1
|
Gionet S, Lord M, Plourde V. The diagnosis of ADHD in children and adolescents with epilepsy: a scoping review. Child Neuropsychol 2024:1-33. [PMID: 38588042 DOI: 10.1080/09297049.2024.2337954] [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: 09/29/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is often diagnosed in children and adolescents with epilepsy, but clear clinical guidelines on how to make this diagnosis are still lacking. Without these guidelines, there is no consensus between specialists on how to proceed when assessing children with epilepsy for ADHD, which can negatively impact the quality of care being offered to this population. As a first step toward gaining more specific clinical guidelines, this scoping review was aimed at documenting the tools and procedures used to diagnose ADHD in children and adolescents with epilepsy over time and at determining whether the diagnoses were made in accordance with clinical guidelines and recommendations. The literature search was conducted using PsycINFO, PubMed, and CINAHL. Studies were included if conducted with children and adolescents aged between 4 and 18 years with epilepsy being evaluated for ADHD. Studies were clustered according to their publication date and the reported diagnostic procedures were identified. Forty-nine out of 3854 records were included. Results highlight discrepancies between how ADHD was diagnosed in reviewed studies and clinical guidelines or recommendations. Indeed, most studies did not use a multi-method and multi-informant approach when diagnosing ADHD in children with epilepsy, with no improvement over time. Future studies aimed at diagnosing ADHD in children and adolescents should ensure that they are following clinical guidelines and recommendations, in addition to adapting their diagnostic procedures to the presence of any neurological comorbidities, such as epilepsy.
Collapse
Affiliation(s)
| | - Maryse Lord
- École de Psychologie, Université de Moncton, Moncton, Canada
| | - Vickie Plourde
- École de Psychologie, Université de Moncton, Moncton, Canada
- Centre de formation médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, Canada
- Faculté Saint-Jean, University of Alberta, Edmonton, Canada
| |
Collapse
|
2
|
Li SP, Lin LC, Yang RC, Ouyang CS, Chiu YH, Wu MH, Tu YF, Chang TM, Wu RC. Predicting the therapeutic response to valproic acid in childhood absence epilepsy through electroencephalogram analysis using machine learning. Epilepsy Behav 2024; 151:109647. [PMID: 38232558 DOI: 10.1016/j.yebeh.2024.109647] [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: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
Childhood absence epilepsy (CAE) is a common type of idiopathic generalized epilepsy, manifesting as daily multiple absence seizures. Although seizures in most patients can be adequately controlled with first-line antiseizure medication (ASM), approximately 25 % of patients respond poorly to first-line ASM. In addition, an accurate method for predicting first-line medication responsiveness is lacking. We used the quantitative electroencephalogram (QEEG) features of patients with CAE along with machine learning to predict the therapeutic effects of valproic acid in this population. We enrolled 25 patients with CAE from multiple medical centers. Twelve patients who required additional medication for seizure control or who were shifted to another ASM and 13 patients who achieved seizure freedom with valproic acid within 6 months served as the nonresponder and responder groups. Using machine learning, we analyzed the interictal background EEG data without epileptiform discharge before ASM. The following features were analyzed: EEG frequency bands, Hjorth parameters, detrended fluctuation analysis, Higuchi fractal dimension, Lempel-Ziv complexity (LZC), Petrosian fractal dimension, and sample entropy (SE). We applied leave-one-out cross-validation with support vector machine, K-nearest neighbor (KNN), random forest, decision tree, Ada boost, and extreme gradient boosting, and we tested the performance of these models. The responders had significantly higher alpha band power and lower delta band power than the nonresponders. The Hjorth mobility, LZC, and SE values in the temporal, parietal, and occipital lobes were higher in the responders than in the nonresponders. Hjorth complexity was higher in the nonresponders than in the responders in almost all the brain regions, except for the leads FP1 and FP2. Using KNN classification with theta band power in the temporal lobe yielded optimal performance, with sensitivity of 92.31 %, specificity of 76.92 %, accuracy of 84.62 %, and area under the curve of 88.46 %.We used various EEG features along with machine learning to accurately predict whether patients with CAE would respond to valproic acid. Our method could provide valuable assistance for pediatric neurologists in selecting suitable ASM.
Collapse
Affiliation(s)
- Sheng-Ping Li
- Division of Pediatric Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan
| | - Lung-Chang Lin
- Division of Pediatric Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan.
| | - Rei-Cheng Yang
- Division of Pediatric Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan
| | - Chen-Sen Ouyang
- Department of Information Management, National Kaohsiung University of Science and Technology, Taiwan
| | - Yi-Hung Chiu
- Department of Information Engineering, I-Shou University, Taiwan
| | - Mu-Han Wu
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Taiwan
| | - Yi-Fang Tu
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tung-Ming Chang
- Department of Pediatric Neurology, Changhua Christian Children's Hospital, Changhua, Taiwan
| | - Rong-Ching Wu
- Department of Electrical Engineering, I-Shou University, Taiwan
| |
Collapse
|
3
|
Eussen MJ, Jansen JF, Voncken TP, Debeij-Van Hall MH, Hendriksen JG, Vermeulen RJ, Klinkenberg S, Backes WH, Drenthen GS. Exploring the core network of the structural covariance network in childhood absence epilepsy. Heliyon 2023; 9:e22657. [PMID: 38107302 PMCID: PMC10724663 DOI: 10.1016/j.heliyon.2023.e22657] [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: 02/09/2023] [Revised: 10/04/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Childhood absence epilepsy (CAE) is a generalized pediatric epilepsy, which is generally considered to be a benign condition since most children become seizure-free before reaching adulthood. However, cognitive deficits and changes of brain morphological have been previously reported in CAE. These morphological changes, even if they might be very subtle, are not independent due to the underlying network structure and can be captured by the structural covariance network (SCN). In this study, SCNs were used to quantify the structural brain network for children with CAE as well as controls. Seventeen children with CAE (6-12y) and fifteen controls (6-12y) were included. To estimate the SCN, T1-weighted images were acquired and parcellated into 68 cortical regions. Graph measures characterizing the core network architecture, i.e. the assortativity and rich-club coefficient, were calculated for all individuals. Multivariable linear regression models, including age and sex as covariates, were used to assess differences between children with CAE and controls. Additionally, potential relations between the core network and cognitive performance was investigated. A lower assortativity (i.e. less efficiently organized core network organization) was found for children with CAE compared to controls. Moreover, better cognitive performance was found to relate to stronger assortative mixing pattern (i.e. more efficient core network structure). Rich-club coefficients did not differ between groups, nor relate to cognitions. The core network organization of the SCN in children with CAE tend to be less efficient organized compared to controls, and relates to cognitive performance, and therefore this study provides novel insights into the SCN organization in relation to CAE and cognition.
Collapse
Affiliation(s)
- Merel J.A. Eussen
- Department of Biomedical Technology, Eindhoven University of Technology, Eindhoven, the Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jacobus F.A. Jansen
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Twan P.C. Voncken
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, the Netherlands
| | | | - Jos G.M. Hendriksen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, the Netherlands
| | - R. Jeroen Vermeulen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sylvia Klinkenberg
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Walter H. Backes
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gerhard S. Drenthen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| |
Collapse
|
4
|
Zhang T, Zhang Y, Ren J, Zhou H, Yang M, Li L, Lei D, Gong Q, Zhou D, Yang T. Dynamic alterations of striatal-related functional networks in juvenile absence epilepsy. Epilepsy Behav 2023; 149:109506. [PMID: 37925871 DOI: 10.1016/j.yebeh.2023.109506] [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: 07/03/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To explore the features of dynamic functional connectivity (dFC) variability of striatal-cortical/subcortical networks in juvenile absence epilepsy (JAE). METHODS We collected resting-state functional magnetic imaging data from 18 JAE patients and 28 healthy controls. The striatum was divided into six pairs of regions: the inferior-ventral striatum (VSi), superior-ventral striatum (VSs), dorsal-caudal putamen, dorsal-rostral putamen, dorsal-caudate (DC) and ventral-rostral putamen. We assessed the dFC variability of each subdivision in the whole brain using the sliding-window method, and correlated altered circuit with clinical variables in JAE patients. RESULTS We found altered dFC variability of striatal-cortical/subcortical networks in patients with JAE. The VSs exhibited decreased dFC variability with subcortical regions, and dFC variability between VSs and thalamus was negatively correlated with epilepsy duration. For the striatal-cortical networks, the dFC variability was decreased in VSi-affective network but increased in DC-executive network. The altered dynamics of striatal-cortical networks involved crucial nodes of the default mode network (DMN). CONCLUSION JAE patients exhibit excessive stability in the striatal-subcortical networks. For striatal-cortical networks in JAE, the striatal-affective circuit was more stable, while the striatal-executive circuit was more variable. Furthermore, crucial nodes of DMN were changed in striatal-cortical networks in JAE.
Collapse
Affiliation(s)
- Tianyu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yingying Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiechuan Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huanyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Menghan Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
5
|
Jiang T, Zhang X, Zhang M, Liu M, Zhu H, Sun Y. Drug-resistant idiopathic generalized epilepsy: A meta-analysis of prevalence and risk factors. Epilepsy Behav 2023; 146:109364. [PMID: 37523796 DOI: 10.1016/j.yebeh.2023.109364] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Idiopathic generalized epilepsy (IGE) is a common epilepsy syndrome with early age onset and generally good seizure outcomes. This study aims to determine the incidence and predictive risk factors for drug-resistant IGE. METHODS We systematically searched three databases (PubMed, Embase, and Cochrane Library) in November 2022 and included 12 eligible studies which reported long-term outcomes (mean = 14.05) after antiseizure medications (ASMs) from 2001 to 2020. We defined drug resistance as the persistence of any seizure despite ASMs treatment (whether as monotherapies or in combination) given the criteria of drug resistance varied in original studies. A random-effects model was used to evaluate the prevalence of refractory IGE. Studies reporting potential poor prognostic factors were included for subsequent subgroup meta-analysis. RESULTS The pooled prevalence of drug resistance in IGE cohorts was 27% (95% CI: 0.19-0.36). Subgroup analysis of the risk factors revealed that the psychiatric comorbidities (odds ratio (OR): 4.87, 95% confidence interval (CI): 2.97-7.98), combined three seizure types (absences, myoclonic jerks, and generalized tonic-clonic seizures) (OR: 5.37, 95% CI: 3.16-9.13), the presence of absence seizure (OR: 4.38, 95% CI: 2.64-7.28), generalized polyspike trains (GPT) (OR: 4.83, 95% CI: 2.42-9.64), sex/catamenial epilepsy (OR: 3.25, 95% CI: 1.97-5.37), and status epilepticus (OR: 5.94, 95% CI: 2.23-15.85) increased the risk of poor prognosis. Other factors, including age onset, family history, and side effects of ASMs, were insignificantly associated with a higher incidence of refractory IGE. CONCLUSION Drug resistance is a severe complication of IGE. Further standardized research about clinical and electroencephalography factors is warranted.
Collapse
Affiliation(s)
- Tong Jiang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Xiaohan Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Mengwen Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Min Liu
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Haifang Zhu
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| | - Yanping Sun
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
| |
Collapse
|
6
|
School performance and psychiatric comorbidity in childhood absence epilepsy: A Danish cohort study. Eur J Paediatr Neurol 2023; 42:75-81. [PMID: 36584475 DOI: 10.1016/j.ejpn.2022.12.008] [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: 03/06/2022] [Revised: 10/12/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
The aim was to determine school performance and psychiatric comorbidity in children with childhood absence epilepsy (CAE). We reviewed the medical records in children with ICD-10 codes for idiopathic generalized epilepsy before 18 years of age, and pediatric neurologists confirmed the International League Against Epilepsy criteria for CAE were met. Control groups were the general pediatric population or children with non-neurological chronic disease. Outcomes were from nationwide and population-based registers on school performance and psychiatric comorbidity. We compared the mean grade point average using linear regression and estimated hazard ratios (HR) using Cox regression for the other outcomes. Analyses were adjusted for the child's sex, and year of birth, and parental highest education, receipt of cash benefits or early disability pension. We included 114 children with CAE with a median age at onset of 5.9 years (interquartile range = 4.5-7.3 years). Compared with both population controls and non-neurological chronically ill children, children with CAE had increased hazard of special needs education (HR = 2.7, 95% confidence interval (CI) = 1.8-4.1, p < 0.0001), lower grade point average at 9th grade by 1.7 grade points (95% CI = -2.5 to -1.0, p < 0.001), increased ADHD medicine use (HR = 4.4, 95% CI = 2.7-7.2, p < 0.001), increased sleep medicine use (HR = 2.7, 95% CI = 1.7-4.3, p < 0.001), and increased psychiatry visits (HR = 2.1, 95% CI = 1.1-4.0, p = 0.03). In conclusion, children with CAE have increased psychiatric comorbidity and a considerable proportion of these children receive special needs education in primary/secondary school, albeit insufficient to normalize their considerably lower grade point average in the 9th grade.
Collapse
|
7
|
Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G, David F. Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures. Brain 2020; 143:2341-2368. [PMID: 32437558 PMCID: PMC7447525 DOI: 10.1093/brain/awaa072] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/19/2019] [Accepted: 01/31/2020] [Indexed: 12/24/2022] Open
Abstract
Absence seizures in children and teenagers are generally considered relatively benign because of their non-convulsive nature and the large incidence of remittance in early adulthood. Recent studies, however, show that 30% of children with absence seizures are pharmaco-resistant and 60% are affected by severe neuropsychiatric comorbid conditions, including impairments in attention, cognition, memory and mood. In particular, attention deficits can be detected before the epilepsy diagnosis, may persist even when seizures are pharmacologically controlled and are aggravated by valproic acid monotherapy. New functional MRI-magnetoencephalography and functional MRI-EEG studies provide conclusive evidence that changes in blood oxygenation level-dependent signal amplitude and frequency in children with absence seizures can be detected in specific cortical networks at least 1 min before the start of a seizure, spike-wave discharges are not generalized at seizure onset and abnormal cortical network states remain during interictal periods. From a neurobiological perspective, recent electrical recordings and imaging of large neuronal ensembles with single-cell resolution in non-anaesthetized models show that, in contrast to the predominant opinion, cortical mechanisms, rather than an exclusively thalamic rhythmogenesis, are key in driving seizure ictogenesis and determining spike-wave frequency. Though synchronous ictal firing characterizes cortical and thalamic activity at the population level, individual cortico-thalamic and thalamocortical neurons are sparsely recruited to successive seizures and consecutive paroxysmal cycles within a seizure. New evidence strengthens previous findings on the essential role for basal ganglia networks in absence seizures, in particular the ictal increase in firing of substantia nigra GABAergic neurons. Thus, a key feature of thalamic ictogenesis is the powerful increase in the inhibition of thalamocortical neurons that originates at least from two sources, substantia nigra and thalamic reticular nucleus. This undoubtedly provides a major contribution to the ictal decrease in total firing and the ictal increase of T-type calcium channel-mediated burst firing of thalamocortical neurons, though the latter is not essential for seizure expression. Moreover, in some children and animal models with absence seizures, the ictal increase in thalamic inhibition is enhanced by the loss-of-function of the astrocytic GABA transporter GAT-1 that does not necessarily derive from a mutation in its gene. Together, these novel clinical and experimental findings bring about paradigm-shifting views of our understanding of absence seizures and demand careful choice of initial monotherapy and continuous neuropsychiatric evaluation of affected children. These issues are discussed here to focus future clinical and experimental research and help to identify novel therapeutic targets for treating both absence seizures and their comorbidities.
Collapse
Affiliation(s)
- Vincenzo Crunelli
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK
| | - Magor L Lőrincz
- Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK.,Department of Physiology, Faculty of Medicine, University of Szeged, Szeged, Hungary.,Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Cian McCafferty
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Régis C Lambert
- Sorbonne Université, CNRS, INSERM, Neuroscience Paris Seine and Institut de Biologie Paris Seine (NPS - IBPS), Paris, France
| | - Nathalie Leresche
- Sorbonne Université, CNRS, INSERM, Neuroscience Paris Seine and Institut de Biologie Paris Seine (NPS - IBPS), Paris, France
| | - Giuseppe Di Giovanni
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Neuroscience Division, School of Bioscience, Cardiff University, Museum Avenue, Cardiff, UK
| | - François David
- Cerebral dynamics, learning and plasticity, Integrative Neuroscience and Cognition Center - UMR 8002, Paris, France
| |
Collapse
|
8
|
Zhang T, Zhang Y, Ren J, Yang C, Zhou H, Li L, Lei D, Gong Q, Zhou D, Yang T. Aberrant basal ganglia-thalamo-cortical network topology in juvenile absence epilepsy: A resting-state EEG-fMRI study. Seizure 2020; 84:78-83. [PMID: 33307464 DOI: 10.1016/j.seizure.2020.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/22/2020] [Accepted: 11/28/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The underlying pathophysiology of juvenile absence epilepsy (JAE) is unclear. Since cortical and subcortical brain regions are thought to be altered in genetic generalized epilepsy, the present study examined the resting-state functional network topology of the same regions in JAE. METHODS Electroencephalography and functional magnetic resonance imaging (EEG-fMRI) were performed on 18 JAE patients and 28 healthy controls (HCs). The topology of functional networks was analyzed using the graph-theoretic method. Both global and nodal network parameters were calculated, and parameters differing significantly between the two groups were correlated with clinical variables. RESULTS Both JAE patients and HCs had small-world functional network topological architectures. However, JAE patients showed higher values for the global parameters of clustering coefficient (Cp) and normalized characteristic path length (Lambda). At the nodal level, patients exhibited greater centrality at widespread cortices, including the left superior parietal gyrus, right superior temporal gyrus, right orbital part of middle frontal gyrus and bilateral supplementary motor area. Conversely, patients showed decreased nodal centrality predominantly in the limbic network, left thalamus and right caudate nucleus. Degree centrality in the right hippocampus and betweenness centrality in the right caudate nucleus positively correlated with epilepsy duration. CONCLUSION The global functional network of JAE shows small-world properties, but tends to be regular with higher segregation and lower integration. Regions in the basal ganglia-thalamo-cortical network have aberrant nodal centrality. The hippocampus and caudate nucleus may reorganize as epilepsy progresses. Our findings indicate the pathogenesis and compensatory mechanisms to seizure attacks and cognitive deficits of JAE.
Collapse
Affiliation(s)
- Tianyu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yingying Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiechuan Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cheng Yang
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huanyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
9
|
Kenchaiah R, Satishchandra P, Bhargava Goutham K, Dawn BR, Sain J, Kulanthaivelu K, Mundlamuri RC, Asranna A, Sinha S. Cortical-Subcortical morphometric signature of hot water epilepsy patients. Epilepsy Res 2020; 167:106436. [PMID: 32846313 DOI: 10.1016/j.eplepsyres.2020.106436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/20/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cortical and subcortical grey matter (GM) morphometric changes have been demonstrated Temporal Lobe Epilepsy (TLE) or Idiopathic Generalized Epilepsies (IGE). Hot Water Epilepsy (HWE) has not hitherto been studied in these perspectives. PURPOSE To investigate the cortical and subcortical grey matter in subjects with HWE in terms of thickness, volume, and surface area using Surface-Based Morphometry (SBM). To assess relationships of SBM-derived metrics with clinical variables. MATERIALS AND METHODS Ninety-nine people with HWE and 50 age-matched healthy controls underwent high resolution volumetric MRI brain. These were processed with FreeSurfer to obtain SBM parameters i:e cortical thickness, cortical volume, and Cortical surface area. Volumes of seven subcortical GM structures (hippocampus, globus pallidus, nucleus ambiguous(NA), caudate nucleus, putamen, thalamus, and amygdala) were computed. Intergroup morphometric differences and their correlation with epilepsy-specific clinical variables were calculated. RESULTS SBM revealed a global reduction in bihemispheric cortical thickness and left hemispheric cortical volume. Besides, a regional difference in the morphometric measures was noted in temporo-limbic, parietal, pre-cuneus, and the cingulate region. Reduced volume of thalami and left caudate alongside an increased volume of the bilateral amygdala, bilateral nucleus ambiguous (NA), right caudate, and putamen was the other cardinal observation. CONCLUSION HWE subjects show alterations in the morphometry of the cortical ribbon and the subcortical grey matter. The temporal semiology, 'reflex nature' pathophysiology correlates involvement of temporo-limbic structures/somatosensory cortex, while the involvement of structures like pre-cuneus, posterior cingulate, and frontal regions are in agreement with functional networks related loss of awareness. That bilateral amygdala swelling occurs in HWE is a novel observation and may signal that it could be a distinct variant of Mesial TLE.
Collapse
Affiliation(s)
- Raghavendra Kenchaiah
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - P Satishchandra
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - K Bhargava Goutham
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India; Departments of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Bharath Rose Dawn
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Jitender Sain
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Karthik Kulanthaivelu
- Departments of Neuro-Imaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | | | - Ajay Asranna
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Sanjib Sinha
- Departments of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India.
| |
Collapse
|
10
|
Purvis EM, O'Donnell JC, Chen HI, Cullen DK. Tissue Engineering and Biomaterial Strategies to Elicit Endogenous Neuronal Replacement in the Brain. Front Neurol 2020; 11:344. [PMID: 32411087 PMCID: PMC7199479 DOI: 10.3389/fneur.2020.00344] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/07/2020] [Indexed: 12/19/2022] Open
Abstract
Neurogenesis in the postnatal mammalian brain is known to occur in the dentate gyrus of the hippocampus and the subventricular zone. These neurogenic niches serve as endogenous sources of neural precursor cells that could potentially replace neurons that have been lost or damaged throughout the brain. As an example, manipulation of the subventricular zone to augment neurogenesis has become a popular strategy for attempting to replace neurons that have been lost due to acute brain injury or neurodegenerative disease. In this review article, we describe current experimental strategies to enhance the regenerative potential of endogenous neural precursor cell sources by enhancing cell proliferation in neurogenic regions and/or redirecting migration, including pharmacological, biomaterial, and tissue engineering strategies. In particular, we discuss a novel replacement strategy based on exogenously biofabricated "living scaffolds" that could enhance and redirect endogenous neuroblast migration from the subventricular zone to specified regions throughout the brain. This approach utilizes the first implantable, biomimetic tissue-engineered rostral migratory stream, thereby leveraging the brain's natural mechanism for sustained neuronal replacement by replicating the structure and function of the native rostral migratory stream. Across all these strategies, we discuss several challenges that need to be overcome to successfully harness endogenous neural precursor cells to promote nervous system repair and functional restoration. With further development, the diverse and innovative tissue engineering and biomaterial strategies explored in this review have the potential to facilitate functional neuronal replacement to mitigate neurological and psychiatric symptoms caused by injury, developmental disorders, or neurodegenerative disease.
Collapse
Affiliation(s)
- Erin M. Purvis
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - John C. O'Donnell
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - H. Isaac Chen
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - D. Kacy Cullen
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
11
|
Ratcliffe C, Wandschneider B, Baxendale S, Thompson P, Koepp MJ, Caciagli L. Cognitive Function in Genetic Generalized Epilepsies: Insights From Neuropsychology and Neuroimaging. Front Neurol 2020; 11:144. [PMID: 32210904 PMCID: PMC7076110 DOI: 10.3389/fneur.2020.00144] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Genetic generalized epilepsies (GGE), previously called idiopathic generalized epilepsies, constitute about 20% of all epilepsies, and include childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, and epilepsy with generalized tonic-clonic seizures alone (CAE, JAE, JME, and GGE-GTCS, respectively). GGE are characterized by high heritability, likely underlain by polygenetic mechanisms, which may relate to atypical neurodevelopmental trajectories. Age of onset ranges from pre-school years, for CAE, to early adulthood for GGE-GTCS. Traditionally, GGE have been considered benign, a belief contrary to evidence from neuropsychology studies conducted over the last two decades. In JME, deficits in executive and social functioning are common findings and relate to impaired frontal lobe function. Studies using neuropsychological measures and cognitive imaging paradigms provide evidence for hyperconnectivity between prefrontal and motor cortices, aberrant fronto-thalamo-cortical connectivity, and reduced fronto-cortical and subcortical gray matter volumes, which are associated with altered cognitive performance. Recent research has also identified associations between abnormal hippocampal morphometry and fronto-temporal activation during episodic memory. Longitudinal studies on individuals with newly diagnosed JME have observed cortical dysmaturation, which is paralleled by delayed cognitive development compared to the patients' peers. Comorbidities and cognitive deficits observed in other GGE subtypes, such as visuo-spatial and language deficits in both CAE and JAE, have also been correlated with atypical neurodevelopment. Although it remains unclear whether cognitive impairment profiles differ amongst GGE subtypes, effects may become more pronounced with disease duration, particularly in absence epilepsies. Finally, there is substantial evidence that patients with JME and their unaffected siblings share patterns of cognitive deficits, which is indicative of an underlying genetic etiology (endophenotype), independent of seizures and anti-epileptic medication.
Collapse
Affiliation(s)
- Corey Ratcliffe
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Pamela Thompson
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Matthias J. Koepp
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
12
|
Kim EH, Shim WH, Lee JS, Yoon HM, Ko TS, Yum MS. Altered Structural Network in Newly Onset Childhood Absence Epilepsy. J Clin Neurol 2020; 16:573-580. [PMID: 33029962 PMCID: PMC7541981 DOI: 10.3988/jcn.2020.16.4.573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Recent quantitative neuroimaging studies of childhood absence epilepsy (CAE) have identified various structural abnormalities that might be involved in the onset of absence seizure and associated cognitive and behavioral functions. However, the neuroanatomical alterations specific to CAE remain unclear, and so this study investigated the regional alterations of brain structures associated with newly diagnosed CAE. METHODS Surface and volumetric magnetic resonance imaging data of patients with newly diagnosed CAE (n=18) and age-matched healthy controls (n=18) were analyzed using Free-Surfer software. A group comparison using analysis of covariance was performed with significance criteria of p<0.05 and p<0.01 in global and regional analyses, respectively. RESULTS Compared with control subjects, the patients with CAE had smaller total and regional volumes of cortical gray-matter (GM) in the right rostral middle frontal, right lateral orbitofrontal, and left rostral middle frontal regions, as well as in the right precentral, right superior, middle, left middle, and inferior temporal gyri. The cortex in the right posterior cingulate gyrus and left medial occipital region was significantly thicker in patients with CAE than in controls. CONCLUSIONS Patients with CAE showed a reduced bilateral frontotemporal cortical GM volume and an increased posterior medial cortical thickness, which are associated with the default mode network. These structural changes can be suggested as the neural basis of the absence seizures and neuropsychiatric comorbidities in CAE.
Collapse
Affiliation(s)
- Eun Hee Kim
- Department of Pediatrics, Sejong Chungnam National University Hospital, Chungnam National University College of Medicine, Sejong, Korea.,Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - Woo Hyun Shim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Seong Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Mang Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Sung Ko
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Sun Yum
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
| |
Collapse
|
13
|
Fonseca Wald ELA, Hendriksen JGM, Drenthen GS, Kuijk SMJV, Aldenkamp AP, Vles JSH, Vermeulen RJ, Debeij-van Hall MHJA, Klinkenberg S. Towards a Better Understanding of Cognitive Deficits in Absence Epilepsy: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2019; 29:421-449. [PMID: 31776780 PMCID: PMC6892766 DOI: 10.1007/s11065-019-09419-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/21/2019] [Indexed: 12/30/2022]
Abstract
Cognition in absence epilepsy (AE) is generally considered undisturbed. However, reports on cognitive deficits in AE in recent years have suggested otherwise. This review systematically assesses current literature on cognitive performance in children with AE. A systematic literature search was performed in Pubmed, Embase, Cochrane and Web of Science. All studies reporting on cognitive performance in children with AE were considered. In total 33 studies were eligible for inclusion. Neuropsychological tests were classified into the following domains: intelligence; executive function; attention; language; motor & sensory-perceptual examinations; visuoperceptual/visuospatial/visuoconstructional function; memory and learning; achievement. Random-effect meta-analyses were conducted by estimating the pooled mean and/or pooling the mean difference in case-control studies. Full-scale IQ in children with AE was estimated at 96.78 (95%CI:94.46–99.10) across all available studies and in case-control studies IQ was on average 8.03 (95%CI:-10.45- -5.61) lower. Verbal IQ was estimated at 97.98 (95%CI:95.80–100.16) for all studies and 9.01 (95%CI:12.11- -5.90) points lower in case-control studies. Performance IQ was estimated at 97.23 (93.24–101.22) for all available studies and 5.32 (95%CI:-8.27–2.36) points lower in case-control studies. Lower performance was most often reported in executive function (cognitive flexibility, planning, and verbal fluency) and attention (sustained, selective and divided attention). Reports on school difficulties, neurodevelopmental problems, and attentional problems were high. In conclusion, in contrast to common beliefs, lower than average neurocognitive performance was noted in multiple cognitive domains, which may influence academic and psychosocial development.
Collapse
Affiliation(s)
- Eric L A Fonseca Wald
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands. .,Epilepsy Center Kempenhaeghe, Heeze, The Netherlands. .,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Jos G M Hendriksen
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands.,Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Gerald S Drenthen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Sander M J V Kuijk
- Department of KEMTA, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Albert P Aldenkamp
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands.,Epilepsy Center Kempenhaeghe, Heeze, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Johan S H Vles
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - R Jeroen Vermeulen
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Sylvia Klinkenberg
- Department of Neurology, Maastricht University Medical Center+, 6202, AZ, Maastricht, The Netherlands. .,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| |
Collapse
|
14
|
Datta AN, Wallbank L, Mak JCH, Wong PKH. Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy. J Child Neurol 2019; 34:631-638. [PMID: 31113278 DOI: 10.1177/0883073819848639] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE Absence epilepsy and benign epilepsy of childhood with central temporal spikes are common childhood epilepsy syndromes. Although 3-Hz generalized spike-wave discharges are almost always associated with absence seizures, rolandic spikes can be present in individuals without rolandic seizures. The co-occurrence of 3-Hz generalized spike-wave and rolandic spikes is very rare. Our objective was to compare clinical features of patients with absence epilepsy with and without rolandic spikes, to determine if the additional feature of rolandic spikes has any clinical significance. METHODS Clinical information of 17 children with absence epilepsy and rolandic spikes was compared to an age-matched control group of 90 children with absence epilepsy. RESULTS Although most patients had excellent seizure control at follow-up, epilepsy comorbidities (cognitive and emotional problems) were observed. Comparing study vs control groups, there was no difference with anxiety (2 [11.8%] vs 8 [9%]), behavioral issues (4 [23.5%] vs 10 [11%]), mood disorders (0 vs 2 [2%]), and attention-deficit hyperactivity disorder (4 [24%] vs 10 [11%]). Significant differences were also observed: more global-developmental (5 [29%] vs 5 [6%], P < .009) and expressive-language (4 [24%] vs 5 [6%], P < .034) delay and more difficulties with school performance (11 [65%] vs 32 [36%], P < .025), especially with language-related tasks (6 [35%] vs 5 [6%], P < .001). CONCLUSION Our results confirm the presence of additional epilepsy comorbidities in patients with absence epilepsy when rolandic spikes are present. Rolandic spikes in patients with absence epilepsy may be a marker of additional cognitive challenges that physicians should be aware of.
Collapse
Affiliation(s)
- Anita N Datta
- 1 Department of Pediatrics, Division of Neurology, BC Children's Hospital, Vancouver, BC, Canada.,2 Department of Diagnostic Neurophysiology, BC Children's Hospital, BC, Canada
| | - Laura Wallbank
- 2 Department of Diagnostic Neurophysiology, BC Children's Hospital, BC, Canada
| | - Jeremy C H Mak
- 3 Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Peter K H Wong
- 1 Department of Pediatrics, Division of Neurology, BC Children's Hospital, Vancouver, BC, Canada.,2 Department of Diagnostic Neurophysiology, BC Children's Hospital, BC, Canada
| |
Collapse
|
15
|
Leo A, Citraro R, Tallarico M, Iannone M, Fedosova E, Nesci V, De Sarro G, Sarkisova K, Russo E. Cognitive impairment in the WAG/Rij rat absence model is secondary to absence seizures and depressive-like behavior. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109652. [PMID: 31095993 DOI: 10.1016/j.pnpbp.2019.109652] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 04/30/2019] [Accepted: 05/12/2019] [Indexed: 01/06/2023]
Abstract
Neuropsychiatric comorbidities are common in patients with epilepsy, remaining still an urgent unmet clinical need. Therefore, the management of epileptic disorders should not only be restricted to the achievement of seizure-freedom but must also be able to counteract its related comorbidities. Experimental animal models of epilepsy represent a valid tool not only to study epilepsy but also its associated comorbidities. The WAG/Rij rat is a well-established genetically-based model of absence epilepsy with depressive-like comorbidity, in which learning and memory impairment was also recently reported. Aim of this study was to clarify whether this cognitive decline is secondary or not to absence seizures and/or depressive-like behavior. The behavioral performance of untreated and ethosuximide-treated (300 mg/kg/day; 17 days) WAG/Rij rats at 6 and 12 months of age were assessed in several tests: forced swimming test, objects recognition test, social recognition test, Morris water maze and passive avoidance. According to our results, it seems that cognitive impairment in this strain, similarly to depressive-like behavior, is secondary to the occurrence of absence seizures, which might be necessary for the expression of cognitive impairment. Furthermore, our results suggest an age-dependent impairment of cognitive performance in WAG/Rij rats, which could be linked to the age-dependent increase of spike wave discharges. Consistently, it is possible that absence seizures, depressive-like behavior and cognitive deficit may arise independently and separately in lifetime from the same underlying network disease, as previously suggested for the behavioral features associated with other epileptic syndromes.
Collapse
Affiliation(s)
- Antonio Leo
- University of Catanzaro, School of Medicine, Science of Health Dept., Catanzaro, Italy
| | - Rita Citraro
- University of Catanzaro, School of Medicine, Science of Health Dept., Catanzaro, Italy.
| | - Martina Tallarico
- University of Catanzaro, School of Medicine, Science of Health Dept., Catanzaro, Italy; CNR, Institute of Neurological Sciences, Pharmacology Section, Roccelletta di Borgia, Catanzaro, Italy
| | - Michelangelo Iannone
- CNR, Institute of Neurological Sciences, Pharmacology Section, Roccelletta di Borgia, Catanzaro, Italy
| | - Ekaterina Fedosova
- Institute of Higher Nervous Activity and Neurophysiology RAS, Moscow, Russia
| | - Valentina Nesci
- University of Catanzaro, School of Medicine, Science of Health Dept., Catanzaro, Italy
| | | | - Karine Sarkisova
- Institute of Higher Nervous Activity and Neurophysiology RAS, Moscow, Russia
| | - Emilio Russo
- University of Catanzaro, School of Medicine, Science of Health Dept., Catanzaro, Italy
| |
Collapse
|
16
|
Young JC, Nasser HM, Casillas-Espinosa PM, O'Brien TJ, Jackson GD, Paolini AG. Multiunit cluster firing patterns of piriform cortex and mediodorsal thalamus in absence epilepsy. Epilepsy Behav 2019; 97:229-243. [PMID: 31254843 DOI: 10.1016/j.yebeh.2019.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/09/2019] [Accepted: 05/20/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The objective of the study were to investigate patterns of multiunit cluster firing in the piriform cortex (PC) and mediodorsal thalamus (MDT) in a rat model of genetic generalized epilepsy (GGE) with absence seizures and to assess whether these regions contribute to the initiation or spread of generalized epileptiform discharges. METHODS Multiunit clusters and their corresponding local field potentials (LFPs) were recorded from microelectrode arrays implanted in the PC and MDT in urethane anesthetized Genetic Absence Epilepsy Rats from Strasbourg (GAERS) and nonepileptic control (NEC) rats. Peristimulus time histograms (PSTHs) and cross-correlograms were used to observe transient changes in both the rate of firing and synchrony over time. The phase locking of multiunit clusters to LFP signals (spike-LFP phase locking) was calculated for frequency bands associated with olfactory communication between the two brain regions. RESULTS There were significant increases in both rate of firing and synchronous activity at the onset of generalized epileptiform discharges in both PC and MDT. Prior to and following these increases in synchronous activity, there were periods of suppression. Significant increases in spike-LFP phase locking were observed within the PC prior to the onset of epileptiform discharges across all spectral bands. There were also significant increases in spike-LFP phase locking within the theta band of the MDT prior to onset. Between the two brain regions, there was a significant decrease in spike-LFP phase locking -0.5 s prior to onset in the theta band which coincided with a significant elevation in spike-LFP phase locking in the gamma band. CONCLUSIONS Both the PC and MDT are engaged in the absence epilepsy network. Early spike-LFP phase locking between these two brain regions suggests potential involvement in the initiation of seizure activity.
Collapse
Affiliation(s)
- James C Young
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Helen M Nasser
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; ISN Psychology - Institute for Social Neuroscience, Melbourne, Australia
| | - Pablo M Casillas-Espinosa
- Department of Neuroscience, Monash University, Melbourne, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Monash University, Melbourne, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; Department of Neurology, Austin Health, Melbourne, Australia
| | - Antonio G Paolini
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; ISN Psychology - Institute for Social Neuroscience, Melbourne, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| |
Collapse
|
17
|
Drenthen GS, Fonseca Wald ELA, Backes WH, Debeij-Van Hall MHJA, Hendriksen JGM, Aldenkamp AP, Vermeulen RJ, Klinkenberg S, Jansen JFA. Lower myelin-water content of the frontal lobe in childhood absence epilepsy. Epilepsia 2019; 60:1689-1696. [PMID: 31283841 DOI: 10.1111/epi.16280] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The frontal lobe in childhood absence epilepsy (CAE) might be affected due to the suggested involvement of the frontal lobe during absence seizures and reports on attentional deficits. Previously, subtle white matter abnormalities have been reported in CAE. However, the impact of one of the most characteristic components of the white matter, the myelin content, remains underdetermined. Therefore, this study investigated whether the myelin content in frontal areas is adversely affected in CAE compared to controls. METHODS Seventeen children with childhood absence epilepsy (mean age ± standard deviation [SD], 9.2 ± 2.1 years) and 15 age- and sex-matched controls (mean age ± SD, 9.8 ± 1.8 years) underwent neuropsychological assessment and a magnetic resonance imaging (MRI) examination. T2 relaxometry scans were used to distinguish myelin-water from tissue water and to determine the myelin-water fraction (MWF) in the frontal, temporal, parietal, occipital, and insular lobes. A linear regression model including age and sex as covariates was used to investigate group differences. Furthermore, the relationship of MWF with cognitive performance and epilepsy characteristics was determined. RESULTS The frontal lobe revealed a significantly lower myelin-water content in children with CAE compared to controls over the developmental age range of 6-12 years (5.7 ± 1.0% vs 6.6 ± 1.1%, P = 0.02). This association was not found for any of the other four lobes (P > 0.10). No significant relation was found between myelin-water content and cognitive performance or epilepsy characteristics. SIGNIFICANCE The lower frontal myelin-water content of children with CAE in comparison with healthy controls probably reflects an altered neurodevelopmental aspect in CAE, of which the underlying mechanisms still need to be unraveled.
Collapse
Affiliation(s)
- Gerhard S Drenthen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Eric L A Fonseca Wald
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Jos G M Hendriksen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Albert P Aldenkamp
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Behavioral Sciences, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - R Jeroen Vermeulen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sylvia Klinkenberg
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
18
|
Yıldız-Çoksan S, Aslan A, Çoksan S, Okuyaz Ç. Cognitive profile and academic achievement of children with absence epilepsy. Epilepsy Behav 2019; 95:95-99. [PMID: 31030079 DOI: 10.1016/j.yebeh.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 11/16/2022]
Abstract
The main aim of this study was to examine the cognitive profile and academic achievement of children with absence epilepsy. It is investigated whether all scale intelligence score, intelligence subscale scores, and academic achievement of the children with absence epilepsy differed from healthy peers and Turkish norm values. Nineteen children with absence epilepsy and 19 healthy children participate in the study. The Wechsler Intelligence Scale for Children-IV (WISC-IV) is used to measure their intelligence scores. A teacher assessment form (Teacher's Report Form (TRF)) is obtained from the participants' teachers for the measurement of academic achievement, and the students' report cards are collected as an additional measure of it. Participants with absence epilepsy have significantly lower scores of total intelligence score (Mean (M) = 76.68, Standard Deviation (SD) = 25.18), verbal comprehension score (M = 81.68, SD = 25.29), perceptual reasoning score (M = 85.47, SD = 20.61), processing speed score (M = 77.95, SD = 18.61), and working memory (M = 83.74, SD = 19.04), which are measured by WISC-IV, than healthy peers (respectively M = 105.84, SD = 16.20; M = 105.47, SD = 18.12; M = 103.63, SD = 12.88; M = 104.05, SD = 12.98; M = 104.74, SD = 18.97) and norm values (M = 100, SD = 10). No difference is observed between the subscale scores of WISC-IV for within group with absence epilepsy. Moreover, they have lower Turkish language (M = 73.65, SD = 19.19) and mathematics (M = 76.26, SD = 22.29) grade report scores than healthy peers (respectively M = 90.76, SD = 12.01; M = 88.64, SD = 15.93). There is no difference between the two groups in terms of the academic achievement obtained from the TRF. It is necessary to support children with absence epilepsy academically. We analyzed whether the current pattern has changed by comparing the intelligent scores and academic achievement of children with absence epilepsy who have recovered after treatment with their healthy peers. In fact, there is no difference between the children with absence epilepsy who have recovered after treatment and their healthy peers in terms of total intelligence score and its subscale scores. Similarly, there is no difference between them in terms of mathematics score on their report. Only the difference in the score of Turkish language continues in the same direction.
Collapse
Affiliation(s)
- Serpil Yıldız-Çoksan
- Ankara University, Faculty of Health Sciences, Department of Child Development, Ankara, Turkey.
| | - Aslı Aslan
- Mersin University, Faculty of Arts and Sciences, Department of Psychology, Mersin, Turkey
| | - Sami Çoksan
- Middle East Technical University, Faculty of Arts and Sciences, Department of Psychology, Ankara, Turkey
| | - Çetin Okuyaz
- Mersin University, School of Medicine, Department of Pediatric Neurology, Mersin, Turkey
| |
Collapse
|
19
|
Source localization of epileptiform discharges in childhood absence epilepsy using a distributed source model: a standardized, low-resolution, brain electromagnetic tomography (sLORETA) study. Neurol Sci 2019; 40:993-1000. [PMID: 30756246 DOI: 10.1007/s10072-019-03751-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
Localizing the source of epileptiform discharges in generalized epilepsy has been controversial for the past few decades. Recent neuroimaging studies have shown that epileptiform discharges in generalized epilepsy can be localized to a particular region. Childhood absence epilepsy (CAE) is the most common generalized epilepsy in childhood and is considered the prototype of idiopathic generalized epilepsy (IGE). To better understand electrophysiological changes and their development in CAE, we investigated the origin of epileptiform discharges. We performed distributed source localization with standardized, low-resolution, brain electromagnetic tomography (sLORETA). In 16 children with CAE, sLORETA images corresponding to the midpoint of the ascending phase and the negative peak of the spike were obtained from a total of 242 EEG epochs (121 epochs at each timepoint). Maximal current source density (CSD) was mostly located in the frontal lobe (69.4%). At the gyral level, maximal CSD was most commonly in the superior frontal gyrus (39.3%) followed by the middle frontal gyrus (14.0%) and medial frontal gyrus (8.7%). At the hemisphere level, maximal CSD was dominant in the right cerebral hemisphere (63.6%). These results were consistent at the midpoint of the ascending phase and the negative peak of the spike. Our results demonstrated that the major source of epileptiform discharges in CAE was the frontal lobe. These results suggest that the frontal lobe is involved in generating CAE. This finding is consistent with recent studies that have suggested selective cortical involvement, especially in the frontal regions, in IGE.
Collapse
|
20
|
Etchell A, Adhikari A, Weinberg LS, Choo AL, Garnett EO, Chow HM, Chang SE. A systematic literature review of sex differences in childhood language and brain development. Neuropsychologia 2018; 114:19-31. [PMID: 29654881 PMCID: PMC5988993 DOI: 10.1016/j.neuropsychologia.2018.04.011] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 01/07/2023]
Abstract
The extent of sex differences in childhood language development is unclear. We conducted a systematic literature review synthesizing results from studies examining sex differences in brain structure and function relevant to language development during childhood. We searched PubMed and Scopus databases, and this returned a total of 46 published studies meeting criteria for inclusion that directly examined sex differences in brain development relevant to language function in children. The results indicate that: (a) sex differences in brain structure or function do not necessarily lead to differences in language task performance; (b) evidence for sex differences in brain and language development are limited; (c) when present, sex differences often interact with a variety of factors such as age and task. Overall, the magnitude of sexual dimorphism of brain developmental trajectories associated with language is not as significant as previously thought. Sex differences were found, however, in studies employing tighter age ranges. This suggests that sex differences may be more prominent during certain developmental stages but are negligible in other stages, likely due to different rates of maturation between the sexes. More research is needed to improve our understanding of how sex differences may arise due to the influence of sex hormones and developmental stages, and how these differences may lead to differences in various language task performance. These studies are expected to provide normative information that may be used in studies examining neurodevelopmental disorders that frequently affect more males than females, and also often affect language development.
Collapse
Affiliation(s)
- Andrew Etchell
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Aditi Adhikari
- College of Arts and Sciences, University of North Carolina at Chapel Hill, USA
| | - Lauren S Weinberg
- College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Ai Leen Choo
- Department of Communication Sciences and Disorders, Georgia State University, USA
| | - Emily O Garnett
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Ho Ming Chow
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Katzin Diagnostic & Research PET/MR Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
21
|
Tenney JR, Kadis DS, Agler W, Rozhkov L, Altaye M, Xiang J, Vannest J, Glauser TA. Ictal connectivity in childhood absence epilepsy: Associations with outcome. Epilepsia 2018; 59:971-981. [PMID: 29633248 DOI: 10.1111/epi.14067] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The understanding of childhood absence epilepsy (CAE) has been revolutionized over the past decade, but the biological mechanisms responsible for variable treatment outcomes are unknown. Our purpose in this prospective observational study was to determine how pretreatment ictal network pathways, defined using a combined electroencephalography (EEG)-functional magnetic resonance imaging (EEG-fMRI) and magnetoencephalography (MEG) effective connectivity analysis, were related to treatment response. METHODS Sixteen children with newly diagnosed and drug-naive CAE had 31 typical absence seizures during EEG-fMRI and 74 during MEG. The spatial extent of the pretreatment ictal network was defined using fMRI hemodynamic response with an event-related independent component analysis (eICA). This spatially defined pretreatment ictal network supplied prior information for MEG-effective connectivity analysis calculated using phase slope index (PSI). Treatment outcome was assessed 2 years following diagnosis and dichotomized to ethosuximide (ETX)-treatment responders (N = 11) or nonresponders (N = 5). Effective connectivity of the pretreatment ictal network was compared to the treatment response. RESULTS Patterns of pretreatment connectivity demonstrated strongest connections in the thalamus and posterior brain regions (parietal, posterior cingulate, angular gyrus, precuneus, and occipital) at delta frequencies and the frontal cortices at gamma frequencies (P < .05). ETX treatment nonresponders had pretreatment connectivity, which was decreased in the precuneus region and increased in the frontal cortex compared to ETX responders (P < .05). SIGNIFICANCE Pretreatment ictal connectivity differences in children with CAE were associated with response to antiepileptic treatment. This is a possible mechanism for the variable treatment response seen in patients sharing the same epilepsy syndrome.
Collapse
Affiliation(s)
- Jeffrey R Tenney
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Darren S Kadis
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - William Agler
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Leonid Rozhkov
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jing Xiang
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Vannest
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
22
|
Pathophysiology of absence epilepsy: Insights from genetic models. Neurosci Lett 2018; 667:53-65. [DOI: 10.1016/j.neulet.2017.02.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/08/2017] [Accepted: 02/12/2017] [Indexed: 11/21/2022]
|
23
|
Savic I, Engel J. Reprint of "Structural and functional correlates of epileptogenesis--does gender matter?". Neurobiol Dis 2018; 72 Pt B:131-5. [PMID: 25448763 DOI: 10.1016/j.nbd.2014.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/15/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022] Open
Abstract
In the majority of neuropsychiatric conditions, marked gender-based differences have been found in the epidemiology,clinical manifestations, and therapy of disease. One possible reason is that sex differences in cerebral morphology, structural and functional connections, render men and women differentially vulnerable to various disease processes. The present review addresses this issue with respect to the functional and structural correlates to some forms of epilepsy.
Collapse
|
24
|
Henbid MT, Marks WN, Collins MJ, Cain SM, Snutch TP, Howland JG. Sociability impairments in Genetic Absence Epilepsy Rats from Strasbourg: Reversal by the T-type calcium channel antagonist Z944. Exp Neurol 2017; 296:16-22. [DOI: 10.1016/j.expneurol.2017.06.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/16/2017] [Accepted: 06/24/2017] [Indexed: 12/21/2022]
|
25
|
Elevated sterol regulatory elementary binding protein 1 and GluA2 levels in the hippocampal nuclear fraction of Genetic Absence Epilepsy Rats from Strasbourg. Epilepsy Res 2017; 136:1-4. [PMID: 28719803 DOI: 10.1016/j.eplepsyres.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 04/06/2017] [Accepted: 07/05/2017] [Indexed: 11/23/2022]
Abstract
Studies in animal models and human tissues show that nuclear translocation of sterol regulatory element binding protein 1 (SREBP1) and glutamate A2 subunit (GluA2) of cell-surface AMPA receptor (AMPAR) trigger neuronal excitotoxicity-induced apoptosis in stroke. However, it is not known whether a similar type of underlying pathophysiology occurs in absence epilepsy. To explore this issue, we examined the levels of mature SREBP1, GluA2, glyceraldehyde 3-phosphate dehydrogenase (GAPDH), p53, and activated to total caspase 3 ratio in nuclear fractions (NF) of hippocampal homogenate from 8 to 10 week old male Genetic Absence Epilepsy Rats from Strasbourg (GAERS) and non-epileptic control (NEC) strains. Mature SREBP1 and GluA2 levels were elevated approximately two-fold in NFs of GAERS hippocampal homogenates compared to NEC animals. Significant increases in GAPDH (∼15-fold) and total caspase 3 (∼10-fold) levels were also found in NFs of GAERS hippocampal homogenates in comparison to the non-epileptic strain. Data from the current study suggest that absence epilepsy in GAERS is associated with nuclear translocation of mature SREBP1, GluA2 subunit of AMPARs, and recruitment of pro-cell death signaling proteins such as GAPDH and caspase 3. These changes may contribute to hippocampal neuronal/glial cell death in GAERS. Therefore, inhibiting the nuclear accumulation of mature SREBP1 and GluA2 translocation may reduce the pathophysiology of absence epilepsy.
Collapse
|
26
|
Wu C, Xiang J, Sun J, Huang S, Tang L, Miao A, Zhou Y, Chen Q, Hu Z, Wang X. Quantify neuromagnetic network changes from pre-ictal to ictal activities in absence seizures. Neuroscience 2017; 357:134-144. [PMID: 28576731 DOI: 10.1016/j.neuroscience.2017.05.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 05/23/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The cortico-thalamo-cortical network plays a key role in childhood absence epilepsy (CAE). However, the exact interaction between the cortex and the thalamus remains incompletely understood. This study aimed to investigate the dynamic changes of frequency-dependent neural networks during the initialization of absence seizures. METHODS Magnetoencephalography data from 14 patients with CAE were recorded during and between seizures at a sampling rate of 6000Hz and analyzed in seven frequency bands. Neuromagnetic sources were volumetrically scanned with accumulated source imaging. Effective connectivity networks of the entire brain, including the cortico-thalamo-cortical network, were evaluated at the source level through Granger causality analysis. RESULTS The low-frequency (1-80Hz) activities showed significant frontal cortical and parieto-occipito-temporal junction source localization around seizures. The high-frequency (80-250Hz) oscillations showed predominant activities consistently localized in deep brain areas and medial frontal cortex. The increased cortico-thalamic effective connectivity was observed around seizures in both low- and high-frequency ranges. The direction was predominantly from the cortex to the thalamus at the early time, although the cortex that drove connectivity varied among subjects. CONCLUSIONS The cerebral cortex plays a key role in driving the cortico-thalamic connections at the early portion of the initialization of absence seizures. The oscillatory activities in the thalamus could be triggered by networks from various regions in the cortex. SIGNIFICANCE The dynamic changes of neural network provide evidences that absence seizures are probably resulted from cortical initialized cortico-thalamic network.
Collapse
Affiliation(s)
- Caiyun Wu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jing Xiang
- MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45220, USA
| | - Jintao Sun
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Shuyang Huang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Lu Tang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ailiang Miao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yuchen Zhou
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Qiqi Chen
- MEG Center, Nanjing Brain Hospital, Nanjing, Jiangsu 210029, China
| | - Zheng Hu
- Department of Neurology, Nanjing Children's Hospital, Nanjing, Jiangsu 210029, China
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| |
Collapse
|
27
|
Schaffer Y, Ben Zeev B, Cohen R, Shufer A, Geva R. Memory, Executive Skills, and Psychosocial Phenotype in Children with Pharmacoresponsive Epilepsy: Reactivity to Intervention. Front Neurol 2017; 8:86. [PMID: 28484417 PMCID: PMC5399087 DOI: 10.3389/fneur.2017.00086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies on pharmacoresponsive epilepsies demonstrate specific memory, executive functions (EF), and psychosocial deficits in this group. These deficits are often undertreated, and little is known about the neuropsychological factors that may support moderation of the deficits through intervention. The aim of this study was to explore the effects of a structured cognitive behavioral group intervention on both memory and emotional domains and to evaluate the factors influencing its efficacy. METHODS The feasibility study implemented a newly designed intervention for children with pharmacoresponsive epilepsies (N = 33, aged 9-14 years, 51% girls), hypothesizing that memory and psychosocial symptoms in children with pharmacoresponsive epilepsies are sensitive to intervention using structured memory and psychosocial modules in a weekly group session setting. Comparable memory and psychosocial assessments were used to evaluate performance at baseline and post-intervention. Results were compared to age- and education-matched healthy controls (N = 27, aged 9-14 years). RESULTS Pre-post-intervention comparisons show improvements in STM (p < 0.01, η2 = 0.358), optimism (p < 0.05, η2 = 0.245), and self-efficacy (p < 0.05, η2 = 0.164). Unique negative relations between memory deficits and psychosocial phenotype were seen in epilepsy patients and not in controls in response to the intervention. EF moderated this intervention effect (p < 0.05, η2 = 0.252), whereas psychosocial status and pharmacological profile did not. CONCLUSION Cognitive behavioral therapy focusing on memory and psychosocial perceptions for children with pharmacoresponsive epilepsies seems promising, with greater improvement in memory and psychosocial functioning in children with more affected EF.
Collapse
Affiliation(s)
- Yael Schaffer
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Bruria Ben Zeev
- The Neurology Department at Sheba Medical Center, Ramat Gan, Israel
| | - Roni Cohen
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avinoam Shufer
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
28
|
Evaluation of deep gray matter volume, cortical thickness and white matter integrity in patients with typical absence epilepsy: a study using voxelwise-based techniques. Neuroradiology 2017; 59:237-245. [DOI: 10.1007/s00234-017-1782-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/02/2017] [Indexed: 11/27/2022]
|
29
|
Abstract
Although neuropsychological studies have demonstrated specific cognitive impairments in children with childhood absence epilepsy (CAE), the potential role of the frontal lobe in these cognitive deficits remains unclear. We therefore evaluated cognitive functions related to and unrelated to the functionality of the frontal lobe in childhood absence epilepsy patients and control subjects. Thirty-seven childhood absence epilepsy patients and 37 age- and gender-matched healthy control subjects were recruited and assessed using a computerized neuropsychological test battery. Childhood absence epilepsy patients, especially a drug-naïve subgroup, showed cognitive deficits in reasoning, visual attention, and executive function, which are typical cognitive functions of the frontal lobe. In contrast, treated childhood absence epilepsy patients only exhibited cognitive deficits in visual attention. There were no significant between-group differences for other cognitive tests. Our findings suggest that frontal lobe-related cognitive deficits represent the characteristic neuropsychological profile associated with childhood absence epilepsy.
Collapse
Affiliation(s)
- Dazhi Cheng
- 1 Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China
| | - Xiuxian Yan
- 1 Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China
| | - Zhijie Gao
- 1 Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China
| | - Keming Xu
- 1 Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China
| | - Xinlin Zhou
- 2 National Key Laboratory of Cognitive Neuroscience and Learning, Institute of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Qian Chen
- 1 Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China
| |
Collapse
|
30
|
Qiu W, Gao Y, Yu C, Miao A, Tang L, Huang S, Hu Z, Xiang J, Wang X. Structural Abnormalities in Childhood Absence Epilepsy: Voxel-Based Analysis Using Diffusion Tensor Imaging. Front Hum Neurosci 2016; 10:483. [PMID: 27733824 PMCID: PMC5039196 DOI: 10.3389/fnhum.2016.00483] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/12/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose: Childhood absence epilepsy (CAE) is a common syndrome of idiopathic generalized epilepsy. However, little is known about the brain structural changes in this type of epilepsy, especially in the default mode network (DMN) regions. This study aims at using the diffusion tensor imaging (DTI) technique to quantify structural abnormalities of DMN nodes in CAE patients. Method: DTI data were acquired in 14 CAE patients (aged 8.64 ± 2.59 years, seven females and seven males) and 16 age- and sex-matched healthy controls. The data were analyzed using voxel-based analysis (VBA) and statistically compared between patients and controls. Pearson correlation was explored between altered DTI metrics and clinical parameters. The difference of brain volumes between patients and controls were also tested using unpaired t-test. Results: Patients showed significant increase of mean diffusivity (MD) and radial diffusivity (RD) in left medial prefrontal cortex (MPFC), and decrease of fractional anisotropy (FA) in left precuneus and axial diffusivity (AD) in both left MPFC and precuneus. In correlation analysis, MD value from left MPFC was positively associated with duration of epilepsy. Neither the disease duration nor the seizure frequency showed significant correlation with FA values. Between-group comparison of brain volumes got no significant difference. Conclusion: The findings indicate that structural impairments exist in DMN regions in children suffering from absence epilepsy and MD values positively correlate with epilepsy duration. This may contribute to understanding the pathological mechanisms of chronic neurological deficits and promote the development of new therapies for this disorder.
Collapse
Affiliation(s)
- Wenchao Qiu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Yuan Gao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Chuanyong Yu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Ailiang Miao
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Lu Tang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Shuyang Huang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| | - Zheng Hu
- Department of Neurology, Nanjing Children's Hospital Nanjing, China
| | - Jing Xiang
- MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center Cincinnati, OH, USA
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University Nanjing, China
| |
Collapse
|
31
|
Nickels KC, Zaccariello MJ, Hamiwka LD, Wirrell EC. Cognitive and neurodevelopmental comorbidities in paediatric epilepsy. Nat Rev Neurol 2016; 12:465-76. [PMID: 27448186 DOI: 10.1038/nrneurol.2016.98] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cognitive and behavioural comorbidities are often seen in children with epilepsy, and are more common and severe in refractory epilepsy. These comorbidities are associated with worse quality of life, increased behavioural and language problems and worse social skills, all of which adversely affect long-term psychosocial functioning. To enable early intervention and therapy, children and teens with epilepsy should be periodically screened for cognitive comorbidities. The location of the epileptic focus can, to a certain degree, predict the type(s) of comorbidity; however, the spectrum of disability is often broad, presumably because focal perturbations can cause network dysfunction. Comorbidities often result from underlying structural or functional pathology that has led to seizures. In selected cases, therapy targeting the underlying cause, such as the ketogenic diet for GLUT1 deficiency syndromes, may be remarkably effective in ameliorating both seizures and cognitive concerns. In many cases, however, cognitive impairment persists despite seizure control. In epileptic encephalopathies, frequent seizures and/or interictal epileptiform abnormalities exacerbate neurocognitive dysfunction, owing to synaptic reorganization or impaired neurogenesis, or to other effects on developing neural circuits, and prompt initiation of effective antiepileptic therapy is essential to limit cognitive comorbidities.
Collapse
Affiliation(s)
- Katherine C Nickels
- Child and Adolescent Neurology and Epilepsy, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
| | - Michael J Zaccariello
- Child and Adolescent Neurology and Epilepsy, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
| | - Lorie D Hamiwka
- Seattle Children's Hospital, MB.7.420 - Neurology, 4800 Sand Point Way NE, Seattle, Washington 98105, USA
| | - Elaine C Wirrell
- Child and Adolescent Neurology and Epilepsy, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
| |
Collapse
|
32
|
Tondelli M, Vaudano AE, Ruggieri A, Meletti S. Cortical and subcortical brain alterations in Juvenile Absence Epilepsy. NEUROIMAGE-CLINICAL 2016; 12:306-11. [PMID: 27551668 PMCID: PMC4983643 DOI: 10.1016/j.nicl.2016.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 12/28/2022]
Abstract
Despite the common assumption that genetic generalized epilepsies are characterized by a macroscopically normal brain on magnetic resonance imaging, subtle structural brain alterations have been detected by advanced neuroimaging techniques in Childhood Absence Epilepsy syndrome. We applied quantitative structural MRI analysis to a group of adolescents and adults with Juvenile Absence Epilepsy (JAE) in order to investigate micro-structural brain changes using different brain measures. We examined grey matter volumes, cortical thickness, surface areas, and subcortical volumes in 24 patients with JAE compared to 24 healthy controls; whole-brain voxel-based morphometry (VBM) and Freesurfer analyses were used. When compared to healthy controls, patients revealed both grey matter volume and surface area reduction in bilateral frontal regions, anterior cingulate, and right mesial-temporal lobe. Correlation analysis with disease duration showed that longer disease was correlated with reduced surface area in right pre- and post-central gyrus. A possible effect of valproate treatment on brain structures was excluded. Our results indicate that subtle structural brain changes are detectable in JAE and are mainly located in anterior nodes of regions known to be crucial for awareness, attention and memory.
Collapse
Affiliation(s)
- Manuela Tondelli
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; NOCSAE Hospital, AUSL Modena, Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; NOCSAE Hospital, AUSL Modena, Italy
| | - Andrea Ruggieri
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; NOCSAE Hospital, AUSL Modena, Italy
| |
Collapse
|
33
|
Marks WN, Cain SM, Snutch TP, Howland JG. The T-type calcium channel antagonist Z944 rescues impairments in crossmodal and visual recognition memory in Genetic Absence Epilepsy Rats from Strasbourg. Neurobiol Dis 2016; 94:106-15. [PMID: 27282256 DOI: 10.1016/j.nbd.2016.06.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 04/27/2016] [Accepted: 06/04/2016] [Indexed: 12/11/2022] Open
Abstract
Childhood absence epilepsy (CAE) is often comorbid with behavioral and cognitive symptoms, including impaired visual memory. Genetic Absence Epilepsy Rats from Strasbourg (GAERS) is an animal model closely resembling CAE; however, cognition in GAERS is poorly understood. Crossmodal object recognition (CMOR) is a recently developed memory task that examines not only purely visual and tactile memory, but also requires rodents to integrate sensory information about objects gained from tactile exploration to enable visual recognition. Both the visual and crossmodal variations of the CMOR task rely on the perirhinal cortex, an area with dense expression of T-type calcium channels. GAERS express a gain-in-function missense mutation in the Cav3.2 T-type calcium channel gene. Therefore, we tested whether the T-type calcium channel blocker Z944 dose dependently (1, 3, 10mg/kg; i.p.) altered CMOR memory in GAERS compared to the non-epileptic control (NEC) strain. GAERS demonstrated recognition memory deficits in the visual and crossmodal variations of the CMOR task that were reversed by the highest dose of Z944. Electroencephalogram recordings determined that deficits in CMOR memory in GAERS were not the result of seizures during task performance. In contrast, NEC showed a decrease in CMOR memory following Z944 treatment. These findings suggest that T-type calcium channels mediate CMOR in both the GAERS and NEC strains. Future research into the therapeutic potential of T-type calcium channel regulation may be particularly fruitful for the treatment of CAE and other disorders characterized by visual memory deficits.
Collapse
Affiliation(s)
- Wendie N Marks
- Department of Physiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Stuart M Cain
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Terrance P Snutch
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - John G Howland
- Department of Physiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada.
| |
Collapse
|
34
|
Gencpinar P, Kalay Z, Turgut S, Bozkurt Ö, Duman Ö, Ozel D, Haspolat S. Evaluation of Executive Functions in Patients With Childhood Absence Epilepsy. J Child Neurol 2016; 31:824-30. [PMID: 26738921 DOI: 10.1177/0883073815623632] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/26/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the executive function of patients with typical absence epilepsy. METHODS Thirty-eight (19 healthy children and 19 patients) individuals were enrolled in this study. Neurocognitive function tests, such as the Serial Digit Learning Test, Wisconsin Card Sorting Test, Visual Aural Digit Span Test-Form B, KAS-Animal Test, Trail Making Test-A Time Test, and STROOP Test, were given to all of the participants. RESULTS There was a significant difference between the groups on the Serial Digit Learning Test (P = .037) and on a subtest of the Wisconsin Card Sorting Test. As for the Wisconsin Card Sorting Test performance, there were significant differences in perseverative errors and perseverative responses between the patient and control groups (P = .011 and P = .010, respectively). CONCLUSION Long-term risk for learning impairments, failure in executive abilities, and short-term memory and attention disorders can occur in children with absence epilepsy.
Collapse
Affiliation(s)
- Pinar Gencpinar
- Department of Pediatric Neurology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Zuhal Kalay
- Department of Pediatrics, Akdeniz University, Antalya, Turkey
| | - Sevil Turgut
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Öznur Bozkurt
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Özgür Duman
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| | - Deniz Ozel
- Department of Biostatistics, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey
| |
Collapse
|
35
|
Wang G, Dai ZY, Song W, Wang S, Shi H, Pan P, Chen F, Xu Y, Zhong J. Grey matter anomalies in drug-naïve childhood absence epilepsy: A voxel-based morphometry study with MRI at 3.0T. Epilepsy Res 2016; 124:63-6. [PMID: 27259070 DOI: 10.1016/j.eplepsyres.2016.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 04/28/2016] [Accepted: 05/17/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known, so far, about the cerebral structural abnormalities in drug-naïve patients with childhood absence epilepsy (CAE). We aimed to investigate regional grey matter (GM) volume differences using voxel-based morphometry (VBM) in patients and closely matched healthy control subjects. METHODS Twenty drug-naïve patients diagnosed with CAE and 20 age- and gender-matched healthy subjects were recruited. All participants underwent structural MRI scans with a 3.0T MR system. The differences in regional GM volumes between the two groups were determined by VBM analysis. Additional regression analyses were performed to identify any associations between regional GM volume and clinical seizure variables. RESULTS Compared with controls, the patients with CAE showed less GM volume in the bilateral thalami. Furthermore, the GM volume in the bilateral thalami was negatively correlated with disease duration and age of onset in the CAE group. CONCLUSIONS By excluding the potential effect of medication on brain structures, our study demonstrates less GM volume in the bilateral thalami in drug-naïve patients with idiopathic CAE. Our study further provides structural neuroimaging evidence on the pathophysiology of absence seizures.
Collapse
Affiliation(s)
- GenDi Wang
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing Medical University, Nanjing, PR China; Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Zhen Yu Dai
- Department of Radiology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - WeiGen Song
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - ShuFang Wang
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - HaiCun Shi
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - PingLei Pan
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Fei Chen
- Department of Radiology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Yun Xu
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing Medical University, Nanjing, PR China.
| | - JianGuo Zhong
- Department of Neurology, The Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China.
| |
Collapse
|
36
|
Neuropsychological impairment in childhood absence epilepsy: Review of the literature. J Neurol Sci 2015; 359:59-66. [DOI: 10.1016/j.jns.2015.10.035] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 11/22/2022]
|
37
|
Marks WN, Cavanagh ME, Greba Q, Cain SM, Snutch TP, Howland JG. The Genetic Absence Epilepsy Rats from Strasbourg model of absence epilepsy exhibits alterations in fear conditioning and latent inhibition consistent with psychiatric comorbidities in humans. Eur J Neurosci 2015; 43:25-40. [DOI: 10.1111/ejn.13110] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/25/2015] [Accepted: 10/15/2015] [Indexed: 01/01/2023]
Affiliation(s)
- Wendie N. Marks
- Department of Physiology; University of Saskatchewan; GB33, Health Sciences Building, 107 Wiggins Road Saskatoon SK Canada S7N 5E5
| | - Mary E. Cavanagh
- Department of Physiology; University of Saskatchewan; GB33, Health Sciences Building, 107 Wiggins Road Saskatoon SK Canada S7N 5E5
| | - Quentin Greba
- Department of Physiology; University of Saskatchewan; GB33, Health Sciences Building, 107 Wiggins Road Saskatoon SK Canada S7N 5E5
| | - Stuart M. Cain
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain Health; University of British Columbia; Vancouver BC Canada
| | - Terrance P. Snutch
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain Health; University of British Columbia; Vancouver BC Canada
| | - John G. Howland
- Department of Physiology; University of Saskatchewan; GB33, Health Sciences Building, 107 Wiggins Road Saskatoon SK Canada S7N 5E5
| |
Collapse
|
38
|
|
39
|
Yeom JS, Kim YS, Lee JH, Jung S, Kwon OY. Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy. Seizure 2015; 31:88-93. [DOI: 10.1016/j.seizure.2015.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/01/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022] Open
|
40
|
Seizure and Psychosocial Outcomes of Childhood and Juvenile Onset Generalized Epilepsies: Wolf in Sheep's Clothing, or Well-Dressed Wolf? Epilepsy Curr 2015; 15:114-7. [PMID: 26316843 DOI: 10.5698/1535-7597-15.3.114] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Studies of generalized electroclinical syndromes can provide guidance regarding long-term seizure, cognitive, and psychosocial outcomes. Childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, and idiopathic generalized epilepsy with generalized tonic-clonic seizures alone are electroclinical syndromes typically associated with normal intellect and good response to antiseizure medications. However, studies have demonstrated significantly poorer psychosocial outcomes than expected for these syndromes, regardless of seizure control. Potential causes for this include underlying abnormalities in social skills, social stigma, and underlying abnormalities in brain development and maturation.
Collapse
|
41
|
Abstract
AIM The objectives of this study were as follows: (1) to explore mechanisms that counteract epileptogenesis and provide antiepileptic protection in the life-threatening condition of status epilepticus; and (2) to access functional state of adaptation system and identify the roles of biochemical, humoral, and neurophysiologic factors in the antiepileptic protective system. METHODS The experimental part of this research included a series of experiments using animal models which studied the influence of apnea (hypoxia and hypercapnia) on seizure activity; in addition, the role of the prefrontal and orbitofrontal cortex in epileptogenesis and antiepileptogenesis was explored. The clinical part consisted of a series of neurophysiological studies, using a method of multistage dipole localization, and clinical models of absence epilepsy and a tumor in the Rolandic region. One more line of clinical investigations was the study of the functional state of the adaptation system. Thirty-one patients with status epilepticus, with ages 14-56, were recruited. Proteins and fractions, electrolytes, acid-base balance, and 17-oxycorticosteroids in the blood plasma and 17-21-dioxy-20-ketosteroids in the urine were examined in relation to clinical data, EEG, and MRI. RESULTS As a result of the experiments, it was determined that asphyxia has a two-phase impact on spike activity; an anticonvulsive effect of asphyxia is mediated by hypercapnia, while the orbitofrontal cortex plays the key role in the system of antiepileptic protection through its inhibition of other structures. Further, the mediobasal prefrontal lobe of the dominant hemisphere plays a significant role in antiepileptic protection, and increased levels of blood 17-corticosteroids and catecholamines are protective in the setting of stress from convulsive status epilepticus. CONCLUSIONS The system of antiepileptic protection includes humoral, biochemical, and neurophysiological mechanisms. We identified the roles of all these factors: hypercapnia, in connection with tonic convulsion, as the humoral factor and inhibitory potential of the prefrontal lobe as the main neurophysiologic factor. In the setting of convulsive status epilepticus, which maximally strains these adaptations, it is essential for endogenous levels of glucocorticoids (17-corticosteroid) and sympathoepinephrine to increase. This article is part of a Special Issue entitled "Status Epilepticus".
Collapse
Affiliation(s)
- Vladimir Karlov
- Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Russian Federation.
| |
Collapse
|
42
|
Jafarian M, Karimzadeh F, Alipour F, Attari F, Lotfinia AA, Speckmann EJ, Zarrindast MR, Gorji A. Cognitive impairments and neuronal injury in different brain regions of a genetic rat model of absence epilepsy. Neuroscience 2015; 298:161-70. [PMID: 25907443 DOI: 10.1016/j.neuroscience.2015.04.033] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/26/2015] [Accepted: 04/14/2015] [Indexed: 11/30/2022]
Abstract
Growing numbers of evidence indicate that cognitive impairments are part of clinical profile of childhood absence epilepsy. Little is known on neuropathological changes accompanied by cognitive deficits in absence epilepsy. The aim of the present study was to investigate age-dependent neuropathological changes accompanied by learning and memory impairments in Wistar Albino Glaxo from Rijswijk (WAG/Rij) rat model of absence epilepsy. Experimental groups were divided into four groups of six rats of both WAG/Rij and Wistar strains with 2 and 6 months of age. The learning and memory performances were assessed using passive avoidance paradigm and neuropathological alterations were investigated by the evaluation of the number of dark neurons and apoptotic cells as well as the expression of caspase-3 in the neocortex, the hippocampus, and different regions of the thalamus. Results revealed a decline in learning and spatial memory of 6-month-old WAG/Rij rats compared to age-matched Wistar rats as well as 2-month-old WAG/Rij and Wistar rats. The mean number of dark neurons was significantly higher in the hippocampal CA1 and CA3 areas as well as in the laterodorsal, centromedial, and reticular thalamic nuclei and the somatosensory cortex of 6-month-old WAG/Rij rats. In addition, a higher number of apoptotic cells as well as a higher expression of caspase-3 was observed in the hippocampal CA1 and CA3 regions, the laterodorsal thalamic nucleus, and the somatosensory cortex of 6-month-old WAG/Rij rats compared to other animal groups. These results indicate significant enhancement of neuronal damage and cell death accompanied by memory deficits after seizure attacks in a rat model of absence epilepsy. Seizure-induced neuronal injury and death may underlie cognitive impairments in absence epilepsy.
Collapse
Affiliation(s)
- M Jafarian
- School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - F Karimzadeh
- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - F Alipour
- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - F Attari
- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - A A Lotfinia
- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - E-J Speckmann
- Epilepsy Research Center, Klinik für Neurochirurgie, Department of Neurology, Institute of Neurophysiology, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - M-R Zarrindast
- School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Gorji
- Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran; Epilepsy Research Center, Klinik für Neurochirurgie, Department of Neurology, Institute of Neurophysiology, Westfälische Wilhelms-Universität Münster, Münster, Germany.
| |
Collapse
|
43
|
Curwood EK, Pedersen M, Carney PW, Berg AT, Abbott DF, Jackson GD. Abnormal cortical thickness connectivity persists in childhood absence epilepsy. Ann Clin Transl Neurol 2015; 2:456-64. [PMID: 26000319 PMCID: PMC4435701 DOI: 10.1002/acn3.178] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 01/04/2015] [Indexed: 02/01/2023] Open
Abstract
Objective Childhood absence epilepsy (CAE) is a childhood-onset generalized epilepsy. Recent fMRI studies have suggested that frontal cortex activity occurs before thalamic involvement in epileptic discharges suggesting that frontal cortex may play an important role in childhood absence seizures. Neurocognitive deficits can persist after resolution of the epilepsy. We investigate whether structural connectivity changes are present in the brains of CAE patients in young adulthood. Methods Cortical thickness measurements were obtained for 30 subjects with CAE (mean age 21 ± 2 years) and 56 healthy controls (mean age 24 ± 4) and regressed for age, sex, and total intracranial volume (TIV). Structural connectivity was evaluated by measuring the correlation between average cortical thicknesses in 915 regions over the brain. Maps of connectivity strength were then obtained for both groups. Results When compared to controls, the CAE group shows overall increased “connectivity” with focal increased connection strength in anterior regions including; the anterior cingulate and the insula and superior temporal gyrus bilaterally; the right orbito-frontal and supramarginal regions; and the left entorhinal cortex. Decreased connection strength in the CAE group was found in the left occipital lobe, with a similar trend in right occipital lobe. Interpretation Brains in young adults whose CAE was resolved had abnormal structural connectivity. Our findings suggest that frontal regions correlate most with cortical thickness throughout the brain in CAE patients, whereas occipital regions correlate most in well matched normal controls. We interpret this as evidence of a developmental difference in CAE that emphasizes these frontal lobe regions, perhaps driven by frontal lobe epileptiform activity.
Collapse
Affiliation(s)
- Evan K Curwood
- The Florey Institute of Neuroscience and Mental Health Austin Campus, Heidelberg, Victoria, Australia
| | - Mangor Pedersen
- Florey Department of Neuroscience and Mental Health, The University of Melbourne Heidelberg, Victoria, Australia
| | - Patrick W Carney
- The Florey Institute of Neuroscience and Mental Health Austin Campus, Heidelberg, Victoria, Australia ; Department of Medicine, The University of Melbourne Parkville, Victoria, Australia
| | - Anne T Berg
- Epilepsy Center, Ann and Robert H. Lurie Children's Hospital of Chicago Chicago, Illinois
| | - David F Abbott
- The Florey Institute of Neuroscience and Mental Health Austin Campus, Heidelberg, Victoria, Australia ; Florey Department of Neuroscience and Mental Health, The University of Melbourne Heidelberg, Victoria, Australia ; Department of Medicine, The University of Melbourne Parkville, Victoria, Australia
| | - Graeme D Jackson
- The Florey Institute of Neuroscience and Mental Health Austin Campus, Heidelberg, Victoria, Australia ; Florey Department of Neuroscience and Mental Health, The University of Melbourne Heidelberg, Victoria, Australia ; Department of Medicine, The University of Melbourne Parkville, Victoria, Australia
| |
Collapse
|
44
|
Yoong M. Quantifying the deficit-imaging neurobehavioural impairment in childhood epilepsy. Quant Imaging Med Surg 2015; 5:225-37. [PMID: 25853081 DOI: 10.3978/j.issn.2223-4292.2015.01.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/14/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neurobehavioral impairments such as learning difficulty, autism, attention deficit hyperactivity disorder (ADHD) and mood or behavioural problems are known to be increased in children with epilepsy; however, they remain under-recognised and often cause considerable morbidity. Quantitative neuroimaging techniques offer a potential avenue to improving our understanding of the underlying pathological basis for these disorders, aiding with diagnosis and risk stratification. METHODS A systematic review was undertaken for original research articles involving magnetic resonance imaging in children with epilepsy and one or more neurobehavioural impairments. Studies were reviewed with respect to patient population, methodology and magnetic resonance imaging (MRI) findings. RESULTS A total of 25 studies were identified and included in this review. The majority of studies looked at single impairments, commonly cognitive impairment or ADHD, with few studies reporting on other impairments. Reductions in cortical grey matter and disruptions of functional and structural brain networks were associated with poorer cognitive performance and disruptions of grey and white matter within a fronto-striatal-cerebellar network associated with ADHD. Insufficient studies were available to report on other impairments. CONCLUSIONS Relatively few studies exist in this field and those that do are methodologically diverse. Further investigation is required to determine if the changes reported to date are epilepsy syndrome specific or have broader applicability.
Collapse
Affiliation(s)
- Michael Yoong
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
45
|
Riccio CA, Pliego JA, Cohen MJ, Park Y. Executive Function Performance for Children With Epilepsy Localized to the Frontal or Temporal Lobes. APPLIED NEUROPSYCHOLOGY-CHILD 2014; 4:277-84. [DOI: 10.1080/21622965.2014.923774] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
46
|
Seneviratne U, Cook M, D'Souza W. Focal abnormalities in idiopathic generalized epilepsy: A critical review of the literature. Epilepsia 2014; 55:1157-69. [DOI: 10.1111/epi.12688] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Udaya Seneviratne
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Melbourne Victoria Australia
- Department of Neuroscience; Monash Medical Centre; Melbourne Victoria Australia
| | - Mark Cook
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Melbourne Victoria Australia
| | - Wendyl D'Souza
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Melbourne Victoria Australia
| |
Collapse
|
47
|
Structural and functional correlates of epileptogenesis - does gender matter? Neurobiol Dis 2014; 70:69-73. [PMID: 24943053 DOI: 10.1016/j.nbd.2014.05.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/15/2014] [Accepted: 05/22/2014] [Indexed: 01/10/2023] Open
Abstract
In the majority of neuropsychiatric conditions, marked gender-based differences have been found in the epidemiology, clinical manifestations, and therapy of disease. One possible reason is that sex differences in cerebral morphology, structural and functional connections, render men and women differentially vulnerable to various disease processes. The present review addresses this issue with respect to the functional and structural correlates to some forms of epilepsy.
Collapse
|
48
|
Savic I. Sex differences in human epilepsy. Exp Neurol 2014; 259:38-43. [PMID: 24747359 DOI: 10.1016/j.expneurol.2014.04.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 04/05/2014] [Accepted: 04/09/2014] [Indexed: 01/07/2023]
Abstract
In the majority of neuropsychiatric conditions, marked gender-based differences have been found in the epidemiology, clinical manifestations, and therapy of disease. Emerging data suggest that gender differences exist also in the epidemiology, and pathophysiology of epilepsy. The present review summarizes the current information regarding gender and epilepsy. These differences are regarded from the perspective of innate sex differences in cerebral morphology, structural and functional connections, and assuming that these differences may render men and women differently vulnerable to epileptogenicity.
Collapse
Affiliation(s)
- Ivanka Savic
- Karolinska Institute, Department of Women's, Children's Health, Neurology Clinic Karolinska Hospital, Q2:07, SE-171 76 Stockholm, Sweden.
| |
Collapse
|
49
|
Yang T, Fang Z, Ren J, Xiao F, Li Q, Liu L, Lei D, Gong Q, Zhou D. Altered spontaneous activity in treatment-naive childhood absence epilepsy revealed by Regional Homogeneity. J Neurol Sci 2014; 340:58-62. [PMID: 24746024 DOI: 10.1016/j.jns.2014.02.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/17/2014] [Accepted: 02/21/2014] [Indexed: 02/05/2023]
Abstract
PURPOSE To explore the differences in regional spontaneous activities throughout the whole brain by the Regional Homogeneity (ReHo) method in untreated childhood absence epilepsy (CAE), in order to understand the neuro-pathophysiological mechanism of function impairments in CAE. METHODS The rest-functional MRI was used to measure the ReHo in 16 patients with untreated CAE and 16 age- and sex-matched healthy controls. The correlations between the ReHo at each voxel of the whole brain and duration of epilepsy were analyzed. RESULTS Compared with healthy controls, we found that ReHo was decreased in bilateral thalamus, caudate, posterior lobe of cerebellum and areas mainly in the default mode network (DMN) (including precuneus and posterior cingulate cortex-PCC, bilateral inferior lateral parietal lobule). The increase of ReHo was found in bilateral insula, left occipital cortex. Moreover, a correlation analysis of the ReHo measurement versus the epilepsy duration was performed, and highly positive correlation was observed in precuneus/PCC and supplementary motor area (SMA). SIGNIFICANCE The current findings demonstrated alterations of ReHo in the striato-thalamo-cortical network in drug naïve CAE subjects during interictal resting state. Some regions with decreased ReHo followed the pattern of 'default' state of brain function. In addition, positive correlations between the ReHo values in the precuneus/PCC and SMA and the disease duration were identified. These results indicate that the involvement of these regions may be related to the pathomechanisms of seizure generation and the neurological deficits observed in CAE patients. ReHo has demonstrated the capability to characterize spontaneous brain dysfunction in epilepsy.
Collapse
Affiliation(s)
- Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Zhijia Fang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China
| | - Jiechuan Ren
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Fenglai Xiao
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Qifu Li
- Department of Neurology, The Affiliated Hospital of Hainan Medical College, Haikou, PR China
| | - Ling Liu
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, PR China.
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Cheng du, PR China.
| |
Collapse
|
50
|
Zelko FA, Pardoe HR, Blackstone SR, Jackson GD, Berg AT. Regional brain volumes and cognition in childhood epilepsy: does size really matter? Epilepsy Res 2014; 108:692-700. [PMID: 24630049 DOI: 10.1016/j.eplepsyres.2014.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 01/13/2014] [Accepted: 02/02/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Recent studies have correlated neurocognitive function and regional brain volumes in children with epilepsy. We tested whether brain volume differences between children with and without epilepsy explained differences in neurocognitive function. METHODS The study sample included 108 individuals with uncomplicated non-syndromic epilepsy (NSE) and 36 healthy age- and gender-matched controls. Participants received a standardized cognitive battery. Whole brain T1-weighted MRI was obtained and volumes analyzed with FreeSurfer (TM). KEY FINDINGS Total brain volume (TBV) was significantly smaller in cases. After adjustment for TBV, cases had significantly larger regional grey matter volumes for total, frontal, parietal, and precentral cortex. Cases had poorer performance on neurocognitive indices of intelligence and variability of sustained attention. In cases, TBV showed small associations with intellectual indices of verbal and perceptual ability, working memory, and overall IQ. In controls, TBV showed medium associations with working memory and variability of sustained attention. In both groups, small associations were seen between some TBV-adjusted regional brain volumes and neurocognitive indices, but not in a consistent pattern. Brain volume differences did not account for cognitive differences between the groups. SIGNIFICANCE Patients with uncomplicated NSE have smaller brains than controls but areas of relative grey matter enlargement. That this relative regional enlargement occurs in the context of poorer overall neurocognitive functioning suggests that it is not adaptive. However, the lack of consistent associations between case-control differences in brain volumes and cognitive functioning suggests that brain volumes have limited explanatory value for cognitive functioning in childhood epilepsy.
Collapse
Affiliation(s)
- Frank A Zelko
- Department of Child and Adolescent Psychiatry, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | - Heath R Pardoe
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; New York University School of Medicine, New York, NY, United States
| | - Sarah R Blackstone
- Department of Public Health, Northern Illinois University, DeKalb, IL, United States
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Anne T Berg
- Epilepsy Center, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| |
Collapse
|