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Sun S, Tian M, Lin X, Zhao P. Disturbed white matter integrity on diffusion tensor imaging in young children with epilepsy. Clin Radiol 2024; 79:e119-e126. [PMID: 37940443 DOI: 10.1016/j.crad.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023]
Abstract
AIM To evaluate whether abnormalities in white matter (WM) integrity are present in young children with epilepsy. MATERIALS AND METHODS Twelve children (3-6 years old) with epilepsy and six matched healthy controls were recruited for brain diffusion tensor imaging (DTI). Track-based spatial statistics (TBSS) was used to analyse and compare DTI indices of mean diffusivity (MD), fractional anisotropy (FA), axial and radial diffusivity (AD/RD) between patients and controls, and correlations between clinical variables and DTI parameters were analysed. RESULTS Compared with controls, patients showed increased FA in the left superior corona radiata and increased AD in the bilateral superior corona radiata. In children with generalised epilepsy, FA was increased in the left external capsule, while AD was decreased in the body of the corpus callosum, the left external capsule and the left superior longitudinal fasciculus. In those with focal epilepsy, FA was increased in the genu and body of the corpus callosum, and RD was decreased in the genu of the corpus callosum and left external capsule. Compared with partial epilepsy, generalised epilepsy was associated with increased FA in the right anterior corona radiata and decreased RD in the right anterior corona radiata and the genu and body of the corpus callosum. No significant correlations were observed between clinical variables and DTI parameters. CONCLUSIONS The results of this study indicate that the microstructure of the white matter is disturbed by epileptic discharges and a compensatory response occurs during early brain development.
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Affiliation(s)
- S Sun
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - M Tian
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - X Lin
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
| | - P Zhao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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2
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De Benedictis A, Rossi-Espagnet MC, de Palma L, Sarubbo S, Marras CE. Structural networking of the developing brain: from maturation to neurosurgical implications. Front Neuroanat 2023; 17:1242757. [PMID: 38099209 PMCID: PMC10719860 DOI: 10.3389/fnana.2023.1242757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/09/2023] [Indexed: 12/17/2023] Open
Abstract
Modern neuroscience agrees that neurological processing emerges from the multimodal interaction among multiple cortical and subcortical neuronal hubs, connected at short and long distance by white matter, to form a largely integrated and dynamic network, called the brain "connectome." The final architecture of these circuits results from a complex, continuous, and highly protracted development process of several axonal pathways that constitute the anatomical substrate of neuronal interactions. Awareness of the network organization of the central nervous system is crucial not only to understand the basis of children's neurological development, but also it may be of special interest to improve the quality of neurosurgical treatments of many pediatric diseases. Although there are a flourishing number of neuroimaging studies of the connectome, a comprehensive vision linking this research to neurosurgical practice is still lacking in the current pediatric literature. The goal of this review is to contribute to bridging this gap. In the first part, we summarize the main current knowledge concerning brain network maturation and its involvement in different aspects of normal neurocognitive development as well as in the pathophysiology of specific diseases. The final section is devoted to identifying possible implications of this knowledge in the neurosurgical field, especially in epilepsy and tumor surgery, and to discuss promising perspectives for future investigations.
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Affiliation(s)
| | | | - Luca de Palma
- Clinical and Experimental Neurology, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
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Kraus D, Farah R, Fischer H, Vannest J, Wade SL, Radhakrishnan R, Modi AC, Horowitz-Kraus T. Altered white matter organization and its correlations with executive functioning among adolescents with epilepsy. Eur J Paediatr Neurol 2023; 46:82-88. [PMID: 37540964 DOI: 10.1016/j.ejpn.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
Deficits in executive functions (EF) are a common comorbidity among adolescents with epilepsy. EF deficits were previously correlated with altered connectivity of the fronto-parietal and cingulo-opercular neural networks. The current study investigated white matter integrity in adolescents with epilepsy (n = 29) relative to healthy controls (n = 19). Participants completed questionnaires, neuropsychological testing, and brain magnetic resonance imaging (MRI) that included diffusion tensor imaging (DTI) sequences. On BRIEF parent-report questionnaires, adolescents with epilepsy demonstrated lower working memory and planning abilities than healthy controls. Among adolescents with epilepsy, DTI measurements revealed lower fractional anisotropy (FA) within the right superior longitudinal fasciculus, forceps minor, and the superior frontal segment of the corpus callosum, and higher FA in the left uncinate fasciculus, compared to healthy controls. Better working memory ability in the epilepsy group was associated with higher FA in the superior frontal segment of the corpus callosum. Only in healthy controls, working memory and planning were positively associated with FA values in the left UF, forceps minor and the superior frontal segment of the corpus callosum. The current study complements previous functional studies on the same cohort and suggests that EF impairments among adolescents with epilepsy may be related to the altered anatomical organization of white matter tracts. Combining structural and functional data could potentially enrich the neuropsychological assessment of executive functioning in adolescents with epilepsy.
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Affiliation(s)
- Dror Kraus
- Pediatric Neurology Institute, Schneider Children's Medical Center of Israel, Tel Aviv University, Israel
| | - Rola Farah
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Haya Fischer
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Jennifer Vannest
- Department of Speech and Language Pathology, Cincinnati Children's Hospital Medical Center, USA
| | - Shari L Wade
- Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel; Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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4
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Ferrario R, Giovagnoli AR. Processing speed in temporal lobe epilepsy. A scoping review. Epilepsy Behav 2023; 142:109169. [PMID: 36963317 DOI: 10.1016/j.yebeh.2023.109169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Impaired processing speed (PS) can affect patients with temporal lobe epilepsy (TLE). However, it is usually considered a nonspecific clinical feature and is not measured, but this raises lexical and methodological problems. This review aims to evaluate the existing terminology and assessment methods of PS in patients with TLE. METHODS A scoping review was conducted based on the extended guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The electronic literature search was conducted on Medline-PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Google Scholar, using the keywords "temporal lobe epilepsy" and "speed" or "slowing" plus "processing," "cognitive," "psychomotor," or "mental." Peer-reviewed articles published before December 2022 were analyzed if they were in English, including patients older than 14 years and at least one neuropsychological measure, reported original research focused on PS and had the selected keywords in the title, keywords, and abstract. RESULTS Seven articles published between December 2004 and September 2021 were selected. The terms "processing speed," "psychomotor speed," and "information processing speed," based on similar theoretical constructs, were the most frequently used. Assessment methods included non-computerized or paper-and-pencil tests (WAIS-III Digit Symbol and Symbol Search subtests, Purdue Pegboard and Grooved Pegboard Tests, Trail Making Test and Stroop Color-Word Test) and computerized tests (Sternberg Memory Scanning Test, Pattern Comparison Processing Speed, Computerized Visual Searching). In some studies, impairment was associated with white and gray matter damage in the brain, independent of clinical and treatment variables. CONCLUSION Clinical research on TLE has focused inconsistently on PS. Different evaluation terms and methods have been used while referring to similar theoretical constructs. These findings highlight a gap between the clinical importance of PS and its assessment. Studies are needed to share terms and tools among clinical centers and clarify the position of PS in the TLE phenotype.
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Affiliation(s)
- Rosalba Ferrario
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy
| | - Anna Rita Giovagnoli
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
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5
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Long R, Wang Y, Chen L, Deng D, Mei L, Mou J, Tang G, Han F, Kemp GJ, Gong Q, Qiu L. Abnormalities of Cerebral White Matter Microstructure in Children With New-Onset, Untreated Idiopathic-Generalized Epilepsy. Front Neurol 2021; 12:744723. [PMID: 34917014 PMCID: PMC8669567 DOI: 10.3389/fneur.2021.744723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/01/2021] [Indexed: 02/05/2023] Open
Abstract
Despite evidence for microstructural brain alterations in epilepsy patients, little is known about how these develop with age and the progress of the disease. The aim of this study was to investigate microstructural abnormalities of the white matter (WM) in children with new-onset, untreated idiopathic-generalized epilepsy (IGE) using the MRI technique of diffusion tensor imaging (DTI). The study was approved by the institutional review board, and all individuals or their parents gave signed informed consent. In total, 45 patients with IGE (age 5-18 years, male: female 26:19) and 32 healthy controls (HCs; age 5-18 years, male: female 21:11) were included. Voxel-based analysis (VBA) was used to compare patients and controls, and Pearson correlation analysis was used to investigate relationships between altered DTI metrics and clinical parameters. Compared with controls, patients with IGE showed increased mean diffusivity (MD) in the left splenium of the corpus callosum, increased fractional anisotropy (FA) in the right WM of the superior and middle frontal gyri, increased axial diffusivity (AD) in the WM of right corona radiata and left occipital lobe, and decreased AD in the WM of the left thalamus and the right middle cerebellar peduncle. There was no correlation between the altered diffusion parameters and clinical measures. Our study demonstrated several distinct microstructural impairments in children with new-onset, untreated IGE, of which altered AD might be the most sensitive marker of dysmyelination. The increased FA in the IGE group might suggest an initiating or compensatory mechanism that is activated prior to cognitive decline in these children.
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Affiliation(s)
- Ran Long
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yuting Wang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Lizhou Chen
- Huaxi Magnetic Resonance Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Dingmei Deng
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lan Mei
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Jingping Mou
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Guangcai Tang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Fugang Han
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Graham John Kemp
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi Magnetic Resonance Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
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6
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Rayatpour A, Farhangi S, Verdaguer E, Olloquequi J, Ureña J, Auladell C, Javan M. The Cross Talk between Underlying Mechanisms of Multiple Sclerosis and Epilepsy May Provide New Insights for More Efficient Therapies. Pharmaceuticals (Basel) 2021; 14:ph14101031. [PMID: 34681255 PMCID: PMC8541630 DOI: 10.3390/ph14101031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022] Open
Abstract
Despite the significant differences in pathological background of neurodegenerative diseases, epileptic seizures are a comorbidity in many disorders such as Huntington disease (HD), Alzheimer's disease (AD), and multiple sclerosis (MS). Regarding the last one, specifically, it has been shown that the risk of developing epilepsy is three to six times higher in patients with MS compared to the general population. In this context, understanding the pathological processes underlying this connection will allow for the targeting of the common and shared pathological pathways involved in both conditions, which may provide a new avenue in the management of neurological disorders. This review provides an outlook of what is known so far about the bidirectional association between epilepsy and MS.
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Affiliation(s)
- Atefeh Rayatpour
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Sahar Farhangi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Ester Verdaguer
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Biomedical Sciences Institute, Health Sciences Faculty, Universidad Autónoma de Chile, Talca 3460000, Chile;
| | - Jesus Ureña
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Carme Auladell
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
- Correspondence: (C.A.); (M.J.)
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
- Cell Science Research Center, Department of Brain and Cognitive Sciences, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran 14117-13116, Iran
- Correspondence: (C.A.); (M.J.)
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7
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Alterations in white matter integrity and asymmetry in patients with benign childhood epilepsy with centrotemporal spikes and childhood absence epilepsy: An automated fiber quantification tractography study. Epilepsy Behav 2021; 123:108235. [PMID: 34411950 DOI: 10.1016/j.yebeh.2021.108235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/11/2021] [Accepted: 07/19/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE To investigate whether patients with benign childhood epilepsy with centrotemporal spikes (BECTS) and childhood absence epilepsy (CAE) show distinct patterns of white matter (WM) alterations and structural asymmetry compared with healthy controls and the relationship between WM alterations and epilepsy-related clinical variables. METHODS We used automated fiber quantification to create tract profiles of fractional anisotropy (FA) and mean diffusivity (MD) in twenty-six patients with BECTS, twenty-nine patients with CAE, and twenty-four healthy controls. Group differences in FA and MD were quantified at 100 equidistant nodes along the fiber tract and these alterations and epilepsy-related clinical variables were correlated. A lateralization index (LI) representing the structural asymmetry of the fiber tract was computed and compared between both patient groups and controls. RESULTS Compared with healthy controls, the BECTS group showed widespread FA reduction in 43.75% (7/16) and MD elevation in 50% (8/16) of identified fiber tracts, and the CAE group showed regional FA reduction in 31.25% (5/16) and MD elevation in 25% (4/16) of identified fiber tracts. In the BECTS group, FA and MD in the right anterior thalamic radiation positively and negatively correlated with the number of antiepileptic drugs, respectively, and MD in the right arcuate fasciculus (AF) positively correlated with seizure frequency. In the CAE group, the LI values were significantly lower in the inferior fronto-occipital fasciculus and the AF. CONCLUSION The two childhood epilepsy syndromes display different patterns of WM alterations and structural asymmetry, suggesting that neuroanatomical differences may underlie the different profiles of BECTS and CAE.
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8
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Salimeen MSA, Liu C, Li X, Wang M, Singh M, Si S, Li M, Cheng Y, Wang X, Zhao H, Wu F, Zhang Y, Tafawa H, Pradhan A, Yang G, Yang J. Exploring Variances of White Matter Integrity and the Glymphatic System in Simple Febrile Seizures and Epilepsy. Front Neurol 2021; 12:595647. [PMID: 33967932 PMCID: PMC8097149 DOI: 10.3389/fneur.2021.595647] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Simple febrile seizures (SFS) and epilepsy are common seizures in childhood. However, the mechanism underlying SFS is uncertain, and the presence of obvious variances in white matter (WM) integrity and glymphatic function between SFS and epilepsy remain unclear. Therefore, this study aimed to investigate the differences in WM integrity and glymphatic function between SFS and epilepsy. Material and Methods: We retrospectively included 26 children with SFS, 33 children with epilepsy, and 28 controls aged 6–60 months who underwent magnetic resonance imaging (MRI). Tract-based spatial statistics (TBSS) were used to compare the diffusion tensor imaging (DTI) metrics of WM among the above-mentioned groups. T2-weighted imaging (T2WI) was used to segment the visible Virchow-Robin space (VRS) through a custom-designed automated method. VRS counts and volume were quantified and compared among the SFS, epilepsy, and control groups. Correlations of the VRS metrics and seizure duration and VRS metrics and the time interval between seizure onset and MRI scan were also investigated. Results: In comparison with controls, children with SFS showed no significant changes in fractional anisotropy (FA), axial diffusivity (AD), or radial diffusivity (RD) in the WM (P > 0.05). Decreased FA, unchanged AD, and increased RD were observed in the epilepsy group in comparison with the SFS and control groups (P < 0.05). Meanwhile, VRS counts were higher in the SFS and epilepsy groups than in the control group (VRS_SFS, 442.42 ± 74.58, VRS_epilepsy, 629.94 ± 106.55, VRS_control, 354.14 ± 106.58; P < 0.001), and similar results were found for VRS volume (VRS_SFS, 6,228.18 ± 570.74 mm3, VRS_epilepsy, 9,684.84 ± 7,292.66mm3, VRS_control, 4,007.22 ± 118.86 mm3; P < 0.001). However, VRS metrics were lower in the SFS group than in the epilepsy group (P < 0.001). In both SFS and epilepsy, VRS metrics positively correlated with seizure duration and negatively correlated with the course after seizure onset. Conclusion: SFS may not be associated with WM microstructural disruption; however, epilepsy is related to WM alterations. Seizures are associated with glymphatic dysfunction in either SFS or epilepsy.
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Affiliation(s)
- Mustafa Salimeen Abdelkareem Salimeen
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, Dongola Teaching Hospital, University of Dongola, Dongola, Sudan
| | - Congcong Liu
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xianjun Li
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Miaomiao Wang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Martha Singh
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuqing Si
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mengxuan Li
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yannan Cheng
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyu Wang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huifang Zhao
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fan Wu
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuli Zhang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Habib Tafawa
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Anuja Pradhan
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guanyu Yang
- School of Electronic Engineering, Xidian University, Xi'an, China
| | - Jian Yang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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9
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Ciumas C, Montavont A, Ilski F, Laurent A, Saignavongs M, Lachaux JP, de Bellescize J, Panagiotakaki E, Ostrowsky-Coste K, Herbillon V, Ibarrola D, Hermier M, Arzimanoglou A, Ryvlin P. Neural correlates of verbal working memory in children with epilepsy with centro-temporal spikes. NEUROIMAGE-CLINICAL 2020; 28:102392. [PMID: 32927234 PMCID: PMC7495114 DOI: 10.1016/j.nicl.2020.102392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous functional magnetic resonance imaging (fMRI) studies have identified brain systems underlying different components of working memory (WM) in healthy subjects. The aim of this study was to compare the functional integrity of these neural networks in children with self-limited childhood epilepsy with centro-temporal spikes (ECTS) as compared to healthy controls, using a verbal working memory task (WMT). METHODS Functional MRI of WM in seventeen 6-to-13 year-old children, diagnosed with ECTS, and 17 sex- and age-matched healthy controls were conducted at 3 T. To estimate BOLD responses during the maintenance of low, medium, and high WMT loads, we used a Sternberg verbal WMT. Neuropsychological testing prior to scanning and behavioral data during scanning were also acquired. RESULTS Behavioral performances during WMT, in particular accuracy and response time, were poorer in children with ECTS than in controls. Increased WM load was associated with increased BOLD signal in all subjects, with significant clusters detected in frontal and parietal regions, predominantly in the left hemisphere. However, under the high load condition, patients showed reduced activation in the frontal, temporal and parietal regions as compared to controls. In brain regions where WM-triggered BOLD activation differed between groups, this activation correlated with neuropsychological performances in healthy controls but not in patients with ECTS, further suggesting WM network dysfunction in the latter. CONCLUSION Children with ECTS differ from healthy controls in how they control WM processes during tasks with increasing difficulty level, notably for high WM load where patients demonstrate both reduced BOLD activation and behavioral performances.
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Affiliation(s)
- Carolina Ciumas
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université Lyon1, Lyon, France; Institute of Epilepsies (IDEE), Lyon, France; Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.
| | - Alexandra Montavont
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Faustine Ilski
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Agathe Laurent
- Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | - Mani Saignavongs
- Translational and Integrative Group in Epilepsy Research (TIGER), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Université Lyon1, Lyon, France
| | - Jean-Philippe Lachaux
- Brain Dynamics and Cognition team (DYCOG), INSERM U1028, CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon, Lyon, France
| | - Julitta de Bellescize
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Eleni Panagiotakaki
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Karine Ostrowsky-Coste
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France
| | - Vania Herbillon
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France; Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | | | - Marc Hermier
- University Hospitals of Lyon (HCL), Department of Diagnostic and Functional Neuroradiology, Hôpital Neurologique & Neurochirurgical P. Wertheimer, Bron, France
| | - Alexis Arzimanoglou
- University Hospitals of Lyon (HCL), Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, Member of the ERN EpiCARE, Lyon, France; Department of Neurosurgery, Sainte-Anne Hospital, 75014 Paris, France
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland
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Moldovan K, Boxerman JL, O'Muircheartaigh J, Dean D, Eyerly-Webb S, Cosgrove GR, Pucci FG, Deoni SCL, Spader HS. Myelin water fraction changes in febrile seizures. Clin Neurol Neurosurg 2018; 175:61-67. [PMID: 30384118 DOI: 10.1016/j.clineuro.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/27/2018] [Accepted: 10/07/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The objective of this feasibility study was to investigate whether myelin water fraction (MWF) patterns can differentiate children presenting with febrile seizures who will go on to develop nonfebrile epilepsy from those who will not. PATIENTS AND METHODS As part of a prospective study of myelination patterns in pediatric epilepsy, seven subjects with febrile seizures underwent magnetic resonance imaging (MRI) including the following standard sequences-T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR)-and an additional experimental sequence, multicomponent-derived equilibrium single-pulse observation of T1 and T2 (mcDESPOT) to quantify MWF. For each of these subjects, MWF maps were derived and compared with an age-matched population-averaged MWF atlas. RESULTS All seven subjects (<5 years old) initially presented with febrile seizures. Of the seven, four had complex seizures and three had simple seizures. All of the children with simple febrile seizures had higher MWF compared with model-derived controls and did not develop epilepsy. All of the children with complex febrile seizures had lower MWF than their model-derived control, and two of these subjects later developed epilepsy. CONCLUSION This is the first study in which MWF maps were used to study children with febrile *seizures. This data suggests that relatively higher or stable MWF compared with normative data indicates a lower risk of nonfebrile epilepsy while relatively lower MWF may indicate a pathological condition that could lead to nonfebrile epilepsy.
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Affiliation(s)
- Krisztina Moldovan
- Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
| | - Jerrold L Boxerman
- Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA.
| | | | - Doug Dean
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA.
| | - Stephanie Eyerly-Webb
- Office of Human Research, Memorial Healthcare System, 3501 Johnson Street, Hollywood, FL, 33021, USA.
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Neurosciences Center, 60 Fenwood Road, 1st Floor, Boston, MA, 02115, USA.
| | - Francesco G Pucci
- Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA
| | - Sean C L Deoni
- Brown University Advanced Baby Imaging Lab, Memorial Hospital of Rhode Island, Department of Pediatrics, 111 Brewster Street, Pawtucket, RI, 02860, USA.
| | - Heather S Spader
- Division of Pediatric Neurosurgery, Joe DiMaggio Children's Hospital, 1150N 35th Ave, Hollywood, FL, 33021, USA.
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A Yassine I, M Eldeeb W, A Gad K, A Ashour Y, A Yassine I, O Hosny A. Cognitive functions, electroencephalographic and diffusion tensor imaging changes in children with active idiopathic epilepsy. Epilepsy Behav 2018; 84:135-141. [PMID: 29800799 DOI: 10.1016/j.yebeh.2018.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/12/2018] [Accepted: 04/29/2018] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Neurocognitive impairment represents one of the most common comorbidities occurring in children with idiopathic epilepsy. Diagnosis of the idiopathic form of epilepsy requires the absence of any macrostructural abnormality in the conventional MRI. Though changes can be seen at the microstructural level imaged using advanced techniques such as the Diffusion Tensor Imaging (DTI). AIM OF THE WORK The aim of this work is to study the correlation between the microstructural white matter DTI findings, the electroencephalographic changes and the cognitive dysfunction in children with active idiopathic epilepsy. METHODS A comparative cross-sectional study, included 60 children with epilepsy based on the Stanford-Binet 5th Edition Scores was conducted. Patients were equally assigned to normal cognitive function or cognitive dysfunction groups. The history of the epileptic condition was gathered via personal interviews. All patients underwent brain Electroencephalography (EEG) and DTI, which was analyzed using FSL. RESULTS The Fractional Anisotropy (FA) was significantly higher whereas the Mean Diffusivity (MD) was significantly lower in the normal cognitive function group than in the cognitive dysfunction group. This altered microstructure was related to the degree of the cognitive performance of the studied children with epilepsy. The microstructural alterations of the neural fibers in children with epilepsy and cognitive dysfunction were significantly related to the younger age of onset of epilepsy, the poor control of the clinical seizures, and the use of multiple antiepileptic medications. CONCLUSION Children with epilepsy and normal cognitive functions differ in white matter integrity, measured using DTI, compared with children with cognitive dysfunction. These changes have important cognitive consequences.
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Affiliation(s)
- Imane A Yassine
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Waleed M Eldeeb
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Khaled A Gad
- Diagnostic Radiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Yossri A Ashour
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Inas A Yassine
- Systems and Biomedical Engineering Department, Faculty of Engineering, Cairo University, Egypt
| | - Ahmed O Hosny
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Garcia-Ramos C, Dabbs K, Meyerand E, Prabhakaran V, Hsu D, Jones J, Seidenberg M, Hermann B. Psychomotor slowing is associated with anomalies in baseline and prospective large scale neural networks in youth with epilepsy. NEUROIMAGE-CLINICAL 2018; 19:222-231. [PMID: 30035016 PMCID: PMC6051771 DOI: 10.1016/j.nicl.2018.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/14/2018] [Accepted: 04/17/2018] [Indexed: 12/18/2022]
Abstract
Purpose Psychomotor slowing is a common but understudied cognitive impairment in epilepsy. Here we test the hypothesis that psychomotor slowing is associated with alterations in brain status reflected through analysis of large scale structural networks. We test the hypothesis that children with epilepsy with cognitive slowing at diagnosis will exhibit a cross-sectional and prospective pattern of altered brain development. Methods A total of 78 children (age 8–18) with new/recent onset idiopathic epilepsies underwent 1.5 T MRI with network analysis of cortical, subcortical and cerebellar volumes. Children with epilepsy were divided into slow and fast psychomotor speed groups (adjusted for age, intelligence and epilepsy syndrome). Results At baseline, slow-speed performers (SSP) presented lower modularity, lower global efficiency, higher transitivity, and lower number of hubs than fast-speed performers (FSP). Community structure in SSP exhibited poor association between cortical regions and both subcortical structures and the cerebellum while FSP presented well-defined communities. Prospectively, SSP displayed lower modularity but higher global efficiency and transitivity compared to FSP. Modules in FSP showed higher integration between and within themselves compared to SSP. SSP showed hubs mainly from frontal and temporal regions while in FSP were spread among frontal, temporal, parietal, subcortical areas and the left cerebellum. Implications Results suggest the presence of widespread alterations in large scale networks between fast- and slow-speed children with recent onset epilepsies both at baseline and 2 years later. Slower processing speed appears to be a marker of abnormal brain development antecedent to epilepsy onset as well as brain development over the 2 years following diagnosis. Baseline: slow-speed performers (SSP) showed lower modularity and global efficiency They also showed higher transitivity but fewer hubs than fast-speed performers (FSP) Prospective: SSP showed lower modularity, harmonic mean and higher transitivity Regional volume changes seem to be occurring as one in SSP, but more modular in FSP SSP showed hubs mainly from frontal and temporal while FSP showed them widespread
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Affiliation(s)
- Camille Garcia-Ramos
- Medical Physics, University of Wisconsin School of Medicine and Public Health Madison WI, USA.
| | - Kevin Dabbs
- Departments of Neurology, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - Elizabeth Meyerand
- Medical Physics, University of Wisconsin School of Medicine and Public Health Madison WI, USA; Radiology, University of Wisconsin School of Medicine and Public Health Madison WI, USA; Biomedical Engineering, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - Vivek Prabhakaran
- Medical Physics, University of Wisconsin School of Medicine and Public Health Madison WI, USA; Radiology, University of Wisconsin School of Medicine and Public Health Madison WI, USA; Psychiatry, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - David Hsu
- Departments of Neurology, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - Jana Jones
- Departments of Neurology, University of Wisconsin School of Medicine and Public Health Madison WI, USA
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Bruce Hermann
- Departments of Neurology, University of Wisconsin School of Medicine and Public Health Madison WI, USA
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13
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Deleo F, Thom M, Concha L, Bernasconi A, Bernhardt BC, Bernasconi N. Histological and MRI markers of white matter damage in focal epilepsy. Epilepsy Res 2017; 140:29-38. [PMID: 29227798 DOI: 10.1016/j.eplepsyres.2017.11.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/10/2017] [Accepted: 11/20/2017] [Indexed: 12/21/2022]
Abstract
Growing evidence highlights the importance of white matter in the pathogenesis of focal epilepsy. Ex vivo and post-mortem studies show pathological changes in epileptic patients in white matter myelination, axonal integrity, and cellular composition. Diffusion-weighted MRI and its analytical extensions, particularly diffusion tensor imaging (DTI), have been the most widely used technique to image the white matter in vivo for the last two decades, and have shown microstructural alterations in multiple tracts both in the vicinity and at distance from the epileptogenic focus. These techniques have also shown promising ability to predict cognitive status and response to pharmacological or surgical treatments. More recently, the hypothesis that focal epilepsy may be more adequately described as a system-level disorder has motivated a shift towards the study of macroscale brain connectivity. This review will cover emerging findings contributing to our understanding of white matter alterations in focal epilepsy, studied by means of histological and ultrastructural analyses, diffusion MRI, and large-scale network analysis. Focus is put on temporal lobe epilepsy and focal cortical dysplasia. This topic was addressed in a special interest group on neuroimaging at the 70th annual meeting of the American Epilepsy Society, held in Houston December 2-6, 2016.
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Affiliation(s)
- Francesco Deleo
- NeuroImaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Canada
| | - Maria Thom
- Division of Neuropathology and Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Andrea Bernasconi
- NeuroImaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Canada
| | - Boris C Bernhardt
- NeuroImaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Canada; Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute, McGill University, Canada
| | - Neda Bernasconi
- NeuroImaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Canada.
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14
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Besson P, Bandt SK, Proix T, Lagarde S, Jirsa VK, Ranjeva JP, Bartolomei F, Guye M. Anatomic consistencies across epilepsies: a stereotactic-EEG informed high-resolution structural connectivity study. Brain 2017; 140:2639-2652. [DOI: 10.1093/brain/awx181] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/12/2017] [Indexed: 11/12/2022] Open
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15
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Sharma P, Wright DK, Johnston LA, Powell KL, Wlodek ME, Shultz SR, O'Brien TJ, Gilby KL. Differences in white matter structure between seizure prone (FAST) and seizure resistant (SLOW) rat strains. Neurobiol Dis 2017; 104:33-40. [DOI: 10.1016/j.nbd.2017.04.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/20/2017] [Accepted: 04/27/2017] [Indexed: 02/09/2023] Open
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16
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Pujar SS, Seunarine KK, Martinos MM, Neville BGR, Scott RC, Chin RFM, Clark CA. Long-term white matter tract reorganization following prolonged febrile seizures. Epilepsia 2017; 58:772-780. [PMID: 28332711 PMCID: PMC5484997 DOI: 10.1111/epi.13724] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 12/17/2022]
Abstract
Objective Diffusion magnetic resonance imaging (MRI) studies have demonstrated acute white matter changes following prolonged febrile seizures (PFS), but their longer‐term evolution is unknown. We investigated a population‐based cohort to determine white matter diffusion properties 8 years after PFS. Methods We used diffusion tensor imaging (DTI) and applied Tract‐Based Spatial Statistics for voxel‐wise comparison of white matter microstructure between 26 children with PFS and 27 age‐matched healthy controls. Age, gender, handedness, and hippocampal volumes were entered as covariates for voxel‐wise analysis. Results Mean duration between the episode of PFS and follow‐up was 8.2 years (range 6.7–9.6). All children were neurologically normal, and had normal conventional neuroimaging. On voxel‐wise analysis, compared to controls, the PFS group had (1) increased fractional anisotropy in early maturing central white matter tracts, (2) increased mean and axial diffusivity in several peripheral white matter tracts and late‐maturing central white matter tracts, and (3) increased radial diffusivity in peripheral white matter tracts. None of the tracts had reduced fractional anisotropy or diffusivity indices in the PFS group. Significance In this homogeneous, population‐based sample, we found increased fractional anisotropy in early maturing central white matter tracts and increased mean and axial diffusivity with/without increased radial diffusivity in several late‐maturing peripheral white matter tracts 8 years post‐PFS. We propose disruption in white matter maturation secondary to seizure‐induced axonal injury, with subsequent neuroplasticity and microstructural reorganization as a plausible explanation.
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Affiliation(s)
- Suresh S Pujar
- Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,Young Epilepsy, Lingfield, Surrey, United Kingdom
| | - Kiran K Seunarine
- Imaging and Biophysics Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Marina M Martinos
- Developmental Cognitive Neuroscience Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Brian G R Neville
- Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Young Epilepsy, Lingfield, Surrey, United Kingdom
| | - Rod C Scott
- Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,Young Epilepsy, Lingfield, Surrey, United Kingdom.,Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, Vermont, U.S.A
| | - Richard F M Chin
- Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Muir Maxwell Epilepsy Centre, Department of Child Life and Health, The University of Edinburgh, Edinburgh, United Kingdom
| | - Chris A Clark
- Imaging and Biophysics Unit, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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17
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Qiu W, Gao Y, Yu C, Miao A, Tang L, Huang S, Hu Z, Xiang J, Wang X. Structural Abnormalities in Childhood Absence Epilepsy: Voxel-Based Analysis Using Diffusion Tensor Imaging. Front Hum Neurosci 2016; 10:483. [PMID: 27733824 PMCID: PMC5039196 DOI: 10.3389/fnhum.2016.00483] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/12/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose: Childhood absence epilepsy (CAE) is a common syndrome of idiopathic generalized epilepsy. However, little is known about the brain structural changes in this type of epilepsy, especially in the default mode network (DMN) regions. This study aims at using the diffusion tensor imaging (DTI) technique to quantify structural abnormalities of DMN nodes in CAE patients. Method: DTI data were acquired in 14 CAE patients (aged 8.64 ± 2.59 years, seven females and seven males) and 16 age- and sex-matched healthy controls. The data were analyzed using voxel-based analysis (VBA) and statistically compared between patients and controls. Pearson correlation was explored between altered DTI metrics and clinical parameters. The difference of brain volumes between patients and controls were also tested using unpaired t-test. Results: Patients showed significant increase of mean diffusivity (MD) and radial diffusivity (RD) in left medial prefrontal cortex (MPFC), and decrease of fractional anisotropy (FA) in left precuneus and axial diffusivity (AD) in both left MPFC and precuneus. In correlation analysis, MD value from left MPFC was positively associated with duration of epilepsy. Neither the disease duration nor the seizure frequency showed significant correlation with FA values. Between-group comparison of brain volumes got no significant difference. Conclusion: The findings indicate that structural impairments exist in DMN regions in children suffering from absence epilepsy and MD values positively correlate with epilepsy duration. This may contribute to understanding the pathological mechanisms of chronic neurological deficits and promote the development of new therapies for this disorder.
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Affiliation(s)
- Wenchao Qiu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Yuan Gao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Chuanyong Yu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Ailiang Miao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Lu Tang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Shuyang Huang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Zheng Hu
- Department of Neurology, Nanjing Children's Hospital Nanjing, China
| | - Jing Xiang
- MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
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18
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Abstract
PURPOSE OF REVIEW Corpus callosotomy is a palliative surgical treatment modality that has gone in and out of favor. The purpose of this review is to summarize the studies of callosotomy in the past years as a treatment for severe drug-resistant epilepsy with traumatizing drop attacks, mostly in children and also in some adults. The aim is also to discuss knowledge gaps and suggest how these could be addressed. RECENT FINDINGS Lately, a number of callosotomy series, mostly retrospective and single center, have included 289 operated patients. A few series have included nonoperated controls; one prospective long-term series is national and population based. Seizure outcome is shown to be comparable to that earlier reported, with best effect against drop attacks. There is no consensus on whether anterior or complete callosotomy is to be preferred. In a meta-analysis of callosotomy versus vagal nerve stimulation, callosotomy led to better seizure outcome. Diffusion tensor imaging may be a promising tool to analyze the completeness of the procedure. SUMMARY Callosotomy remains an effective palliative procedure. Many unresolved issues, such as prognostic indicators, nonseizure-related outcomes, whether to choose anterior or complete callosotomy, and outcomes and adverse effects in adults, need to be studied in prospective, preferably multicenter studies.
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19
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Park KM, Han YH, Kim TH, Mun CW, Shin KJ, Ha SY, Park J, Hur YJ, Kim HY, Park SH, Kim SE. Cerebellar white matter changes in patients with newly diagnosed partial epilepsy of unknown etiology. Clin Neurol Neurosurg 2015; 138:25-30. [DOI: 10.1016/j.clineuro.2015.07.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 07/10/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
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20
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Pohlmann-Eden B, Aldenkamp A, Baker GA, Brandt C, Cendes F, Coras R, Crocker CE, Helmstaedter C, Jones-Gotman M, Kanner AM, Mazarati A, Mula M, Smith ML, Omisade A, Tellez-Zenteno J, Hermann BP. The relevance of neuropsychiatric symptoms and cognitive problems in new-onset epilepsy - Current knowledge and understanding. Epilepsy Behav 2015; 51:199-209. [PMID: 26291774 DOI: 10.1016/j.yebeh.2015.07.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 07/03/2015] [Indexed: 01/11/2023]
Abstract
Neurobehavioral and cognition problems are highly prevalent in epilepsy, but most research studies to date have not adequately addressed the precise nature of the relationship between these comorbidities and seizures. To address this complex issue and to facilitate collaborative, innovative research in the rising field of neurobehavioral comorbidities and cognition disturbances in new-onset epilepsy, international epilepsy experts met at the 3rd Halifax International Epilepsy Conference & Retreat at White Point, South Shore, Nova Scotia, Canada from September 18 to 20, 2014. This Conference Proceedings provides a summary of the conference proceedings. Specifically, the following topics are discussed: (i) role of comorbidities in epilepsy diagnosis and management, (ii) role of antiepileptic medications in understanding the relationship between epilepsy and neurobehavioral and cognition problems, and (iii) animal data and diagnostic approaches. Evidence to date, though limited, strongly suggests a bidirectional relationship between epilepsy and cognitive and psychiatric comorbidities. In fact, it is likely that seizures and neurobehavioral problems represent different symptoms of a common etiology or network-wide disturbance. As a reflection of this shared network, psychiatric comorbidities and/or cognition problems may actually precede the seizure occurrence and likely get often missed if not screened.
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Affiliation(s)
- B Pohlmann-Eden
- Division of Neurology, Dalhousie University of Halifax, Canada; Brain Repair Center, Dalhousie University of Halifax, Canada.
| | - A Aldenkamp
- Epilepsiecentrum Kempenhaeghe, The Netherlands
| | - G A Baker
- Division of Neurosciences, University of Liverpool, United Kingdom
| | - C Brandt
- Bethel Epilepsy Center, Mara Hospital, Bielefeld, Germany
| | - F Cendes
- Department of Neurology, University of Campinas, São Paulo, Brazil
| | - R Coras
- Department of Neuropathology, University of Erlangen, Germany
| | - C E Crocker
- Division of Neurology, Dalhousie University of Halifax, Canada
| | | | - M Jones-Gotman
- McGill University, Montreal Neurological Institute, Montreal, Canada
| | - A M Kanner
- Epilepsy Center, University of Miami, Miller School of Medicine, USA
| | - A Mazarati
- Children's Discovery and Innovation Institute, D. Geffen School of Medicine at UCLA, Los Angeles, USA
| | - M Mula
- Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust and Institute of Medical and Biomedical Sciences St. George's University of London, United Kingdom
| | - M L Smith
- Department of Psychology, University of Toronto, Canada
| | - A Omisade
- Division of Neurology, Dalhousie University of Halifax, Canada
| | | | - B P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, USA
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Kwan S, Boudes E, Gilbert G, Saint-Martin C, Albrecht S, Shevell M, Wintermark P. Injury to the Cerebellum in Term Asphyxiated Newborns Treated with Hypothermia. AJNR Am J Neuroradiol 2015; 36:1542-9. [PMID: 26138137 DOI: 10.3174/ajnr.a4326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND PURPOSE Until now, most studies of brain injury related to term neonatal encephalopathy have focused on the cerebrum and ignored the cerebellum. We sought to evaluate whether cerebellar injury occurs in term asphyxiated neonates. MATERIALS AND METHODS Asphyxiated neonates treated with hypothermia were enrolled prospectively. Severity of brain injury in the cerebrum was scored on each MR imaging obtained during the first month of life; cerebellar injury was recorded when mentioned in the imaging or autopsy report. In addition, for some of the neonates, the ADC and fractional anisotropy were measured in 4 regions of interest in the cerebellum. RESULTS One hundred seventy-two asphyxiated neonates met the criteria for hypothermia. Cerebellar injury was visible only on conventional imaging of 4% of the neonates for whom brain imaging was available, but it was reported in the autopsy report of 72% of the neonates who died. In addition, 41 of the asphyxiated neonates had a total of 84 ADC and fractional anisotropy maps. Neonates with brain injury described only in the cerebrum demonstrated ADC and fractional anisotropy changes similar to those of the neonates with brain injury in the cerebrum and cerebellum--increased ADC around day 10 of life and decreased fractional anisotropy on day 2-3 of life, around day 10 of life, and around 1 month of age. CONCLUSIONS The cerebellum may be injured in term neonates after birth asphyxia. These cerebellar injuries are only rarely visible on conventional imaging, but advanced neuroimaging techniques may help to identify them.
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Affiliation(s)
- S Kwan
- From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.)
| | - E Boudes
- From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.)
| | - G Gilbert
- MR Clinical Science (G.G.), Philips Healthcare, Montreal, Quebec, Canada
| | | | - S Albrecht
- Department of Pediatric Pathology (S.A.)
| | - M Shevell
- Division of Pediatric Neurology, Department of Pediatrics (M.S.), Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - P Wintermark
- From the Division of Newborn Medicine, Department of Pediatrics (S.K., E.B., P.W.)
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Baumer FM, Song JW, Mitchell PD, Pienaar R, Sahin M, Grant PE, Takahashi E. Longitudinal changes in diffusion properties in white matter pathways of children with tuberous sclerosis complex. Pediatr Neurol 2015; 52:615-23. [PMID: 25817702 PMCID: PMC4442035 DOI: 10.1016/j.pediatrneurol.2015.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 02/02/2015] [Accepted: 02/04/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Abnormal white matter development in patients with tuberous sclerosis complex, a multisystem hamartomatous disorder caused by aberrant neural proliferation and axonal maturation, may be associated with poorer neurocognitive outcomes. The purpose of this study is to identify predictors of longitudinal changes in diffusion properties of white matter tracts in patients with tuberous sclerosis complex. METHODS Diffusion magnetic resonance imaging was carried out in 17 subjects with tuberous sclerosis complex (mean age, 7.2 ± 4.4 years) with at least two magnetic resonance imaging scans (mean number of days between scans, 419.4 ± 105.4). There were 10 males; 5 of 17 had autism spectrum disorder and 10 of 17 had epilepsy. Regions of interest were placed to delineate the internal capsule/corona radiata, cingulum, and corpus callosum. The outcomes were mean change in apparent diffusion coefficient and fractional anisotropy. Data were analyzed using Pearson's correlation and multiple linear regression analyses. RESULTS Gender was a significant predictor of mean change in apparent diffusion coefficient in the left internal capsule, right and left cingulum bundles, and corpus callosum and a significant predictor of mean change in fractional anisotropy in the corpus callosum. Epilepsy was a significant predictor of mean change in apparent diffusion coefficient in the left internal capsule. Autism spectrum disorder was not predictive of diffusion changes in any of the studied pathways. CONCLUSION Clinical variables, including gender and epilepsy, have an effect on the development of white matter pathways. These variables should be taken into consideration when counseling tuberous sclerosis complex patients and in future imaging studies in this population.
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Affiliation(s)
- Fiona M Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA,Correspondence should be addressed to: Emi Takahashi, Ph.D., Division of Newborn Medicine, Boston Children's Hospital, 1 Autumn St. #456, Boston, MA 02115, phone (617) 999-0433
- fax (617) 730-4671, , , Fiona Baumer, M.D., Department of Neurology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood, Avenue, Boston, MA, 02115, USA,
| | - Jae W Song
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Paul D Mitchell
- Clinical Research Center, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Rudolph Pienaar
- Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston MA, 02115, USA
| | - Mustafa Sahin
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - P Ellen Grant
- Division of Newborn Medicine, Department of Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA,Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA,Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston MA, 02115, USA
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts; Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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Regaining white matter integrity and neurocognitive development in rolandic epilepsy after the storm. Epilepsy Curr 2015; 15:20-3. [PMID: 25678881 DOI: 10.5698/1535-7597-15.1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Westall CA, Wright T, Cortese F, Kumarappah A, Snead OC, Buncic JR. Vigabatrin retinal toxicity in children with infantile spasms: An observational cohort study. Neurology 2014; 83:2262-8. [PMID: 25381295 PMCID: PMC4277676 DOI: 10.1212/wnl.0000000000001069] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/07/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To determine time to vigabatrin (VGB, Sabril; Lundbeck, Deerfield, IL) induced retinal damage in children with infantile spasms (IS) and to identify risk factors for VGB-induced retinal damage (VGB-RD). METHODS Observational cohort study including 146 participants (68 female, 81 male) with IS, an age-specific epilepsy syndrome of early infancy, treated with VGB. Participants ranged from 3 to 34.9 months of age (median 7.6 months). The median duration of VGB treatment was 16 months (range 4.6-78.5 months). Electroretinograms (ERGs) were performed according to the Standards of the International Society for Clinical Electrophysiology of Vision. Inclusion required baseline (pre-VGB or within 4 weeks of starting VGB treatment) and at least 2 follow-up ERGs. Significant reduction from baseline of the 30-Hz ERG flicker amplitude on 2 consecutive visits identified VGB-RD. Kaplan-Meier survival analyses depicted the effect of duration of VGB on VGB-RD. RESULTS These data represent the largest survival analysis of children treated with VGB who did not succumb to retinal toxicity during the study. Thirty of the 146 participants (21%) showed VGB-RD. The ERG amplitude reduced with duration of VGB treatment (p = 0.0004) with no recovery after VGB cessation. With 6 and 12 months of VGB treatment, 5.3% and 13.3%, respectively, developed VGB-RD. There was neither effect of age of initiation of VGB treatment nor sex of the child on survival statistics and no significant effect of cumulative dosage on the occurrence of VGB-RD. CONCLUSIONS Minimizing VGB treatment to 6 months will reduce the prevalence of VGB-RD in patients with IS.
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Affiliation(s)
- Carol A Westall
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada.
| | - Tom Wright
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada
| | - Filomeno Cortese
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada
| | - Ananthavalli Kumarappah
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada
| | - O Carter Snead
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada
| | - Joseph R Buncic
- From the Department of Ophthalmology and Vision Science (C.A.W., T.W., A.K., J.R.B.), and Faculty of Medicine (O.C.S.), The Hospital for Sick Children, University of Toronto (C.A.W., J.R.B., O.C.S.); and Hotchkiss Brain Institute, University of Calgary (F.C.), Canada
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25
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Rathouz PJ, Zhao Q, Jones JE, Jackson DC, Hsu DA, Stafstrom CE, Seidenberg M, Hermann BP. Cognitive development in children with new onset epilepsy. Dev Med Child Neurol 2014; 56:635-41. [PMID: 24650092 PMCID: PMC4057956 DOI: 10.1111/dmcn.12432] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2013] [Indexed: 11/28/2022]
Abstract
AIM To characterize the prospective trajectory of cognitive development in children with new or recent onset epilepsy from baseline to 5 to 6 years after diagnosis. METHOD Sixty-nine children (40 males, 29 females; age 8-18y), with new or recent onset epilepsies underwent neuropsychological assessment shortly after diagnosis (Wave 1), 2 years (Wave 2), and 5 to 6 years after diagnosis (Wave 3). Intelligence, academic achievement, language, executive function, and psychomotor speed were evaluated. Sixty-two children (28 males, 34 females; age 8-18) with typical development served as a comparison group at each time point. The cognitive data were examined by syndrome (localization-related epilepsy [LRE]; idiopathic generalized epilepsy [IGE]; comparison group). Mixed effect regression models compared trajectories among groups with respect to time since diagnosis. RESULTS Cognitive abnormalities exhibited by children with epilepsy in arithmetic computation, response inhibition, attention, fine motor dexterity, and psychomotor speed (all p values <0.001), are detectable at or near the time of diagnosis and largely remain stable over the ensuing 5 to 6 years without evidence of progressive worsening or recovery. This course is evident across both LRE and IGE groups, with the LRE group performing better for some outcomes (arithmetic, response inhibition, psychomotor speed) and never worse than the IGE group. INTERPRETATION Cognitive development in children with LRE and IGE is not characterized by progressive deterioration or lack of age-appropriate development; rather, development lags behind that of children with typical development. Cognitive abnormalities, when detected, are present near the time of diagnosis, persist over time, and require early intervention.
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Affiliation(s)
- Paul J Rathouz
- Department of Biostatistics & Medical Informatics, University of Wisconsin School of Medicine and Public Health
| | - Qianqian Zhao
- Department of Biostatistics & Medical Informatics, University of Wisconsin School of Medicine and Public Health
| | - Jana E Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Daren C Jackson
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Dave A Hsu
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Carl E Stafstrom
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Michael Seidenberg
- Department of Psychology, Rosalind Franklin University, North Chicago, IL, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Gao J, Feng ST, Wu B, Gong N, Lu M, Wu PM, Wang H, He X, Huang B. Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic-clonic seizure: A voxel-based diffusional kurtosis imaging study. J Magn Reson Imaging 2014; 41:1088-95. [PMID: 24797060 DOI: 10.1002/jmri.24647] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 11/06/2022] Open
Affiliation(s)
- Junling Gao
- Department of Medicine; The University of Hong Kong; Hong Kong
| | - Shi-Ting Feng
- Department of Radiology; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Bangxian Wu
- Department of Industrial Engineering; Hong Kong University of Science and Technology; Hong Kong
| | - Nanjie Gong
- Department of Radiology; Stanford University; Stanford California USA
| | - Minhua Lu
- Department of Biomedical Engineering; Shenzhen University; Guangdong P.R China
| | - Po-Man Wu
- Medical Physics and Research Department; Hong Kong Sanatorium & Hospital; Hong Kong
| | - He Wang
- Applied Science Lab, GE Healthcare; Shanghai P.R China
| | - Xiaoming He
- Department of Neurology; Xiangyang Central Hospital/Affiliated Hospital of Hubei University of Arts and Science; Xiangyang Hubei P.R China
| | - Bingsheng Huang
- Department of Biomedical Engineering; Shenzhen University; Guangdong P.R China
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Kumar R, Pham TT, Macey PM, Woo MA, Yan-Go FL, Harper RM. Abnormal myelin and axonal integrity in recently diagnosed patients with obstructive sleep apnea. Sleep 2014; 37:723-32. [PMID: 24899761 DOI: 10.5665/sleep.3578] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Patients with obstructive sleep apnea (OSA) show significant white matter injury; whether that injury represents myelin or axonal damage is unclear. The objective was to examine myelin and axonal changes in patients with newly diagnosed OSA over control subjects. DESIGN Cross-sectional study. SETTING University-based medical center. PARTICIPANTS Twenty-three newly-diagnosed, treatment-naïve OSA and 23 age- and sex-matched control subjects. INTERVENTIONS None. MEASUREMENTS AND RESULTS Radial and axial diffusivity maps, calculated from diffusion tensor imaging data (3.0 Tesla MRI scanner), indicating diffusion perpendicular (myelin status) or parallel (axonal status) to fibers, respectively, were normalized, smoothed, and compared between groups (analysis of covariance; covariate: age). Global brain radial and axial diffusivity values, and global brain volume with myelin and axonal changes were determined, and region-of-interest analyses performed in areas of significant differences between groups based on voxel-based procedures. Global radial and axial diffusivity values were significantly reduced in OSA versus control subjects (radial, P = 0.004; axial, P = 0.019), with radial (myelin) diffusivity reduced more than axial (axonal), and more left-sided reduction for both measures. Localized declines for myelin and axonal measures appeared in the dorsal and ventral medulla, cerebellar cortex and deep nuclei, basal ganglia, hippocampus, amygdala, corpus callosum, insula, cingulate and medial frontal cortices, and other cortical areas (P < 0.005), all regions mediating functions affected in OSA. CONCLUSIONS Fiber injury appears in critical medullary respiratory regulatory sites, as well as cognitive and autonomic control areas. Myelin is more affected in newly diagnosed OSA than axons, and primarily on the left side, possibly from the increased myelin sensitivity to hypoxia and asymmetric perfusion.
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Affiliation(s)
- Rajesh Kumar
- Department of Anesthesiology ; Department of Radiological Sciences ; The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
| | - Tiffany T Pham
- Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Paul M Macey
- UCLA School of Nursing, Los Angeles, CA ; The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
| | | | - Frisca L Yan-Go
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Ronald M Harper
- Department of Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA ; The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA
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Spader HS, Ellermeier A, O'Muircheartaigh J, Dean DC, Dirks H, Boxerman JL, Cosgrove GR, Deoni SCL. Advances in myelin imaging with potential clinical application to pediatric imaging. Neurosurg Focus 2014; 34:E9. [PMID: 23544415 DOI: 10.3171/2013.1.focus12426] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
White matter development and myelination are critical processes in neurodevelopment. Myelinated white matter facilitates the rapid and coordinated brain messaging required for higher-order cognitive and behavioral processing. Whereas several neurological disorders such as multiple sclerosis are associated with gross white matter damage and demyelination, other disorders such as epilepsy may involve altered myelination in the efferent or afferent white matter pathways adjoining epileptic foci. Current MRI techniques including T1 weighting, T2 weighting, FLAIR, diffusion tensor imaging, and MR spectroscopy permit visualization of gross white matter abnormalities and evaluation of underlying white matter fiber architecture and integrity, but they provide only qualitative information regarding myelin content. Quantification of these myelin changes could provide new insight into disease severity and prognosis, reveal information regarding spatial location of foci or lesions and the associated affected neural systems, and create a metric to evaluate treatment efficacy. Multicomponent analysis of T1 and T2 relaxation data, or multicomponent relaxometry (MCR), is a quantitative imaging technique that is sensitive and specific to myelin content alteration. In the past, MCR has been associated with lengthy imaging times, but a new, faster MCR technique (mcDESPOT) has made quantitative analysis of myelin content more accessible for clinical research applications. The authors briefly summarize traditional white matter imaging techniques, describe MCR and mcDESPOT, and discuss current and future clinical applications of MCR, with a particular focus on pediatric epilepsy.
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Affiliation(s)
- Heather S Spader
- Departments of Neurosurgery, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
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Lin JJ, Siddarth P, Riley JD, Gurbani SG, Ly R, Yee VW, Levitt JG, Toga AW, Caplan R. Neurobehavioral comorbidities of pediatric epilepsies are linked to thalamic structural abnormalities. Epilepsia 2013; 54:2116-24. [PMID: 24304435 DOI: 10.1111/epi.12428] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2013] [Indexed: 12/13/2022]
Abstract
PURPOSE Neurobehavioral comorbidities are common in pediatric epilepsy with enduring adverse effects on functioning, but their neuroanatomic underpinning is unclear. Striatal and thalamic abnormalities have been associated with childhood-onset epilepsies, suggesting that epilepsy-related changes in the subcortical circuit might be associated with the comorbidities of children with epilepsy. We aimed to compare subcortical volumes and their relationship with age in children with complex partial seizures (CPS), childhood absence epilepsy (CAE), and healthy controls (HC). We examined the shared versus unique structural-functional relationships of these volumes with behavior problems, intelligence, language, peer interaction, and epilepsy variables in these two epilepsy syndromes. METHODS We investigated volumetric differences of caudate, putamen, pallidum, and thalamus in children with CPS (N = 21), CAE (N = 20), and HC (N = 27). Study subjects underwent structural magnetic resonance imaging (MRI), intelligence, and language testing. Parent-completed Child Behavior Checklists provided behavior problem and peer interaction scores. We examined the association of age, intelligence quotient (IQ), language, behavioral problems, and epilepsy variables with subcortical volumes that were significantly different between the children with epilepsy and HC. KEY FINDINGS Both children with CPS and CAE exhibited significantly smaller left thalamic volume compared to HC. In terms of developmental trajectory, greater thalamic volume was significantly correlated with increasing age in children with CPS and CAE but not in HC. With regard to the comorbidities, reduced left thalamic volumes were related to more social problems in children with CPS and CAE. Smaller left thalamic volumes in children with CPS were also associated with poor attention, lower IQ and language scores, and impaired peer interaction. SIGNIFICANCE Our study is the first to directly compare and detect shared thalamic structural abnormalities in children with CPS and CAE. These findings highlight the vulnerability of the thalamus and provide important new insights on its possible role in the neurobehavioral comorbidities of childhood-onset epilepsy.
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Affiliation(s)
- Jack J Lin
- Department of Neurology, University of California Irvine, Irvine, California, U.S.A
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30
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Xiao F, Chen Q, Yu X, Tang Y, Luo C, Fang J, Liu L, Huang X, Gong Q, Zhou D. Hemispheric lateralization of microstructural white matter abnormalities in children with active benign childhood epilepsy with centrotemporal spikes (BECTS): a preliminary DTI study. J Neurol Sci 2013; 336:171-9. [PMID: 24210075 DOI: 10.1016/j.jns.2013.10.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 10/05/2013] [Accepted: 10/21/2013] [Indexed: 02/05/2023]
Abstract
PURPOSE The deficit of white matter is reported to be involved during the disease progression in patients with benign childhood epilepsy with centrotemporal spikes (BECTS). The aim of this study is to investigate patterns of white matter damage in children with BECTS with left- or right-hemispheric focus by using diffusion tensor imaging (DTI), and its relationship with the cofactors such duration, seizure frequency and handedness. METHODS Diffusion tensor imaging (DTI) was performed in twenty-eight children with BECTS and eighteen healthy controls. The data were analyzed using both tract-based spatial statistics (TBSS) and region of interest (ROI) analyses. Correlations were investigated between the fractional anisotropy (FA) values of the identified altered regions and clinical features such as age, age of onset and seizure frequency. RESULTS The TBSS analysis revealed that white matter impairment in children with rolandic spikes on the ipsilateral hemisphere was much wider. The FA value was significantly lower in the body of the corpus callosum and forceps minor in BECTS patients with spikes on the ipsilateral hemisphere. The seizure frequency correlated positively with the FA values of body of corpus callosum (CC), bilateral cingulate gyrus and left uncinate fasciculi (UA). CONCLUSION The impaired WM integrity in patients with BECTS was greater in patients with spikes on the dominant hemisphere, possibly due to the greater vulnerability of the left hemisphere and excitotoxic effects of seizures.
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Affiliation(s)
- Fenglai Xiao
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Qin Chen
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiaofeng Yu
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Yingying Tang
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Chunyan Luo
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Jiajia Fang
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Ling Liu
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Xiaoqi Huang
- Huaxi MR Research Center, Department of Radiology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China.
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Amarreh I, Dabbs K, Jackson DC, Jones JE, Meyerand ME, Stafstrom CE, Hsu DA, Seidenberg M, Hermann BP. Cerebral white matter integrity in children with active versus remitted epilepsy 5 years after diagnosis. Epilepsy Res 2013; 107:263-71. [PMID: 24148888 DOI: 10.1016/j.eplepsyres.2013.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 08/28/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Diffusion tensor imaging (DTI) studies have reported white matter abnormalities in childhood-onset epilepsy, but the mechanisms and timing underlying these abnormalities, and their resolution, are not well understood. This study examined white matter integrity in children with active versus remitted epilepsy. METHODS Tract-based spatial statistics (TBSS) was used to examine whole-brain DTI indices of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in 20 children with epilepsy 5-6 years after diagnosis, compared to 29 healthy controls. To determine the status of white matter following cessation of seizures, participants with epilepsy were classified as active versus remitted and comparisons included: (1) controls versus all children with epilepsy, (2) controls versus children with remitted seizures, (3) controls versus children with active seizures, and (4) children with active versus remitted epilepsy. RESULTS In the active compared to remitted epilepsy group, significantly higher FA and lower MD, AD and RD values were dispersed in the internal capsule, cingulum, body of the corpus callosum, superior corona radiata and superior fronto-occipital fasciculus. Similar differences were found between the active epilepsy and the control group. There were no significant differences between the remitted epilepsy and control groups. CONCLUSION Children with active epilepsy differed in white matter integrity compared to children with remitted epilepsy and healthy controls. It remains to be determined whether these findings represent the outcomes of seizure remission versus an initial biomarker for those children who will ultimately have intractable epilepsy.
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Affiliation(s)
- Ishmael Amarreh
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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