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Nash Y, Sitty M. Non-Motor Symptoms of Amyotrophic Lateral Sclerosis: A Multi-Faceted Disorder. J Neuromuscul Dis 2021; 8:699-713. [PMID: 34024773 DOI: 10.3233/jnd-210632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease characterized by progressive degeneration of motor pathways. A growing body of evidence from recent years suggests that ALS results in a wide range of non-motor symptoms as well, which can have a significant impact on patients' quality of life. These symptoms could also, in turn, provide useful information as biomarkers for disease progression, and can shed insight on ALS mechanisms. Here we aim to review a wide range of non-motor symptoms of ALS, with emphasis on their importance to research and clinical treatment of patients.
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Affiliation(s)
- Yuval Nash
- Tel Aviv Youth University, The Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
| | - Michal Sitty
- Clalit Health Services, Kiryat Ono, Israel.,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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Gruenbaum BF, Sandhu MRS, Bertasi RAO, Bertasi TGO, Schonwald A, Kurup A, Gruenbaum SE, Freedman IG, Funaro MC, Blumenfeld H, Sanacora G. Absence seizures and their relationship to depression and anxiety: Evidence for bidirectionality. Epilepsia 2021; 62:1041-1056. [PMID: 33751566 PMCID: PMC8443164 DOI: 10.1111/epi.16862] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/12/2022]
Abstract
Absence seizures (AS), presenting as short losses of consciousness with staring spells, are a common manifestation of childhood epilepsy that is associated with behavioral, emotional, and social impairments. It has also been suggested that patients with AS are more likely to suffer from mood disorders such as depression and anxiety. This systematic review and meta-analysis synthesizes human and animal models that investigated mood disorders and AS. Of the 1019 scientific publications identified, 35 articles met the inclusion criteria for this review. We found that patients with AS had greater odds of developing depression and anxiety when compared to controls (odds ratio = 4.93, 95% confidence interval = 2.91-8.35, p < .01). The included studies further suggest a strong correlation between AS and depression and anxiety in the form of a bidirectional relationship. The current literature emphasizes that these conditions likely share underlying mechanisms, such as genetic predisposition, neurophysiology, and anatomical pathways. Further research will clarify this relationship and ensure more effective treatment for AS and mood disorders.
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Affiliation(s)
- Benjamin F Gruenbaum
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Mani Ratnesh S Sandhu
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Raphael A O Bertasi
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Tais G O Bertasi
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Antonia Schonwald
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Anirudh Kurup
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Shaun E Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Isaac G Freedman
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA
| | - Hal Blumenfeld
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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3
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Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G, David F. Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures. Brain 2020; 143:2341-2368. [PMID: 32437558 PMCID: PMC7447525 DOI: 10.1093/brain/awaa072] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/19/2019] [Accepted: 01/31/2020] [Indexed: 12/24/2022] Open
Abstract
Absence seizures in children and teenagers are generally considered relatively benign because of their non-convulsive nature and the large incidence of remittance in early adulthood. Recent studies, however, show that 30% of children with absence seizures are pharmaco-resistant and 60% are affected by severe neuropsychiatric comorbid conditions, including impairments in attention, cognition, memory and mood. In particular, attention deficits can be detected before the epilepsy diagnosis, may persist even when seizures are pharmacologically controlled and are aggravated by valproic acid monotherapy. New functional MRI-magnetoencephalography and functional MRI-EEG studies provide conclusive evidence that changes in blood oxygenation level-dependent signal amplitude and frequency in children with absence seizures can be detected in specific cortical networks at least 1 min before the start of a seizure, spike-wave discharges are not generalized at seizure onset and abnormal cortical network states remain during interictal periods. From a neurobiological perspective, recent electrical recordings and imaging of large neuronal ensembles with single-cell resolution in non-anaesthetized models show that, in contrast to the predominant opinion, cortical mechanisms, rather than an exclusively thalamic rhythmogenesis, are key in driving seizure ictogenesis and determining spike-wave frequency. Though synchronous ictal firing characterizes cortical and thalamic activity at the population level, individual cortico-thalamic and thalamocortical neurons are sparsely recruited to successive seizures and consecutive paroxysmal cycles within a seizure. New evidence strengthens previous findings on the essential role for basal ganglia networks in absence seizures, in particular the ictal increase in firing of substantia nigra GABAergic neurons. Thus, a key feature of thalamic ictogenesis is the powerful increase in the inhibition of thalamocortical neurons that originates at least from two sources, substantia nigra and thalamic reticular nucleus. This undoubtedly provides a major contribution to the ictal decrease in total firing and the ictal increase of T-type calcium channel-mediated burst firing of thalamocortical neurons, though the latter is not essential for seizure expression. Moreover, in some children and animal models with absence seizures, the ictal increase in thalamic inhibition is enhanced by the loss-of-function of the astrocytic GABA transporter GAT-1 that does not necessarily derive from a mutation in its gene. Together, these novel clinical and experimental findings bring about paradigm-shifting views of our understanding of absence seizures and demand careful choice of initial monotherapy and continuous neuropsychiatric evaluation of affected children. These issues are discussed here to focus future clinical and experimental research and help to identify novel therapeutic targets for treating both absence seizures and their comorbidities.
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Affiliation(s)
- Vincenzo Crunelli
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK
| | - Magor L Lőrincz
- Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK.,Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary.,Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Cian McCafferty
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Régis C Lambert
- Sorbonne Université, CNRS, INSERM, Neuroscience Paris Seine and Institut de Biologie Paris Seine (NPS - IBPS), Paris, France
| | - Nathalie Leresche
- Sorbonne Université, CNRS, INSERM, Neuroscience Paris Seine and Institut de Biologie Paris Seine (NPS - IBPS), Paris, France
| | - Giuseppe Di Giovanni
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK
| | - François David
- Cerebral dynamics, learning and plasticity, Integrative Neuroscience and Cognition Center - UMR 8002, Paris, France
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4
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Kim EH, Shim WH, Lee JS, Yoon HM, Ko TS, Yum MS. Altered Structural Network in Newly Onset Childhood Absence Epilepsy. J Clin Neurol 2020; 16:573-580. [PMID: 33029962 PMCID: PMC7541981 DOI: 10.3988/jcn.2020.16.4.573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Recent quantitative neuroimaging studies of childhood absence epilepsy (CAE) have identified various structural abnormalities that might be involved in the onset of absence seizure and associated cognitive and behavioral functions. However, the neuroanatomical alterations specific to CAE remain unclear, and so this study investigated the regional alterations of brain structures associated with newly diagnosed CAE. METHODS Surface and volumetric magnetic resonance imaging data of patients with newly diagnosed CAE (n=18) and age-matched healthy controls (n=18) were analyzed using Free-Surfer software. A group comparison using analysis of covariance was performed with significance criteria of p<0.05 and p<0.01 in global and regional analyses, respectively. RESULTS Compared with control subjects, the patients with CAE had smaller total and regional volumes of cortical gray-matter (GM) in the right rostral middle frontal, right lateral orbitofrontal, and left rostral middle frontal regions, as well as in the right precentral, right superior, middle, left middle, and inferior temporal gyri. The cortex in the right posterior cingulate gyrus and left medial occipital region was significantly thicker in patients with CAE than in controls. CONCLUSIONS Patients with CAE showed a reduced bilateral frontotemporal cortical GM volume and an increased posterior medial cortical thickness, which are associated with the default mode network. These structural changes can be suggested as the neural basis of the absence seizures and neuropsychiatric comorbidities in CAE.
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Affiliation(s)
- Eun Hee Kim
- Department of Pediatrics, Sejong Chungnam National University Hospital, Chungnam National University College of Medicine, Sejong, Korea.,Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Woo Hyun Shim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Seong Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Mang Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Sung Ko
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Sun Yum
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
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5
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Marwha D, Halari M, Eliot L. Meta-analysis reveals a lack of sexual dimorphism in human amygdala volume. Neuroimage 2016; 147:282-294. [PMID: 27956206 DOI: 10.1016/j.neuroimage.2016.12.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 11/27/2016] [Accepted: 12/08/2016] [Indexed: 12/31/2022] Open
Abstract
The amygdala plays a key role in many affective behaviors and psychiatric disorders that differ between men and women. To test whether human amygdala volume (AV) differs reliably between the sexes, we performed a systematic review and meta-analysis of AVs reported in MRI studies of age-matched healthy male and female groups. Using four search strategies, we identified 46 total studies (58 matched samples) from which we extracted effect sizes for the sex difference in AV. All data were converted to Hedges g values and pooled effect sizes were calculated using a random-effects model. Each dataset was further meta-regressed against study year and average participant age. We found that uncorrected amygdala volume is about 10% larger in males, with pooled sex difference effect sizes of g=0.581 for right amygdala (κ=28, n=2022), 0.666 for left amygdala (κ=28, n=2006), and 0.876 for bilateral amygdala (κ=16, n=1585) volumes (all p values < 0.001). However, this difference is comparable to the sex differences in intracranial volume (ICV; g=1.186, p<.001, 11.9% larger in males, κ=11) and total brain volume (TBV; g=1.278, p<0.001, 11.5% larger in males, κ=15) reported in subsets of the same studies, suggesting the sex difference in AV is a product of larger brain size in males. Among studies reporting AVs normalized for ICV or TBV, sex difference effect sizes were small and not statistically significant: g=0.171 for the right amygdala (p=0.206, κ=13, n=1560); 0.233 for the left amygdala (p=0.092, κ=12, n=1512); and 0.257 for bilateral volume (p=0.131, κ=5, n=1629). These values correspond to less than 0.1% larger corrected right AV and 2.5% larger corrected left AV in males compared to females. In summary, AV is not selectively enhanced in human males, as often claimed. Although we cannot rule out subtle male-female group differences, it is not accurate to refer to the human amygdala as "sexually dimorphic."
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Affiliation(s)
- Dhruv Marwha
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States
| | - Meha Halari
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States
| | - Lise Eliot
- Department of Neuroscience, Chicago Medical School, Rosalind Franklin University of Medicine & Science, United States.
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6
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Garcia-Ramos C, Lin JJ, Bonilha L, Jones JE, Jackson DC, Prabhakaran V, Hermann BP. Disruptions in cortico-subcortical covariance networks associated with anxiety in new-onset childhood epilepsy. NEUROIMAGE-CLINICAL 2016; 12:815-824. [PMID: 27830114 PMCID: PMC5094270 DOI: 10.1016/j.nicl.2016.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/17/2016] [Accepted: 10/21/2016] [Indexed: 01/26/2023]
Abstract
Anxiety disorders represent a prevalent psychiatric comorbidity in both adults and children with epilepsy for which the etiology remains controversial. Neurobiological contributions have been suggested, but only limited evidence suggests abnormal brain volumes particularly in children with epilepsy and anxiety. Since the brain develops in an organized fashion, covariance analyses between different brain regions can be investigated as a network and analyzed using graph theory methods. We examined 46 healthy children (HC) and youth with recent onset idiopathic epilepsies with (n = 24) and without (n = 62) anxiety disorders. Graph theory (GT) analyses based on the covariance between the volumes of 85 cortical/subcortical regions were investigated. Both groups with epilepsy demonstrated less inter-modular relationships in the synchronization of cortical/subcortical volumes compared to controls, with the epilepsy and anxiety group presenting the strongest modular organization. Frontal and occipital regions in non-anxious epilepsy, and areas throughout the brain in children with epilepsy and anxiety, showed the highest centrality compared to controls. Furthermore, most of the nodes correlating to amygdala volumes were subcortical structures, with the exception of the left insula and the right frontal pole, which presented high betweenness centrality (BC); therefore, their influence in the network is not necessarily local but potentially influencing other more distant regions. In conclusion, children with recent onset epilepsy and anxiety demonstrate large scale disruptions in cortical and subcortical brain regions. Network science may not only provide insight into the possible neurobiological correlates of important comorbidities of epilepsy, but also the ways that cortical and subcortical disruption occurs.
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Affiliation(s)
- Camille Garcia-Ramos
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Jack J Lin
- Department of Neurology, University of California-Irvine, Irvine, CA 92697, USA
| | - Leonardo Bonilha
- Neurosciences Department, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jana E Jones
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Daren C Jackson
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Vivek Prabhakaran
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI 53705, USA; Department of Radiology, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin-Madison, Madison, WI 53705, USA
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7
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Wang G, Dai ZY, Song W, Wang S, Shi H, Pan P, Chen F, Xu Y, Zhong J. Grey matter anomalies in drug-naïve childhood absence epilepsy: A voxel-based morphometry study with MRI at 3.0T. Epilepsy Res 2016; 124:63-6. [PMID: 27259070 DOI: 10.1016/j.eplepsyres.2016.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 04/28/2016] [Accepted: 05/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known, so far, about the cerebral structural abnormalities in drug-naïve patients with childhood absence epilepsy (CAE). We aimed to investigate regional grey matter (GM) volume differences using voxel-based morphometry (VBM) in patients and closely matched healthy control subjects. METHODS Twenty drug-naïve patients diagnosed with CAE and 20 age- and gender-matched healthy subjects were recruited. All participants underwent structural MRI scans with a 3.0T MR system. The differences in regional GM volumes between the two groups were determined by VBM analysis. Additional regression analyses were performed to identify any associations between regional GM volume and clinical seizure variables. RESULTS Compared with controls, the patients with CAE showed less GM volume in the bilateral thalami. Furthermore, the GM volume in the bilateral thalami was negatively correlated with disease duration and age of onset in the CAE group. CONCLUSIONS By excluding the potential effect of medication on brain structures, our study demonstrates less GM volume in the bilateral thalami in drug-naïve patients with idiopathic CAE. Our study further provides structural neuroimaging evidence on the pathophysiology of absence seizures.
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Affiliation(s)
- GenDi Wang
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing Medical University, Nanjing, PR China; Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Zhen Yu Dai
- Department of Radiology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - WeiGen Song
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - ShuFang Wang
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - HaiCun Shi
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - PingLei Pan
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Fei Chen
- Department of Radiology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Yun Xu
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing Medical University, Nanjing, PR China.
| | - JianGuo Zhong
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China.
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8
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Yoong M. Quantifying the deficit-imaging neurobehavioural impairment in childhood epilepsy. Quant Imaging Med Surg 2015; 5:225-37. [PMID: 25853081 DOI: 10.3978/j.issn.2223-4292.2015.01.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/14/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neurobehavioral impairments such as learning difficulty, autism, attention deficit hyperactivity disorder (ADHD) and mood or behavioural problems are known to be increased in children with epilepsy; however, they remain under-recognised and often cause considerable morbidity. Quantitative neuroimaging techniques offer a potential avenue to improving our understanding of the underlying pathological basis for these disorders, aiding with diagnosis and risk stratification. METHODS A systematic review was undertaken for original research articles involving magnetic resonance imaging in children with epilepsy and one or more neurobehavioural impairments. Studies were reviewed with respect to patient population, methodology and magnetic resonance imaging (MRI) findings. RESULTS A total of 25 studies were identified and included in this review. The majority of studies looked at single impairments, commonly cognitive impairment or ADHD, with few studies reporting on other impairments. Reductions in cortical grey matter and disruptions of functional and structural brain networks were associated with poorer cognitive performance and disruptions of grey and white matter within a fronto-striatal-cerebellar network associated with ADHD. Insufficient studies were available to report on other impairments. CONCLUSIONS Relatively few studies exist in this field and those that do are methodologically diverse. Further investigation is required to determine if the changes reported to date are epilepsy syndrome specific or have broader applicability.
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Affiliation(s)
- Michael Yoong
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK
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9
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Marques-Carneiro JE, Faure JB, Cosquer B, Koning E, Ferrandon A, de Vasconcelos AP, Cassel JC, Nehlig A. Anxiety and locomotion in Genetic Absence Epilepsy Rats from Strasbourg (GAERS): Inclusion of Wistar rats as a second control. Epilepsia 2014; 55:1460-8. [DOI: 10.1111/epi.12738] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- José Eduardo Marques-Carneiro
- Laboratory of Cognitive and Adaptive Neuroscience (LNCA); Faculty of Psychology; UMR 7364; University of Strasbourg - CNRS; Strasbourg France
- Faculty of Medicine; INSERM U 666; University of Strasbourg; Strasbourg France
| | - Jean-Baptiste Faure
- Laboratory of Cognitive and Adaptive Neuroscience (LNCA); Faculty of Psychology; UMR 7364; University of Strasbourg - CNRS; Strasbourg France
- Faculty of Medicine; INSERM U 666; University of Strasbourg; Strasbourg France
| | - Brigitte Cosquer
- Laboratory of Cognitive and Adaptive Neuroscience (LNCA); Faculty of Psychology; UMR 7364; University of Strasbourg - CNRS; Strasbourg France
| | - Estelle Koning
- Faculty of Medicine; INSERM U 666; University of Strasbourg; Strasbourg France
| | - Arielle Ferrandon
- Faculty of Medicine; INSERM U 666; University of Strasbourg; Strasbourg France
| | - Anne Pereira de Vasconcelos
- Laboratory of Cognitive and Adaptive Neuroscience (LNCA); Faculty of Psychology; UMR 7364; University of Strasbourg - CNRS; Strasbourg France
| | - Jean-Christophe Cassel
- Laboratory of Cognitive and Adaptive Neuroscience (LNCA); Faculty of Psychology; UMR 7364; University of Strasbourg - CNRS; Strasbourg France
| | - Astrid Nehlig
- Faculty of Medicine; INSERM U 666; University of Strasbourg; Strasbourg France
- Hospital Necker; INSERM U 1129; University Paris Descartes; Paris France
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10
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Yang T, Fang Z, Ren J, Xiao F, Li Q, Liu L, Lei D, Gong Q, Zhou D. Altered spontaneous activity in treatment-naive childhood absence epilepsy revealed by Regional Homogeneity. J Neurol Sci 2014; 340:58-62. [PMID: 24746024 DOI: 10.1016/j.jns.2014.02.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/17/2014] [Accepted: 02/21/2014] [Indexed: 02/05/2023]
Abstract
PURPOSE To explore the differences in regional spontaneous activities throughout the whole brain by the Regional Homogeneity (ReHo) method in untreated childhood absence epilepsy (CAE), in order to understand the neuro-pathophysiological mechanism of function impairments in CAE. METHODS The rest-functional MRI was used to measure the ReHo in 16 patients with untreated CAE and 16 age- and sex-matched healthy controls. The correlations between the ReHo at each voxel of the whole brain and duration of epilepsy were analyzed. RESULTS Compared with healthy controls, we found that ReHo was decreased in bilateral thalamus, caudate, posterior lobe of cerebellum and areas mainly in the default mode network (DMN) (including precuneus and posterior cingulate cortex-PCC, bilateral inferior lateral parietal lobule). The increase of ReHo was found in bilateral insula, left occipital cortex. Moreover, a correlation analysis of the ReHo measurement versus the epilepsy duration was performed, and highly positive correlation was observed in precuneus/PCC and supplementary motor area (SMA). SIGNIFICANCE The current findings demonstrated alterations of ReHo in the striato-thalamo-cortical network in drug naïve CAE subjects during interictal resting state. Some regions with decreased ReHo followed the pattern of 'default' state of brain function. In addition, positive correlations between the ReHo values in the precuneus/PCC and SMA and the disease duration were identified. These results indicate that the involvement of these regions may be related to the pathomechanisms of seizure generation and the neurological deficits observed in CAE patients. ReHo has demonstrated the capability to characterize spontaneous brain dysfunction in epilepsy.
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Affiliation(s)
- Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Zhijia Fang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China
| | - Jiechuan Ren
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Qifu Li
- Department of Neurology, The Affiliated Hospital of Hainan Medical College, Haikou, PR China
| | - Ling Liu
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China.
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11
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Citraro R, Russo E, Scicchitano F, van Rijn CM, Cosco D, Avagliano C, Russo R, D'Agostino G, Petrosino S, Guida F, Gatta L, van Luijtelaar G, Maione S, Di Marzo V, Calignano A, De Sarro G. Antiepileptic action of N-palmitoylethanolamine through CB1 and PPAR-α receptor activation in a genetic model of absence epilepsy. Neuropharmacology 2012. [PMID: 23206503 DOI: 10.1016/j.neuropharm.2012.11.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
N-palmitoylethanolamine (PEA), an endogenous fatty acid ethanolamide, plays a key role in the regulation of the inflammatory response and pain through, among others, activation of nuclear peroxisome proliferator-activated receptors (PPAR-α). Endogenous cannabinoids play a protective role in several central nervous system (CNS) disorders, particularly those associated with neuronal hyperexcitability. We investigated the effects of PEA and the role of PPAR-α in absence epilepsy using the WAG/Rij rat model. PEA, anandamide (AEA), a PPAR-α antagonist (GW6471) and a synthetic CB1 receptor antagonist/inverse agonist (SR141716) were administered to WAG/Rij rats in order to evaluate the effects on epileptic spike-wave discharges (SWDs) on EEG recordings. We studied also the effects of PEA co-administration with SR141716 and GW6471 and compared these effects with those of AEA to evaluate PEA mechanism of action and focusing on CB1 receptors and PPAR-α. Both PEA and AEA administration significantly decreased SWDs parameters (absence seizures). In contrast, GW6471 was devoid of effects while SR141716 had pro-absence effects. The co-administration of SR141716 with PEA or AEA completely blocked the anti-absence effects of these compounds. GW6471 antagonized PEA's effects whereas it did not modify AEA's effects. Furthermore, we have also measured PEA, AEA and 2-AG (2-arachidonoylglycerol) brain levels identifying significant differences between epileptic and control rats such as decreased PEA levels in both thalamus and cortex that might contribute to absence epilepsy. Our data demonstrate that PEA has anti-absence properties in the WAG/Rij rat model and that such properties depend on PPAR-α and indirect activation of CB1 receptors. This article is part of the Special Issue entitled 'New Targets and Approaches to the Treatment of Epilepsy'.
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Affiliation(s)
- Rita Citraro
- Department of Health Science, School of Medicine and Surgery, University Magna Graecia of Catanzaro, Viale Europa - Germaneto, 88100 Catanzaro, Italy
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White matter impairment in the basal ganglia-thalamocortical circuit of drug-naïve childhood absence epilepsy. Epilepsy Res 2012; 99:267-73. [DOI: 10.1016/j.eplepsyres.2011.12.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Revised: 11/10/2011] [Accepted: 12/11/2011] [Indexed: 11/18/2022]
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Abstract
This paper first summarizes the main findings of clinical studies conducted over the past two and a half decades on psychopathology (i.e., psychiatric diagnoses, behavior and emotional problems) in children with new onset and chronic epilepsy both with and without intellectual disability who are treated medically and surgically. Although impaired social relationships are core features of the psychiatric disorders found in pediatric epilepsy, few studies have examined social competence (i.e., social behavior, social adjustment, and social cognition) in these children. There also is a dearth of treatment studies on the frequent psychiatric comorbidities of pediatric epilepsy, attention deficit hyperactivity disorder, anxiety disorders, and depression. Drs. Hamiwka and Jones then describe their current and planned studies on social competence and cognitive behavioral treatment of anxiety disorders, respectively, in these children and how they might mitigate the poor long-term psychiatric and social outcome of pediatric epilepsy.
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Affiliation(s)
- Lorie Hamiwka
- Division of Child Neurology, Ohio State University College of Medicine, Columbus, OH, USA
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Jones NC, O’Brien TJ, Powell KL. Morphometric changes and molecular mechanisms in rat models of idiopathic generalized epilepsy with absence seizures. Neurosci Lett 2011; 497:185-93. [DOI: 10.1016/j.neulet.2011.02.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 01/21/2011] [Accepted: 02/15/2011] [Indexed: 01/29/2023]
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Hermann BP, Dabbs K, Becker T, Jones JE, Myers y Gutierrez A, Wendt G, Koehn MA, Sheth R, Seidenberg M. Brain development in children with new onset epilepsy: a prospective controlled cohort investigation. Epilepsia 2010; 51:2038-46. [PMID: 20384719 DOI: 10.1111/j.1528-1167.2010.02563.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To characterize prospective neurodevelopmental changes in brain structure in children with new and recent-onset epilepsy compared to healthy controls. METHODS Thirty-four healthy controls (mean age 12.9 years) and 38 children with new/recent-onset idiopathic epilepsy (mean age 12.9 years) underwent 1.5 T magnetic resonance imaging (MRI) at baseline and 2 years later. Prospective changes in total cerebral and lobar gray and white matter volumes were compared within and between groups. RESULTS Prospective changes in gray matter volume were comparable for the epilepsy and control groups, with significant (p < 0.0001) reduction in total cerebral gray matter, due primarily to significant (p < 0.001) reductions in frontal and parietal gray matter. Prospective white matter volume changes differed between groups. Controls exhibited a significant (p = 0.0012) increase in total cerebral white matter volume due to significant (p < 0.001) volume increases in the frontal, parietal, and temporal lobes. In contrast, the epilepsy group exhibited nonsignificant white matter volume change in the total cerebrum (p = 0.51) as well as across all lobes (all p's > 0.06). The group by white matter volume change interactions were significant for total cerebrum (p = 0.04) and frontal lobe (p = 0.04). DISCUSSION Children with new and recent-onset epilepsy exhibit an altered pattern of brain development characterized by delayed age-appropriate increase in white matter volume. These findings may affect cognitive development through reduced brain connectivity and may also be related to the impairments in executive function commonly reported in this population.
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Affiliation(s)
- Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
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Loutfi KS, Carvalho AM. Possíveis interfaces entre TDAH e epilepsia. JORNAL BRASILEIRO DE PSIQUIATRIA 2010. [DOI: 10.1590/s0047-20852010000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Identificar na literatura elementos para explicar uma possível associação entre o transtorno de déficit de atenção e hiperatividade (TDAH) e a epilepsia e orientar quanto ao manejo clínico dos pacientes que compartilham esses transtornos. MÉTODOS: Realizou-se revisão da literatura dos últimos 10 anos nas bases de dados MedLine e Lilacs com a combinação dos descritores "attention deficit hyperactivity disorder", "ADHD" e "epilepsy". RESULTADOS: Sintomas de TDAH são frequentes em síndromes epilépticas idiopáticas. Vários fatores podem contribuir para a coexistência desses transtornos: 1) possibilidade de uma mesma propensão genética; 2) participação dos neurotransmissores noradrenalina e dopamina no TDAH e na modulação da excitabilidade neuronal; 3) anormalidades estruturais do cérebro evidenciadas em epilépticos portadores de TDAH; 4) influência dos efeitos crônicos das crises e das descargas epileptiformes interictais sob a atenção; 5) efeitos adversos das drogas antiepilépticas sob a cognição. CONCLUSÕES: As evidências atuais apontam que crises epilépticas e TDAH podem apresentar bases neurobiológicas comuns. Estudos que avaliam disfunções nas vias de sinalização das catecolaminas cerebrais e o papel das descargas epileptiformes interictais na geração dos sintomas são fundamentais na investigação desses mecanismos. Drogas psicoestimulantes são seguras e eficazes para o tratamento do TDAH na maioria dos portadores de epilepsia.
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