1
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Omisade A, Nugent M, O'Grady C, Ikeda K, Woodroffe S, Legg K, Schmidt M, Biggs K. Cognitive dysfunction at epilepsy onset as a marker for seizure recurrence. Epilepsy Res 2024; 202:107335. [PMID: 38484613 DOI: 10.1016/j.eplepsyres.2024.107335] [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: 01/16/2024] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Cognitive dysfunction has been correlated with seizure control in chronic epilepsy and in newly diagnosed epilepsy, which potentially makes it a good marker for predicting disease course and seizure control. However, there is a lack of prospective studies examining the role of cognitive dysfunction in predicting seizure recurrence at the earliest stages of the disease, such as following the first unprovoked seizure (UFS) or new onset epilepsy (NOE). METHODS Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit. RESULTS Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed. CONCLUSIONS Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.
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Affiliation(s)
- Antonina Omisade
- Acquired Brain Injury (Epilepsy Program), Nova Scotia Health Authority, Halifax, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada.
| | - Madison Nugent
- Acquired Brain Injury (Epilepsy Program), Nova Scotia Health Authority, Halifax, Canada
| | | | - Kristin Ikeda
- Division of Neurology, Department of Medicine, Dalhousie University, Canada
| | | | - Karen Legg
- Neurology Department, Nova Scotia Health Authority, Canada
| | - Matthias Schmidt
- Department of Diagnostic Radiology (Neuroradiology section), Dalhousie University, Canada
| | - Krista Biggs
- Neurology Department, Nova Scotia Health Authority, Canada
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2
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Kimura N, Takahashi Y, Usui N, Matsuda K, Otani H, Kasai Y, Kondo A, Imai K, Takita J. Neuropsychological outcome after frontal surgery for pediatric-onset epilepsy with focal cortical dysplasia in adolescent and young adult. Epilepsy Behav 2024; 153:109687. [PMID: 38368791 DOI: 10.1016/j.yebeh.2024.109687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE We investigated neuropsychological outcome in patients with pharmacoresistant pediatric-onset epilepsy caused by focal cortical dysplasia (FCD), who underwent frontal lobe resection during adolescence and young adulthood. METHODS Twenty-seven patients were studied, comprising 15 patients who underwent language-dominant side resection (LDR) and 12 patients who had languagenondominant side resection (n-LDR). We evaluated intelligence (language function, arithmetic ability, working memory, processing speed, visuo-spatial reasoning), executive function, and memory in these patients before and two years after resection surgery. We analyzed the relationship between neuropsychological outcome and resected regions (side of language dominance and location). RESULTS Although 75% of the patients showed improvement or no change in individual neuropsychological tests after surgical intervention, 25% showed decline. The cognitive tests that showed improvement or decline varied between LDR and n-LDR. In patients who had LDR, decline was observed in Vocabulary and Phonemic Fluency (both 5/15 patients), especially after resection of ventrolateral frontal cortex, and improvement was observed in WCST-Category (7/14 patients), Block Design (6/15 patients), Digit Symbol (4/15 patients), and Delayed Recall (3/9 patients). In patients who underwent n-LDR, improvement was observed in Vocabulary (3/12 patients), but decline was observed in Block Design (2/9 patients), and WCST-Category (2/9 patients) after resection of dorsolateral frontal cortex; and Arithmetic (3/10 patients) declined after resection of dorsolateral frontal cortex or ventrolateral frontal cortex. General Memory (3/8 patients), Visual Memory (3/8 patients), Delayed Recall (3/8 patients), Verbal Memory (2/9 patients), and Digit Symbol (3/12 patients) also declined after n-LDR. CONCLUSION Postoperative changes in cognitive function varied depending on the location and side of the resection. For precise presurgical prediction of neuropsychological outcome after surgery, further prospective studies are needed to accumulate data of cognitive changes in relation to the resection site.
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Affiliation(s)
- Nobusuke Kimura
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Naniwa Ikuno Hospital, Daikoku 1-10-3, Naniwa-ku, Oosaka 556-0014, Japan.
| | - Yukitoshi Takahashi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Department of Pediatrics, Gifu University School of Medicine, Japan; School of Pharmaceutical Sciences, University of Shizuoka, Japan.
| | - Naotaka Usui
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Kazumi Matsuda
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Hideyuki Otani
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Yoshinobu Kasai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Akihiko Kondo
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Katsumi Imai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorder, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Junko Takita
- Kyoto University, Shogoin Kawahara-cho 53, Sakyo-ku, Kyoto 606-8507, Japan.
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3
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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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4
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Breuer LEM, Bernas A, Boon P, Besseling RMH, Carrette ECB, de Louw A, Aldenkamp AP. Accelerated Cognitive Ageing in Epilepsy: A Neuropsychological Evaluation of Cognitive Deterioration. Arch Clin Neuropsychol 2019; 34:301-309. [PMID: 29718070 DOI: 10.1093/arclin/acy042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/14/2018] [Accepted: 04/10/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Shed light on cognitive deterioration in Accelerated Cognitive Ageing (ACA) in epilepsy from a neuropsychological point of view in order to improve clinical diagnostics. METHODS We compared the IQ-profile including GAI, OPIE IV-premorbid IQ and deterioration-scores of 21 epilepsy patients with ACA with 21 matched epilepsy patients without ACA (Epilepsy Controls) and 16 age- and education-matched Healthy Controls. Memory was also evaluated. RESULTS Premorbid IQs were equal in all groups. Deterioration was apparent in the ACA-group in the WAIS-IV FSIQ and PRI, whereas no deterioration was found in the two control groups. PSI was impaired in both epilepsy groups, though with more impairment seen in the ACA-group. The VCI remained unimpaired. The FSIQ-GAI discrepancy was equal in both patient groups and significantly larger than in the Healthy Controls. WMS-IV memory indices were of average level in all groups. Memory impairment in ACA was not statistically different from the Epilepsy Controls. 85.7% of ACA-patients could be correctly classified through factors DET_FSIQ and PSI. CONCLUSIONS Cognitive deterioration in ACA is characterized by an average drop of 19 IQ-points in FSIQ and PRI. Verbal abilities remain unimpaired. Impairments in fluid functions compromise cognitive abilities in epilepsy, but only partially contribute to cognitive deterioration in ACA. PSI proved to have some diagnostic value in differentiating epilepsy patients from healthy controls, but fails to differentiate between ACA and Epilepsy Controls. A comparison made between OPIE-IV equations and obtained IQs leads to a significant better detection of cognitive deterioration in epilepsy than the use of GAI-FSIQ discrepancies alone.
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Affiliation(s)
- Lisanne E M Breuer
- Academic Centre for Epilepsy Kempenhaeghe/MUMC+, Department of Behavioral Sciences, Heeze, the Netherlands
| | - Antoine Bernas
- University of Technology Eindhoven, Department of Electrical Engineering, Eindhoven, the Netherlands
| | - Paul Boon
- University of Technology Eindhoven, Department of Electrical Engineering, Eindhoven, the Netherlands.,Ghent University Hospital, Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent, Belgium.,Academic Centre for Epilepsy Kempenhaeghe/MUMC+, Department of Neurology, Heeze, the Netherlands
| | - René M H Besseling
- University of Technology Eindhoven, Department of Electrical Engineering, Eindhoven, the Netherlands
| | - Evelien C B Carrette
- Academic Centre for Epilepsy Kempenhaeghe/MUMC+, Department of Neurology, Heeze, the Netherlands
| | | | - Albert P Aldenkamp
- Academic Centre for Epilepsy Kempenhaeghe/MUMC+, Department of Behavioral Sciences, Heeze, the Netherlands.,University of Technology Eindhoven, Department of Electrical Engineering, Eindhoven, the Netherlands.,Academic Centre for Epilepsy Kempenhaeghe/MUMC+, Department of Neurology, Heeze, the Netherlands
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5
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Tenney JR, Kadis DS, Agler W, Rozhkov L, Altaye M, Xiang J, Vannest J, Glauser TA. Ictal connectivity in childhood absence epilepsy: Associations with outcome. Epilepsia 2018; 59:971-981. [PMID: 29633248 DOI: 10.1111/epi.14067] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The understanding of childhood absence epilepsy (CAE) has been revolutionized over the past decade, but the biological mechanisms responsible for variable treatment outcomes are unknown. Our purpose in this prospective observational study was to determine how pretreatment ictal network pathways, defined using a combined electroencephalography (EEG)-functional magnetic resonance imaging (EEG-fMRI) and magnetoencephalography (MEG) effective connectivity analysis, were related to treatment response. METHODS Sixteen children with newly diagnosed and drug-naive CAE had 31 typical absence seizures during EEG-fMRI and 74 during MEG. The spatial extent of the pretreatment ictal network was defined using fMRI hemodynamic response with an event-related independent component analysis (eICA). This spatially defined pretreatment ictal network supplied prior information for MEG-effective connectivity analysis calculated using phase slope index (PSI). Treatment outcome was assessed 2 years following diagnosis and dichotomized to ethosuximide (ETX)-treatment responders (N = 11) or nonresponders (N = 5). Effective connectivity of the pretreatment ictal network was compared to the treatment response. RESULTS Patterns of pretreatment connectivity demonstrated strongest connections in the thalamus and posterior brain regions (parietal, posterior cingulate, angular gyrus, precuneus, and occipital) at delta frequencies and the frontal cortices at gamma frequencies (P < .05). ETX treatment nonresponders had pretreatment connectivity, which was decreased in the precuneus region and increased in the frontal cortex compared to ETX responders (P < .05). SIGNIFICANCE Pretreatment ictal connectivity differences in children with CAE were associated with response to antiepileptic treatment. This is a possible mechanism for the variable treatment response seen in patients sharing the same epilepsy syndrome.
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Affiliation(s)
- Jeffrey R Tenney
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Darren S Kadis
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - William Agler
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Leonid Rozhkov
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jing Xiang
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Vannest
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Pediatric Neuroimaging Research Consortium (PNRC), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Division of Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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6
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Altered functional connectivity in mesial temporal lobe epilepsy. Epilepsy Res 2017; 137:45-52. [DOI: 10.1016/j.eplepsyres.2017.09.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/23/2017] [Accepted: 09/03/2017] [Indexed: 11/23/2022]
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7
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Besson P, Bandt SK, Proix T, Lagarde S, Jirsa VK, Ranjeva JP, Bartolomei F, Guye M. Anatomic consistencies across epilepsies: a stereotactic-EEG informed high-resolution structural connectivity study. Brain 2017; 140:2639-2652. [DOI: 10.1093/brain/awx181] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/12/2017] [Indexed: 11/12/2022] Open
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8
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Breuer LEM, Grevers E, Boon P, Bernas A, Bergmans JWM, Besseling RMH, Klooster DCW, de Louw A, Mestrom RMC, Vonck K, Zinger S, Aldenkamp AP. Cognitive deterioration in adult epilepsy: clinical characteristics of "Accelerated Cognitive Ageing". Acta Neurol Scand 2017; 136:47-53. [PMID: 27790700 DOI: 10.1111/ane.12700] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES "Epileptic dementia" is reported in adults with childhood-onset refractory epilepsy. Cognitive deterioration can also occur in a "second-hit model". MATERIALS AND METHODS We studied the clinical and neuropsychological characteristics of patients with cognitive deterioration (≥1 SD discrepancy between current IQ and premorbid IQ). Memory function, reaction time and processing speed were also evaluated. Analyses were performed to investigate which clinical characteristics correlated with cognitive deterioration. RESULTS Twenty-seven patients were included with a mean age of 55.7 years old, an average age at epilepsy onset of 33.9 years and a mean duration of 21.8 years. Over 40% had experienced at least one status epilepticus. About 77.8% had at least one comorbid disease (most of (cardio)vascular origin). Cognitive deterioration scores were significant for both Performance IQ and Full Scale IQ, but not for Verbal IQ. Impairments in fluid functions primarily affected the IQ-scores. Memory was not impaired. Epilepsy factors explained 7% of the variance in deterioration, whereas 38% was explained by relatively low premorbid IQ and educational level, high age at seizure onset and older age. CONCLUSIONS A subgroup of patients with localization-related epilepsy exhibits cognitive decline characterized by deterioration in PIQ and FSIQ, but with preserved higher order functions (VIQ and memory). Patients typically have epilepsia tarda, comorbid pathology, relatively low educational level and older age. These are factors known to increase the vulnerability of the brain by diminishing cognitive reserve. Cognitive deterioration may develop according to a stepwise "second-hit model", affecting and accelerating the cognitive ageing process.
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Affiliation(s)
- L. E. M. Breuer
- Department of Behavioral Sciences; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Research and Development; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - E. Grevers
- Department of Behavioral Sciences; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
| | - P. Boon
- Department of Research and Development; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Neurology; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology; Ghent University Hospital; Ghent Belgium
| | - A. Bernas
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - J. W. M. Bergmans
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - R. M. H. Besseling
- Department of Research and Development; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - D. C. W. Klooster
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - A. de Louw
- Department of Research and Development; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
- Department of Neurology; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
| | - R. M. C. Mestrom
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - K. Vonck
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology; Ghent University Hospital; Ghent Belgium
| | - S. Zinger
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
| | - A. P. Aldenkamp
- Department of Behavioral Sciences; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Research and Development; Epilepsy Centre Kempenhaeghe; Heeze The Netherlands
- Department of Electrical Engineering; University of Technology; Eindhoven The Netherlands
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology; Ghent University Hospital; Ghent Belgium
- Department of Neurology and Clinical Neurophysiology; Maastricht University Medical Center; Maastricht The Netherlands
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Moguilner S, García AM, Mikulan E, Del Carmen García M, Vaucheret E, Amarillo Y, Bekinschtein TA, Ibáñez A. An unaware agenda: interictal consciousness impairments in epileptic patients. Neurosci Conscious 2017; 2017:niw024. [PMID: 30042834 PMCID: PMC6007167 DOI: 10.1093/nc/niw024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/16/2016] [Accepted: 12/21/2016] [Indexed: 01/07/2023] Open
Abstract
Consciousness impairments have been described as a cornerstone of epilepsy. Generalized seizures are usually characterized by a complete loss of consciousness, whereas focal seizures have more variable degrees of responsiveness. In addition to these impairments that occur during ictal episodes, alterations of consciousness have also been repeatedly observed between seizures (i.e. during interictal periods). In this opinion article, we review evidence supporting the novel hypothesis that epilepsy produces consciousness impairments which remain present interictally. Then, we discuss therapies aimed to reduce seizure frequency, which may modulate consciousness between epileptic seizures. We conclude with a consideration of relevant pathophysiological mechanisms. In particular, the thalamocortical network seems to be involved in both seizure generation and interictal consciousness impairments, which could inaugurate a promising translational agenda for epilepsy studies.
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Affiliation(s)
- Sebastian Moguilner
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,Fundación Escuela de Medicina Nuclear (FUESMEN) and Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Instituto Balseiro and Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Cuyo (UNCuyo), Mendoza, Argentina
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Faculty of Elementary and Special Education (FEEyE), National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Ezequiel Mikulan
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Maria Del Carmen García
- Programa de Cirugía de Epilepsia, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Esteban Vaucheret
- Servicio de Neurologia Infantil del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Yimy Amarillo
- Consejo Nacional de Investigaciones Científicas y Técnicas, Física Estadística e Interdisciplinaria, Centro Atómico Bariloche, San Carlos de Bariloche, Rio Negro, Argentina
| | | | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.,Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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10
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Ravizza T, Onat FY, Brooks-Kayal AR, Depaulis A, Galanopoulou AS, Mazarati A, Numis AL, Sankar R, Friedman A. WONOEP appraisal: Biomarkers of epilepsy-associated comorbidities. Epilepsia 2016; 58:331-342. [PMID: 28035782 DOI: 10.1111/epi.13652] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2016] [Indexed: 01/04/2023]
Abstract
Neurologic and psychiatric comorbidities are common in patients with epilepsy. Diagnostic, predictive, and pharmacodynamic biomarkers of such comorbidities do not exist. They may share pathogenetic mechanisms with epileptogenesis/ictogenesis, and as such are an unmet clinical need. The objectives of the subgroup on biomarkers of comorbidities at the XIII Workshop on the Neurobiology of Epilepsy (WONOEP) were to present the state-of-the-art recent research findings in the field that highlighting potential biomarkers for comorbidities in epilepsy. We review recent progress in the field, including molecular, imaging, and genetic biomarkers of comorbidities as discussed during the WONOEP meeting on August 31-September 4, 2015, in Heybeliada Island (Istanbul, Turkey). We further highlight new directions and concepts from studies on comorbidities and potential new biomarkers for the prediction, diagnosis, and treatment of epilepsy-associated comorbidities. The activation of various molecular signaling pathways such as the "Janus Kinase/Signal Transducer and Activator of Transcription," "mammalian Target of Rapamycin," and oxidative stress have been shown to correlate with the presence and severity of subsequent cognitive abnormalities. Furthermore, dysfunction in serotonergic transmission, hyperactivity of the hypothalamic-pituitary-adrenocortical axis, the role of the inflammatory cytokines, and the contributions of genetic factors have all recently been regarded as relevant for understanding epilepsy-associated depression and cognitive deficits. Recent evidence supports the utility of imaging studies as potential biomarkers. The role of such biomarker may be far beyond the diagnosis of comorbidities, as accumulating clinical data indicate that comorbidities can predict epilepsy outcomes. Future research is required to reveal whether molecular changes in specific signaling pathways or advanced imaging techniques could be detected in the clinical settings and correlate with epilepsy-associated comorbidities. A reliable biomarker will allow a more accurate diagnosis and improved treatment of epilepsy-associated comorbidities.
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Affiliation(s)
- Teresa Ravizza
- Department of Neuroscience, IRCCS-"Mario Negri" Institute for Pharmacological Research, Milano, Italy
| | - Filiz Y Onat
- Department of Medical Pharmacology, Epilepsy Research Center, School of Medicine Marmara University, Istanbul, Turkey
| | - Amy R Brooks-Kayal
- Department of Pediatrics, Neurology and Pharmaceutical Sciences, Children's Hospital Colorado, University of Colorado Schools of Medicine and Pharmacy, Aurora, Colorado, U.S.A
| | | | - Aristea S Galanopoulou
- Laboratory of Developmental Neuroscience, Saul R. Korey Department of Neurology, Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, U.S.A.,Montefiore/Einstein Comprehensive Epilepsy Center, Montefiore Medical Center, Bronx, New York, U.S.A
| | - Andrey Mazarati
- Neurology Division, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Adam L Numis
- Neurology Division, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Raman Sankar
- Neurology Division, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.,Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Alon Friedman
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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11
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Dinkelacker V, Dupont S, Samson S. The new approach to classification of focal epilepsies: Epileptic discharge and disconnectivity in relation to cognition. Epilepsy Behav 2016; 64:322-328. [PMID: 27765519 DOI: 10.1016/j.yebeh.2016.08.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 12/23/2022]
Abstract
The new classification of epilepsy stratifies the disease into an acute level, based on seizures, and an overarching chronic level of epileptic syndromes (Berg et al., 2010). In this new approach, seizures are considered either to originate and evolve in unilateral networks or to rapidly encompass both hemispheres. This concept extends the former vision of focal and generalized epilepsies to a genuine pathology of underlying networks. These key aspects of the new classification can be linked to the concept of cognitive curtailing in focal epilepsy. The present review will discuss the conceptual implications for acute and chronic cognitive deficits with special emphasis on transient and structural disconnectivity. Acute transient disruption of brain function is the hallmark of focal seizures. Beyond seizures, however, interictal epileptic discharges (IEDs) are increasingly recognized to interfere with physiological brain circuitry. Both concomitant EEG and high-precision neuropsychological testing are necessary to detect these subtle effects, which may concern task-specific or default-mode networks. More recent data suggest that longstanding IEDs may affect brain maturation and eventually be considered as a biomarker of pathological wiring. This brings us to the overarching level of chronic cognitive and behavioral comorbidity. We will discuss alterations in structural connectivity measured with diffusion-weighted imaging and tractography. Among focal epilepsies, much of our current insights are derived from temporal lobe epilepsy and its impact on neuropsychological and psychiatric functioning. Structural disconnectivity is maximal in the temporal lobe but also concerns widespread language circuitry. Eventually, pathological wiring may contribute to the clinical picture of cognitive dysfunction. We conclude with the extrapolation of these concepts to current research topics and to the necessity of establishing individual patient profiles of network pathology with EEG, high-precision neuropsychological testing, and state-of-the-art neuroimaging. This article is part of a Special Issue entitled "The new approach to classification: Rethinking cognition and behavior in epilepsy".
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Affiliation(s)
- Vera Dinkelacker
- Neurology Unit, Rothschild Foundation, 25 Rue Manin, 75019, Paris, France; Centre de Recherche de l'Institut du Cerveau et de la Moëlle Épinière (CRICM), UPMC-UMR 7225 CNRS-UMRS 975 INSERM, Paris, France.
| | - Sophie Dupont
- Centre de Recherche de l'Institut du Cerveau et de la Moëlle Épinière (CRICM), UPMC-UMR 7225 CNRS-UMRS 975 INSERM, Paris, France; Epilepsy Unit, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Séverine Samson
- Epilepsy Unit, Pitié-Salpêtrière Hospital, 47-83 boulevard de l'Hôpital, 75013, Paris, France; Laboratoire PSITEC (EA 4072), Université de Lille 3, France
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12
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Khalil R, Abo Elfetoh N, Moftah MZ, Khedr EM. Acquired equivalence associative learning in GTC epileptic patients: experimental and computational study. Front Cell Neurosci 2015; 9:418. [PMID: 26578883 PMCID: PMC4621864 DOI: 10.3389/fncel.2015.00418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 10/02/2015] [Indexed: 12/24/2022] Open
Abstract
Previous cognitive behavioral studies based on Acquired Equivalence Associative learning Task (AEALT) showed a strong relation between hippocampus and basal ganglia in associative learning. However, experimental behavioral studies of patients with Generalized Tonic Clonic (GTC) epilepsy remained sparse. The aim of the present study is to integrate a classical behavioral cognitive analysis with a computational model approach to investigate cognitive associative learning impairments in patients with GTC epilepsy. We measured the accuracy of associative learning response performance in five GTC epileptic patients and five control subjects by using AEALT, all subjects were matched in age and gender. We ran the task using E-Prime, a neuropsychological software program, and SPSS for data statistical analysis. We tested whether GTC epileptic patients would have different learning performance than normal subjects, based on the degree and the location of impairment either in basal ganglia and/or hippocampus. With the number of patients that was available, our behavioral analysis showed no remarkable differences in learning performance of GTC patients as compared to their control subjects, both in the transfer and acquisition phases. In parallel, our simulation results confirmed strong connection and interaction between hippocampus and basal ganglia in our GTC and their control subjects. Nevertheless, the differences in neural firing rate of the connectionist model and weight update of basal ganglia were not significantly different between GTC and control subjects. Therefore, the behavioral analysis and the simulation data provided the same result, thus indicating that the computational model is likely to predict cognitive outcomes.
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Affiliation(s)
- Radwa Khalil
- Department of Cognitive Biology, Otto-von-Guericke Universität Magdeburg, Germany ; Department of Developmental Physiology, Institute of Physiology, Otto-von-Guericke Universität Magdeburg, Germany ; IMN - Institut des Maladies Neurodégénératives, University of Bordeaux Bordeaux, France
| | - Noha Abo Elfetoh
- Department of Neurology, Faculty of Medicine, Assiut University Assiut, Egypt
| | - Marie Z Moftah
- Department of Zoology, Faculty of Science, Alexandria University Alexandria, Egypt
| | - Eman M Khedr
- Department of Neurology, Faculty of Medicine, Assiut University Assiut, Egypt
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13
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Pohlmann-Eden B, Aldenkamp A, Baker GA, Brandt C, Cendes F, Coras R, Crocker CE, Helmstaedter C, Jones-Gotman M, Kanner AM, Mazarati A, Mula M, Smith ML, Omisade A, Tellez-Zenteno J, Hermann BP. The relevance of neuropsychiatric symptoms and cognitive problems in new-onset epilepsy - Current knowledge and understanding. Epilepsy Behav 2015; 51:199-209. [PMID: 26291774 DOI: 10.1016/j.yebeh.2015.07.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 07/03/2015] [Indexed: 01/11/2023]
Abstract
Neurobehavioral and cognition problems are highly prevalent in epilepsy, but most research studies to date have not adequately addressed the precise nature of the relationship between these comorbidities and seizures. To address this complex issue and to facilitate collaborative, innovative research in the rising field of neurobehavioral comorbidities and cognition disturbances in new-onset epilepsy, international epilepsy experts met at the 3rd Halifax International Epilepsy Conference & Retreat at White Point, South Shore, Nova Scotia, Canada from September 18 to 20, 2014. This Conference Proceedings provides a summary of the conference proceedings. Specifically, the following topics are discussed: (i) role of comorbidities in epilepsy diagnosis and management, (ii) role of antiepileptic medications in understanding the relationship between epilepsy and neurobehavioral and cognition problems, and (iii) animal data and diagnostic approaches. Evidence to date, though limited, strongly suggests a bidirectional relationship between epilepsy and cognitive and psychiatric comorbidities. In fact, it is likely that seizures and neurobehavioral problems represent different symptoms of a common etiology or network-wide disturbance. As a reflection of this shared network, psychiatric comorbidities and/or cognition problems may actually precede the seizure occurrence and likely get often missed if not screened.
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Affiliation(s)
- B Pohlmann-Eden
- Division of Neurology, Dalhousie University of Halifax, Canada; Brain Repair Center, Dalhousie University of Halifax, Canada.
| | - A Aldenkamp
- Epilepsiecentrum Kempenhaeghe, The Netherlands
| | - G A Baker
- Division of Neurosciences, University of Liverpool, United Kingdom
| | - C Brandt
- Bethel Epilepsy Center, Mara Hospital, Bielefeld, Germany
| | - F Cendes
- Department of Neurology, University of Campinas, São Paulo, Brazil
| | - R Coras
- Department of Neuropathology, University of Erlangen, Germany
| | - C E Crocker
- Division of Neurology, Dalhousie University of Halifax, Canada
| | | | - M Jones-Gotman
- McGill University, Montreal Neurological Institute, Montreal, Canada
| | - A M Kanner
- Epilepsy Center, University of Miami, Miller School of Medicine, USA
| | - A Mazarati
- Children's Discovery and Innovation Institute, D. Geffen School of Medicine at UCLA, Los Angeles, USA
| | - M Mula
- Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust and Institute of Medical and Biomedical Sciences St. George's University of London, United Kingdom
| | - M L Smith
- Department of Psychology, University of Toronto, Canada
| | - A Omisade
- Division of Neurology, Dalhousie University of Halifax, Canada
| | | | - B P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, USA
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14
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Senra Filho ACDS, Rondinoni C, dos Santos AC, Murta LO. Brain activation inhomogeneity highlighted by the Isotropic Anomalous Diffusion filter. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:3313-6. [PMID: 25570699 DOI: 10.1109/embc.2014.6944331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The visual appealing nature of the now popular BOLD fMRI may give the false impression of extreme simplicity, as if the the functional maps could be generated with the press of a single button. However, one can only get plausible maps after long and cautious processing, considering that time and noise come into play during acquisition. One of the most popular ways to account for noise and individual variability in fMRI is the use of a Gaussian spatial filter. Although very robust, this filter may introduce excessive blurring, given the strong dependence of results on the central voxel value. Here, we propose the use of the Isotropic Anomalous Diffusion (IAD) approach, aiming to reduce excessive homogeneity while retaining the natural variability of signal across brain space. We found differences between Gaussian and IAD filters in two parameters gathered from Independent Component maps (ICA), identified on brain areas responsible for auditory processing during rest. Analysis of data gathered from 7 control subjects shows that the IAD filter rendered more localized active areas and higher contrast-to-noise ratios, when compared to equivalent Gaussian filtered data (Student t-test, p<0.05). The results seem promising, since the anomalous filter performs satisfactorily in filtering noise with less distortion of individual localized brain responses.
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15
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Busch RM. Comments on Motamedi G, Meador K. Epilepsy and cognition. Epilepsy & behavior 2003;4:S25-S28. Epilepsy Behav 2014; 40:26-8. [PMID: 25307191 PMCID: PMC4391193 DOI: 10.1016/j.yebeh.2014.08.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 08/10/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Robyn M Busch
- Cleveland Clinic Epilepsy Center, 9500 Euclid Avenue, P57, Cleveland, OH 44195, USA.
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16
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Gulati S, Yoganathan S, Chakrabarty B. Epilepsy, cognition and behavior. Indian J Pediatr 2014; 81:1056-62. [PMID: 25073691 DOI: 10.1007/s12098-014-1530-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/27/2014] [Indexed: 02/08/2023]
Abstract
Epilepsy is defined as two or more unprovoked seizures. Epileptic patients have intellectual disability and behavioral co-morbidities to the tune of up to 25 and 75% respectively. Various factors like underlying etiology, socioeconomic environment at home, age at onset, seizure semiology, seizure descriptors like duration, severity and frequency, therapy related adverse effects secondary to antiepileptic drugs and epilepsy surgery have been implicated for the causation of cognitive and behavioral impairment in epilepsy. Cognitive epilepsy has emerged as a specific entity. This may manifest as a transient behavioral or cognitive change, insidous onset subacute to chronic encephalopathy or more catastrophic in the form of nonconvulsive status epilepticus. Cognitive impairment seen in epileptic children include difficulties in learning, memory, problem solving as well as concept formation. Anxiety, depression and attention deficit hyperkinetic disorders are the most common psychiatric co-morbidities seen. Investigating a child with epilepsy for cognitive and behavioral impairment is difficult as these tests would require cooperation from the patient's side to a significant extent. A rational approach towards treatment would be judicious selection of antiepileptic drugs, treatment of underlying cause, appropriate management of behavioral co-morbidities including psychopharmacotherapy and a trial of immunotherapy (particularly in cognitive epilepsies), wherever appropriate.
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Affiliation(s)
- Sheffali Gulati
- Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India,
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17
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Choi H, Kim YK, Kang H, Lee H, Im HJ, Hwang DW, Kim EE, Chung JK, Lee DS. Abnormal metabolic connectivity in the pilocarpine-induced epilepsy rat model: A multiscale network analysis based on persistent homology. Neuroimage 2014; 99:226-36. [PMID: 24857713 DOI: 10.1016/j.neuroimage.2014.05.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 01/18/2023] Open
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18
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Bates RC, Stith BJ, Stevens KE, Adams CE. Reduced CHRNA7 expression in C3H mice is associated with increases in hippocampal parvalbumin and glutamate decarboxylase-67 (GAD67) as well as altered levels of GABA(A) receptor subunits. Neuroscience 2014; 273:52-64. [PMID: 24836856 DOI: 10.1016/j.neuroscience.2014.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/23/2014] [Accepted: 05/02/2014] [Indexed: 12/14/2022]
Abstract
Decreased expression of CHRNA7, the gene encoding the α7(∗) subtype of nicotinic receptor, may contribute to the cognitive dysfunction observed in schizophrenia by disrupting the inhibitory/excitatory balance in the hippocampus. C3H mice with reduced Chrna7 expression have significant reductions in hippocampal α7(∗) receptor density, deficits in hippocampal auditory gating, increased hippocampal activity as well as significant decreases in hippocampal glutamate decarboxylase-65 (GAD65) and γ-aminobutyric acid-A (GABAA) receptor levels. The current study investigated whether altered Chrna7 expression is associated with changes in the levels of parvalbumin, GAD67 and/or GABAA receptor subunits in the hippocampus from male and female C3H Chrna7 wildtype, C3H Chrna7 heterozygous and C3H Chrna7 knockout (KO) mice using quantitative Western immunoblotting. Reduced Chrna7 expression was associated with significant increases in hippocampal parvalbumin and GAD67 and with complex alterations in GABAA receptor subunits. A decrease in α3 subunit protein was seen in both female C3H Chrna7 Het and KO mice while a decrease in α4 subunit protein was also detected in C3H Chrna7 KO mice with no sex difference. In contrast, an increase in δ subunit protein was observed in C3H Chrna7 Het mice while a decrease in this subunit was observed in C3H Chrna7 KO mice, with δ subunit protein levels being greater in males than in females. Finally, an increase in γ2 subunit protein was found in C3H Chrna7 KO mice with the levels of this subunit again being greater in males than in females. The increases in hippocampal parvalbumin and GAD67 observed in C3H Chrna7 mice are contrary to reports of reductions in these proteins in the postmortem hippocampus from schizophrenic individuals. We hypothesize that the disparate results may occur because of the influence of factors other than CHRNA7 that have been found to be abnormal in schizophrenia.
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Affiliation(s)
- R C Bates
- Medical Research, Veterans Affairs Medical Center, Denver, CO 80220, United States; Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, United States; Department of Integrative Biology, University of Colorado Denver Downtown Denver Campus, Denver, CO 80217, United States
| | - B J Stith
- Department of Integrative Biology, University of Colorado Denver Downtown Denver Campus, Denver, CO 80217, United States
| | - K E Stevens
- Medical Research, Veterans Affairs Medical Center, Denver, CO 80220, United States; Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, United States
| | - C E Adams
- Medical Research, Veterans Affairs Medical Center, Denver, CO 80220, United States; Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, United States.
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19
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Neuner I, Arrubla J, Felder J, Shah NJ. Simultaneous EEG-fMRI acquisition at low, high and ultra-high magnetic fields up to 9.4 T: perspectives and challenges. Neuroimage 2013; 102 Pt 1:71-9. [PMID: 23796544 DOI: 10.1016/j.neuroimage.2013.06.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 01/25/2023] Open
Abstract
In this perspectives article we highlight the advantages of simultaneous acquisition of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). As MRI moves towards using ultra-high magnetic fields in the quest for increased signal-to-noise, the question arises whether combined EEG-fMRI measurements are feasible at magnetic fields of 7 T and higher. We describe the challenges of MRI-EEG at 1.5, 3, 7 and 9.4 T and review the proposed solutions. In an outlook, we discuss further developments such as simultaneous trimodal imaging using MR, positron emission tomography (PET) and EEG under the same physiological conditions in the same subject.
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Affiliation(s)
- Irene Neuner
- Institute of Neuroscience and Medicine 4, INM 4, Forschungszentrum Jülich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Germany; JARA - BRAIN - Translational Medicine, Germany.
| | - Jorge Arrubla
- Institute of Neuroscience and Medicine 4, INM 4, Forschungszentrum Jülich, Germany
| | - Jörg Felder
- Institute of Neuroscience and Medicine 4, INM 4, Forschungszentrum Jülich, Germany
| | - N Jon Shah
- Institute of Neuroscience and Medicine 4, INM 4, Forschungszentrum Jülich, Germany; Department of Neurology, RWTH Aachen University, Germany; JARA - BRAIN - Translational Medicine, Germany
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