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Zhang Q, Sun W, Huang K, Qin L, Wen S, Long X, Wang Q, Feng L. Frontal lobe epilepsy: an eye tracking study of memory and attention. Front Neurosci 2023; 17:1298468. [PMID: 38116071 PMCID: PMC10728291 DOI: 10.3389/fnins.2023.1298468] [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: 09/21/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Objective To explore the characteristics and mechanisms of working memory impairment in patients with frontal lobe epilepsy (FLE) through a memory game paradigm combined with eye tracking technology. Method We included 44 patients with FLE and 50 healthy controls (HC). All participants completed a series of neuropsychological scale assessments and a short-term memory game on an automated computer-based memory evaluation platform with an eye tracker. Results Memory scale scores of FLE patients including digit span (U = 747.50, p = 0.007), visual recognition (U = 766.50, p = 0.010), and logical memory (U = 544.00, p < 0.001) were significantly lower than HC. The patients with FLE took longer to complete the four levels of difficulty of the short-term memory game than healthy controls (level 1: U = 2974.50, p = 0.000; level 2: U = 3060.50, p = 0.000; level 3: U = 2465.00, p = 0.000; level 4: U = 2199.00, p = 0.000). During the memory decoding period, first fixation on the targets took significantly longer for FLE patients for all difficulty levels compared to controls (level 1: U = 3407.00, p = 0.008; level 2: U = 3618.00, p = 0.036; level 3: U = 3345.00, p = 0.006; level 4: U = 2781.00, p = 0.000). The average fixation duration per target among patients with FLE was found to be significantly longer compared to HC (level 1: U = 2994.50, p = 0.000; level 2: U = 3101.00, p = 0.000; level 3: U = 2559.50, p = 0.000; level 4: U = 2184.50, p = 0.000). The total fixation duration on AOI/total completion time of FLE patients was significantly lower than those of HC for levels 1 to 3 (level 1: U = 1557.00, p = 0.000; level 2: U = 2333.00, p = 0.000; level 3: U = 2757.00, p = 0.000). Furthermore, the eye tracking data during the memory decoding phase were correlated with neuropsychological scale scores (p < 0.05). Conclusion Patients with FLE exhibited short-term memory impairment probably due to deficits in attentional maintenance, especially during the memory decoding phase. Eye tracking technology provided the possibility to help separate and quantify visual attention from memory processing, contributing to exploring underlying mechanisms of memory impairment in FLE.
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Affiliation(s)
- Qiong Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weifeng Sun
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi’an, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Qin
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shirui Wen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaoyan Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Quan Wang
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi’an, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Cavaco S, Moreira B, Dias D, Gonçalves A, Pinto C, Almeida E, Gomes F, Moreira I, Chaves J, Lopes J, Ramalheira J, Freitas J, Samões R, Rangel R, Martins da Silva A. Auditory verbal learning test can lateralize hippocampal sclerosis. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-7. [PMID: 35754382 DOI: 10.1080/23279095.2022.2090257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The ability of the Auditory Verbal Learning Test (AVLT) to lateralize hippocampal sclerosis (HS) in mesial temporal lobe epilepsy (MTLE) was explored in a sample of 50 patients with MTLE-HS (23 right and 27 left). Patients' AVLT scores were adjusted to the demographic characteristics of each individual in accordance with the Portuguese normative data. The laterality of the HS was determined by consensus by two neuroradiologists. ROC curves were used to identify the best AVLT cutoff scores to differentiate right vs. left HS. Diagnostic statistics were applied to different AVLT measures. The study results revealed that four AVLT scores can correctly classify the laterality of HS in the total sample and a sub-group of 39 right-handed patients (Edinburgh Laterality Inventory +100): delayed recall trial (76 and 80%, respectively), delayed recognition trial (64 and 67%, respectively), learning over trials index (64 and 74%, respectively), and long-term percent retention index (68 and 72%, respectively). In right-handed patients, the diagnostic capability of the delayed recall trial was improved by pairing it with the learning over trials index (accuracy of 85%). In sum, AVLT measures of verbal memory differentiate left from right HS in MTLE. The delayed recall trial demonstrated good diagnostic capacity.
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Affiliation(s)
- Sara Cavaco
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
- UMIB, Universidade do Porto Instituto de Ciencias Biomedicas Abel Salazar, Porto, Portugal
| | - Bruno Moreira
- Neuroradiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Daniel Dias
- Neuroradiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Alexandra Gonçalves
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Claudia Pinto
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Eduarda Almeida
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Filomena Gomes
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Inês Moreira
- Neuropsychology Unit, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Chaves
- Neurology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Lopes
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - João Ramalheira
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Joel Freitas
- Neurophysiology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Raquel Samões
- Neurology Department, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
| | - Rui Rangel
- Department of Neurosurgery, Centro Hospitalar Universitario do Porto EPE, Porto, Portugal
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Mezjan I, Brissart H, Masson D, Vignal JP, Aron O, Ferrand M, Civit T, Maillard L, Colnat-Coulbois S. Epilepsy surgery for drug-resistant temporal lobe epilepsy in over-50 year-olds: seizure outcome, surgical complications and neuropsychological outcome. Neurochirurgie 2022; 68:510-517. [DOI: 10.1016/j.neuchi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/19/2022] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
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Syndrome of the trephined: clinical spectrum, risk factors, and impact of cranioplasty on neurologic recovery in a prospective cohort. Neurosurg Rev 2021; 45:1431-1443. [PMID: 34618250 PMCID: PMC8976790 DOI: 10.1007/s10143-021-01655-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/09/2021] [Accepted: 09/24/2021] [Indexed: 01/18/2023]
Abstract
Syndrome of the trephined (SoT) is an underrecognized complication after decompressive craniectomy. We aimed to investigate SoT incidence, clinical spectrum, risk factors, and the impact of the cranioplasty on neurologic recovery. Patients undergoing a large craniectomy (> 80 cm2) and cranioplasty were prospectively evaluated using modified Rankin score (mRS), cognitive (attention/processing speed, executive function, language, visuospatial), motor (Motricity Index, Jamar dynamometer, postural score, gait assessment), and radiologic evaluation within four days before and after a cranioplasty. The primary outcome was SoT, diagnosed when a neurologic improvement was observed after the cranioplasty. The secondary outcome was a good neurologic outcome (mRS 0–3) 4 days and 90 days after the cranioplasty. Logistic regression models were used to evaluate the risk factors for SoT and the impact of cranioplasty timing on neurologic recovery. We enrolled 40 patients with a large craniectomy; 26 (65%) developed SoT and improved after the cranioplasty. Brain trauma, hemorrhagic lesions, and shifting of brain structures were associated with SoT. After cranioplasty, a shift towards a good outcome was observed within 4 days (p = 0.025) and persisted at 90 days (p = 0.005). Increasing delay to cranioplasty was associated with decreased odds of improvement when adjusting for age and baseline disability (odds ratio 0.96; 95% CI, 0.93–0.99, p = 0.012). In conclusion, SoT is frequent after craniectomy and interferes with neurologic recovery. High suspicion of SoT should be exercised in patients who fail to progress or have a previous trauma, hemorrhage, or shifting of brain structures. Performing the cranioplasty earlier was associated with improved and quantifiable neurologic recovery.
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Zhu G, Wang J, Xiao L, Yang K, Huang K, Li B, Huang S, Hu B, Xiao B, Liu D, Feng L, Wang Q. Memory Deficit in Patients With Temporal Lobe Epilepsy: Evidence From Eye Tracking Technology. Front Neurosci 2021; 15:716476. [PMID: 34557066 PMCID: PMC8453169 DOI: 10.3389/fnins.2021.716476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore quantitative measurements of the visual attention and neuroelectrophysiological relevance of memory deficits in temporal lobe epilepsy (TLE) by eye tracking and electroencephalography (EEG). Methods: Thirty-four TLE patients and twenty-eight healthy controls were invited to complete neurobehavioral assessments, cognitive oculomotor tasks, and 24-h video EEG (VEEG) recordings using an automated computer-based memory assessment platform with an eye tracker. Visit counts, visit time, and time of first fixation on areas of interest (AOIs) were recorded and analyzed in combination with interictal epileptic discharge (IED) characteristics from the bilateral temporal lobes. Results: The TLE patients had significantly worse Wechsler Digit Span scores [F(1, 58) = 7.49, p = 0.008]. In the Short-Term Memory Game with eye tracking, TLE patients took a longer time to find the memorized items [F(1, 57) = 17.30, p < 0.001]. They had longer first fixation [F(1, 57) = 4.06, p = 0.049] and more visit counts [F(1, 57) = 7.58, p = 0.008] on the target during the recall. Furthermore, the performance of the patients in the Digit Span task was negatively correlated with the total number of IEDs [r(28) = −0.463, p = 0.013] and the number of spikes per sleep cycle [r(28) = −0.420, p = 0.026]. Conclusion: Eye tracking appears to be a quantitative, objective measure of memory evaluation, demonstrating memory retrieval deficits but preserved visual attention in TLE patients. Nocturnal temporal lobe IEDs are closely associated with memory performance, which might be the electrophysiological mechanism for memory impairment in TLE.
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Affiliation(s)
- Guangpu Zhu
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China.,University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
| | - Jing Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ling Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ke Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Beibin Li
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Bingliang Hu
- Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Ding Liu
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Quan Wang
- Key Laboratory of Spectral Imaging Technology, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China.,Key Laboratory of Biomedical Spectroscopy of Xi'an, Xi'an Institute of Optics and Precision Mechanics of the Chinese Academy of Sciences, Xi'an, China
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Hua X, Liu C, Qiao Y, Jia C, Zhang R, Jiao H. Effect of Co-administration of Compound Danshen Dripping Pills and Valproic Acid on Temporal Lobe Epilepsy. INT J PHARMACOL 2021. [DOI: 10.3923/ijp.2021.200.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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