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Lozano-García A, Catalán-Aguilar J, Tormos-Pons P, Hampel KG, Villanueva V, Cano-López I, González-Bono E. Impact of Polytherapy on Memory Functioning in Patients With Drug-Resistant Epilepsy: The Role of Attention and Executive Functions. Arch Clin Neuropsychol 2024; 39:423-442. [PMID: 37987193 DOI: 10.1093/arclin/acad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE The aim was to examine the effect of polytherapy (i.e., the number of administered anti-seizure medications (ASMs)) on memory, and whether the interaction between the number of ASMs and attentional/executive functioning affect presurgical memory functioning and postsurgical memory changes in patients with drug-resistant epilepsy. METHODS Two studies were carried out. Study 1 consisted of a presurgical assessment of 125 adult patients, in which attention/executive function (EpiTrack screening tool) and memory were assessed (cross-sectional study). Of them, 72 patients underwent a second postsurgical evaluation, in which memory was assessed (Study 2). Patients were distributed into groups based on EpiTrack performance and number of ASMs. RESULTS The interaction between the number of ASMs and the attentional/executive functioning significantly affected presurgical memory, with patients with impaired EpiTrack performance taking three-four ASMs having poorer scores than patients with intact EpiTrack performance taking three-four ASMs (for all, p < .0001). This interaction also affected postsurgical memory changes, with patients with impaired Epitrack performance taking three-four ASMs having higher postsurgical decline than those with intact Epitrack performance taking three-four ASMs (for all, p < .005). No differences were found in patients taking two ASMs. Furthermore, the number of ASMs was associated with presurgical memory performance and postsurgical memory changes only in patients with impaired EpiTrack performance (for all, p < .05). CONCLUSIONS Our findings underline the utility of EpiTrack, together with the clinical information on the number of prescribed ASMs, to corroborate the impact of polytherapy on memory and to optimize the prediction of postsurgical memory changes.
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Affiliation(s)
- Alejandro Lozano-García
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Department of Psychology, Universidad Europea de Valencia, Valencia, Spain
- Faculty of Health Sciences, Universidad Isabel I, Burgos, Spain
| | - Judit Catalán-Aguilar
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Paula Tormos-Pons
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Kevin G Hampel
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Irene Cano-López
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
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Aljishi A, Sherman BE, Huberdeau DM, Obaid S, Khan K, Lamsam L, Zibly Z, Sivaraju A, Turk-Browne NB, Damisah EC. Statistical learning in epilepsy: Behavioral and anatomical mechanisms in the human brain. Epilepsia 2024; 65:753-765. [PMID: 38116686 PMCID: PMC10948305 DOI: 10.1111/epi.17871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe (MTL) in the healthy brain. This leads to the hypothesis that statistical learning (SL) may be impaired in patients with epilepsy (PWE) involving the temporal lobe, and that this impairment could contribute to their varied memory deficits. In turn, studies done in collaboration with PWE, that evaluate the necessity of MTL circuitry through disease and causal perturbations, provide an opportunity to advance basic understanding of SL. METHODS We implemented behavioral testing, volumetric analysis of the MTL substructures, and direct electrical brain stimulation to examine SL across a cohort of 61 PWE and 28 healthy controls. RESULTS We found that behavioral performance in an SL task was negatively associated with seizure frequency irrespective of seizure origin. The volume of hippocampal subfields CA1 and CA2/3 correlated with SL performance, suggesting a more specific role of the hippocampus. Transient direct electrical stimulation of the hippocampus disrupted SL. Furthermore, the relationship between SL and seizure frequency was selective, as behavioral performance in an episodic memory task was not impacted by seizure frequency. SIGNIFICANCE Overall, these results suggest that SL may be hippocampally dependent and that the SL task could serve as a clinically useful behavioral assay of seizure frequency that may complement existing approaches such as seizure diaries. Simple and short SL tasks may thus provide patient-centered endpoints for evaluating the efficacy of novel treatments in epilepsy.
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Affiliation(s)
- Ayman Aljishi
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, 37240, USA
| | - Brynn E. Sherman
- Department of Psychology, Yale University, New Haven, CT 06520, USA
| | | | - Sami Obaid
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Kamren Khan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Layton Lamsam
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Zion Zibly
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Adithya Sivaraju
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Nicholas B. Turk-Browne
- Department of Psychology, Yale University, New Haven, CT 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
| | - Eyiyemisi C. Damisah
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
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Ma K, Zhang X, Song C, Han S, Li W, Wang K, Mao X, Zhang Y, Cheng J. Altered topological properties and their relationship to cognitive functions in unilateral temporal lobe epilepsy. Epilepsy Behav 2023; 144:109247. [PMID: 37267843 DOI: 10.1016/j.yebeh.2023.109247] [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: 11/22/2022] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate abnormalities in topological properties in unilateral temporal lobe epilepsy (TLE) with hippocampal sclerosis and their correlations with cognitive functions. METHODS Thirty-eight patients with TLE and 19 age- and sex-matched healthy controls (HCs) were enrolled in this research and underwent resting-state functional magnetic resonance imaging (fMRI) examinations. Whole-brain functional networks of participants were constructed based on the fMRI data. Topological characteristics of the functional network were compared between patients with left and right TLE and HCs. Correlations between altered topological properties and cognitive measurements were explored. RESULTS Compared with the HCs, patients with left TLE showed decreased clustering coefficient, global efficiency, and local efficiency (Eloc), and patients with right TLE showed decreased Eloc. We found altered nodal centralities in six regions related to the basal ganglia (BG) network or default mode network (DMN) in patients with left TLE and those in three regions related to reward/emotion network or ventral attention network in patients with right TLE. Patients with right TLE showed higher integration (reduced nodal shortest path length) in four regions related to the DMN and lower segregation (reduced nodal local efficiency and nodal clustering coefficient) in the right middle temporal gyrus. When comparing left TLE with right TLE, no significant differences were detected in global parameters, but the nodal centralities in the left parahippocampal gyrus and the left pallidum were decreased in left TLE. The Eloc and several nodal parameters were significantly correlated with memory functions, duration, national hospital seizure severity scale (NHS3), or antiseizure medications (ASMs) in patients with TLE. CONCLUSIONS The topological properties of whole-brain functional networks were disrupted in TLE. Networks of left TLE were characterized by lower efficiency; right TLE was preserved in global efficiency but disrupted in fault tolerance. Several nodes with abnormal topological centrality in the basal ganglia network beyond the epileptogenic focus in the left TLE were not found in the right TLE. Right TLE had some nodes with reduced shortest path length in regions of the DMN as compensation. These findings provide new insights into the effect of lateralization on TLE and help us to understand the cognitive impairment of patients with TLE.
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Affiliation(s)
- Keran Ma
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Xiaonan Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Chengru Song
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Wenbin Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Kefan Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Xinyue Mao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China; Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China.
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Aljishi A, Sherman BE, Huberdeau DM, Obaid S, Sivaraju A, Turk-Browne NB, Damisah EC. Statistical learning in epilepsy: Behavioral, anatomical, and causal mechanisms in the human brain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.25.538321. [PMID: 37162937 PMCID: PMC10168289 DOI: 10.1101/2023.04.25.538321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe in the healthy brain. This leads to the hypothesis that statistical learning may be impaired in epilepsy patients, and that this impairment could contribute to their varied memory deficits. In turn, epilepsy patients provide a platform to advance basic understanding of statistical learning by helping to evaluate the necessity of medial temporal lobe circuitry through disease and causal perturbations. We implemented behavioral testing, volumetric analysis of the medial temporal lobe substructures, and direct electrical brain stimulation to examine statistical learning across a cohort of 61 epilepsy patients and 28 healthy controls. Behavioral performance in a statistical learning task was negatively associated with seizure frequency, irrespective of where seizures originated in the brain. The volume of hippocampal subfields CA1 and CA2/3 correlated with statistical learning performance, suggesting a more specific role of the hippocampus. Indeed, transient direct electrical stimulation of the hippocampus disrupted statistical learning. Furthermore, the relationship between statistical learning and seizure frequency was selective: behavioral performance in an episodic memory task was impacted by structural lesions in the medial temporal lobe and by antiseizure medications, but not by seizure frequency. Overall, these results suggest that statistical learning may be hippocampally dependent and that this task could serve as a clinically useful behavioral assay of seizure frequency distinct from existing neuropsychological tests. Simple and short statistical learning tasks may thus provide patient-centered endpoints for evaluating the efficacy of novel treatments in epilepsy.
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Affiliation(s)
- Ayman Aljishi
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Brynn E. Sherman
- Department of Psychology, Yale University, New Haven, CT 06520, USA
| | | | - Sami Obaid
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Adithya Sivaraju
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Nicholas B. Turk-Browne
- Department of Psychology, Yale University, New Haven, CT 06520, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
| | - Eyiyemisi C. Damisah
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
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Jamus DR, Mäder-Joaquim MJ, de Paula Souza L, de Paola L, Claro-Höpker CD, Terra VC, Soares Silvado CE. Rey-Osterrieth complex figure test: Comparison of traditional and qualitative scoring systems after unilateral temporal lobectomy. Clin Neuropsychol 2023; 37:416-431. [PMID: 35264077 DOI: 10.1080/13854046.2022.2047790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE We compared the performance on the Rey-Osterrieth Complex Figure Test (ROCF) of patients that had undergone unilateral anterior temporal lobectomy under both Taylor's and Loring's scoring systems to identify the sensitivity and specificity of each item for differentiating visuospatial memory deficits. METHOD We administered the ROCF to evaluate the visual memory of 37 left anterior temporal lobectomy (LATL) and 38 right anterior temporal lobectomy (RATL) patients with unilateral temporal lobe epilepsy who had undergone a standard unilateral anterior temporal lobectomy between 1996 and 2010. Fisher's exact and Qui-Quadrado tests were used to analyze the relationships between the qualitative variables. The Mann-Whitney U test was used to compare the quantitative variables from the right and left sides. RESULTS RATL patients performed worse than LATL patients based on the total score for delayed recall (DR) (p = 0.012). The scoring system's showed a specificity of 97.2% & 78.9% and sensitivity of 10.5% & 62.2% on DR, for the Taylor and Loring systems respectively. Our detailed analysis of certain items showed that some differed between the groups in terms of the presence/absence, correct reproduction, and errors of those items. Loring' errors I, IV, and X on DR and errors IV and X on immediate recall were more frequent in the RATL group. CONCLUSIONS The use of these two scoring systems combined may help maximize sensitivity and specificity with clinical populations. Further, our analyses showed that items could be clustered better and different weights could be given to them to maximize sensitivity and specificity.
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Affiliation(s)
- Denise Ribas Jamus
- Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
| | | | | | - Luciano de Paola
- Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil
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Zimmermann N, Pontes M, da Silva Fontana R, D'Andrea Meira I, Fonseca R, Delaere FJ. The modified Ruche visuospatial learning test (RUCHE-M) for the assessment of visuospatial episodic memory in patients with temporal lobe epilepsy: Preliminary evidence for the investigation of memory binding. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-16. [PMID: 35133219 DOI: 10.1080/23279095.2022.2031200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The Ruche test is a visuospatial form of the Rey auditory verbal learning test (RAVLT), with initial evidence of utility in the diagnosis of temporal lobe epilepsy (TLE)-related memory disorders. AIMS To present the translation to Brazilian Portuguese and modification of the Ruche test (RUCHE-M) and compare the RUCHE-M and RAVLT performance between patients with right and left TLE. METHODS Twenty-five neuropsychologists participated in instrument adaptation. Thirty-seven patients with right (n = 19) and left (n = 18) TLE participated. Data were compared with the Mann-Whitney U test. RESULTS All specialists considered the final RUCHE-M to be adequate. The RUCHE-M forgetting speed index (FSI) score and several RAVLT scores differed significantly between patients with right and left TLE. CONCLUSION The RUCHE-M showed limited utility for the assessment of visuospatial episodic memory in patients with TLE. The manipulation of memory binding as demonstrated by FSI score seems to be a promising paradigm for the assessment of right hippocampal function.
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Affiliation(s)
- Nicolle Zimmermann
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
| | - Monique Pontes
- Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
| | | | | | - Rochele Fonseca
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Beh HC, Tan HJ, Hod R, Khoo CS, Mohamad K. Prevalence and Factors Influencing Visual Memory Dysfunction among Epilepsy Patients-A Single-Center Study. Neurol India 2021; 68:581-585. [PMID: 32643667 DOI: 10.4103/0028-3886.289011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Epilepsy is associated with cognitive impairment due to the disease itself or side-effects of antiepileptic drugs. Objective We aimed to study the prevalence of visual memory dysfunction among epilepsy patients and identify the predictors that could contribute to the impairment. Materials and Methods This was a cross-sectional study. We analyzed 250 patients with epilepsy from neurology clinic at our tertiary center. Assessment of visual memory was done using Wechsler Memory Scale-IV (WMS-IV) with scores from subsets of visual reproduction I, II and designs I, II contributing to visual memory index (VMI) score. The correlation between continuous variables was analyzed using Pearson correlation; whereas the VMI scores of different factors were analyzed via a 1-way ANOVA test. The statistical significance was set at P < 0.05. Results The prevalence of visual memory dysfunction in our epilepsy population was 37.2%. Analysis of individual predictors showed that older patients, lower educational level, combined generalized and focal types of epilepsy, longer duration of epilepsy, greater number of antiepileptic drugs (AEDs) used, and abnormal neuroimaging contributed to poor visual memory. Multiple logistic regression analysis showed that educational level, types of epilepsy, and the number of AEDs used were significant predictors for visual memory impairment. Conclusion Visual memory dysfunction in patients with epilepsy was due to manifold confounding factors. Our findings enabled us to identify patients with visual memory dysfunction and modifiable factors that contribute to it. WMS-IV is a suitable assessment tool to determine visual memory function, which can help clinicians to optimize the patients' treatment.
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Affiliation(s)
- Hui-Chien Beh
- Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui-Jan Tan
- Department of Medicine; Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching-Soong Khoo
- Department of Medicine; Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Khairiyah Mohamad
- Department of Medicine; Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Maiman M, Del Bene VA, Farrell E, MacAllister WS, Sheldon S, Rentería MA, Slugh M, Gazzola DM, Barr WB. The Utility of the Repeatable Battery of Neuropsychological Status in Patients with Temporal and Non-temporal Lobe Epilepsy. Arch Clin Neuropsychol 2021; 36:203-213. [PMID: 31761928 DOI: 10.1093/arclin/acz056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/05/2019] [Accepted: 09/10/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neuropsychological battery that has been validated in the assessment of dementia and other clinical populations. The current study examines the utility of the RBANS in patients with epilepsy. METHODS Ninety-eight patients with epilepsy completed the RBANS as part of a more comprehensive neuropsychological evaluation. Performance on the RBANS was evaluated for patients with a diagnosis of temporal lobe epilepsy (TLE; n = 51) and other epilepsy patients (non-TLE, n = 47) in comparison to published norms. Multivariate analysis of variance compared group performances on RBANS indices. Rates of impairment were also compared across groups using cutoff scores of ≤1.0 and ≤1.5 standard deviations below the normative mean. Exploratory hierarchical regressions were used to examine the relations between epilepsy severity factors (i.e., age of onset, disease duration, and number of antiepileptic drugs [AEDs]) and RBANS performance. RESULTS TLE and non-TLE patients performed below the normative sample across all RBANS indices. Those with TLE performed worse than non-TLE patients on the Immediate and Delayed Memory indices and exhibited higher rates of general cognitive impairment. Number of AEDs was the only epilepsy severity factor that significantly predicted RBANS total performance, accounting for 14% of the variance. CONCLUSIONS These findings suggest that the RBANS has utility in evaluating cognition in patients with epilepsy and can differentiate TLE and non-TLE patients. Additionally, number of AEDs appears to be associated with global cognitive performance in adults with epilepsy.
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Affiliation(s)
- Moshe Maiman
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Victor A Del Bene
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Eileen Farrell
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Institute of Neurology and Neurosurgery, Saint Barnabas Hospital, Livingston, NJ 07039, USA
| | - William S MacAllister
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Sloane Sheldon
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Neurology, Columbia University Medical Center, New York, NY 10034, USA
| | - Miguel Arce Rentería
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY 10034, USA
| | - Mitchell Slugh
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,University of Miami, The Evelyn F. McKnight Brain Institute, Miami, FL 33136, USA
| | - Deana M Gazzola
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA
| | - William B Barr
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA
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Zaki MA, ElSherif LN, Shamloul RM. Assessment of the response to antiepileptic drugs in epileptic patients with structural lesion(s) on neuroimaging. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00243-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Focal epilepsy is the most common form of epilepsy in adults. Advances in brain imaging allowed better identification of different structural lesions underlying focal epilepsy. However, the response to antiepileptic drugs in lesional epilepsy is heterogeneous and difficult to anticipate. This study aimed to evaluate the response to antiepileptic drugs (AED) in patients with lesional epilepsy and to identify the predictors for poor seizure control.
Methods
One hundred and sixty-five patients with lesional epilepsy were included; the clinical diagnosis of epilepsy and seizure classification was based on the revised criteria of the International League Against Epilepsy (ILAE). Patients were subjected to full clinical assessment, MRI brain imaging epilepsy protocol, and EEG monitoring. All subjects were followed in the epilepsy clinic for at least 6 months.
Results
75.8% of patients with lesional epilepsy showed poor response to antiepileptic medications. Cerebromalatic lesions related to brain trauma was the most frequently encountered (21.8%). Malformations of cortical development were significantly associated with poor response to AED (p = 0.040). Polytherapy and the combined use of 1st- and 2nd-generation AED were higher in the poor response group. Logistic regression analysis revealed that younger age at seizure onset and abnormal EEG findings was 0.965 times and 2.5 times more associated with poor seizure control, respectively.
Conclusion
This study revealed that patients with lesional epilepsy who develop seizures in their early life, who suffer from malformations of cortical development, or who show abnormal EEG findings are more suspected to show poor response to AED.
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10
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Balachandra AR, Kaestner E, Bahrami N, Reyes A, Lalani S, Macari AC, Paul BM, Bonilha L, McDonald CR. Clinical utility of structural connectomics in predicting memory in temporal lobe epilepsy. Neurology 2020; 94:e2424-e2435. [PMID: 32358221 PMCID: PMC7455364 DOI: 10.1212/wnl.0000000000009457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the predictive power of white matter neuronal networks (i.e., structural connectomes [SCs]) in discriminating memory-impaired patients with temporal lobe epilepsy (TLE) from those with normal memory. METHODS T1- and diffusion MRI (dMRI), clinical variables, and neuropsychological measures of verbal memory were available for 81 patients with TLE. Prediction of memory impairment was performed with a tree-based classifier (XGBoost) for 4 models: (1) a clinical model including demographic and clinical features, (2) a hippocampal volume (HCV) model, (3) a tract model including 5 temporal lobe white matter association tracts derived from a dMRI atlas, and (4) an SC model based on dMRI. SCs were derived by extracting cortical-cortical connections from a temporal lobe subnetwork with probabilistic tractography. Principal component (PC) analysis was then applied to reduce the dimensionality of the SC, yielding 10 PCs. Multimodal models were also tested combining SCs and tracts with HCV. Each model was trained on 48 patients from 1 epilepsy center and tested on 33 patients from a different center. RESULTS Multimodal models that included the SC + HCV model yielded the highest classification accuracy (81%; 0.90 sensitivity; 0.67 specificity), outperforming the clinical model (61%; p < 0.001) and HCV model (66%; p < 0.001). In addition, the unimodal SC model (76% accuracy) and tract model (73% accuracy) outperformed the clinical model (p < 0.001) and HCV model (p < 0.001) for classifying patients with TLE with and without memory impairment. Furthermore, the SC identified that short-range temporal-temporal connections were important contributors to memory performance. CONCLUSION SCs and tract-based models are stronger predictors of memory impairment in TLE than HCVs and clinical variables. However, SCs may provide additional information about local cortical-cortical connectivity contributing to memory that is not captured in large association tracts.
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Affiliation(s)
- Akshara R Balachandra
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Naeim Bahrami
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Sanam Lalani
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anna Christina Macari
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Brianna M Paul
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Leonardo Bonilha
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA.
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11
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Griffith SP, Malpas CB, Alpitsis R, O'Brien TJ, Monif M. The neuropsychological spectrum of anti-LGI1 antibody mediated autoimmune encephalitis. J Neuroimmunol 2020; 345:577271. [PMID: 32480239 DOI: 10.1016/j.jneuroim.2020.577271] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022]
Abstract
Anti-Leucine Glioma Inactivated 1 (LGI-1) autoimmune encephalitis (AE) is a rare neuroinflammatory brain condition. Individuals afflicted with this condition can present with cognitive and psychological manifestations that can impact the individual's quality of life, day to day functioning, independence, return to work and interpersonal relationships. Our knowledge of the cognitive profiles and disease associated psychopathology is severely lacking. This review provides a comprehensive summary of the currently available literature, conceptualising our current understanding of the neuropsychological manifestations of anti LGI-1 AE and summarises methodological limitations of the current research to inform and improve future investigations. Key Terms: Autoimmune Diseases; Neuroimmunology; Autoimmune Encephalitis, Limbic Encephalitis; Anti-LGI1 Encephalitis, LGI1; Neuropsychology, Cognitive Assessment.
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Affiliation(s)
- Sarah P Griffith
- Department of Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Charles B Malpas
- Department of Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia; Department of Neurology, Melbourne Health, Parkville, VIC, Australia; Department of Medicine, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Rubina Alpitsis
- Department of Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Terence J O'Brien
- Department of Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia; Department of Neurology, Melbourne Health, Parkville, VIC, Australia; Department of Medicine, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Mastura Monif
- Department of Neurosciences, Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia; Department of Neurology, Melbourne Health, Parkville, VIC, Australia.
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12
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Wagner K, Gau K, Metternich B, Geiger MJ, Wendling AS, Kadish NE, Reuner G, Mayer H, Mader I, Beck J, Zentner J, Urbach H, Schulze-Bonhage A, Kaller CP, Foit NA. Effects of hippocampus-sparing resections in the temporal lobe: Hippocampal atrophy is associated with a decline in memory performance. Epilepsia 2020; 61:725-734. [PMID: 32162320 DOI: 10.1111/epi.16473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In patients with temporal lobe epilepsy (TLE) with a nonlesional and nonepileptogenic hippocampus (HC), in order to preserve functionally intact brain tissue, the HC is not resected. However, some patients experience postoperative memory decline, possibly due to disruption of the extrahippocampal memory network and secondary hippocampal volume (HV) loss. The purpose of this study was to determine the extent of hippocampal atrophy ipsilateral and contralateral to the side of the surgery and its relation to memory outcomes. METHODS Hippocampal volume and verbal as well as visual memory performance were retrospectively examined in 55 patients (mean age ± standard deviation [SD] 30 ± 15 years, 25 female, 31 left) before and 5 months after surgery within the temporal lobe that spared the entire HC. HV was extracted based on prespecified templates, and resection volumes were also determined. RESULTS HV loss was found both ipsilateral and contralateral to the side of surgery (P < .001). Postoperative left HV loss was a significant predictor of postoperative verbal memory deterioration after left-sided surgery (P < .01). Together with the preoperative verbal memory performance, postoperative left HV explained almost 60% of the variance (P < .0001). However, right HV was not a clear predictor of visual memory performance. Larger resection volumes were associated with smaller postoperative HV, irrespective of side of surgery (left: P < .05, right: P < .01). SIGNIFICANCE A disruption of the memory network by any resection within the TL, especially within the language-dominant hemisphere, may lead to HC atrophy and memory decline. These findings may further improve the counseling of patients concerning their postoperative memory outcome before TL resections sparing the entire HC.
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Affiliation(s)
- Kathrin Wagner
- Epilepsy Centre, Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Karin Gau
- Epilepsy Centre, Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Birgitta Metternich
- Epilepsy Centre, Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Maximilian J Geiger
- Epilepsy Centre, Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | | | - Navah E Kadish
- Department of Neuropediatrics, University Medical Centre Schleswig-Holstein, Kiel, Germany.,Department of Medical Psychology and Medical Sociology, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - Gitta Reuner
- Institute for Education Studies, Heidelberg University, Heidelberg, Germany.,Division of Neuropediatrics and Metabolic Medicine, Clinic I, Centre for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans Mayer
- Epilepsy Centre Kork, Kehl-Kork, Germany
| | - Irina Mader
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neuroradiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany
| | - Josef Zentner
- Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neuroradiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Centre, Medical Center - University of Freiburg, Freiburg, Germany.,Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany
| | - Christoph P Kaller
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neuroradiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Niels A Foit
- Freiburg Brain Imaging, Medical Center - University of Freiburg, Freiburg, Germany.,Department of Neurosurgery, Medical Center - University of Freiburg, Freiburg, Germany
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13
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Yuan T, Zuo Z, Ying J, Jin L, Kang J, Gui S, Wang R, Li C. Structural and Functional Alterations in the Contralesional Medial Temporal Lobe in Glioma Patients. Front Neurosci 2020; 14:10. [PMID: 32153348 PMCID: PMC7044242 DOI: 10.3389/fnins.2020.00010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/08/2020] [Indexed: 01/13/2023] Open
Abstract
Background The human brain has an extraordinary ability to functionally change or reorganize its structure in response to disease. The aim of this study is to assess the structural and functional plasticity of contralesional medial temporal lobe (MTL) in patients with unilateral MTL glioma. Methods Sixty-eight patients with unilateral MTL glioma (left MTL glioma, n = 33; right MTL glioma, n = 35) and 40 healthy controls were recruited and scanned with 3D T1 MRI and rest-fMRI. We explored the structure of the contralesional MTL using voxel-based morphometry (VBM) and assessed the memory networks of the contralesional hemisphere using resting-state functional connectivity (rs-FC). The association between FC and cognitive function was assessed with partial correlation analysis. Results Compared with healthy controls, both patient groups exhibited (1) a large cluster of voxels with gray matter (GM) volume decrease in the contralesional MTL using region of interest (ROI)-based VBM analysis (cluster level p < 0.05, FDR corrected); and (2) decreased intrahemispheric FC between the posterior hippocampus (pHPC) and posterior cingulate cortex (PCC) (p < 0.01, Bonferroni corrected). Intrahemispheric FC between the pHPC and PCC was positively correlated with cognitive function in both patient groups. Conclusion Using multi-modality brain imaging tools, we found structural and functional changes in the contralesional MTL in patients with unilateral MTL glioma. These findings suggest that the contralesional cortex may have decompensation of structure and function in patients with unilateral glioma, except for compensatory structural and functional adaptations. Our study provides additional insight into the neuroanatomical and functional network changes in the contralesional cortex in patients with glioma.
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Affiliation(s)
- Taoyang Yuan
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhentao Zuo
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China
| | - Jianyou Ying
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Lu Jin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jie Kang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Rui Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Chuzhong Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Institute for Brain Disorders Brain Tumour Center, Beijing, China
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14
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Maia GH, Soares JI, Almeida SG, Leite JM, Baptista HX, Lukoyanova AN, Brazete CS, Lukoyanov NV. Altered serotonin innervation in the rat epileptic brain. Brain Res Bull 2019; 152:95-106. [DOI: 10.1016/j.brainresbull.2019.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 01/19/2023]
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15
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Chang YHA, Marshall A, Bahrami N, Mathur K, Javadi SS, Reyes A, Hegde M, Shih JJ, Paul BM, Hagler DJ, McDonald CR. Differential sensitivity of structural, diffusion, and resting-state functional MRI for detecting brain alterations and verbal memory impairment in temporal lobe epilepsy. Epilepsia 2019; 60:935-947. [PMID: 31020649 DOI: 10.1111/epi.14736] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Temporal lobe epilepsy (TLE) is known to affect large-scale gray and white matter networks, and these network changes likely contribute to the verbal memory impairments observed in many patients. In this study, we investigate multimodal imaging patterns of brain alterations in TLE and evaluate the sensitivity of different imaging measures to verbal memory impairment. METHODS Diffusion tensor imaging (DTI), volumetric magnetic resonance imaging (vMRI), and resting-state functional MRI (rs-fMRI) were evaluated in 46 patients with TLE and 33 healthy controls to measure patterns of microstructural, structural, and functional alterations, respectively. These measurements were obtained within the white matter directly beneath neocortex (ie, superficial white matter [SWM]) for DTI and across neocortex for vMRI and rs-fMRI. The degree to which imaging alterations within left medial temporal lobe/posterior cingulate (LMT/PC) and left lateral temporal regions were associated with verbal memory performance was evaluated. RESULTS Patients with left TLE and right TLE both demonstrated pronounced microstructural alterations (ie, decreased fractional anisotropy [FA] and increased mean diffusivity [MD]) spanning the entire frontal and temporolimbic SWM, which were highly lateralized to the ipsilateral hemisphere. Conversely, reductions in cortical thickness in vMRI and alterations in the magnitude of the rs-fMRI response were less pronounced and less lateralized than the microstructural changes. Both stepwise regression and mediation analyses further revealed that FA and MD within SWM in LMT/PC regions were the most robust predictors of verbal memory, and that these associations were independent of left hippocampal volume. SIGNIFICANCE These findings suggest that microstructural loss within the SWM is pronounced in patients with TLE, and injury to the SWM within the LMT/PC region plays a critical role in verbal memory impairment.
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Affiliation(s)
- Yu-Hsuan A Chang
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Anisa Marshall
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Naeim Bahrami
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Kushagra Mathur
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Sogol S Javadi
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Manu Hegde
- Department of Neurology, University of California, San Francisco, California.,UCSF Comprehensive Epilepsy Center, San Francisco, California
| | - Jerry J Shih
- Department of Neurosciences, University of California, San Diego, California.,UCSD Comprehensive Epilepsy Center, San Diego, California
| | - Brianna M Paul
- Department of Neurology, University of California, San Francisco, California.,UCSF Comprehensive Epilepsy Center, San Francisco, California
| | - Donald J Hagler
- Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,Department of Radiology, University of California, San Diego, California
| | - Carrie R McDonald
- Department of Psychiatry, University of California, San Diego, California.,Center for Multimodal Imaging and Genetics, University of California, San Diego, California.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California.,UCSD Comprehensive Epilepsy Center, San Diego, California
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16
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Bartha-Doering L, Novak A, Kollndorfer K, Kasprian G, Schuler AL, Berl MM, Fischmeister FPS, Gaillard WD, Alexopoulos J, Prayer D, Seidl R. When two are better than one: Bilateral mesial temporal lobe contributions associated with better vocabulary skills in children and adolescents. BRAIN AND LANGUAGE 2018; 184:1-10. [PMID: 29913315 PMCID: PMC6192511 DOI: 10.1016/j.bandl.2018.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/14/2018] [Accepted: 06/10/2018] [Indexed: 05/30/2023]
Abstract
This study considered the involvement of the mesial temporal lobe (MTL) in language and verbal memory functions in healthy children and adolescents. We investigated 30 healthy, right-handed children and adolescents, aged 7-16, with a fMRI language paradigm and a comprehensive cognitive test battery. We found significant MTL activations during language fMRI in all participants; 63% of them had left lateralized MTL activations, 20% exhibited right MTL lateralization, and 17% showed bilateral MTL involvement during the fMRI language paradigm. Group analyses demonstrated a strong negative correlation between the lateralization of MTL activations and language functions. Specifically, children with less lateralized MTL activation showed significantly better vocabulary skills. These findings suggest that the mesial temporal lobes of both hemispheres play an important role in language functioning, even in right-handers. Our results furthermore show that bilateral mesial temporal lobe involvement is advantageous for vocabulary skills in healthy, right-handed children and adolescents.
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Affiliation(s)
- Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Astrid Novak
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Kathrin Kollndorfer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Anna-Lisa Schuler
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Madison M Berl
- Center for Neuroscience and Behavioral Health, Children's National Health System (CNHS), George Washington University School of Medicine, 111 Michigan Avenue, NW, WA, DC 20010, United States.
| | | | - William D Gaillard
- Center for Neuroscience and Behavioral Health, Children's National Health System (CNHS), George Washington University School of Medicine, 111 Michigan Avenue, NW, WA, DC 20010, United States.
| | - Johanna Alexopoulos
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Daniela Prayer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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17
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Limotai C, McLachlan RS, Hayman-Abello S, Hayman-Abello B, Brown S, Bihari F, Mirsattari SM. Memory loss and memory reorganization patterns in temporal lobe epilepsy patients undergoing anterior temporal lobe resection, as demonstrated by pre-versus post-operative functional MRI. J Clin Neurosci 2018; 55:38-44. [PMID: 29934057 DOI: 10.1016/j.jocn.2018.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/28/2018] [Accepted: 06/04/2018] [Indexed: 11/29/2022]
Abstract
This study was aimed to longitudinally assess memory function and whole-brain memory circuit reorganization in patients with temporal lobe epilepsy (TLE) by comparing activation potentials before versus after anterior temporal lobe (ATL) resection. Nineteen patients with medically-intractable TLE (10 left TLE, 9 right TLE) and 15 healthy controls were enrolled. Group analyses were conducted pre- and post-ATL of a novelty complex scene-encoding paradigm comparing areas of blood oxygen-level-dependent (BOLD) signal activations on functional magnetic resonance imaging (fMRI). None of the pre-operative patient characteristics we studied predicted the extent of pre- to post-operative memory loss. On fMRI, extra-temporal activations were detected pre-operatively in both LTLE and RTLE, particularly in the frontal lobe. Greater activations also were noted in the contralateral hippocampus and parahippocampus in both groups. Performing within-subject comparisons, post-op relative to pre-op, pronounced ipsilateral activations were identified in the left parahippocampal gyrus in LTLE, versus the right middle temporal gyrus in RTLE patients. Memory function was impaired pre-operatively but declined after ATL resection in both RTLE and LTLE patients. Post-operative fMRI results indicate possible functional adaptations to ATL loss, primarily occurring within the left parahippocampal gyrus versus right middle temporal gyrus in LTLE versus RTLE patients, respectively.
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Affiliation(s)
- Chusak Limotai
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Chulalongkorn Comprehensive Epilepsy Center of Excellence (CCEC), King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Richard S McLachlan
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Susan Hayman-Abello
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Brent Hayman-Abello
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Suzan Brown
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Frank Bihari
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Seyed M Mirsattari
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Medical Imaging, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada.
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Berger J, Plotkin M, Demin K, Holtkamp M, Bengner T. The relationship between structural MRI, FDG-PET, and memory in temporal lobe epilepsy: Preliminary results. Epilepsy Behav 2018; 80:61-67. [PMID: 29414560 DOI: 10.1016/j.yebeh.2017.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
Structural and metabolic abnormalities of the temporal lobe are frequently found in temporal lobe epilepsy (TLE). In the present retrospective study, we investigated whether structural abnormalities evident in magnetic resonance imaging (MRI) and hypometabolism evident in [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) independently influence verbal and nonverbal learning and delayed memory in patients with TLE. Sixty-eight patients with refractory unilateral TLE (35 left TLE, 33 right TLE) were divided into three groups: (1) no evidence of pathology in either MRI or FDG-PET studies (MRI-/PET-, n=15), (2) temporal FDG-PET determined hypometabolism with normal MRI findings (MRI-/PET+, n=21), and (3) evidence of temporal abnormalities in both MRI and FDG-PET studies (MRI+/PET+, n=32). A fourth group (MRI+/PET-, n=4) was too small for further statistical analysis and could not be included. Patients with MRI+/PET+ showed worse verbal memory than patients with MRI-/PET- (p<0.01), regardless of side of seizure focus. Verbal memory performance of patients with MRI-/PET+ was located between patients with MRI+/PET+ and MRI-/PET-, although group differences did not achieve statistical significance (ps>0.1). No group differences were found for nonverbal memory (p=0.27). Our results may suggest an interactive negative effect of metabolic and structural temporal lobe abnormalities on verbal memory. Still, our results are preliminary and need further validation by studies involving larger patient groups and up-to date quantitative imaging analysis methods.
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Affiliation(s)
- Justus Berger
- Epilepsy-Center Berlin-Brandenburg, Department of Epileptology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany.
| | | | - Katharina Demin
- Epilepsy-Center Berlin-Brandenburg, Department of Epileptology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany.
| | - Martin Holtkamp
- Epilepsy-Center Berlin-Brandenburg, Department of Epileptology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany; Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité - Universitätsmedizin, Berlin, Germany.
| | - Thomas Bengner
- Epilepsy-Center Berlin-Brandenburg, Department of Epileptology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany.
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Volumetric Changes in Hippocampal Subregions and Memory Performance in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis. Neurosci Bull 2017; 34:389-396. [PMID: 29094314 DOI: 10.1007/s12264-017-0186-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/03/2017] [Indexed: 10/18/2022] Open
Abstract
In the present study we explored the different patterns of volumetric atrophy in hippocampal subregions of patients with left and right mesial temporal lobe epilepsy with hippocampal sclerosis (TLE-HS). Meanwhile, the memory impairment patterns in Chinese-speaking TLE-HS patients and potential influencing factors were also determined. TLE-HS patients (21 left and 17 right) and 21 healthy controls were recruited to complete T2-weighted imaging and verbal/nonverbal memory assessment. The results showed that both left and right TLE-HS patients had overall reduced hippocampal subregion volumes on the sclerotic side, and cornu ammonis sectors (CA1) exhibited maximum atrophy. The verbal memory of left TLE-HS patients was significantly impaired (P < 0.001) and was not associated with the volumes of the left hippocampal subregions. Verbal or nonverbal memory impairment was not found in the patients with right TLE-HS. These results suggested that the atrophy of hippocampal subregion volumes cannot account for the verbal memory impairment, which might be related to the functional network.
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20
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Serotonin depletion increases seizure susceptibility and worsens neuropathological outcomes in kainate model of epilepsy. Brain Res Bull 2017; 134:109-120. [PMID: 28716398 DOI: 10.1016/j.brainresbull.2017.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 11/22/2022]
Abstract
Serotonin is implicated in the regulation of seizures, but whether or not it can potentiate the effects of epileptogenic factors is not fully established. Using the kainic acid model of epilepsy in rats, we tested the effects of serotonin depletion on (1) susceptibility to acute seizures, (2) development of spontaneous recurrent seizures and (3) behavioral and neuroanatomical sequelae of kainic acid treatment. Serotonin was depleted by pretreating rats with p-chlorophenylalanine. In different groups, kainic acid was injected at 3 different doses: 6.5mg/kg, 9.0mg/kg or 12.5mg/kg. A single dose of 6.5mg/kg of kainic acid reliably induced status epilepticus in p-chlorophenylalanine-pretreated rats, but not in saline-pretreated rats. The neuroexcitatory effects of kainic acid in the p-chlorophenylalanine-pretreated rats, but not in saline-pretreated rats, were associated with the presence of tonic-clonic convulsions and high lethality. Compared to controls, a greater portion of serotonin-depleted rats showed spontaneous recurrent seizures after kainic acid injections. Loss of hippocampal neurons and spatial memory deficits associated with kainic acid treatment were exacerbated by prior depletion of serotonin. The present findings are of particular importance because they suggest that low serotonin activity may represent one of the major risk factors for epilepsy and, thus, offer potentially relevant targets for prevention of epileptogenesis.
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Soares JI, Valente MC, Andrade PA, Maia GH, Lukoyanov NV. Reorganization of the septohippocampal cholinergic fiber system in experimental epilepsy. J Comp Neurol 2017; 525:2690-2705. [PMID: 28472854 DOI: 10.1002/cne.24235] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 04/11/2017] [Accepted: 04/24/2017] [Indexed: 12/28/2022]
Abstract
The septohippocampal cholinergic neurotransmission has long been implicated in seizures, but little is known about the structural features of this projection system in epileptic brain. We evaluated the effects of experimental epilepsy on the areal density of cholinergic terminals (fiber varicosities) in the dentate gyrus. For this purpose, we used two distinct post-status epilepticus rat models, in which epilepsy was induced with injections of either kainic acid or pilocarpine. To visualize the cholinergic fibers, we used brain sections immunostained for the vesicular acetylcholine transporter. It was found that the density of cholinergic fiber varicosities was higher in epileptic rats versus control rats in the inner and outer zones of the dentate molecular layer, but it was reduced in the dentate hilus. We further evaluated the effects of kainate treatment on the total number, density, and soma volume of septal cholinergic cells, which were visualized in brain sections stained for either vesicular acetylcholine transporter or choline acetyltransferase (ChAT). Both the number of septal cells with cholinergic phenotype and their density were increased in epileptic rats when compared to control rats. The septal cells stained for vesicular acetylcholine transporter, but not for ChAT, have enlarged perikarya in epileptic rats. These results revealed previously unknown details of structural reorganization of the septohippocampal cholinergic system in experimental epilepsy, involving fiber sprouting into the dentate molecular layer and a parallel fiber retraction from the dentate hilus. We hypothesize that epilepsy-related neuroplasticity of septohippocampal cholinergic neurons is capable of increasing neuronal excitability of the dentate gyrus.
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Affiliation(s)
- Joana I Soares
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal.,Neuronal Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal.,Departamento de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - Maria C Valente
- Departamento de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Pedro A Andrade
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal.,Department of Neurobiology, A.I. Virtanen Institute, University of Eastern Finland, Kuopio, Finland
| | - Gisela H Maia
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal.,Neuronal Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal.,Departamento de Biologia Experimental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - Nikolai V Lukoyanov
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal.,Neuronal Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal.,Departamento de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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22
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Reorganization of anterior and posterior hippocampal networks associated with memory performance in mesial temporal lobe epilepsy. Clin Neurophysiol 2017; 128:830-838. [DOI: 10.1016/j.clinph.2017.02.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/14/2017] [Accepted: 02/23/2017] [Indexed: 11/23/2022]
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23
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Tang Y, Xia W, Yu X, Zhou B, Luo C, Huang X, Chen Q, Gong Q, Zhou D. Short-term cerebral activity alterations after surgery in patients with unilateral mesial temporal lobe epilepsy associated with hippocampal sclerosis: A longitudinal resting-state fMRI study. Seizure 2017; 46:43-49. [DOI: 10.1016/j.seizure.2016.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/20/2016] [Accepted: 12/30/2016] [Indexed: 11/16/2022] Open
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24
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Farrell JS, Wolff MD, Teskey GC. Neurodegeneration and Pathology in Epilepsy: Clinical and Basic Perspectives. ADVANCES IN NEUROBIOLOGY 2017; 15:317-334. [PMID: 28674987 DOI: 10.1007/978-3-319-57193-5_12] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Epilepsy is commonly associated with a number of neurodegenerative and pathological alterations in those areas of the brain that are involved in repeated electrographic seizures. These most prominently include neuron loss and an increase in astrocyte number and size but may also include enhanced blood-brain barrier permeability, the formation of new capillaries, axonal sprouting, and central inflammation. In animal models in which seizures are either repeatedly elicited or are self-generated, a similar set of neurodegenerative and pathological alterations in brain anatomy are observed. The primary causal agent responsible for these alterations may be the cascade of events that follow a seizure and lead to an hypoperfusion/hypoxic episode. While epilepsy has long and correctly been considered an electrical disorder, the vascular system likely plays an important causal role in the neurodegeneration and pathology that occur as a consequence of repeated seizures.
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Affiliation(s)
- Jordan S Farrell
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Marshal D Wolff
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - G Campbell Teskey
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada.
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Whitman L, Scharaga EA, Blackmon K, Wiener J, Bender HA, Weiner HL, MacAllister WS. Material specificity of memory deficits in children with temporal tumors and seizures: A case series. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:335-344. [PMID: 27366934 DOI: 10.1080/21622965.2016.1197126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In adults, left temporal lobe pathology is typically associated with verbal memory deficits, whereas right temporal lobe pathology is thought to produce visual memory deficits in right-handed individuals. However, in children and adolescents with temporal lobe pathology, conclusions regarding material specificity of memory deficits remain unclear. The goal of the present case series is to examine the profile of verbal and visual memory impairment in children with temporal lobe tumors. Three patients with identified right temporal tumors and three patients with left temporal tumors are included. The Wide Range Assessment of Memory and Learning-Second Edition (WRAML-2) was administered as part of a larger neuropsychological battery. As anticipated, participants with right temporal lesions showed impaired visual memory relative to intact verbal memory. Interestingly, although the discrepancies between verbal and visual indices were less extreme, those with left temporal lesions showed a similar memory profile. These seemingly counterintuitive findings among left temporal tumor patients likely reflect less hemispheric specialization in children in comparison to adults and the fact that early developmental lesions in the left hemisphere may lead to functional reorganization of language-based skills.
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Affiliation(s)
| | - Elyssa A Scharaga
- b Ferkauf Graduate School of Psychology at Yeshiva University , New York , New York
| | - Karen Blackmon
- c Department of Neurology , New York University School of Medicine , New York , New York
| | - Jennifer Wiener
- c Department of Neurology , New York University School of Medicine , New York , New York
| | - Heidi Allison Bender
- d Mount Sinai Center for Cognitive Health, Icahn School of Medicine at Mount Sinai , New York , New York
| | - Howard L Weiner
- e Department of Neurosurgery , Baylor College of Medicine , Houston , Texas
| | - William S MacAllister
- f NYU Comprehensive Epilepsy Center, New York University School of Medicine , New York , New York
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26
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Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy. Sci Rep 2016; 6:28513. [PMID: 27349503 PMCID: PMC4923886 DOI: 10.1038/srep28513] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 06/03/2016] [Indexed: 11/08/2022] Open
Abstract
The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [(18)F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [(18)F]FDG PET uptake correlations, in right-sided (RTLE; n = 30) and left-sided TLE (LTLE; n = 32) with healthy controls (HC; n = 31) using graph theory based network analysis. Comparing LTLE and RTLE and patient groups separately to HC, we observed higher lobar connectivity weights in RTLE compared to LTLE for connections of the temporal and the parietal lobe of the contralateral hemisphere (CH). Moreover, especially in RTLE compared to LTLE higher local efficiency were found in the temporal cortices and other brain regions of the CH. The results of this investigation implicate altered metabolic networks in patients with TLE specific to the lateralization of seizure focus, and describe compensatory mechanisms especially in the CH of patients with RTLE. We propose that graph theoretical analysis of metabolic connectivity using [(18)F]FDG-PET offers an important additional modality to explore brain networks.
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28
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Li H, Fan W, Yang J, Song S, Liu Y, Lei P, Shrestha L, Mella G, Chen W, Xu H. Asymmetry in cross-hippocampal connectivity in unilateral mesial temporal lobe epilepsy. Epilepsy Res 2015; 118:14-21. [PMID: 26561924 DOI: 10.1016/j.eplepsyres.2015.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/15/2015] [Accepted: 10/25/2015] [Indexed: 01/06/2023]
Abstract
Mesial temporal lobe epilepsy (mTLE) is mostly characterized by hippocampal sclerosis (HS) changes. Although considerable progress has been made in understanding the altered functional network of mTLE patients, whether one side of the abnormal hippocampal (HP) structure will affect the other healthy side of the hippocampal network is still unclear. Here, we used a seed-based method to explore the commonly alterative hippocampal network in mTLE patients by comparing the bilateral hippocampal network of unilateral mTLE patients with healthy control participants. We observed that both sides of the hippocampal network in unilateral mTLE patients were changed independent of the affected or "healthy" side, which may suggest a common plasticity network for both sides of hippocampal sclerosis mesial temporal lobe epilepsy patients. Furthermore, using the HP as the ROI, we found that the functional connectivity of the intra-HP in the left mTLE-HS group was moderately positively correlated with the duration of the disease, while a strong negative correlation between functional connectivity of the intra-HP and duration were detected in the right mTLE-HS group, which suggested that it was easier for the right HP than the left HP to communicate with the contralateral HP according to the progression of mTLE disease because the hippocampus plays different roles in the communication and compensatory mechanism associated with the contralateral side of the hemisphere. We hope that this potential relevance may help us to better characterize mTLE with hippocampal sclerosis and ultimately assist in providing a better diagnosis and more accurate invasive treatments of mTLE.
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Affiliation(s)
- Hong Li
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Wenliang Fan
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Jie Yang
- Department of Communication Sciences and Disorders, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA.
| | - Shuyan Song
- School of Life Science and Technology, Key Laboratory of Image Processing and Intelligent Control of Education Ministry of China, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Yuan Liu
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Ping Lei
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Lochan Shrestha
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Grace Mella
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Wei Chen
- Department of Radiology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Radiology and Medical Imaging Center, The First People's Hospital of Yibin, Sichuan 644000, China.
| | - Haibo Xu
- Department of Radiology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
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Voltzenlogel V, Hirsch E, Vignal JP, Valton L, Manning L. Preserved anterograde and remote memory in drug-responsive temporal lobe epileptic patients. Epilepsy Res 2015. [PMID: 26220389 DOI: 10.1016/j.eplepsyres.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate cognition, particularly anterograde and remote memory, in patients suffering from unilateral drug-responsive mesial temporal lobe epilepsy (mTLE) patients and to compare their performance with that observed in drug-resistant mTLE patients. METHODS Sixteen drug-responsive mTLE patients, with only infrequent seizures in their lifetime, were matched for demographic and clinical variables to 18 patients suffering from drug-resistant unilateral mTLE. A comprehensive neuropsychological examination, including baseline, anterograde memory tasks, and a large range of remote memory tests was carried out. RESULTS Patients with drug-responsive epilepsy obtained average scores on every anterograde memory test. Although in general, they obtained lower scores than the healthy controls on remote memory tests, the differences failed to reach significance. Moreover, the drug-responsive group performed significantly better than the drug-resistant group on anterograde recall tests and an episodic autobiographical memory test. Performance was not significantly different between the patient groups in personal semantics or memory for public events. CONCLUSION Our results show that a mild clinical course of mTLE with no cognitive deficits can occur notwithstanding hippocampal sclerosis. The differences in cognitive function between the two groups are likely due to distinct pathophysiology of the underlying cause of epilepsy. Drug-resistant seizures and cognitive deficits may be the consequence of a more severe underlying cerebral process. Better understanding of the variety of pathogenesis of mTLE could help to answer this open question.
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Affiliation(s)
| | - Edouard Hirsch
- Fédération de médecine translationnelle, University Hospital, Strasbourg, France.
| | | | - Luc Valton
- Explorations Neurophysiologiques, Department of Neurology, Hôpital Pierre Paul Riquet, University Hospital, & CerCo, Centre de recherche Cerveau et Cognition UMR 5549 - CNRS, Toulouse, France.
| | - Liliann Manning
- INSERM, U1114 and Strasbourg University, Strasbourg, France.
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30
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The Role of Wnt/β-Catenin Signaling Pathway in Disrupted Hippocampal Neurogenesis of Temporal Lobe Epilepsy: A Potential Therapeutic Target? Neurochem Res 2015; 40:1319-32. [PMID: 26012365 DOI: 10.1007/s11064-015-1614-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/06/2015] [Accepted: 05/12/2015] [Indexed: 02/05/2023]
Abstract
Temporal lobe epilepsy is one of the most common clinical neurological disorders. One of the major pathological findings in temporal lobe epilepsy is hippocampal sclerosis, characterized by massive neuronal loss and severe gliosis. The epileptogenesis process of temporal lobe epilepsy usually starts with initial precipitating insults, followed by neurodegeneration, abnormal hippocampus circuitry reorganization, and the formation of hypersynchronicity. Experimental and clinical evidence strongly suggests that dysfunctional neurogenesis is involved in the epileptogenesis. Recent data demonstrate that neurogenesis is induced by acute seizures or precipitating insults, whereas the capacity of neuronal recruitment and proliferation substantially decreases in the chronic phase of epilepsy. Participation of the Wnt/β-catenin signaling pathway in neurogenesis reveals its importance in epileptogenesis; its dysfunction contributes to the structural and functional abnormality of temporal lobe epilepsy, while rescuing this pathway exerts neuroprotective effects. Here, we summarize data supporting the involvement of Wnt/β-catenin signaling in the epileptogenesis of temporal lobe epilepsy. We also propose that the Wnt/β-catenin signaling pathway may serve as a promising therapeutic target for temporal lobe epilepsy treatment.
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31
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Enriched Environment Altered Aberrant Hippocampal Neurogenesis and Improved Long-Term Consequences After Temporal Lobe Epilepsy in Adult Rats. J Mol Neurosci 2015; 56:409-21. [DOI: 10.1007/s12031-015-0571-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
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32
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Gregory AM, Nenert R, Allendorfer JB, Martin R, Kana RK, Szaflarski JP. The effect of medial temporal lobe epilepsy on visual memory encoding. Epilepsy Behav 2015; 46:173-84. [PMID: 25934583 DOI: 10.1016/j.yebeh.2015.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 03/03/2015] [Accepted: 03/07/2015] [Indexed: 11/30/2022]
Abstract
Effective visual memory encoding, a function important for everyday functioning, relies on episodic and semantic memory processes. In patients with medial temporal lobe epilepsy (MTLE), memory deficits are common as the structures typically involved in seizure generation are also involved in acquisition, maintenance, and retrieval of episodic memories. In this study, we used group independent component analysis (GICA) combined with Granger causality analysis to investigate the neuronal networks involved in visual memory encoding during a complex fMRI scene-encoding task in patients with left MTLE (LMTLE; N=28) and in patients with right MTLE (RMTLE; N=18). Additionally, we built models of memory encoding in LMTLE and RMTLE and compared them with a model of healthy memory encoding (Nenert et al., 2014). For those with LMTLE, we identified and retained for further analyses and model generation 7 ICA task-related components that were attributed to four different networks: the frontal and posterior components of the DMN, visual network, auditory-insular network, and an "other" network. For those with RMTLE, ICA produced 9 task-related components that were attributed to the somatosensory and cerebellar networks in addition to the same networks as in patients with LMTLE. Granger causality analysis revealed group differences in causality relations within the visual memory network and MTLE-related deviations from normal network function. Our results demonstrate differences in the networks for visual memory encoding between those with LMTLE and those with RMTLE. Consistent with previous studies, the organization of memory encoding is dependent on laterality of seizure focus and may be mediated by functional reorganization in chronic epilepsy. These differences may underlie the observed differences in memory abilities between patients with LMTLE and patients with RMTLE and highlight the modulating effects of epilepsy on the network for memory encoding.
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Affiliation(s)
- A M Gregory
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - R Nenert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - J B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - R Martin
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - R K Kana
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - J P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
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Schaapsmeerders P, van Uden IWM, Tuladhar AM, Maaijwee NAM, van Dijk EJ, Rutten-Jacobs LCA, Arntz RM, Schoonderwaldt HC, Dorresteijn LDA, de Leeuw FE, Kessels RPC. Ipsilateral hippocampal atrophy is associated with long-term memory dysfunction after ischemic stroke in young adults. Hum Brain Mapp 2015; 36:2432-42. [PMID: 25757914 DOI: 10.1002/hbm.22782] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 01/16/2015] [Accepted: 02/24/2015] [Indexed: 11/06/2022] Open
Abstract
Memory impairment after stroke in young adults is poorly understood. In elderly stroke survivors memory impairments and the concomitant loss of hippocampal volume are usually explained by coexisting neurodegenerative disease (e.g., amyloid pathology) in interaction with stroke. However, neurodegenerative disease, such as amyloid pathology, is generally absent at young age. Accumulating evidence suggests that infarction itself may cause secondary neurodegeneration in remote areas. Therefore, we investigated the relation between long-term memory performance and hippocampal volume in young patients with first-ever ischemic stroke. We studied all consecutive first-ever ischemic stroke patients, aged 18-50 years, admitted to our academic hospital center between 1980 and 2010. Episodic memory of 173 patients was assessed using the Rey Auditory Verbal Learning Test and the Rey Complex Figure and compared with 87 stroke-free controls. Hippocampal volume was determined using FSL-FIRST, with manual correction. On average 10 years after stroke, patients had smaller ipsilateral hippocampal volumes compared with controls after left-hemispheric stroke (5.4%) and right-hemispheric stroke (7.7%), with most apparent memory dysfunctioning after left-hemispheric stroke. A larger hemispheric stroke was associated with a smaller ipsilateral hippocampal volume (b=-0.003, P<0.0001). Longer follow-up duration was associated with smaller ipsilateral hippocampal volume after left-hemispheric stroke (b=-0.028 ml, P=0.002) and right-hemispheric stroke (b=-0.015 ml, P=0.03). Our results suggest that infarction is associated with remote injury to the hippocampus, which may lower or expedite the threshold for cognitive impairment or even dementia later in life.
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Affiliation(s)
- Pauline Schaapsmeerders
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Inge W M van Uden
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Noortje A M Maaijwee
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ewoud J van Dijk
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Loes C A Rutten-Jacobs
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Renate M Arntz
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Hennie C Schoonderwaldt
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Centre for Neuroscience and Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Schmidt CSM, Lassonde M, Gagnon L, Sauerwein CH, Carmant L, Major P, Paquette N, Lepore F, Gallagher A. Neuropsychological functioning in children with temporal lobe epilepsy and hippocampal atrophy without mesial temporal sclerosis: a distinct clinical entity? Epilepsy Behav 2015; 44:17-22. [PMID: 25597528 DOI: 10.1016/j.yebeh.2014.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 12/26/2022]
Abstract
Unilateral hippocampal atrophy (HA) is considered as a precursor of mesial temporal sclerosis (MTS) in some patients with temporal lobe epilepsy. However, in other cases, it has been suggested that HA without MTS may constitute a distinct epileptic entity. Hippocampal atrophy without MTS was defined as HA without T2-weighted hyperintensity, loss of internal architecture, or associated lesion seen on the MRI data. To date, no study has focused on the cognitive pattern of children with epilepsy with HA without MTS. The objectives of the present study were to characterize the cognitive profile of these children and to investigate the presence (or the absence) of material-specific memory deficits in these young patients, as found in patients with MTS. Toward this end, 16 young patients with epilepsy with either left or right HA without MTS completed a set of neuropsychological tests, assessing overall intelligence, verbal memory and nonverbal memory, and some aspects of attention and executive functions. Results showed normal intellectual functioning without specific memory deficits in these patients. Furthermore, comparison between patients with left HA and patients with right HA failed to reveal a material-specific lateralized memory pattern. Instead, attention and executive functions were found to be impaired in most patients. These results suggest that HA may constitute a distinct epileptic entity, and this information may help health-care providers initiate appropriate and timely interventions.
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Affiliation(s)
- Charlotte S M Schmidt
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada; Department of Neuropsychology, Maastricht University, Universiteitssingel 40, 6229 Maastricht, The Netherlands
| | - Maryse Lassonde
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada
| | - Louise Gagnon
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada
| | - Catherine H Sauerwein
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada
| | - Lionel Carmant
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada
| | - Philippe Major
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada
| | - Natacha Paquette
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada
| | - Franco Lepore
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada
| | - Anne Gallagher
- Centre de Recherche du CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Département de Psychologie, Université de Montréal, 90 Avenue Vincent-d'Indy, Montréal, QC H2V 2S9, Canada.
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Song C, Xu W, Zhang X, Wang S, Zhu G, Xiao T, Zhao M, Zhao C. CXCR4 Antagonist AMD3100 Suppresses the Long-Term Abnormal Structural Changes of Newborn Neurons in the Intraventricular Kainic Acid Model of Epilepsy. Mol Neurobiol 2015; 53:1518-1532. [PMID: 25650120 DOI: 10.1007/s12035-015-9102-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/15/2015] [Indexed: 12/19/2022]
Abstract
Abnormal hippocampal neurogenesis is a prominent feature of temporal lobe epilepsy (TLE) models, which is thought to contribute to abnormal brain activity. Stromal cell-derived factor-1 (SDF-1) and its specific receptor CXCR4 play important roles in adult neurogenesis. We investigated whether treatment with the CXCR4 antagonist AMD3100 suppressed aberrant hippocampal neurogenesis, as well as the long-term consequences in the intracerebroventricular kainic acid (ICVKA) model of epilepsy. Adult male rats were randomly assigned as control rats, rats subjected to status epilepticus (SE), and post-SE rats treated with AMD3100. Animals in each group were divided into two subgroups (acute stage and chronic stage). We used immunofluorescence staining of BrdU and DCX to analyze the hippocampal neurogenesis on post-SE days 10 or 74. Nissl staining and Timm staining were used to evaluate hippocampal damage and mossy fiber sprouting, respectively. On post-SE day 72, the frequency and mean duration of spontaneous seizures were measured by electroencephalography (EEG). Cognitive function was evaluated by Morris water maze testing on post-SE day 68. The ICVKA model of TLE resulted in aberrant neurogenesis such as altered proliferation, abnormal dendrite development of newborn neurons, as well as spontaneous seizures and spatial learning impairments. More importantly, AMD3100 treatment reversed the aberrant neurogenesis seen after TLE, which was accompanied by decreased long-term seizure activity, though improvement in spatial learning was not seen. AMD3100 could suppress long-term seizure activity and alter adult neurogenesis in the ICVKA model of TLE, which provided morphological evidences that AMD3100 might be beneficial for treating chronic epilepsy.
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Affiliation(s)
- Chengguang Song
- Department of Neurology, The First Affiliated Hospital, China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.,Department of Neurology, Benxi Central Hospital of China Medical University, Benxi, Liaoning, People's Republic of China
| | - Wangshu Xu
- Department of Neurology, The First Affiliated Hospital, China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaoqian Zhang
- Department of Neurology, The First Affiliated Hospital, China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Shang Wang
- Department of Neurology, The First Affiliated Hospital, China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Ting Xiao
- Department of Dermatology, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China.,Key Laboratory of Immunodermatology, Ministry of Health, Ministry of Education, Shenyang, Liaoning, People's Republic of China
| | - Mei Zhao
- Department of Cardiology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Chuansheng Zhao
- Department of Neurology, The First Affiliated Hospital, China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, People's Republic of China.
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Voltzenlogel V, Vignal JP, Hirsch E, Manning L. The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy. Seizure 2014; 23:792-8. [DOI: 10.1016/j.seizure.2014.06.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/18/2014] [Accepted: 06/23/2014] [Indexed: 12/25/2022] Open
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Park KM, Shin KJ, Ha SY, Park J, Kim SE, Kim SE. Response to antiepileptic drugs in partial epilepsy with structural lesions on MRI. Clin Neurol Neurosurg 2014; 123:64-8. [DOI: 10.1016/j.clineuro.2014.04.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 03/21/2014] [Accepted: 04/30/2014] [Indexed: 11/26/2022]
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Pacagnella D, Lopes TM, Morita ME, Yasuda CL, Cappabianco FAM, Bergo F, Balthazar MLF, Coan AC, Cendes F. Memory impairment is not necessarily related to seizure frequency in mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia 2014; 55:1197-204. [DOI: 10.1111/epi.12691] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Denise Pacagnella
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | - Tatila M. Lopes
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | - Marcia E. Morita
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | - Clarissa L. Yasuda
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | - Fabio A. M. Cappabianco
- Department of Science and Technology; Federal University of Sao Paulo; São José dos Campos SP Brazil
| | - Felipe Bergo
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | | | - Ana C. Coan
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
| | - Fernando Cendes
- Department of Neurology; University of Campinas; Campinas Sao Paulo Brazil
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Rzezak P, Valente KD, Duchowny MS. Temporal lobe epilepsy in children: executive and mnestic impairments. Epilepsy Behav 2014; 31:117-22. [PMID: 24397914 DOI: 10.1016/j.yebeh.2013.12.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 02/02/2023]
Abstract
The current definition of epilepsy emphasizes the importance of cognitive impairment for a complete understanding of the disorder. Cognitive deficits have distinct functional manifestations that differentially impact the daily life experiences of children and adolescents with epilepsy and are a particular concern as they frequently impair academic performance. In particular, memory impairment and executive dysfunction are common disabilities in adults with temporal lobe epilepsy but are less easily recognized and studied in the pediatric population. This review focuses on the consequences of early-onset temporal lobe epilepsy for the development of memory and executive function and discusses current theories to explain these deficits.
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Affiliation(s)
- Patricia Rzezak
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, SP, Brazil.
| | - Kette D Valente
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Laboratory of Clinical Neurophysiology, Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
| | - Michael S Duchowny
- Brain Institute and Department of Neurology, Miami Children's Hospital, Miami, FL, USA; Department of Neurology, Wertheim College of Medicine, Florida International University, Miami, FL, USA.
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Maia GH, Quesado JL, Soares JI, do Carmo JM, Andrade PA, Andrade JP, Lukoyanov NV. Loss of hippocampal neurons after kainate treatment correlates with behavioral deficits. PLoS One 2014; 9:e84722. [PMID: 24409306 PMCID: PMC3883667 DOI: 10.1371/journal.pone.0084722] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 11/18/2013] [Indexed: 11/18/2022] Open
Abstract
Treating rats with kainic acid induces status epilepticus (SE) and leads to the development of behavioral deficits and spontaneous recurrent seizures later in life. However, in a subset of rats, kainic acid treatment does not induce overt behaviorally obvious acute SE. The goal of this study was to compare the neuroanatomical and behavioral changes induced by kainate in rats that developed convulsive SE to those who did not. Adult male Wistar rats were treated with kainic acid and tested behaviorally 5 months later. Rats that had experienced convulsive SE showed impaired performance on the spatial water maze and passive avoidance tasks, and on the context and tone retention tests following fear conditioning. In addition, they exhibited less anxiety-like behaviors than controls on the open-field and elevated plus-maze tests. Histologically, convulsive SE was associated with marked neuron loss in the hippocampal CA3 and CA1 fields, and in the dentate hilus. Rats that had not experienced convulsive SE after kainate treatment showed less severe, but significant impairments on the spatial water maze and passive avoidance tasks. These rats had fewer neurons than control rats in the dentate hilus, but not in the hippocampal CA3 and CA1 fields. Correlational analyses revealed significant relationships between spatial memory indices of rats and neuronal numbers in the dentate hilus and CA3 pyramidal field. These results show that a part of the animals that do not display intense behavioral seizures (convulsive SE) immediately after an epileptogenic treatment, later in life, they may still have noticeable structural and functional changes in the brain.
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Affiliation(s)
- Gisela H. Maia
- Departamento de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Neural Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - José L. Quesado
- Departamento de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Joana I. Soares
- Neural Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - Joana M. do Carmo
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - Pedro A. Andrade
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
| | - José P. Andrade
- Departamento de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Nikolai V. Lukoyanov
- Departamento de Anatomia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Neural Networks Group, Instituto de Biologia Molecular e Celular da Universidade do Porto, Porto, Portugal
- Programa Doutoral em Neurociências, Universidade do Porto, Porto, Portugal
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Gold JJ, Trauner DA. Hippocampal volume and memory performance in children with perinatal stroke. Pediatr Neurol 2014; 50:18-25. [PMID: 24188909 PMCID: PMC4208717 DOI: 10.1016/j.pediatrneurol.2013.08.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/21/2013] [Accepted: 08/27/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pediatric neurologists and neonatologists often are asked to predict cognitive outcome after perinatal brain injury (including likely memory and learning outcomes). However, relatively few data exist on how accurate predictions can be made. Furthermore, although the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children. METHODS We measured the volume of the hippocampus in 27 children with perinatal stroke and 19 controls, and measured their performance on standardized verbal and non-verbal memory tests. RESULTS We discovered the following: (1) As a group, children with perinatal stroke had smaller left and right hippocampi compared with control children. (2) Individually, children with perinatal stroke demonstrated 1 of 3 findings: no hippocampal loss, unilateral hippocampal loss, or bilateral hippocampal volume loss compared with control children. (3) Hippocampal volume inversely correlated with memory test performance in the perinatal stroke group, with smaller left and right hippocampal volumes related to poorer verbal and non-verbal memory test performance, respectively. (4) Seizures played a significant role in determining memory deficit and extent of hippocampal volume reduction in patients with perinatal stroke. CONCLUSIONS These findings support the view that, in the developing brain, the left and right hippocampi preferentially support verbal and nonverbal memory respectively, a consistent finding in the adult literature but a subject of debate in the pediatric literature. This is the first work to report that children with focal brain injury incurred from perinatal stroke have volume reduction in the hippocampus and impairments in certain aspects of declarative memory.
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Affiliation(s)
- Jeffrey J Gold
- University of California, San Diego, La Jolla, California; Rady Children's Hospital, San Diego, California.
| | - Doris A Trauner
- University of California, San Diego, La Jolla, California; Rady Children's Hospital, San Diego, California.
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Abstract
Forty-four patients with temporal lobe epilepsy (TLE) (25 left) and 40 healthy control participants performed a complex visual scene-encoding fMRI task in a 4-T Varian scanner. Healthy controls and left temporal lobe epilepsy (LTLE) patients demonstrated symmetric activation during scene encoding. In contrast, right temporal lobe (RTLE) patients demonstrated left lateralization of scene encoding which differed significantly from healthy controls and LTLE patients (all p≤.05). Lateralization of scene encoding to the right hemisphere among LTLE patients was associated with inferior verbal memory performance as measured by neuropsychological testing (WMS-III Logical Memory Immediate, p = 0.049; WMS-III Paired Associates Immediate, p = 0.036; WMS-III Paired Associates Delayed, p = 0.047). In RTLE patients, left lateralization of scene encoding was associated with lower visuospatial memory performance (BVRT, p = 0.043) but improved verbal memory performance (WMS-III Word List, p = 0.049). These findings indicate that, despite the negative effects of epilepsy, memory functioning is better supported by the affected hemisphere than the hemisphere contralateral to the seizure focus.
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Affiliation(s)
- Cristina Bigras
- Department of Psychology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
| | - Paula K. Shear
- Department of Psychology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
,Center for Imaging Research, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
| | - Jennifer Vannest
- Division of Pediatric Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
,Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Jane B. Allendorfer
- Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
| | - Jerzy P. Szaflarski
- Department of Psychology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
,Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
,Center for Imaging Research, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
,Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Gascoigne MB, Barton B, Webster R, Gill D, Antony J, Lah SS. Accelerated long-term forgetting in children with idiopathic generalized epilepsy. Epilepsia 2012; 53:2135-40. [DOI: 10.1111/j.1528-1167.2012.03719.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Kurzbuch K, Pauli E, Gaál L, Kerling F, Kasper BS, Stefan H, Hamer H, Graf W. Computerized cognitive testing in epilepsy (CCTE): a new method for cognitive screening. Seizure 2012; 22:424-32. [PMID: 22999215 DOI: 10.1016/j.seizure.2012.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 08/29/2012] [Accepted: 08/29/2012] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Optimized therapy in epilepsy should include individual care for cognitive functions. Here we introduce a computerized screening instrument, called "Computerized Cognitive Testing in Epilepsy" (CCTE), which allows for time-efficient repetitive assessment of the patient's cognitive profile regarding the domains of memory and attention, which are frequently impaired due to side effects of antiepileptic medication. METHODS The CCTE battery takes 30min and covers tasks of verbal and figural memory, cognitive speed, attention and working memory. The patient's results are displayed immediately in comparison to age-related normative data. For evaluation of psychometrics and clinical correlations, data from patients of a tertiary referral epilepsy center (n=240) and healthy subjects (n=83) were explored. RESULTS CCTE subtests show good reliability and concurrent validity compared to standard neuropsychological tests (p<0.01). Adverse cognitive effects of antiepileptic medication can be detected (p<0.05), e.g. significant negative effects of increasing drug load. Specific epilepsy subgroups, e.g. focal versus primary generalized epilepsy or right versus left mesial temporal lobe epilepsy, showed different CCTE profiles. CONCLUSION CCTE appears valuable for early detection of individual cognitive alterations related to medication. In addition, it displays interesting differences between epilepsy syndromes. The CCTE battery provides a standardized, time- and personnel-efficient assessment of cognitive functions open to a large number of patients and applicable for clinical and scientific use in epilepsy.
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Affiliation(s)
- Katrin Kurzbuch
- Epilepsy Center, Department of Neurology, University of Erlangen-Nürnberg, Germany.
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Karádi K, Janszky J, Gyimesi C, Horváth Z, Lucza T, Dóczi T, Kállai J, Abrahám H. Correlation between calbindin expression in granule cells of the resected hippocampal dentate gyrus and verbal memory in temporal lobe epilepsy. Epilepsy Behav 2012; 25:110-9. [PMID: 22796338 DOI: 10.1016/j.yebeh.2012.06.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 06/05/2012] [Accepted: 06/07/2012] [Indexed: 01/06/2023]
Abstract
Calbindin expression of granule cells of the dentate gyrus is decreased in temporal lobe epilepsy (TLE) regardless of its etiology. In this study, we examined the relation between reduction of calbindin immunoreactivity and the verbal and visuo-spatial memory function of patients with TLE of different etiologies. Significant linear correlation was shown between calbindin expression and short-term and long-term percent retention and retroactive interference in auditory verbal learning test (AVLT) of patients including those with hippocampal sclerosis. In addition, we found significant linear regression between calbindin expression and short-term and long-term percent retention of AVLT in patients whose epilepsy was caused by malformation of cortical development or tumor and when no hippocampal sclerosis and substantial neuronal loss were detected. Together with the role of calbindin in memory established in previous studies on calbindin knock-out mice, our results suggest that reduction of calbindin expression may contribute to memory impairments of patients with TLE, particularly, when neuronal loss is not significant.
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Affiliation(s)
- Kázmér Karádi
- Department of Behavioral Sciences, Faculty of Medicine, University of Pécs, Szigeti u. 12., Pécs 7624, Hungary
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Hill SW, Strutt AM, Uber-Zak L, Fogel TG, Ropacki MT. The NAB shape learning subtest as a predictor of lateralized seizure onset. Epilepsy Behav 2012; 24:59-64. [PMID: 22483644 DOI: 10.1016/j.yebeh.2012.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 01/27/2012] [Accepted: 02/12/2012] [Indexed: 11/26/2022]
Abstract
This study presents the first empirical evaluation of the predictive value of the Neuropsychological Assessment Battery Shape Learning (NAB-SL) subtest in a sample of patients with unilateral temporal lobe epilepsy. Stimulus characteristics of the NAB-SL may improve predictive ability over other commonly used visual memory tests. Forty-nine patients with unilateral temporal lobe epilepsy were compared on measures of non-verbal and verbal memory (NAB-SL and Wechsler Memory Scale-III subtests). Univariate and forward conditional logistic regressions identified predictive values for each memory test individually and in combination. The NAB-SL delayed memory demonstrated consistently stronger predictive power over visual reproduction at the univariate and multivariate levels. The NAB-SL was a good predictor (80% range) of lateralized seizure onset when combined with a verbal memory measure. These preliminary results provide support for the use of the NAB-SL in preoperative epilepsy evaluations as a predictor of non-dominant temporal lobe dysfunction. Potential benefits of this test are discussed.
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Doucet G, Osipowicz K, Sharan A, Sperling MR, Tracy JI. Extratemporal functional connectivity impairments at rest are related to memory performance in mesial temporal epilepsy. Hum Brain Mapp 2012; 34:2202-16. [PMID: 22505284 DOI: 10.1002/hbm.22059] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 01/19/2011] [Accepted: 01/20/2012] [Indexed: 11/12/2022] Open
Abstract
Mesial temporal lobe epilepsy (MTLE) is the most frequent form of focal epilepsy. At rest, there is evidence that brain abnormalities in MTLE are not limited to the epileptogenic region, but extend throughout the whole brain. It is also well established that MTLE patients suffer from episodic memory deficits. Thus, we investigated the relation between the functional connectivity seen at rest in fMRI and episodic memory impairments in MTLE. We focused on resting state BOLD activity and evaluated whether functional connectivity (FC) differences emerge from MTL seeds in left and right MTLE groups, compared with healthy controls. Results revealed significant FC reductions in both patient groups, localized in angular gyri, thalami, posterior cingulum and medial frontal cortex. We found that the FC between the left non-pathologic MTL and the medial frontal cortex was positively correlated with the delayed recall score of a non-verbal memory test in right MTLE patients, suggesting potential adaptive changes to preserve this memory function. In contrast, we observed a negative correlation between a verbal memory test and the FC between the left pathologic MTL and posterior cingulum in left MTLE patients, suggesting potential functional maladaptative changes in the pathologic hemisphere. Overall, the present study provides some indication that left MTLE may be more impairing than right MTLE patients to normative functional connectivity. Our data also indicates that the pattern of extra-temporal FC may vary as a function of episodic memory material and each hemisphere's capacity for cognitive reorganization.
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Affiliation(s)
- Gaëlle Doucet
- Department of Neurology, Cognitive Neuroscience and Brain Imaging Laboratory, Thomas Jefferson University, Jefferson Medical College, 901 Walnut St., Philadelphia, PA 19107, USA
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Alessio A, Pereira FRS, Sercheli MS, Rondina JM, Ozelo HB, Bilevicius E, Pedro T, Covolan RJM, Damasceno BP, Cendes F. Brain plasticity for verbal and visual memories in patients with mesial temporal lobe epilepsy and hippocampal sclerosis: an fMRI study. Hum Brain Mapp 2011; 34:186-99. [PMID: 22038783 DOI: 10.1002/hbm.21432] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 06/13/2011] [Accepted: 07/08/2011] [Indexed: 11/08/2022] Open
Abstract
We aimed to identify the brain areas involved in verbal and visual memory processing in normal controls and patients with unilateral mesial temporal lobe epilepsy (MTLE) associated with unilateral hippocampal sclerosis (HS) by means of functional magnetic resonance imaging (fMRI). The sample comprised nine normal controls, eight patients with right MTLE, and nine patients with left MTLE. All subjects underwent fMRI with verbal and visual memory paradigms, consisting of encoding and immediate recall of 17 abstract words and 17 abstract drawings. A complex network including parietal, temporal, and frontal cortices seems to be involved in verbal memory encoding and retrieval in normal controls. Although similar areas of activation were identified in both patient groups, the extension of such activations was larger in the left-HS group. Patients with left HS also tended to exhibit more bilateral or right lateralized encoding related activations. This finding suggests a functional reorganization of verbal memory processing areas in these patients due to the failure of left MTL system. As regards visual memory encoding and retrieval, our findings support the hypothesis of a more diffuse and bilateral representation of this cognitive function in the brain. Compared to normal controls, encoding in the left-HS group recruited more widespread cortical areas, which were even more widespread in the right-HS group probably to compensate for their right mesial temporal dysfunction. In contrast, the right-HS group exhibited fewer activated areas during immediate recall than the other two groups, probably related to their greater difficulty in dealing with visual memory content.
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Affiliation(s)
- Andréa Alessio
- Neuroimaging Laboratory, School of Medical Sciences, University of Campinas, Unicamp, Campinas, Brazil
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Li J, Zhang Z, Shang H. A meta-analysis of voxel-based morphometry studies on unilateral refractory temporal lobe epilepsy. Epilepsy Res 2011; 98:97-103. [PMID: 22024190 DOI: 10.1016/j.eplepsyres.2011.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 09/25/2011] [Accepted: 10/02/2011] [Indexed: 02/05/2023]
Abstract
PURPOSE To identify consistent results of voxel-based morphometry (VBM) studies in unilateral refractory temporal lobe epilepsy (TLE). METHODS Whole-brain VBM studies comparing refractory TLE patients with healthy controls (HC) were systematically searched in PubMed, ISI Web of Science, Embase, and Medline databases from January 1990 to May 2011. Coordinates were extracted from clusters with significant difference in gray matter volume (GMV) between refractory TLE patients and HC. Meta-analysis was performed using activation likelihood estimation (ALE). KEY FINDINGS A total of 6 studies, comprising 180 refractory left TLE (LTLE) patients, 142 refractory right TLE (RTLE) patients, and 283 HC, were enrolled. The included studies reported GMV reduction at 93 coordinates in refractory LTLE, and 46 coordinates in refractory RTLE, as well as GMV increase at 9 coordinates in refractory LTLE, and 8 coordinates in refractory RTLE. Given the small number of studies and coordinates that reported GMV increase, only a subgroup analysis of GMV reduction between refractory LTLE or RTLE and the HC was performed respectively. There were significant reductions in ipsilateral mesiotemporal structures and the bilateral thalamus in both refractory LTLE and refractory RTLE. Abnormalities of bilateral frontal lobe and right cingulate gyrus were also found in the refractory LTLE patients, whereas right insular atrophy was found in the refractory RTLE group. SIGNIFICANCE The findings suggested that unilateral refractory TLE patients had widespread GMV reduction and asymmetrical areas beyond the mesial temporal structures.
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Affiliation(s)
- JianPeng Li
- Department of Neurology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
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Wright MJ, Schmitter-Edgecombe M. The impact of verbal memory encoding and consolidation deficits during recovery from moderate-to-severe traumatic brain injury. J Head Trauma Rehabil 2011; 26:182-91. [PMID: 21552067 DOI: 10.1097/htr.0b013e318218dcf9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Encoding and consolidation deficits appear to account for verbal memory impairment following traumatic brain injury (TBI). It is unknown whether these abilities vary during TBI recovery. We sought to determine the pattern and impact of verbal encoding and consolidation deficits following TBI. METHODS Twenty-three participants with moderate-to-severe TBI and 25 age- and education-matched control participants' verbal memory abilities were assessed at 2 time points approximately 1 year apart; assessments occurred at acute and chronic visits for TBI survivors. MAIN OUTCOME MEASURES Rey Auditory Verbal Learning Test and Item Specific Deficit Approach indices of encoding, consolidation, and retrieval deficits. RESULTS In contrast to the controls, participants with TBI showed impaired verbal memory characterized by encoding and consolidation deficits at both time points. The TBI group's short-delayed recall and consolidation scores improved between the acute and chronic assessments. Encoding (primary) and consolidation (secondary) deficits emerged as predictors of acute and chronic recall in the TBI group. Also, acute visit encoding deficits predicted chronic visit delayed recall in TBI survivors, but acute consolidation deficits did not. CONCLUSIONS These findings suggest that memory rehabilitation efforts focused on improving encoding of verbal material may be useful during both the acute and chronic phases of recovery following TBI.
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Affiliation(s)
- Matthew J Wright
- Department of Psychiatry/Psychology Division, Harbor-UCLA Medical Center, Torrance, California 90502, USA.
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