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Rodriguez S, Sharma S, Tiarks G, Peterson Z, Jackson K, Thedens D, Wong A, Keffala-Gerhard D, Mahajan VB, Ferguson PJ, Newell EA, Glykys J, Nickl-Jockschat T, Bassuk AG. Neuroprotective effects of naltrexone in a mouse model of post-traumatic seizures. Sci Rep 2024; 14:13507. [PMID: 38867062 PMCID: PMC11169394 DOI: 10.1038/s41598-024-63942-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
Traumatic Brain Injury (TBI) induces neuroinflammatory response that can initiate epileptogenesis, which develops into epilepsy. Recently, we identified anti-convulsive effects of naltrexone, a mu-opioid receptor (MOR) antagonist, used to treat drug addiction. While blocking opioid receptors can reduce inflammation, it is unclear if post-TBI seizures can be prevented by blocking MORs. Here, we tested if naltrexone prevents neuroinflammation and/or seizures post-TBI. TBI was induced by a modified Marmarou Weight-Drop (WD) method on 4-week-old C57BL/6J male mice. Mice were placed in two groups: non-telemetry assessing the acute effects or in telemetry monitoring for interictal events and spontaneous seizures both following TBI and naltrexone. Molecular, histological and neuroimaging techniques were used to evaluate neuroinflammation, neurodegeneration and fiber track integrity at 8 days and 3 months post-TBI. Peripheral immune responses were assessed through serum chemokine/cytokine measurements. Our results show an increase in MOR expression, nitro-oxidative stress, mRNA expression of inflammatory cytokines, microgliosis, neurodegeneration, and white matter damage in the neocortex of TBI mice. Video-EEG revealed increased interictal events in TBI mice, with 71% mice developing post-traumatic seizures (PTS). Naltrexone treatment ameliorated neuroinflammation, neurodegeneration, reduced interictal events and prevented seizures in all TBI mice, which makes naltrexone a promising candidate against PTS, TBI-associated neuroinflammation and epileptogenesis in a WD model of TBI.
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Affiliation(s)
- Saul Rodriguez
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Shaunik Sharma
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Grant Tiarks
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Zeru Peterson
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Kyle Jackson
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Daniel Thedens
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Angela Wong
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - David Keffala-Gerhard
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Vinit B Mahajan
- Department of Ophthalmology, Stanford University, Palo Alto, CA, USA
| | - Polly J Ferguson
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Elizabeth A Newell
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
| | - Joseph Glykys
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
- Department of Neurology, University of Iowa, Iowa City, IA, USA
| | - Thomas Nickl-Jockschat
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany German Center for Mental Health (DZPG), partner site Halle-Jena-Magdeburg, Germany Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Halle-Jena-Magdeburg, Germany
| | - Alexander G Bassuk
- Stead Family Department of Pediatrics , Carver College of Medicine, University of Iowa, 25 South Grand Ave, 2040 MedLabs, Iowa City, IA, 52242, USA.
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA.
- Department of Neurology, University of Iowa, Iowa City, IA, USA.
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De Benedictis A, de Palma L, Rossi-Espagnet MC, Marras CE. Connectome-based approaches in pediatric epilepsy surgery: "State-of-the art" and future perspectives. Epilepsy Behav 2023; 149:109523. [PMID: 37944286 DOI: 10.1016/j.yebeh.2023.109523] [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: 06/25/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
Modern epilepsy science has overcome the traditional interpretation of a strict region-specific origin of epilepsy, highlighting the involvement of wider patterns of altered neuronal circuits. In selected cases, surgery may constitute a valuable option to achieve both seizure freedom and neurocognitive improvement. Although epilepsy is now considered as a brain network disease, the most relevant literature concerning the "connectome-based" epilepsy surgery mainly refers to adults, with a limited number of studies dedicated to the pediatric population. In this review, the Authors summarized the main current available knowledge on the relevance of WM surgical anatomy in epilepsy surgery, the post-surgical modifications of brain structural connectivity and the related clinical impact of such modifications within the pediatric context. In the last part, possible implications and future perspectives of this approach have been discussed, especially concerning the optimization of surgical strategies and the predictive value of the epilepsy network analysis for planning tailored approaches, with the final aim of improving case selection, presurgical planning, intraoperative management, and postoperative results.
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Affiliation(s)
| | - Luca de Palma
- Epilepsy and Movement Disorders Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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3
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De Benedictis A, Rossi-Espagnet MC, de Palma L, Sarubbo S, Marras CE. Structural networking of the developing brain: from maturation to neurosurgical implications. Front Neuroanat 2023; 17:1242757. [PMID: 38099209 PMCID: PMC10719860 DOI: 10.3389/fnana.2023.1242757] [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: 06/19/2023] [Accepted: 11/09/2023] [Indexed: 12/17/2023] Open
Abstract
Modern neuroscience agrees that neurological processing emerges from the multimodal interaction among multiple cortical and subcortical neuronal hubs, connected at short and long distance by white matter, to form a largely integrated and dynamic network, called the brain "connectome." The final architecture of these circuits results from a complex, continuous, and highly protracted development process of several axonal pathways that constitute the anatomical substrate of neuronal interactions. Awareness of the network organization of the central nervous system is crucial not only to understand the basis of children's neurological development, but also it may be of special interest to improve the quality of neurosurgical treatments of many pediatric diseases. Although there are a flourishing number of neuroimaging studies of the connectome, a comprehensive vision linking this research to neurosurgical practice is still lacking in the current pediatric literature. The goal of this review is to contribute to bridging this gap. In the first part, we summarize the main current knowledge concerning brain network maturation and its involvement in different aspects of normal neurocognitive development as well as in the pathophysiology of specific diseases. The final section is devoted to identifying possible implications of this knowledge in the neurosurgical field, especially in epilepsy and tumor surgery, and to discuss promising perspectives for future investigations.
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Affiliation(s)
| | | | - Luca de Palma
- Clinical and Experimental Neurology, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, Santa Chiara Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
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4
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Kerestes R, Perry A, Vivash L, O'Brien TJ, Alvim MKM, Arienzo D, Aventurato ÍK, Ballerini A, Baltazar GF, Bargalló N, Bender B, Brioschi R, Bürkle E, Caligiuri ME, Cendes F, de Tisi J, Duncan JS, Engel JP, Foley S, Fortunato F, Gambardella A, Giacomini T, Guerrini R, Hall G, Hamandi K, Ives-Deliperi V, João RB, Keller SS, Kleiser B, Labate A, Lenge M, Marotta C, Martin P, Mascalchi M, Meletti S, Owens-Walton C, Parodi CB, Pascual-Diaz S, Powell D, Rao J, Rebsamen M, Reiter J, Riva A, Rüber T, Rummel C, Scheffler F, Severino M, Silva LS, Staba RJ, Stein DJ, Striano P, Taylor PN, Thomopoulos SI, Thompson PM, Tortora D, Vaudano AE, Weber B, Wiest R, Winston GP, Yasuda CL, Zheng H, McDonald CR, Sisodiya SM, Harding IH. Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA-Epilepsy study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.21.562994. [PMID: 37961570 PMCID: PMC10634708 DOI: 10.1101/2023.10.21.562994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Objective The intricate neuroanatomical structure of the cerebellum is of longstanding interest in epilepsy, but has been poorly characterized within the current cortico-centric models of this disease. We quantified cross-sectional regional cerebellar lobule volumes using structural MRI in 1,602 adults with epilepsy and 1,022 healthy controls across twenty-two sites from the global ENIGMA-Epilepsy working group. Methods A state-of-the-art deep learning-based approach was employed that parcellates the cerebellum into 28 neuroanatomical subregions. Linear mixed models compared total and regional cerebellar volume in i) all epilepsies; ii) temporal lobe epilepsy with hippocampal sclerosis (TLE-HS); iii) non-lesional temporal lobe epilepsy (TLE-NL); iv) genetic generalised epilepsy; and (v) extra-temporal focal epilepsy (ETLE). Relationships were examined for cerebellar volume versus age at seizure onset, duration of epilepsy, phenytoin treatment, and cerebral cortical thickness. Results Across all epilepsies, reduced total cerebellar volume was observed (d=0.42). Maximum volume loss was observed in the corpus medullare (dmax=0.49) and posterior lobe grey matter regions, including bilateral lobules VIIB (dmax= 0.47), Crus I/II (dmax= 0.39), VIIIA (dmax=0.45) and VIIIB (dmax=0.40). Earlier age at seizure onset (ηρ2max=0.05) and longer epilepsy duration (ηρ2max=0.06) correlated with reduced volume in these regions. Findings were most pronounced in TLE-HS and ETLE with distinct neuroanatomical profiles observed in the posterior lobe. Phenytoin treatment was associated with reduced posterior lobe volume. Cerebellum volume correlated with cerebral cortical thinning more strongly in the epilepsy cohort than in controls. Significance We provide robust evidence of deep cerebellar and posterior lobe subregional grey matter volume loss in patients with chronic epilepsy. Volume loss was maximal for posterior subregions implicated in non-motor functions, relative to motor regions of both the anterior and posterior lobe. Associations between cerebral and cerebellar changes, and variability of neuroanatomical profiles across epilepsy syndromes argue for more precise incorporation of cerebellum subregions into neurobiological models of epilepsy.
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Affiliation(s)
- Rebecca Kerestes
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Andrew Perry
- Monash Bioinformatics Platform, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Marina K M Alvim
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Donatello Arienzo
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Ítalo K Aventurato
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Alice Ballerini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gabriel F Baltazar
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Department of Radiology of Center of Image Diagnosis (CDIC), Hospital Clinic de Barcelona, Barcelona, Spain
- CIBERSAM, Madrid, Spain
| | - Benjamin Bender
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Ricardo Brioschi
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Eva Bürkle
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Jerome P Engel
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Thea Giacomini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Renzo Guerrini
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Gerard Hall
- School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | | | - Rafael B João
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Benedict Kleiser
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Angelo Labate
- Neurophysiopatology and Movement Disorders Clinic, University of Messina, Messina, Italy
- Regional Epilepsy Center, University of Messina, Messina, Italy
| | - Matteo Lenge
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | | | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medical Sciences, University of Florence, Florence, Italy
- Division of Epidemiology and Clinical Governance, Institute for Study, Prevention and network in Oncology of the Tuscany Region, Florence, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria Modena, Modena, Italy
| | - Conor Owens-Walton
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | | | - Saül Pascual-Diaz
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - David Powell
- Monash Bioinformatics Platform, Monash University, Melbourne, VIC, Australia
| | - Jun Rao
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johannes Reiter
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | | | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Lucas S Silva
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Richard J Staba
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Dan J Stein
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Monash Bioinformatics Platform, Monash University, Melbourne, VIC, Australia
- Department of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Department of Radiology of Center of Image Diagnosis (CDIC), Hospital Clinic de Barcelona, Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, UK
- Institute of Neurology, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
- School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- The Walton Centre NHS Foundation Trust, Liverpool, UK
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Neurophysiopatology and Movement Disorders Clinic, University of Messina, Messina, Italy
- Regional Epilepsy Center, University of Messina, Messina, Italy
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
- 'Mario Serio' Department of Clinical and Experimental Medical Sciences, University of Florence, Florence, Italy
- Division of Epidemiology and Clinical Governance, Institute for Study, Prevention and network in Oncology of the Tuscany Region, Florence, Italy
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria Modena, Modena, Italy
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- IRCCS Istituto 'Giannina Gaslini', Genova, Italy
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
- Epilepsy Society MRI Unit, Chalfont St Peter, UK
- Department of Medicine (Division of Neurology), Queen's University Kingston, ON, Canada
- Chalfont Centre for Epilepsy, Bucks, UK
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
- IRCCS Istituto 'Giannina Gaslini', Genova, Italy
| | - Peter N Taylor
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | | | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria Modena, Modena, Italy
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont St Peter, UK
- Department of Medicine (Division of Neurology), Queen's University Kingston, ON, Canada
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Hong Zheng
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
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5
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Xi Y, Lan Z, Chen Y, Zhang Q, Wu Z, Li G. Patients with epilepsy without cognitive impairment show altered brain networks in multiple frequency bands in an audiovisual integration task. Neurophysiol Clin 2023; 53:102888. [PMID: 37660635 DOI: 10.1016/j.neucli.2023.102888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES Comorbid cognitive and behavioral deficits are often observed in patients with epilepsy. It is not clear whether the brain networks of patients with epilepsy without cognitive decline differs from that of healthy controls in different frequency bands in the task-state. The purpose of our study was to explore whether epilepsy affects the structure of brain networks associated with cognitive processing, even when patients with epilepsy do not have cognitive impairment. METHODS We designed an audiovisual discrimination task and recorded electroencephalogram (EEG) data from healthy controls and patients with epilepsy. We established constructed time-varying brain networks across the delta, theta, alpha, and beta bands on the task-state EEG data during audiovisual integration processing. RESULTS The results showed changes in the structure of the brain networks in the theta, alpha, and beta bands in patients with epilepsy who had no cognitive deficit. No significant difference in the connectivity strength, clustering coefficient, characteristic path length, or global efficiency was noted between patients and healthy controls. Moreover, the structure of brain networks in patients showed no correlation with the behavioral performance. CONCLUSION The repeated abnormal firing of neurons in the brain of patients with epilepsy may inhibit it from optimizing networks into more efficient structures. Epilepsy might affect decision-making ability by damaging the neural activity in the beta band and preventing its correlation with decision-making behaviors.
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Affiliation(s)
- Yang Xi
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China.
| | - Zhu Lan
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Ying Chen
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Qiushi Zhang
- School of Computer Science, Northeast Electric Power University, Jilin 132012, P.R. China
| | - Zhenyu Wu
- Department of Orthopedics of Affiliated Hospital of Beihua University, Beihua University, Jilin 132012, P.R. China
| | - Guangjian Li
- Department of Neurology of First Affiliated Hospital of Jilin University, Jilin University, Changchun 130022, P.R. China
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6
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Zanao TA, Seitz‐Holland J, O'Donnell LJ, Zhang F, Rathi Y, Lopes TM, Pimentel‐Silva LR, Yassuda CL, Makris N, Shenton ME, Bouix S, Lyall AE, Cendes F. Exploring the impact of hippocampal sclerosis on white matter tracts and memory in individuals with mesial temporal lobe epilepsy. Epilepsia Open 2023; 8:1111-1122. [PMID: 37469213 PMCID: PMC10472386 DOI: 10.1002/epi4.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 07/14/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVE To investigate how the presence/side of hippocampal sclerosis (HS) are related to the white matter structure of cingulum bundle (CB), arcuate fasciculus (AF), and inferior longitudinal fasciculus (ILF) in mesial temporal lobe epilepsy (MTLE). METHODS We acquired diffusion-weighted magnetic resonance imaging (MRI) from 86 healthy and 71 individuals with MTLE (22 righ-HS; right-HS, 34 left-HS; left-HS, and 15 nonlesional MTLE). We utilized two-tensor tractography and fiber clustering to compare fractional anisotropy (FA) of each side/tract between groups. Additionally, we examined the association between FA and nonverbal (WMS-R) and verbal (WMS-R, RAVLT codification) memory performance for MTLE individuals. RESULTS White matter abnormalities depended on the side and presence of HS. The left-HS demonstrated widespread abnormalities for all tracts, the right-HS showed lower FA for ipsilateral tracts and the nonlesional MTLE group did not differ from healthy individuals. Results indicate no differences in verbal/nonverbal memory performance between the groups, but trend-level associations between higher FA of visual memory and the left CB (r = 0.286, P = 0.018), verbal memory (RAVLT) and -left CB (r = 0.335, P = 0.005), -right CB (r = 0.286, P = 0.016), and -left AF (r = 0.287, P = 0.017). SIGNIFICANCE Our results highlight that the presence and side of HS are crucial to understand the pathophysiology of MTLE. Specifically, left-sided HS seems to be related to widespread bilateral white matter abnormalities. Future longitudinal studies should focus on developing diagnostic and treatment strategies dependent on HS's presence/side.
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Affiliation(s)
- Tamires A. Zanao
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | - Johanna Seitz‐Holland
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Lauren J. O'Donnell
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fan Zhang
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Tátila M. Lopes
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | | | - Clarissa L. Yassuda
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Sylvain Bouix
- Département de génie logiciel et TI, École de technologie supérieureUniversité du QuébecMontrealQuebecCanada
| | - Amanda E. Lyall
- Psychiatry Neuroimaging Laboratory, Department of PsychiatryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fernando Cendes
- Neuroimaging Laboratory, School of Medical SciencesUniversity of CampinasCampinasSão PauloBrazil
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Sufianov A, Gonzalez-Lopez P, Simfukwe K, Martorell-Llobregat C, Iakimov IA, Sufianov RA, Mastronardi L, Borba LAB, Rangel CC, Forlizzi V, Campero A, Baldoncini M. Clinical and anatomical analysis of the epileptogenic spread patterns in focal cortical dysplasia patients. Surg Neurol Int 2023; 14:291. [PMID: 37680931 PMCID: PMC10481808 DOI: 10.25259/sni_210_2023] [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: 03/04/2023] [Accepted: 07/07/2023] [Indexed: 09/09/2023] Open
Abstract
Background Focal cortical dysplasia (FCD) is one of the main causes of intractable epilepsy, which is amendable by surgery. During the surgical management of FCD, the understanding of its epileptogenic foci, interconnections, and spreading pathways is crucial for attaining a good postoperative seizure free outcome. Methods We retrospectively evaluated 54 FCD patients operated in Federal Center of Neurosurgery, Tyumen, Russia. The electroencephalogram findings were correlated to the involved brain anatomical areas. Subsequently, we analyzed the main white matter tracts implicated during the epileptogenic spreading in some representative cases. We prepared 10 human hemispheres using Klinger's method and dissected them through the fiber dissection technique. Results The clinical results were displayed and the main white matter tracts implicated in the seizure spread were described in 10 patients. Respective FCD foci, interconnections, and ectopic epileptogenic areas in each patient were discussed. Conclusion A strong understanding of the main implicated tracts in epileptogenic spread in FCD patient remains cardinal for neurosurgeons dealing with epilepsy. To achieve meaningful seizure freedom, despite the focal lesion resection, the interconnections and tracts should be understood and somehow disconnected to stop the spreading.
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Affiliation(s)
- Albert Sufianov
- Department of Neurosurgery, Federal Center of Neurosurgery, Tyumen, Russian Federation
| | - Pablo Gonzalez-Lopez
- Department of Neurosurgery, Hospital General Universitario de Alicante, Alicante, Spain
| | - Keith Simfukwe
- Department of Neurosurgery, First Moscow Medical University, Moscow, Russian Federation
| | | | - Iurii A. Iakimov
- Department of Neurosurgery, First Moscow Medical University, Moscow, Russian Federation
| | - Rinat A. Sufianov
- Department of Neurosurgery, First Moscow Medical University, Moscow, Russian Federation
| | | | - Luis A. B. Borba
- Department of Neurosurgery, Mackenzie Evangelical University Hospital, Curitiba, Parana, Brazil
| | - Carlos Castillo Rangel
- Department of Neurosurgery, Institute of Security and Social Services for State Workers (ISSSTE), Mexico City, Mexico
| | - Valeria Forlizzi
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Alvaro Campero
- Department of Neurosurgery, Hospital Padilla de Tucuman, Tucuman, Argentina
| | - Matias Baldoncini
- Department of Neurosurgery, San Fernando Hospital, San Fernando, Argentina
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8
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Yu H, Gao J, Chang RSK, Mak W, Thach TQ, Cheung RTF. Inhibitory dysfunction may cause prospective memory impairment in temporal lobe epilepsy (TLE) patients: an event-related potential study. Front Hum Neurosci 2023; 17:1006744. [PMID: 37565055 PMCID: PMC10410078 DOI: 10.3389/fnhum.2023.1006744] [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: 07/29/2022] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Prospective memory (PM) is the ability to remember future intentions, and PM function is closely related to independence in daily life, particularly in patients with temporal lobe epilepsy (TLE). As PM involves various cognitive components of attention, working memory, inhibition and other executive functions, this study investigated how TLE may affect PM components and the underlying neural mechanisms. Methods Sixty-four subjects were recruited, including 20 refractory TLE patients, 18 well-controlled TLE patients and 26 age-matched healthy controls. A set of neuropsychological tests was administered to assess specific brain functions. An event-related potential (ERP) task was used to further explore how PM and its components would be differentially affected in the two TLE types. Results Our findings revealed that: (1) refractory TLE patients scored lower than the healthy controls in the digit span, Verbal Fluency Test and Symbol Digit Modalities Test; (2) refractory TLE patients exhibited impaired PM performance and reduced prospective positivity amplitudes over the frontal, central and parietal regions in ERP experiments when compared to the healthy controls; and (3) decreased P3 amplitudes in the nogo trials were observed over the frontal-central sites in refractory but not in well-controlled TLE patients. Discussion To our knowledge, this is the first ERP study on PM that has specifically identified PM impairment in refractory but not in well-controlled TLE patients. Our finding of double dissociation in PM components suggests that inhibition dysfunction may be the main reason for PM deficit in refractory TLE patients. The present results have clinical implications for neuropsychological rehabilitation in TLE patients.
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Affiliation(s)
- Hemei Yu
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Junling Gao
- Centre of Buddhist Studies, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Windsor Mak
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Thuan-Quoc Thach
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Raymond Tak Fai Cheung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
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9
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Uher D, Drenthen GS, Schijns OEMG, Colon AJ, Hofman PAM, van Lanen RHGJ, Hoeberigs CM, Jansen JFA, Backes WH. Advances in Image Processing for Epileptogenic Zone Detection with MRI. Radiology 2023; 307:e220927. [PMID: 37129491 DOI: 10.1148/radiol.220927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Focal epilepsy is a common and severe neurologic disorder. Neuroimaging aims to identify the epileptogenic zone (EZ), preferably as a macroscopic structural lesion. For approximately a third of patients with chronic drug-resistant focal epilepsy, the EZ cannot be precisely identified using standard 3.0-T MRI. This may be due to either the EZ being undetectable at imaging or the seizure activity being caused by a physiologic abnormality rather than a structural lesion. Computational image processing has recently been shown to aid radiologic assessments and increase the success rate of uncovering suspicious regions by enhancing their visual conspicuity. While structural image analysis is at the forefront of EZ detection, physiologic image analysis has also been shown to provide valuable information about EZ location. This narrative review summarizes and explains the current state-of-the-art computational approaches for image analysis and presents their potential for EZ detection. Current limitations of the methods and possible future directions to augment EZ detection are discussed.
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Affiliation(s)
- Daniel Uher
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Gerhard S Drenthen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Olaf E M G Schijns
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Albert J Colon
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Paul A M Hofman
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Rick H G J van Lanen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Christianne M Hoeberigs
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Jacobus F A Jansen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Walter H Backes
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
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10
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Hoxhaj P, Habiya SK, Sayabugari R, Balaji R, Xavier R, Ahmad A, Khanam M, Kachhadia MP, Patel T, Abdin ZU, Haider A, Nazir Z. Investigating the Impact of Epilepsy on Cognitive Function: A Narrative Review. Cureus 2023; 15:e41223. [PMID: 37525802 PMCID: PMC10387362 DOI: 10.7759/cureus.41223] [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] [Accepted: 06/28/2023] [Indexed: 08/02/2023] Open
Abstract
It has been noted that people who have epilepsy have an increased propensity for cognitive dysfunction. We explored 25 relevant articles on PubMed and Cochrane Library after implementing inclusion criteria. Different factors have been postulated and studied that may cause cognitive dysfunction in these patients; structural brain abnormalities, polypharmacy of antiepileptic medication, and neuropsychiatric disorders are the most common causes. Cognitive assessments such as Montreal Cognitive Assessment (MOCA) and Mini-Mental State Exam (MMSE) are the mainstay tools used to diagnose the degree of cognitive decline, and alterations in EEG (electroencephalogram) parameters have also been noted in people with cognitive decline. The mechanisms and treatments for cognitive decline are still being studied, while attention has also been directed toward preventive and predictive methods. Early detection and treatment of cognitive impairment can help minimize its impact on the patient's quality of life. Regular cognitive assessments are essential for epileptic patients, particularly those on multiple antiepileptic drugs. While proper management of epilepsy and related comorbidities would reduce cognitive decline and improve the overall quality of life for people with epilepsy.
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Affiliation(s)
- Pranvera Hoxhaj
- Medicine, University of Medicine, Tirana, Tirana, ALB
- Obstetrics and Gynaecology, Scher & Kerenyi MDS, New York, USA
| | - Sana K Habiya
- Internal Medicine, Indian Institute of Medical Science and Research, Jalna, IND
- Public Health, Northeastern Illinois University, Chicago, USA
| | | | - Roghan Balaji
- Neurology, Ponjesly Super Speciality Hospital, Nagercoil, IND
- Neurology, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry, IND
| | - Roshni Xavier
- Internal Medicine, Rajagiri Hospital, Aluva, IND
- Internal Medicine, Carewell Hospital, Malappuram, IND
| | - Arghal Ahmad
- Internal Medicine, Ziauddin University, Karachi, PAK
| | | | | | - Tirath Patel
- Internal Medicine, American University of Antigua, St John, ATG
| | - Zain U Abdin
- Internal Medicine, District Head Quarter Hospital, Faisalabad, PAK
| | - Ali Haider
- Internal Medicine, Quetta Institute of Medical Sciences, Quetta, PAK
| | - Zahra Nazir
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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11
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Zhang W, Duan Y, Qi L, Li Z, Ren J, Nangale N, Yang C. Distinguishing Patients with MRI-Negative Temporal Lobe Epilepsy from Normal Controls Based on Individual Morphological Brain Network. Brain Topogr 2023:10.1007/s10548-023-00962-z. [PMID: 37204610 DOI: 10.1007/s10548-023-00962-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 04/15/2023] [Indexed: 05/20/2023]
Abstract
Temporal Lobe Epilepsy (TLE) is the most common subtype of focal epilepsy and the most refractory to drug treatment. Roughly 30% of patients do not have easily identifiable structural abnormalities. In other words, MRI-negative TLE has normal MRI scans on visual inspection. Thus, MRI-negative TLE is a diagnostic and therapeutic challenge. In this study, we investigate the cortical morphological brain network to identify MRI-negative TLE. The 210 cortical ROIs based on the Brainnetome atlas were used to define the network nodes. The least absolute shrinkage and selection operator (LASSO) algorithm and Pearson correlation methods were used to calculate the inter-regional morphometric features vector correlation respectively. As a result, two types of networks were constructed. The topological characteristics of networks were calculated by graph theory. Then after, a two-stage feature selection strategy, including a two-sample t-test and support vector machine-based recursive feature elimination (SVM-RFE), was performed in feature selection. Finally, classification with support vector machine (SVM) and leave-one-out cross-validation (LOOCV) was employed for the training and evaluation of the classifiers. The performance of two constructed brain networks was compared in MRI-negative TLE classification. The results indicated that the LASSO algorithm achieved better performance than the Pearson pairwise correlation method. The LASSO algorithm provides a robust method of individual morphological network construction for distinguishing patients with MRI-negative TLE from normal controls.
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Affiliation(s)
- Wenxiu Zhang
- Department of Environment and Life Sciences, Beijing University of Technology, Beijing, China
| | - Ying Duan
- Beijing Universal Medical Imaging Diagnostic Center, Beijing, China
| | - Lei Qi
- Beijing Universal Medical Imaging Diagnostic Center, Beijing, China
| | - Zhimei Li
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiechuan Ren
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | - Chunlan Yang
- Department of Environment and Life Sciences, Beijing University of Technology, Beijing, China.
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12
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Chaari N, Akdağ HC, Rekik I. Comparative survey of multigraph integration methods for holistic brain connectivity mapping. Med Image Anal 2023; 85:102741. [PMID: 36638747 DOI: 10.1016/j.media.2023.102741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
One of the greatest scientific challenges in network neuroscience is to create a representative map of a population of heterogeneous brain networks, which acts as a connectional fingerprint. The connectional brain template (CBT), also named network atlas, presents a powerful tool for capturing the most representative and discriminative traits of a given population while preserving its topological patterns. The idea of a CBT is to integrate a population of heterogeneous brain connectivity networks, derived from different neuroimaging modalities or brain views (e.g., structural and functional), into a unified holistic representation. Here we review current state-of-the-art methods designed to estimate well-centered and representative CBT for populations of single-view and multi-view brain networks. We start by reviewing each CBT learning method, then we introduce the evaluation measures to compare CBT representativeness of populations generated by single-view and multigraph integration methods, separately, based on the following criteria: Centeredness, biomarker-reproducibility, node-level similarity, global-level similarity, and distance-based similarity. We demonstrate that the deep graph normalizer (DGN) method significantly outperforms other multi-graph and all single-view integration methods for estimating CBTs using a variety of healthy and disordered datasets in terms of centeredness, reproducibility (i.e., graph-derived biomarkers reproducibility that disentangle the typical from the atypical connectivity variability), and preserving the topological traits at both local and global graph-levels.
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Affiliation(s)
- Nada Chaari
- BASIRA lab, Faculty of Computer and Informatics, Istanbul Technical University, Istanbul, Turkey; Faculty of Management, Istanbul Technical University, Istanbul, Turkey
| | | | - Islem Rekik
- BASIRA lab, Faculty of Computer and Informatics, Istanbul Technical University, Istanbul, Turkey; Computing, Imperial-X Translation and Innovation Hub, Imperial College London, London, UK.
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Vilà-Balló A, De la Cruz-Puebla M, López-Barroso D, Miró J, Sala-Padró J, Cucurell D, Falip M, Rodríguez-Fornells A. Reward-based decision-making in mesial temporal lobe epilepsy patients with unilateral hippocampal sclerosis pre- and post-surgery. Neuroimage Clin 2022; 36:103251. [PMID: 36510413 PMCID: PMC9668642 DOI: 10.1016/j.nicl.2022.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Correct functioning of the reward processing system is critical for optimizing decision-making as well as preventing the development of addictions and/or neuropsychiatric symptoms such as depression, apathy, and anhedonia. Consequently, patients with mesial temporal lobe epilepsy due to unilateral hippocampal sclerosis (mTLE-UHS) represent an excellent opportunity to study the brain networks involved in this system. OBJECTIVE The aim of the current study was to evaluate decision-making and the electrophysiological correlates of feedback processing in a sample of mTLE-UHS patients, compared to healthy controls. In addition, we assessed the impact of mesial temporal lobe surgical resection on these processes, as well as general, neuropsychological functioning. METHOD 17 mTLE-UHS patients and 17 matched healthy controls completed: [1] a computerized version of the Game of Dice Task, [2] a Standard Iowa Gambling Task, and [3] a modified ERP version of a probabilistic gambling task coupled with multichannel electroencephalography. Neuropsychological scores were also obtained both pre- and post-surgery. RESULTS Behavioral analyses showed a pattern of increased risk for the mTLE-UHS group in decision-making under ambiguity compared to the control group. A decrease in the amplitude of the Feedback Related Negativity (FRN), a weaker effect of valence on delta power, and a general reduction of delta and theta power in the mTLE-UHS group, as compared to the control group, were also found. The beta-gamma activity associated with the delivery of positive reward was similar in both groups. Behavioral performance and electrophysiological measures did not worsen post-surgery. CONCLUSIONS Patients with mTLE-UHS showed impairments in decision-making under ambiguity, particularly when they had to make decisions based on the outcomes of their choices, but not in decision-making under risk. No group differences were observed in decision-making when feedbacks were random. These results might be explained by the abnormal feedback processing seen in the EEG activity of patients with mTLE-UHS, and by concomitant impairments in working memory, and memory. These impairments may be linked to the disruption of mesial temporal lobe networks. Finally, feedback processing and decision-making under ambiguity were already affected in mTLE-UHS patients pre-surgery and did not show evidence of clear worsening post-surgery.
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Affiliation(s)
- Adrià Vilà-Balló
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain,Department of Psychology, Faculty of Education and Psychology, University of Girona, Girona, Spain,Corresponding authors.
| | - Myriam De la Cruz-Puebla
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Department of Cellular Biology, Physiology, and Immunology, Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain,Department of Equity in Brain Health, Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), CA, USA,Department of Internal Medicine, Health Sciences Faculty, Technical University of Ambato, Tungurahua, Ecuador,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Málaga, Málaga, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Júlia Miró
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Epilepsy Unit, Neurological Service, Neurology and Genetics Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Jacint Sala-Padró
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - David Cucurell
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mercè Falip
- Epilepsy Unit, Neurological Service, Neurology and Genetics Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Rodríguez-Fornells
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
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14
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Leveraging manifold learning techniques to explore white matter anomalies: An application of the TractLearn pipeline in epilepsy. Neuroimage Clin 2022; 36:103209. [PMID: 36162235 PMCID: PMC9668609 DOI: 10.1016/j.nicl.2022.103209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
An accurate description of brain white matter anatomy in vivo remains a challenge. However, technical progress allows us to analyze structural variations in an increasingly sophisticated way. Current methods of processing diffusion MRI data now make it possible to correct some limiting biases. In addition, the development of statistical learning algorithms offers the opportunity to analyze the data from a new perspective. We applied newly developed tractography models to extract quantitative white matter parameters in a group of patients with chronic temporal lobe epilepsy. Furthermore, we implemented a statistical learning workflow optimized for the MRI diffusion data - the TractLearn pipeline - to model inter-individual variability and predict structural changes in patients. Finally, we interpreted white matter abnormalities in the context of several other parameters reflecting clinical status, as well as neuronal and cognitive functioning for these patients. Overall, we show the relevance of such a diffusion data processing pipeline for the evaluation of clinical populations. The "global to fine scale" funnel statistical approach proposed in this study also contributes to the understanding of neuroplasticity mechanisms involved in refractory epilepsy, thus enriching previous findings.
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15
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Aronica E, Binder DK, Drexel M, Ikonomidou C, Kadam SD, Sperk G, Steinhäuser C. A companion to the preclinical common data elements and case report forms for neuropathology studies in epilepsy research. A report of the TASK3 WG2 Neuropathology Working Group of the ILAE/AES Joint Translational Task Force. Epilepsia Open 2022. [PMID: 35938285 DOI: 10.1002/epi4.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/28/2022] [Indexed: 11/06/2022] Open
Abstract
The International League Against Epilepsy/American Epilepsy Society (ILAE/AES) Joint Translational Task Force initiated the TASK3 working group to create common data elements (CDEs) for various aspects of preclinical epilepsy research studies, which could help improve the standardization of experimental designs. This article addresses neuropathological changes associated with seizures and epilepsy in rodent models of epilepsy. We discuss CDEs for histopathological parameters for neurodegeneration, changes in astrocyte morphology and function, mechanisms of inflammation, and changes in the blood-brain barrier and myelin/oligodendrocytes resulting from recurrent seizures in rats and mice. We provide detailed CDE tables and case report forms (CRFs), and with this companion manuscript, we discuss the rationale and methodological aspects of individual neuropathological examinations. The CDEs, CRFs, and companion paper are available to all researchers, and their use will benefit the harmonization and comparability of translational preclinical epilepsy research. The ultimate hope is to facilitate the development of rational therapy concepts for treating epilepsies, seizures, and comorbidities and the development of biomarkers assessing the pathological state of the disease.
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Affiliation(s)
- Eleonora Aronica
- Amsterdam UMC, University of Amsterdam, Department of (Neuro) Pathology, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - Devin K Binder
- Center for Glial-Neuronal Interactions, Division of Biomedical Sciences, School of Medicine, University of California, Riverside, California, USA
| | - Meinrad Drexel
- Department of Genetics and Pharmacology, Institute of Molecular and Cellular Pharmacology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Shilpa D Kadam
- The Hugo Moser Research Institute at Kennedy Krieger, Baltimore, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guenther Sperk
- Department of Pharmacology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Steinhäuser
- Institute of Cellular Neurosciences, Medical School, University of Bonn, Bonn, Germany
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16
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Horsley JJ, Schroeder GM, Thomas RH, de Tisi J, Vos SB, Winston GP, Duncan JS, Wang Y, Taylor PN. Volumetric and structural connectivity abnormalities co-localise in TLE. Neuroimage Clin 2022; 35:103105. [PMID: 35863179 PMCID: PMC9421455 DOI: 10.1016/j.nicl.2022.103105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/17/2022] [Accepted: 06/29/2022] [Indexed: 12/02/2022]
Abstract
Patients with temporal lobe epilepsy (TLE) exhibit both volumetric and structural connectivity abnormalities relative to healthy controls. How these abnormalities inter-relate and their mechanisms are unclear. We computed grey matter volumetric changes and white matter structural connectivity abnormalities in 144 patients with unilateral TLE and 96 healthy controls. Regional volumes were calculated using T1-weighted MRI, while structural connectivity was derived using white matter fibre tractography from diffusion-weighted MRI. For each regional volume and each connection strength, we calculated the effect size between patient and control groups in a group-level analysis. We then applied hierarchical regression to investigate the relationship between volumetric and structural connectivity abnormalities in individuals. Additionally, we quantified whether abnormalities co-localised within individual patients by computing Dice similarity scores. In TLE, white matter connectivity abnormalities were greater when joining two grey matter regions with abnormal volumes. Similarly, grey matter volumetric abnormalities were greater when joined by abnormal white matter connections. The extent of volumetric and connectivity abnormalities related to epilepsy duration, but co-localisation did not. Co-localisation was primarily driven by neighbouring abnormalities in the ipsilateral hemisphere. Overall, volumetric and structural connectivity abnormalities were related in TLE. Our results suggest that shared mechanisms may underlie changes in both volume and connectivity alterations in patients with TLE.
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Affiliation(s)
- Jonathan J Horsley
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gabrielle M Schroeder
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rhys H Thomas
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Microscopy, Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia; Centre for Medical Image Computing, Computer Science Department, University College London, London, United Kingdom
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yujiang Wang
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Peter N Taylor
- CNNP Lab (www.cnnp-lab.com), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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17
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Stasenko A, Kaestner E, Reyes A, Lalani SJ, Paul B, Hegde M, Helm JL, Ben-Haim S, McDonald CR. Association Between Microstructural Asymmetry of Temporal Lobe White Matter and Memory Decline After Anterior Temporal Lobectomy. Neurology 2022; 98:e1151-e1162. [PMID: 35058338 PMCID: PMC8935440 DOI: 10.1212/wnl.0000000000200047] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Risk for memory decline is a substantial concern in patients with temporal lobe epilepsy (TLE) undergoing anterior temporal lobectomy (ATL). Although prior studies have identified associations between memory and integrity of white matter (WM) networks within the medial temporal lobe (MTL) preoperatively, we contribute a study examining whether microstructural asymmetry of deep and superficial WM networks within the MTL predicts postoperative memory decline. METHODS Patients with drug-resistant TLE were recruited from 2 epilepsy centers in a prospective longitudinal study. All patients completed preoperative T1 and diffusion-weighted MRI (DWI) as well as preoperative and postoperative neuropsychological testing. Preoperative fractional anisotropy (FA) of the WM directly beneath the neocortex (i.e., superficial WM [SWM]) and of deep WM tracts associated with memory were calculated. Asymmetry was calculated for hippocampal volume and FA of each WM tract or region and examined in linear and logistic regressions with preoperative to postoperative memory change as the primary outcome. RESULTS Data were analyzed from 42 patients with TLE (19 left TLE [LTLE], 23 right TLE [RTLE]) who underwent ATL. Leftward FA asymmetry of the entorhinal SWM was associated with decline on prose and associative recall in LTLE, whereas leftward FA asymmetry of the uncinate fasciculus (UNC) was associated with decline on prose recall only. After controlling for preoperative memory score and hippocampal volume, leftward FA asymmetry of the entorhinal SWM uniquely contributed to decline in both prose and associative recall (β = -0.46; SE 0.14 and β = -0.68; SE 0.22, respectively) and leftward FA asymmetry of the UNC uniquely contributed to decline in prose recall (β = -0.31; SE 0.14). A model combining asymmetry of hippocampal volume and entorhinal FA correctly classified memory outcomes in 79% of patients with LTLE for prose (area under the curve [AUC] 0.89; sensitivity 82%; specificity 75%) and 81% of patients for associative (AUC 0.79; sensitivity 83%; specificity 80%) recall. Entorhinal SWM asymmetry was the strongest predictor in both models. DISCUSSION Preoperative asymmetry of deep WM and SWM integrity within the MTL is a strong predictor of postoperative memory decline in TLE, suggesting that surgical decision-making may benefit from considering each patient's WM network adequacy and reserve in addition to hippocampal integrity. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that preoperative asymmetry of deep WM and SWM integrity within the MTL is a predictor of postoperative memory decline.
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Affiliation(s)
- Alena Stasenko
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Sanam J Lalani
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Brianna Paul
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Manu Hegde
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Jonathan L Helm
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Sharona Ben-Haim
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A.S., E.K., A.R., C.R.M.) and Departments of Psychiatry (A.S., E.K., A.R., S.J.L., C.R.M.) and Neurosurgery (S.B.-H.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (B.P., M.H.), University of California, San Francisco; and Department of Psychology (J.L.H.), San Diego State University, CA.
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Kai J, Khan AR. Assessing the Reliability of Template-Based Clustering for Tractography in Healthy Human Adults. Front Neuroinform 2022; 16:777853. [PMID: 35250526 PMCID: PMC8891507 DOI: 10.3389/fninf.2022.777853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/06/2022] [Indexed: 11/21/2022] Open
Abstract
Tractography is a non-invasive technique to investigate the brain’s structural pathways (also referred to as tracts) that connect different brain regions. A commonly used approach for identifying tracts is with template-based clustering, where unsupervised clustering is first performed on a template in order to label corresponding tracts in unseen data. However, the reliability of this approach has not been extensively studied. Here, an investigation into template-based clustering reliability was performed, assessing the output from two datasets: Human Connectome Project (HCP) and MyConnectome project. The effect of intersubject variability on template-based clustering reliability was investigated, as well as the reliability of both deep and superficial white matter tracts. Identified tracts were evaluated by assessing Euclidean distances from a dataset-specific tract average centroid, the volumetric overlap across corresponding tracts, and along-tract agreement of quantitative values. Further, two template-based techniques were employed to evaluate the reliability of different clustering approaches. Reliability assessment can increase the confidence of a tract identifying technique in future applications to study pathways of interest. The two different template-based approaches exhibited similar reliability for identifying both deep white matter tracts and the superficial white matter.
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Affiliation(s)
- Jason Kai
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
| | - Ali R. Khan
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
- *Correspondence: Ali R. Khan,
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Zhang W, Yang C, Li Z, Ren J. A Comparison of Three Brain Atlases for Temporal Lobe Epilepsy Prediction. J Med Biol Eng 2022. [DOI: 10.1007/s40846-021-00676-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Sóki N, Richter Z, Karádi K, Lőrincz K, Horváth R, Gyimesi C, Szekeres-Paraczky C, Horváth Z, Janszky J, Dóczi T, Seress L, Ábrahám H. Investigation of synapses in the cortical white matter in human temporal lobe epilepsy. Brain Res 2022; 1779:147787. [PMID: 35041843 DOI: 10.1016/j.brainres.2022.147787] [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: 09/16/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 11/02/2022]
Abstract
Temporal lobe epilepsy (TLE) is one of the most common focal pharmacotherapy-resistant epilepsy in adults. Previous studies have shown significantly higher numbers of neurons in the neocortical white matter in TLE patients than in controls. The aim of this work was to investigate whether white matter neurons are part of the neuronal circuitry. Therefore, we studied the distribution and density of synapses in surgically resected neocortical tissue of pharmacotherapy-resistant TLE patients. Neocortical white matter of temporal lobe from non-epileptic patients were used as controls. Synapses and neurons were visualized with immunohistochemistry using antibodies against synaptophysin and NeuN, respectively. The presence of synaptophysin in presynaptic terminals was verified by electron microscopy. Quantification of immunostaining was performed and the data of the patients' cognitive tests as well as clinical records were compared to the density of neurons and synapses. Synaptophysin density in the white matter of TLE patients was significantly higher than in controls. In TLE, a significant correlation was found between synaptophysin immunodensity and density of white matter neurons. Neuronal as well as synaptophysin density significantly correlated with scores of verbal memory of TLE patients. Neurosurgical outcome of TLE patients did not significantly correlate with histological data, although, higher neuronal and synaptophysin densities were observed in patients with favorable post-surgical outcome. Our results suggest that white matter neurons in TLE patients receive substantial synaptic input and indicate that white matter neurons may be integrated in epileptic neuronal networks responsible for the development or maintenance of seizures.
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Affiliation(s)
- Noémi Sóki
- Department of Medical Biology and Central Electron Microscopic Laboratory, University of Pécs Medical School Szigeti u. 12. Pécs, 7643, Hungary; Neuromorphology and Cellular Neurobiology Research Group, Center for Neuroscience, University of Pécs Ifjúság u. 20. Pécs, 7624, Hungary
| | - Zsófia Richter
- Department of Medical Biology and Central Electron Microscopic Laboratory, University of Pécs Medical School Szigeti u. 12. Pécs, 7643, Hungary
| | - Kázmér Karádi
- Department of Behavioral Sciences, University of Pécs Medical School Szigeti u. 12. Pécs, 7624, Hungary
| | - Katalin Lőrincz
- Department of Neurology, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary
| | - Réka Horváth
- Department of Neurology, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary
| | - Csilla Gyimesi
- Department of Neurology, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary
| | - Cecília Szekeres-Paraczky
- Human Brain Research Laboratory, Institute of Experimental Medicine, ELKH Szigony u. 43. Budapest, 1083, Hungary
| | - Zsolt Horváth
- Department of Neurosurgery, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary
| | - József Janszky
- Department of Neurology, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Center for Neuroscience, University of Pécs Ifjúság u 20. Pécs, 7624, Hungary
| | - Tamás Dóczi
- Department of Neurosurgery, University of Pécs Medical School Rét u. 2. Pécs, 7623, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Center for Neuroscience, University of Pécs Ifjúság u 20. Pécs, 7624, Hungary
| | - László Seress
- Department of Medical Biology and Central Electron Microscopic Laboratory, University of Pécs Medical School Szigeti u. 12. Pécs, 7643, Hungary; Neuromorphology and Cellular Neurobiology Research Group, Center for Neuroscience, University of Pécs Ifjúság u. 20. Pécs, 7624, Hungary
| | - Hajnalka Ábrahám
- Department of Medical Biology and Central Electron Microscopic Laboratory, University of Pécs Medical School Szigeti u. 12. Pécs, 7643, Hungary; Neuromorphology and Cellular Neurobiology Research Group, Center for Neuroscience, University of Pécs Ifjúság u. 20. Pécs, 7624, Hungary.
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Samson S, Denos M. Neuropsychology of temporal lobe epilepsies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:519-529. [PMID: 35964990 DOI: 10.1016/b978-0-12-823493-8.00012-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This chapter focuses on the neuropsychology of adults with temporal lobe epilepsy (TLE). First, a thorough description of the brain-behavior relationship characterizing focal TLE with and without hippocampal sclerosis is presented. Then, the aim and the specificity of the NPA in the care of epilepsy are described. Considering the high frequency of medically intractable TLE that can be treated by surgery, an assessment carried out in the context of pre- and postoperative evaluation is presented and discussed in light of insights from functional neuroimaging findings. Finally, we propose concluding remarks about the place of neuropsychology in the care of epilepsy in improving our understanding of the cognitive and emotional phenotypes associated with TLE.
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Affiliation(s)
- Séverine Samson
- Department of Psychology, University of Lille, Lille, France; Epilepsy Unit, Neurosciences Department, Hôpital de la Pitié-Salpêtrière, Paris, France.
| | - Marisa Denos
- Rehabilitation Unit, Neurosciences Department, Hôpital de la Pitié-Salpêtrière, Paris, France
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22
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Rayatpour A, Farhangi S, Verdaguer E, Olloquequi J, Ureña J, Auladell C, Javan M. The Cross Talk between Underlying Mechanisms of Multiple Sclerosis and Epilepsy May Provide New Insights for More Efficient Therapies. Pharmaceuticals (Basel) 2021; 14:ph14101031. [PMID: 34681255 PMCID: PMC8541630 DOI: 10.3390/ph14101031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/17/2022] Open
Abstract
Despite the significant differences in pathological background of neurodegenerative diseases, epileptic seizures are a comorbidity in many disorders such as Huntington disease (HD), Alzheimer's disease (AD), and multiple sclerosis (MS). Regarding the last one, specifically, it has been shown that the risk of developing epilepsy is three to six times higher in patients with MS compared to the general population. In this context, understanding the pathological processes underlying this connection will allow for the targeting of the common and shared pathological pathways involved in both conditions, which may provide a new avenue in the management of neurological disorders. This review provides an outlook of what is known so far about the bidirectional association between epilepsy and MS.
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Affiliation(s)
- Atefeh Rayatpour
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Sahar Farhangi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Ester Verdaguer
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Biomedical Sciences Institute, Health Sciences Faculty, Universidad Autónoma de Chile, Talca 3460000, Chile;
| | - Jesus Ureña
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
| | - Carme Auladell
- Department of Cell Biology, Physiology and Immunology, Biology Faculty, Universitat de Barcelona, 08028 Barcelona, Spain; (E.V.); (J.U.)
- Centre for Biomedical Research of Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035 Barcelona, Spain
- Correspondence: (C.A.); (M.J.)
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14117-13116, Iran; (A.R.); (S.F.)
- Institute for Brain and Cognition, Tarbiat Modares University, Tehran 14117-13116, Iran
- Cell Science Research Center, Department of Brain and Cognitive Sciences, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran 14117-13116, Iran
- Correspondence: (C.A.); (M.J.)
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Kanel D, Vanes LD, Pecheva D, Hadaya L, Falconer S, Counsell SJ, Edwards DA, Nosarti C. Neonatal White Matter Microstructure and Emotional Development during the Preschool Years in Children Who Were Born Very Preterm. eNeuro 2021; 8:ENEURO.0546-20.2021. [PMID: 34373253 PMCID: PMC8489022 DOI: 10.1523/eneuro.0546-20.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 11/21/2022] Open
Abstract
Children born very preterm (<33 weeks of gestation) are at a higher risk of developing socio-emotional difficulties compared with those born at term. In this longitudinal study, we tested the hypothesis that diffusion characteristics of white matter (WM) tracts implicated in socio-emotional processing assessed in the neonatal period are associated with socio-emotional development in 151 very preterm children previously enrolled into the Evaluation of Preterm Imaging study (EudraCT 2009-011602-42). All children underwent diffusion tensor imaging at term-equivalent age and fractional anisotropy (FA) was quantified in the uncinate fasciculus (UF), inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and superior longitudinal fasciculus (SLF). Children's socio-emotional development was evaluated at preschool age (median = 4.63 years). Exploratory factor analysis conducted on the outcome variables revealed a three-factor structure, with latent constructs summarized as: "emotion moderation," "social function," and "empathy." Results of linear regression analyses, adjusting for full-scale IQ and clinical and socio-demographic variables, showed an association between lower FA in the right UF and higher "emotion moderation" scores (β = -0.280; p < 0.001), which was mainly driven by negative affectivity scores (β = -0.281; p = 0.001). Results further showed an association between higher full-scale IQ and better social functioning (β = -0.334, p < 0.001). Girls had higher empathy scores than boys (β = -0.341, p = 0.006). These findings suggest that early alterations of diffusion characteristics of the UF could represent a biological substrate underlying the link between very preterm birth and emotional dysregulation in childhood and beyond.
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Affiliation(s)
- Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Lucy D Vanes
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
| | - Diliana Pecheva
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
| | - David A Edwards
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
- MRC Centre for Neurodevelopmental Disorders, King's College London, London SE1 1UL, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London SE1 7EH, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
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24
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Chen PC, Messina SA, Castillo E, Baumgartner J, Seo JH, Skinner H, Gireesh ED, Lee KH. Altered integrity of corpus callosum in generalized epilepsy in relation to seizure lateralization after corpus callosotomy. Neurosurg Focus 2021; 48:E15. [PMID: 32234995 DOI: 10.3171/2020.1.focus19791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/24/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Generalized-onset seizures are usually conceptualized as engaging bilaterally distributed networks with no clear focus. However, the authors previously reported a case series demonstrating that in some patients with generalized-onset seizures, focal seizure onset could be discovered after corpus callosotomy. The corpus callosum is considered to be a major pathway for seizure generalization in this group of patients. The authors hypothesized that, in patients with generalized-onset seizures, the structure of the corpus callosum could be different between patients who have lateralized seizures and those who have nonlateralized seizures after corpus callosotomy. The authors aimed to evaluate the structural difference through statistical analysis of diffusion tensor imaging (DTI) scalars between these two groups of patients. METHODS Thirty-two patients diagnosed with generalized-onset motor seizures and without an MRI lesion were included in this study. Among them, 16 patients developed lateralized epileptic activities after corpus callosotomy, and the remaining 16 patients continued to have nonlateralized seizures after corpus callosotomy. Presurgical DTI studies were acquired to quantify the structural integrity of the corpus callosum. RESULTS The DTI analysis showed significant reduction of fractional anisotropy (FA) and increase in radial diffusivity (RD) in the body of the corpus callosum in the lateralized group compared with the nonlateralized group. CONCLUSIONS The authors' findings indicate the existence of different configurations of bilateral epileptic networks in generalized epilepsy. Generalized seizures with focal onset relying on rapid spread through the corpus callosum might cause more structural damage related to demyelination in the corpus callosum, showing reduced FA and increased RD. This study suggests that presurgical DTI analysis of the corpus callosum might predict the seizure lateralization after corpus callosotomy.
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Affiliation(s)
| | | | | | - James Baumgartner
- 4Neurosurgery, Neuroscience Institute, Florida Hospital, AdventHealth, Orlando, Florida; and
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25
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Cui W, Shang K, Qiu B, Lu J, Gao JH. White matter network disorder in mesial temporal epilepsy: An fMRI study. Epilepsy Res 2021; 172:106590. [PMID: 33639419 DOI: 10.1016/j.eplepsyres.2021.106590] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/11/2020] [Accepted: 02/16/2021] [Indexed: 01/13/2023]
Abstract
Mesial temporal lobe epilepsy (mTLE) has been considered a network disorder disease in which brain regions extending beyond the epileptogenic zones are always affected. However, abnormalities in white matter (WM) functional networks and their associations with widespread network dysfunction are still being identified in mTLE. Accordingly, we investigated the altered functional activities in WM networks in mTLE using fMRI, which has recently been used to probe WM function. We collected resting-state fMRI data from 39 unilateral mTLE patients with hippocampal sclerosis and 29 healthy controls. Eleven WM networks were clustered according to temporal correlation profile. The functional connectivity (FC) of the WM networks were evaluated and compared between the two groups. Furthermore, we assessed the capacity of WM FC for seizure lateralization. According to our analysis, mTLE led to decreased FC within deep WM networks. In addition, the cortical regions involved in seizure propagation and several brain regions displaying interhemispheric disruption showed enhanced functional coupling with deep WM networks. FCs between the ipsilateral deep WM networks and the insula, temporal lobe, and supramarginal gyrus demonstrated positive correlation with seizure frequency. Moreover, the seizure onset zones of 33 patients out of 39 patients could be correctly lateralized. Our findings reveal functional disruptions in WM networks extending to extratemporal regions, supporting the network disorder hypothesis and suggesting that deep WM networks are key network nodes associated with massive dysfunction in mTLE. Moreover, the FC of the WM represents a potentially useful functional imaging measure for the diagnosis of mTLE.
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Affiliation(s)
- Wei Cui
- Center for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Kun Shang
- Department of Nuclear Medicine, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Bensheng Qiu
- Center for Biomedical Engineering, University of Science and Technology of China, Hefei, Anhui, China
| | - Jie Lu
- Department of Nuclear Medicine, Xuanwu Hospital Capital Medical University, Beijing, China.
| | - Jia-Hong Gao
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Beijing City Key Laboratory for Medical Physics and Engineering, Institution of Heavy Ion Physics, School of Physics, Peking University, Beijing, China; McGovern Institute for Brain Research, Peking University, Beijing, China.
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26
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Maiman M, Del Bene VA, Farrell E, MacAllister WS, Sheldon S, Rentería MA, Slugh M, Gazzola DM, Barr WB. The Utility of the Repeatable Battery of Neuropsychological Status in Patients with Temporal and Non-temporal Lobe Epilepsy. Arch Clin Neuropsychol 2021; 36:203-213. [PMID: 31761928 DOI: 10.1093/arclin/acz056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/05/2019] [Accepted: 09/10/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neuropsychological battery that has been validated in the assessment of dementia and other clinical populations. The current study examines the utility of the RBANS in patients with epilepsy. METHODS Ninety-eight patients with epilepsy completed the RBANS as part of a more comprehensive neuropsychological evaluation. Performance on the RBANS was evaluated for patients with a diagnosis of temporal lobe epilepsy (TLE; n = 51) and other epilepsy patients (non-TLE, n = 47) in comparison to published norms. Multivariate analysis of variance compared group performances on RBANS indices. Rates of impairment were also compared across groups using cutoff scores of ≤1.0 and ≤1.5 standard deviations below the normative mean. Exploratory hierarchical regressions were used to examine the relations between epilepsy severity factors (i.e., age of onset, disease duration, and number of antiepileptic drugs [AEDs]) and RBANS performance. RESULTS TLE and non-TLE patients performed below the normative sample across all RBANS indices. Those with TLE performed worse than non-TLE patients on the Immediate and Delayed Memory indices and exhibited higher rates of general cognitive impairment. Number of AEDs was the only epilepsy severity factor that significantly predicted RBANS total performance, accounting for 14% of the variance. CONCLUSIONS These findings suggest that the RBANS has utility in evaluating cognition in patients with epilepsy and can differentiate TLE and non-TLE patients. Additionally, number of AEDs appears to be associated with global cognitive performance in adults with epilepsy.
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Affiliation(s)
- Moshe Maiman
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Victor A Del Bene
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Eileen Farrell
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Institute of Neurology and Neurosurgery, Saint Barnabas Hospital, Livingston, NJ 07039, USA
| | - William S MacAllister
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Sloane Sheldon
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Neurology, Columbia University Medical Center, New York, NY 10034, USA
| | - Miguel Arce Rentería
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY 10034, USA
| | - Mitchell Slugh
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA.,University of Miami, The Evelyn F. McKnight Brain Institute, Miami, FL 33136, USA
| | - Deana M Gazzola
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA
| | - William B Barr
- NYU-Langone Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY 10016, USA
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27
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He C, Liu P, Wu Y, Chen H, Song Y, Yin J. Gamma-aminobutyric acid (GABA) changes in the hippocampus and anterior cingulate cortex in patients with temporal lobe epilepsy. Epilepsy Behav 2021; 115:107683. [PMID: 33360398 DOI: 10.1016/j.yebeh.2020.107683] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE To explore the changes of gamma-aminobutyric acid (GABA) levels in the bilateral hippocampus and anterior cingulate cortex (ACC) of healthy control subjects and patients with temporal lobe epilepsy (TLE) and the correlation of GABA levels with the clinical symptoms by quantitative magnetic resonance spectroscopy (MRS). METHODS N-acetylaspartate (NAA), creatine (Cr) as well as choline (Cho) and GABA levels in the bilateral hippocampus and ACC were measured in 40 patients with TLE and 26 healthy control (NC) subjects with quantitative Meshcher-Garwood point resolved spectroscopy (MEGA-PRESS). The NAA/(Cho + Cr) and GABA/Cr ratios were compared between the NC and TLE groups. Comparisons were also made between the subgroups with lateralization (left TLE, right TLE and uncertain), short (<10 years) and longer (≥10 years) clinical seizure history (CSH), low (<1/month) and higher (≥1/month) seizure frequency (SF), with and without cognitive impairment (CI) in the patients with TLE, and by antiepileptic medications. Further analyses of the clinical information and metabolite ratios between the patients with TLE with and without CI were preformed. RESULTS The GABA/Cr ratio was significantly decreased in the bilateral hippocampus (left: P = 0.028, right: P = 0.035), while the NAA/(Cho + Cr) ratio was decreased only in the right hippocampus (RH) (P = 0.004) in patients with TLE compared with that of the NCs. Whereas the NAA/(Cho + Cr) ratio showed a consistent decreasing trend in bilateral hippocampus during the CSH, it only showed a significant difference in the RH. The GABA changes in the hippocampal and ACC regions were not consistent during different stages of the disease. In the bilateral hippocampus, the GABA/Cr ratio was decreased in the short seizure history (<10 years) patients with TLE compared with NCs (left: P = 0.018, right: P = 0.012), whereas the long seizure history (≥10 years) patients with TLE showed no difference with the NCs. However, in the ACC, the GABA/Cr ratio of the CI group was significantly decreased compared with that of NCs (P = 0.015). Further analysis showed that the patients with TLE with CI had obvious atrophy of the gray matter volume (GMV) and total parenchymal brain volume (PBV); GABA/Cr ratio was decreased in ACC, but increased in bilateral hippocampus compared with that of the no cognitive impairment (NOCI) group. CONCLUSION The GABA/Cr ratio was more valuable than the NAA/(Cho + Cr) ratio in evaluating the dynamic metabolite changes in patients with TLE. Importantly, the GABA changes in the hippocampal and ACC regions were not consistent during different stages of the disease. In the bilateral hippocampus, the GABA/Cr ratio was decreased at the early stage, but recovered to normal levels later. The decreased GABA/Cr ratio in the ACC might indicate more cerebral cortex was involved, resulting in more CI in patients with TLE.
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Affiliation(s)
- Che He
- Tianjin Medical University, Tianjin, China
| | - Pei Liu
- Tianjin Medical University, Tianjin, China
| | - Yalin Wu
- Tianjin Medical University, Tianjin, China
| | - Hong Chen
- Tianjin Medical University, Tianjin, China
| | - Yijun Song
- Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Street, Tianjin 300052, China.
| | - Jianzhong Yin
- Department of Radiology, Tianjin First Central Hospital, 24 Fukang Road, Tianjin 300192, China.
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28
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Effects of Lifelong Musicianship on White Matter Integrity and Cognitive Brain Reserve. Brain Sci 2021; 11:brainsci11010067. [PMID: 33419228 PMCID: PMC7825624 DOI: 10.3390/brainsci11010067] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 02/07/2023] Open
Abstract
There is a significant body of research that has identified specific, high-end cognitive demand activities and lifestyles that may play a role in building cognitive brain reserve, including volume changes in gray matter and white matter, increased structural connectivity, and enhanced categorical perception. While normal aging produces trends of decreasing white matter (WM) integrity, research on cognitive brain reserve suggests that complex sensory–motor activities across the life span may slow down or reverse these trends. Previous research has focused on structural and functional changes to the human brain caused by training and experience in both linguistic (especially bilingualism) and musical domains. The current research uses diffusion tensor imaging to examine the integrity of subcortical white matter fiber tracts in lifelong musicians. Our analysis, using Tortoise and ICBM-81, reveals higher fractional anisotropy, an indicator of greater WM integrity, in aging musicians in bilateral superior longitudinal fasciculi and bilateral uncinate fasciculi. Statistical methods used include Fisher’s method and linear regression analysis. Another unique aspect of this study is the accompanying behavioral performance data for each participant. This is one of the first studies to look specifically at musicianship across the life span and its impact on bilateral WM integrity in aging.
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29
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Phuong TH, Houot M, Méré M, Denos M, Samson S, Dupont S. Cognitive impairment in temporal lobe epilepsy: contributions of lesion, localization and lateralization. J Neurol 2020; 268:1443-1452. [PMID: 33216221 DOI: 10.1007/s00415-020-10307-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive impairment is an important comorbidity of refractory temporal lobe epilepsy (TLE). We aimed to explore the impact of (i) specific lesions, such as dysembryoplastic neuroepithelial tumor (DNET), dysplasia, or hippocampal sclerosis, (ii) focus localization (medial versus lateral) and (iii) focus lateralization (right versus left) on the neuropsychological profile of refractory TLE adult patients. METHODS We examined the neuropsychological characteristics of 312 adults with refractory TLE: 100 patients without hippocampal sclerosis (HS) and 212 with HS. Scores on tests of intelligence (Global IQ, Verbal IQ and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions and language abilities were analyzed. RESULTS Three main factors influenced the neuropsychological profile of refractory TLE patients: (i) the lesion, patients with HS obtaining poorer cognitive performances than patients without HS and specifically DNET patients performing better than patients with HS, (ii) the focus side, that seems only relevant for verbal memory abilities which are affected in left but not right TLE patients and (iii) the localization of seizure focus, patients with medial TLE exhibiting lower memory performances than patients with lateral TLE. CONCLUSION Lesion, localization and lateralization are major contributors of the cognitive impairment depicted in TLE. Hippocampal sclerosis appears as the main contributor.
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Affiliation(s)
- Thanh Ha Phuong
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Neurology Unit, Hôpital Bach Mai, Hanoi, Vietnam
| | - Marion Houot
- Clinical Investigation Centre, Institut du Cerveau Et de La Moelle Épinière (ICM), Pitié-Salpêtrière Hospital Paris, Paris, France.,Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.,Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Méré
- Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marisa Denos
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Séverine Samson
- Univ. Lille, ULR 4072-PSITEC-Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
| | - Sophie Dupont
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. .,Université Paris Sorbonne, Paris, France. .,Centre de Recherche de l'Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France.
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30
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Park YW, Choi YS, Kim SE, Choi D, Han K, Kim H, Ahn SS, Kim SA, Kim HJ, Lee SK, Lee HW. Radiomics features of hippocampal regions in magnetic resonance imaging can differentiate medial temporal lobe epilepsy patients from healthy controls. Sci Rep 2020; 10:19567. [PMID: 33177624 PMCID: PMC7658973 DOI: 10.1038/s41598-020-76283-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022] Open
Abstract
To investigative whether radiomics features in bilateral hippocampi from MRI can identify temporal lobe epilepsy (TLE). A total of 131 subjects with MRI (66 TLE patients [35 right and 31 left TLE] and 65 healthy controls [HC]) were allocated to training (n = 90) and test (n = 41) sets. Radiomics features (n = 186) from the bilateral hippocampi were extracted from T1-weighted images. After feature selection, machine learning models were trained. The performance of the classifier was validated in the test set to differentiate TLE from HC and ipsilateral TLE from HC. Identical processes were performed to differentiate right TLE from HC (training set, n = 69; test set; n = 31) and left TLE from HC (training set, n = 66; test set, n = 30). The best-performing model for identifying TLE showed an AUC, accuracy, sensitivity, and specificity of 0.848, 84.8%, 76.2%, and 75.0% in the test set, respectively. The best-performing radiomics models for identifying right TLE and left TLE subgroups showed AUCs of 0.845 and 0.840 in the test set, respectively. In addition, multiple radiomics features significantly correlated with neuropsychological test scores (false discovery rate-corrected p-values < 0.05). The radiomics model from hippocampus can be a potential biomarker for identifying TLE.
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Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Yun Seo Choi
- Department of Neurology, Epilepsy and Sleep Center, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.,Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea
| | - Song E Kim
- Department of Neurology, Epilepsy and Sleep Center, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.,Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea
| | - Dongmin Choi
- Department of Computer Science, Yonsei University, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hwiyoung Kim
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sol-Ah Kim
- Department of Neurology, Epilepsy and Sleep Center, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.,Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.,Interdisciplinary Programs of Computational Medicine, System Health & Engineering Major in Graduate School, Ewha Womans University, Seoul, Korea
| | - Hyeon Jin Kim
- Department of Neurology, Epilepsy and Sleep Center, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea.,Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hyang Woon Lee
- Department of Neurology, Epilepsy and Sleep Center, Ewha Womans University School of Medicine and Ewha Medical Research Institute, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Korea. .,Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea. .,Interdisciplinary Programs of Computational Medicine, System Health & Engineering Major in Graduate School, Ewha Womans University, Seoul, Korea.
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Zhi D, Wu W, Xiao B, Qi S, Jiang R, Yang X, Yang J, Xiao W, Liu C, Long H, Calhoun VD, Long L, Sui J. NR4A1 Methylation Associated Multimodal Neuroimaging Patterns Impaired in Temporal Lobe Epilepsy. Front Neurosci 2020; 14:727. [PMID: 32760244 PMCID: PMC7372187 DOI: 10.3389/fnins.2020.00727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/18/2020] [Indexed: 11/25/2022] Open
Abstract
DNA hypermethylation has been widely observed in temporal lobe epilepsy (TLE), in which NR4A1 knockdown has been reported to be able to alleviate seizure severity in mouse model, while the underlying methylation-imaging pathway modulated by aberrant methylation levels of NR4A1 remains to be clarified in patients with TLE. Here, using multi-site canonical correlation analysis with reference, methylation levels of NR4A1 in blood were used as priori to guide fusion of three MRI features: functional connectivity (FC), fractional anisotropy (FA), and gray matter volume (GMV) for 56 TLE patients and 65 healthy controls. Post-hoc correlations were further evaluated between the identified NR4A1-associated brain components and disease onset. Results suggested that higher NR4A1 methylation levels in TLE were related with impaired temporal-cerebellar and occipital-cerebellar FC strength, lower FA in cingulum (hippocampus), and reduced GMV in putamen, temporal pole, and cerebellum. Moreover, findings were also replicated well in both patient subsets with either right TLE or left TLE only. Particularly, right TLE patients showed poorer cognitive abilities and more severe brain impairment than left TLE patients, especially more reduced GMV in thalamus. In summary, this work revealed a potential imaging-methylation pathway modulated by higher NR4A1 methylation in TLE via data mining, which may impact the above-mentioned multimodal brain circuits and was also associated with earlier disease onset and more cognitive deficits.
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Affiliation(s)
- Dongmei Zhi
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Wenyue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, The Second Affiliated Hospital, Nanchang University, Nanchang, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Shile Qi
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Georgia State University - Emory University, Atlanta, GA, United States
| | - Rongtao Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xingdong Yang
- Department of Neurology, Beijing Haidian Hospital, Beijing, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, China
| | - Wenbiao Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Chaorong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongyu Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Vince D Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Georgia State University - Emory University, Atlanta, GA, United States
| | - Lili Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Sui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China.,Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia Institute of Technology, Georgia State University - Emory University, Atlanta, GA, United States.,CAS Centre for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
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da Silva NM, Forsyth R, McEvoy A, Miserocchi A, de Tisi J, Vos SB, Winston GP, Duncan J, Wang Y, Taylor PN. Network reorganisation following anterior temporal lobe resection and relation with post-surgery seizure relapse: A longitudinal study. NEUROIMAGE-CLINICAL 2020; 27:102320. [PMID: 32623138 PMCID: PMC7334605 DOI: 10.1016/j.nicl.2020.102320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/12/2020] [Accepted: 06/13/2020] [Indexed: 12/18/2022]
Abstract
Diffusion changes assessed at two time points following epilepsy surgery. Graph theory and connectometry revealed substantial longitudinal diffusion changes. Changes were found beyond the site of resection. Postoperative seizure freedom associated with longitudinal structural changes.
Objective To characterise temporal lobe epilepsy (TLE) surgery-induced changes in brain network properties, as measured using diffusion weighted MRI, and investigate their association with postoperative seizure-freedom. Methods For 48 patients who underwent anterior temporal lobe resection, diffusion weighted MRI was acquired pre-operatively, 3–4 months post-operatively (N = 48), and again 12 months post-operatively (N = 13). Data for 17 controls were also acquired over the same period. After registering all subjects to a common space, we performed two complementary analyses of the subjects’ quantitative anisotropy (QA) maps. 1) A connectometry analysis which is sensitive to changes in subsections of fasciculi. 2) A graph theory approach which integrates connectivity information across the wider brain network. Results We found significant postoperative alterations in QA in patients relative to controls measured over the same period. Reductions were primarily located in the uncinate fasciculus and inferior fronto-occipital fasciculus ipsilaterally for all patients. Larger reductions were associated with postoperative seizure-freedom in left TLE. Increased QA was mainly located in corona radiata and corticopontine tracts. Graph theoretic analysis revealed widespread increases in nodal betweenness centrality, which were not associated with patient outcomes. Conclusion Substantial alterations in QA occur in the months after epilepsy surgery, suggesting Wallerian degeneration and strengthening of specific white matter tracts. Greater reductions in QA were related to postoperative seizure freedom in left TLE.
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Affiliation(s)
- Nádia Moreira da Silva
- CNNP lab(1), Interdisciplinary Complex Systems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rob Forsyth
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew McEvoy
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - Anna Miserocchi
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - Jane de Tisi
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - Sjoerd B Vos
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom; Centre for Medical Image Computing, University College London, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom
| | - Gavin P Winston
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom; Department of Medicine, Division of Neurology, Queen's University, Kingston, Canada
| | - John Duncan
- NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont St Peter, United Kingdom
| | - Yujiang Wang
- CNNP lab(1), Interdisciplinary Complex Systems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
| | - Peter N Taylor
- CNNP lab(1), Interdisciplinary Complex Systems Group, School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom.
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Balachandra AR, Kaestner E, Bahrami N, Reyes A, Lalani S, Macari AC, Paul BM, Bonilha L, McDonald CR. Clinical utility of structural connectomics in predicting memory in temporal lobe epilepsy. Neurology 2020; 94:e2424-e2435. [PMID: 32358221 PMCID: PMC7455364 DOI: 10.1212/wnl.0000000000009457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the predictive power of white matter neuronal networks (i.e., structural connectomes [SCs]) in discriminating memory-impaired patients with temporal lobe epilepsy (TLE) from those with normal memory. METHODS T1- and diffusion MRI (dMRI), clinical variables, and neuropsychological measures of verbal memory were available for 81 patients with TLE. Prediction of memory impairment was performed with a tree-based classifier (XGBoost) for 4 models: (1) a clinical model including demographic and clinical features, (2) a hippocampal volume (HCV) model, (3) a tract model including 5 temporal lobe white matter association tracts derived from a dMRI atlas, and (4) an SC model based on dMRI. SCs were derived by extracting cortical-cortical connections from a temporal lobe subnetwork with probabilistic tractography. Principal component (PC) analysis was then applied to reduce the dimensionality of the SC, yielding 10 PCs. Multimodal models were also tested combining SCs and tracts with HCV. Each model was trained on 48 patients from 1 epilepsy center and tested on 33 patients from a different center. RESULTS Multimodal models that included the SC + HCV model yielded the highest classification accuracy (81%; 0.90 sensitivity; 0.67 specificity), outperforming the clinical model (61%; p < 0.001) and HCV model (66%; p < 0.001). In addition, the unimodal SC model (76% accuracy) and tract model (73% accuracy) outperformed the clinical model (p < 0.001) and HCV model (p < 0.001) for classifying patients with TLE with and without memory impairment. Furthermore, the SC identified that short-range temporal-temporal connections were important contributors to memory performance. CONCLUSION SCs and tract-based models are stronger predictors of memory impairment in TLE than HCVs and clinical variables. However, SCs may provide additional information about local cortical-cortical connectivity contributing to memory that is not captured in large association tracts.
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Affiliation(s)
- Akshara R Balachandra
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Erik Kaestner
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Naeim Bahrami
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anny Reyes
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Sanam Lalani
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Anna Christina Macari
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Brianna M Paul
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Leonardo Bonilha
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA
| | - Carrie R McDonald
- From the Center for Multimodal Imaging and Genetics (A.R.B., E.K., N.B., A.R., A.C.M., C.R.M.) and Department of Psychiatry (C.R.M.), University of California, San Diego; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology (A.R., C.R.M.); Department of Neurology (S.L., B.M.P.), University of California, San Francisco; Department of Neurology (L.B.), Medical University of South Carolina, Charleston; and Boston University School of Medicine (A.R.B.), MA.
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Dumlu SN, Ademoğlu A, Sun W. Investigation of functional variability and connectivity in temporal lobe epilepsy: A resting state fMRI study. Neurosci Lett 2020; 733:135076. [PMID: 32446775 DOI: 10.1016/j.neulet.2020.135076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 04/12/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
It is crucial to reveal the variability between patients with epilepsy and healthy subjects to elucidate the underpinnings of the disease pathology. Herein, we assessed the inter-subject variability between patients with temporal lobe epilepsy (TLE) and healthy subjects in terms of estimating the functional connectivity using resting-state functional magnetic resonance (rs-fMRI) scans. According to inter-subject variability results between healthy and TLE population, the latter showed more variability mainly in frontoparietal control, default mode, dorsal/ventral attention, visual and somatomotor networks in line with the broad seizure onset and propagation pathway. As a result of 17-Network parcellation, a significant attenuation is observed in functional connectivity, mostly in bilateral frontoparietal control, somatomotor, default mode and ventral attention networks associated with the functional impairment in attention, long/short term memory, executive functioning. The results are in favor of the argument that the functional disruption in TLE spreads throughout the cortex beyond the temporal lobe with an implication of greater diversity in the TLE population.
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Affiliation(s)
- Seda Nilgün Dumlu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Institute of Biomedical Engineering, Bogazici University, Istanbul 34684, Turkey
| | - Ahmet Ademoğlu
- Institute of Biomedical Engineering, Bogazici University, Istanbul 34684, Turkey
| | - Wei Sun
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
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35
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García-Pallero MA, Torres Díaz CV, Hernando CG, Plasencia PM, Manzanares R, García LE, Navas M, Pulido P, Delgado-Fernández J, Aragón Rubio JI, Sola RG. Prediction of Memory Impairment in Epilepsy Surgery by White Matter Diffusion. World Neurosurg 2020; 139:e78-e87. [PMID: 32229300 DOI: 10.1016/j.wneu.2020.03.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the relationship between cognitive performance and white matter integrity in patients with temporal lobe epilepsy (TLE) to establish radiologic criteria to help with patient selection for surgery. METHODS The study included 19 adults with temporal lobe epilepsy. A tractography analysis of fractional anisotropy and mean diffusivity (MD) of the following fascicles was performed: arcuate fascicle, cingulum, fornix, inferior fronto-occipital fascicle, inferior longitudinal fascicle, parahippocampal fibers of the cingulum, and uncinate fascicle. The Wechsler Memory Scale-Third Edition neuropsychological test was performed to evaluate short- and long-term verbal (Logical Memory I and II subtests) and nonverbal (Visual Reproduction I and II subtests) memory. Relationships between memory scores and diffusion were calculated. RESULTS Lower Logical Memory I subtest scores were correlated with lower MD of the right inferior fronto-occipital fascicle, while lower Logical Memory II subtest scores were related to higher values of fractional anisotropy in bilateral cingulum, right uncinate, and right parahippocampal fibers of the cingulum and lower MD in left cingulum fascicle. Finally, lower values in Visual Reproduction I subtest scores were associated with lower values in MD in right cingulum and inferior fronto-occipital fascicles. CONCLUSIONS Structural changes of some white matter tracts were associated with deterioration of both short- and long-term memory. These alterations were more associated with verbal memory than with nonverbal memory. These changes mainly consist of an increase in fractional anisotropy and a decrease in MD, which could be interpreted as reorganization phenomena. Diffusion tensor imaging could be a useful tool for cognitive assessment in surgical candidates with temporal lobe epilepsy who are not suitable for neuropsychological testing or in whom their results do not lead to definitive conclusions.
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Affiliation(s)
| | | | | | - Pilar Martín Plasencia
- Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Rafael Manzanares
- Department of Radiology, University Hospital la Princesa, Madrid, Spain
| | | | - Marta Navas
- Department of Neurosurgery, University Hospital la Princesa, Madrid, Spain
| | - Paloma Pulido
- Department of Neurosurgery, University Hospital la Princesa, Madrid, Spain
| | | | - José I Aragón Rubio
- Department of Radiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Rafael G Sola
- Innovation in Neurosurgery of University Autonomous of Madrid, Madrid, Spain
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Rodríguez-Cruces R, Bernhardt BC, Concha L. Multidimensional associations between cognition and connectome organization in temporal lobe epilepsy. Neuroimage 2020; 213:116706. [PMID: 32151761 DOI: 10.1016/j.neuroimage.2020.116706] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/14/2020] [Accepted: 03/03/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is known to affect large-scale structural networks and cognitive function in multiple domains. The study of complex relations between structural network organization and cognition requires comprehensive analytical methods and a shift towards multivariate techniques. Here, we sought to identify multidimensional associations between cognitive performance and structural network topology in TLE. METHODS We studied 34 drug-resistant adult TLE patients and 24 age- and sex-matched healthy controls. Participants underwent a comprehensive neurocognitive battery and multimodal MRI, allowing for large-scale connectomics, and morphological evaluation of subcortical and neocortical regions. Using canonical correlation analysis, we identified a multivariate mode that links cognitive performance to a brain structural network. Our approach was complemented by bootstrap-based hierarchical clustering to derive cognitive subtypes and associated patterns of macroscale connectome anomalies. RESULTS Both methodologies provided converging evidence for a close coupling between cognitive impairments across multiple domains and large-scale structural network compromise. Cognitive classes presented with an increasing gradient of abnormalities (increasing cortical and subcortical atrophy and less efficient white matter connectome organization in patients with increasing degrees of cognitive impairments). Notably, network topology characterized cognitive performance better than morphometric measures did. CONCLUSIONS Our multivariate approach emphasized a close coupling of cognitive dysfunction and large-scale network anomalies in TLE. Our findings contribute to understand the complexity of structural connectivity regulating the heterogeneous cognitive deficits found in epilepsy.
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Affiliation(s)
- Raúl Rodríguez-Cruces
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Querétaro, Querétaro, Mexico; MICA Laboratory, Montreal Neurological Institute and Hospital, Montreal, Canada.
| | - Boris C Bernhardt
- MICA Laboratory, Montreal Neurological Institute and Hospital, Montreal, Canada.
| | - Luis Concha
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Querétaro, Querétaro, Mexico.
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Del Tufo SN, Earle FS, Cutting LE. The impact of expressive language development and the left inferior longitudinal fasciculus on listening and reading comprehension. J Neurodev Disord 2019; 11:37. [PMID: 31838999 PMCID: PMC6912995 DOI: 10.1186/s11689-019-9296-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND During the first 3-years of life, as the brain undergoes dramatic growth, children begin to develop speech and language. Hallmarks of this progression are seen when children reach developmental milestones, forming the foundation of language. Expressive language milestones, such as the production of a child's first word, are delayed in 5-8% of children. While for some children delays in reaching these milestones are harbingers of developmental disorders, for others expressive language delays appear to resolve. Regardless of whether or not early language skills appear resolved, difficulty with later comprehension is a likely outcome. Whether this heightened risk for poor comprehension differs based on text features, individual characteristics, or receipt of intervention remains unknown. Moreover, this relationship between expressive language development and comprehension is not yet linked to neurobiology, though the inferior longitudinal fasciculus (ILF) is a potential neurobiological correlate. Therefore, we investigated the impact of, and interactions between, expressive language development, early intervention, and the ILF on comprehension. METHODS Longitudinal recurrent survival analyses predicted the risk of answering a comprehension question incorrectly. Predictors of comprehension included expressive language development, passage features, participant characteristics, fractional anisotropy, receipt of early intervention, and later diagnosis of speech or language disorders. RESULTS Children with later expressive language milestones had poorer comprehension. When comprehension text features were examined, children with later milestones had poorer listening and reading comprehension, and poorer narrative and expository comprehension. The left ILF acted as a neurodevelopmental correlate, one that moderated the relationship between expressive language milestones and comprehension. Specifically, the left ILF exacerbated the relationship for those who did not receive early intervention and buffered the relationship for those who received intervention services. Early intervention decreased the risk of poor comprehension by 39% for children later diagnosed with a speech or language disorder. CONCLUSIONS Early intervention should be provided for children with delayed expressive language milestones, particularly those who are at risk for speech or language disorders. The ILF plays a critical role in the relationship between expressive language development and comprehension, which may be that of a protective factor for children with the most severe early issues with speech and language.
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Affiliation(s)
- Stephanie N Del Tufo
- Peabody College of Education and Human Development, Vanderbilt University, 416C One Magnolia Circle, Box 228, Nashville, TN, 37203, USA.,Vanderbilt Brain Institute, Vanderbilt University School of Medicine, 6133 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, USA.,Vanderbilt Kennedy Center, Vanderbilt University, 110 Magnolia Circle, Nashville, TN, 37203, USA.,College of Education and Human Development, University of Delaware, 106 Alison Hall West, Newark, DE, 19716, USA
| | - F Sayako Earle
- Communication Sciences and Disorders, University of Delaware, 100 Discovery Boulevard, Newark, DE, 19713, USA
| | - Laurie E Cutting
- Peabody College of Education and Human Development, Vanderbilt University, 416C One Magnolia Circle, Box 228, Nashville, TN, 37203, USA. .,Vanderbilt Brain Institute, Vanderbilt University School of Medicine, 6133 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, USA. .,Vanderbilt Kennedy Center, Vanderbilt University, 110 Magnolia Circle, Nashville, TN, 37203, USA.
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38
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Chauvière L. Update on temporal lobe‐dependent information processing, in health and disease. Eur J Neurosci 2019; 51:2159-2204. [DOI: 10.1111/ejn.14594] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/06/2019] [Accepted: 09/27/2019] [Indexed: 01/29/2023]
Affiliation(s)
- Laëtitia Chauvière
- INSERM U1266 Institut de Psychiatrie et de Neurosciences de Paris (IPNP) Paris France
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Buksakowska I, Szabó N, Martinkovič L, Faragó P, Király A, Vrána J, Kincses ZT, Meluzín J, Šulc V, Kynčl M, Roček M, Tichý M, Charvát F, Hořínek D, Marusič P. Distinctive Patterns of Seizure-Related White Matter Alterations in Right and Left Temporal Lobe Epilepsy. Front Neurol 2019; 10:986. [PMID: 31632330 PMCID: PMC6779711 DOI: 10.3389/fneur.2019.00986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/29/2019] [Indexed: 12/14/2022] Open
Abstract
Background: We hypothesized that right and left temporal lobe epilepsy (RTLE and LTLE, respectively) have distinctive spatial patterns of white matter (WM) changes that can be differentiated and interpreted with the use of multiple diffusion parameters. We compared the global microstructure of fiber bundles with regard to WM alterations in both RTLE and LTLE, addressing some of the methodological issues of previous studies. Methods: Diffusion tensor imaging data from 17 patients with RTLE (age: 40.7 ± 10.4), 15 patients with LTLE (age: 37.3 ± 10.4), and 15 controls (age: 34.8 ± 11.2) were used in the study. WM integrity was quantified by fractional anisotropy (FA), mean diffusivity (MD), longitudinal diffusivity (LD), and radial diffusivity (RD). The diffusion parameters were compared between the groups in tracts representing the core of the fiber bundles. The volumes of hippocampi and amygdala were subsequently compared across the groups, while the data were adjusted for the effect of hippocampal sclerosis. Results: Significantly reduced FA and increased MD, LD, and RD were found bilaterally over widespread brain regions in RTLE. An increase in MD and RD values was observed in widespread WM fiber bundles ipsilaterally in LTLE, largely overlapping with regions where FA was lower, while no increase in LD was observed. We also found a difference between the LTLE and RTLE groups for the right hippocampal volume (with and without adjustment for HS), whereas no significant volume differences were found between patients and controls. Conclusions: It appears that patients with RTLE exhibit a more widespread pattern of WM alterations that extend far beyond the temporal lobe in both ipsilateral and contralateral hemisphere; furthermore, these changes seem to reflect more severe damage related to chronic degeneration. Conversely, more restrained changes in the LTLE may imply a pattern of less severe axonal damage, more restricted to ipsilateral hemisphere. Comprehensive finding of more prominent hippocampal atrophy in the RTLE raises an interesting issue of seizure-induced implications on gray matter and WM microstructure that may not necessarily mean a straightforward causal relationship. Further correlations of diffusion-derived metrics with neuropsychological and functional imaging measures may provide complementary information on underlying WM abnormalities with regard to functional hemispheric specialization.
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Affiliation(s)
- Irena Buksakowska
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Nikoletta Szabó
- Department of Neurology, Faculty of General Medicine, University of Szeged, Szeged, Hungary
| | - Lukáš Martinkovič
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Péter Faragó
- Department of Neurology, Faculty of General Medicine, University of Szeged, Szeged, Hungary
| | - András Király
- Department of Neurology, Faculty of General Medicine, University of Szeged, Szeged, Hungary
| | - Jiří Vrána
- Department of Radiodiagnostics, University Central Military Hospital, Prague, Czechia
| | - Zsigmond Tamás Kincses
- Department of Neurology, Faculty of General Medicine, University of Szeged, Szeged, Hungary
| | - Jan Meluzín
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Vlastimil Šulc
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Martin Kynčl
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Miloslav Roček
- Department of Radiology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Michal Tichý
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - František Charvát
- Department of Radiodiagnostics, University Central Military Hospital, Prague, Czechia
| | - Daniel Hořínek
- Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
| | - Petr Marusič
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia
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Selçuk ML, Tıpırdamaz S. A morphological and stereological study on brain, cerebral hemispheres and cerebellum of New Zealand rabbits. Anat Histol Embryol 2019; 49:90-96. [DOI: 10.1111/ahe.12489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/12/2019] [Accepted: 08/09/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Muhammet Lütfi Selçuk
- Department of Physiotherapy and Rehabilitation Faculty of Health Sciences Karamanoglu Mehmetbey University Karaman Turkey
| | - Saadettin Tıpırdamaz
- Department of Anatomy Faculty of Veterinary Medicine Selcuk University Konya Turkey
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Zhou X, Zhang Z, Liu J, Qin L, Pang X, Zheng J. Disruption and lateralization of cerebellar-cerebral functional networks in right temporal lobe epilepsy: A resting-state fMRI study. Epilepsy Behav 2019; 96:80-86. [PMID: 31103016 DOI: 10.1016/j.yebeh.2019.03.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 01/05/2023]
Abstract
Numerous studies have highlighted important roles for the cerebellum in cognition and movement, based on numerous fiber connections between the cerebrum and cerebellum. Abnormal cerebellar activity caused by epileptic discharges has been reported in previous studies, but researchers have not clearly determined whether aberrant cerebellar activity contributes to the disruption of the cerebellar-cerebral networks in right temporal lobe epilepsy (rTLE). Here, thirty patients with rTLE and 30 age- and sex-matched healthy controls (HCs) were recruited. All participants underwent the Attention Network Test (ANT) and resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Cerebellar functional networks were extracted and analyzed by defining seeds in the cerebellum. A correlation analysis was performed between attentional performance and voxels that showed differences in functional connectivity (FC) in patients compared with HCs. Relative to HCs, patients exhibited significantly decreased FC in the dentate nucleus (DN) network (right DN with the left postcentral gyrus, left precentral gyrus, left cuneus, and left calcarine gyrus) and motor network (right cerebellar lobule V with the right putamen) and increased FC in the executive control network (right cerebellar crus I with the right inferior parietal lobule). Alerting, orienting, and executive control performances were impaired in patients with rTLE. Furthermore, the executive control effect was significantly correlated with aberrant FC strength between the right DN and the left precentral/postcentral gyrus. Our findings highlight that the disrupted cerebellar-cerebral functional network ipsilateral to the epileptogenic focus causes both impairments in and compensatory effects on attentional deficits in patients with rTLE. These findings contribute to our understanding of the cerebellar damage caused by epileptic discharges and the corresponding effect on attentional performance.
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Affiliation(s)
- Xia Zhou
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhao Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Association of cerebrospinal fluid zinc-α2-glycoprotein and tau protein with temporal lobe epilepsy and related white matter impairment. Neuroreport 2019; 30:586-591. [DOI: 10.1097/wnr.0000000000001252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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43
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Rayner G, Tailby C, Jackson G, Wilson S. Looking beyond lesions for causes of neuropsychological impairment in epilepsy. Neurology 2019; 92:e680-e689. [PMID: 30635484 PMCID: PMC6382365 DOI: 10.1212/wnl.0000000000006905] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/08/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Patients with temporal lobe epilepsy (TLE) are similar in their epileptology regardless of whether they have a lesion evident on MRI; this study aims to prospectively clarify whether they are also similar in their neuropsychological profiles. METHODS Participants comprised 152 adults: 79 patients with TLE and 73 healthy controls. Patients and controls did not differ in age, sex, or education (p > 0.05). Sixty-two percent of patients had an MRI-resolvable lesion (39% with presumed hippocampal sclerosis [HS-TLE], 61% with a lesion other than HS [MRI-positive TLE]); the remaining 38% of patients were lesion-negative. Psychometric measures well established in epilepsy were used. RESULTS Relative to controls, all 3 patient subgroups showed significantly impaired autobiographical, verbal, and visual memory (p < 0.05-0.001) and significantly more depression and anxiety (p < 0.05-0.01). Yet, contrary to expectations, the 3 TLE subgroups did not differ in their severity of memory or mood impairment (p > 0.05). Lower Full-Scale IQ predicted memory impairments across all TLE subtypes, with early age at seizure onset a predictor unique to MRI-negative TLE. CONCLUSIONS MRI-negative TLE is associated with memory and mood dysfunction equivalent to that seen in patients with hippocampal sclerosis and other MRI-resolvable pathologies. As such, neuropsychological impairments in TLE are not contingent on a macroscopic lesion and might be an intrinsic property of the underlying network disease.
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Affiliation(s)
- Genevieve Rayner
- From the Florey Institute of Neuroscience and Mental Health (G.R., C.T., G.J., S.W.), and Comprehensive Epilepsy Programme, Austin Health (G.J., S.W.), Melbourne Brain Centre, Heidelberg; Melbourne School of Psychological Sciences (G.R., S.W.), the University of Melbourne, Parkville; and Institute for Social Neuroscience (C.T.), Heidelberg, Australia.
| | - Chris Tailby
- From the Florey Institute of Neuroscience and Mental Health (G.R., C.T., G.J., S.W.), and Comprehensive Epilepsy Programme, Austin Health (G.J., S.W.), Melbourne Brain Centre, Heidelberg; Melbourne School of Psychological Sciences (G.R., S.W.), the University of Melbourne, Parkville; and Institute for Social Neuroscience (C.T.), Heidelberg, Australia
| | - Graeme Jackson
- From the Florey Institute of Neuroscience and Mental Health (G.R., C.T., G.J., S.W.), and Comprehensive Epilepsy Programme, Austin Health (G.J., S.W.), Melbourne Brain Centre, Heidelberg; Melbourne School of Psychological Sciences (G.R., S.W.), the University of Melbourne, Parkville; and Institute for Social Neuroscience (C.T.), Heidelberg, Australia
| | - Sarah Wilson
- From the Florey Institute of Neuroscience and Mental Health (G.R., C.T., G.J., S.W.), and Comprehensive Epilepsy Programme, Austin Health (G.J., S.W.), Melbourne Brain Centre, Heidelberg; Melbourne School of Psychological Sciences (G.R., S.W.), the University of Melbourne, Parkville; and Institute for Social Neuroscience (C.T.), Heidelberg, Australia
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Bi XA, Xu Q, Luo X, Sun Q, Wang Z. Analysis of Progression Toward Alzheimer's Disease Based on Evolutionary Weighted Random Support Vector Machine Cluster. Front Neurosci 2018; 12:716. [PMID: 30349454 PMCID: PMC6186825 DOI: 10.3389/fnins.2018.00716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/19/2018] [Indexed: 12/02/2022] Open
Abstract
Alzheimer’s disease (AD) could be described into following four stages: healthy control (HC), early mild cognitive impairment (EMCI), late MCI (LMCI) and AD dementia. The discriminations between different stages of AD are considerably important issues for future pre-dementia treatment. However, it is still challenging to identify LMCI from EMCI because of the subtle changes in imaging which are not noticeable. In addition, there were relatively few studies to make inferences about the brain dynamic changes in the cognitive progression from EMCI to LMCI to AD. Inspired by the above problems, we proposed an advanced approach of evolutionary weighted random support vector machine cluster (EWRSVMC). Where the predictions of numerous weighted SVM classifiers are aggregated for improving the generalization performance. We validated our method in multiple binary classifications using Alzheimer’s Disease Neuroimaging Initiative dataset. As a result, the encouraging accuracy of 90% for EMCI/LMCI and 88.89% for LMCI/AD were achieved respectively, demonstrating the excellent discriminating ability. Furthermore, disease-related brain regions underlying the AD progression could be found out on the basis of the amount of discriminative information. The findings of this study provide considerable insight into the neurophysiological mechanisms in AD development.
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Affiliation(s)
- Xia-An Bi
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
| | - Qian Xu
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
| | - Xianhao Luo
- College of Mathematics and Statistics, Hunan Normal University, Changsha, China
| | - Qi Sun
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
| | - Zhigang Wang
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
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45
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Widespread white matter DTI alterations in mesial temporal sclerosis independent of disease side. Epilepsy Behav 2018; 87:7-13. [PMID: 30149360 DOI: 10.1016/j.yebeh.2018.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/11/2018] [Accepted: 08/11/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study was to evaluate white matter (WM) integrity in vivo in patients with unilateral mesial temporal sclerosis (MTS). METHODS Diffusion tensor imaging (DTI) findings from patients with left-sided MTS (L-MTS; N = 14) and right-sided MTS (R-MTS; N = 13), all taking antiepileptic medication, were compared with those from gender- and age-matched controls; DTI was performed along 30 noncollinear directions in a 1.5-T scanner. Tract-based spatial statistics (TBSS) analysis was performed by creating a WM skeleton; 5000-permutation-based inference (threshold, p < 0.05) was used to identify fractional anisotropy (FA) abnormalities. Mean (MD), radial (RD), and axial diffusivities (AD) were projected onto the mean FA skeleton. RESULTS Compared with the control groups, patients with MTS had decreased FA affecting widespread WM tracts as well as extensive areas with increased RD, bilaterally and independent of the disease side. Areas with decreased FA and increased RD overlapped substantially. There were no significant differences in DTI parameters between L-MTS and R-MTS patients. CONCLUSION Diffusion tensor imaging abnormalities were observed within and beyond the temporal lobe in patients with MTS. Patients with R- and L-MTS had extensive bilateral abnormalities in comparison to controls. These findings suggest that MTS pathobiology involves diffuse dysfunction of WM tracts, even in areas with no direct connections to the hippocampus.
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46
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Herbet G, Zemmoura I, Duffau H. Functional Anatomy of the Inferior Longitudinal Fasciculus: From Historical Reports to Current Hypotheses. Front Neuroanat 2018; 12:77. [PMID: 30283306 PMCID: PMC6156142 DOI: 10.3389/fnana.2018.00077] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
The inferior longitudinal fasciculus (ILF) is a long-range, associative white matter pathway that connects the occipital and temporal-occipital areas of the brain to the anterior temporal areas. In view of the ILF's anatomic connections, it has been suggested that this pathway has a major role in a relatively large array of brain functions. Until recently, however, the literature data on these potential functions were scarce. Here, we review the key findings of recent anatomic, neuromodulation, and neuropsychological studies. We also summarize reports on how this tract is disrupted in a wide range of brain disorders, including psychopathologic, neurodevelopmental, and neurologic diseases. Our review reveals that the ILF is a multilayered, bidirectional tract involved in processing and modulating visual cues and thus in visually guided decisions and behaviors. Accordingly, sudden disruption of the ILF by neurologic insult is mainly associated with neuropsychological impairments of visual cognition (e.g., visual agnosia, prosopagnosia, and alexia). Furthermore, disruption of the ILF may constitute the pathophysiologic basis for visual hallucinations and socio-emotional impairments in schizophrenia, as well as emotional difficulties in autism spectrum disorder. Degeneration of the ILF in neurodegenerative diseases affecting the temporal lobe may explain (at least in part) the gradual onset of semantic and lexical access difficulties. Although some of the functions mediated by the ILF appear to be relatively lateralized, observations from neurosurgery suggest that disruption of the tract's anterior portion can be dynamically compensated for by the contralateral portion. This might explain why bilateral disruption of the ILF in either acute or progressive disease is highly detrimental in neuropsychological terms.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Ilyess Zemmoura
- Department of Neurosurgery, Tours University Medical Center, Tours, France
- UMR 1253, iBrain, INSERM, University of Tours, Tours, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
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Xu SW, Xi JH, Lin C, Wang XY, Fu LY, Kralik SF, Chen ZQ. Cognitive decline and white matter changes in mesial temporal lobe epilepsy. Medicine (Baltimore) 2018; 97:e11803. [PMID: 30113469 PMCID: PMC6113048 DOI: 10.1097/md.0000000000011803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Noninvasive imaging plays a pivotal role in assessing the brain structural and functional changes in presurgical mesial temporal lobe epilepsy (MTLE) patients. Our goal was to study the relationship between the changes of cerebral white matter (WM) and cognitive functions in MTLE patients.Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) MRI were performed on 24 right-handed MTLE patients (12 with left MTLE and 12 with right MTLE) and 12 matching healthy controls. Gray matter (GM), WM, and whole brain (WB) volumes were measured with VBM while fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured with TBSS. All patients and controls also underwent Montreal Cognitive Assessment (MoCA) before MRI.WM volume and the ratio of WM volume versus WB volume were significantly lower in MTLE patients compared with controls. WM volume in MTLE patients had a positive correlation with MoCA score (r = 0.71, P < .001) and a negative correlation with the duration of epilepsy (r = -0.693, P < .001). Volumetric differences were mainly located in the corpus callosum, uncinate fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus. FA of both left MTLE and right MTLE groups was significantly decreased, while MD, AD, and RD were significantly increased. Most left MTLE patients showed bilateral WM fiber tract changes versus ipsilateral changes for right MTLE patients.Changes in DTI parameters and WM volume were found in MTLE patients and more ipsilateral changes were seen with right-sided MTLE. Cognitive changes of MTLE patients were found to be correlated with the changes in WM structure. These findings not only provide useful information for lateralization of the seizure focus but can also be used to explain functional connectivity disorders which may be an important physiological basis for cognitive changes in patients with MTLE.
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Affiliation(s)
- Shang-wen Xu
- Department of Medical Imaging, Fuzhou General Hospital, Xi’erhuan Beilu, Fuzhou, Fujian, PR China
| | - Ji-hui Xi
- Department of Medical Imaging, Fuzhou General Hospital, Xi’erhuan Beilu, Fuzhou, Fujian, PR China
| | - Chen Lin
- DABR Department of Radiology Mayo Clinic
| | - Xiao-yang Wang
- Department of Medical Imaging, Fuzhou General Hospital, Xi’erhuan Beilu, Fuzhou, Fujian, PR China
| | - Li-yuan Fu
- Department of Medical Imaging, Fuzhou General Hospital, Xi’erhuan Beilu, Fuzhou, Fujian, PR China
| | - Stephen Francis Kralik
- Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN
| | - Zi-qian Chen
- Department of Medical Imaging, Fuzhou General Hospital, Xi’erhuan Beilu, Fuzhou, Fujian, PR China
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48
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A Yassine I, M Eldeeb W, A Gad K, A Ashour Y, A Yassine I, O Hosny A. Cognitive functions, electroencephalographic and diffusion tensor imaging changes in children with active idiopathic epilepsy. Epilepsy Behav 2018; 84:135-141. [PMID: 29800799 DOI: 10.1016/j.yebeh.2018.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/12/2018] [Accepted: 04/29/2018] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Neurocognitive impairment represents one of the most common comorbidities occurring in children with idiopathic epilepsy. Diagnosis of the idiopathic form of epilepsy requires the absence of any macrostructural abnormality in the conventional MRI. Though changes can be seen at the microstructural level imaged using advanced techniques such as the Diffusion Tensor Imaging (DTI). AIM OF THE WORK The aim of this work is to study the correlation between the microstructural white matter DTI findings, the electroencephalographic changes and the cognitive dysfunction in children with active idiopathic epilepsy. METHODS A comparative cross-sectional study, included 60 children with epilepsy based on the Stanford-Binet 5th Edition Scores was conducted. Patients were equally assigned to normal cognitive function or cognitive dysfunction groups. The history of the epileptic condition was gathered via personal interviews. All patients underwent brain Electroencephalography (EEG) and DTI, which was analyzed using FSL. RESULTS The Fractional Anisotropy (FA) was significantly higher whereas the Mean Diffusivity (MD) was significantly lower in the normal cognitive function group than in the cognitive dysfunction group. This altered microstructure was related to the degree of the cognitive performance of the studied children with epilepsy. The microstructural alterations of the neural fibers in children with epilepsy and cognitive dysfunction were significantly related to the younger age of onset of epilepsy, the poor control of the clinical seizures, and the use of multiple antiepileptic medications. CONCLUSION Children with epilepsy and normal cognitive functions differ in white matter integrity, measured using DTI, compared with children with cognitive dysfunction. These changes have important cognitive consequences.
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Affiliation(s)
- Imane A Yassine
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Waleed M Eldeeb
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Khaled A Gad
- Diagnostic Radiology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Yossri A Ashour
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Inas A Yassine
- Systems and Biomedical Engineering Department, Faculty of Engineering, Cairo University, Egypt
| | - Ahmed O Hosny
- Neurology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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49
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Law N, Smith ML, Widjaja E. Thalamocortical Connections and Executive Function in Pediatric Temporal and Frontal Lobe Epilepsy. AJNR Am J Neuroradiol 2018; 39:1523-1529. [PMID: 29880477 DOI: 10.3174/ajnr.a5691] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/11/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Largely accepted in the literature is the role the interconnections between the thalamus and cortex play in generalized epilepsy. However, thalamocortical involvement is less understood in focal epilepsy in terms of the effect of seizures on thalamocortical circuitry in the developing brain and subsequent cognitive outcome. We investigated thalamocortical pathway microstructure in pediatric frontal lobe epilepsy and temporal lobe epilepsy and examined the associations between pathway microstructure and measures of executive function. MATERIALS AND METHODS We examined thalamocortical connections in 24 children with frontal lobe epilepsy, 17 patients with temporal lobe epilepsy, and 25 healthy children using DTI. We investigated several executive function measures in patients and controls, which were distilled into latent executive function components to compare among groups, and the associations between measures of thalamocortical microstructure and executive function. RESULTS We found no differences in thalamocortical pathway microstructure between the groups, but aspects of executive function (mental flexibility/inhibition/shifting) were impaired in the frontal lobe epilepsy group compared with controls. In patients with frontal lobe epilepsy, younger age at seizure onset and a greater number of antiepileptic drugs were associated with DTI indices indicative of damaged/less developed thalamocortical pathways. In patients with temporal lobe epilepsy, poorer performance on all measures of executive function was associated with DTI indices reflective of damaged/less developed pathways. CONCLUSIONS Our results give insight into vulnerable neural networks in pediatric focal epilepsy and suggest thalamocortical pathway damage as a potential mechanism of executive function impairment in temporal lobe epilepsy but not frontal lobe epilepsy. Identifying structure-function relations can help inform how we measure functional and cognitive/behavioral outcomes in these populations.
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Affiliation(s)
- N Law
- From the Department of Psychology (N.L., M.L.S.), University of Toronto, Toronto, Ontario, Canada.,Department of Psychology (N.L., M.L.S.).,Program in Neurosciences and Mental Health (N.L., M.L.S.)
| | - M L Smith
- From the Department of Psychology (N.L., M.L.S.), University of Toronto, Toronto, Ontario, Canada.,Department of Psychology (N.L., M.L.S.).,Program in Neurosciences and Mental Health (N.L., M.L.S.)
| | - E Widjaja
- Diagnostic Imaging (E.W.) .,Division of Neurology (E.W.), Hospital for Sick Children, Toronto, Ontario, Canada
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50
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Allebone J, Kanaan R, Wilson SJ. Systematic review of structural and functional brain alterations in psychosis of epilepsy. J Neurol Neurosurg Psychiatry 2018; 89:611-617. [PMID: 29275328 DOI: 10.1136/jnnp-2017-317102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/18/2017] [Accepted: 10/25/2017] [Indexed: 11/04/2022]
Abstract
This systematic review critically assesses structural and functional neuroimaging studies of psychosis of epilepsy (POE). We integrate findings from 18 studies of adults with POE to examine the prevailing view that there is a specific relationship between temporal lobe epilepsy (TLE) and POE, and that mesial temporal lobe pathology is a biomarker for POE. Our results show: (1) conflicting evidence of volumetric change in the hippocampus and amygdala; (2) distributed structural pathology beyond the mesial temporal lobe; and (3) changes in frontotemporal functional network activation. These results provide strong evidence for a revised conceptualisation of POE as disorder of brain networks, and highlight that abnormalities in mesial temporal structures alone are unlikely to account for its neuropathogenesis. Understanding POE as a disease of brain networks has important implications for neuroimaging research and clinical practice. Specifically, we suggest that future neuroimaging studies of POE target structural and functional networks, and that practitioners are vigilant for psychotic symptoms in all epilepsies, not just TLE.
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Affiliation(s)
- James Allebone
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Richard Kanaan
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Brain Research Institute (Austin Campus), Melbourne, Victoria, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Brain Research Institute (Austin Campus), Melbourne, Victoria, Australia.,Comprehensive Epilepsy Programme, Austin Health, Melbourne Brain Centre, Melbourne, Victoria, Australia
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