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Turner EM, Olsen E, Duvall S. Neurocognition in Pediatric Temporal Lobe Tumor-Related Epilepsy. Dev Neuropsychol 2024; 49:178-189. [PMID: 38753032 DOI: 10.1080/87565641.2024.2354745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
Tumor-related epilepsy is a common and understudied neurological comorbidity among pediatric temporal lobe tumor patients that poses risk for neurocognitive impairment (NCI). Forty-one youth with either TLT+ (n = 23) or nonneoplastic temporal lobe epilepsy (n = 18) ages 6-20 years completed routine neuropsychological evaluations. Rates of NCI were similar across groups; however, NCI was more common in nonneoplastic participants on a task of phonemic fluency, p = .047. Younger age of seizure onset and greater number of antiseizure medications were associated with NCI among TLT+ participants only. Preliminary findings suggest separate prognostic models of cognitive outcomes between TLT+ and nonneoplastic epilepsy populations may be needed.
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Affiliation(s)
- Elise M Turner
- Section of Neurology, Department of Pediatrics, Children's Hospital Colorado/University of Colorado School of Medicine, Portland, Oregon, USA
| | - Emily Olsen
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Susanne Duvall
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
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Karadag N, Hagen E, Shadrin AA, van der Meer D, O'Connell KS, Rahman Z, Kutrolli G, Parker N, Bahrami S, Fominykh V, Heuser K, Taubøll E, Steen NE, Djurovic S, Dale AM, Frei O, Andreassen OA, Smeland OB. Dissecting the Shared Genetic Architecture of Common Epilepsies With Cortical Brain Morphology. Neurol Genet 2024; 10:e200143. [PMID: 38817246 PMCID: PMC11139015 DOI: 10.1212/nxg.0000000000200143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/27/2024] [Indexed: 06/01/2024]
Abstract
Background and Objectives Epilepsies are associated with differences in cortical thickness (TH) and surface area (SA). However, the mechanisms underlying these relationships remain elusive. We investigated the extent to which these phenotypes share genetic influences. Methods We analyzed genome-wide association study data on common epilepsies (n = 69,995) and TH and SA (n = 32,877) using Gaussian mixture modeling MiXeR and conjunctional false discovery rate (conjFDR) analysis to quantify their shared genetic architecture and identify overlapping loci. We biologically interrogated the loci using a variety of resources and validated in independent samples. Results The epilepsies (2.4 k-2.9 k variants) were more polygenic than both SA (1.8 k variants) and TH (1.3 k variants). Despite absent genome-wide genetic correlations, there was a substantial genetic overlap between SA and genetic generalized epilepsy (GGE) (1.1 k), all epilepsies (1.1 k), and juvenile myoclonic epilepsy (JME) (0.7 k), as well as between TH and GGE (0.8 k), all epilepsies (0.7 k), and JME (0.8 k), estimated with MiXeR. Furthermore, conjFDR analysis identified 15 GGE loci jointly associated with SA and 15 with TH, 3 loci shared between SA and childhood absence epilepsy, and 6 loci overlapping between SA and JME. 23 loci were novel for epilepsies and 11 for cortical morphology. We observed a high degree of sign concordance in the independent samples. Discussion Our findings show extensive genetic overlap between generalized epilepsies and cortical morphology, indicating a complex genetic relationship with mixed-effect directions. The results suggest that shared genetic influences may contribute to cortical abnormalities in epilepsies.
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Affiliation(s)
- Naz Karadag
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Espen Hagen
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Alexey A Shadrin
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Dennis van der Meer
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Kevin S O'Connell
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Zillur Rahman
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Gleda Kutrolli
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Nadine Parker
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Shahram Bahrami
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Vera Fominykh
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Kjell Heuser
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Erik Taubøll
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Nils Eiel Steen
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Srdjan Djurovic
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Anders M Dale
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Oleksandr Frei
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Ole A Andreassen
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
| | - Olav B Smeland
- From the Institute of Clinical Medicine (N.K., E.H., A.A.S., D.M., K.S.O.C., Z.R., G.K., N.P., S.B., V.F., N.E.S., O.F., O.A.A., O.B.S.), NORMENT, University of Oslo; K.G. Jebsen Centre for Neurodevelopmental Disorders (A.A.S., O.A.A.), University of Oslo and Oslo University Hospital, Norway; Faculty of Health (D.M.), School of Mental Health and Neuroscience, Maastricht University, Netherlands; Department of Neurology (K.H., E.T.), Oslo University Hospital; Faculty of Medicine (E.T.), University of Oslo; Division of Mental Health and Addiction (N.E.S., O.A.A., O.B.S.), Oslo University Hospital; Department of Psychiatric Research (N.E.S.), Diakonhjemmet Hospital; Department of Medical Genetics (S.D.), Oslo University Hospital, Norway; Department of Clinical Science (S.D.), NORMENT, University of Bergen, Norway; Department of Cognitive Science (A.M.D.); Multimodal Imaging Laboratory (A.M.D.); Department of Psychiatry (A.M.D.); Department of Neurosciences (A.M.D.), University of California, San Diego; and Department of Informatics (O.F.), Center for Bioinformatics, University of Oslo, Norway
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Kloc ML, Holmes GL, Barry JM. Sex differences in cholinergic signaling affect functional outcomes for theta-gamma coordination in hippocampal subcircuits following experimental febrile status epilepticus. Epilepsia 2024. [PMID: 38780490 DOI: 10.1111/epi.18017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Sex determines cognitive outcome in animal models of early life seizure, where males exhibit impaired hippocampal-dependent learning and memory compared with females. The physiological underpinnings of this sex effect are unclear. Cholinergic signaling is essential for the generation of hippocampal oscillations, and supplementation of cholinergic precursors prior to status epilepticus in immature male rats prevents subsequent memory deficits. We hypothesized that there are sex differences in acetylcholine circuits and their response to experimental febrile status epilepticus (eFSE). METHODS eFSE was induced in male and female rat pups. We transversed the hippocampus of postnatal day >60 control (CTL) and eFSE rats with a 64-channel laminar silicon probe to assay cholinergic-dependent theta oscillations under urethane anesthesia. Local field potential properties were compared during (1) baseline sensory stimulation, (2) pharmacological stimulation via acetylcholine reuptake blockade, and (3) sensory stimulation after muscarinic acetylcholine receptor block (atropine). RESULTS In all groups, a baseline tail pinch could elicit theta oscillations via corticohippocampal synaptic input. Following atropine, a tail pinch response could no longer be elicited in CTL male, CTL female, or eFSE female rats. In contrast, induced slow theta power in eFSE males after atropine was not decreased to spontaneous levels. Analysis of oscillation bandwidths revealed sex differences in acetylcholine modulation of theta frequency and slow gamma frequency and power. This study also identified significant effects of both sex and eFSE on baseline theta-gamma comodulation, indicating a loss of coupling in eFSE males and a potential gain of function in eFSE females. SIGNIFICANCE There are differences in cholinergic modulation of theta and gamma signal coordination between male and female rats. These differences may underlie worse cognitive outcomes in males following eFSE. Promoting the efficacy of muscarinic acetylcholine signaling prior to or following early life seizures could elucidate a mechanism for the temporal discoordination of neural signals within and between hippocampus and neocortex and provide a novel therapeutic approach for improving cognitive outcomes.
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Affiliation(s)
- Michelle L Kloc
- Epilepsy Cognition and Development Group, Department of Neurological Sciences, University of Vermont, Larner College of Medicine, Burlington, Vermont, USA
| | - Gregory L Holmes
- Epilepsy Cognition and Development Group, Department of Neurological Sciences, University of Vermont, Larner College of Medicine, Burlington, Vermont, USA
| | - Jeremy M Barry
- Epilepsy Cognition and Development Group, Department of Neurological Sciences, University of Vermont, Larner College of Medicine, Burlington, Vermont, USA
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Su HW, Chen HT, Kao CL, Hung KC, Lin YT, Liu PH, Lin CM, Chen IW. Efficacy and safety of herbal medicine combined with acupuncture in pediatric epilepsy treatment: A meta-analysis of randomized controlled trials. PLoS One 2024; 19:e0303201. [PMID: 38723054 PMCID: PMC11081325 DOI: 10.1371/journal.pone.0303201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/21/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of herbal medicine and acupuncture combination for pediatric epilepsy treatment. METHODS Databases were searched from their interception until October 2023 to identify randomized controlled trials focusing on the therapeutic efficacy of herbal medicine-acupuncture combination (intervention group) for pediatric epilepsy. The primary outcome was the risk of treatment failure, whereas the secondary outcomes included the risk of post-treatment electroencephalogram (EEG) abnormalities and adverse events. Subgroup analyses were conducted based on the type of herbal compound formulas. Meta-regression analysis was conducted to examine the influence of patient demographics and clinical history on the therapeutic efficacy of herbal medicine-acupuncture combination for pediatric epilepsy. To assess the cumulative evidence, trial sequential analysis (TSA) was performed. RESULTS The analysis included 10 trials involving a total of 882 pediatric patients. Meta-analysis revealed that the intervention group had a lower risk of treatment failure than the control group (risk ratio [RR] = 0.3, 95% confidence interval [CI]: 0.19-0.47, P<0.00001, I2 = 0%, 10 trials). Subgroup analyses showed that therapeutic efficacy was consistent among the different herbal compound formulas. Meta-regression analysis revealed that the efficacy of the treatments did not significantly vary with patient age, male sex, and duration of seizure history. TSA suggested that herbal medicine-acupuncture combination exerted a robust and conclusive effect on seizure treatment. Although the combined used of herbal medicine and acupuncture was not associated with a lower risk of post-treatment EEG abnormalities (RR = 0.82, 95%CI:0.6-1.11, P = 0.2, 3 trials), the risk of adverse events was reduced (RR = 0.27, 95%CI:0.18-0.41, P<0.00001, 4 trials). CONCLUSION The meta-analysis suggested that combined use of herbal medicine and acupuncture is a promising and safe clinical approach for pediatric epilepsy treatment. Further large-scale studies are necessary to conclusively determine the efficacy and safety of herbal medicine and acupuncture in pediatric epilepsy treatment.
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Affiliation(s)
- Hong-Wen Su
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Hsiao-Tien Chen
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chia-Li Kao
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Yao-Tsung Lin
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - Ping-Hsin Liu
- Department of Anesthesiology, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Chien-Ming Lin
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
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Smolińska K, Szopa A, Sobczyński J, Serefko A, Dobrowolski P. Nutritional Quality Implications: Exploring the Impact of a Fatty Acid-Rich Diet on Central Nervous System Development. Nutrients 2024; 16:1093. [PMID: 38613126 PMCID: PMC11013435 DOI: 10.3390/nu16071093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/14/2024] Open
Abstract
Given the comprehensive examination of the role of fatty acid-rich diets in central nervous system development in children, this study bridges significant gaps in the understanding of dietary effects on neurodevelopment. It delves into the essential functions of fatty acids in neurodevelopment, including their contributions to neuronal membrane formation, neuroinflammatory modulation, neurogenesis, and synaptic plasticity. Despite the acknowledged importance of these nutrients, this review reveals a lack of comprehensive synthesis in current research, particularly regarding the broader spectrum of fatty acids and their optimal levels throughout childhood. By consolidating the existing knowledge and highlighting critical research gaps, such as the effects of fatty acid metabolism on neurodevelopmental disorders and the need for age-specific dietary guidelines, this study sets a foundation for future studies. This underscores the potential of nutritional strategies to significantly influence neurodevelopmental trajectories, advocating an enriched academic and clinical understanding that can inform dietary recommendations and interventions aimed at optimizing neurological health from infancy.
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Affiliation(s)
- Katarzyna Smolińska
- Chronic Wounds Laboratory, Medical University of Lublin, Chodźki St. 7, 20-093 Lublin, Poland;
| | - Aleksandra Szopa
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Lublin, Chodźki St. 1, 20-093 Lublin, Poland; (A.S.); (J.S.); (A.S.)
| | - Jan Sobczyński
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Lublin, Chodźki St. 1, 20-093 Lublin, Poland; (A.S.); (J.S.); (A.S.)
| | - Anna Serefko
- Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Lublin, Chodźki St. 1, 20-093 Lublin, Poland; (A.S.); (J.S.); (A.S.)
| | - Piotr Dobrowolski
- Department of Functional Anatomy and Cytobiology, Maria Curie Sklodowska University, Akademicka St. 19, 20-033 Lublin, Poland
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Mazzone PP, Weir CJ, Stephen J, Bhattacharya S, Chin RFM. Socioeconomic status in adulthood of children with and without a history of seizures: A retrospective cohort study. Epilepsy Behav 2024; 153:109705. [PMID: 38428172 DOI: 10.1016/j.yebeh.2024.109705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Compare adulthood socioeconomic status for children with and without a history of seizures. METHODS Retrospective cohort study using Aberdeen Children of the Nineteen Fifties (ACONF) data comprising children born 1950-1956 attending primary school 1962-1964, with follow-up data collected in 2001. Adulthood socioeconomic status was based on registrar general measure of occupational social class and categorised as high or low. We adjusted for potentially confounding variables including childhood socioeconomic status, behavioural issues (Rutter A/B scores), biological sex, school test scores, educational attainment, parental engagement with education, peer-status in school, and alcohol use in adulthood. A multivariate binary logistic regression was performed to estimate the adjusted association between children with a history of seizures of any type (for example febrile seizures, or provoked seizures of any other etiology or seizures in the context of epilepsy) or severity and adult socioeconomic status. Multiple imputation using the Monte-Carlo-Markov-Chain method accounted for missing data. RESULTS Pooled estimates (N = 2,208) comparing children with a history of seizures (n = 81) and children without a history of seizures (n = 2,127) found no differences between these cohorts in terms of adulthood socioeconomic status in both unadjusted (Odds Ratio (OR) 1.45 [95 % CI 0.71-2.96], p = 0.31) and adjusted (1.02 [0.46, 2.24], p = 0.96) analyses. Compared to males, females were at increased odds of having a lower socioeconomic status in adulthood (1.56 [1.13-2.17], p = 0.01).Compared to those with low educational attainment, those with moderate (0.32 [0.21, 0.48], p < 0.001) and high (0.12 [0.07, 0.20], p < 0.001) educational attainment were at reduced odds of having a lower socioeconomic status in adulthood. CONCLUSION Cognitive problems in childhood (using educational attainment and scores on primary school tests proxy markers for cognition) rather than a history of seizures per se, were associated with lower SES in a population of adults born 1950-56 in Aberdeen. This relationship may be different depending on the time in history and nation/region of study. Given the changes in health, education and social support in the management of children with seizures over time, it would be of interest to investigate outcomes in a contemporary cohort. Such studies should ideally have validated diagnoses of seizures, details on seizure characteristics such as seizure type and severity, and a large sample size using national data.
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Affiliation(s)
- Paolo P Mazzone
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
| | - Christopher J Weir
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, United Kingdom; Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Jacqueline Stephen
- Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Sohinee Bhattacharya
- Formerly of Aberdeen Centre for Women's Health Research, The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Richard F M Chin
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, United Kingdom; Royal Hospital for Children and Young People, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom; Child Life and Health, Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
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Chu H, Wang B, Zhao X, Mu L. Epilepsy and psychiatric comorbidities: A bidirectional mendelian randomization study. J Affect Disord 2024; 350:774-783. [PMID: 38272360 DOI: 10.1016/j.jad.2024.01.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
STUDY OBJECTIVES Psychiatric comorbidities are relatively common among patients with epilepsy; however, the underlying mechanisms of this association remain largely unknown. The objective of this Mendelian randomization (MR) study was to analyze the genetic correlations and causality underlying these reciprocal associations. METHODS Single-nucleotide polymorphisms associated with epilepsy (29,677 controls and 15,212 cases) and seven psychiatric comorbidities (485,436 controls and 269,495 cases) were identified from genome-wide association studies. Causal significance was estimated using inverse variance weighting. Sensitivity analyses included the weighted median, MR-Egger, and MR-PRESSO. The psychiatric comorbidities analyzed in this study included attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder (OCD), and anorexia nervosa. RESULTS Both forward and reverse genetic associations were observed for the selected psychiatric disorders. Notably, ADHD was significantly associated with an increased risk of generalized epilepsy (odds ratio [OR], 1.09; 95 % confidence interval [CI], 1.01-1.18; p = 0.013). However, MR-PRESSO detected the existence of pleiotropy (p = 0.001). Additionally, focal epilepsy was significantly associated with a higher risk of OCD (OR, 1.44; 95 % CI, 1.08-1.92; p = 0.013), and all sensitivity tests yielded favorably nonsignificant results. There was no significant genetic association between epilepsy and other examined psychiatric disorders. However, due to the detection of pleiotropy by MR-Egger and considerations related to the threshold for genetic instruments, a cautious approach is warranted in interpreting some of the results. CONCLUSIONS This study revealed significant genetic causality between focal epilepsy and OCD, as well as between ADHD and generalized epilepsy. However, no casual significance was observed with other psychiatric comorbidities examined. Considering the inherent limitations of MR studies, further research is warranted to definitively clarify these genetic causal associations.
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Affiliation(s)
- Hongyuan Chu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Bing Wang
- Department of Radiotherapy, Jilin Cancer Hospital, Changchun, China
| | - Xinyu Zhao
- Department of Neurology, The People's Hospital of Shuangyashan, Shuangyashan, China
| | - Li Mu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China; Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, China.
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Kamand M, Taleb R, Wathikthinnakon M, Mohamed FA, Ghazanfari SP, Konstantinov D, Hald JL, Holst B, Brasch-Andersen C, Møller RS, Lemke JR, Krey I, Freude K, Chandrasekaran A. Generation of two patient specific GABRD variants and their isogenic controls for modeling epilepsy. Stem Cell Res 2024; 76:103372. [PMID: 38458029 DOI: 10.1016/j.scr.2024.103372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Developmental and epileptic encephalopathies (DEEs) are early-onset conditions that cause intractable seizures and developmental delays. Missense variants in Gamma-aminobutyric acid type A receptor (GABAAR) subunits commonly cause DEEs. Ahring et al. (2022) showed a variant in the gene that encodes the delta subunit (GABRD) is strongly associated with the gain-of-function of extrasynaptic GABAAR. Here, we report the generation of two patient-specific human induced pluripotent stem cells (hiPSC) lines with (i) a de novo variant and (ii) a maternal variant, both for the pathogenic GABRD c.872 C>T, (p.T291I). The variants in the generated cell line were corrected using the CRISPR-Cas9 gene editing technique (respective isogenic control lines).
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Affiliation(s)
- Morad Kamand
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark; Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Reema Taleb
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Methi Wathikthinnakon
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Fadumo Abdullahi Mohamed
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Said Pasalar Ghazanfari
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Denis Konstantinov
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark; Novo Nordisk Foundation Center for Biosustainability (DTU Biosustain) at the Technical University of Denmark, Denmark
| | - Jonas Laugård Hald
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Bjørn Holst
- Bioneer A/S, Kogle Alle 2, 2970 Hørsholm, Denmark
| | - Charlotte Brasch-Andersen
- Department of Clinical Genetics Odense University Hospital, University of Southern Denmark, Odense, Denmark; Department of Clinical Research, Human Genetics, University of Southern Denmark, Odense, Denmark
| | - Rikke S Møller
- Department of Epilepsy Genetics and Personalized Treatment, The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Johannes R Lemke
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany; Center for Rare Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Ilona Krey
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany; Center for Rare Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Kristine Freude
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark
| | - Abinaya Chandrasekaran
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg 1870, Denmark.
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Düken ME, Zengin M. The mediating role of social support in the relationship between psychosocial problems and sleep patterns of adolescents with epilepsy. Epilepsy Behav 2024; 152:109656. [PMID: 38277846 DOI: 10.1016/j.yebeh.2024.109656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
Abstract
AIM This study was conducted to examine the mediating role of social support in the relationship between psychosocial problems of adolescents with epilepsy and their sleep patterns. METHODS The data were collected with Adolescent Information Form, Strength and Difficulties Questionnaire, Sleep Disturbance Scale for Children and Multidimensional Scale of Perceived Social Support in this descriptive and correlational study. The mediating role of multidimensional social support that children with epilepsy received with the Process Macro program was examined in the relationship between their psychosocial problems and their sleep status. Process model 4 was used and analysis was made based on the Bootstrap method. RESULTS As a result of the analysis, it was found that the participants had been diagnosed with epilepsy for a mean of 6.0 ± 1.61 years and had a mean of 3.1 ± 2.48 seizures per week. It was found that the sleep problems experienced by adolescents with epilepsy affected their psychosocial health and this effect was at the level of 84 % (β = 0.933; p < 0.001). The effect of perceived social support on the dependent variable sleep disturbance in adolescents with epilepsy was found to be statistically significant (β = -0.540; p < 0.001). It was determined that the Psychosocial Health Status score of adolescents diagnosed with epilepsy explained 87 % of the change in sleep disturbance experienced with perceived social support (p < 0.001). The effect of social support perceived by adolescents with epilepsy on sleep disturbance was found to be statistically significant. Perceived social support has no effect on the psychosocial problems they experience. CONCLUSIONS It was found that social support was not a mediator in the relationship between psychosocial problems of adolescents with epilepsy and their sleep status.
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Affiliation(s)
- Mehmet Emin Düken
- Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Mürşide Zengin
- Health Sciences of Faculty, Department of Child Health and Diseases Nursing, Adıyaman University, Adıyaman, Turkey.
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10
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Casella C, Vecchiato K, Cromb D, Guo Y, Winkler AM, Hughes E, Dillon L, Green E, Colford K, Egloff A, Siddiqui A, Price A, Grande LC, Wood TC, Malik S, Teixeira RPAG, Carmichael DW, O'Muircheartaigh J. Widespread, depth-dependent cortical microstructure alterations in pediatric focal epilepsy. Epilepsia 2024; 65:739-752. [PMID: 38088235 DOI: 10.1111/epi.17861] [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: 08/18/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Tissue abnormalities in focal epilepsy may extend beyond the presumed focus. The underlying pathophysiology of these broader changes is unclear, and it is not known whether they result from ongoing disease processes or treatment-related side effects, or whether they emerge earlier. Few studies have focused on the period of onset for most focal epilepsies, childhood. Fewer still have utilized quantitative magnetic resonance imaging (MRI), which may provide a more sensitive and interpretable measure of tissue microstructural change. Here, we aimed to determine common spatial modes of changes in cortical architecture in children with heterogeneous drug-resistant focal epilepsy and, secondarily, whether changes were related to disease severity. METHODS To assess cortical microstructure, quantitative T1 and T2 relaxometry (qT1 and qT2) was measured in 43 children with drug-resistant focal epilepsy (age range = 4-18 years) and 46 typically developing children (age range = 2-18 years). We assessed depth-dependent qT1 and qT2 values across the neocortex, as well as their gradient of change across cortical depths. We also determined whether global changes seen in group analyses were driven by focal pathologies in individual patients. Finally, as a proof-of-concept, we trained a classifier using qT1 and qT2 gradient maps from patients with radiologically defined abnormalities (MRI positive) and healthy controls, and tested whether this could classify patients without reported radiological abnormalities (MRI negative). RESULTS We uncovered depth-dependent qT1 and qT2 increases in widespread cortical areas in patients, likely representing microstructural alterations in myelin or gliosis. Changes did not correlate with disease severity measures, suggesting they may represent antecedent neurobiological alterations. Using a classifier trained with MRI-positive patients and controls, sensitivity was 71.4% at 89.4% specificity on held-out MRI-negative patients. SIGNIFICANCE These findings suggest the presence of a potential imaging endophenotype of focal epilepsy, detectable irrespective of radiologically identified abnormalities.
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Affiliation(s)
- Chiara Casella
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Katy Vecchiato
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Daniel Cromb
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Yourong Guo
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Anderson M Winkler
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Emer Hughes
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Louise Dillon
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Elaine Green
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Kathleen Colford
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Alexia Egloff
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Ata Siddiqui
- Department of Radiology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK
| | - Anthony Price
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Lucilio Cordero Grande
- Department of Biomedical Engineering, King's College London, London, UK
- Biomedical Image Technologies, Telecommunication Engineering School (ETSIT), Technical University of Madrid, Bioengineering, Biomaterials and Nanomedicine Networking Biomedical Research Centre, National Institute of Health Carlos III, Madrid, Spain
| | - Tobias C Wood
- Department of Neuroimaging, King's College London, London, UK
| | - Shaihan Malik
- Department of Biomedical Engineering, King's College London, London, UK
| | | | | | - Jonathan O'Muircheartaigh
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department for Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Medical Research Council (MRC) Centre for Neurodevelopmental Disorders, London, UK
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Iyer SH, Yeh MY, Netzel L, Lindsey MG, Wallace M, Simeone KA, Simeone TA. Dietary and Metabolic Approaches for Treating Autism Spectrum Disorders, Affective Disorders and Cognitive Impairment Comorbid with Epilepsy: A Review of Clinical and Preclinical Evidence. Nutrients 2024; 16:553. [PMID: 38398876 PMCID: PMC10893388 DOI: 10.3390/nu16040553] [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: 12/24/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.
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Affiliation(s)
| | | | | | | | | | | | - Timothy A. Simeone
- Department of Pharmacology & Neuroscience, Creighton University School of Medicine, Omaha, NE 68178, USA; (S.H.I.); (K.A.S.)
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12
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Su L, Chang M, Li Y, Ding H, Zhao X, Li B, Li J. Analysis of factors influencing the efficacy of vagus nerve stimulation for the treatment of drug-resistant epilepsy in children and prediction model for efficacy evaluation. Front Neurol 2024; 15:1321245. [PMID: 38419715 PMCID: PMC10899677 DOI: 10.3389/fneur.2024.1321245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Vagus nerve stimulation (VNS) has been widely used in the treatment of drug-resistant epilepsy (DRE) in children. We aimed to explore the efficacy and safety of VNS, focusing on factors that can influence the efficacy of VNS, and construct a prediction model for the efficacy of VNS in the treatment of DRE children. Methods Retrospectively analyzed 45 DRE children who underwent VNS at Qilu Hospital of Shandong University from June 2016 to November 2022. A ≥50% reduction in seizure frequency was defined as responder, logistic regression analyses were performed to analyze factors affecting the efficacy of VNS, and a predictive model was constructed. The predictive model was evaluated by receiver operating characteristic curve (ROC), calibration curves, and decision curve analyses (DCA). Results A total of 45 DRE children were included in this study, and the frequency of seizures was significantly reduced after VNS treatment, with 25 responders (55.6%), of whom 6 (13.3%) achieved seizure freedom. There was a significant improvement in the Quality of Life in Childhood Epilepsy Questionnaire (15.5%) and Seizure Severity Score (46.2%). 16 potential factors affecting the efficacy of VNS were included, and three statistically significant positive predictors were ultimately screened: shorter seizure duration, focal seizure, and absence of intellectual disability. We developed a nomogram for predicting the efficacy of VNS in the treatment of DRE children. The ROC curve confirmed that the predictive model has good diagnostic performance (AUC = 0.864, P < 0.05), and the nomogram can be further validated by bootstrapping for 1,000 repetitions, with a C-index of 0.837. Besides, this model showed good fitting and calibration and positive net benefits in decision curve analysis. Conclusion VNS is a safe and effective treatment for DRE children. We developed a predictive nomogram for the efficacy of VNS, which provides a basis for more accurate selection of VNS patients.
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Affiliation(s)
- Li Su
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Mengmeng Chang
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yumei Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Hao Ding
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaoyu Zhao
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jun Li
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Seth EA, Watterson J, Xie J, Arulsamy A, Md Yusof HH, Ngadimon IW, Khoo CS, Kadirvelu A, Shaikh MF. Feasibility of cardiac-based seizure detection and prediction: A systematic review of non-invasive wearable sensor-based studies. Epilepsia Open 2024; 9:41-59. [PMID: 37881157 PMCID: PMC10839362 DOI: 10.1002/epi4.12854] [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: 05/17/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023] Open
Abstract
A reliable seizure detection or prediction device can potentially reduce the morbidity and mortality associated with epileptic seizures. Previous findings indicating alterations in cardiac activity during seizures suggest the usefulness of cardiac parameters for seizure detection or prediction. This study aims to examine available studies on seizure detection and prediction based on cardiac parameters using non-invasive wearable devices. The Embase, PubMed, and Scopus databases were used to systematically search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Human studies that evaluated seizure detection or prediction based on cardiac parameters collected using wearable devices were included. The QUADAS-2 tool and proposed standards for validation for seizure detection devices were used for quality assessment. Twenty-four articles were identified and included in the analysis. Twenty studies evaluated seizure detection algorithms, and four studies focused on seizure prediction. Most studies used either a wrist-worn or chest-worn device for data acquisition. Among the seizure detection studies, cardiac parameters utilized for the algorithms mainly included heart rate (HR) (n = 11) or a combination of HR and heart rate variability (HRV) (n = 6). HR-based seizure detection studies collectively reported a sensitivity range of 56%-100% and a false alarm rate (FAR) of 0.02-8/h, with most studies performing retrospective validation of the algorithms. Three of the seizure prediction studies retrospectively validated multimodal algorithms, combining cardiac features with other physiological signals. Only one study prospectively validated their seizure prediction algorithm using HRV extracted from ECG data collected from a custom wearable device. These studies have demonstrated the feasibility of using cardiac parameters for seizure detection and prediction with wearable devices, with varying algorithmic performance. Many studies are in the proof-of-principle stage, and evidence for real-time detection or prediction is currently limited. Future studies should prioritize further refinement of the algorithm performance with prospective validation using large-scale longitudinal data. PLAIN LANGUAGE SUMMARY: This systematic review highlights the potential use of wearable devices, like wristbands, for detecting and predicting seizures via the measurement of heart activity. By reviewing 24 articles, it was found that most studies focused on using heart rate and changes in heart rate for seizure detection. There was a lack of studies looking at seizure prediction. The results were promising but most studies were not conducted in real-time. Therefore, more real-time studies are needed to verify the usage of heart activity-related wearable devices to detect seizures and even predict them, which will be beneficial to people with epilepsy.
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Affiliation(s)
- Eryse Amira Seth
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Jessica Watterson
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Department of Human‐Centred ComputingMonash UniversityMelbourneVictoriaAustralia
| | - Jue Xie
- Department of Human‐Centred ComputingMonash UniversityMelbourneVictoriaAustralia
| | - Alina Arulsamy
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Hadri Hadi Md Yusof
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Irma Wati Ngadimon
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of MedicineUniversiti Kebangsaan Malaysia Medical CentreKuala LumpurMalaysia
| | - Amudha Kadirvelu
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Mohd Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwayMalaysia
- School of Dentistry and Medical SciencesCharles Sturt UniversityOrangeNew South WalesAustralia
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14
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Ünalp A, Güzin Y, Ünay B, Tosun A, Çavuşoğlu D, Tekin HG, Kurul SH, Arhan E, Edizer S, Öztürk G, Yiş U, Yılmaz Ü. Retracted: Clinical and genetic evaluations of rare childhood epilepsies in Turkey's national cohort. Epileptic Disord 2023; 25:924. [PMID: 37584621 DOI: 10.1002/epd2.20150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 12/25/2022] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Abstract
Aycan Ünalp, Yiğithan Güzin, Bülent Ünay, Ayşe Tosun, Dilek Çavuşoğlu, Hande Gazeteci Tekin, Semra Hız Kurul, Ebru Arhan, Selvinaz Edizer, Gülten Öztürk, Uluç Yiş, Ünsal Yılmaz, Turkish Rare Epilepsies Study Group, Clinical and genetic evaluations of rare childhood epilepsies in Turkey's national cohort, Epileptic Disorders, 2023, (https://doi.org/10.1002/epd2.20150) The above article, published online on 16 August 2023 on Wiley Online Library (www.onlinelibrary.wiley.com), has been retracted by agreement between the authors, the Editor-in-Chief, Sándor Beniczky, and John Wiley & Sons Ltd. The authors asked for a retraction based on an experimental error which would alter the results of the study if corrected.
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15
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Yang L, Zhang Q, Wu XQ, Qiu XY, Fei F, Lai NX, Zheng YY, Zhang MD, Zhang QY, Wang Y, Wang F, Xu CL, Ruan YP, Wang Y, Chen Z. Chemogenetic inhibition of subicular seizure-activated neurons alleviates cognitive deficit in male mouse epilepsy model. Acta Pharmacol Sin 2023; 44:2376-2387. [PMID: 37488426 PMCID: PMC10692337 DOI: 10.1038/s41401-023-01129-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
Cognitive deficit is a common comorbidity in temporal lobe epilepsy (TLE) and is not well controlled by current therapeutics. How epileptic seizure affects cognitive performance remains largely unclear. In this study we investigated the role of subicular seizure-activated neurons in cognitive impairment in TLE. A bipolar electrode was implanted into hippocampal CA3 in male mice for kindling stimulation and EEG recording; a special promoter with enhanced synaptic activity-responsive element (E-SARE) was used to label seizure-activated neurons in the subiculum; the activity of subicular seizure-activated neurons was manipulated using chemogenetic approach; cognitive function was assessed in object location memory (OLM) and novel object recognition (NOR) tasks. We showed that chemogenetic inhibition of subicular seizure-activated neurons (mainly CaMKIIα+ glutamatergic neurons) alleviated seizure generalization and improved cognitive performance, but inhibition of seizure-activated GABAergic interneurons had no effect on seizure and cognition. For comparison, inhibition of the whole subicular CaMKIIα+ neuron impaired cognitive function in naïve mice in basal condition. Notably, chemogenetic inhibition of subicular seizure-activated neurons enhanced the recruitment of cognition-responsive c-fos+ neurons via increasing neural excitability during cognition tasks. Our results demonstrate that subicular seizure-activated neurons contribute to cognitive impairment in TLE, suggesting seizure-activated neurons as the potential therapeutic target to alleviate cognitive impairment in TLE.
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Affiliation(s)
- Lin Yang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Qi Zhang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xue-Qing Wu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xiao-Yun Qiu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Fan Fei
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Zhejiang Rehabilitation Medical Center, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310013, China
| | - Nan-Xi Lai
- Institute of Pharmacology & Toxicology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Yu-Yi Zheng
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Meng-di Zhang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Qing-Yang Zhang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yu Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Fei Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ceng-Lin Xu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ye-Ping Ruan
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
- Zhejiang Rehabilitation Medical Center, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310013, China.
- Institute of Pharmacology & Toxicology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
- Institute of Pharmacology & Toxicology, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, 310058, China.
- Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
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16
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Ailion A, Duong P, Maiman M, Tsuboyama M, Smith ML. Clinical recommendations for conducting pediatric functional language and memory mapping during the phase I epilepsy presurgical workup. Clin Neuropsychol 2023:1-25. [PMID: 37985747 DOI: 10.1080/13854046.2023.2281708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Objective: Pediatric epilepsy surgery effectively controls seizures but may risk cognitive, language, or memory decline. Historically, the intra-carotid anesthetic procedure (IAP or Wada Test) was pivotal for language and memory function. However, advancements in noninvasive mapping, notably functional magnetic resonance imaging (fMRI), have transformed clinical practice, reducing IAP's role in presurgical evaluations. Method: We conducted a critical narrative review on mapping technologies, including factors to consider for discordance. Results: Neuropsychological findings suggest that if pre-surgery function remains intact and the surgery targets the eloquent cortex, there is a high chance for decline. Memory and language decline are particularly pronounced post-left anterior temporal lobe resection (ATL), making presurgical cognitive assessment crucial for predicting postoperative outcomes. However, the risk of functional decline is not always clear - particularly with higher rates of atypical organization in pediatric epilepsy patients and discordant findings from cognitive mapping. We found little research to date on the use of IAP and other newer technologies for lateralization/localization in pediatric epilepsy. Based on this review, we introduce an IAP decision tree to systematically navigate discordance in IAP decisions for epilepsy presurgical workup. Conclusions: Future research should be aimed at pediatric populations to improve the precision of functional mapping, determine which methods predict post-surgical deficits and then create evidence-based practice guidelines to standardize mapping procedures. Explicit directives are needed for resolving conflicts between developing mapping procedures and established clinical measures. The proposed decision tree is the first step to standardize when to consider IAP or invasive mapping, in coordination with the multidisciplinary epilepsy surgical team.
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Affiliation(s)
- Alyssa Ailion
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School
- Department of Neurology, Boston Children's Hospital, Harvard Medical School
| | - Priscilla Duong
- Department of Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University School of Medicine
| | - Moshe Maiman
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School
| | - Melissa Tsuboyama
- Department of Neurology, Boston Children's Hospital, Harvard Medical School
| | - Mary Lou Smith
- Department of Psychology, The Hospital for Sick Children, University of Toronto Mississauga
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17
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Ghosh S, Sinha JK, Ghosh S, Sharma H, Bhaskar R, Narayanan KB. A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management. Brain Sci 2023; 13:1305. [PMID: 37759906 PMCID: PMC10527076 DOI: 10.3390/brainsci13091305] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.
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Affiliation(s)
- Shampa Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
- ICMR—National Institute of Nutrition, Tarnaka, Hyderabad 500007, India
| | | | - Soumya Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
| | | | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
| | - Kannan Badri Narayanan
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
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18
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Kraus D, Farah R, Fischer H, Vannest J, Wade SL, Radhakrishnan R, Modi AC, Horowitz-Kraus T. Altered white matter organization and its correlations with executive functioning among adolescents with epilepsy. Eur J Paediatr Neurol 2023; 46:82-88. [PMID: 37540964 DOI: 10.1016/j.ejpn.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
Deficits in executive functions (EF) are a common comorbidity among adolescents with epilepsy. EF deficits were previously correlated with altered connectivity of the fronto-parietal and cingulo-opercular neural networks. The current study investigated white matter integrity in adolescents with epilepsy (n = 29) relative to healthy controls (n = 19). Participants completed questionnaires, neuropsychological testing, and brain magnetic resonance imaging (MRI) that included diffusion tensor imaging (DTI) sequences. On BRIEF parent-report questionnaires, adolescents with epilepsy demonstrated lower working memory and planning abilities than healthy controls. Among adolescents with epilepsy, DTI measurements revealed lower fractional anisotropy (FA) within the right superior longitudinal fasciculus, forceps minor, and the superior frontal segment of the corpus callosum, and higher FA in the left uncinate fasciculus, compared to healthy controls. Better working memory ability in the epilepsy group was associated with higher FA in the superior frontal segment of the corpus callosum. Only in healthy controls, working memory and planning were positively associated with FA values in the left UF, forceps minor and the superior frontal segment of the corpus callosum. The current study complements previous functional studies on the same cohort and suggests that EF impairments among adolescents with epilepsy may be related to the altered anatomical organization of white matter tracts. Combining structural and functional data could potentially enrich the neuropsychological assessment of executive functioning in adolescents with epilepsy.
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Affiliation(s)
- Dror Kraus
- Pediatric Neurology Institute, Schneider Children's Medical Center of Israel, Tel Aviv University, Israel
| | - Rola Farah
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Haya Fischer
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Jennifer Vannest
- Department of Speech and Language Pathology, Cincinnati Children's Hospital Medical Center, USA
| | - Shari L Wade
- Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel; Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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19
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Fitneva SA, Corbett BA, Prasad AN. Psychosocial correlates of neurodevelopmental disabilities in 2- to 3-year-olds. Epilepsy Behav 2023; 146:109370. [PMID: 37556967 DOI: 10.1016/j.yebeh.2023.109370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023]
Abstract
RATIONALE Canada's National Longitudinal Study of Children and Youth survey data provide insights into chronic health conditions in children. Children with neurodevelopmental disabilities (NDD) are at increased risk for adverse behavioral outcomes. METHODS We examined data from 3 cycles of Canada's National Longitudinal Survey of Children and Youth for the presence of epilepsy (Epi), cerebral palsy (CP), and intellectual disability (ID) in 2- to 3-year-olds. We then examined the relationship of NDD to composite measures of behavior: hyperactivity-inattention (HI), prosocial behaviors (PS), emotional disorder-anxiety (EA), physical aggression oppositional behavior (AO), and separation anxiety (SA). RESULTS There were 15 children with Epi, 25 with CP and 28 with ID in a sample of 10,879, which represented a population of 756,848 2- to 3-year-old Canadian children. Comparison of mean scores of the NDD groups and controls (Welch's ANOVA), indicated statistically significant differences in HI, PS, EA, and SA at the p < 0.001 level. Post hoc analysis showed significant intergroup differences. Children with epilepsy did not differ from controls on any of the behavioral measures. However, in comparison to controls, children with intellectual disability had higher EA and SA scores and lower PS scores, and those with cerebral palsy had lower PS scores. CONCLUSIONS Children with NDD show differences in behavioral outcomes at a very early age when compared with controls. Screening for these behaviors and early intervention programs may help avoid longer term psychiatric comorbidity associated with these disabilities.
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Affiliation(s)
| | - Bradley A Corbett
- Richard Ivey School of Business, Western University, London, ON, Canada
| | - Asuri N Prasad
- Division of Pediatric Neurology, Dept. of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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20
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Pan PY, Taylor MJ, Larsson H, Almqvist C, Lichtenstein P, Lundström S, Bölte S. Genetic and environmental contributions to co-occurring physical health conditions in autism spectrum condition and attention-deficit/hyperactivity disorder. Mol Autism 2023; 14:17. [PMID: 37085910 PMCID: PMC10122407 DOI: 10.1186/s13229-023-00548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/13/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Autism spectrum condition and attention-deficit/hyperactivity disorder (ADHD) are associated with a range of physical health conditions. The aim of this study was to examine the etiological components contributing to co-occurring physical health conditions in autism and ADHD. METHODS In this nationwide Child and Adolescent Twin Study in Sweden, we analyzed data from 10,347 twin pairs aged 9 and 12. Clinical diagnoses of autism, ADHD, and physical health conditions were identified through the Swedish National Patient Register. Subclinical phenotypes of autism and ADHD were defined by symptom thresholds on a standardized parent-interview, the Autism-Tics, ADHD, and Other Comorbidities inventory. Associations between physical health conditions and autism/ADHD phenotypes were examined using generalized estimating equations. Bivariate twin models were applied to estimate the extent to which genetic and environmental risk factors accounted for physical health comorbidities. RESULTS Similar patterns of association with physical health conditions were found in clinical and subclinical autism/ADHD, with odds ratios ranging from 1.31 for asthma in subclinical ADHD to 8.03 for epilepsy in clinical autism. The estimated genetic correlation (ra) with epilepsy was 0.50 for clinical autism and 0.35 for subclinical autism. In addition, a modest genetic correlation was estimated between clinical autism and constipation (ra = 0.31), functional diarrhea (ra = 0.27) as well as mixed gastrointestinal disorders (ra = 0.30). Genetic effects contributed 0.86 for mixed gastrointestinal disorders in clinical ADHD (ra = 0.21). Finally, subclinical ADHD shared genetic risk factors with epilepsy, constipation, and mixed gastrointestinal disorders (ra = 0.30, 0.17, and 0.17, respectively). LIMITATIONS Importantly, since medical records from primary care were not included in the registry data used, we probably identified only more severe rather than the full range of physical health conditions. Furthermore, it needs to be considered that the higher prevalence of physical health conditions among autistic children and children with ADHD could be associated with the increased number of medical visits. CONCLUSIONS Shared genetic effects contribute significantly to autism and ADHD phenotypes with the co-occurring physical health conditions across different organ systems, including epilepsy and gastrointestinal disorders. The shared genetic liability with co-occurring physical health conditions was present across different levels of autism and ADHD symptom severity.
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Affiliation(s)
- Pei-Yin Pan
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22, 11330, Stockholm, Sweden.
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Berzelius Väg 8, Solna, 17165, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Berzelius Väg 8, Solna, 17165, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Berzelius Väg 8, Solna, 17165, Stockholm, Sweden
- Lung and Allergy Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Eugeniavägen 23, Solna, 17164, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Berzelius Väg 8, Solna, 17165, Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Kungsgatan 12, 41119, GothenburgGöteborg, Sweden
- Centre for Ethics, Law, and Mental Health, University of Gothenburg, Universitetsplatsen 1, 41124, Gothenburg, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22, 11330, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Solnavägen 1E, 113 65, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
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21
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He Z, Li J. The therapeutic effects of lacosamide on epilepsy-associated comorbidities. Front Neurol 2023; 14:1063703. [PMID: 37006477 PMCID: PMC10062524 DOI: 10.3389/fneur.2023.1063703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Epilepsy is a chronic neurological disorder associated with severe social and psychological effects, and most epilepsy patients often report at least one comorbidity. Accumulating evidence have suggested that lacosamide, a new generation of anti-seizure medications, may exhibit efficacy in the management of both epilepsy and its related comorbidities. Therefore, this narrative review aimed to elucidate the recent advancements regarding the therapeutic role of lacosamide in epilepsy-associated comorbidities. The possible pathophysiological mechanisms between epilepsy and epilepsy-associated comorbidities have been also partially described. Whether lacosamide improves cognitive and behavioral functions in patients with epilepsy has not been conclusively established. Some studies support that lacosamide may alleviate anxiety and depression in epilepsy patients. In addition, lacosamide has been found to be safe and effective in the treatment of epilepsy in people with intellectual disabilities, epilepsy of cerebrovascular etiology, and epilepsy associated with brain tumors. Moreover, lacosamide treatment has demonstrated fewer side effects on other systems. Hence, future larger and higher quality clinical studies are needed to further explore both the safety and efficacy of lacosamide in the treatment of epilepsy-associated comorbidities.
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22
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Smith ML, Risse G, Sziklas V, Banks S, Small D, Frasnelli J, Klein D. Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead. Cognition and Sensory Systems in Healthy and Diseased Subjects. Epilepsy Behav 2023; 140:109119. [PMID: 36804713 DOI: 10.1016/j.yebeh.2023.109119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/18/2023]
Abstract
This article summarizes selected presentations from a session titled "Cognition and Sensory Systems in Healthy and Diseased Subjects", held to highlight and honor the work of Dr. Marilyn Jones-Gotman. The session was part of a two-day symposium, "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". The session presented research on epilepsy and sensory systems by colleagues and former trainees of Dr. Jones-Gotman. The extended summaries provide an overview of historical and current work in the neuropsychology of epilepsy, neuropsychological and neuroimaging approaches to understanding brain organization, sex differences in brain mechanisms underlying neurological disorders, dietary influences on brain function and cognition, and expertise in olfactory training and language experiences and their implications for brain organization and structure.
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Affiliation(s)
- Mary Lou Smith
- Department of Psychology, University of Toronto Mississauga; Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada.
| | - Gail Risse
- Minnesota Epilepsy Group, Roseville, MN, USA; Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Viviane Sziklas
- Department of Neurology and Neurosurgery; Department of Psychology, McGill University, Montreal, QC, Canada
| | - Sarah Banks
- Departments of Neuroscience and Psychiatry, University of California, San Diego, CA, USA
| | - Dana Small
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Denise Klein
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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23
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Oldrati V, Minghetti S, Zanotta N, Bardoni A, Zucca C. Etiology and duration of the disease in the assessment of intellectual functioning of pediatric patients with epilepsy: An observational study. Heliyon 2023; 9:e14085. [PMID: 36915569 PMCID: PMC10006677 DOI: 10.1016/j.heliyon.2023.e14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Childhood epilepsy can be frequently associated with impaired cognitive functioning. Previous research has suggested an increased risk of cognitive impairment that may be related to the etiology, the electro-clinical pattern and the load of anti-seizure medications (ASMs). The aim of this study was to evaluate the impact of different clinical features on the global intellectual functioning in a cohort of children and adolescents with epilepsy. We studied eighty patients diagnosed and followed in a tertiary care center. These factors were examined: 1. Etiology of epileptic syndrome; 2. Type of seizure; 3. Number of ASMs; 4. Seizure frequency; 5. Age at seizure onset; 6. Total duration of epilepsy; and 7. Active duration of epilepsy. Multiple regression analysis showed that the etiology and the total duration of epilepsy were the best indicators of intellectual functioning. The present data indicate that children with symptomatic epilepsy (SE) have lower IQ scores (M = 63.5), while children with self-limited focal epilepsy and generalized idiopathic epilepsy, i.e. age-related epileptic syndromes (ARES), have a higher IQ (M = 100.0; p < 0.01). Children with epilepsy of unknown etiology (UEE) (M = 75.1; p < 0.05) are positioned at an intermediate level between the SE and the ARES group (p < 0.01). Increased duration of epilepsy was associated with decreased intellectual functioning. In conclusion, knowledge about the risks associated with etiologic factors and the duration of the disease may guide the definition of optimal neuropsychological rehabilitation strategies.
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Affiliation(s)
- Viola Oldrati
- Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
| | - Sara Minghetti
- Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
| | - Nicoletta Zanotta
- Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
| | - Alessandra Bardoni
- Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
| | - Claudio Zucca
- Scientific Institute IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
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24
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Forrest MP, Dos Santos M, Piguel NH, Wang YZ, Hawkins NA, Bagchi VA, Dionisio LE, Yoon S, Simkin D, Martin-de-Saavedra MD, Gao R, Horan KE, George AL, LeDoux MS, Kearney JA, Savas JN, Penzes P. Rescue of neuropsychiatric phenotypes in a mouse model of 16p11.2 duplication syndrome by genetic correction of an epilepsy network hub. Nat Commun 2023; 14:825. [PMID: 36808153 PMCID: PMC9938216 DOI: 10.1038/s41467-023-36087-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/16/2023] [Indexed: 02/19/2023] Open
Abstract
Neuropsychiatric disorders (NPDs) are frequently co-morbid with epilepsy, but the biological basis of shared risk remains poorly understood. The 16p11.2 duplication is a copy number variant that confers risk for diverse NPDs including autism spectrum disorder, schizophrenia, intellectual disability and epilepsy. We used a mouse model of the 16p11.2 duplication (16p11.2dup/+) to uncover molecular and circuit properties associated with this broad phenotypic spectrum, and examined genes within the locus capable of phenotype reversal. Quantitative proteomics revealed alterations to synaptic networks and products of NPD risk genes. We identified an epilepsy-associated subnetwork that was dysregulated in 16p11.2dup/+ mice and altered in brain tissue from individuals with NPDs. Cortical circuits from 16p11.2dup/+ mice exhibited hypersynchronous activity and enhanced network glutamate release, which increased susceptibility to seizures. Using gene co-expression and interactome analysis, we show that PRRT2 is a major hub in the epilepsy subnetwork. Remarkably, correcting Prrt2 copy number rescued aberrant circuit properties, seizure susceptibility and social deficits in 16p11.2dup/+ mice. We show that proteomics and network biology can identify important disease hubs in multigenic disorders, and reveal mechanisms relevant to the complex symptomatology of 16p11.2 duplication carriers.
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Affiliation(s)
- Marc P Forrest
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Marc Dos Santos
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Nicolas H Piguel
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Yi-Zhi Wang
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Nicole A Hawkins
- Department of Pharmacology Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Vikram A Bagchi
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Leonardo E Dionisio
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Sehyoun Yoon
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Dina Simkin
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Pharmacology Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Maria Dolores Martin-de-Saavedra
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Instituto Universitario de Investigación en Neuroquímica, Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad Complutense, 28040, Madrid, Spain
| | - Ruoqi Gao
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Katherine E Horan
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Alfred L George
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Pharmacology Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Mark S LeDoux
- Department of Psychology, University of Memphis, Memphis, TN, 38152, USA
- Veracity Neuroscience LLC, Memphis, TN, 38157, USA
| | - Jennifer A Kearney
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Pharmacology Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Jeffrey N Savas
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Peter Penzes
- Department of Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
- Center for Autism and Neurodevelopment, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
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25
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Iqbal S, Brünger T, Pérez-Palma E, Macnee M, Brunklaus A, Daly MJ, Campbell AJ, Hoksza D, May P, Lal D. Delineation of functionally essential protein regions for 242 neurodevelopmental genes. Brain 2023; 146:519-533. [PMID: 36256779 PMCID: PMC9924913 DOI: 10.1093/brain/awac381] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/12/2022] [Accepted: 09/04/2022] [Indexed: 01/25/2023] Open
Abstract
Neurodevelopmental disorders (NDDs), including severe paediatric epilepsy, autism and intellectual disabilities are heterogeneous conditions in which clinical genetic testing can often identify a pathogenic variant. For many of them, genetic therapies will be tested in this or the coming years in clinical trials. In contrast to first-generation symptomatic treatments, the new disease-modifying precision medicines require a genetic test-informed diagnosis before a patient can be enrolled in a clinical trial. However, even in 2022, most identified genetic variants in NDD genes are 'variants of uncertain significance'. To safely enrol patients in precision medicine clinical trials, it is important to increase our knowledge about which regions in NDD-associated proteins can 'tolerate' missense variants and which ones are 'essential' and will cause a NDD when mutated. In addition, knowledge about functionally indispensable regions in the 3D structure context of proteins can also provide insights into the molecular mechanisms of disease variants. We developed a novel consensus approach that overlays evolutionary, and population based genomic scores to identify 3D essential sites (Essential3D) on protein structures. After extensive benchmarking of AlphaFold predicted and experimentally solved protein structures, we generated the currently largest expert curated protein structure set for 242 NDDs and identified 14 377 Essential3D sites across 189 gene disorders associated proteins. We demonstrate that the consensus annotation of Essential3D sites improves prioritization of disease mutations over single annotations. The identified Essential3D sites were enriched for functional features such as intermembrane regions or active sites and discovered key inter-molecule interactions in protein complexes that were otherwise not annotated. Using the currently largest autism, developmental disorders, and epilepsies exome sequencing studies including >360 000 NDD patients and population controls, we found that missense variants at Essential3D sites are 8-fold enriched in patients. In summary, we developed a comprehensive protein structure set for 242 NDDs and identified 14 377 Essential3D sites in these. All data are available at https://es-ndd.broadinstitute.org for interactive visual inspection to enhance variant interpretation and development of mechanistic hypotheses for 242 NDDs genes. The provided resources will enhance clinical variant interpretation and in silico drug target development for NDD-associated genes and encoded proteins.
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Affiliation(s)
- Sumaiya Iqbal
- The Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Tobias Brünger
- Cologne Center for Genomics, University of Cologne, 50923 Köln, Germany
| | - Eduardo Pérez-Palma
- Universidad del Desarrollo, Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana, 7610658 Las Condes, Santiago de Chile, Chile
| | - Marie Macnee
- Cologne Center for Genomics, University of Cologne, 50923 Köln, Germany
| | - Andreas Brunklaus
- The Paediatric Neurosciences Research Group, Royal Hospital for Children, Glasgow G12 8QQ, UK
- School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Mark J Daly
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Institute for Molecular Medicine Finland (FIMM), Centre of Excellence in Complex Disease Genetics, University of Helsinki, 00100 Helsinki, Finland
| | - Arthur J Campbell
- The Center for the Development of Therapeutics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - David Hoksza
- Department of Software Engineering, Faculty of Mathematics and Physics, Charles University, 110 00 Staré Město, Czechia, Czech Republic
| | - Patrick May
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
| | - Dennis Lal
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Cologne Center for Genomics, University of Cologne, 50923 Köln, Germany
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Genomic Medicine Institute, Lerner Research Institute Cleveland Clinic, Cleveland, OH 44106, USA
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26
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Zhuang XF, Liu YX, Yang ZH, Gao Q, Wang L, Ju C, Wang K. Attenuation of Epileptogenesis and Cognitive Deficits by a Selective and Potent Kv7 Channel Opener in Rodent Models of Seizures. J Pharmacol Exp Ther 2023; 384:315-325. [PMID: 36396352 DOI: 10.1124/jpet.122.001328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/12/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
Targeting neuronal Kv7 channels by pharmacological activation has been proven to be an attractive therapeutic strategy for epilepsy. Here, we show that activation of Kv7 channels by an opener SCR2682 dose-dependently reduces seizure activity and severity in rodent models of epilepsy induced by a GABAa receptor antagonist pentylenetetrazole (PTZ), maximal electroshock, and a glutamate receptor agonist kainic acid (KA). Electroencephalographic recordings of rat cerebral cortex confirm that SCR2682 also decreases epileptiform discharges in KA-induced seizures. Nissl and neuronal nuclei staining further demonstrates that SCR2682 also protects neurons from injury induced by KA. In Morris water maze navigation and Y-maze tests, SCR2682 improves PTZ- and KA-induced cognitive impairment. Taken together, our findings demonstrate that pharmacological activation of Kv7 by novel opener SCR2682 may hold promise for therapy of epilepsy with cognitive impairment. SIGNIFICANCE STATEMENT: A neuronal Kv7 channel opener SCR2682 attenuates epileptogenesis and seizure-induced cognitive impairment in rodent models of seizures, thus possessing a developmental potential for effective therapy of epilepsy with cognitive impairment.
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Affiliation(s)
- Xiao-Fei Zhuang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - Yu-Xue Liu
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - Zhi-Hong Yang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - Qin Gao
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - Lei Wang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - Chuanxia Ju
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
| | - KeWei Wang
- Department of Pharmacology, School of Pharmacy, Qingdao University Medical College (X.-F.Z., Y.-X.L., Z.-H.Y., Q.G., L.W., C.J., K.W.) and Institute of Innovative Drugs, Qingdao University, Qingdao, China (K.W.)
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27
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Löscher W, Stafstrom CE. Epilepsy and its neurobehavioral comorbidities: Insights gained from animal models. Epilepsia 2023; 64:54-91. [PMID: 36197310 DOI: 10.1111/epi.17433] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 01/21/2023]
Abstract
It is well established that epilepsy is associated with numerous neurobehavioral comorbidities, with a bidirectional relationship; people with epilepsy have an increased incidence of depression, anxiety, learning and memory difficulties, and numerous other psychosocial challenges, and the occurrence of epilepsy is higher in individuals with those comorbidities. Although the cause-and-effect relationship is uncertain, a fuller understanding of the mechanisms of comorbidities within the epilepsies could lead to improved therapeutics. Here, we review recent data on epilepsy and its neurobehavioral comorbidities, discussing mainly rodent models, which have been studied most extensively, and emphasize that clinically relevant information can be gained from preclinical models. Furthermore, we explore the numerous potential factors that may confound the interpretation of emerging data from animal models, such as the specific seizure induction method (e.g., chemical, electrical, traumatic, genetic), the role of species and strain, environmental factors (e.g., laboratory environment, handling, epigenetics), and the behavioral assays that are chosen to evaluate the various aspects of neural behavior and cognition. Overall, the interplay between epilepsy and its neurobehavioral comorbidities is undoubtedly multifactorial, involving brain structural changes, network-level differences, molecular signaling abnormalities, and other factors. Animal models are well poised to help dissect the shared pathophysiological mechanisms, neurological sequelae, and biomarkers of epilepsy and its comorbidities.
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Affiliation(s)
- Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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28
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Operto FF, Pastorino GMG, Viggiano A, Dell’Isola GB, Dini G, Verrotti A, Coppola G. Epilepsy and Cognitive Impairment in Childhood and Adolescence: A Mini-Review. Curr Neuropharmacol 2023; 21:1646-1665. [PMID: 35794776 PMCID: PMC10514538 DOI: 10.2174/1570159x20666220706102708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
Managing epilepsy in people with an intellectual disability remains a therapeutic challenge and must take into account additional issues such as diagnostic difficulties and frequent drug resistance. Advances in genomic technologies improved our understanding of epilepsy and raised the possibility to develop patients-tailored treatments acting on the key molecular mechanisms involved in the development of the disease. In addition to conventional antiseizure medications (ASMs), ketogenic diet, hormone therapy and epilepsy surgery play an important role, especially in cases of drugresistance. This review aims to provide a comprehensive overview of the mainfactors influencing cognition in children and adolescents with epilepsy and the main therapeutic options available for the epilepsies associated with intellectual disability.
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Affiliation(s)
- Francesca Felicia Operto
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, SA, Italy
| | - Grazia Maria Giovanna Pastorino
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, SA, Italy
| | - Andrea Viggiano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, SA, Italy
| | | | - Gianluca Dini
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of Perugia, Giorgio Menghini Square, 06129 Perugia, Italy
| | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, SA, Italy
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29
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Morey N, Przybyla M, van der Hoven J, Ke YD, Delerue F, van Eersel J, Ittner LM. Treatment of epilepsy using a targeted p38γ kinase gene therapy. SCIENCE ADVANCES 2022; 8:eadd2577. [PMID: 36459557 PMCID: PMC10936047 DOI: 10.1126/sciadv.add2577] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/19/2022] [Indexed: 06/17/2023]
Abstract
Hyperphosphorylated microtubule-associated protein tau has been implicated in dementia, epilepsy, and other neurological disorders. In contrast, site-specific phosphorylation of tau at threonine 205 (T205) by the kinase p38γ was shown to disengage tau from toxic pathways, serving a neuroprotective function in Alzheimer's disease. Using a viral-mediated gene delivery approach in different mouse models of epilepsy, we show that p38γ activity-enhancing treatment reduces seizure susceptibility, restores neuronal firing patterns, reduces behavioral deficits, and ameliorates epilepsy-induced deaths. Furthermore, we show that p38γ-mediated phosphorylation of tau at T205 is essential for this protection in epilepsy, as a lack of this critical interaction reinstates pathological features and accelerates epilepsy in vivo. Hence, our work provides a scope to harness p38γ as a future therapy applicable to acute neurological conditions.
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Affiliation(s)
- Nicolle Morey
- Dementia Research Centre, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Magdalena Przybyla
- Dementia Research Centre, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Julia van der Hoven
- Dementia Research Centre, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Yazi D. Ke
- Dementia Research Centre, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Fabien Delerue
- Dementia Research Centre, Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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30
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Beesley RE, Lew AR, Hindley D, Jameson H, Panwar N, Walton C. Carer's perceptions of paediatric epilepsy services with and without epilepsy specialist nurses: A thematic analysis. Seizure 2022; 103:26-31. [DOI: 10.1016/j.seizure.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/20/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
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31
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Le JT, Ballester-Rosado CJ, Frost JD, Swann JW. Neurobehavioral deficits and a progressive ictogenesis in the tetrodotoxin model of epileptic spasms. Epilepsia 2022; 63:3078-3089. [PMID: 36179064 PMCID: PMC9742150 DOI: 10.1111/epi.17428] [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: 06/29/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Our goal was to determine whether animals with a history of epileptic spasms have learning and memory deficits. We also used continuous (24/7) long-term electroencephalographic (EEG) recordings to evaluate the evolution of epileptiform activity in the same animals over time. METHODS Object recognition memory and object location memory tests were undertaken, as well as a matching to place water maze test that evaluated working memory. A retrospective analysis was undertaken of long-term video/EEG recordings from rats with epileptic spasms. The frequency and duration of the ictal events of spasms were quantified. RESULTS Rats with a history of epileptic spasms showed impairment on the three behavioral tests, and their scores on the object recognition memory and matching to place water maze tests indicated neocortical involvement in the observed impaired cognition. Analysis of EEG recordings unexpectedly showed that the ictal events of spasms and their accompanying behaviors progressively increased in duration over a 2-week period soon after onset, after which spasm duration plateaued. At the same time, spasm frequency remained unchanged. Soon after spasm onset, ictal events were variable in wave form but became more stereotyped as the syndrome evolved. SIGNIFICANCE Our EEG findings are the first to demonstrate progressive ictogenesis for epileptic spasms. Furthermore, in demonstrating cognitive deficits in the tetrodotoxin model, we have met a criterion for an animal model of West syndrome. Animal models will allow in-depth studies of spasm progression's potential role in cognitive regression and may elucidate why early treatment is considered essential for improved neurodevelopmental outcomes in children.
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Affiliation(s)
- John T. Le
- The Cain Foundation Laboratories, the Jan and Dan Neurological Research Institute, Texas Children’s Hospital, Houston Texas
- Department of Pediatrics, Baylor College of Medicine, Houston Texas
| | - Carlos J. Ballester-Rosado
- The Cain Foundation Laboratories, the Jan and Dan Neurological Research Institute, Texas Children’s Hospital, Houston Texas
- Department of Pediatrics, Baylor College of Medicine, Houston Texas
| | - James D. Frost
- Department of Neurology, Baylor College of Medicine, Houston Texas
| | - John W. Swann
- The Cain Foundation Laboratories, the Jan and Dan Neurological Research Institute, Texas Children’s Hospital, Houston Texas
- Department of Pediatrics, Baylor College of Medicine, Houston Texas
- Department of Neuroscience, Baylor College of Medicine, Houston Texas
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32
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Glutig K, Lange L, Krüger PC, Gräger S, de Vries H, Brandl U, Gaser C, Mentzel HJ. Differences in Cerebellar Volume as a Diagnostic and Prognostic Biomarker in Children and Adolescents With Epilepsy of Unknown Etiology. J Child Neurol 2022; 37:939-948. [PMID: 36113051 PMCID: PMC9703387 DOI: 10.1177/08830738221114241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVE Epilepsy is one of the most common brain diseases during childhood and adolescence. Atrophy in different brain areas is possible during epilepsy. This study aimed to verify whether cerebellar volume differences could be detected by volume analysis using magnetic resonance imaging (MRI) in children with epilepsy. METHOD In this retrospective study, 41 children (3.1-18.8 years) with epilepsy of unknown etiology were included (duration of epilepsy 1.9 ± 3 years). A cranial MRI with a volumetric 3-dimensional, T1-weighted sequence was used for volume analysis. The MRIs of 26 patients with headache (5.3-17.1 years) were analyzed for comparison. A volume analysis of the cerebellum was performed using region-based morphometry. Total cerebellar volume, total white and gray matter volume, and 48 regional lobules (L), separated into white and gray matter, were calculated. Cerebellar volumes are presented in relative ratios as the volume fraction of cerebellar volume to total intracranial volume: CV/TIV. RESULTS The ratio of overall white matter volume was significantly lower in the case group (23.93 × 10-3, P = .039). A significantly lower ratio of regional white matter volume was detected in LV right (P = .031) and left (P = .014), in LVIIIB right (P = .011) and left (P = .019), and in LVIIIA left (P = .009). CONCLUSION Our results emphasize that volume analysis of the total cerebellar volume alone is insufficient to characterize cerebellar differences in children with epilepsy. Rather, in specific cerebellar region volume analysis using region-based morphometry, children with epilepsy showed significantly lower regional volumes of lobules, which are important for sensorimotor function (LV, LVIII) and higher cognitive function (crus I).
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Affiliation(s)
- Katja Glutig
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany,Katja Glutig, Jena University Hospital, Department of Radiology, Section of Pediatric Radiology, Am Klinikum 1, 07747 Jena, Germany.
| | - Luisa Lange
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Paul-Christian Krüger
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Stephanie Gräger
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
| | - Heike de Vries
- Department of Neuropediatrics, University Children’s Hospital, Jena, Germany
| | - Ulrich Brandl
- Department of Neuropediatrics, University Children’s Hospital, Jena, Germany
| | - Christian Gaser
- Structural Brain Mapping Group, Departments of Psychiatry and Neurology, University Hospital, Jena, Germany
| | - Hans-Joachim Mentzel
- Department of Radiology, Section of Pediatric Radiology, University Hospital, Jena, Germany
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Moorhouse FJ, Cornell S, Gerstl L, Wagner J, Tacke M, Roser T, Heinen F, von Stülpnagel C, Vollmar C, Kunz M, Ramantani G, Borggraefe I. Cognitive profiles in pediatric unilobar vs. multilobar epilepsy. Eur J Paediatr Neurol 2022; 41:48-54. [PMID: 36265333 DOI: 10.1016/j.ejpn.2022.09.006] [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: 09/27/2021] [Revised: 09/12/2022] [Accepted: 09/24/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to determine how cognitive impairment relates to the extent of the presumed epileptogenic zone in pediatric focal epilepsies. We analyzed the cognitive functions in unilobar compared to multilobar focal epilepsy patients that underwent neuropsychological testing at a tertiary epilepsy center. METHODS We assessed cognitive functions of pediatric focal epilepsy patients with the German version of the Wechsler Intelligence Scales that measures full-scale IQ and subcategories. We assessed differences in IQ and epilepsy-related variables between unilobar and multilobar epilepsy patients. RESULTS We included 62 patients (37 unilobar, 25 multilobar), aged 10.6 ± 3.7 years. Full-scale IQ values were significantly higher in unilobar (93.6 ± 17.7, 95% CI 87.7-99.6) than in multilobar epilepsy patients (77.3 ± 17.2, 95% CI 69.3-85.0; p = 0.001). In all but one IQ subcategory (working memory), significantly higher values were measured in unilobar than in multilobar epilepsy patients. The proportion of unilobar epilepsy patients with severe cognitive impairment (8.3%) and below-average intelligence (30.5%) was lower compared to multilobar epilepsy patients (47.6% and 61.9%; p = 0.002 and p = 0.021, respectively). Epilepsy onset occurred earlier in multilobar (4.0 years, 95% CI 2.6-5.5, SD ± 3.4 years) than in unilobar epilepsy patients (7.0 years, 95% CI 5.5-8.5, SD ± 4.4 years, p = 0.008). CONCLUSIONS Pediatric multilobar epilepsy patients face more cognitive issues than unilobar epilepsy patients on average. Our findings should help to identify children and adolescents who are most at risk for impaired cognitive development. A limitation of our study is the simple division into unilobar and multilobar epilepsies, with no specific account being taken of etiology/epilepsy syndrome, which can have a profound effect on cognition.
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Affiliation(s)
- Frederik Jan Moorhouse
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Sonia Cornell
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Lucia Gerstl
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Johanna Wagner
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Moritz Tacke
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Timo Roser
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Heinen
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Celina von Stülpnagel
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany; Paracelsus Medical University, Salzburg, Austria
| | - Christian Vollmar
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany; Comprehensive Epilepsy Center, Ludwig-Maximilians-University, Munich, Germany
| | - Mathias Kunz
- Comprehensive Epilepsy Center, Ludwig-Maximilians-University, Munich, Germany; Department of Neurosurgery, Ludwig-Maximilians-University, Munich, Germany
| | - Georgia Ramantani
- Department of Neuropediatrics, University Children's Hospital, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
| | - Ingo Borggraefe
- Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany; Comprehensive Epilepsy Center, Ludwig-Maximilians-University, Munich, Germany.
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Executive Functioning and Social Skills in Children with Epileptic Seizures and Non-Epileptic Seizures. Epilepsy Res 2022; 188:107051. [DOI: 10.1016/j.eplepsyres.2022.107051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
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Iverson GL, Iverson IA. Perceived cognitive impairment in high school students in the United States. Front Psychol 2022; 13:1019159. [PMID: 36267070 PMCID: PMC9577466 DOI: 10.3389/fpsyg.2022.1019159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019. Methods Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use. Results The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [χ2(1) = 212.23, p < 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [χ2(11) = 569.158, p < 0.001; Nagelkerke R2 = 0.212] and girls [χ2(11) = 1,026.189, p < 0.001; Nagelkerke R2 = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%). Conclusion A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.
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Affiliation(s)
- Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Charlestown, Massachusetts, United States
- MassGeneral Hospital for Children Sports Concussion Program, Boston, Massachusetts, United States
- *Correspondence: Grant L. Iverson,
| | - Ila A. Iverson
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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Chen X, Yao T, Cai J, Zhang Q, Li S, Li H, Fu X, Wu J. A novel genetic variant potentially altering the expression of MANBA in the cerebellum associated with attention deficit hyperactivity disorder in Han Chinese children. World J Biol Psychiatry 2022; 23:548-559. [PMID: 34870556 DOI: 10.1080/15622975.2021.2014248] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To obtain additional insight into the genetic factors of attention deficit hyperactivity disorder (ADHD). METHODS First, we performed a transcriptome-wide association study (TWAS) integrating human cerebellum-specific variant-expression/splicing correlations to identify ADHD susceptibility genes. Then, the associations between expression/splicing quantitative trait loci (eQTLs/sQTLs) of the transcriptome-wide significant genes and ADHD were observed in a case-control study of Han Chinese children. Furthermore, dual luciferase reporter gene assays were performed to validate the regulatory function of ADHD risk variants. Additionally, the transcription level of target genes in blood was detected by real-time quantitative polymerase chain reaction (RT-qPCR) assay. RESULTS TWAS identified that the genetically regulated expression of MANBA in the cerebellum was significantly associated with ADHD risk. Furthermore, we observed a higher risk of ADHD and more severe clinical symptoms in subjects harbouring heterozygous (TC) or mutant homozygous (TT) genotypes of MANBA rs1054037 than CC carriers. The dual luciferase reporter gene assay revealed that the mutation of rs1054037(C > T) potentially upregulated MANBA expression by eliminating the binding site for hsa-miR-5591-3P. Finally, RT-qPCR showed that MANBA expression in blood samples of patients was significantly higher than that of controls. CONCLUSIONS Taken together, these results suggest a role of MANBA in the development of ADHD.
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Affiliation(s)
- Xinzhen Chen
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Yao
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinliang Cai
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanyawen Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiru Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xihang Fu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhang L, Liu X. Clinical phenotype and genotype of children with GABAA receptor α1 subunit gene-related epilepsy. Front Neurol 2022; 13:941054. [PMID: 35937053 PMCID: PMC9350551 DOI: 10.3389/fneur.2022.941054] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/27/2022] [Indexed: 12/03/2022] Open
Abstract
Objective This study aimed to summarize the clinical phenotype and genotype of children with epilepsy caused by GABRA1 gene variants. Methods Eight epilepsy patients, who were admitted to Qilu Hospital of Shandong University from 2015 to 2021, were enrolled in the study. GABRA1 gene variants were detected by whole-exome sequencing. Epilepsy clinical manifestations, electroencephalography, neuroimaging characteristics and treatment methods were retrospectively analyzed. Results Among the eight patients, four were males and four were females. Epilepsy onset age was between 3 and 8 months of age. Two patients had a family history of epilepsy. Six cases were de novo variants, and two were hereditary variants. Two children carried the same pathogenic variants, and five carried novel pathogenic variants that had not been reported internationally. The types of seizures were diverse, including focal seizures in five cases, generalized tonic-clonic seizures in five cases, and spasms in two cases. Electroencephalography of seven cases showed abnormal background rhythms, and six cases showed abnormal discharge during the interictal period. No obvious abnormalities were found on magnetic resonance imaging in five cases. All eight children had different degrees of developmental retardation. Conclusion De novo pathogenic variants in GABRA1 are more common than inherited pathogenic variants, and most epilepsy symptoms begin in the first year of life, manifesting with a variety of seizure types and developmental delays. Conventional treatment usually involves one or more drugs; although drug treatment can control seizures in some cases, cognitive and developmental deficits often exist. The five newly discovered pathogenic variants enrich the GABRA1 gene pathogenic variant spectrum.
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Cognitive disorders in childhood epilepsy: a comparative longitudinal study using administrative healthcare data. J Neurol 2022; 269:3789-3799. [PMID: 35166927 PMCID: PMC9217877 DOI: 10.1007/s00415-022-11008-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The study aimed to assess the risk of cognitive impairment in patients with epilepsy, the impact of age of epilepsy onset on cognition and the temporal relationship of epilepsy onset and intellectual impairment. METHODS This longitudinal study analyzed birth cohorts and followed-up children born 2005-2007 up to the age of ten using administrative healthcare data of about 8.9 million members insured by the statutory health insurance "BARMER" in Germany. We compared prevalence of cognitive impairment (ICD-code F7*) in children with epilepsy (ICD-code G40) to controls, and calculated relative risks by age groups at onset of epilepsy and assessed differences in relation to the temporal sequence of the diagnoses. RESULTS Of the 142,563 pre-pubertal children included in the analysis, 2728 (1.9%) had an epilepsy diagnosis within the first 10 years of life. 17.4% (475/2728) of children with epilepsy had a diagnosis of cognitive impairment compared to 1.7% (2309/139835) in controls. The relative risk for cognitive impairment compared to age-matched controls was 10.5 (95% CI 9.6, 11.6) and was highest in epilepsy cases with seizure manifestation within the first 2 years of life compared to older children. The prevalence of cognitive impairment before epilepsy diagnosis was slightly increased compared to controls, while it was increased by a factor of nine in children diagnosed with cognitive impairment in the year of onset of epilepsy or afterwards. CONCLUSIONS Pre-pubertal children with epilepsy have a ten-fold higher risk for intellectual impairment compared to age-matched controls. This risk inversely correlates with the age of epilepsy manifestation. Cognitive impairment was diagnosed after epilepsy manifestation in the majority of patients.
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Jensen-Willett S, Cunha A, Lobo MA, Harbourne R, Dusing SC, McCoy SW, Koziol NA, Hsu LY, Marcinowski EC, Babik I, An M, Bovaird JA. The Effect of Early-Life Seizures on Cognitive and Motor Development: A Case Series. Pediatr Phys Ther 2022; 34:425-431. [PMID: 35703307 DOI: 10.1097/pep.0000000000000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This case series documents developmental changes over time and in response to a novel intervention, Sitting Together and Reaching to Play (START-Play), in children with early-life seizures. METHODS Thirteen children with early-life seizures were included from a subset of participants in the START-Play multisite, randomized controlled trial. Seven received 3 months of twice weekly START-Play intervention; 6 continued with usual care early intervention. Bayley Scales of Infant Development-III (Cognitive Composite), Gross Motor Function Measure-66 Item Set, Assessment of Problem-Solving in Play, and reaching assessments were administered at baseline, 3, 6, and 12 months postbaseline. Change scores are reported at 3 and 12 months postbaseline. RESULTS Over time, plateau or decline was noted in standardized cognition measures; motor development improved or was stable. Children receiving START-Play showed positive trends in problem-solving (71.4%) and reaching behaviors (57.2%). CONCLUSIONS Interventions such as START-Play that combine motor and cognitive constructs may benefit children with early-life seizures.
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Affiliation(s)
- Sandra Jensen-Willett
- Department of Physical Therapy (Dr Willett), Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska; Department of Physical Therapy (Drs Cunha and Lobo), Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware; Department of Physical Therapy (Dr Harbourne), Duquesne University, Pittsburgh, Pennsylvania; Division of Biokinesiology and Physical Therapy (Dr Dusing), University of Southern California, Los Angeles CA; Department of Rehabilitation Medicine (Drs Westcott-McCoy and Hsu), University of Washington, Seattle, Washington; Nebraska Center for Research on Children, Youth, Families and Schools (Drs Koziol and Bovaird), University of Nebraska-Lincoln, Lincoln, Nebraska; College of Human Science and Education (Dr Marcinowski), Louisiana State University, Baton Rouge, Louisiana; Department of Psychological Science (Dr Babik), Boise State University, Boise, Idaho; Department of Physical Therapy (Dr An), Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea
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Duan R, Li HM, Hu WB, Hong CG, Chen ML, Cao J, Wang ZX, Chen CY, Yin F, Hu ZH, Li JD, Xie H, Liu ZZ. Recurrent de novo single point variant on the gene encoding Na +/K + pump results in epilepsy. Prog Neurobiol 2022; 216:102310. [PMID: 35724808 DOI: 10.1016/j.pneurobio.2022.102310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/28/2022] [Accepted: 06/15/2022] [Indexed: 10/18/2022]
Abstract
The etiology of epilepsy remains undefined in two-thirds of patients. Here, we identified a de novo variant of ATP1A2 (c.2426 T > G, p.Leu809Arg), which encodes the α2 subunit of Na+/K+-ATPase, from a family with idiopathic epilepsy. This variant caused epilepsy with hemiplegic migraine in the study patients. We generated the point variant mouse model Atp1a2L809R, which recapitulated the epilepsy observed in the study patients. In Atp1a2L809R/WT mice, convulsions were observed and cognitive and memory function was impaired. This variant affected the potassium binding function of the protein, disabling its ion transport ability, thereby increasing the frequency of nerve impulses. Valproate (VPA) and Carbamazepine (CBZ) have limited therapeutic efficacy in ameliorating the epileptic syndromes of Atp1a2L809R/WT mice. Our work revealed that ATP1A2L809R variants cause a predisposition to epilepsy. Moreover, we provide a point variant mouse model for epilepsy research and drug screening.
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Affiliation(s)
- Ran Duan
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Hong-Ming Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Wen-Bao Hu
- Institute of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Chun-Gu Hong
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Meng-Lu Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jia Cao
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhen-Xing Wang
- Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Chun-Yuan Chen
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zhong-Hua Hu
- Institute of Molecular Precision Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Jia-Da Li
- State Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410078, China
| | - Hui Xie
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan 410008, China; Hunan Key Laboratory of Bone Joint Degeneration and Injury, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan 410008, China.
| | - Zheng-Zhao Liu
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan 410008, China.
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Ren Z, Yang C, Yu D. Cognitive deficiency, parental relationship, and coping strategies are related with anxiety and depression among parents of children with epilepsy. Chronic Dis Transl Med 2022; 8:229-237. [PMID: 36161201 PMCID: PMC9481879 DOI: 10.1002/cdt3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Zhengjia Ren
- Department of Clinical Psychology The Third Affiliated Hospital of Chongqing Medical University Chongqing 401120 China
| | - Chunsong Yang
- Department of Pharmacy, Evidence‐based Pharmacy Center, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
| | - Dan Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
- Department of Medical Genetics, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
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Proost R, Lagae L, Van Paesschen W, Jansen K. Sleep in children with refractory epilepsy and epileptic encephalopathies: A systematic review of literature. Eur J Paediatr Neurol 2022; 38:53-61. [PMID: 35395626 DOI: 10.1016/j.ejpn.2022.03.010] [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: 11/23/2021] [Revised: 03/14/2022] [Accepted: 03/25/2022] [Indexed: 10/18/2022]
Abstract
Children with epilepsy have more sleep disorders compared to healthy children. The bidirectional interaction between epilepsy and sleep is not completely understood. However, disruption of sleep architecture during childhood may have consequences for cognitive development. As children with drug-refractory epilepsy often have intellectual disability, sleep disruption could be an important contributing factor in severity of their cognitive impairment. To better understand these interactions, sleep architecture in children with drug-refractory epilepsy and epileptic encephalopathies should be investigated. In this review, we conducted a systematic literature search on this topic. Articles that investigated sleep macro- and/or microstructure by means of electroencephalogram/polysomnography were included, as well as articles that used validated questionnaires. Sixteen articles were reviewed, eight of which used polysomnography. Only 2 articles examined sleep in children with epileptic encephalopathies. Consistent findings on measures of sleep architecture were a reduction in REM percentage and an increase in sleep fragmentation when comparing drug-refractory patients with non-refractory and healthy subjects. The findings on slow wave sleep were less clear. Studies with questionnaires unambiguously confirmed subjectively more sleep problems in children with drug-refractory epilepsy. This is the first review of literature in this patient population. More good quality sleep studies in children with drug-refractory epilepsy are warranted. The use of wearables in the home setting together with automatic sleep staging could provide more insights.
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Affiliation(s)
- R Proost
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium.
| | - L Lagae
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium
| | - W Van Paesschen
- Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - K Jansen
- Department of Pediatric Neurology, University Hospital Leuven, Leuven, Belgium.
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Gogou M, Cross JH. Seizures and Epilepsy in Childhood. Continuum (Minneap Minn) 2022; 28:428-456. [PMID: 35393965 DOI: 10.1212/con.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article highlights basic concepts of seizures and epilepsy in pediatric patients, as well as basic treatment principles for this age group. RECENT FINDINGS Epilepsy is the most common neurologic disorder in childhood. Accurate diagnosis is key; in older children, epileptic seizures need to be differentiated from various paroxysmal nonepileptic events, whereas in neonates, the majority of seizures are subclinical (electroencephalographic). Antiseizure medications remain the first-line treatment, but ketogenic diet and epilepsy surgery have also shown positive outcomes and can decrease drug burden. Genetic causes account for approximately 30% of cases, and the recognition of electroclinical syndromes is being replaced by the concept of genetic spectrums. Precision medicine therapies are promising, but wide application in daily practice still has a long way to go. Early access to specialist centers and optimal treatments positively affects prognosis and future neurodevelopment. SUMMARY Although novel findings from all fields of research are being incorporated into everyday clinical practice, a better quality of life for children with seizures and epilepsy and their families is the ultimate priority.
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Li Y, Zhang T, Feng J, Qian S, Wu S, Zhou R, Wang J, Sa G, Wang X, Li L, Chen F, Yang H, Zhang H, Tian M. Processing speed dysfunction is associated with functional corticostriatal circuit alterations in childhood epilepsy with centrotemporal spikes: a PET and fMRI study. Eur J Nucl Med Mol Imaging 2022; 49:3186-3196. [PMID: 35199226 PMCID: PMC9250469 DOI: 10.1007/s00259-022-05740-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2022]
Abstract
Purpose Epilepsy with centrotemporal spikes (ECTS) is the most common epilepsy syndrome in children and usually presents with cognitive dysfunctions. However, little is known about the processing speed dysfunction and the associated neuroimaging mechanism in ECTS. This study aims to investigate the brain functional abnormality of processing speed dysfunction in ECTS patients by using the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and resting-state functional magnetic resonance imaging (rs-fMRI). Methods This prospective study recruited twenty-eight ECTS patients who underwent the 18F-FDG PET, rs-fMRI, and neuropsychological examinations. Twenty children with extracranial tumors were included as PET controls, and 20 healthy children were recruited as MRI controls. The PET image analysis investigated glucose metabolism by determining standardized uptake value ratio (SUVR). The MRI image analysis explored abnormal functional connectivity (FC) within the cortical–striatal circuit through network-based statistical (NBS) analysis. Correlation analysis was performed to explore the relationship between SUVR, FC, and processing speed index (PSI). Results Compared with healthy controls, ECTS patients showed normal intelligence quotient but significantly decreased PSI (P = 0.04). PET analysis showed significantly decreased SUVRs within bilateral caudate, putamen, pallidum, left NAc, right rostral middle frontal gyrus, and frontal pole of ECTS patients (P < 0.05). Rs-fMRI analysis showed absolute values of 20 FCs were significantly decreased in ECTS patients compared with MRI controls, which connected 16 distinct ROIs. The average SUVR of right caudate and the average of 20 FCs were positively correlated with PSI in ECTS patients (P = 0.034 and P = 0.005, respectively). Conclusion This study indicated that ECTS patients presented significantly reduced PSI, which is closely associated with decreased SUVR and FC of cortical–striatal circuit. Caudate played an important role in processing speed dysfunction. Clinical trial registration NCT04954729; registered on July 8, 2021, public site, https://clinicaltrials.gov/ct2/show/NCT04954729 Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-05740-w.
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Affiliation(s)
- Yuting Li
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Teng Zhang
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Jianhua Feng
- Department of Pediatrics, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Shufang Qian
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Shuang Wu
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Rui Zhou
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Jing Wang
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Guo Sa
- Department of Radiology, The First Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xiawan Wang
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
| | - Lina Li
- College of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Feng Chen
- Department of Radiology, The First Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hong Yang
- Department of Radiology, The First Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Hong Zhang
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China. .,Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China. .,The College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China.
| | - Mei Tian
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. .,Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China. .,Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
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Li B, Kang H, Xiao Y, Du Y, Xiao Y, Song G, Zhang Y, Guo Y, Yang F, He F, Yang S. LncRNA GAL promotes colorectal cancer liver metastasis through stabilizing GLUT1. Oncogene 2022; 41:1882-1894. [PMID: 35149838 DOI: 10.1038/s41388-022-02230-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/20/2022] [Accepted: 02/02/2022] [Indexed: 12/12/2022]
Abstract
Colorectal cancer liver metastasis (CRLM) is the leading cause of colorectal cancer-related deaths and remains a clinical challenge. Enhancement of glucose uptake is involved in CRLM; however, whether long noncoding RNAs (lncRNAs) participate in these molecular events remains largely unclear. Here, we report an lncRNA, GAL (glucose transporter 1 (GLUT1) associated lncRNA), that was upregulated in CRLM tissues compared with primary colorectal cancer (CRC) tissues or matched normal tissues and was associated with the overall survival rates of CRLM patients. Functionally, GAL served as an oncogene because it promoted CRC cell migration and invasion in vitro and enhanced the ability of CRC cells to metastasize from the intestine to the liver in vivo. Mechanistically, GAL interacted with the GLUT1 protein to increase GLUT1 SUMOylation, inhibiting the effect of the ubiquitin-proteasome system on the GLUT1 protein. GLUT1-knockout (-/+) repressed the GAL-mediated increase in CRC cell uptake of glucose, migrate, and invade in vitro, as well as metastasis from the intestine to the liver in vivo, and enforced expression of GLUT1 rescued GAL knockout-induced biological functions in CRC cells. Taken together, our findings demonstrated that GAL promotes CRLM by stabilizing GLUT1, suggesting that the GAL-GLUT1 complex may act as a potential therapeutic target for CRLM.
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Affiliation(s)
- Bosheng Li
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Army Medical University, Chongqing, 400038, China.,Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Houyi Kang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yufeng Xiao
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Yexiang Du
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China
| | - Yunhua Xiao
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Guojing Song
- Department of Urology, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Yan Zhang
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Army Medical University, Chongqing, 400038, China
| | - Yu Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Fan Yang
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Army Medical University, Chongqing, 400038, China
| | - Fengtian He
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences, Army Medical University, Chongqing, 400038, China.
| | - Shiming Yang
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
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Baggio M, Toffoli L, Da Rold M, Duma GM, Mento G, Morao V, Danieli A, Bonanni P. Neuropsychological and behavioral profiles of self-limited epileptic syndromes of childhood: a cross-syndrome comparison. Child Neuropsychol 2022; 28:878-902. [PMID: 35086426 DOI: 10.1080/09297049.2022.2028754] [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: 10/19/2022]
Abstract
Childhood epilepsy with centro-temporal spikes (CECTS), Childhood absence epilepsy (CAE) and Panayiotopoulos syndrome (PS) are some of the most common pediatric epileptic syndromes. Despite the relatively benign (self-limited) course of epilepsy, current evidence suggests that these conditions are associated with an increased risk of neuropsychological and behavioral comorbidities. This study provides a cross-epileptic syndromes' comparison reporting on the cognitive and behavioral profile of a cohort of 32 children with CECTS (n = 14), CAE (n = 10) and PS (n = 8), aged 6 to 15 years old. Frequent, although often subclinical cognitive difficulties involving attention, executive functions and academic abilities were found in children with CECTS and CAE, and to a lesser extent in PS. Internalizing symptoms (particularly anxiety) were more common in the PS group compared to CECTS and CAE based on parental reports. Correlational analysis revealed a significant correlation between phonemic fluency and seizure-free interval at the time of evaluation, suggesting a beneficial effect of epilepsy remission on this executive function measure in all the three groups. These results add to existing literature providing further detail on neuropsychological and behavioral peculiarities of children with CECTS, CAE, and PS. Moreover, the need for neuropsychological assessment as part of the standard childhood epilepsy evaluation is stressed. The results are discussed in the context of the current literature, highlighting areas of consensus and controversies related to the clinical management of these epileptic syndromes as well as directions for future research.
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Affiliation(s)
- Martina Baggio
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy
| | - Lisa Toffoli
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy.,Department of General Psychology, University of Padova, Italy
| | - Martina Da Rold
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy
| | - Gian Marco Duma
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy.,Department of General Psychology, University of Padova, Italy
| | - Giovanni Mento
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy.,Padova Neuroscience Center (PNC), University of Padova, Italy
| | - Veronica Morao
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy
| | - Alberto Danieli
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy
| | - Paolo Bonanni
- Epilepsy and Clinical Neurophysiology Unit, Irccs "E. Medea," Conegliano, Treviso, Italy
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Zhao S, Liu F, Shi W, Wang J, Zhou Z, Zhang X. DL-3-n-butylphthalide promotes hippocampal neurogenesis and reduces mossy fiber sprouting in chronic temporal lobe epilepsy rats. BMC Neurol 2022; 22:3. [PMID: 34979964 PMCID: PMC8722179 DOI: 10.1186/s12883-021-02516-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background A decrease in hippocampal neurogenesis is considered an important cause of cognitive impairment, while changes in mossy fiber sprouting are closely related to development of spontaneous recurrent seizures in chronic temporal lobe epilepsy (TLE). Racemic l-3-n-butylphthalide (DL-NBP) can alleviate cognitive impairment in ischemic stroke and Alzheimer’s disease by promoting neurogenesis. DL-NBP treatment can also improve cognitive function and reduce seizure incidence in chronic epileptic mice. However, the mechanisms of action of DL-NBP remain unclear. The aim of the present study was to examine the effects of DL-NBP on mossy fiber sprouting, hippocampal neurogenesis, spontaneous epileptic seizures, and cognitive functioning in the chronic phase of TLE. Methods Nissl staining was used to evaluate hippocampal injury, while immunofluorescent staining was used to analyze hippocampal neurogenesis. The duration of spontaneous seizures was measured by electroencephalography. The Morris water maze was used to evaluate cognitive function. Timm staining was used to assess mossy fiber sprouting. Results TLE animals showed reduced proliferation of newborn neurons, cognitive dysfunction, and spontaneous seizures. Treatment with DL-NBP after TLE increased the proliferation and survival of newborn neurons in the dentate gyrus, reversed the neural loss in the hippocampus, alleviated cognitive impairments, and decreased mossy fiber sprouting and long-term spontaneous seizure activity. Conclusions We provided pathophysiological and morphological evidence that DL-NBP might be a useful therapeutic for the treatment of TLE.
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Affiliation(s)
- Shanshan Zhao
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Fangxi Liu
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Wei Shi
- Department of Neurology, Tacheng District People's Hospital, Tacheng, 834700, Xinjiang, China
| | - Jialu Wang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Zhike Zhou
- Department of Geriatrics, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Xiaoqian Zhang
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China.
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48
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Phillips NS, Khan RB, Li C, Salehabadi SM, Brinkman TM, Srivastava D, Robison LL, Hudson MM, Krull KR, Sadighi ZS. Seizures' impact on cognition and quality of life in childhood cancer survivors. Cancer 2022; 128:180-191. [PMID: 34468985 PMCID: PMC8678188 DOI: 10.1002/cncr.33879] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The objective of this study was to determine the impact of seizure-related factors on neurocognitive, health-related quality of life (HRQOL), and social outcomes in survivors of childhood cancer. METHODS Survivors of childhood cancer treated at St. Jude Children's Hospital (n = 2022; 48.3% female; median age, 31.5 years; median time since diagnosis, 23.6 years) completed neurocognitive testing and questionnaires. The presence, severity, resolution, and treatment history of seizures were abstracted from medical records. Adjusting for the age at diagnosis, sex, and prior cancer therapy, multivariable models examined the impact of seizures on neurocognitive and HRQOL outcomes. Mediation analyses were conducted for social outcomes. RESULTS Seizures were identified in 232 survivors (11.5%; 29.9% of survivors with central nervous system [CNS] tumors and 9.0% of those without CNS tumors). In CNS tumor survivors, seizures were associated with poorer executive function and processing speed (P < .02); in non-CNS tumor survivors, seizures were associated with worse function in every domain (P < .05). Among non-CNS survivors, seizure severity was associated with worse processing speed (P = .023), and resolution was associated with better executive function (P = .028) and attention (P = .044). In CNS survivors, seizure resolution was associated with improved attention (P = .047) and memory (P < .02). Mediation analysis revealed that the impact of seizures on social outcomes was mediated by neurocognitive function. CONCLUSIONS Seizures in cancer survivors adversely affect long-term functional and psychosocial outcomes independently of cancer therapy. The resolution of seizure occurrence is associated with better outcomes. Seizure severity is associated with poorer outcomes and should be a focus of clinical management and patient education.
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Affiliation(s)
- Nicholas S. Phillips
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Raja B. Khan
- Division of Neurology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Chenghong Li
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | | | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Zsila S. Sadighi
- Division of Neurology, St. Jude Children’s Research Hospital, Memphis, Tennessee
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49
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Yang X, Wang R, Zhou H, Wang L, Wang R, Li H, Tan B, Wu Q, Xu X, Cui L, Li Z, Li H. β-hydroxybutyrate Alleviates Learning and Memory Impairment Through the SIRT1 Pathway in D-Galactose-Injured Mice. Front Pharmacol 2021; 12:751028. [PMID: 34880753 PMCID: PMC8645592 DOI: 10.3389/fphar.2021.751028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Learning and memory impairment is a common clinical symptom of aging and nervous system injuries, and seriously affects quality of life. Memory impairment is associated with increased oxidative stress (OS) and inflammatory response. β-hydroxybutyrate (BHBA) is a water-soluble endogenous small-molecule ketone body that easily crosses the blood-brain barrier and has shown neuroprotection activities. In this study, we investigated the effects and mechanisms of BHBA on D-galactose (D-gal)-induced memory impairment in mice by in vitro and in vivo experiments. BHBA was administered intragastrically to D-gal-injured C57BL/6 mice for 42 days. Water maze performance, the morphology of the hippocampus with Nissl staining, the ACh content, OS, and inflammation status were examined. To further investigate the mechanism, hippocampal neuronal cells (HT22) were treated with BHBA with or without the SIRT1 inhibitor or small interfering RNAs against sirt1 (si-SIRT1) before incubation with D-gal. BHBA significantly improved water maze performance; increased the ACh content, SOD activity, and SIRT1 expression; and decreased AChE and LDH activity, ROS, MDA, IL-1β, TNF-α contents, and NLRP3 expression. Further studies with the SIRT inhibitor or siRNAs against sirt1 reversed the above effects of BHBA. Collectively, BHBA inhibited hippocampal OS and the inflammation process to alleviate learning and memory impairment through activating the SIRT1 pathway in D-gal-injured mice, suggesting that BHBA could be a potential option for drug development of learning and memory impairment induced by nervous system injuries.
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Affiliation(s)
- Xiaojing Yang
- College of Pharmacy, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Ruonan Wang
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Hailun Zhou
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Li Wang
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Rui Wang
- Dalian Key Laboratory of Hematology, Department of Hematology, the Second Hospital of Dalian Medical University, Institute of Stem Cell Transplantation of Dalian Medical University, Dalian, China
| | - Haomin Li
- Department of Neurosurgery, Foshan Affiliated Hospital to Sun Yat -Sen University and the First People's Hospital of Foshan, Foshan, China
| | - Baodong Tan
- Department of Neurosurgery, Foshan Affiliated Hospital to Sun Yat -Sen University and the First People's Hospital of Foshan, Foshan, China
| | - Qiong Wu
- National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Xin Xu
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Lianxu Cui
- Department of Neurosurgery, Foshan Affiliated Hospital to Sun Yat -Sen University and the First People's Hospital of Foshan, Foshan, China
| | - Zaiyu Li
- Department of Neurosurgery, Foshan Affiliated Hospital to Sun Yat -Sen University and the First People's Hospital of Foshan, Foshan, China
| | - Hua Li
- College of Pharmacy, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
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50
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Li Y, Zhao X, Wang S, Xu K, Zhao X, Huang S, Zhu S. A Novel Loss-of-Function Mutation in the NPRL3 Gene Identified in Chinese Familial Focal Epilepsy with Variable Foci. Front Genet 2021; 12:766354. [PMID: 34868250 PMCID: PMC8633433 DOI: 10.3389/fgene.2021.766354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Familial focal epilepsy with variable foci is an autosomal dominant disorder characterized by partial epilepsy with variable foci. In this study, we report a six-generation with segregation of the mutation present in four generations Chinese family presenting with focal epilepsy with variable foci. Whole exome sequencing confirms a novel pathogenic mutation in the NPRL3 gene (c316C>T; p. Q106*). PCR, Western blotting, and immunohistochemistry were conducted to analyze the gene transcription, protein expression, and subcellular localization of NPRL3 and related signaling molecules in peripheral blood cells from family members. As compared with healthy family members, both mRNA level and protein expression of NPRL3 are decreased in peripheral blood cells of the mutation carrier. In addition, the expression of downstream molecular Phospho-p70 S6 kinase (P-s6k) are increased consequently. Our findings expand the genotypic and phenotypic spectrum of the NPRL3-associated epilepsy and reveal the mechanisms of mTOR pathway signaling and GATOR1 pathogenesis in focal epilepsies, providing exciting potential for future diagnostic and therapeutic interventions. However, further in vitro and animal experiments are still needed to evaluate the role of NPRL3 loss-of-function mutation in epileptogensis.
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Affiliation(s)
- Youzhi Li
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Zhao
- Department of Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Wang
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Xu
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Zhao
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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