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Otabe H, Taniguchi G, Iijima K, Iwasaki M. Surgical treatment may improve depressive and hysterical traits in temporal lobe epilepsy with hippocampal sclerosis: Study using the Minnesota Multiphasic Personality Inventory. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e193. [PMID: 38868085 PMCID: PMC11114346 DOI: 10.1002/pcn5.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/07/2024] [Accepted: 04/04/2024] [Indexed: 06/14/2024]
Abstract
Aim The influence of surgeries on psychiatric symptoms and personality traits is not well known in patients with intractable temporal lobe epilepsy (TLE). We investigated changes in personality traits with respect to postoperative seizure outcomes, etiology, side of surgery, and sex differences. Methods Clinical information was retrospectively collected for 44 patients whose Minnesota Multiphasic Personality Inventory (MMPI) was examined before and 1 year after surgical treatment for drug-resistant TLE. Postoperative changes in MMPI T-scores were analyzed using a paired t-test. Participants were divided into two groups based on postoperative seizure outcome, the presence or absence of hippocampal sclerosis (HS) as the etiology, side of surgery, and sex differences. The effect of these clinical factors on postoperative changes in MMPI T-scores was evaluated using analysis of covariance (P-values < 0.05). Results The hypochondria (Hs) scale decreased significantly in all patients (p = 0.022). The postoperative seizure-free group had a significant decrease in the depression (D) scale (p = 0.037). The HS group had significant decreases in the D scale and the hysteria (Hy) scale (p = 0.016 and 0.004, respectively), and a significant increase in the masculinity-femininity (Mf) scale (p = 0.009). No significant differences existed between the sides of surgery or sex. Conclusion Depressive traits were improved in patients with postoperative seizure freedom. Depressive and hysterical traits were improved in patients with HS, which may be attributed to a reduction in anxiety and fear associated with aura. Most personality traits are not significantly changed or exacerbated by surgical treatment of TLE.
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Affiliation(s)
- Hiroyuki Otabe
- Department of NeurosurgeryNational Center Hospital, National Center of Neurology and PsychiatryKodairaJapan
- Department of PsychiatrySaiseikai Konosu HospitalKonosuJapan
| | - Go Taniguchi
- Department of EpileptologyNational Center Hospital, National Center of Neurology and PsychiatryKodairaJapan
| | - Keiya Iijima
- Department of NeurosurgeryNational Center Hospital, National Center of Neurology and PsychiatryKodairaJapan
| | - Masaki Iwasaki
- Department of NeurosurgeryNational Center Hospital, National Center of Neurology and PsychiatryKodairaJapan
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Rauh R, Schulze-Bonhage A, Metternich B. Assessment of Anxiety in Patients With Epilepsy: A Literature Review. Front Neurol 2022; 13:836321. [PMID: 35547374 PMCID: PMC9081800 DOI: 10.3389/fneur.2022.836321] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/16/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Approximately 20% of people with epilepsy (PWE) suffer from anxiety. These fears are quite diverse and may manifest periictally or interictally, be part of the seizure's semiology, or an expression of reactive psychological distress from seizures themselves. Our review addresses the question of what screening tools are used in clinical care and epileptological research to capture the complexity of epilepsy-specific anxieties. Method On 2021/11/11, we entered a search string in PubMed that covered our research interest as completely as possible. We also screened the bibliographies of our findings and followed PubMed's recommendations. From the assessments we found in the included studies, we extracted domains that represent the range of manifestations of anxiety, in order to compare the tools and to discuss to what extent they are suitable for assessing epilepsy-specific anxieties. Results We screened 1,621 abstracts. In total, we identified 24 different anxiety assessments. In addition to the psychiatric assessments in use, we found 7 tools that were designed to assess epilepsy-specific anxieties. The latter focus on different aspects of epilepsy-specific anxieties. In some cases, the conceptual frameworks are not sufficiently transparent or divergent. Conclusion Because a diagnosis of epilepsy can result in, or seizures may appear as, anxiety, it is important to better understand this psychological burden and address it therapeutically, if necessary. There is a need for screening tools that integrate specific points of a variety of assessments, so as to cover the broad range of epilepsy-specific fears. None of the assessments we found meets this integrative perspective. At the same time, the appropriate design of such a required tool presupposes a conceptual framework of what should be considered as epilepsy-specific anxiety.
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Affiliation(s)
- Raphael Rauh
- Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Birgitta Metternich
- Epilepsy Center, University Medical Center, University of Freiburg, Freiburg, Germany
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Radaelli G, Majolo F, Leal-Conceição E, de Souza Santos F, Escobar V, Zanirati GG, Portuguez MW, Scorza FA, da Costa JC. Left Hemisphere Lateralization of Epileptic Focus Can Be More Frequent in Temporal Lobe Epilepsy Surgical Patients with No Consensus Associated with Depression Lateralization. Dev Neurosci 2021; 43:1-8. [PMID: 33789300 DOI: 10.1159/000513537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/02/2020] [Indexed: 11/19/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is considered to be the most common form of epilepsy, and it has been seen that most patients are refractory to antiepileptic drugs. A strong association of this ailment has been established with psychiatric comorbidities, primarily mood and anxiety disorders. The side of epileptogenic may contribute to depressive and anxiety symptoms; thus, in this study, we performed a systematic review to evaluate the prevalence of depression in TLE in surgical patients. The literature search was performed using PubMed/Medline, Web of Science, and PsycNet to gather data from inception until January 2019. The search strategy was related to TLE, depressive disorder, and anxiety. After reading full texts, 14 articles meeting the inclusion criteria were screened. The main method utilized for psychiatric diagnosis was Diagnostic and Statistical Manual of Mental Disorders/Structured Clinical Interview for DSM. However, most studies failed to perform the neuropsychological evaluation. For those with lateralization of epilepsy, focus mostly occurred in the left hemisphere. For individual depressive diagnosis, 9 studies were evaluated, and 5 for anxiety. Therefore, from the data analyzed in both situations, no diagnosis was representative in preoperative and postoperative cases. In order to estimate the efficacy of surgery in the psychiatry episodes and its relation to seizure control, the risk of depression and anxiety symptoms in epileptic patients need to be determined before surgical procedures. Rigorous preoperative and postoperative evaluation is essential for psychiatry conditions in patients with refractory epilepsy candidates for surgery.
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Affiliation(s)
- Graciane Radaelli
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda Majolo
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,Post-graduate Program in Biotechnology, Universidade do Vale do Taquari - Univates, Lajeado, Brazil
| | - Eduardo Leal-Conceição
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Francisco de Souza Santos
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vinícius Escobar
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriele Goulart Zanirati
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Mirna Wetters Portuguez
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fulvio Alexandre Scorza
- Department of Neurology and Neurosurgery, Laboratory of Neuroscience, Federal University of São Paulo, São Paulo, Brazil.,Researcher from CNPq, Porto Alegre, Brazil
| | - Jaderson Costa da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,Researcher from CNPq, Porto Alegre, Brazil
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Carvajal F, Calahorra-Romillo A, Rubio S, Martín P. Verbal emotional memory laterality effect on amygdalohippocampectomy for refractory epilepsy. Brain Behav 2020; 10:e01872. [PMID: 33016003 PMCID: PMC7749565 DOI: 10.1002/brb3.1872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To study the brain lateralization of the verbal emotional memory and the influence of the emotional valence, we investigated a sample composed of patients with medial temporal lobe refractory epilepsy (MTLE) treated with unilateral amygdalohippocampectomy compared to a control group. MATERIALS & METHODS A new task (Verbal Association) was designed and implemented to assess emotional memory performance. It was applied to 62 patients with MTLE of whom 31 have been subjected to right amygdalohippocampectomy and 31 to left amygdalohippocampectomy. These patients were compared with 31 participants with no cerebral pathology, as a control group. RESULTS (a) The control group obtained a higher number of recalled words than the rest of the groups, while the MTLE-right group obtained better results than the MTLE-left group. (b) In the case of positive emotional valence words, the MTLE-left group performed significantly worse than the rest of the groups; whereas for negative emotional words, the MTLE-left group presented the lowest average performance and the control group obtained a higher number of recalled words compared to MTLE-right group. In the case of neutral emotional words, no significant differences were found among the groups. (c) The MTLE-left group showed poorer performance on positive and negative words than neutral; the control group demonstrated lower average performance on positive and neutral words compared to negative; the MTLE-right group did not show any significant differences on the recall of different emotional valences. CONCLUSIONS Patients with MTLE show a deficit in the verbal recall which is exacerbated for information with an affective component. This deficit is more prominent in the case of patients with left unilateral resection (MTLE-left group) since they lose the benefits of the emotional information for the recall.
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Affiliation(s)
- Fernando Carvajal
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Sandra Rubio
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | - Pilar Martín
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
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5
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Múnera CP, Lomlomdjian C, Terpiluk V, Medel N, Solís P, Kochen S. Memory for emotional material in temporal lobe epilepsy. Epilepsy Behav 2015; 52:57-61. [PMID: 26409130 DOI: 10.1016/j.yebeh.2015.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/29/2022]
Abstract
Several studies suggest that highly emotional information could facilitate long-term memory encoding and consolidation processes via an amygdala-hippocampal network. Our aim was to assess emotional perception and episodic memory for emotionally arousing material in patients with temporal lobe epilepsy (TLE) who are candidates for surgical treatment. We did this by using an audiovisual paradigm. Forty-six patients with medically resistant TLE (26 with left TLE and 20 with right TLE) and 19 healthy controls were assessed with a standard narrative test of emotional memory. The experimental task consisted of sequential picture slides with an accompanying narrative depicting a story that has an emotional central section. Subjects were asked to rate their emotional arousal reaction to each stimulus after the story was shown, while emotional memory (EM) was assessed a week later with a multiple choice questionnaire and a visual recognition task. Our results showed that ratings for emotional stimuli for the patients with TLE were significantly higher than for neutral stimuli (p=0.000). It was also observed that patients with TLE recalled significantly less information from each slide compared with controls, with a trend to lower scores on the questionnaire task for the group with LTLE, as well as poorer performance on the visual recognition task for the group with RLTE. Emotional memory was preserved in patients with RTLE despite having generally poorer memory performance compared with controls, while it was found to be impaired in patients with LTLE.
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Affiliation(s)
- Claudia P Múnera
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina.
| | - Carolina Lomlomdjian
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina
| | - Verónica Terpiluk
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina
| | - Nancy Medel
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina
| | - Patricia Solís
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina; National Neuroscience and Neurosurgery Center, El Cruce Hospital, Av. Calchaqui, 5401, C1888 Florencio Varela, Buenos Aires, Argentina
| | - Silvia Kochen
- Epilepsy Center, Neurology Division, Ramos Mejia Hospital, Gral Urquiza 609, C1221ADC CABA, Argentina; Center for Clinical and Experimental Neurosciences: Epilepsy, Cognition and Behavior, Cell Biology and Neuroscience Institute (IBCN), School of Medicine, UBA-CONICET, Paraguay 2155, 2nd Floor, C1121ABG CABA, Argentina; National Neuroscience and Neurosurgery Center, El Cruce Hospital, Av. Calchaqui, 5401, C1888 Florencio Varela, Buenos Aires, Argentina
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Hecht D. The neural basis of optimism and pessimism. Exp Neurobiol 2013; 22:173-99. [PMID: 24167413 PMCID: PMC3807005 DOI: 10.5607/en.2013.22.3.173] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/18/2013] [Accepted: 09/21/2013] [Indexed: 12/12/2022] Open
Abstract
Our survival and wellness require a balance between optimism and pessimism. Undue pessimism makes life miserable; however, excessive optimism can lead to dangerously risky behaviors. A review and synthesis of the literature on the neurophysiology subserving these two worldviews suggests that optimism and pessimism are differentially associated with the two cerebral hemispheres. High self-esteem, a cheerful attitude that tends to look at the positive aspects of a given situation, as well as an optimistic belief in a bright future are associated with physiological activity in the left-hemisphere (LH). In contrast, a gloomy viewpoint, an inclination to focus on the negative part and exaggerate its significance, low self-esteem as well as a pessimistic view on what the future holds are interlinked with neurophysiological processes in the right-hemisphere (RH). This hemispheric asymmetry in mediating optimistic and pessimistic outlooks is rooted in several biological and functional differences between the two hemispheres. The RH mediation of a watchful and inhibitive mode weaves a sense of insecurity that generates and supports pessimistic thought patterns. Conversely, the LH mediation of an active mode and the positive feedback it receives through its motor dexterity breed a sense of confidence in one's ability to manage life's challenges, and optimism about the future.
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Affiliation(s)
- David Hecht
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, United Kingdom
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7
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Kangas M, Tate RL, Williams JR, Smee RI. The effects of radiotherapy on psychosocial and cognitive functioning in adults with a primary brain tumor: a prospective evaluation. Neuro Oncol 2012; 14:1485-502. [PMID: 23066111 DOI: 10.1093/neuonc/nos244] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A paucity of studies have evaluated the biopsychosocial factors contributing to quality of life (QoL) in adults with a primary brain tumor (BT). Our objective was to investigate (i) the effects of radiotherapy on the psychosocial (ie, posttraumatic stress symptoms [PTSS]) and cognitive functioning of adults with a primary BT, assessed preradiotherapy [T1] and postradiotherapy [T2], and (ii) predictors of PTSS and QoL postradiotherapy. Seventy adults with a BT were assessed at T1, and 67 patients were reassessed 3.5 months postradiotherapy. At each assessment, participants completed measures of PTSS, mood, QoL, and quality of social support and neurocognitive tests focusing on memory and executive functioning. Minimal differences in functioning were found between patients according to BT type (benign [n = 45] vs malignant [n = 25]) and tumor laterality (left vs right hemisphere), with 2 exceptions. Individuals with a left hemisphere benign BT experienced greater distress at T1, which declined at T2, whereas individuals with a left hemisphere malignant BT reported poorer social support at T2. The full sample performed poorly on tests of executive functioning, and 17% reported clinically elevated PTSS at T1, which reduced to 13% at T2. Younger age (<65 y), reduced QoL, and elevated anger symptoms at T1 predicted PTSS at T2, whilst having a benign BT, low PTSS, and depressive symptoms at T1 were predictive of improved QoL at T2. Findings highlight the importance of screening for psychosocial and cognitive disturbances in BT patients undergoing treatment to identify those at risk for acute and more prolonged problems.
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Affiliation(s)
- Maria Kangas
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
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Andrade P, Noblesse LHM, Temel Y, Ackermans L, Lim LW, Steinbusch HWM, Visser-Vandewalle V. Neurostimulatory and ablative treatment options in major depressive disorder: a systematic review. Acta Neurochir (Wien) 2010; 152:565-77. [PMID: 20101419 PMCID: PMC2844529 DOI: 10.1007/s00701-009-0589-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Accepted: 12/22/2009] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Major depressive disorder is one of the most disabling and common diagnoses amongst psychiatric disorders, with a current worldwide prevalence of 5-10% of the general population and up to 20-25% for the lifetime period. HISTORICAL PERSPECTIVE Nowadays, conventional treatment includes psychotherapy and pharmacotherapy; however, more than 60% of the treated patients respond unsatisfactorily, and almost one fifth becomes refractory to these therapies at long-term follow-up. NONPHARMACOLOGICAL TECHNIQUES Growing social incapacity and economic burdens make the medical community strive for better therapies, with fewer complications. Various nonpharmacological techniques like electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, lesion surgery, and deep brain stimulation have been developed for this purpose. DISCUSSION We reviewed the literature from the beginning of the twentieth century until July 2009 and described the early clinical effects and main reported complications of these methods.
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Affiliation(s)
- Pablo Andrade
- Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands.
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Gruber J, Lemoine JN, Knight RT, Harvey AG. Positive mood and sleep disturbance in acquired mania following temporal lobe damage. Brain Inj 2009; 21:1209-15. [DOI: 10.1080/02699050701644111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carvajal F, Rubio S, Martín P, Serrano JM, García-Sola R. Perception and recall of faces and facial expressions following temporal lobectomy. Epilepsy Behav 2009; 14:60-5. [PMID: 18804183 DOI: 10.1016/j.yebeh.2008.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 08/04/2008] [Accepted: 08/26/2008] [Indexed: 11/26/2022]
Abstract
The perception of and memory for faces, with or without emotional content, were studied in 43 patients with temporal lobe epilepsy who had undergone unilateral resection of the hippocampus and the amygdala and in 43 healthy participants for comparison. Each participant performed four tasks from the Florida Affect Battery (Facial Discrimination, Affect Discrimination, Affect Naming, Affect Selection) and two memory tasks (in one case of a face and in the other of a facial expression). Findings indicated that, although patients with unilateral temporal lobectomy (right or left) showed no difficulty in discriminating faces, they were not as good at remembering faces. Also, patients who had had a left temporal lobectomy showed impairment in discriminating facial expressions, in the memory of a facial expression and/or in naming facial expressions.
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Affiliation(s)
- Fernando Carvajal
- Departamento Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.
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Mollet GA, Harrison DW. Emotion and Pain: A Functional Cerebral Systems Integration. Neuropsychol Rev 2006; 16:99-121. [PMID: 17006768 DOI: 10.1007/s11065-006-9009-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Accepted: 08/02/2006] [Indexed: 10/24/2022]
Abstract
Emotion and pain are psychological constructs that have received extensive attention in neuropsychological research. However, neuropsychological models of emotional processing have made more progress in describing how brain regions interact to process emotion. Theories of emotional processing can describe inter-hemispheric and intra-hemispheric interactions during emotional processing. Due to similarities between emotion and pain, it is thought that emotional models can be applied to pain. The following review examines the neuropsychology of emotion and pain using a functional cerebral systems approach. Specific comparisons are made between pain and anger. Attention is given to differences in cerebral function and physiology that may contribute to the processing of emotion and pain. Suggestions for future research in emotion and pain are given.
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Affiliation(s)
- Gina A Mollet
- Virginia Tech Department of Psychology, Virginia Polytechnic University, Williams Hall, Blacksburg, VA 24061, USA
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Pompili M, Girardi P, Tatarelli G, Angeletti G, Tatarelli R. Suicide after surgical treatment in patients with epilepsy: a meta-analytic investigation. Psychol Rep 2006; 98:323-38. [PMID: 16796084 DOI: 10.2466/pr0.98.2.323-338] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Suicide is a major issue in surgically treated epileptic patients. A meta-analysis was performed comparing suicides in a sample of such patients and in the general population. The Index Medicus and the World Health Statistics Annual were searched to ascertain the suicide rates in the age groups indicated in the studies of epileptic patients for specific years and country. 11 studies were selected, comprising 2,425 patients, 24 of whom committed suicide. Data obtained for each study were processed together to calculate the mean number of suicides per 100,000 individuals with surgically treated epilepsy for each year. This meta-analysis shows that suicide in patients with epilepsy after surgical treatment is more frequent than in the general population. Results are discussed with particular attention to possible causative factors.
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Affiliation(s)
- Maurizio Pompili
- McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA.
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Mainio A, Hakko H, Niemelä A, Tuurinkoski T, Koivukangas J, Räsänen P. The effect of brain tumour laterality on anxiety levels among neurosurgical patients. J Neurol Neurosurg Psychiatry 2003; 74:1278-82. [PMID: 12933936 PMCID: PMC1738657 DOI: 10.1136/jnnp.74.9.1278] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the level of anxiety in patients with a primary brain tumour and to analyse the effect of tumour laterality and histology on the level of anxiety. Recurrent measurements were assessed preoperatively, three months, and one year after operation. METHODS The study population consisted of 101 patients with a primary brain tumour from unselected and homogeneous population in northern Finland. The patients were studied preoperatively with CT or MRI to determine the location of the tumour. The histology of the tumour was defined according to WHO classification. The level of anxiety was obtained by Crown-Crisp Experiential Index (CCEI) scale. RESULTS The patients with a tumour in the right hemisphere had statistically significantly higher mean anxiety scores compared to the patients with a tumour in the left hemisphere before surgery of the tumour. By three months and by one year after surgical resection of the tumour, the level of anxiety declined in patients with a tumour in the right hemisphere. A corresponding decline was not found in patients with a tumour in the left hemisphere. According to laterality by tumour histology, the level of anxiety decreased significantly in male and female patients with a glioma in the right hemisphere, but a corresponding decline was not significant in the female patients with a meningioma in the right hemisphere. Decreased level of anxiety was not found in patients with gliomas or meningiomas in the left hemisphere by follow up measurements. CONCLUSIONS Primary brain tumour in right hemisphere is associated with anxiety symptoms. The laterality of anxiety seems to reflect the differentiation of the two hemispheres. The level of anxiety declined after operation of right tumour, approaching that of the general population. The effect of right hemisphere gliomas on anxiety symptoms deserves special attention in future research.
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Affiliation(s)
- A Mainio
- Department of Psychiatry, University of Oulu, Finland.
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Andersen SL, Dumont NL, Teicher MH. Differences in behavior and monoamine laterality following neonatal clomipramine treatment. Dev Psychobiol 2002; 41:50-7. [PMID: 12115290 DOI: 10.1002/dev.10055] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Postnatal treatment between 8 to 21 days of age with clomipramine (15 mg/kg, twice daily) produces an animal model that has many of the behavioral hallmarks of depression. In this study, we investigated the enduring behavioral and neurochemical effects of this early treatment in adult animals. Locomotor activity was increased in clomipramine-treated males, but not females, relative to vehicle-treated subjects. Increases in anxiety-like behavior in the elevated plus maze also were observed in clomipramine-exposed adults, but no sex differences were detected. Clomipramine-treated animals had shifts in the laterality of monoamines in limbic regions with lower serotonin levels on the right side while vehicle-treated animals had lower serotonin on the left side. The lateralization of dopamine content demonstrated the same pattern. This decline in monoaminergic content is consistent with clinical studies demonstrating decrements in serotonin as well as alterations in the lateralization of function in individuals with major depressive order.
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Affiliation(s)
- Susan L Andersen
- Department of Psychiatry, Harvard Medical School, Laboratory of Developmental Psychopharmacology, McLean Hospital, Belmont, MA 02478, USA
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