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Lozano-García A, Catalán-Aguilar J, Tormos-Pons P, Hampel KG, Villanueva V, Cano-López I, González-Bono E. Impact of Polytherapy on Memory Functioning in Patients With Drug-Resistant Epilepsy: The Role of Attention and Executive Functions. Arch Clin Neuropsychol 2024; 39:423-442. [PMID: 37987193 DOI: 10.1093/arclin/acad086] [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: 04/16/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE The aim was to examine the effect of polytherapy (i.e., the number of administered anti-seizure medications (ASMs)) on memory, and whether the interaction between the number of ASMs and attentional/executive functioning affect presurgical memory functioning and postsurgical memory changes in patients with drug-resistant epilepsy. METHODS Two studies were carried out. Study 1 consisted of a presurgical assessment of 125 adult patients, in which attention/executive function (EpiTrack screening tool) and memory were assessed (cross-sectional study). Of them, 72 patients underwent a second postsurgical evaluation, in which memory was assessed (Study 2). Patients were distributed into groups based on EpiTrack performance and number of ASMs. RESULTS The interaction between the number of ASMs and the attentional/executive functioning significantly affected presurgical memory, with patients with impaired EpiTrack performance taking three-four ASMs having poorer scores than patients with intact EpiTrack performance taking three-four ASMs (for all, p < .0001). This interaction also affected postsurgical memory changes, with patients with impaired Epitrack performance taking three-four ASMs having higher postsurgical decline than those with intact Epitrack performance taking three-four ASMs (for all, p < .005). No differences were found in patients taking two ASMs. Furthermore, the number of ASMs was associated with presurgical memory performance and postsurgical memory changes only in patients with impaired EpiTrack performance (for all, p < .05). CONCLUSIONS Our findings underline the utility of EpiTrack, together with the clinical information on the number of prescribed ASMs, to corroborate the impact of polytherapy on memory and to optimize the prediction of postsurgical memory changes.
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Affiliation(s)
- Alejandro Lozano-García
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Department of Psychology, Universidad Europea de Valencia, Valencia, Spain
- Faculty of Health Sciences, Universidad Isabel I, Burgos, Spain
| | - Judit Catalán-Aguilar
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Paula Tormos-Pons
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Kevin G Hampel
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Irene Cano-López
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
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2
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Trimmel K, Vos SB, Binding L, Caciagli L, Xiao F, van Graan LA, Koepp MJ, Thompson PJ, Duncan JS. Naming fMRI-guided white matter language tract volumes influence naming decline after temporal lobe resection. J Neurol 2024:10.1007/s00415-024-12315-2. [PMID: 38583105 DOI: 10.1007/s00415-024-12315-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE The aim of this study was to explore the relation of language functional MRI (fMRI)-guided tractography with postsurgical naming decline in people with temporal lobe epilepsy (TLE). METHODS Twenty patients with unilateral TLE (9 left) were studied with auditory and picture naming functional MRI tasks. Activation maxima in the left posterobasal temporal lobe were used as seed regions for whole-brain fibre tractography. Clinical naming performance was assessed preoperatively, 4 months, and 12 months following temporal lobe resection. Volumes of white matter language tracts in both hemispheres as well as tract volume laterality indices were explored as moderators of postoperative naming decline using Pearson correlations and multiple linear regression with other clinical variables. RESULTS Larger volumes of white matter language tracts derived from auditory and picture naming maxima in the hemisphere of subsequent surgery as well as stronger lateralization of picture naming tract volumes to the side of surgery correlated with greater language decline, which was independent of fMRI lateralization status. Multiple regression for picture naming tract volumes was associated with a significant decline of naming function with 100% sensitivity and 93% specificity at both short-term and long-term follow-up. INTERPRETATION Naming fMRI-guided white matter language tract volumes relate to postoperative naming decline after temporal lobe resection in people with TLE. This can assist stratification of surgical outcome and minimize risk of postoperative language deficits in TLE.
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Affiliation(s)
- Karin Trimmel
- Department of Neurology, Medical University of Vienna, Vienna, Austria.
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.
| | - Sjoerd B Vos
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
- Centre for Microscopy Characterisation and Analysis, University of Western Australia, Nedlands, Australia
| | - Lawrence Binding
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Lorenzo Caciagli
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fenglai Xiao
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Louis A van Graan
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Matthias J Koepp
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Pamela J Thompson
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - John S Duncan
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
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3
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Stasenko A, Lin C, Bonilha L, Bernhardt BC, McDonald CR. Neurobehavioral and Clinical Comorbidities in Epilepsy: The Role of White Matter Network Disruption. Neuroscientist 2024; 30:105-131. [PMID: 35193421 PMCID: PMC9393207 DOI: 10.1177/10738584221076133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Epilepsy is a common neurological disorder associated with alterations in cortical and subcortical brain networks. Despite a historical focus on gray matter regions involved in seizure generation and propagation, the role of white matter (WM) network disruption in epilepsy and its comorbidities has sparked recent attention. In this review, we describe patterns of WM alterations observed in focal and generalized epilepsy syndromes and highlight studies linking WM disruption to cognitive and psychiatric comorbidities, drug resistance, and poor surgical outcomes. Both tract-based and connectome-based approaches implicate the importance of extratemporal and temporo-limbic WM disconnection across a range of comorbidities, and an evolving literature reveals the utility of WM patterns for predicting outcomes following epilepsy surgery. We encourage new research employing advanced analytic techniques (e.g., machine learning) that will further shape our understanding of epilepsy as a network disorder and guide individualized treatment decisions. We also address the need for research that examines how neuromodulation and other treatments (e.g., laser ablation) affect WM networks, as well as research that leverages larger and more diverse samples, longitudinal designs, and improved magnetic resonance imaging acquisitions. These steps will be critical to ensuring generalizability of current research and determining the extent to which neuroplasticity within WM networks can influence patient outcomes.
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Affiliation(s)
- Alena Stasenko
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Christine Lin
- School of Medicine, University of California, San Diego, CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Boris C Bernhardt
- Departments of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Carrie R McDonald
- Department of Psychiatry, University of California, San Diego, CA, USA
- Department of Radiation Medicine & Applied Sciences, University of California, San Diego, CA, USA
- Center for Multimodal Imaging and Genetics (CMIG), University of California, San Diego, CA, USA
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4
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Mito R, Pedersen M, Pardoe H, Parker D, Smith RE, Cameron J, Scheffer IE, Berkovic SF, Vaughan DN, Jackson GD. Exploring individual fixel-based white matter abnormalities in epilepsy. Brain Commun 2023; 6:fcad352. [PMID: 38187877 PMCID: PMC10768884 DOI: 10.1093/braincomms/fcad352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/02/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
Diffusion MRI has provided insight into the widespread structural connectivity changes that characterize epilepsies. Although syndrome-specific white matter abnormalities have been demonstrated, studies to date have predominantly relied on statistical comparisons between patient and control groups. For diffusion MRI techniques to be of clinical value, they should be able to detect white matter microstructural changes in individual patients. In this study, we apply an individualized approach to a technique known as fixel-based analysis, to examine fibre-tract-specific abnormalities in individuals with epilepsy. We explore the potential clinical value of this individualized fixel-based approach in epilepsy patients with differing syndromic diagnoses. Diffusion MRI data from 90 neurologically healthy control participants and 10 patients with epilepsy (temporal lobe epilepsy, progressive myoclonus epilepsy, and Dravet Syndrome, malformations of cortical development) were included in this study. Measures of fibre density and cross-section were extracted for all participants across brain white matter fixels, and mean values were computed within select tracts-of-interest. Scanner harmonized and normalized data were then used to compute Z-scores for individual patients with epilepsy. White matter abnormalities were observed in distinct patterns in individual patients with epilepsy, both at the tract and fixel level. For patients with specific epilepsy syndromes, the detected white matter abnormalities were in line with expected syndrome-specific clinical phenotypes. In patients with lesional epilepsies (e.g. hippocampal sclerosis, periventricular nodular heterotopia, and bottom-of-sulcus dysplasia), white matter abnormalities were spatially concordant with lesion location. This proof-of-principle study demonstrates the clinical potential of translating advanced diffusion MRI methodology to individual-patient-level use in epilepsy. This technique could be useful both in aiding diagnosis of specific epilepsy syndromes, and in localizing structural abnormalities, and is readily amenable to other neurological disorders. We have included code and data for this study so that individualized white matter changes can be explored robustly in larger cohorts in future work.
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Affiliation(s)
- Remika Mito
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Mangor Pedersen
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
- Department of Psychology and Neuroscience, Auckland University of Technology (AUT), Auckland 1142, New Zealand
| | - Heath Pardoe
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
| | - Donna Parker
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
| | - Robert E Smith
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Jillian Cameron
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Samuel F Berkovic
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia
| | - David N Vaughan
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
- Department of Neurology, Austin Health, Heidelberg, Victoria 3084, Australia
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
- Department of Neurology, Austin Health, Heidelberg, Victoria 3084, Australia
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5
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Bou Assi E, Schindler K, de Bézenac C, Denison T, Desai S, Keller SS, Lemoine É, Rahimi A, Shoaran M, Rummel C. From basic sciences and engineering to epileptology: A translational approach. Epilepsia 2023; 64 Suppl 3:S72-S84. [PMID: 36861368 DOI: 10.1111/epi.17566] [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: 02/20/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/03/2023]
Abstract
Collaborative efforts between basic scientists, engineers, and clinicians are enabling translational epileptology. In this article, we summarize the recent advances presented at the International Conference for Technology and Analysis of Seizures (ICTALS 2022): (1) novel developments of structural magnetic resonance imaging; (2) latest electroencephalography signal-processing applications; (3) big data for the development of clinical tools; (4) the emerging field of hyperdimensional computing; (5) the new generation of artificial intelligence (AI)-enabled neuroprostheses; and (6) the use of collaborative platforms to facilitate epilepsy research translation. We highlight the promise of AI reported in recent investigations and the need for multicenter data-sharing initiatives.
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Affiliation(s)
- Elie Bou Assi
- Department of Neuroscience, Université de Montréal, Montréal, Canada
- Centre de Recherche du CHUM (CRCHUM), Montréal, Canada
| | - Kaspar Schindler
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, Bern University, Bern, Switzerland
| | - Christophe de Bézenac
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Timothy Denison
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK
- Department of Engineering Science, University of Oxford, Oxford, UK
| | | | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Émile Lemoine
- Centre de Recherche du CHUM (CRCHUM), Montréal, Canada
- Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Canada
| | | | - Mahsa Shoaran
- Institute of Electrical and Micro Engineering, Neuro-X Institute, EPFL, Lausanne, Switzerland
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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6
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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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7
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Neophytou K, Wiley R, Litovsky C, Tsapkini K, Rapp B. The right hemisphere's capacity for language: evidence from primary progressive aphasia. Cereb Cortex 2023; 33:9971-9985. [PMID: 37522277 PMCID: PMC10502784 DOI: 10.1093/cercor/bhad258] [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: 01/06/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
The role of the right hemisphere (RH) in core language processes is still a matter of intense debate. Most of the relevant evidence has come from studies of gray matter, with relatively little research on RH white matter (WM) connectivity. Using Diffusion Tensor Imaging-based tractography, the current work examined the role of the two hemispheres in language processing in 33 individuals with Primary Progressive Aphasia (PPA), aiming to better characterize the contribution of the RH to language processing in the context of left hemisphere (LH) damage. The findings confirm the impact of PPA on the integrity of the WM language tracts in the LH. Additionally, an examination of the relationship between tract integrity and language behaviors provides robust evidence of the involvement of the WM language tracts of both hemispheres in language processing in PPA. Importantly, this study provides novel evidence of a unique contribution of the RH to language processing (i.e. a contribution independent from that of the language-dominant LH). Finally, we provide evidence that the RH contribution is specific to language processing rather than being domain general. These findings allow us to better characterize the role of RH in language processing, particularly in the context of LH damage.
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Affiliation(s)
- Kyriaki Neophytou
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Robert Wiley
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
| | - Celia Litovsky
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
| | - Brenda Rapp
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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8
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Kraus D, Farah R, Fischer H, Vannest J, Wade SL, Radhakrishnan R, Modi AC, Horowitz-Kraus T. Altered white matter organization and its correlations with executive functioning among adolescents with epilepsy. Eur J Paediatr Neurol 2023; 46:82-88. [PMID: 37540964 DOI: 10.1016/j.ejpn.2023.07.004] [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: 02/01/2022] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
Deficits in executive functions (EF) are a common comorbidity among adolescents with epilepsy. EF deficits were previously correlated with altered connectivity of the fronto-parietal and cingulo-opercular neural networks. The current study investigated white matter integrity in adolescents with epilepsy (n = 29) relative to healthy controls (n = 19). Participants completed questionnaires, neuropsychological testing, and brain magnetic resonance imaging (MRI) that included diffusion tensor imaging (DTI) sequences. On BRIEF parent-report questionnaires, adolescents with epilepsy demonstrated lower working memory and planning abilities than healthy controls. Among adolescents with epilepsy, DTI measurements revealed lower fractional anisotropy (FA) within the right superior longitudinal fasciculus, forceps minor, and the superior frontal segment of the corpus callosum, and higher FA in the left uncinate fasciculus, compared to healthy controls. Better working memory ability in the epilepsy group was associated with higher FA in the superior frontal segment of the corpus callosum. Only in healthy controls, working memory and planning were positively associated with FA values in the left UF, forceps minor and the superior frontal segment of the corpus callosum. The current study complements previous functional studies on the same cohort and suggests that EF impairments among adolescents with epilepsy may be related to the altered anatomical organization of white matter tracts. Combining structural and functional data could potentially enrich the neuropsychological assessment of executive functioning in adolescents with epilepsy.
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Affiliation(s)
- Dror Kraus
- Pediatric Neurology Institute, Schneider Children's Medical Center of Israel, Tel Aviv University, Israel
| | - Rola Farah
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Haya Fischer
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Jennifer Vannest
- Department of Speech and Language Pathology, Cincinnati Children's Hospital Medical Center, USA
| | - Shari L Wade
- Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rupa Radhakrishnan
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Faculty of Biomedical Engineering, Technion, Haifa, Israel; Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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9
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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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10
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Guo Z, Mo J, Zhang J, Hu W, Zhang C, Wang X, Zhao B, Zhang K. Altered Metabolic Networks in Mesial Temporal Lobe Epilepsy with Focal to Bilateral Seizures. Brain Sci 2023; 13:1239. [PMID: 37759840 PMCID: PMC10526398 DOI: 10.3390/brainsci13091239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
This study was designed to identify whether the metabolic network changes in mesial temporal lobe epilepsy (MTLE) patients with focal to bilateral tonic-clonic seizures (FBTCS) differ from changes in patients without FBTCS. This retrospective analysis enrolled 30 healthy controls and 54 total MTLE patients, of whom 27 had FBTCS. Fluorodeoxyglucose positron emission tomography (FDG-PET) data and graph theoretical analyses were used to examine metabolic connectivity. The differences in metabolic networks between the three groups were compared. Significant changes in both local and global network topology were evident in FBTCS+ patients as compared to healthy controls, with a lower assortative coefficient and altered betweenness centrality in 15 brain regions. While global network measures did not differ significantly when comparing FBTCS- patients to healthy controls, alterations in betweenness centrality were evident in 13 brain regions. Significantly altered betweenness centrality was also observed in four brain regions when comparing patients with and without FBTCS. The study revealed greater metabolic network abnormalities in MTLE patients with FBTCS as compared to FBTCS- patients, indicating the existence of distinct epileptogenic networks. These findings can provide insight into the pathophysiological basis of FBTCS.
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Affiliation(s)
- Zhihao Guo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Jiajie Mo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Wenhan Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Chao Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Xiu Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Kai Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Z.G.); (J.M.); (J.Z.); (W.H.); (C.Z.); (X.W.); (B.Z.)
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
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Vavassori L, Venturini M, Zigiotto L, Annicchiarico L, Corsini F, Avesani P, Petit L, De Benedictis A, Sarubbo S. The arcuate fasciculus: Combining structure and function into surgical considerations. Brain Behav 2023; 13:e3107. [PMID: 37280786 PMCID: PMC10454270 DOI: 10.1002/brb3.3107] [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: 01/18/2023] [Revised: 03/19/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Two Centuries from today, Karl Friedrich Burdach attributed the nomenclature "arcuate fasciculus" to a white matter (WM) pathway connecting the frontal to the temporal cortices by arching around the Sylvian fissure. Although this label remained essentially unvaried, the concepts related to it and the characterization of the structural properties of this bundle evolved along with the methodological progress of the past years. Concurrently, the functional relevance of the arcuate fasciculus (AF) classically restricted to the linguistic domain has extended to further cognitive abilities. These features make it a relevant structure to consider in a large variety of neurosurgical procedures. OBJECTIVE Herein, we build on our previous review uncovering the connectivity provided by the Superior Longitudinal System, including the AF, and provide a handy representation of the structural organization of the AF by considering the frequency of defined reports in the literature. By adopting the same approach, we implement an account of which functions are mediated by this WM bundle. We highlight how this information can be transferred to the neurosurgical field by presenting four surgical cases of glioma resection requiring the evaluation of the relationship between the AF and the nearby structures, and the safest approaches to adopt. CONCLUSIONS Our cumulative overview reports the most common wiring patterns and functional implications to be expected when approaching the study of the AF, while still considering seldom descriptions as an account of interindividual variability. Given its extension and the variety of cortical territories it reaches, the AF is a pivotal structure for different cognitive functions, and thorough understanding of its structural wiring and the functions it mediates is necessary for preserving the patient's cognitive abilities during glioma resection.
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Affiliation(s)
- Laura Vavassori
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
- Center for Mind and Brain Sciences (CIMeC)University of TrentoTrento Provincia Autonoma di TrentoItaly
| | - Martina Venturini
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Luca Zigiotto
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Luciano Annicchiarico
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Francesco Corsini
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Paolo Avesani
- Center for Mind and Brain Sciences (CIMeC)University of TrentoTrento Provincia Autonoma di TrentoItaly
- Neuroinfrmatics Laboratory (NiLab)Bruno Kessler FoundationPovo Provincia Autonoma di TrentoItaly
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives (GIN‐IMN), UMR5293, CNRS, CEAUniversity of BordeauxBordeauxFrance
| | | | - Silvio Sarubbo
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
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12
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Liu Z, Shu K, Geng Y, Cai C, Kang H. Deep brain stimulation of fornix in Alzheimer's disease: From basic research to clinical practice. Eur J Clin Invest 2023; 53:e13995. [PMID: 37004153 DOI: 10.1111/eci.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023]
Abstract
Alzheimer's disease (AD) is one of the most common progressive neurodegenerative diseases associated with the degradation of memory and cognitive ability. Current pharmacotherapies show little therapeutic effect in AD treatment and still cannot prevent the pathological progression of AD. Deep brain stimulation (DBS) has shown to enhance memory in morbid obese, epilepsy and traumatic brain injury patients, and cognition in Parkinson's disease (PD) patients deteriorates during DBS off. Some relevant animal studies and clinical trials have been carried out to discuss the DBS treatment for AD. Reviewing the fornix trials, no unified conclusion has been reached about the clinical benefits of DBS in AD, and the dementia ratings scale has not been effectively improved in the long term. However, some patients have presented promising results, such as improved glucose metabolism, increased connectivity in cognition-related brain regions and even elevated cognitive function rating scale scores. The fornix plays an important regulatory role in memory, attention, and emotion through its complex fibre projection to cognition-related structures, making it a promising target for DBS for AD treatment. Moreover, the current stereotaxic technique and various evaluation methods have provided references for the operator to select accurate stimulation points. Related adverse events and relatively higher costs in DBS have been emphasized. In this article, we summarize and update the research progression on fornix DBS in AD and seek to provide a reliable reference for subsequent experimental studies on DBS treatment of AD.
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Affiliation(s)
- Zhikun Liu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kai Shu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yumei Geng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Chang Cai
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan, Hubei Province, China
| | - Huicong Kang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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13
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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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Smetana RM, Batchala PP, Lee BG, Albataineh T, Broshek DK, Fountain NB, Abbas S, Quigg M. Multifocal hypometabolic correlates to deficits of verbal memory in mesial temporal lobe epilepsy. Epilepsy Behav 2023; 143:109244. [PMID: 37192585 DOI: 10.1016/j.yebeh.2023.109244] [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: 02/17/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Neuropsychological research on mesial temporal lobe epilepsy (MTLE) often highlights material-specific memory deficits, but a lesion-focused model may not accurately reflect the underlying networks that support episodic memory in these patients. Our study evaluated the pathophysiology behind verbal learning/memory deficits as revealed by hypometabolism quantified through 18-fluorodeoxyglucose positron emission tomography (FDG-PET). METHODS This retrospective study included thirty presurgical patients with intractable unilateral MTLE who underwent interictal FDG-PET and verbal memory assessment (12 females, mean age: 38.73 years). Fluorodeoxyglucose-positron emission tomography mapping was performed with voxel-based mapping of glucose utilization to a database of age-matched controls to derive regional Z-scores. Neuropsychological outcome variables included scores on learning and recall trials of two distinct verbal memory measures validated for use in epilepsy research. Pearson's correlations evaluated relationships between clinical variables and verbal memory. Linear regression was used to relate regional hypometabolism and verbal memory assessment. Post hoc analyses assessed areas of FDG-PET hypometabolism (threshold Z ≤ -1.645 below mean) where verbal memory was impaired. RESULTS Verbal memory deficits correlated with hypometabolism in limbic structures ipsilateral to language dominance but also correlated with hypometabolism in networks involving the ipsilateral perisylvian cortex and contralateral limbic and nonlimbic structures. DISCUSSION We conclude that traditional models of verbal memory may not adequately capture cognitive deficits in a broader sample of patients with MTLE. This study has important implications for epilepsy surgery protocols that use neuropsychological data and FDG-PET to draw conclusions about surgical risks.
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Affiliation(s)
- Racheal M Smetana
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Bern G Lee
- Department of Neuropsychology, Ochsner Health, Baton Rouge, LA, USA.
| | - Tamer Albataineh
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Donna K Broshek
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Nathan B Fountain
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
| | - Salma Abbas
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
| | - Mark Quigg
- Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, VA, USA.
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Olivé G, Peñaloza C, Vaquero L, Laine M, Martin N, Rodriguez-Fornells A. The right uncinate fasciculus supports verbal short-term memory in aphasia. Brain Struct Funct 2023; 228:875-893. [PMID: 37005932 PMCID: PMC10147778 DOI: 10.1007/s00429-023-02628-9] [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: 09/13/2022] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
Verbal short-term memory (STM) deficits are associated with language processing impairments in people with aphasia. Importantly, the integrity of STM can predict word learning ability and anomia therapy gains in aphasia. While the recruitment of perilesional and contralesional homologous brain regions has been proposed as a possible mechanism for aphasia recovery, little is known about the white-matter pathways that support verbal STM in post-stroke aphasia. Here, we investigated the relationships between the language-related white matter tracts and verbal STM ability in aphasia. Nineteen participants with post-stroke chronic aphasia completed a subset of verbal STM subtests of the TALSA battery including nonword repetition (phonological STM), pointing span (lexical-semantic STM without language output) and repetition span tasks (lexical-semantic STM with language output). Using a manual deterministic tractography approach, we investigated the micro- and macrostructural properties of the structural language network. Next, we assessed the relationships between individually extracted tract values and verbal STM scores. We found significant correlations between volume measures of the right Uncinate Fasciculus and all three verbal STM scores, with the association between the right UF volume and nonword repetition being the strongest one. These findings suggest that the integrity of the right UF is associated with phonological and lexical-semantic verbal STM ability in aphasia and highlight the potential compensatory role of right-sided ventral white matter language tracts in supporting verbal STM after aphasia-inducing left hemisphere insult.
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Affiliation(s)
- Guillem Olivé
- 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.
| | - Claudia Peñaloza
- 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
| | - Lucía Vaquero
- Legal Medicine, Psychiatry and Pathology Department, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Nadine Martin
- Department of Communication Sciences and Disorders, Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA
| | - Antoni Rodriguez-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.
- Institució Catalana de Recerca i Estudis Avançats, ICREA, 08010, Barcelona, Spain.
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16
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Ferrario R, Giovagnoli AR. Processing speed in temporal lobe epilepsy. A scoping review. Epilepsy Behav 2023; 142:109169. [PMID: 36963317 DOI: 10.1016/j.yebeh.2023.109169] [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: 12/23/2022] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Impaired processing speed (PS) can affect patients with temporal lobe epilepsy (TLE). However, it is usually considered a nonspecific clinical feature and is not measured, but this raises lexical and methodological problems. This review aims to evaluate the existing terminology and assessment methods of PS in patients with TLE. METHODS A scoping review was conducted based on the extended guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The electronic literature search was conducted on Medline-PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Google Scholar, using the keywords "temporal lobe epilepsy" and "speed" or "slowing" plus "processing," "cognitive," "psychomotor," or "mental." Peer-reviewed articles published before December 2022 were analyzed if they were in English, including patients older than 14 years and at least one neuropsychological measure, reported original research focused on PS and had the selected keywords in the title, keywords, and abstract. RESULTS Seven articles published between December 2004 and September 2021 were selected. The terms "processing speed," "psychomotor speed," and "information processing speed," based on similar theoretical constructs, were the most frequently used. Assessment methods included non-computerized or paper-and-pencil tests (WAIS-III Digit Symbol and Symbol Search subtests, Purdue Pegboard and Grooved Pegboard Tests, Trail Making Test and Stroop Color-Word Test) and computerized tests (Sternberg Memory Scanning Test, Pattern Comparison Processing Speed, Computerized Visual Searching). In some studies, impairment was associated with white and gray matter damage in the brain, independent of clinical and treatment variables. CONCLUSION Clinical research on TLE has focused inconsistently on PS. Different evaluation terms and methods have been used while referring to similar theoretical constructs. These findings highlight a gap between the clinical importance of PS and its assessment. Studies are needed to share terms and tools among clinical centers and clarify the position of PS in the TLE phenotype.
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Affiliation(s)
- Rosalba Ferrario
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy
| | - Anna Rita Giovagnoli
- Department of Diagnostics and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy.
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17
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Quartarone C, Navarrete E, Budisavljević S, Peressotti F. Exploring the ventral white matter language network in bimodal and unimodal bilinguals. BRAIN AND LANGUAGE 2022; 235:105187. [PMID: 36244164 DOI: 10.1016/j.bandl.2022.105187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
We used diffusion magnetic resonance imaging tractography to investigate the effect of language modality on the anatomy of the ventral white matter language network by comparing unimodal (Italian/English) and bimodal bilinguals (Italian/Italian Sign Language). We extracted the diffusion tractography measures of the Inferior Longitudinal fasciculus (ILF), Uncinate fasciculus (UF) and Inferior Fronto-Occipital fasciculus (IFOF) and we correlated them with the degree of bilingualism and the individual performance in fluency tasks. For both groups of bilinguals, the microstructural properties of the right ILF were correlated with individual level of proficiency in L2, confirming the involvement of this tract in bilingualism. In addition, we found that the degree of left lateralization of the ILF predicted the performance in semantic fluency in L1. The microstructural properties of the right UF correlated with performance in phonological fluency in L1, only for bimodal bilinguals. Overall, the pattern shows both similarities and differences between the two groups of bilinguals.
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Affiliation(s)
- Cinzia Quartarone
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy
| | - Eduardo Navarrete
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy
| | - Sanja Budisavljević
- School of Medicine, St. Andrews University, College Gate, St Andrews KY16, 9AJ, UK
| | - Francesca Peressotti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione - University of Padua, Via Venezia, 8, 35137 Padova, Italy.
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18
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Gao Y, Tong X, Hu J, Huang H, Guo T, Wang G, Li Y, Wang G. Decreased resting-state neural signal in the left angular gyrus as a potential neuroimaging biomarker of schizophrenia: An amplitude of low-frequency fluctuation and support vector machine analysis. Front Psychiatry 2022; 13:949512. [PMID: 36090354 PMCID: PMC9452648 DOI: 10.3389/fpsyt.2022.949512] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Schizophrenia (SCH) is primarily diagnosed based on specific clinical symptoms, with the lack of any objective SCH-related biomarkers often resulting in patient misdiagnosis and the underdiagnosis of this condition. This study was developed to assess the utility of amplitude of low-frequency fluctuation (ALFF) values analyzed via support vector machine (SVM) methods as a means of diagnosing SCH. Methods In total, 131 SCH patients and 128 age- and gender-matched healthy control (HC) individuals underwent resting-state functional magnetic resonance imaging (rs-fMRI), with the resultant data then being analyzed using ALFF values and SVM methods. Results Relative to HC individuals, patients with SCH exhibited ALFF reductions in the left angular gyrus (AG), fusiform gyrus, anterior cingulate cortex (ACC), right cerebellum, bilateral middle temporal gyrus (MTG), and precuneus (PCu) regions. No SCH patient brain regions exhibited significant increases in ALFF relative to HC individuals. SVM results indicated that reductions in ALFF values in the bilateral PCu can be used to effectively differentiate between SCH patients and HCs with respective accuracy, sensitivity, and specificity values of 73.36, 91.60, and 54.69%. Conclusion These data indicate that SCH patients may exhibit characteristic reductions in regional brain activity, with decreased ALFF values of the bilateral PCu potentially offering value as a candidate biomarker capable of distinguishing between SCH patients and HCs.
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Affiliation(s)
- Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Tong
- School of Mental Health and Psychological Science, Anhui Medical University, Heifei, China
- Wuhan Mental Health Center, Wuhan, China
| | - Jianxiu Hu
- Wuhan Mental Health Center, Wuhan, China
| | | | - Tian Guo
- Wuhan Mental Health Center, Wuhan, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, China
| | - Yi Li
- Wuhan Mental Health Center, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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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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20
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Binding LP, Dasgupta D, Giampiccolo D, Duncan JS, Vos SB. Structure and function of language networks in temporal lobe epilepsy. Epilepsia 2022; 63:1025-1040. [PMID: 35184291 PMCID: PMC9773900 DOI: 10.1111/epi.17204] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
Individuals with temporal lobe epilepsy (TLE) may have significant language deficits. Language capabilities may further decline following temporal lobe resections. The language network, comprising dispersed gray matter regions interconnected with white matter fibers, may be atypical in individuals with TLE. This review explores the structural changes to the language network and the functional reorganization of language abilities in TLE. We discuss the importance of detailed reporting of patient's characteristics, such as, left- and right-sided focal epilepsies as well as lesional and nonlesional pathological subtypes. These factors can affect the healthy functioning of gray and/or white matter. Dysfunction of white matter and displacement of gray matter function could concurrently impact their ability, in turn, producing an interactive effect on typical language organization and function. Surgical intervention can result in impairment of function if the resection includes parts of this structure-function network that are critical to language. In addition, impairment may occur if language function has been reorganized and is included in a resection. Conversely, resection of an epileptogenic zone may be associated with recovery of cortical function and thus improvement in language function. We explore the abnormality of functional regions in a clinically applicable framework and highlight the differences in the underlying language network. Avoidance of language decline following surgical intervention may depend on tailored resections to avoid critical areas of gray matter and their white matter connections. Further work is required to elucidate the plasticity of the language network in TLE and to identify sub-types of language representation, both of which will be useful in planning surgery to spare language function.
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Affiliation(s)
- Lawrence P. Binding
- Department of Computer ScienceCentre for Medical Image ComputingUniversity College LondonLondonUK
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Debayan Dasgupta
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Victor Horsley Department of NeurosurgeryNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Davide Giampiccolo
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Victor Horsley Department of NeurosurgeryNational Hospital for Neurology and NeurosurgeryLondonUK
- Institute of NeuroscienceCleveland Clinic LondonLondonUK
- Department of NeurosurgeryVerona University HospitalUniversity of VeronaVeronaItaly
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Sjoerd B. Vos
- Department of Computer ScienceCentre for Medical Image ComputingUniversity College LondonLondonUK
- Neuroradiological Academic UnitUCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Centre for Microscopy, Characterisation, and AnalysisThe University of Western AustraliaNedlandsWestern AustraliaAustralia
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21
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Lozano-García A, Hampel KG, Gutiérrez A, Villanueva V, Cano-López I, González-Bono E. Clinical utility of Epitrack for differentiating profiles and patterns of post-surgical change in memory and quality of life in patients with drug-resistant epilepsy. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-12. [PMID: 35148237 DOI: 10.1080/23279095.2022.2036990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE To assess whether performance in attention and executive functions evaluated with the Epitrack screening tool before surgery can differentiate memory and quality of life (QOL) profiles, and detect different post-surgical change patterns in these variables in patients with epilepsy. METHODS This is a longitudinal study. Seventy-seven patients with drug-resistant epilepsy (mean age = 37.91) underwent a neuropsychological assessment before and one year after surgery. Epitrack, a screening tool that exclusively evaluates attention and executive functioning, was administered in the pre-surgical assessment, and verbal and visual memory and QOL were assessed before and after surgery. RESULTS Patients with impaired Epitrack performance had poorer verbal and visual memory than those with intact Epitrack performance, regardless of the time point (for all, p < 0.0001). They also showed a post-surgical decline in immediate verbal recall (p = 0.04) and discriminability (p = 0.001). Patients with intact Epitrack performance did not exhibit this decline. Epitrack total score significantly contributed to 13 and 11% of the variance of post-surgical changes in immediate verbal recall and discriminability, respectively. Epitrack groups did not differ in QOL profiles or changes, but post-surgical immediate verbal recall improvements were related to post-surgical QOL improvements. CONCLUSION Our findings underline the utility of Epitrack screening tool to detect different patterns of verbal and visual memory dysfunction, as well as to predict post-surgical verbal memory decline in patients with drug-resistant epilepsy. Patients with lower pre-surgical Epitrack scores appear to be at increased risk for post-surgical memory decline.
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Affiliation(s)
- Alejandro Lozano-García
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
| | - Kevin G Hampel
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Gutiérrez
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Valencia, Spain
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22
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Kaestner E, Stasenko A, Ben-Haim S, Shih J, Paul BM, McDonald CR. The importance of basal-temporal white matter to pre- and post-surgical naming ability in temporal lobe epilepsy. Neuroimage Clin 2022; 34:102963. [PMID: 35220106 PMCID: PMC8888987 DOI: 10.1016/j.nicl.2022.102963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Emerging research highlights the importance of basal-temporal cortex, centered on the fusiform gyrus, to both pre-surgical naming ability and post-surgical naming outcomes in temporal lobe epilepsy (TLE). In this study, we investigate whether integrity of the white matter network that interconnects this basal region to the distributed language network affects naming ability and risk for post-surgical naming decline. METHODS Patients with drug-resistant TLE were recruited from two epilepsy centers in a prospective longitudinal study. The pre-surgical dataset included 50 healthy controls, 47 left TLE (L-TLE), and 41 right TLE (R-TLE) patients. All participants completed pre-surgical T1- and diffusion-weighted MRI (dMRI), as well as neuropsychological tests of auditory and visual naming. Nineteen L-TLE and 18 R-TLE patients underwent anterior temporal lobectomy (ATL) and also completed post-surgical neuropsychological testing. Pre-surgical fractional anisotropy (FA) of the white matter directly beneath the fusiform neocortex (i.e., superficial white matter; SWM) and of deep white matter tracts with connections to the basal-temporal cortex [inferior longitudinal fasciculus (ILF) and inferior frontal occipital fasciculus (IFOF)] was calculated. Clinical variables, hippocampal volume, and FA of each white matter tract or region were examined in linear regressions with naming scores, or change in naming scores, as the primary outcomes. RESULTS Pre-surgically, higher FA in the bilateral ILF, bilateral IFOF, and left fusiform SWM was associated with better visual and auditory naming scores (all ps < 0.05 with FDR correction). In L-TLE, higher pre-surgical FA was also associated with less naming decline post-surgically, but results varied across tracts. When including only patients with typical language dominance, only integrity of the right fusiform SWM was associated with less visual naming decline (p = .0018). DISCUSSION Although a broad network of white matter network matter may contribute to naming ability pre-surgically, the reserve capacity of the contralateral (right) fusiform SWM may be important for mitigating visual naming decline following ATL in L-TLE. This shows that the study of the structural network interconnecting the basal-temporal region to the wider language network has implications for understanding both pre- and post-surgical naming in TLE.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Alena Stasenko
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharona Ben-Haim
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Jerry Shih
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California -San Francisco, San Francisco, CA, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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23
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Resection of dominant fusiform gyrus is associated with decline of naming function when temporal lobe epilepsy manifests after the age of five: A voxel-based lesion-symptom mapping study. NEUROIMAGE: CLINICAL 2022; 35:103129. [PMID: 36002957 PMCID: PMC9421498 DOI: 10.1016/j.nicl.2022.103129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/08/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Resection in the dominant fusiform gyrus is associated with an increased risk of postoperative decline in picture naming. More temporo-posterior resections in this area results in a greater degree of naming decline. Risk of significant naming decline after left temporal surgery increased by 5% with every year of later seizure onset.
Objective To determine patients’ characteristics and regions in the temporal lobe where resections lead to a decline in picture naming. Methods 311 patients with left hemispheric dominance for language were included who underwent epilepsy surgery at the Epilepsy Center of Erlangen and whose picture naming scores (Boston Naming Test, BNT) were available preoperatively and 6-months postoperatively. Surgical lesions were mapped to an averaged template based on preoperative and postoperative MRI using voxel-based lesion-symptom mapping (VBLSM). Postoperative brain shifts were corrected. The relationship between lesioned brain areas and the presence of a postoperative naming decline was examined voxel-wise while controlling for effects of overall lesion size at first in the total cohort and then restricted to temporal lobe resections. Results In VBLSM in the total sample, a decline in BNT score was significantly related to left temporal surgery. When only considering patients with left temporal lobe resections (n = 121), 40 (33.1%) significantly worsened in BNT postoperatively. VBLSM including all patients with left temporal resections generated no significant results within the temporal lobe. However, naming decline of patients with epilepsy onset after 5 years of age was significantly associated with resections in the left inferior temporal (extent of BNT decline range: 10.8− 14.4%) and fusiform gyrus (decline range: 12.1−18.4%). Significance Resections in the posterior part of the dominant fusiform and inferior temporal gyrus was associated with a risk of deterioration in naming performance at six months after surgery in patients with epilepsy onset after 5 years of age but not with earlier epilepsy onset.
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24
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Gleichgerrcht E, Keller SS, Bryant L, Moss H, Kellermann TS, Biswas S, Marson AG, Wilmskoetter J, Jensen JH, Bonilha L. High b-value diffusion tractography: Abnormal axonal network organization associated with medication-refractory epilepsy. Neuroimage 2021; 248:118866. [PMID: 34974117 PMCID: PMC8872809 DOI: 10.1016/j.neuroimage.2021.118866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 11/17/2021] [Accepted: 12/28/2021] [Indexed: 01/22/2023] Open
Abstract
Diffusion magnetic resonance imaging (dMRI) tractography has played a critical role in characterizing patterns of aberrant brain network reorganization among patients with epilepsy. However, the accuracy of dMRI tractography is hampered by the complex biophysical properties of white matter tissue. High b-value diffusion imaging overcomes this limitation by better isolating axonal pathways. In this study, we introduce tractography derived from fiber ball imaging (FBI), a high b-value approach which excludes non-axonal signals, to identify atypical neuronal networks in patients with epilepsy. Specifically, we compared network properties obtained from multiple diffusion tractography approaches (diffusion tensor imaging, diffusion kurtosis imaging, FBI) in order to assess the pathophysiological relevance of network rearrangement in medication-responsive vs. medication-refractory adults with focal epilepsy. We show that drug-resistant epilepsy is associated with increased global network segregation detected by FBI-based tractography. We propose exploring FBI as a clinically feasible alternative to quantify topological changes that could be used to track disease progression and inform on clinical outcomes.
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Affiliation(s)
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Lorna Bryant
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Hunter Moss
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Tanja S Kellermann
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | | | - Anthony G Marson
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Janina Wilmskoetter
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Jens H Jensen
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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25
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Trimmel K, Vos SB, Caciagli L, Xiao F, van Graan LA, Winston GP, Koepp MJ, Thompson PJ, Duncan JS. Decoupling of functional and structural language networks in temporal lobe epilepsy. Epilepsia 2021; 62:2941-2954. [PMID: 34642939 PMCID: PMC8776336 DOI: 10.1111/epi.17098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 12/01/2022]
Abstract
Objective To identify functional and structural alterations in language networks of people with temporal lobe epilepsy (TLE), who frequently present with naming and word‐finding difficulties. Methods Fifty‐five patients with unilateral TLE (29 left) and 16 controls were studied with auditory and picture naming functional magnetic resonance imaging (fMRI) tasks. Activation maxima in the left posterobasal temporal lobe were used as seed regions for whole‐brain functional connectivity analyses (psychophysiological interaction). White matter language pathways were investigated using diffusion tensor imaging and neurite orientation dispersion and density imaging metrics extracted along fiber bundles starting from fMRI‐guided seeds. Regression analyses were performed to investigate the correlation of functional connectivity with diffusion MRI metrics. Results In the whole group of patients and controls, weaker functional connectivity from the left posterobasal temporal lobe (1) to the bilateral anterior temporal lobe, precentral gyrus, and lingual gyrus during auditory naming and (2) to the bilateral occipital cortex and right fusiform gyrus during picture naming was associated with decreased neurite orientation dispersion and higher free water fraction of white matter tracts. Compared to controls, TLE patients exhibited fewer structural connections and an impaired coupling of functional and structural metrics. Significance TLE is associated with an impairment and decoupling of functional and structural language networks. White matter damage, as evidenced by diffusion abnormalities, may contribute to impaired functional connectivity and language dysfunction in TLE.
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Affiliation(s)
- Karin Trimmel
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sjoerd B Vos
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.,Centre for Medical Image Computing, University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Lorenzo Caciagli
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
| | - Fenglai Xiao
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.,Department of Neurology, West China of Sichuan University, Chengdu, China
| | | | - Gavin P Winston
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK.,Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada
| | - Matthias J Koepp
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
| | - Pamela J Thompson
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
| | - John S Duncan
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, UK
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26
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The Impact of Right Temporal Lobe Epilepsy On Nonverbal Memory: Meta-regression of Stimulus- and Task-related Moderators. Neuropsychol Rev 2021; 32:537-557. [PMID: 34559363 DOI: 10.1007/s11065-021-09514-3] [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: 06/01/2020] [Accepted: 05/24/2021] [Indexed: 11/08/2022]
Abstract
Nonverbal memory tests have great potential value for detecting the impact of lateralized pathology and predicting the risk of memory loss following right temporal lobe resection (TLR) for temporal lobe epilepsy (TLE) patients, but this potential has not been realized. Previous reviews suggest that stimulus type moderates the capacity of nonverbal memory tests to detect right-lateralized pathology (i.e., faces > designs), but the roles of other task-related factors have not been systematically explored. We address these limitations using mixed model meta-regression (k = 158) of right-lateralization effects (right worse than left TLE) testing the moderating effects of: 1) stimulus type (designs, faces, spatial), 2) learning format (single trial, repeated trials), 3) testing delay (immediate or long delay), and 4) testing format (recall, recognition) for three patient scenarios: 1) presurgical, 2) postsurgical, and 3) postsurgical change. Stimulus type significantly moderated the size of the right-lateralization effect (faces > designs) for postsurgical patients, test format moderated the size of the right-lateralization effect for presurgical-postsurgical change (recognition > recall) but learning format and test delay had no right-lateralization effect for either sample. For presurgical patients, none of the task-related factors significantly increased right-lateralization effects. This comprehensive review reveals the value of recognition testing in gauging the risk of nonverbal memory decline.
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27
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Medhi G, Kapadia A, Parida S, C D, Bagepalli BS, M N, Kumar K, Gupta AK, Saini J. Long-term sequelae of herpes simplex virus encephalitis-related white matter injury: correlation of neuropsychological outcome and diffusion tensor imaging. J Neurovirol 2021; 27:601-608. [PMID: 34398444 DOI: 10.1007/s13365-021-01000-z] [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: 02/16/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022]
Abstract
The pathophysiology of the memory impairment following Herpes Simplex virus encephalitis is not yet established and understood. This study attempts to elucidate the role of white matter injury and its impact on neuropsychological outcome in patients with history of Herpes Simplex virus encephalitis. This is a single-institution prospective study assessing 9 patients and 15 matched controls utilizing a combination of MRI with diffusion tensor imaging and neuropsychological testing. Tract-based spatial statistics analysis was performed and correlated with neuropsychological outcomes. Significantly decreased fractional anisotropy (FA) values were noted in corpus callosum, corona radiata, left posterior thalamic radiation, cingulum, superior longitudinal fasciculus, fornix, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, and uncinated fasciculus. Impaired facial recognition significantly correlated with reduction in FA of right uncinate fasciculus, right inferior longitudinal fasciculus, and splenium genu of corpus callosum. FA value of left cingulum significantly correlated with logical memory, auditory verbal learning. FA value of fornix correlated with visual recognition; FA value of left uncinate fasciculus with auditory verbal learning and delayed recall. In conclusion, this study demonstrates microstructural abnormalities involving several white matter tracts corresponding to neuropsychological deficits.
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Affiliation(s)
- Gorky Medhi
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India.,Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Anish Kapadia
- Department of Medical Imaging, University of Toronto, Toronto, Canada.
| | - Subhendu Parida
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dhanya C
- Department of Neuropsychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - B S Bagepalli
- ICMR National Institute of Epidemiology, Chennai, India
| | - Netravathi M
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Keshav Kumar
- Department of Neuropsychology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arun Kumar Gupta
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
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28
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Gleichgerrcht E, Munsell BC, Alhusaini S, Alvim MKM, Bargalló N, Bender B, Bernasconi A, Bernasconi N, Bernhardt B, Blackmon K, Caligiuri ME, Cendes F, Concha L, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Gambardella A, Gong B, Guerrini R, Hatton SN, Kälviäinen R, Keller SS, Kochunov P, Kotikalapudi R, Kreilkamp BAK, Labate A, Langner S, Larivière S, Lenge M, Lui E, Martin P, Mascalchi M, Meletti S, O'Brien TJ, Pardoe HR, Pariente JC, Xian Rao J, Richardson MP, Rodríguez-Cruces R, Rüber T, Sinclair B, Soltanian-Zadeh H, Stein DJ, Striano P, Taylor PN, Thomas RH, Elisabetta Vaudano A, Vivash L, von Podewills F, Vos SB, Weber B, Yao Y, Lin Yasuda C, Zhang J, Thompson PM, Sisodiya SM, McDonald CR, Bonilha L. Artificial intelligence for classification of temporal lobe epilepsy with ROI-level MRI data: A worldwide ENIGMA-Epilepsy study. Neuroimage Clin 2021; 31:102765. [PMID: 34339947 PMCID: PMC8346685 DOI: 10.1016/j.nicl.2021.102765] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 01/22/2023]
Abstract
Artificial intelligence has recently gained popularity across different medical fields to aid in the detection of diseases based on pathology samples or medical imaging findings. Brain magnetic resonance imaging (MRI) is a key assessment tool for patients with temporal lobe epilepsy (TLE). The role of machine learning and artificial intelligence to increase detection of brain abnormalities in TLE remains inconclusive. We used support vector machine (SV) and deep learning (DL) models based on region of interest (ROI-based) structural (n = 336) and diffusion (n = 863) brain MRI data from patients with TLE with ("lesional") and without ("non-lesional") radiographic features suggestive of underlying hippocampal sclerosis from the multinational (multi-center) ENIGMA-Epilepsy consortium. Our data showed that models to identify TLE performed better or similar (68-75%) compared to models to lateralize the side of TLE (56-73%, except structural-based) based on diffusion data with the opposite pattern seen for structural data (67-75% to diagnose vs. 83% to lateralize). In other aspects, structural and diffusion-based models showed similar classification accuracies. Our classification models for patients with hippocampal sclerosis were more accurate (68-76%) than models that stratified non-lesional patients (53-62%). Overall, SV and DL models performed similarly with several instances in which SV mildly outperformed DL. We discuss the relative performance of these models with ROI-level data and the implications for future applications of machine learning and artificial intelligence in epilepsy care.
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Affiliation(s)
| | - Brent C Munsell
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA; Department of Computer Science, University of North Carolina at Chapel Hill, NC, USA
| | - Saud Alhusaini
- Neurology Department, Yale University School of Medicine, New Haven, CT, USA; Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marina K M Alvim
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, 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
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Boris Bernhardt
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Karen Blackmon
- Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Fernando Cendes
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Orrin Devinsky
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Colin P Doherty
- Trinity College Dublin, School of Medicine, Dublin, Ireland; FutureNeuro SFI Research Centre for Rare and Chronic Neurological Diseases, Dublin, Ireland
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Niels K Focke
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Bo Gong
- Department of Radiology, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Renzo Guerrini
- Neuroscience Department, University of Florence, Florence, Italy
| | - Sean N Hatton
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - Reetta Kälviäinen
- Kuopio University Hospital, Member of EpiCARE ERN, Kuopio, Finland; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Peter Kochunov
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Raviteja Kotikalapudi
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany; Department of Clinical Neurophysiology, University Hospital Göttingen, Goettingen, Germany; Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Barbara A K Kreilkamp
- University Medicine Göttingen, Clinical Neurophysiology, Göttingen, Germany; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy; Institute of Neurology, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany; Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Sara Larivière
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy; Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Tübingen, Germany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medica Sciences, University of Florence, Florence, Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Terence J O'Brien
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Heath R Pardoe
- Department of Neurology, Langone School of Medicine, New York University, New York, NY, USA
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Jun Xian Rao
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Raúl Rodríguez-Cruces
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico; Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Theodor Rüber
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Ben Sinclair
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System, Detroit, MI, USA; School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Pasquale Striano
- IRCCS Istituto 'G. Gaslini', Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; School of Computing, Newcastle University, Newcastle Upon Tyne, UK
| | - Rhys H Thomas
- Institute of Translational and Clinical Research, Newcastle University, Newcastle Upon Tyne, UK
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, OCB Hospital, AOU Modena, Modena, Italy
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, VIC, Australia; The Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Felix von Podewills
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Yi Yao
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging Laboratory, University of Campinas - UNICAMP, Campinas, SP, Brazil
| | - Junsong Zhang
- Cognitive Science Department, School of Informatics, Xiamen University, Xiamen, China
| | - 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
| | - Sanjay M Sisodiya
- UCL Queen Square Institute of Neurology, London, UK; Chalfont Centre for Epilepsy, Bucks, UK
| | - Carrie R McDonald
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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29
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Banjac S, Roger E, Cousin E, Perrone-Bertolotti M, Haldin C, Pichat C, Lamalle L, Minotti L, Kahane P, Baciu M. Interactive mapping of language and memory with the GE2REC protocol. Brain Imaging Behav 2021; 15:1562-1579. [PMID: 32761343 PMCID: PMC8286228 DOI: 10.1007/s11682-020-00355-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Previous studies have highlighted the importance of considering cognitive functions from a dynamic and interactive perspective and multiple evidence was brought for a language and memory interaction. In this study performed with healthy participants, we present a new protocol entitled GE2REC that interactively accesses the neural representation of language-and-memory network. This protocol consists of three runs related to each other, providing a link between tasks, in order to assure an interactive measure of linguistic and episodic memory processes. GE2REC consists of a sentence generation (GE) in the auditory modality and two recollecting (2REC) memory tasks, one recognition performed in the visual modality, and another one recall performed in the auditory modality. Its efficiency was evaluated in 20 healthy volunteers using a 3T MR imager. Our results corroborate the ability of GE2REC to robustly activate fronto-temporo-parietal language network as well as temporal mesial, prefrontal and parietal cortices in encoding during sentence generation and recognition. GE2REC is useful because it: (a) requires simultaneous and interactive language-and-memory processes and jointly maps their neural basis; (b) explores encoding and retrieval, managing to elicit activation of mesial temporal structures; (c) is easy to perform, hence being suitable for more restrictive settings, and (d) has an ecological dimension of tasks and stimuli. GE2REC may be useful for studying neuroplasticity of cognitive functions, especially in patients with temporal lobe epilepsy who show reorganization of both language and memory networks. Overall, GE2REC can provide valuable information in terms of the practical foundation of exploration language and memory interconnection.
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Affiliation(s)
- Sonja Banjac
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France
| | - Elise Roger
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France.,Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, F-38000, Grenoble, France
| | | | - Célise Haldin
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France
| | - Cédric Pichat
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France
| | - Laurent Lamalle
- Univ. Grenoble Alpes, UMS IRMaGe CHU Grenoble, F-38000, Grenoble, France
| | - Lorella Minotti
- Univ. Grenoble Alpes, GIN, Synchronisation et modulation des Réseaux Neuronaux dans l'Epilepsie' and Neurology Department, F-38000, Grenoble, France
| | - Philippe Kahane
- Univ. Grenoble Alpes, GIN, Synchronisation et modulation des Réseaux Neuronaux dans l'Epilepsie' and Neurology Department, F-38000, Grenoble, France
| | - Monica Baciu
- Univ. Grenoble Alpes, CNRS LPNC UMR 5105, F-38000, Grenoble, France.
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30
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Liang X, Pang X, Zhao J, Yu L, Wu P, Li X, Wei W, Zheng J. Altered static and dynamic functional network connectivity in temporal lobe epilepsy with different disease duration and their relationships with attention. J Neurosci Res 2021; 99:2688-2705. [PMID: 34269468 DOI: 10.1002/jnr.24915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 11/09/2022]
Abstract
The brain network alterations associated with temporal lobe epilepsy (TLE) progression are still unclear. The purpose of this study was to investigate altered patterns of static and dynamic functional network connectivity (sFNC and dFNC) in TLE with different durations of disease. In this study, 19 TLE patients with a disease duration of ≤5 years (TLE-SD), 24 TLE patients with a disease duration of >5 years (TLE-LD), and 21 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging and attention network test. We used group independent component analysis to determine the target resting-state networks. Sliding window correlation and k-means clustering analysis methods were used to obtain different dFNC states, temporal properties, and temporal variability. We then compared sFNC and dFNC between groups and found that compared with HCs, TLE-SD patients had increased sFNC between the dorsal attention network and sensorimotor network/visual network (VN), but decreased sFNC between the inferior-posterior default mode network and VN. In the strongly connected dFNC state, TLE-SD patients spent more time, had greater mean dwell time, and showed greater inconsistent abnormal network connectivity. There was a significant negative correlation between the temporal variability of auditory network- left fronto-parietal network connectivity and orienting effect. No significant differences in sFNC and dFNC were detected between TLE-LD and HC groups. These findings suggest that the damage and functional brain network abnormalities gradually occur in TLE patients after the onset of epilepsy, which might lead to functional network reorganization and compensatory remodeling as the disease progresses.
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Affiliation(s)
- Xiulin Liang
- 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
| | - Jingyuan Zhao
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lu Yu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peirong Wu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinrong Li
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wutong Wei
- 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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31
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Buyanova IS, Arsalidou M. Cerebral White Matter Myelination and Relations to Age, Gender, and Cognition: A Selective Review. Front Hum Neurosci 2021; 15:662031. [PMID: 34295229 PMCID: PMC8290169 DOI: 10.3389/fnhum.2021.662031] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022] Open
Abstract
White matter makes up about fifty percent of the human brain. Maturation of white matter accompanies biological development and undergoes the most dramatic changes during childhood and adolescence. Despite the advances in neuroimaging techniques, controversy concerning spatial, and temporal patterns of myelination, as well as the degree to which the microstructural characteristics of white matter can vary in a healthy brain as a function of age, gender and cognitive abilities still exists. In a selective review we describe methods of assessing myelination and evaluate effects of age and gender in nine major fiber tracts, highlighting their role in higher-order cognitive functions. Our findings suggests that myelination indices vary by age, fiber tract, and hemisphere. Effects of gender were also identified, although some attribute differences to methodological factors or social and learning opportunities. Findings point to further directions of research that will improve our understanding of the complex myelination-behavior relation across development that may have implications for educational and clinical practice.
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Affiliation(s)
- Irina S. Buyanova
- Neuropsy Lab, HSE University, Moscow, Russia
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Marie Arsalidou
- Neuropsy Lab, HSE University, Moscow, Russia
- Cognitive Centre, Sirius University of Science and Technology, Sochi, Russia
- Department of Psychology, York University, Toronto, ON, Canada
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32
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Liakos F, Komaitis S, Drosos E, Neromyliotis E, Skandalakis GP, Gerogiannis AI, Kalyvas AV, Troupis T, Stranjalis G, Koutsarnakis C. The Topography of the Frontal Terminations of the Uncinate Fasciculus Revisited Through Focused Fiber Dissections: Shedding Light on a Current Controversy and Introducing the Insular Apex as a Key Anatomoclinical Area. World Neurosurg 2021; 152:e625-e634. [PMID: 34144169 DOI: 10.1016/j.wneu.2021.06.012] [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: 05/02/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recent studies advocate a connectivity pattern wider than previously believed of the uncinate fasciculus that extends to the ventrolateral and dorsolateral prefrontal cortices. These new percepts on the connectivity of the tract suggest a more expansive role for the uncinate fasciculus. Our aim was to shed light on this controversy through fiber dissections. METHODS Twenty normal adult human formalin-fixed cerebral hemispheres were used. Focused dissections on the insular, orbitofrontal, ventromedial, ventrolateral, and dorsolateral prefrontal areas were performed to record the topography of the frontal terminations of the uncinate fasciculus. RESULTS Three discrete fiber layers were consistently disclosed: the first layer was recorded to terminate at the posterior orbital gyrus and pars orbitalis, the second layer at the posterior two thirds of the gyrus rectus, and the last layer at the posterior one third of the paraolfactory gyrus. The insular apex was documented as a crucial landmark regarding the topographic differentiation of the uncinate and occipitofrontal fasciculi (i.e., fibers that travel ventrally belong to the uncinate fasciculus whereas those traveling dorsally are occipitofrontal fibers). CONCLUSIONS The frontal terminations of the uncinate fasciculus were consistently documented to project to the posterior orbitofrontal area. The area of the insular apex is introduced for the first time as a crucial surface landmark to effectively distinguish the stems of the uncinate and occipitofrontal fasciculi. This finding could refine the spatial resolution of awake subcortical mapping, especially for insular lesions, and improve the accuracy of in vivo diffusion tensor imaging protocols.
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Affiliation(s)
- Faidon Liakos
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Komaitis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Drosos
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Neromyliotis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece
| | | | | | - Aristotelis V Kalyvas
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Troupis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Stranjalis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece
| | - Christos Koutsarnakis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Edinburgh Microneurosurgery Education Laboratory, Department of Clinical Neurosciences, Edinburgh, United Kingdom; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece.
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33
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Bryant L, McKinnon ET, Taylor JA, Jensen JH, Bonilha L, de Bezenac C, Kreilkamp BAK, Adan G, Wieshmann UC, Biswas S, Marson AG, Keller SS. Fiber ball white matter modeling in focal epilepsy. Hum Brain Mapp 2021; 42:2490-2507. [PMID: 33605514 PMCID: PMC8090772 DOI: 10.1002/hbm.25382] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022] Open
Abstract
Multicompartment diffusion magnetic resonance imaging (MRI) approaches are increasingly being applied to estimate intra‐axonal and extra‐axonal diffusion characteristics in the human brain. Fiber ball imaging (FBI) and its extension fiber ball white matter modeling (FBWM) are such recently described multicompartment approaches. However, these particular approaches have yet to be applied in clinical cohorts. The modeling of several diffusion parameters with interpretable biological meaning may offer the development of new, noninvasive biomarkers of pharmacoresistance in epilepsy. In the present study, we used FBI and FBWM to evaluate intra‐axonal and extra‐axonal diffusion properties of white matter tracts in patients with longstanding focal epilepsy. FBI/FBWM diffusion parameters were calculated along the length of 50 white matter tract bundles and statistically compared between patients with refractory epilepsy, nonrefractory epilepsy and controls. We report that patients with chronic epilepsy had a widespread distribution of extra‐axonal diffusivity relative to controls, particularly in circumscribed regions along white matter tracts projecting to cerebral cortex from thalamic, striatal, brainstem, and peduncular regions. Patients with refractory epilepsy had significantly greater markers of extra‐axonal diffusivity compared to those with nonrefractory epilepsy. The extra‐axonal diffusivity alterations in patients with epilepsy observed in the present study could be markers of neuroinflammatory processes or a reflection of reduced axonal density, both of which have been histologically demonstrated in focal epilepsy. FBI is a clinically feasible MRI approach that provides the basis for more interpretive conclusions about the microstructural environment of the brain and may represent a unique biomarker of pharmacoresistance in epilepsy.
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Affiliation(s)
- Lorna Bryant
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Emilie T McKinnon
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James A Taylor
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jens H Jensen
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina, USA.,Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christophe de Bezenac
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK
| | - Barbara A K Kreilkamp
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.,Department of Clinical Neurophysiology, University Medicine Göttingen, Göttingen, Germany
| | - Guleed Adan
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | | | - Anthony G Marson
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, UK.,The Walton Centre NHS Foundation Trust, Liverpool, UK
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34
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Abstract
Epilepsy is characterized by specific alterations in network organization. The main parameters at the basis of epileptogenic network formation are alterations of cortical thickness, development of pathologic hubs, modification of hub distribution, and white matter alterations. The effect is a reinforcement of brain connectivity in both the epileptogenic zone and the propagation zone. Moreover, the epileptogenic network is characterized by some specific neurophysiologic biomarkers that evidence the tendency of the network itself to shift from an interictal state to an ictal one. The recognition of these features is crucial in planning epilepsy surgery.
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35
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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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36
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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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37
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Jber M, Habibabadi JM, Sharifpour R, Marzbani H, Hassanpour M, Seyfi M, Mobarakeh NM, Keihani A, Hashemi-Fesharaki SS, Ay M, Nazem-Zadeh MR. Temporal and extratemporal atrophic manifestation of temporal lobe epilepsy using voxel-based morphometry and corticometry: clinical application in lateralization of epileptogenic zone. Neurol Sci 2021; 42:3305-3325. [PMID: 33389247 DOI: 10.1007/s10072-020-05003-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Advances in MRI acquisition and data processing have become important for revealing brain structural changes. Previous studies have reported widespread structural brain abnormalities and cortical thinning in patients with temporal lobe epilepsy (TLE), as the most common form of focal epilepsy. METHODS In this research, healthy control cases (n = 20) and patients with left TLE (n = 19) and right TLE (n = 14) were recruited, all underwent 3.0 T MRI with magnetization-prepared rapid gradient echo sequence to acquire T1-weighted images. Morphometric alterations in gray matter were identified using voxel-based morphometry (VBM). Volumetric alterations in subcortical structures and cortical thinning were also determined. RESULTS Patients with left TLE demonstrated more prevailing and widespread changes in subcortical volumes and cortical thickness than right TLE, mainly in the left hemisphere, compared to the healthy group. Both VBM analysis and subcortical volumetry detected significant hippocampal atrophy in ipsilateral compared to contralateral side in TLE group. In addition to hippocampus, subcortical volumetry found the thalamus and pallidum bilaterally vulnerable to the TLE. Furthermore, the TLE patients underwent cortical thinning beyond the temporal lobe, affecting gray matter cortices in frontal, parietal, and occipital lobes in the majority of patients, more prevalently for left TLE cases. Exploiting volume changes in individual patients in the hippocampus alone led to 63.6% sensitivity and 100% specificity for lateralization of TLE. CONCLUSION Alteration of gray matter volumes in subcortical regions and neocortical temporal structures and also cortical gray matter thickness were evidenced as common effects of epileptogenicity, as manifested by the majority of cases in this study.
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Affiliation(s)
- Majdi Jber
- Medical School, International Campus, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Roya Sharifpour
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Hengameh Marzbani
- Department of Biomedical Engineering, Amirkabir University of Technology (AUT), Tehran, Iran
| | - Masoud Hassanpour
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Seyfi
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mohammadi Mobarakeh
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmedreza Keihani
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammadreza Ay
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Nazem-Zadeh
- Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran.
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38
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Lee JC, Dick AS, Tomblin JB. Altered brain structures in the dorsal and ventral language pathways in individuals with and without developmental language disorder (DLD). Brain Imaging Behav 2020; 14:2569-2586. [PMID: 31933046 PMCID: PMC7354888 DOI: 10.1007/s11682-019-00209-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Developmental Language Disorder (DLD) is a neurodevelopmental disorder characterized by difficulty learning and using language, and this difficulty cannot be attributed to other developmental conditions. The aim of the current study was to examine structural differences in dorsal and ventral language pathways between adolescents and young adults with and without DLD (age range: 14-27 years) using anatomical magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Results showed age-related structural brain differences in both dorsal and ventral pathways in individuals with DLD. These findings provide evidence for neuroanatomical correlates of persistent language deficits in adolescents/young adults with DLD, and further suggest that this brain-language relationship in DLD is better characterized by taking account the dynamic course of the disorder along development.
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Affiliation(s)
- Joanna C Lee
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA.
| | | | - J Bruce Tomblin
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA
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39
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Tibbs MD, Huynh-Le MP, Karunamuni R, Reyes A, Macari AC, Tringale KR, Salans M, Yip A, Liu E, Simon A, McDonald CR, Hattangadi-Gluth JA. Microstructural Injury to Left-Sided Perisylvian White Matter Predicts Language Decline After Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 108:1218-1228. [PMID: 32712255 PMCID: PMC7680351 DOI: 10.1016/j.ijrobp.2020.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE Our purpose was to investigate the association between imaging biomarkers of radiation-induced white matter (WM) injury within perisylvian regions and longitudinal language decline in patients with brain tumors. METHODS AND MATERIALS Patients with primary brain tumors (n = 44) on a prospective trial underwent brain magnetic resonance imaging, diffusion-weighted imaging, and language assessments of naming (Boston Naming Test [BNT]) and fluency (Delis-Kaplan Executive Function System Category Fluency [DKEFS-CF]) at baseline and 3, 6, and 12 months after fractionated radiation therapy (RT). Reliable change indices of language function (0-6 months), accounting for practice effects (RCI-PE), evaluated decline. Bilateral perisylvian WM regions (superficial WM subadjacent to Broca's area and the superior temporal gyrus [STG], inferior longitudinal fasciculus [ILF], inferior fronto-occipital fasciculus [IFOF], and arcuate fasciculus) were autosegmented. We quantified volume and diffusion measures of WM microstructure: fractional anisotropy (FA; lower values indicate disruption) and mean diffusivity (MD; higher values indicate injury). Linear mixed-effects models assessed mean dose as predictor of imaging biomarker change and imaging biomarkers as longitudinal predictors of language scores. RESULTS DKEFS-CF scores declined at 6 months post-RT (RCI-PE, -0.483; P = .01), whereas BNT scores improved (RCI-PE, 0.262; P = .04). Higher mean dose to left and right regions was predictive of decreased volume (left-STG, P = .02; right-ILF and IFOF, P = .03), decreased FA (left-WM tracts, all P < .01; right-STG and IFOF, P < .02), and increased MD of left-WM tracts (all P < .03). Volume loss within left-Broca's area (P = .01), left-ILF (P = .01), left-IFOF (P = .01), and left-arcuate fasciculus (P = .04) was associated with lower BNT scores. Lower FA correlated with poorer DKEFS-CF and BNT scores within left-ILF (P = .02, not significant), left-IFOF (P = .02, .04), and left-arcuate fasciculus (P = .01, .01), respectively. Poorer DKEFS-CF scores correlated with increased MD values within the left-arcuate fasciculus (P = .03). Right-sided biomarkers did not correlate with language scores. CONCLUSIONS Patients with primary brain tumors experience language fluency decline post-RT. Poorer fluency and naming function may be explained by microstructural injury to left-sided perisylvian WM, representing potential dose-avoidance targets for language preservation.
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Affiliation(s)
- Michelle D Tibbs
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Minh-Phuong Huynh-Le
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California
| | - Anny Reyes
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | | | - Kathryn R Tringale
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, New York
| | - Mia Salans
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Anthony Yip
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Eulanca Liu
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Aaron Simon
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Jona A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California.
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40
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Larivière S, Bernasconi A, Bernasconi N, Bernhardt BC. Connectome biomarkers of drug-resistant epilepsy. Epilepsia 2020; 62:6-24. [PMID: 33236784 DOI: 10.1111/epi.16753] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
Drug-resistant epilepsy (DRE) considerably affects patient health, cognition, and well-being, and disproportionally contributes to the overall burden of epilepsy. The most common DRE syndromes are temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal epilepsy related to cortical malformations. Both syndromes have been traditionally considered as "focal," and most patients benefit from brain surgery for long-term seizure control. However, increasing evidence indicates that many DRE patients also present with widespread structural and functional network disruptions. These anomalies have been suggested to relate to cognitive impairment and prognosis, highlighting their importance for patient management. The advent of multimodal neuroimaging and formal methods to quantify complex systems has offered unprecedented ability to profile structural and functional brain networks in DRE patients. Here, we performed a systematic review on existing DRE network biomarker candidates and their contribution to three key application areas: (1) modeling of cognitive impairments, (2) localization of the surgical target, and (3) prediction of clinical and cognitive outcomes after surgery. Although network biomarkers hold promise for a range of clinical applications, translation of neuroimaging biomarkers to the patient's bedside has been challenged by a lack of clinical and prospective studies. We therefore close by highlighting conceptual and methodological strategies to improve the evaluation and accessibility of network biomarkers, and ultimately guide clinically actionable decisions.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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41
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White matter pathways underlying Chinese semantic and phonological fluency in mild cognitive impairment. Neuropsychologia 2020; 149:107671. [PMID: 33189733 DOI: 10.1016/j.neuropsychologia.2020.107671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging evidence has suggested that Chinese-language processing differs from that of its alphabetic-language counterparts. However, the underlying white matter pathway correlations between semantic and phonological fluency in Chinese-language processing remain unknown. Thus, we investigated the differences between two verbal fluency tests on 50 participants with amnestic mild cognitive impairment (aMCI) and 36 healthy controls (HC) with respect to five groups (ventral and dorsal stream fibers, frontal-striatal fibers, hippocampal-related fibers, and the corpus callosum) of white matter microstructural integrity. Diffusion spectrum imaging was used. The results revealed a progressive reduction in advantage in semantic fluency relative to phonological fluency from HC to single-domain aMCI to multidomain aMCI. Common and dissociative white matter correlations between tests of the two types of fluency were identified. Both types of fluency relied on the corpus callosum and ventral stream fibers, semantic fluency relied on the hippocampal-related fibers, and phonological fluency relied on the dorsal stream and frontal-striatal fibers. The involvement of bilateral tracts of interest as well as the association with the corpus callosum indicate the uniqueness of Chinese-language fluency processing. Dynamic associations were noted between white matter tract involvement and performance on the two fluency tests in four time blocks. Overall, our findings suggest the clinical utility of verbal fluency tests in geriatric populations, and they elucidate both task-specific and language-specific brain-behavior associations.
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42
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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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Gleichgerrcht E, Keller SS, Drane DL, Munsell BC, Davis KA, Kaestner E, Weber B, Krantz S, Vandergrift WA, Edwards JC, McDonald CR, Kuzniecky R, Bonilha L. Temporal Lobe Epilepsy Surgical Outcomes Can Be Inferred Based on Structural Connectome Hubs: A Machine Learning Study. Ann Neurol 2020; 88:970-983. [PMID: 32827235 PMCID: PMC8019146 DOI: 10.1002/ana.25888] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Medial temporal lobe epilepsy (TLE) is the most common form of medication-resistant focal epilepsy in adults. Despite removal of medial temporal structures, more than one-third of patients continue to have disabling seizures postoperatively. Seizure refractoriness implies that extramedial regions are capable of influencing the brain network and generating seizures. We tested whether abnormalities of structural network integration could be associated with surgical outcomes. METHODS Presurgical magnetic resonance images from 121 patients with drug-resistant TLE across 3 independent epilepsy centers were used to train feed-forward neural network models based on tissue volume or graph-theory measures from whole-brain diffusion tensor imaging structural connectomes. An independent dataset of 47 patients with TLE from 3 other epilepsy centers was used to assess the predictive values of each model and regional anatomical contributions toward surgical treatment results. RESULTS The receiver operating characteristic area under the curve based on regional betweenness centrality was 0.88, significantly higher than a random model or models based on gray matter volumes, degree, strength, and clustering coefficient. Nodes most strongly contributing to the predictive models involved the bilateral parahippocampal gyri, as well as the superior temporal gyri. INTERPRETATION Network integration in the medial and lateral temporal regions was related to surgical outcomes. Patients with abnormally integrated structural network nodes were less likely to achieve seizure freedom. These findings are in line with previous observations related to network abnormalities in TLE and expand on the notion of underlying aberrant plasticity. Our findings provide additional information on the mechanisms of surgical refractoriness. ANN NEUROL 2020;88:970-983.
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Affiliation(s)
| | - Simon S. Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Bioology, University of Liverpool, Liverpool, United Kingdom; Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Daniel L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Brent C. Munsell
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | - Kathryn A. Davis
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Erik Kaestner
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of Bonn
| | - Samantha Krantz
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | | | - Jonathan C. Edwards
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Carrie R. McDonald
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Ruben Kuzniecky
- Department of Neurology, Hofstra University / Northwell, NY, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
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44
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Hatton SN, Huynh KH, Bonilha L, Abela E, Alhusaini S, Altmann A, Alvim MKM, Balachandra AR, Bartolini E, Bender B, Bernasconi N, Bernasconi A, Bernhardt B, Bargallo N, Caldairou B, Caligiuri ME, Carr SJA, Cavalleri GL, Cendes F, Concha L, Davoodi-bojd E, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Foley SF, Gambardella A, Gleichgerrcht E, Guerrini R, Hamandi K, Ishikawa A, Keller SS, Kochunov PV, Kotikalapudi R, Kreilkamp BAK, Kwan P, Labate A, Langner S, Lenge M, Liu M, Lui E, Martin P, Mascalchi M, Moreira JCV, Morita-Sherman ME, O’Brien TJ, Pardoe HR, Pariente JC, Ribeiro LF, Richardson MP, Rocha CS, Rodríguez-Cruces R, Rosenow F, Severino M, Sinclair B, Soltanian-Zadeh H, Striano P, Taylor PN, Thomas RH, Tortora D, Velakoulis D, Vezzani A, Vivash L, von Podewils F, Vos SB, Weber B, Winston GP, Yasuda CL, Zhu AH, Thompson PM, Whelan CD, Jahanshad N, Sisodiya SM, McDonald CR. White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study. Brain 2020; 143:2454-2473. [PMID: 32814957 PMCID: PMC7567169 DOI: 10.1093/brain/awaa200] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/07/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
The epilepsies are commonly accompanied by widespread abnormalities in cerebral white matter. ENIGMA-Epilepsy is a large quantitative brain imaging consortium, aggregating data to investigate patterns of neuroimaging abnormalities in common epilepsy syndromes, including temporal lobe epilepsy, extratemporal epilepsy, and genetic generalized epilepsy. Our goal was to rank the most robust white matter microstructural differences across and within syndromes in a multicentre sample of adult epilepsy patients. Diffusion-weighted MRI data were analysed from 1069 healthy controls and 1249 patients: temporal lobe epilepsy with hippocampal sclerosis (n = 599), temporal lobe epilepsy with normal MRI (n = 275), genetic generalized epilepsy (n = 182) and non-lesional extratemporal epilepsy (n = 193). A harmonized protocol using tract-based spatial statistics was used to derive skeletonized maps of fractional anisotropy and mean diffusivity for each participant, and fibre tracts were segmented using a diffusion MRI atlas. Data were harmonized to correct for scanner-specific variations in diffusion measures using a batch-effect correction tool (ComBat). Analyses of covariance, adjusting for age and sex, examined differences between each epilepsy syndrome and controls for each white matter tract (Bonferroni corrected at P < 0.001). Across 'all epilepsies' lower fractional anisotropy was observed in most fibre tracts with small to medium effect sizes, especially in the corpus callosum, cingulum and external capsule. There were also less robust increases in mean diffusivity. Syndrome-specific fractional anisotropy and mean diffusivity differences were most pronounced in patients with hippocampal sclerosis in the ipsilateral parahippocampal cingulum and external capsule, with smaller effects across most other tracts. Individuals with temporal lobe epilepsy and normal MRI showed a similar pattern of greater ipsilateral than contralateral abnormalities, but less marked than those in patients with hippocampal sclerosis. Patients with generalized and extratemporal epilepsies had pronounced reductions in fractional anisotropy in the corpus callosum, corona radiata and external capsule, and increased mean diffusivity of the anterior corona radiata. Earlier age of seizure onset and longer disease duration were associated with a greater extent of diffusion abnormalities in patients with hippocampal sclerosis. We demonstrate microstructural abnormalities across major association, commissural, and projection fibres in a large multicentre study of epilepsy. Overall, patients with epilepsy showed white matter abnormalities in the corpus callosum, cingulum and external capsule, with differing severity across epilepsy syndromes. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric co-morbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research.
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Affiliation(s)
- Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
| | - Khoa H Huynh
- Center for Multimodal Imaging and Genetics, University of California San
Diego, La Jolla 92093 CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina,
Charleston 29425 SC, USA
| | - Eugenio Abela
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry,
Psychology and Neuroscience, Kings College London, London SE5 9NU UK
| | - Saud Alhusaini
- Neurology Department, Yale School of Medicine, New Haven 6510 CT,
USA
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
| | - Andre Altmann
- Centre of Medical Image Computing, Department of Medical Physics and Biomedical
Engineering, University College London, London WC1V 6LJ, UK
| | - Marina K M Alvim
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, UCSD School of
Medicine, La Jolla 92037 CA, USA
- Boston University School of Medicine, Boston 2118 MA, USA
| | - Emanuele Bartolini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano,
Prato, Italy
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076, Germany
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Boris Bernhardt
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
| | - Núria Bargallo
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Maria E Caligiuri
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
| | - Sarah J A Carr
- Neuroscience, Institute of Psychiatry, Psychology and
Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Gianpiero L Cavalleri
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- FutureNeuro Research Centre, Science Foundation Ireland, Dublin
D02 YN77, Ireland
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Esmaeil Davoodi-bojd
- Radiology and Research Administration, Henry Ford Hospital, 1
Detroit 48202 MI, USA
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
| | | | - Colin P Doherty
- Division of Neurology, Trinity College Dublin, TBSI, Pearce
Street, Dublin D02 R590, Ireland
- FutureNeuro SFI Centre for Neurological Disease, RCSI, St Stephen’s
Green, Dublin D02 H903, Ireland
| | - Martin Domin
- Functional Imaging Unit, University Medicine Greifswald,
Greifswald 17475 M/V, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of
Neurology, Queen Square, London WC1N 3BG, UK
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire SL9 0RJ, UK
| | - Niels K Focke
- Clinical Neurophysiology, University Medicine Göttingen, 37099
Göttingen, Germany
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | | | - Antonio Gambardella
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | | | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Khalid Hamandi
- The Wales Epilepsy Unit, Cardiff and Vale University Health
Board, Cardiff CF144XW, UK
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24
4HQ, UK
| | - Akari Ishikawa
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Simon S Keller
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Peter V Kochunov
- Maryland Psychiatric Research Center, 55 Wade Ave, Baltimore
21228, MD, USA
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
| | - Barbara A K Kreilkamp
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Angelo Labate
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt
University Greifswald Faculty of Medicine, Greifswald 17475, Germany
- Institute for Diagnostic and Interventional Radiology, Pediatric and
Neuroradiology, Rostock University Medical Centre, Rostock 18057, Germany
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Children’s Hospital A.
Meyer-University of Florence, Florence 50139, Italy
| | - Min Liu
- Department of Neurology, Montreal Neurological Institute,
Montreal H3A 2B4 QC, Canada
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
- Department of Medicine and Radiology, University of Melbourne,
3Parkville 3050 Victoria, Australia
| | - Pascal Martin
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | - Mario Mascalchi
- Meyer Children Hospital University of Florence, Florence 50130
Tuscany, Italy
| | - José C V Moreira
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Marcia E Morita-Sherman
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
- Cleveland Clinic, Cleveland 44195 OH, USA
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Heath R Pardoe
- Department of Neurology, New York University School of Medicine,
New York City 10016 NY, USA
| | - José C Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Letícia F Ribeiro
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Mark P Richardson
- Division of Neuroscience, King’s College London, Institute of
Psychiatry, London SE5 8AB, UK
| | - Cristiane S Rocha
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Raúl Rodríguez-Cruces
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt,
Germany, Frankfurt 60528 Hesse, Germany
- Center for Personalized Translational Epilepsy Research (CePTER),
Goethe-University Frankfurt, Frankfurt a. M. 60528, Germany
| | - Mariasavina Severino
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa 16147
Liguria, Italy
| | - Benjamin Sinclair
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
- School of Electrical and Computer Engineering, University of
Tehran, Tehran 14399-57131, Iran
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal
and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- School of Computing, Newcastle University, Urban Sciences Building, Science
Square, Newcastle upon Tyne NE4 5TG, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle
University, Newcastle upon Tyne NE2 4HH, UK
- Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Domenico Tortora
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
| | - Dennis Velakoulis
- Royal Melbourne Hospital, Melbourne 3050 Victoria, Australia
- University of Melbourne, Parkville, Melbourne 3050 Victoria,
Australia
| | - Annamaria Vezzani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano
20156 Italy
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Felix von Podewils
- Epilepsy Center, University Medicine Greifswald, Greifswald 17489
Mecklenburg-Vorpommern, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, University College London,
London, WC1V 6LJ, UK
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of
Bonn, Venusberg Campus 1, Bonn 53127 NRW, Germany
| | - Gavin P Winston
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
- Department of Medicine, Division of Neurology, Queen's
University, Kingston K7L 3N6 ON, Canada
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Christopher D Whelan
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
- Research and Early Development (RED), Biogen Inc., Cambridge, MA
02139, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Sanjay M Sisodiya
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
- Chalfont Centre for Epilepsy, Chalfont-St-Peter, SL9 0RJ Bucks,
UK
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
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Delgado-Fernández J, García-Pallero MÁ, Manzanares-Soler R, Martín-Plasencia P, Blasco G, Frade-Porto N, Navas-García M, Pulido P, Sola RG, Torres CV. Language hemispheric dominance analyzed with magnetic resonance DTI: correlation with the Wada test. J Neurosurg 2020; 134:1703-1710. [PMID: 32707542 DOI: 10.3171/2020.4.jns20456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Language lateralization is a major concern in some patients with pharmacoresistant epilepsy who will face surgery; in these patients, hemispheric dominance testing is essential to avoid further complications. The Wada test is considered the gold standard examination for language localization, but is invasive and requires many human and material resources. Functional MRI and tractography with diffusion tensor imaging (DTI) have demonstrated that they could be useful for locating language in epilepsy surgery, but there is no evidence of the correlation between the Wada test and DTI MRI in language dominance. METHODS The authors performed a retrospective review of patients who underwent a Wada test before epilepsy surgery at their institution from 2012 to 2017. The authors retrospectively analyzed fractional anisotropy (FA), number and length of fibers, and volume of the arcuate fasciculus and uncinate fasciculus, comparing dominant and nondominant hemispheres. RESULTS Ten patients with temporal lobe epilepsy were reviewed. Statistical analysis showed that the mean FA of the arcuate fasciculus in the dominant hemisphere was higher than in the nondominant hemisphere (0.369 vs 0.329, p = 0.049). Also, the number of fibers in the arcuate fasciculus was greater in the dominant hemisphere (881.5 vs 305.4, p = 0.003). However, no differences were found in the FA of the uncinate fasciculus or number of fibers between hemispheres. The length of fibers of the uncinate fasciculus was longer in the dominant side (74.4 vs 50.1 mm, p = 0.05). Volume in both bundles was more prominent in the dominant hemisphere (12.12 vs 6.48 cm3, p = 0.004, in the arcuate fasciculus, and 8.41 vs 4.16 cm3, p = 0.018, in the uncinate fasciculus). Finally, these parameters were compared in patients in whom the seizure focus was situated in the dominant hemisphere: FA (0.37 vs 0.30, p = 0.05), number of fibers (114.4 vs 315.6, p = 0.014), and volume (12.58 vs 5.88 cm3, p = 0.035) in the arcuate fasciculus were found to be statistically significantly higher in the dominant hemispheres. Linear discriminant analysis of FA, number of fibers, and volume of the arcuate fasciculus showed a correct discrimination in 80% of patients (p = 0.024). CONCLUSIONS The analysis of the arcuate fasciculus and other tract bundles by DTI could be a useful tool for language location testing in the preoperative study of patients with refractory epilepsy.
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Affiliation(s)
| | | | | | | | - Guillermo Blasco
- 4Department of Neurosurgery, University Hospital La Princesa, Madrid
| | | | | | - Paloma Pulido
- 4Department of Neurosurgery, University Hospital La Princesa, Madrid
| | - Rafael G Sola
- 5Department of Innovation in Neurosurgery, Universidad Autonoma de Madrid; and.,6Department of Neurosurgery, Hospital del Rosario, Madrid, Spain
| | - Cristina V Torres
- 4Department of Neurosurgery, University Hospital La Princesa, Madrid
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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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Li IC, Chang HH, Lin CH, Chen WP, Lu TH, Lee LY, Chen YW, Chen YP, Chen CC, Lin DPC. Prevention of Early Alzheimer's Disease by Erinacine A-Enriched Hericium erinaceus Mycelia Pilot Double-Blind Placebo-Controlled Study. Front Aging Neurosci 2020; 12:155. [PMID: 32581767 PMCID: PMC7283924 DOI: 10.3389/fnagi.2020.00155] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/07/2020] [Indexed: 12/13/2022] Open
Abstract
Objective To investigate the efficacy and safety of three H. erinaceus mycelia (EAHE) capsules (350 mg/capsule; containing 5 mg/g erinacine A active ingredient) per day for the treatment of patients with mild Alzheimer’s Disease (AD). Methods This study comprised a 3-week no-drug screening period, followed by a 49-week double-blind treatment period with 2-parallel groups in which eligible patients were randomized to either three 5 mg/g EAHE mycelia capsules per day or identical appearing placebo capsules. Cognitive assessments, ophthalmic examinations, biomarker collection, and neuroimaging were followed throughout the study period. Results After 49 weeks of EAHE intervention, a significant decrease in Cognitive Abilities Screening Instrument score was noted in the placebo group, a significant improvement in Mini-Mental State Examination score was observed in the EAHE group and a significant Instrumental Activities of Daily Living score difference were found between the two groups. In addition, EAHE group achieved a significantly better contrast sensitivity when compared to the placebo group. Moreover, only the placebo group observed significantly lowered biomarkers such as calcium, albumin, apolipoprotein E4, hemoglobin, and brain-derived neurotrophic factor and significantly elevated alpha1-antichymotrypsin and amyloid-beta peptide 1–40 over the study period. Using diffusion tensor imaging, the mean apparent diffusion coefficient (ADC) values from the arcuate fasciculus region in the dominant hemisphere significantly increased in the placebo group while no significant difference was found in the EAHE group in comparison to their baselines. Moreover, ADC values from the parahippocampal cingulum region in the dominant hemisphere significantly decreased in the EAHE group whereas no significant difference was found in the placebo group when compared to their baselines. Lastly, except for four subjects who dropped out of the study due to abdominal discomfort, nausea, and skin rash, no other adverse events were reported. Conclusion Three 350 mg/g EAHE capsules intervention for 49 weeks demonstrated higher CASI, MMSE, and IADL scores and achieved a better contrast sensitivity in patients with mild AD when compared to the placebo group, suggesting that EAHE is safe, well-tolerated, and may be important in achieving neurocognitive benefits. Clinical Trial Registration ClinicalTrials.gov, identifier NCT04065061.
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Affiliation(s)
- I-Chen Li
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan
| | - Han-Hsin Chang
- Department of Nutrition, Chung Shan Medical University, Taichung City, Taiwan
| | - Chuan-Han Lin
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung City, Taiwan
| | - Wan-Ping Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan
| | - Tsung-Han Lu
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung City, Taiwan
| | - Li-Ya Lee
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan
| | - Yu-Wen Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan
| | - Yen-Po Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan
| | - Chin-Chu Chen
- Biotech Research Institute, Grape King Bio Ltd., Taoyuan City, Taiwan.,Institute of Food Science and Technology, National Taiwan University, Taipei City, Taiwan.,Department of Food Science, Nutrition and Nutraceutical Biotechnology, Shih Chien University, Taipei City, Taiwan.,Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - David Pei-Cheng Lin
- Department of Medical Laboratory and Biotechnology, Chung Shan Medical University, Taichung City, Taiwan.,Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung City, Taiwan
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48
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Di Tella S, Baglio F, Pelizzari L, Cabinio M, Nemni R, Traficante D, Silveri MC. Uncinate fasciculus and word selection processing in Parkinson's disease. Neuropsychologia 2020; 146:107504. [PMID: 32485199 DOI: 10.1016/j.neuropsychologia.2020.107504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 01/13/2023]
Abstract
We explored with Diffusion Tensor Imaging (DTI) technique whether the ability to select words among competitive alternatives during word production is related to the integrity of the left uncinate fasciculus (UF) in Parkinson's disease (PD). Nineteen PD patients (10 right-sided and 9 left-sided) and 17 matched healthy controls (HC) took part in the study. Participants were asked to derive nouns from verbs (reading from to read) or to generate verbs from nouns (to build from building). Noun and verb production, in this task, differ in the number of lexical entries among which the response is selected, as the noun must be selected from a larger number of alternatives compared to the verb, and thus is more demanding of processing resources. DTI evaluation was obtained for each subject. Fractional anisotropy (FA) and mean diffusivity (MD) maps were derived from DTI and median FA and MD values were computed within the left and right UF. Then, FA and MD of the left and right UF were correlated with noun and verb production. Both the left and right UF-FA correlated with the global (noun + verb) production and noun production in the whole PD group. In right-sided PD, correlations were found with the contralateral UF-FA; in left-sided PD the correlations emerged with both the left and right UF-FA. The most difficult task, noun production, significantly correlated with the right UF-FA in left-sided PD. The left UF is involved in word selection processes, and the right UF intervenes when the selection is particularly demanding of attentional resources.
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Affiliation(s)
- Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy.
| | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Laura Pelizzari
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Raffaello Nemni
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Daniela Traficante
- Department of Psychology, Catholic University, Largo A. Gemelli, 1, 20123, Milan, Italy
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49
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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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