterior effects. However, data-driven clustering failed to separate the ripple events into defined clusters. Correlation analyses with the resulting clusters revealed no meaningful or significant associations with the memory scores. Our results corroborate the role of scalp spindles in memory processes in patients with drug-resistant temporal lobe epilepsy. Yet, physiological and pathological ripples were not separable when using data-driven clustering, and thus our findings do not provide support for a role of sleep ripples as trait-like characteristics of general memory abilities in epilepsy.
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Affiliation(s)
- Véronique Latreille
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
| | - Tamir Avigdor
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
| | - John Thomas
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
| | - Joelle Crane
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Viviane Sziklas
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Marilyn Jones-Gotman
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Birgit Frauscher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada
- Analytical Neurophysiology (ANPHY) Lab, Duke University Medical Center, Durham, NC, USA
- Department of Neurology, Duke University Medical Center, Durham, NC, USA
- Department of Biomedical Engineering. Duke Pratt School of Engineering, Durham NC, USA
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12
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Finn S, Aliyianis T, Beattie B, Boissé Lomax L, Shukla G, Scott SH, Winston GP. Robotic assessment of sensorimotor and cognitive deficits in patients with temporal lobe epilepsy. Epilepsy Behav 2024; 151:109613. [PMID: 38183928 DOI: 10.1016/j.yebeh.2023.109613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Individuals with temporal lobe epilepsy (TLE) frequently demonstrate impairments in executive function, working memory, and/or declarative memory. It is recommended that screening for cognitive impairment is undertaken in all people newly diagnosed with epilepsy. However, standard neuropsychological assessments are a limited resource and thus not available to all. Our study investigated the use of robotic technology (the Kinarm robot) for cognitive screening. METHODS 27 participants with TLE (17 left) underwent both a brief neuropsychological screening and a robotic (Kinarm) assessment. The degree of impairments and correlations between standardized scores from both approaches to assessments were analysed across different neurocognitive domains. Performance was compared between people with left and right TLE to look for laterality effects. Finally, the association between the duration of epilepsy and performance was assessed. RESULTS Across the 6 neurocognitive domains (attention, executive function, language, memory, motor and visuospatial) assessed by our neuropsychological screening, all showed scores that significantly correlated with Kinarm tasks assessing the same cognitive domains except language and memory that were not adequately assessed with Kinarm. Participants with right TLE performed worse on most tasks than those with left TLE, including both visuospatial (typically considered right hemisphere), and verbal memory and language tasks (typically considered left hemisphere). No correlations were found between the duration of epilepsy and either the neuropsychological screening or Kinarm assessment. SIGNIFICANCE Our findings suggest that Kinarm may be a useful tool in screening for neurocognitive impairment in people with TLE. Further development may facilitate an easier and more rapid screening of cognition in people with epilepsy and distinguishing patterns of cognitive impairment.
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Affiliation(s)
- Spencer Finn
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | | | - Brooke Beattie
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Lysa Boissé Lomax
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Garima Shukla
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Gavin P Winston
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
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Löscher W. Of Mice and Men: The Inter-individual Variability of the Brain's Response to Drugs. eNeuro 2024; 11:ENEURO.0518-23.2024. [PMID: 38355298 PMCID: PMC10867552 DOI: 10.1523/eneuro.0518-23.2024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Biological variation is ubiquitous in nature. Despite highly standardized breeding and husbandry under controlled environmental conditions, phenotypic diversity exists in laboratory mice and rats just as it does in humans. The resulting inter-individual variability affects various characteristics of animal disease models, including the responsiveness to drugs. Thus, the common practice of averaging data within an experimental group can lead to misinterpretations in neuroscience and other research fields. In this commentary, the impact of inter-individual variation in drug responsiveness is illustrated by examples from the testing of antiseizure medications in rodent temporal lobe epilepsy models. Individual mice and rats rendered epileptic by treatment according to standardized protocols fall into groups that either do or do not respond to antiseizure medications, thus mimicking the clinical situation in patients with epilepsy. Population responses are not normally distributed, and divergent responding is concealed in averages subjected to parametric statistical tests. Genetic, epigenetic, and environmental factors are believed to contribute to inter-individual variation in drug response but the specific molecular and physiological causes are not well understood. Being aware of inter-individual variability in rodents allows an improved interpretation of both behavioral phenotypes and drug effects in a pharmacological experiment.
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Affiliation(s)
- Wolfgang Löscher
- Translational Neuropharmacology Lab, NIFE, Department of Experimental Otology of the ENT Clinics, Hannover Medical School, Hannover 30625, Germany
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14
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Cairós-González M, Verche E, Hernández S, Alonso MÁ. Cognitive flexibility impairment in temporal lobe epilepsy: The impact of epileptic foci lateralization on executive functions. Epilepsy Behav 2024; 151:109587. [PMID: 38159506 DOI: 10.1016/j.yebeh.2023.109587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Temporal Lobe Epilepsy (TLE) has been associated with memory impairments, which are typically linked to hippocampal and mesial temporal cortex lesions. Considering the presence of extensive bidirectional frontotemporal connections, it can be hypothesized that executive dysfunction in TLE is modulated by the lateralization of the epileptic foci. MATERIAL AND METHODS A comprehensive neuropsychological executive functions protocol was administered to 63 participants, including 42 individuals with temporal lobe epilepsy (20 with right-TLE and 22 with left-TLE) and 21 healthy controls aged 20-49. RESULTS The results indicate that TLE patients exhibit poorer executive performance compared to healthy controls in working memory (F(2,60) = 4.18, p <.01), planning (F(2,60) = 4.71, p <.05), set shifting (F(2,60) = 10.1, p <.001), phonetic verbal fluency (F(2,60) = 11.71, p <.01) and semantic verbal fluency (F(2,60) = 9.61, p <.001. No significant differences were found in cognitive inhibition. Furthermore, right-TLE patients showed lower performance than left-TLE in set shifting (F(1,61) = 6.45, p <.05), while no significant differences were observed in working memory, planning, inhibition, and verbal fluency. CONCLUSIONS This research emphasize the importance of considering the lateralization of the temporal lobe focus to achieve a more accurate neuropsychological characterization. The cognitive differences between left and right TLE patients highlight the need for individualized approaches in their treatment and care.
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Affiliation(s)
- Mariana Cairós-González
- Faculty of Health Sciences, Valencian International University, Pintor Sorolla St., 21, 46002, Valencia, Spain.
| | - Emilio Verche
- Department of Psychobiology and Methodology in Behavioural Sciences, University Complutense de Madrid, Rector Royo Villanova St., 1, 28040, Madrid, Spain
| | - Sergio Hernández
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology and Language Therapy, University of La Laguna, Campus de Guajara, 456, 38200, San Cristóbal de La Laguna, Spain
| | - María Ángeles Alonso
- Department of Cognitive Psychology, Social and Organizational Faculty of Psychology and Language Therapy, University of La Laguna, Campus de Guajara, 456, 38200, San Cristóbal de La Laguna, Spain
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15
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Yang S, Zhou Y, Peng C, Meng Y, Chen H, Zhang S, Kong X, Kong R, Yeo BTT, Liao W, Zhang Z. Macroscale intrinsic dynamics are associated with microcircuit function in focal and generalized epilepsies. Commun Biol 2024; 7:145. [PMID: 38302632 PMCID: PMC10834476 DOI: 10.1038/s42003-024-05819-0] [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: 08/08/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
Epilepsies are a group of neurological disorders characterized by abnormal spontaneous brain activity, involving multiscale changes in brain functional organizations. However, it is not clear to what extent the epilepsy-related perturbations of spontaneous brain activity affect macroscale intrinsic dynamics and microcircuit organizations, that supports their pathological relevance. We collect a sample of patients with temporal lobe epilepsy (TLE) and genetic generalized epilepsy with tonic-clonic seizure (GTCS), as well as healthy controls. We extract massive temporal features of fMRI BOLD time-series to characterize macroscale intrinsic dynamics, and simulate microcircuit neuronal dynamics used a large-scale biological model. Here we show whether macroscale intrinsic dynamics and microcircuit dysfunction are differed in epilepsies, and how these changes are linked. Differences in macroscale gradient of time-series features are prominent in the primary network and default mode network in TLE and GTCS. Biophysical simulations indicate reduced recurrent connection within somatomotor microcircuits in both subtypes, and even more reduced in GTCS. We further demonstrate strong spatial correlations between differences in the gradient of macroscale intrinsic dynamics and microcircuit dysfunction in epilepsies. These results emphasize the impact of abnormal neuronal activity on primary network and high-order networks, suggesting a systematic abnormality of brain hierarchical organization.
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Affiliation(s)
- Siqi Yang
- School of Cybersecurity (Xin Gu Industrial College), Chengdu University of Information Technology, Chengdu, 610225, PR China.
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China.
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Yimin Zhou
- School of Cybersecurity (Xin Gu Industrial College), Chengdu University of Information Technology, Chengdu, 610225, PR China
| | - Chengzong Peng
- School of Cybersecurity (Xin Gu Industrial College), Chengdu University of Information Technology, Chengdu, 610225, PR China
| | - Yao Meng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China
| | - Shaoshi Zhang
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiaolu Kong
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ru Kong
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - B T Thomas Yeo
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, PR China.
| | - Zhiqiang Zhang
- Laboratory of Neuroimaging, Department of Radiology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, PR China.
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16
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Milano C, Montali M, Barachini S, Burzi IS, Pratesi F, Petrozzi L, Chico L, Morganti R, Gambino G, Rossi L, Ceravolo R, Siciliano G, Migliorini P, Petrini I, Pizzanelli C. Increased production of inflammatory cytokines by circulating monocytes in mesial temporal lobe epilepsy: A possible role in drug resistance. J Neuroimmunol 2024; 386:578272. [PMID: 38160122 DOI: 10.1016/j.jneuroim.2023.578272] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
We analyzed peripheral blood mononuclear cells (PBMCs) and serum inflammatory biomarkers in patients with mesial temporal lobe epilepsy (drug-resistant - DR, vs. drug-sensitive - DS). Patients with epilepsy showed higher levels of serum CCL2, CCL3, IL-8 and AOPP, and lower levels of FRAP and thiols compared to healthy controls (HC). Although none of the serum biomarkers distinguished DR from DS patients, when analysing intracellular cytokines after in vitro stimulation, DR patients presented higher percentages of IL-1β and IL-6 positive monocytes compared to DS patients and HC. Circulating innate immune cells might be implicated in DR epilepsy and constitute potential new targets for treatments.
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Affiliation(s)
- C Milano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
| | - M Montali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Barachini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - I S Burzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Pratesi
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - L Petrozzi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - L Chico
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - R Morganti
- Section of Statistics, University of Pisa, Pisa, Italy
| | - G Gambino
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - L Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - R Ceravolo
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - G Siciliano
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - P Migliorini
- Department of Clinical and Experimental Medicine, Clinical Immunology and Allergy Unit, University of Pisa, Pisa, Italy
| | - I Petrini
- Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - C Pizzanelli
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
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17
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Lang M, Colby S, Ashby-Padial C, Bapna M, Jaimes C, Rincon SP, Buch K. An imaging review of the hippocampus and its common pathologies. J Neuroimaging 2024; 34:5-25. [PMID: 37872430 DOI: 10.1111/jon.13165] [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: 06/29/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
The hippocampus is a complex structure located in the mesial temporal lobe that plays a critical role in cognitive and memory-related processes. The hippocampal formation consists of the dentate gyrus, hippocampus proper, and subiculum, and its importance in the neural circuitry makes it a key anatomic structure to evaluate in neuroimaging studies. Advancements in imaging techniques now allow detailed assessment of hippocampus internal architecture and signal features that has improved identification and characterization of hippocampal abnormalities. This review aims to summarize the neuroimaging features of the hippocampus and its common pathologies. It provides an overview of the hippocampal anatomy on magnetic resonance imaging and discusses how various imaging techniques can be used to assess the hippocampus. The review explores neuroimaging findings related to hippocampal variants (incomplete hippocampal inversion, sulcal remnant and choroidal fissure cysts), and pathologies of neoplastic (astrocytoma and glioma, ganglioglioma, dysembryoplastic neuroepithelial tumor, multinodular and vacuolating neuronal tumor, and metastasis), epileptic (mesial temporal sclerosis and focal cortical dysplasia), neurodegenerative (Alzheimer's disease, progressive primary aphasia, and frontotemporal dementia), infectious (Herpes simplex virus and limbic encephalitis), vascular (ischemic stroke, arteriovenous malformation, and cerebral cavernous malformations), and toxic-metabolic (transient global amnesia and opioid-associated amnestic syndrome) etiologies.
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Affiliation(s)
- Min Lang
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Samantha Colby
- Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah, USA
| | | | - Monika Bapna
- School of Medicine, Georgetown University, Washington, DC, USA
| | - Camilo Jaimes
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Sandra P Rincon
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Karen Buch
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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18
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Kalinin VV, Zemlyanaya AA, Subbotin KY. [The relationship between immunological and psychopathological characteristics in patients with focal epilepsy depending on the profile of interhemispheric asymmetry]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:37-44. [PMID: 38465809 DOI: 10.17116/jnevro202412402137] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To identify the possible influence of cellular immunity parameters and neurobiological variables (frequency of seizures of various semiotics and their severity) on comorbid psychopathological symptoms depending on the profile of interhemispheric asymmetry in patients with focal forms of epilepsy. MATERIAL AND METHODS The study included 92 patients with epilepsy (38 men, 54 women, mean age 38.7+8.45 years). Focal temporal lobe epilepsy was diagnosed in 36 patients, focal frontal lobe epilepsy in 16 patients, and temporal-frontal lobe epilepsy in 40 patients. For each type of seizure, severity was assessed according to the National Seizure Severity Scale (NHS3). The mental status of patients was assessed using the SCL-90 self-report questionnaire. The Annette scale was used to assess the profile of interhemispheric asymmetry. The number of different clusters of lymphocytes was studied, including the number of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), T-cytotoxic (CD3+CD8+), T-NK (natural killers CD3+CD16+CD56+), B-lymphocytes (CD3-CD19+), as well as immunoregulatory index (CD4/CD8 ratio). In order to identify any possible relationships between neurobiological and immune variables, on the one hand, and the SCL-90 constructs, on the other hand, a separate correlation analysis of Spearman ranks within the left-handed group and the right-handed group was carried out. RESULTS We revealed the differences between groups of patients with epilepsy with right and left profiles of hemispheric asymmetry regarding the relationship between the frequency of seizures, their severity and accompanying psychopathological variables, on the one hand, and between immunity indices and psychopathological constructs, on the other hand. It has been established that neurobiological and immune variables in left-handers can determine the psychopathological structure of the comorbid mental disorder. CONCLUSION Prediction of concomitant psychopathological syndromes in patients with epilepsy on the basis of clinical data and data on immunity is quite possible, but only in left-handed patients.
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Affiliation(s)
- V V Kalinin
- Moscow Research Institute of Psychiatry - Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - A A Zemlyanaya
- Moscow Research Institute of Psychiatry - Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - K Y Subbotin
- Moscow Research Institute of Psychiatry - Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
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Rigoni I, Padmasola GP, Sheybani L, Schaller K, Quairiaux C, Vulliemoz S. Reproducible network changes occur in a mouse model of temporal lobe epilepsy but do not correlate with disease severity. Neurobiol Dis 2024; 190:106382. [PMID: 38114050 DOI: 10.1016/j.nbd.2023.106382] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/27/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
Studying the development of brain network disruptions in epilepsy is challenged by the paucity of data before epilepsy onset. Here, we used the unilateral, kainate mouse model of hippocampal epilepsy to investigate brain network changes before and after epilepsy onset and their stability across time. Using 32 epicranial electrodes distributed over the mouse hemispheres, we analyzed EEG epochs free from epileptic activity in 15 animals before and 28 days after hippocampal injection (group 1) and in 20 animals on two consecutive days (d28 and d29, group 2). Statistical dependencies between electrodes were characterized with the debiased-weighted phase lag index. We analyzed: a) graph metric changes from baseline to chronic stage (d28) in group 1; b) their reliability across d28 and d29, in group 2; c) their correlation with epileptic activity (EA: seizure, spike and fast-ripple rates), averaged over d28 and d29, in group 2. During the chronic stage, intra-hemispheric connections of the non-injected hemisphere strengthened, yielding an asymmetrical network in low (4-8 Hz) and high theta (8-12 Hz) bands. The contralateral hemisphere also became more integrated and segregated within the high theta band. Both network topology and EEG markers of EA were stable over consecutive days but not correlated with each other. Altogether, we show reproducible large-scale network modifications after the development of focal epilepsy. These modifications are mostly specific to the non-injected hemisphere. The absence of correlation with epileptic activity does not allow to specifically ascribe these network changes to mechanisms supporting EA or rather compensatory inhibition but supports the notion that epilepsy extends beyond the sole repetition of EA and impacts network that might not be involved in EA generation.
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Affiliation(s)
- Isotta Rigoni
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland.
| | - Guru Prasad Padmasola
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Laurent Sheybani
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Karl Schaller
- Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - Charles Quairiaux
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Serge Vulliemoz
- EEG and Epilepsy unit, Department of Neuroscience, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Geneva, Switzerland
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Tung H, Tsai SC, Huang PR, Hsieh PF, Lin YC, Peng SJ. Morphological and metabolic asymmetries of the thalamic subregions in temporal lobe epilepsy predict cognitive functions. Sci Rep 2023; 13:22611. [PMID: 38114641 PMCID: PMC10730825 DOI: 10.1038/s41598-023-49856-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: 06/06/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
Both morphological and metabolic imaging were used to determine how asymmetrical changes of thalamic subregions are involved in cognition in temporal lobe epilepsy (TLE). We retrospectively recruited 24 left-TLE and 15 right-TLE patients. Six thalamic subnuclei were segmented by magnetic resonance imaging, and then co-registered onto Positron emission tomography images. We calculated the asymmetrical indexes of the volumes and normalized standard uptake value ratio (SUVR) of the entire and individual thalamic subnuclei. The SUVR of ipsilateral subnuclei were extensively and prominently decreased compared with the volume loss. The posterior and medial subnuclei had persistently lower SUVR in both TLE cases. Processing speed is the cognitive function most related to the metabolic asymmetry. It negatively correlated with the metabolic asymmetrical indexes of subregions in left-TLE, while positively correlated with the subnuclei volume asymmetrical indexes in right-TLE. Epilepsy duration negatively correlated with the volume asymmetry of most thalamic subregions in left-TLE and the SUVR asymmetry of ventral and intralaminar subnuclei in right-TLE. Preserved metabolic activity of contralateral thalamic subregions is the key to maintain the processing speed in both TLEs. R-TLE had relatively preserved volume of the ipsilateral thalamic volume, while L-TLE had relatively decline of volume and metabolism in posterior subnucleus.
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Affiliation(s)
- Hsin Tung
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Center of Faculty Development, Taichung Veterans General Hospital, Taichung, Taiwan
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Chuan Tsai
- Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medical Imaging and Radiological Technology, Institute of Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Pu-Rong Huang
- Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Peiyuan F Hsieh
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Ching Lin
- Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medical Imaging and Radiological Technology, Institute of Radiological Science, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, No.250, Wuxing St., Xinyi Dist., Taipei City, 110, Taiwan.
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
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Bender AC, Jaleel A, Pellerin KR, Moguilner S, Sarkis RA, Cash SS, Lam AD. Altered Sleep Microarchitecture and Cognitive Impairment in Patients With Temporal Lobe Epilepsy. Neurology 2023; 101:e2376-e2387. [PMID: 37848332 PMCID: PMC10752648 DOI: 10.1212/wnl.0000000000207942] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/28/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the spatiotemporal characteristics of sleep waveforms in temporal lobe epilepsy (TLE) and examine their association with cognition. METHODS In this retrospective, cross-sectional study, we examined overnight EEG data from adult patients with TLE and nonepilepsy comparisons (NECs) admitted to the epilepsy monitoring unit at Mass General Brigham hospitals. Automated algorithms were used to characterize sleep macroarchitecture (sleep stages) and microarchitecture (spindles, slow oscillations [SOs]) on scalp EEG and to detect hippocampal interictal epileptiform discharges (hIEDs) from foramen ovale electrodes simultaneously recorded in a subset of patients with TLE. We examined the association of sleep features and hIEDs with memory and executive function from clinical neuropsychological evaluations. RESULTS A total of 81 adult patients with TLE and 28 NEC adult patients were included with similar mean ages. There were no significant differences in sleep macroarchitecture between groups, including relative time spent in each sleep stage, sleep efficiency, and sleep fragmentation. By contrast, the spatiotemporal characteristics of sleep microarchitecture were altered in TLE compared with NEC and were associated with cognitive impairments. Specifically, we observed a ∼30% reduction in spindle density in patients with TLE compared with NEC, which was significantly associated with worse memory performance. Spindle-SO coupling strength was also reduced in TLE and, in contrast to spindles, was associated with diminished executive function. We found no significant association between sleep macroarchitectural and microarchitectural parameters and hIEDs. DISCUSSION There is a fundamental alteration of sleep microarchitecture in TLE, characterized by a reduction in spindle density and spindle-SO coupling, and these changes may contribute to neurocognitive comorbidity in this disorder.
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Affiliation(s)
- Alex C Bender
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA.
| | - Afareen Jaleel
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Kyle R Pellerin
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Sebastian Moguilner
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Rani A Sarkis
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Sydney S Cash
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
| | - Alice D Lam
- From the Epilepsy Service (A.C.B., A.J., K.R.P., S.M., S.S.C., A.D.L.), Department of Neurology, Massachusetts General Hospital & Harvard Medical School, Boston; and Epilepsy Service (R.A.S.), Department of Neurology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA
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Kishore M, Pradeep M, Narne P, Jayalakshmi S, Panigrahi M, Patil A, Babu PP. Regulation of Keap1-Nrf2 axis in temporal lobe epilepsy-hippocampal sclerosis patients may limit the seizure outcomes. Neurol Sci 2023; 44:4441-4450. [PMID: 37432566 DOI: 10.1007/s10072-023-06936-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/02/2022] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Accumulation of reactive oxygen species (ROS) exacerbates neuronal loss during seizure-induced excitotoxicity. Keap1 (Kelch-like ECH-associated protein1)-nuclear factor erythroid 2-related factor 2 (Nrf2) axis is one of the known active antioxidant response mechanisms. Our study focused on finding the factors influencing Keap1-Nrf2 axis regulation in temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) patients. METHODS Based on post-surgical follow-up data, patient samples (n = 26) were categorized into class 1 (completely seizure-free) and class 2 (only focal-aware seizures/auras), as suggested by International League Against Epilepsy (ILAE). For molecular analyses, double immunofluorescence assay and Western blot analysis were employed. RESULTS A significant decrease in expression of Nrf2 (p < 0.005), HO-1; p < 0.02) and NADPH Quinone oxidoreductase1 (NQO1; p < 0.02) was observed in ILAE class 2. Keap1 (p < 0.02) and histone methyltransferases (HMTs) like SetD7 (SET7/9; SET domain-containing 7 histone lysine methyltransferase) (p < 0.009) and enhancer of zeste homolog 2 (EZH2; p < 0.02) and methylated histones viz., H3K4me1 (p < 0.001), H3K9me3 (p < 0.001), and H3K27me3 (p < 0.001) was upregulated in ILAE class 2. Nrf2-interacting proteins viz., p21 (p < 0.001) and heat shock protein 90 (HSP90; p < 0.03) increased in class 1 compared to class 2 patients. CONCLUSION Upregulation of HMTs and methylated histones can limit phase II antioxidant enzyme expression. Also, HSP90 and p21 that interfere with Keap1-Nrf2 interaction could contribute to a marginal increase in HO-1 and NQO1 expression despite histone methylation and Keap1. Based on our findings, we conclude that TLE-HS patients prone to seizure recurrence were found to have dysfunctional antioxidant response, in part, owing to Keap1-Nrf2 axis. The significance of Keap1-Nrf2 signaling mechanism in generation of phase II antioxidant response. Keap1-Nrf2 controls antioxidant response through regulation of phase II antioxidant enzymes like HO-1 (heme oxygenase-1), NQO1 (NADPH-Quinone Oxidoreductase1), and glutathione S-transferase (GST). Release of Nrf2 from negative regulation by Keap1 causes its translocation into nucleus, forming a complex with cAMP response-element binding protein (CBP) and small Maf proteins (sMaf). This complex subsequently binds antioxidant response element (ARE) and elicits and antioxidant response involving expression of phase II antioxidant enzymes. Reactive oxygen species (ROS) modify Cysteine 151 residue, p62 (sequsetosome-1), and interacts with Nrf2- binding site in Keap 1. p21 and HSP90 prevent Nrf2 interaction with Keap1. At transcriptional level, histone methyltransferases like EZH2 (enhancer of zeste homologue2), and SetD7 (SET7/9; SET domain-containing 7 histone lysine methyltransferase) and corresponding histone targets viz., H3K27me3, H3K9me3, and H3K4me1 influence Nrf2 and Keap1 expression respectively.
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Affiliation(s)
- Madhamanchi Kishore
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
| | - Madhamanchi Pradeep
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
- Govt. Degree College for Men's, Srikakulam District, Srikakulam, Andhra Pradesh, 532001, India
| | - Parimala Narne
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
| | - Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Manas Panigrahi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Anuja Patil
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Phanithi Prakash Babu
- Department of Biotechnology & Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India.
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Shao M, Yu H, Santhakumar V, Yu J. Antiepileptogenic and neuroprotective effect of mefloquine after experimental status epilepticus. Epilepsy Res 2023; 198:107257. [PMID: 37989006 DOI: 10.1016/j.eplepsyres.2023.107257] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
Acquired temporal lobe epilepsy (TLE) characterized by spontaneous recurrent seizures (SRS) and hippocampal inhibitory neuron dysfunction is often refractory to current therapies. Gap junctional or electrical coupling between inhibitory neurons has been proposed to facilitate network synchrony and intercellular molecular exchange suggesting a role in both seizures and neurodegeneration. While gap junction blockers can limit acute seizures, whether blocking neuronal gap junctions can modify development of chronic epilepsy has not been examined. This study examined whether mefloquine, a selective blocker of Connexin 36 gap junctions which are well characterized in inhibitory neurons, can limit epileptogenesis and related cellular and behavioral pathology in a model of acquired TLE. A single, systemic dose of mefloquine administered early after pilocarpine-induced status epilepticus (SE) in rat reduced both development of SRS and behavioral co-morbidities. Immunostaining for interneuron subtypes identified that mefloquine treatment likely reduced delayed inhibitory neuronal loss after SE. Uniquely, parvalbumin expressing neurons in the hippocampal dentate gyrus appeared relatively resistant to early cell loss after SE. Functionally, whole cell patch clamp recordings revealed that mefloquine treatment preserved inhibitory synaptic drive to projection neurons one week and one month after SE. These results demonstrate that mefloquine, a drug already approved for malaria prophylaxis, is potentially antiepileptogenic and can protect against progressive interneuron loss and behavioral co-morbidities of epilepsy.
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Affiliation(s)
- Mingting Shao
- Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China; Guangdong-Hongkong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Hang Yu
- Guangdong-Hongkong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Vijayalakshmi Santhakumar
- Department of Molecular, Cell and Systems Biology, University of California Riverside, Riverside, CA 92521, USA
| | - Jiandong Yu
- Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
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Oates M, Sharma AA, Nenert R, Mueller C, Szaflarski JP. An exploratory study of brain temperature and choline abnormalities in temporal lobe epilepsy patients with depressive symptoms. Epilepsia Open 2023; 8:1541-1555. [PMID: 37813409 PMCID: PMC10690665 DOI: 10.1002/epi4.12838] [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: 03/14/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE Epilepsy and depression share neurobiological origins, and evidence suggests a possible bidirectional relationship that remains poorly understood. This exploratory, cross-sectional study aimed to investigate this relationship by employing magnetic resonance spectroscopic imaging (MRSI) and thermometry (MRSI-t) in patients with temporal lobe epilepsy (TLE) with comorbid depressive symptoms and control participants. This is the first study to combine MRSI and MRSI-t to examine brain temperature and choline abnormalities in regions implicated in seizure onset and depression. METHODS Twenty-six patients with TLE and 26 controls completed questionnaires and underwent imaging at 3T. Volumetric echo-planar MRSI/MRSI-t data were processed within the Metabolite Imaging and Data Analysis System (MIDAS). Choline (CHO) was quantified as a ratio over creatine (CRE; CHO/CRE). Brain temperature (TCRE ) was calculated based on the chemical shift difference of H2 O relative to CRE's stable location on the ppm spectrum. The Hospital Anxiety and Depression Scale measured anxiety and depressive symptoms. The Chalfont Seizure Severity Scale measured seizure severity in patients with TLE. Two sets of voxelwise independent sample t tests examined group differences in CHO/CRE and TCRE maps. Voxel-based multimodal canonical correlation analysis (mCCA) linked both datasets to investigate if, how, and where CHO/CRE and TCRE abnormalities were correlated in TLE participants and controls. RESULTS Compared to controls, patients with TLE reported more depressive symptoms (P = 0.04) and showed CHO/CRE and TCRE elevations in left temporal and bilateral frontal regions implicated in seizure onset and depressive disorders (pFWE < 0.05). For the TLE group, CHO/CRE levels in temporal and frontal cortices were associated with elevated TCRE in bilateral frontal and temporal gyri (r = 0.96), and decreased TCRE in bilateral fronto-parietal regions (r = -0.95). SIGNIFICANCE Abnormalities in TCRE and CHO/CRE were observed in seizure-producing areas and in regions implicated in depression. These preliminary findings suggest that common metabolic changes may underlie TLE and depression. Our results suggest further investigations into the proposed bidirectional mechanisms underlying this relationship are warranted.
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Affiliation(s)
- Mina Oates
- Department of NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
- Present address:
Haverford CollegeHaverfordPennsylvaniaUSA
| | - Ayushe A. Sharma
- Department of NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
| | - Rodolphe Nenert
- Department of NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
| | - Christina Mueller
- Department of NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
| | - Jerzy P. Szaflarski
- Department of NeurologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
- Department of NeurobiologyUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
- Department of NeurosurgeryUniversity of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
- UAB Epilepsy Center, University of Alabama at Birmingham (UAB)BirminghamAlabamaUSA
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Puteikis K, Wolf P, Mameniškienė R. Longer-term verbal and visual memory patterns in patients with temporal lobe and genetic generalized epilepsies. Epilepsia Open 2023; 8:1279-1287. [PMID: 37381720 PMCID: PMC10690666 DOI: 10.1002/epi4.12779] [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: 02/10/2023] [Accepted: 06/24/2023] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVE To compare forgetting patterns between patients with temporal lobe (TLE) and generalized (GGE) epilepsies and to assess whether recall is associated with epileptic activity. METHODS Thirty-three patients with TLE (13 left, 17 right, and 3 nonlateralized TLE), 42 patients with GGE, and 57 healthy controls (HCs) were asked to recall words, verbal story material, and the Rey-Osterrieth complex figure at two delays. Accelerated long-term forgetting (ALF) was defined by group performance comparable to HCs at 30 min and worse recall than HCs after 4 weeks. ALF was assessed by comparing raw test scores in a two-way repeated measures analysis of variance (ANOVA) adjusted for the learning capacity. RESULTS Compared to HCs, patients with R-TLE remembered fewer items of the word list after 30 min as well as after 4 weeks. Patients with L-TLE and GGE had comparable learning-adjusted performance to HCs at the 30 min delay but scored less after 4 weeks (group by delay interaction F(3, 124) = 3.2, P = 0.026,η p 2 = 0.07). The epilepsy group (patients with TLE and GGE combined) performed as well as HCs at 30 min but worse after 4 weeks irrespective of experienced seizures during the 4-week delay or interictal bilateral (TLE) or generalized (GGE) activity before the study. We noted no statistically significant differences between patient and HC verbal story (group by delay interaction F(3, 124) = 0.7, P = 0.570,η p 2 = 0.02) or complex figure (F(3, 124) = 0.8, P = 0.488,η p 2 = 0.02) recall. SIGNIFICANCE Our data support verbal and visual memory impairment in both TLE and GGE with different performances between these groups in the task of word recall. We suggest the presence of ALF in patients with GGE and left TLE after adjusting for learning capacity. We could not confirm the influence of epileptic activity on long-term forgetting patterns. Future studies are required to better define domain-specific differences in memory impairment in TLE and GGE.
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Affiliation(s)
| | - Peter Wolf
- Center for NeurologyVilnius UniversityVilniusLithuania
- Danish Epilepsy Center FiladelfiaDianalundDenmark
- Postgraduation Program of Medical SciencesSanta Catarina Federal UniversityFlorianópolisBrazil
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Fan L, Liu L, Rao X, Wang X, Luo H, Gan J. The 100 most-cited manuscripts in epilepsy epigenetics: a bibliometric analysis. Childs Nerv Syst 2023; 39:3111-3122. [PMID: 37340273 PMCID: PMC10643235 DOI: 10.1007/s00381-023-06032-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/12/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE The top citation article reflects the developmental milestone of a given field. The purpose of this bibliometric analysis was to identify and assess the 100 most-cited (T100) articles on the epigenetics mechanism of epilepsy. METHODS The Web of Science Core Collection (WoSCC) database was used to investigate, and search terms related to epilepsy epigenetics were compiled. Results were ranked according to citation number. The publication year, citation density, authorship, journal, country, institution, manuscript type, theme, and clinical topics were further evaluated. RESULTS The Web of Science search returned a total of 1231 manuscripts. The number of citations for a manuscript ranges from 739 to 75. The greatest number of manuscripts in the top 100 was published in the Human Molecular Genetics and Neurobiology of Disease (n = 4). The journal with the highest 2021 impact factor was Nature Medicine (IF = 87.244). The most-cited paper by Aid et al. reported a new nomenclature for mouse and rat BDNF gene and its expression profiles. Most manuscripts were original articles (n = 69), of which 52 (75.4%) report findings of basic scientific work. The most prevalent theme was microRNA (n = 29), and the most popular clinical topic was temporal lobe epilepsy (n = 13). CONCLUSIONS The research on the epigenetics mechanism of epilepsy was in its infancy but full of potential. The developmental history and current achievements of hot themes, including microRNA, DNA methylation, and temporal lobe epilepsy, were overviewed. This bibliometric analysis provides useful information and insight for researchers when launching new projects.
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Affiliation(s)
- Lijuan Fan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Chengdu, Sichuan, China
| | - Lu Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China
- West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Xueyi Rao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Chengdu, Sichuan, China
| | - Xiaoqian Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Chengdu, Sichuan, China
| | - Huan Luo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Chengdu, Sichuan, China
| | - Jing Gan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China.
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China.
- Key Laboratory of Development and Maternal and Child Diseases of Sichuan Province, Chengdu, Sichuan, China.
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Tian Z, Huang S, Wen S, Zhang Q, Huang K, Gui Y, Hu B, Feng L, Wang Q. Event-related potentials reveal visual episodic memory deficits in patients with temporal lobe epilepsy. Epilepsy Behav 2023; 148:109460. [PMID: 37839245 DOI: 10.1016/j.yebeh.2023.109460] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/17/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) patients usually suffer from impaired episodic memory (EM), but its underlying electrophysiologic mechanism and impacted cognitive performance are unclear. We aim to investigate the association between episodic memory reserve and physiological measures of memory workload in TLE patients using Event-related potentials (ERP). METHODS A change detection task with image stimuli assesses visual episodic memory. During the memory encoding and decoding phases, the ERP signals were analyzed from twenty-nine TLE patients (twelve with left TLE patients, seventeen with TLE), and thirty healthy controls. Given that EM is a complex process involving many fundamental cognitive processes, the amplitudes and latencies of EM-related ERP (FN400, late positive potential (LPC), and late posterior negativity (LPN)), and the ERP reflecting the fundamental processes (P100, N100, P200, and P300) were calculated. Then we used a three-by-two factorial design on the ERP metrics for interaction and main effects. The correlation analysis among Wechsler Memory Scales-Chinese Revision (WMS-RC) results, behavioral data, and the ERPs was carried out. RESULTS The TLE patients performed worse in WMS-RC and the memory task. The increased P200 and decreased P300 amplitudes were observed in the TLE patients, and LPN was abnormal in only LTLE patients. For EM-related components, differences were observed in both the LTLE and RTLE patients: the lack of the FN400 effect, the lack of the reversed LPC effect, and the reduced FN400. No significant inter-group difference was detected for the latencies of all the ERPs. Additionally, there were significant correlations among WMS-RC scores, behaviors, and some ERP amplitudes. CONCLUSIONS The impaired EM is linked to the increased P200 and decreased P300 amplitudes. LPN seems to be sensitive to left temporal lobe dysfunction. More importantly, the abnormal old or new effects of the FN400 and LPC, and the reduced FN400 amplitude might be associated with the visual EM deficit in the TLE patients. These findings may assist in the deep understanding of the EM disorder and the evaluation of the side effects of antiepileptic drugs.
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Affiliation(s)
- Ziwei Tian
- Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China; University of Chinese Academy of Sciences, Beijing 101408, China; Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 330000, China
| | - Shirui Wen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 330000, China
| | - Qiong Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 330000, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 330000, China
| | - Yawei Gui
- Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China; University of Chinese Academy of Sciences, Beijing 101408, China; Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China
| | - Bingliang Hu
- Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China; Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 330000, China; Department of Neurology, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, Jiangxi 410008, China.
| | - Quan Wang
- Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China; Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi'an 710119, China.
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Sanborn V, Ayub N, Margolis SA. AGR - 3 Epilepsy Surgical Planning in a Patient with Co-Morbid Multiple Sclerosis and Seizures. Arch Clin Neuropsychol 2023; 38:1143. [PMID: 37807102 DOI: 10.1093/arclin/acad067.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Research increasingly points to historically unappreciated cortical effects of multiple sclerosis (MS), with two-fold elevated risk of seizures. Nevertheless, epilepsy only occurs in 2-5% of cases. We present a 42-year-old, right-handed, woman with epilepsy and MS under consideration for epilepsy surgery. METHOD Epilepsy and MS were diagnosed concurrently at age 31; seizures were the presenting symptom. Despite infrequent MS flares, seizures are weekly-to-monthly focal aware, focal unaware and focal-to-bilateral, starting with right head version, dysarthria, and spinning, followed by secondary generalization, at times occurring in clusters. Brain MRI revealed bilateral MS lesions including in left medial-frontal lobe and left hippocampus (Figure 1). Phase I EEG suggested left-lateralized seizures with broad frontotemporal evolution and rapid bifrontal synchrony. Interictal PET was unrevealing. fMRI determined left-hemisphere language dominance. Neuropsychological evaluation (NPE) was ordered to estimate cognitive risks of left-sided surgery. RESULTS NPE revealed relatively intact language and verbal learning/memory with exceptionally low visual learning/memory. Visuospatial skills were below average to exceptionally low. Although motor dexterity was exceptionally low bilaterally, her left-hand was markedly slower. Executive functioning, processing speed, and sustained attention were exceptionally low. Risk stratification drew upon traditional epilepsy surgery outcomes, as only 2 cases of epilepsy surgery in vastly different MS patients have been published. CONCLUSIONS NPE suggested high functional adequacy of the left hemisphere with low functional reserve of the right hemisphere. Due to paradoxical findings across structural/functional brain imaging, EEG, and NPE, with unclear effects/implications of MS, cautions were raised about surgery. Stereo-EEG and magnetoencephalography were recommended/ordered to determine the safest surgical option.
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Whitebirch AC, Santoro B, Barnett A, Lisgaras CP, Scharfman HE, Siegelbaum SA. Reduced Cholecystokinin-Expressing Interneuron Input Contributes to Disinhibition of the Hippocampal CA2 Region in a Mouse Model of Temporal Lobe Epilepsy. J Neurosci 2023; 43:6930-6949. [PMID: 37643861 PMCID: PMC10573827 DOI: 10.1523/jneurosci.2091-22.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/09/2022] [Revised: 08/04/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
A significant proportion of temporal lobe epilepsy (TLE) patients experience drug-resistant seizures associated with mesial temporal sclerosis, in which there is extensive cell loss in the hippocampal CA1 and CA3 subfields, with a relative sparing of dentate gyrus granule cells and CA2 pyramidal neurons (PNs). A role for CA2 in seizure generation was suggested based on findings of a reduction in CA2 synaptic inhibition (Williamson and Spencer, 1994) and the presence of interictal-like spike activity in CA2 in resected hippocampal tissue from TLE patients (Wittner et al., 2009). We recently found that in the pilocarpine-induced status epilepticus (PILO-SE) mouse model of TLE there was an increase in CA2 intrinsic excitability associated with a loss of CA2 synaptic inhibition. Furthermore, chemogenetic silencing of CA2 significantly reduced seizure frequency, consistent with a role of CA2 in promoting seizure generation and/or propagation (Whitebirch et al., 2022). In the present study, we explored the cellular basis of this inhibitory deficit using immunohistochemical and electrophysiological approaches in PILO-SE male and female mice. We report a widespread decrease in the density of pro-cholecystokinin-immunopositive (CCK+) interneurons and a functional impairment of CCK+ interneuron-mediated inhibition of CA2 PNs. We also found a disruption in the perisomatic perineuronal net in the CA2 stratum pyramidale. Such pathologic alterations may contribute to an enhanced excitation of CA2 PNs and CA2-dependent seizure activity in the PILO-SE mouse model.SIGNIFICANCE STATEMENT Impaired synaptic inhibition in hippocampal circuits has been identified as a key feature that contributes to the emergence and propagation of seizure activity in human patients and animal models of temporal lobe epilepsy (TLE). Among the hippocampal subfields, the CA2 region is particularly resilient to seizure-associated neurodegeneration and has been suggested to play a key role in seizure activity in TLE. Here we report that perisomatic inhibition of CA2 pyramidal neurons mediated by cholecystokinin-expressing interneurons is selectively reduced in acute hippocampal slices from epileptic mice. Parvalbumin-expressing interneurons, in contrast, appear relatively conserved in epileptic mice. These findings advance our understanding of the cellular mechanisms underlying inhibitory disruption in hippocampal circuits in a mouse model of spontaneous recurring seizures.
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Affiliation(s)
- Alexander C Whitebirch
- Departments of Neuroscience and Pharmacology, Kavli Institute for Brain Science, Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University Irving Medical Center, New York, New York 10027
| | - Bina Santoro
- Departments of Neuroscience and Pharmacology, Kavli Institute for Brain Science, Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University Irving Medical Center, New York, New York 10027
| | - Anastasia Barnett
- Departments of Neuroscience and Pharmacology, Kavli Institute for Brain Science, Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University Irving Medical Center, New York, New York 10027
| | - Christos Panagiotis Lisgaras
- Department of Child & Adolescent Psychiatry, New York University Langone Health, New York, New York 10016
- Department of Neuroscience & Physiology, New York University Langone Health, New York, New York 10016
- Department of Psychiatry, New York University Langone Health, New York, New York 10016
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962
| | - Helen E Scharfman
- Department of Child & Adolescent Psychiatry, New York University Langone Health, New York, New York 10016
- Department of Neuroscience & Physiology, New York University Langone Health, New York, New York 10016
- Department of Psychiatry, New York University Langone Health, New York, New York 10016
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962
| | - Steven A Siegelbaum
- Departments of Neuroscience and Pharmacology, Kavli Institute for Brain Science, Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University Irving Medical Center, New York, New York 10027
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Maliekal L, Zutshi D, Millis S, Basha MM. Predicting seizure clustering in the epilepsy monitoring unit: A multivariable analysis. Epilepsy Behav 2023; 147:109433. [PMID: 37717459 DOI: 10.1016/j.yebeh.2023.109433] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/20/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Seizure clustering, is the most frequently reported adverse event in epilepsy monitoring unit (EMU) safety studies which, can also potentiate other adverse events, such as falls, status epilepticus, and increased length of stay. The purpose of this study is to determine variables associated with increased risk of seizure clustering among patients admitted to the EMU. METHODS A retrospective review of patients admitted to the EMU over a two-year period was completed. Data collected included patient demographics, types of epilepsy, seizure frequency, anti-seizure medications (ASMs) and hospital and EMU course including incidence of seizure clustering. RESULTS Two hundred seven patients were included in our study; of these, ninety patients experienced two or more seizures in a 24-hour period (24SC), and 68 patients experienced two or more seizures in a 4-hour period (4SC). Logistic regression analysis associated the absence of long-acting ASM with increased clustering within the 4SC group (p = 0.038). For every additional ASM taken by a patient at home, the odds of seizure clustering increased by 81% in the 4SC group (p = 0.009) and by 61% in the 24SC group (p = 0.022). In addition, patients with a diagnosis of temporal lobe epilepsy had some association with clustering in the 24SC group (p = 0.061). CONCLUSION Our data showed that long-acting ASMs can be protective against seizure clustering. Furthermore, patients with temporal lobe epilepsy, and those on increased numbers of ASMs, were more likely to experience seizure clustering when undergoing medication withdrawal during an EMU evaluation.
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Affiliation(s)
- Leya Maliekal
- Comprehensive Epilepsy Center, Department of Neurology, Wayne State University School of Medicine, 4201 St. Antoine, UHC 8C, Detroit, MI 48201, USA.
| | - Deepti Zutshi
- Comprehensive Epilepsy Center, Department of Neurology, Wayne State University School of Medicine, 4201 St. Antoine, UHC 8C, Detroit, MI 48201, USA.
| | - Scott Millis
- Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, 261 Mack Avenue, Detroit, MI 48201, USA.
| | - Maysaa M Basha
- Comprehensive Epilepsy Center, Department of Neurology, Wayne State University School of Medicine, 4201 St. Antoine, UHC 8C, Detroit, MI 48201, USA.
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Dyomina AV, Smolensky IV, Zaitsev AV. Refinement of the Barnes and Morris water maze protocols improves characterization of spatial cognitive deficits in the lithium-pilocarpine rat model of epilepsy. Epilepsy Behav 2023; 147:109391. [PMID: 37619464 DOI: 10.1016/j.yebeh.2023.109391] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
Temporal lobe epilepsy (TLE) often causes cognitive impairment, especially a decline in spatial memory. Reductions in spatial memory and learning are also common in rodent models of TLE. The Morris water maze and the Barnes maze are the standard methods for evaluating spatial learning and memory in rodents. However, animals with TLE may exhibit agitation, distress, and fail to follow the paradigmatic context of these tests, making the interpretation of experimental data difficult. This study optimized the procedure of the Morris water maze and the Barnes maze to evaluate spatial learning and memory in rats with the lithium-pilocarpine TLE model (LPM rats). It was demonstrated that LPM rats required a mandatory and prolonged habituation stage for both tests. Therefore, the experimental rats performed relatively well on these tests. Nevertheless, LPM rats exhibited a slower learning process compared to the control rats. LPM rats also showed a reduction in spatial memory formation. This was more pronounced in the Barnes maze. Also, LPM rats utilized a sequential strategy for searching in the Barnes maze and were incapable of developing a more efficient spatial search strategy that is common in control animals. The Barnes maze may be a better choice for assessing search strategies, learning deficits, and spatial memory in rats with TLE when choosing between the two tests. This is because of the risk of unexpected seizure occurrence during the Morris water maze tests, and the potential risks for animal welfare.
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Affiliation(s)
- Alexandra V Dyomina
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS (IEPhB), 44, Toreza pr., Saint Petersburg 194223, Russia
| | - Ilya V Smolensky
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS (IEPhB), 44, Toreza pr., Saint Petersburg 194223, Russia; Department of Community Health, University of Fribourg, Chemin du Musée 4, 1700 Fribourg, Switzerland; Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland
| | - Aleksey V Zaitsev
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS (IEPhB), 44, Toreza pr., Saint Petersburg 194223, Russia.
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Tayebi Meybodi A, Mignucci-Jiménez G, Xu Y, Preul MC. Artery of Uchimura: origin and evolution of identification of the vascular supply to the hippocampus. J Neurosurg 2023; 139:1128-1139. [PMID: 37086167 DOI: 10.3171/2023.2.jns221963] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/02/2023] [Indexed: 04/03/2023]
Abstract
In 1928, neuroscientist Yushi Uchimura (1897-1980) published a landmark study detailing the hippocampal vasculature. Working in Walther Spielmeyer's Munich laboratory (1925-1927), Uchimura sought evidence for a vascular theory of Ammon's horn sclerosis (AHS). He described an artery supplying the vulnerable sector of the hippocampus, where pathognomonic changes of AHS were noted, and characterized the artery as particularly susceptible to circulatory disturbances. Discovery of this artery led to new concepts and new terminology pertaining to the hippocampus. In addition to having a distinguished career in psychiatry and academia (including a position as University of Tokyo dean), Uchimura was, before attending medical school, one of Japan's best baseball pitchers; he was eventually named Nippon Professional Baseball Organization commissioner and inducted into the Japan Baseball Hall of Fame. Uchimura's description of hippocampal vasculature, which is still subject to debate after nearly a century, brought international attention to AHS and epilepsy and showed the hippocampal vasculature to be variable and vulnerable; important considerations for later neurosurgeons in the development of selective mesial temporal surgery. Prominent figures in neurosurgery have since developed classification systems for the hippocampal vasculature in which the artery of Uchimura remains central. Perhaps no other brain artery has been the nexus for such intense investigation and debate about its association to structure, function, disease, and treatment methodology.
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Affiliation(s)
- Ali Tayebi Meybodi
- 1Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Giancarlo Mignucci-Jiménez
- 2Department of Neurosurgery, The Loyal and Edith Davis Neurosurgical Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Yuan Xu
- 2Department of Neurosurgery, The Loyal and Edith Davis Neurosurgical Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Mark C Preul
- 2Department of Neurosurgery, The Loyal and Edith Davis Neurosurgical Research Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Mueller JS, Tescarollo FC, Huynh T, Brenner DA, Valdivia DJ, Olagbegi K, Sangappa S, Chen SC, Sun H. Ictogenesis proceeds through discrete phases in hippocampal CA1 seizures in mice. Nat Commun 2023; 14:6010. [PMID: 37752179 PMCID: PMC10522592 DOI: 10.1038/s41467-023-41711-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Epilepsy is characterized by spontaneous non-provoked seizures, yet the mechanisms that trigger a seizure and allow its evolution remain underexplored. To dissect out phases of ictogenesis, we evoked hypersynchronous activity with optogenetic stimulation. Focal optogenetic activation of putative excitatory neurons in the mouse hippocampal CA1 reliably evoked convulsive seizures in awake mice. A time-vs-time pulsogram plot characterized the evolution of the EEG pulse response from a light evoked response to induced seizure activity. Our results depict ictogenesis as a stepwise process comprised of three distinctive phases demarcated by two transition points. The induction phase undergoes the first transition to reverberant phase activity, followed by the second transition into the paroxysmal phase or a seizure. Non-seizure responses are confined to either induction or reverberant phases. The pulsogram was then constructed in seizures recorded from a murine model of temporal lobe epilepsy and it depicted a similar reverberance preceding spontaneous seizures. The discovery of these distinct phases of ictogenesis may offer means to abort a seizure before it develops.
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Affiliation(s)
- John-Sebastian Mueller
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Fabio C Tescarollo
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Trong Huynh
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Daniel A Brenner
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Daniel J Valdivia
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Kanyin Olagbegi
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Sahana Sangappa
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Spencer C Chen
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Hai Sun
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA.
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Goirand-Lopez L, Moulinier M, Vigier A, Boileau C, Carleton A, Muldoon SF, Marissal T, Crépel V. Kainate receptors modulate the microstructure of synchrony during dentate gyrus epileptiform activity. Neurobiol Dis 2023; 185:106260. [PMID: 37573957 DOI: 10.1016/j.nbd.2023.106260] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/28/2023] [Accepted: 08/11/2023] [Indexed: 08/15/2023] Open
Abstract
Temporal Lobe Epilepsy (TLE) is the most common form of epilepsy in adults. In TLE, recurrent mossy fiber (rMF) sprouting from dentate gyrus granule cells (DGCs) forms an aberrant epileptogenic network between dentate granule cells (DGCs) that operates via ectopically expressed kainate receptors (KARs). It was previously shown that KARs expressed at the rMF-DGC synapses play a prominent role in epileptiform network events in TLE. However, it is not well understood how KARs influence neuronal network dynamics and contribute to the generation of epileptiform network activity in the dentate gyrus. To address this question, we monitored the activity of DGCs using single-cell resolution calcium imaging performed in a reliable in vitro model of TLE. Under our experimental conditions, the most prominent DGC activity patterns were interictal-like epileptiform network events, which were correlated with high levels of neuronal synchronization. The pharmacological blockade of KARs reduced the frequency as well as the number of neurons involved in these events, without altering their spatiotemporal dynamics. Analysis of the microstructure of synchrony showed that blockade of KARs diminished the fraction of neurons forming the main functional cluster. Therefore, we propose that KARs act as modulators in the epileptic network by facilitating the recruitment of neurons into coactive cell assemblies, thereby contributing to the occurrence of epileptiform network events.
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Affiliation(s)
| | - Marie Moulinier
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | | | - Alan Carleton
- Department of Basic Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sarah F Muldoon
- Mathematics Department, Institute for Artificial Intelligence and Data Science, and Neuroscience Program, University at Buffalo, SUNY, Buffalo NY14260, USA
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Madhamanchi K, Madhamanchi P, Jayalakshmi S, Panigrahi M, Patil A, Phanithi PB. Dopamine and Glutamate Crosstalk Worsen the Seizure Outcome in TLE-HS Patients. Mol Neurobiol 2023; 60:4952-4965. [PMID: 37209264 DOI: 10.1007/s12035-023-03361-4] [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: 10/18/2022] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
Temporal lobe epilepsy (TLE), accompanied by hippocampal sclerosis (HS), is the most common form of drug-resistant epilepsy (DRE). Nearly 20% of the patients showed seizure recurrence even after surgery, and the reasons are yet to be understood. Dysregulation of neurotransmitters is evident during seizures, which can induce excitotoxicity. The present study focused on understanding the molecular changes associated with Dopamine (DA) and glutamate signaling and their possible impact on the persistence of excitotoxicity and seizure recurrence in patients with drug-resistant TLE-HS who underwent surgery. According to the International League against Epilepsy (ILAE) suggested classification for seizure outcomes, the patients (n = 26) were classified as class 1 (no seizures) and class 2 (persistent seizures) using the latest post-surgery follow-up data to understand the prevalent molecular changes in seizure-free and seizure-recurrence patient groups. Our study uses thioflavin T assay, western blot analysis, immunofluorescence assays, and fluorescence resonance energy transfer (FRET) assays. We have observed a substantial increase in the DA and glutamate receptors that promote excitotoxicity. Patients who had seizure recurrence showed a significant increase in (pNR2B, p < 0.009; and pGluR1, p < 0.01), protein phosphatase1γ (PP1γ; p < 0.009), protein kinase A (PKAc; p < 0.001) and dopamine-cAMP regulated phospho protein32 (pDARPP32T34; p < 0.009) which are critical for long-term potentiation (LTP), excitotoxicity compared to seizure-free patients and controls. A significant increase in D1R downstream kinases like PKA (p < 0.001), pCAMKII (p < 0.009), and Fyn (p < 0.001) was observed in patient samples compared to controls. Anti-epileptic DA receptor D2R was found to be decreased in ILAE class 2 (p < 0.02) compared to class 1. Since upregulation of DA and glutamate signaling supports LTP and excitotoxicity, we believe it could impact seizure recurrence. Further studies about the impact of DA and glutamate signaling on the distribution of PP1γ at postsynaptic density and synaptic strength could help us understand the seizure microenvironment in patients. Dopamine, Glutamate signal crosstalk. Diagram representing the PP1γ regulation by NMDAR negative feedback inhibition signaling (green circle-left) and D1R signal (red circle-middle) domination over PP1γ though increased PKA, pDARPP32T34, and supports pGluR1, pNR2B in seizure recurrent patients. D1R-D2R hetero dimer activation (red circle-right) increases cellular Ca2+ and pCAMKIIα activation. All these events lead to calcium overload in HS patients and excitotoxicity, particularly in patients experiencing recurrent seizures.
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Affiliation(s)
- Kishore Madhamanchi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
| | - Pradeep Madhamanchi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India
- Govt. Degree College for Men's, Srikakulam District, Andhra Pradesh, 532001, India
| | - Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Manas Panigrahi
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Anuja Patil
- Department of Neurology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India
| | - Prakash Babu Phanithi
- Department of Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, Telangana, 500046, India.
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Rigoni I, Rué Queralt J, Glomb K, Preti MG, Roehri N, Tourbier S, Spinelli L, Seeck M, Van De Ville D, Hagmann P, Vulliémoz S. Structure-function coupling increases during interictal spikes in temporal lobe epilepsy: A graph signal processing study. Clin Neurophysiol 2023; 153:1-10. [PMID: 37364402 DOI: 10.1016/j.clinph.2023.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/04/2023] [Revised: 04/21/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Structure-function coupling remains largely unknown in brain disorders. We studied this coupling during interictal epileptic discharges (IEDs), using graph signal processing in temporal lobe epilepsy (TLE). METHODS We decomposed IEDs of 17 patients on spatial maps, i.e. network harmonics, extracted from a structural connectome. Harmonics were split in smooth maps (long-range interactions reflecting integration) and coarse maps (short-range interactions reflecting segregation) and were used to reconstruct the part of the signal coupled (Xc) and decoupled (Xd) from the structure, respectively. We analysed how Xc and Xd embed the IED energy over time, at global and regional level. RESULTS For Xc, the energy was smaller than for Xd before the IED onset (p < .001), but became larger around the first IED peak (p < .05, cluster 2, C2). Locally, the ipsilateral mesial regions were significantly coupled to the structure over the whole epoch. The ipsilateral hippocampus increased its coupling during C2 (p < .01). CONCLUSIONS At whole-brain level, segregation gives way to integrative processes during the IED. Locally, brain regions commonly involved in the TLE epileptogenic network increase their reliance on long-range couplings during IED (C2). SIGNIFICANCE In TLE, integration mechanisms prevail during the IED and are localized in the ipsilateral mesial temporal regions.
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Affiliation(s)
- I Rigoni
- EEG and Epilepsy Unit, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Switzerland.
| | - J Rué Queralt
- Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Switzerland
| | - K Glomb
- Brain Simulation Section, Berlin Institute of Health/Charite, 10098 Berlin, Germany
| | - M G Preti
- Neuro-X Institute, School of Engineering, Ecole polytechnique fédérale de Lausanne, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Switzerland
| | - N Roehri
- EEG and Epilepsy Unit, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Switzerland
| | - S Tourbier
- Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Switzerland
| | - L Spinelli
- EEG and Epilepsy Unit, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Switzerland
| | - M Seeck
- EEG and Epilepsy Unit, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Switzerland
| | - D Van De Ville
- Neuro-X Institute, School of Engineering, Ecole polytechnique fédérale de Lausanne, Geneva, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - P Hagmann
- Department of Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Switzerland
| | - S Vulliémoz
- EEG and Epilepsy Unit, University Hospital and Faculty of Medicine of Geneva, University of Geneva, Switzerland
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Sekimoto M, Kato M, Muramatsu R, Onuma T. Cognitive dysfunction in drug-naïve late-onset temporal lobe epilepsy. Epilepsy Behav 2023; 146:109356. [PMID: 37499577 DOI: 10.1016/j.yebeh.2023.109356] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES To evaluate cognitive functions including memory in middle-aged and elderly patients with antiseizure drug-naïve late-onset temporal lobe epilepsy (TLE). METHODS We performed assessments with the Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-Revised (WMS-R) in 26 antiseizure drug-naïve patients with late-onset TLE, in comparison to 30 healthy subjects. We investigated the relationships between these cognitive function scores and clinical characteristics, seizure frequency, and frequency of interictal epileptic discharges (IEDs). RESULTS Patients with epilepsy had a significantly lower score than healthy controls in the verbal intelligence quotient (IQ), the performance IQ, and full-scale IQ in intelligence testing. Patients showed significantly decrease in the verbal memory scores, visual memory scores, general memory scores, and delayed recall scores compared with those in the control subjects. Delayed recall scores were significantly negatively correlated with recent seizure frequency and the total IEDs count per minute, but not with age of onset or duration of illness. SIGNIFICANCE Patients with antiseizure drug-naïve late-onset TLE displayed cognitive deficits including the domains of memory by using standard clinical neuropsychological test. Patients with late-onset epilepsy need to be considered for cognitive dysfunction at the time of diagnosis of TLE because they may have their daily life and work affected not only by epileptic seizures but also by cognitive deficits. Appearance of seizures and EEG abnormalities may affect the memory function in patients with late-onset TLE.
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Yang X, Cao Q, Guo Y, He J, Xu D, Lin A. GSDMD knockdown attenuates phagocytic activity of microglia and exacerbates seizure susceptibility in TLE mice. J Neuroinflammation 2023; 20:193. [PMID: 37612735 PMCID: PMC10464294 DOI: 10.1186/s12974-023-02876-w] [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: 05/23/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Temporal lobe epilepsy (TLE) is often characterized pathologically by severe neuronal loss in the hippocampus. Phagocytic activity of microglia is essential for clearing apoptotic neuronal debris, allowing for repair and regeneration. Our previous research has shown that gasdermin D (GSDMD)-mediated pyroptosis is involved in the pathogenesis of TLE. However, whether GSDMD-mediated pyroptosis influences the accumulation of apoptotic neurons remains unclear. Therefore, the present study was designed to investigate whether phagocytic activity of microglia is involved in GSDMD-mediated pyroptosis and the pathogenesis of TLE. METHODS To establish a TLE model, an intra-amygdala injection of kainic acid (KA) was performed. The Racine score and local field potential (LFP) recordings were used to assess seizure severity. Neuronal death in the bilateral hippocampus was assessed by Nissl staining and TUNEL staining. Microglial morphology and phagocytic activity were detected by immunofluorescence and verified by lipopolysaccharide (LPS) and the P2Y12R agonist 2MeSADP. RESULTS GSDMD knockdown augmented the accumulation of apoptotic neurons and seizure susceptibility in TLE mice. Microglia activated and transition to the M1 type with increased pro-inflammatory cytokines. Furthermore, GSDMD knockdown attenuated the migration and phagocytic activity of microglia. Of note, LPS-activated microglia attenuated seizure susceptibility and the accumulation of apoptotic neurons in TLE after GSDMD knockdown. A P2Y12R selective agonist, 2MeSADP, enhanced the migration and phagocytic activity of microglia. CONCLUSIONS Our results demonstrate that GSDMD knockdown exacerbates seizure susceptibility and the accumulation of apoptotic neurons by attenuating phagocytic activity of microglia. These findings suggest that GSDMD plays a protective role against KA-induced seizure susceptibility.
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Affiliation(s)
- Xiaoxia Yang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Anshan Road No. 154, Tianjin, 300052, China
| | - Qingqing Cao
- Department of Neurology, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, No. 9 Shuangxing Road, Chongqing, 402760, China
| | - Yi Guo
- Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, 32# W. Sec 2, 1st Ring Rd, Chengdu, 610072, Sichuan, China
| | - Jingchuan He
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital, No.6 Jizhao Road Jinnan District, Tianjin, 300350, China
| | - Demei Xu
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1Youyi Road, Chongqing, 400016, China
| | - Aolei Lin
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Anshan Road No. 154, Tianjin, 300052, China.
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Fernández-Cabrera A, López-González FJ, García-de Soto J, Pardellas-Santiago E, Lara-Lezama LB, Rodríguez-Osorio X. [The sign of the cross: a very rare automatism in temporal lobe epilepsy. Two case reports]. Rev Neurol 2023; 77:105-108. [PMID: 37489859 PMCID: PMC10662193 DOI: 10.33588/rn.7704.2023128] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION In the evaluation of drug-resistant epilepsy (DRF), a detailed analysis of the semiology is essential to establish a diagnostic hypothesis of the location of the epileptogenic zone. Cross-sign (CS) is a very infrequent complex manual automatism described for the first time in 2008 and rarely reported in the literature. CASE REPORT We present two cases from our series of patients monitored by videoEEG, one of whom also studied with deep electrodes, in which we describe the location of the discharge while performing the CS. A bibliographic review is also carried out to try to establish a localizing and/or lateralizing value of this sign. CONCLUSION The sign of the cross is a rare ictal automatism that occurs in patients with temporal lobe epilepsy. The hand used to make the sign of the cross is the dominant one, regardless of the origin of the crises.
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Affiliation(s)
| | - F J López-González
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - J García-de Soto
- Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - E Pardellas-Santiago
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
| | | | - X Rodríguez-Osorio
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, España
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Ballerini A, Arienzo D, Stasenko A, Schadler A, Vaudano AE, Meletti S, Kaestner E, McDonald CR. Spatial patterns of gray and white matter compromise relate to age of seizure onset in temporal lobe epilepsy. Neuroimage Clin 2023; 39:103473. [PMID: 37531834 PMCID: PMC10415805 DOI: 10.1016/j.nicl.2023.103473] [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: 04/29/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Temporal Lobe Epilepsy (TLE) is frequently a neurodevelopmental disorder, involving subcortical volume loss, cortical atrophy, and white matter (WM) disruption. However, few studies have addressed how these pathological changes in TLE relate to one another. In this study, we investigate spatial patterns of gray and white matter degeneration in TLE and evaluate the hypothesis that the relationship among these patterns varies as a function of the age at which seizures begin. METHODS Eighty-two patients with TLE and 59 healthy controls were enrolled. T1-weighted images were used to obtain hippocampal volumes and cortical thickness estimates. Diffusion-weighted imaging was used to obtain fractional anisotropy (FA) and mean diffusivity (MD) of the superficial WM (SWM) and deep WM tracts. Analysis of covariance was used to examine patterns of WM and gray matter alterations in TLE relative to controls, controlling for age and sex. Sliding window correlations were then performed to examine the relationships between SWM degeneration, cortical thinning, and hippocampal atrophy across ages of seizure onset. RESULTS Cortical thinning in TLE followed a widespread, bilateral pattern that was pronounced in posterior centroparietal regions, whereas SWM and deep WM loss occurred mostly in ipsilateral, temporolimbic regions compared to controls. Window correlations revealed a relationship between hippocampal volume loss and whole brain SWM disruption in patients who developed epilepsy during childhood. On the other hand, in patients with adult-onset TLE, co-occurring cortical and SWM alterations were observed in the medial temporal lobe ipsilateral to the seizure focus. SIGNIFICANCE Our results suggest that although cortical, hippocampal and WM alterations appear spatially discordant at the group level, the relationship among these features depends on the age at which seizures begin. Whereas neurodevelopmental aspects of TLE may result in co-occurring WM and hippocampal degeneration near the epileptogenic zone, the onset of seizures in adulthood may set off a cascade of SWM microstructural loss and cortical atrophy of a neurodegenerative nature.
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Affiliation(s)
- Alice Ballerini
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Department of Psychiatry, University of California, San Diego, USA
| | - Donatello Arienzo
- Department of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Alena Stasenko
- Department of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Adam Schadler
- Department of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Italy
| | - Erik Kaestner
- Department of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Carrie R McDonald
- Department of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA; Department of Radiation Medicine & Applied Sciences, University of California, San Diego, USA.
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Stasenko A, Kaestner E, Arienzo D, Schadler A, Reyes A, Shih JJ, Helm JL, Połczyńska M, McDonald CR. Bilingualism and Structural Network Organization in Temporal Lobe Epilepsy: Resilience in Neurologic Disease. Neurology 2023; 100:e1887-e1899. [PMID: 36854619 PMCID: PMC10159767 DOI: 10.1212/wnl.0000000000207087] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/06/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is growing evidence that bilingualism can induce neuroplasticity and modulate neural efficiency, resulting in greater resistance to neurologic disease. However, whether bilingualism is beneficial to neural health in the presence of epilepsy is unknown. We tested whether bilingual individuals with temporal lobe epilepsy (TLE) have improved whole-brain structural white matter network organization. METHODS Healthy controls and individuals with TLE recruited from 2 specialized epilepsy centers completed diffusion-weighted MRI and neuropsychological testing as part of an observational cohort study. Whole-brain connectomes were generated via diffusion tractography and analyzed using graph theory. Global analyses compared network integration (path length) and specialization (transitivity) in TLE vs controls and in a 2 (left vs right TLE) × 2 (bilingual vs monolingual) model. Local analyses compared mean local efficiency of predefined frontal-executive and language (i.e., perisylvian) subnetworks. Exploratory correlations examined associations between network organization and neuropsychological performance. RESULTS A total of 29 bilingual and 88 monolingual individuals with TLE matched on several demographic and clinical variables and 81 age-matched healthy controls were included. Globally, a significant interaction between language status and side of seizure onset revealed higher network organization in bilinguals compared with monolinguals but only in left TLE (LTLE). Locally, bilinguals with LTLE showed higher efficiency in frontal-executive but not in perisylvian networks compared with LTLE monolinguals. Improved whole-brain network organization was associated with better executive function performance in bilingual but not monolingual LTLE. DISCUSSION Higher white matter network organization in bilingual individuals with LTLE suggests a neuromodulatory effect of bilingualism on whole-brain connectivity in epilepsy, providing evidence for neural reserve. This may reflect attenuation of or compensation for epilepsy-related dysfunction of the left hemisphere, potentially driven by increased efficiency of frontal-executive networks that mediate dual-language control. This highlights a potential role of bilingualism as a protective factor in epilepsy, motivating further research across neurologic disorders to define mechanisms and develop interventions.
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Affiliation(s)
- Alena Stasenko
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Donatello Arienzo
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Adam Schadler
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Jerry J Shih
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Jonathan L Helm
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Monika Połczyńska
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A. Stasenko, E.K., D.A., A. Schadler, A.R., C.R.M.), Department of Psychiatry (A. Stasenko, E.K., D.A., A. Schadler, C.R.M.), Department of Radiation Medicine & Applied Sciences (A.R., C.R.M.), and Department of Neurosciences (J.J.S.), University of California, San Diego; Department of Psychology (J.L.H.), San Diego State University, CA; and Department of Psychiatry and Biobehavioral Sciences (M.P.), David Geffen School of Medicine at UCLA, University of California, Los Angeles.
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Lucas A, Cornblath EJ, Sinha N, Hadar P, Caciagli L, Keller SS, Bonilha L, Shinohara RT, Stein JM, Das S, Gleichgerrcht E, Davis KA. Resting state functional connectivity demonstrates increased segregation in bilateral temporal lobe epilepsy. Epilepsia 2023; 64:1305-1317. [PMID: 36855286 DOI: 10.1111/epi.17565] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 10/04/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is the most common type of focal epilepsy. An increasingly identified subset of patients with TLE consists of those who show bilaterally independent temporal lobe seizures. The purpose of this study was to leverage network neuroscience to better understand the interictal whole brain network of bilateral TLE (BiTLE). METHODS In this study, using a multicenter resting state functional magnetic resonance imaging (rs-fMRI) data set, we constructed whole-brain functional networks of 19 patients with BiTLE, and compared them to those of 75 patients with unilateral TLE (UTLE). We quantified resting-state, whole-brain topological properties using metrics derived from network theory, including clustering coefficient, global efficiency, participation coefficient, and modularity. For each metric, we computed an average across all brain regions, and iterated this process across network densities. Curves of network density vs each network metric were compared between groups. Finally, we derived a combined metric, which we term the "integration-segregation axis," by combining whole-brain average clustering coefficient and global efficiency curves, and applying principal component analysis (PCA)-based dimensionality reduction. RESULTS Compared to UTLE, BiTLE had decreased global efficiency (p = .031), and decreased whole brain average participation coefficient across a range of network densities (p = .019). Modularity maximization yielded a larger number of smaller communities in BiTLE than in UTLE (p = .020). Differences in network properties separate BiTLE and UTLE along the integration-segregation axis, with regions within the axis having a specificity of up to 0.87 for BiTLE. Along the integration-segregation axis, UTLE patients with poor surgical outcomes were distributed in the same regions as BiTLE, and network metrics confirmed similar patterns of increased segregation in both BiTLE and poor outcome UTLE. SIGNIFICANCE Increased interictal whole-brain network segregation, as measured by rs-fMRI, is specific to BiTLE, as well as poor surgical outcome UTLE, and may assist in non-invasively identifying this patient population prior to intracranial electroencephalography or device implantation.
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Affiliation(s)
- Alfredo Lucas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eli J Cornblath
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nishant Sinha
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Peter Hadar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Leonardo Bonilha
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Russell T Shinohara
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Joel M Stein
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sandhitsu Das
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ezequiel Gleichgerrcht
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kathryn A Davis
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Yu Y, Han F, Wang Q. A hippocampal-entorhinal cortex neuronal network for dynamical mechanisms of epileptic seizure. IEEE Trans Neural Syst Rehabil Eng 2023; 31:1986-1996. [PMID: 37027276 DOI: 10.1109/tnsre.2023.3265581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Temporal lobe epilepsy (TLE) is thought to be associated with neuronal hyperexcitability in the hippocampal-entorhinal cortical (EC) circuit. Due to the complexity of the hippocampal-EC network connections, the biophysical mechanisms of the different circuits in epilepsy generation and propagation are still not fully established. In this work, we propose a hippocampal-EC neuronal network model to explore the mechanism of epileptic generation. We demonstrate that enhanced excitability of pyramidal neurons in cornu ammonis 3 (CA3) can drive hippocampal-EC to produce a transition from background to seizure state and cause exaggerated phase-amplitude coupling (PAC) phenomenon of theta modulated high-frequency oscillations (HFO) in CA3, cornu ammonis 1 (CA1), dentate gyrus, and EC. Interestingly, PAC strength indirectly responds to the degree of CA3 pyramidal (PY) neuron hyperexcitability, suggesting that PAC can be used as a potential marker of seizures. Furthermore, we find that enhanced synaptic connectivity of mossy cells to granule cells and CA3 PY neurons drives the system to produce epileptic discharges. These two channels may play a key role in mossy fiber sprouting. In particular, the PAC phenomenon of delta-modulated HFO and theta-modulated HFO can be generated according to the different degrees of moss fiber sprouting. Finally, the results suggest that hyperexcitability of stellate cells in EC can lead to seizures, which supports the argument that EC can act as an independent source of seizures. Overall, these results highlight the key role of different circuits in seizures, providing a theoretical basis and new insights into the generation and propagation of TLE.
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Dono F, Evangelista G, Consoli S, Venditti R, Russo M, De Angelis MV, Faustino M, Di Iorio A, Vollono C, Anzellotti F, Onofrj M, Sensi SL. Heart rate variability modifications in adult patients with early versus late-onset temporal lobe epilepsy: A comparative observational study. Neurophysiol Clin 2023; 53:102852. [PMID: 36966709 DOI: 10.1016/j.neucli.2023.102852] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/25/2023] [Accepted: 02/25/2023] [Indexed: 03/28/2023] Open
Abstract
OBJECTIVES Temporal lobe epilepsy (TLE) is the most frequent form of focal epilepsy. TLE is associated with cardio-autonomic dysfunction and increased cardiovascular (CV) risk in patients over the fifth decade of age. In these subjects, TLE can be classified as early-onset (EOTLE; i.e., patients who had developed epilepsy in their youth) and late-onset (LOTLE; i.e., patients who developed epilepsy in adulthood). Heart rate variability (HRV) analysis is useful for assessing cardio-autonomic function and identifying patients with increased CV risk. This study compared changes in HRV occurring in patients over the age of 50, with EOTLE or LOTLE. METHODS We enrolled twenty-seven adults with LOTLE and 23 with EOTLE. Each patient underwent a EEG and EKG recording during 20-minutes of resting state and a 5-minutes hyperventilation (HV). Short-term HRV analysis was performed both in time and frequency domains. Linear Mixed Models (LMM) were used to analyze HRV parameters according to the condition (baseline and HV) and group (LOTLE and EOTLE groups). RESULTS Compared to the LOTLE group, the EOTLE group showed significantly decreased LnRMSSD (natural logarithm of the root mean square of the difference between contiguous RR intervals) (p-value=0.05), LnHF ms2 (natural logarithm of high frequency absolute power) (p-value=0.05), HF n.u. (high frequency power expressed in normalized units) (p-value=0.008) and HF% (high frequency power expressed in percentage) (p-value=0.01). In addition, EOTLE patients exhibited increased LF n.u. (low frequency power expressed in normalized units) (p-value=0.008) and LF/HF (low frequency/high frequency) ratio (p-value=0.007). During HV, the LOTLE group exhibited a multiplicative effect for the interaction between group and condition with increased LF n.u. (p = 0.003) and LF% (low frequency expressed in percentage) (p = 0.05) values. CONCLUSIONS EOTLE is associated with reduced vagal tone compared to LOTLE. Patients with EOTLE may have a higher risk of developing cardiac dysfunction or cardiac arrhythmia than LOTLE patients.
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Affiliation(s)
- Fedele Dono
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies, and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy.
| | - Giacomo Evangelista
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy
| | - Stefano Consoli
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy
| | - Romina Venditti
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies, and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy
| | | | | | - Angelo Di Iorio
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - Catello Vollono
- Unit of Neurophysiopathology and Sleep Medicine, Department of Geriatrics, Neurosciences and Orthopedics, IRCCS Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | - Francesca Anzellotti
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies, and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies, and Technology - CAST-, University G. d'Annunzio of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technology, ITAB, University G. d'Annunzio of Chieti-Pescara, Italy
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Hinds W, Modi S, Ankeeta A, Sperling MR, Pustina D, Tracy JI. Pre-surgical features of intrinsic brain networks predict single and joint epilepsy surgery outcomes. Neuroimage Clin 2023; 38:103387. [PMID: 37023491 PMCID: PMC10122017 DOI: 10.1016/j.nicl.2023.103387] [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: 12/15/2022] [Revised: 03/02/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
Despite the effectiveness of surgical interventions for the treatment of intractable focal temporal lobe epilepsy (TLE), the substrates that support good outcomes are poorly understood. While algorithms have been developed for the prediction of either seizure or cognitive/psychiatric outcomes alone, no study has reported on the functional and structural architecture that supports joint outcomes. We measured key aspects of pre-surgical whole brain functional/structural network architecture and evaluated their ability to predict post-operative seizure control in combination with cognitive/psychiatric outcomes. Pre-surgically, we identified the intrinsic connectivity networks (ICNs) unique to each person through independent component analysis (ICA), and computed: (1) the spatial-temporal match between each person's ICA components and established, canonical ICNs, (2) the connectivity strength within each identified person-specific ICN, (3) the gray matter (GM) volume underlying the person-specific ICNs, and (4) the amount of variance not explained by the canonical ICNs for each person. Post-surgical seizure control and reliable change indices of change (for language [naming, phonemic fluency], verbal episodic memory, and depression) served as binary outcome responses in random forest (RF) models. The above functional and structural measures served as input predictors. Our empirically derived ICN-based measures customized to the individual showed that good joint seizure and cognitive/psychiatric outcomes depended upon higher levels of brain reserve (GM volume) in specific networks. In contrast, singular outcomes relied on systematic, idiosyncratic variance in the case of seizure control, and the weakened pre-surgical presence of functional ICNs that encompassed the ictal temporal lobe in the case of cognitive/psychiatric outcomes. Our data made clear that the ICNs differed in their propensity to provide reserve for adaptive outcomes, with some providing structural (brain), and others functional (cognitive) reserve. Our customized methodology demonstrated that when substantial unique, patient-specific ICNs are present prior to surgery there is a reliable association with poor post-surgical seizure control. These ICNs are idiosyncratic in that they did not match the canonical, normative ICNs and, therefore, could not be defined functionally, with their location likely varying by patient. This important finding suggested the level of highly individualized ICN's in the epileptic brain may signal the emergence of epileptogenic activity after surgery.
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Affiliation(s)
- Walter Hinds
- Thomas Jefferson University, Department of Neurology, and Vicky and Jack Farber Institute for Neuroscience, USA
| | - Shilpi Modi
- Thomas Jefferson University, Department of Neurology, and Vicky and Jack Farber Institute for Neuroscience, USA
| | - Ankeeta Ankeeta
- Thomas Jefferson University, Department of Neurology, and Vicky and Jack Farber Institute for Neuroscience, USA
| | - Michael R Sperling
- Thomas Jefferson University, Department of Neurology, and Vicky and Jack Farber Institute for Neuroscience, USA
| | | | - Joseph I Tracy
- Thomas Jefferson University, Department of Neurology, and Vicky and Jack Farber Institute for Neuroscience, USA.
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Scalmani P, Paterra R, Mantegazza M, Avoli M, de Curtis M. Involvement of GABAergic Interneuron Subtypes in 4-Aminopyridine-Induced Seizure-Like Events in Mouse Entorhinal Cortex in Vitro. J Neurosci 2023; 43:1987-2001. [PMID: 36810229 PMCID: PMC10027059 DOI: 10.1523/jneurosci.1190-22.2023] [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: 06/17/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 02/23/2023] Open
Abstract
Single-unit recordings performed in temporal lobe epilepsy patients and in models of temporal lobe seizures have shown that interneurons are active at focal seizure onset. We performed simultaneous patch-clamp and field potential recordings in entorhinal cortex slices of GAD65 and GAD67 C57BL/6J male mice that express green fluorescent protein in GABAergic neurons to analyze the activity of specific interneuron (IN) subpopulations during acute seizure-like events (SLEs) induced by 4-aminopyridine (4-AP; 100 μm). IN subtypes were identified as parvalbuminergic (INPV, n = 17), cholecystokinergic (INCCK), n = 13], and somatostatinergic (INSOM, n = 15), according to neurophysiological features and single-cell digital PCR. INPV and INCCK discharged at the start of 4-AP-induced SLEs characterized by either low-voltage fast or hyper-synchronous onset pattern. In both SLE onset types, INSOM fired earliest before SLEs, followed by INPV and INCCK discharges. Pyramidal neurons became active with variable delays after SLE onset. Depolarizing block was observed in ∼50% of cells in each INs subgroup, and it was longer in IN (∼4 s) than in pyramidal neurons (<1 s). As SLE evolved, all IN subtypes generated action potential bursts synchronous with the field potential events leading to SLE termination. High-frequency firing throughout the SLE occurred in one-third of INPV and INSOM We conclude that entorhinal cortex INs are very active at the onset and during the progression of SLEs induced by 4-AP. These results support earlier in vivo and in vivo evidence and suggest that INs have a preferential role in focal seizure initiation and development.SIGNIFICANCE STATEMENT Focal seizures are believed to result from enhanced excitation. Nevertheless, we and others demonstrated that cortical GABAergic networks may initiate focal seizures. Here, we analyzed for the first time the role of different IN subtypes in seizures generated by 4-aminopyridine in the mouse entorhinal cortex slices. We found that in this in vitro focal seizure model, all IN types contribute to seizure initiation and that INs precede firing of principal cells. This evidence is in agreement with the active role of GABAergic networks in seizure generation.
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Affiliation(s)
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano 20133, Italy
| | - Massimo Mantegazza
- Université Côte d'Azur, 06560 Valbonne-Sophia Antipolis, France
- Institute of Molecular and Cellular Pharmacology, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7275, Laboratoire d'Excellence/Canaux Ioniques d'Intérêt Thérapeutique, 06650 Valbonne-Sophia Antipolis, France
- Institut National de la Santé et de la Recherche Médicale, 06650 Valbonne-Sophia Antipolis, France
| | - Massimo Avoli
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
- Departments of Neurology and Neurosurgery and Physiology, McGill University, Montreal, Quebec H3A 2B4, Canada
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Gupta J, Naegele JR. Forming new connections: Advances in human stem-cell-derived interneuron therapy for treating epilepsy. Neuron 2023; 111:758-760. [PMID: 36924760 DOI: 10.1016/j.neuron.2023.02.034] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Inhibitory interneuron progenitors capable of integrating into epileptic host circuitry hold great potential for correcting network hyperexcitability and reducing seizures in temporal lobe epilepsy. In this issue of Neuron, Zhu and colleagues1 report robust seizure suppression by hPSC-derived interneurons up to 9 months post-transplantation, significantly extending the duration observed previously.
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Affiliation(s)
- Jyoti Gupta
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Janice R Naegele
- Department of Biology, Program in Neuroscience and Behavior, Wesleyan University, Middletown, CT, USA.
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Hadidane S, Lagarde S, Medina-Villalon S, McGonigal A, Laguitton V, Carron R, Scavarda D, Bartolomei F, Trebuchon A. Basal temporal lobe epilepsy: SEEG electroclinical characteristics. Epilepsy Res 2023; 191:107090. [PMID: 36774667 DOI: 10.1016/j.eplepsyres.2023.107090] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 12/16/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy is the most common type of focal drug-resistant epilepsy. Seizures with predominant involvement of basal temporal regions (BTR) are not well characterized. In this stereo electroencephalography (SEEG) study, we aimed at describing the ictal networks involving BTR and the associated clinical features. METHODS We studied 24 patients explored with SEEG in our center with BTR sampling. We analyzed their seizures using a quantitative method: the "epileptogenicity index". Then we reported the features of the patients with maximal epileptogenicity within BTR, especially ictal network involved, ictal semiology and post-surgical outcome. RESULTS We found that rhinal cortex, parahippocampal cortex and posterior fusiform gyrus were the most epileptogenic structures within the BTR (mean EI: 0.57, 0.55, 0.54 respectively). Three main groups of epileptogenic zone organization were found: anterior (23% of total seizures) posterior (30%) and global (47%, both anterior and posterior). Contralateral spread was found in 35% of left seizures and 20% of right seizures. Naming deficit was more prevalent in left BTR (71% vs 29% in right seizures; p = 0.01) whereas automatic speech production was preferentially represented in right seizures (11% vs 54%; p = 0.001). Surgery was proposed for 11 patients (45.8%), leading to seizure freedom in 72% (Engel Class I). One patient presented post-operative permanent functional deficit. CONCLUSION Basal-temporal lobe epilepsy seems to be a specific entity among the temporal epilepsy spectrum with specific clinical characteristics. Resective surgery can be proposed with good outcomes in a significant proportion of patients and is safe provided that adequate language assessment has been preoperatively made.
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Affiliation(s)
- S Hadidane
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - S Lagarde
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - S Medina-Villalon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - A McGonigal
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - V Laguitton
- APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - R Carron
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Stereotactic and Functional Neurosurgery, Marseille, France
| | - D Scavarda
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Pediatric, Neurosurgery Department, Marseille, France
| | - F Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - A Trebuchon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France; INSERM UMR1106, Institut des Neurosciences des Systèmes, Aix-Marseille Université, Faculté de Médecine Timone, 27, Bd Jean-Moulin, 13385 Marseille Cedex 05, France; Service de Neurophysiologie Clinique, Hôpital de la Timone, 13005 Marseille, France.
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Conrad EC, Revell AY, Greenblatt AS, Gallagher RS, Pattnaik AR, Hartmann N, Gugger JJ, Shinohara RT, Litt B, Marsh ED, Davis KA. Spike patterns surrounding sleep and seizures localize the seizure-onset zone in focal epilepsy. Epilepsia 2023; 64:754-768. [PMID: 36484572 PMCID: PMC10045742 DOI: 10.1111/epi.17482] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 09/02/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Interictal spikes help localize seizure generators as part of surgical planning for drug-resistant epilepsy. However, there are often multiple spike populations whose frequencies change over time, influenced by brain state. Understanding state changes in spike rates will improve our ability to use spikes for surgical planning. Our goal was to determine the effect of sleep and seizures on interictal spikes, and to use sleep and seizure-related changes in spikes to localize the seizure-onset zone (SOZ). METHODS We performed a retrospective analysis of intracranial electroencephalography (EEG) data from patients with focal epilepsy. We automatically detected interictal spikes and we classified different time periods as awake or asleep based on the ratio of alpha to delta power, with a secondary analysis using the recently published SleepSEEG algorithm. We analyzed spike rates surrounding sleep and seizures. We developed a model to localize the SOZ using state-dependent spike rates. RESULTS We analyzed data from 101 patients (54 women, age range 16-69). The normalized alpha-delta power ratio accurately classified wake from sleep periods (area under the curve = .90). Spikes were more frequent in sleep than wakefulness and in the post-ictal compared to the pre-ictal state. Patients with temporal lobe epilepsy had a greater wake-to-sleep and pre- to post-ictal spike rate increase compared to patients with extra-temporal epilepsy. A machine-learning classifier incorporating state-dependent spike rates accurately identified the SOZ (area under the curve = .83). Spike rates tended to be higher and better localize the seizure-onset zone in non-rapid eye movement (NREM) sleep than in wake or REM sleep. SIGNIFICANCE The change in spike rates surrounding sleep and seizures differs between temporal and extra-temporal lobe epilepsy. Spikes are more frequent and better localize the SOZ in sleep, particularly in NREM sleep. Quantitative analysis of spikes may provide useful ancillary data to localize the SOZ and improve surgical planning.
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Affiliation(s)
- Erin C. Conrad
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Andrew Y. Revell
- Medical Scientist Training Program, University of Pennsylvania, Philadelphia, PA
| | | | - Ryan S. Gallagher
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Akash R. Pattnaik
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA
| | - Nicole Hartmann
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - James J. Gugger
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Russell T. Shinohara
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA
- Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, PA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA
| | - Brian Litt
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Eric D. Marsh
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
- Division of Child Neurology, Department of Biostatistics, University of Pennsylvania, Epidemiology, & Informatics, Philadelphi Department of Biostatistics, University of Pennsylvania, Epidemiology, & Informatics, Philadelphi Pediatric Epilepsy Program, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kathryn A. Davis
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
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Stieve BJ, Smith MM, Krook-Magnuson E. LINCs Are Vulnerable to Epileptic Insult and Fail to Provide Seizure Control via On-Demand Activation. eNeuro 2023; 10:ENEURO.0195-22.2022. [PMID: 36725340 PMCID: PMC9933934 DOI: 10.1523/eneuro.0195-22.2022] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 02/03/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is notoriously pharmacoresistant, and identifying novel therapeutic targets for controlling seizures is crucial. Long-range inhibitory neuronal nitric oxide synthase-expressing cells (LINCs), a population of hippocampal neurons, were recently identified as a unique source of widespread inhibition in CA1, able to elicit both GABAA-mediated and GABAB-mediated postsynaptic inhibition. We therefore hypothesized that LINCs could be an effective target for seizure control. LINCs were optogenetically activated for on-demand seizure intervention in the intrahippocampal kainate (KA) mouse model of chronic TLE. Unexpectedly, LINC activation at 1 month post-KA did not substantially reduce seizure duration in either male or female mice. We tested two different sets of stimulation parameters, both previously found to be effective with on-demand optogenetic approaches, but neither was successful. Quantification of LINCs following intervention revealed a substantial reduction of LINC numbers compared with saline-injected controls. We also observed a decreased number of LINCs when the site of initial insult (i.e., KA injection) was moved to the amygdala [basolateral amygdala (BLA)-KA], and correspondingly, no effect of light delivery on BLA-KA seizures. This indicates that LINCs may be a vulnerable population in TLE, regardless of the site of initial insult. To determine whether long-term circuitry changes could influence outcomes, we continued testing once a month for up to 6 months post-KA. However, at no time point did LINC activation provide meaningful seizure suppression. Altogether, our results suggest that LINCs are not a promising target for seizure inhibition in TLE.
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Affiliation(s)
- Bethany J Stieve
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, Minnesota 55455
| | - Madison M Smith
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota 55455
| | - Esther Krook-Magnuson
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, Minnesota 55455
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota 55455
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