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Weidner EM, Moratti S, Schindler S, Grewe P, Bien CG, Kissler J. Amygdala and cortical gamma-band responses to emotional faces are modulated by attention to valence. Psychophysiology 2024; 61:e14512. [PMID: 38174584 DOI: 10.1111/psyp.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/22/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
The amygdala might support an attentional bias for emotional faces. However, whether and how selective attention toward a specific valence modulates this bias is not fully understood. Likewise, it is unclear whether amygdala and cortical signals respond to emotion and attention in a similar way. We recorded gamma-band activity (GBA, > 30 Hz) intracranially in the amygdalae of 11 patients with epilepsy and collected scalp recordings from 19 healthy participants. We presented angry, neutral, and happy faces randomly, and we denoted one valence as the target. Participants detected happy targets most quickly and accurately. In the amygdala, during attention to negative faces, low gamma-band activity (LGBA, < 90 Hz) increased for angry compared with happy faces from 160 ms. From 220 ms onward, amygdala high gamma-band activity (HGBA, > 90 Hz) was higher for angry and neutral faces than for happy ones. Monitoring neutral faces increased amygdala HGBA for emotions compared with neutral faces from 40 ms. Expressions were not differentiated in GBA while monitoring positive faces. On the scalp, only threat monitoring resulted in expression differentiation. Here, posterior LGBA was increased selectively for angry targets from 60 ms. The data show that GBA differentiation of emotional expressions is modulated by attention to valence: Top-down-controlled threat vigilance coordinates widespread GBA in favor of angry faces. Stimulus-driven emotion differentiation in amygdala GBA occurs during a neutral attentional focus. These findings align with a multi-pathway model of emotion processing and specify the role of GBA in this process.
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Affiliation(s)
- Enya M Weidner
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Stephan Moratti
- Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Sebastian Schindler
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Philip Grewe
- Deptartment of Epileptology, Krankenhaus Mara, Bethel Epilepsy Center, Medical School OWL, Bielefeld University, Bielefeld, Germany
- Clinical Neuropsychology and Epilepsy Research, Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Christian G Bien
- Deptartment of Epileptology, Krankenhaus Mara, Bethel Epilepsy Center, Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Johanna Kissler
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Singh B, Wang Z, Madiah LM, Gatti SE, Fulton JN, Johnson GW, Li R, Dawant BM, Englot DJ, Bick SK, Roberson SW, Constantinidis C. Brain-wide human oscillatory local field potential activity during visual working memory. iScience 2024; 27:109130. [PMID: 38380249 PMCID: PMC10877957 DOI: 10.1016/j.isci.2024.109130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/10/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Oscillatory activity in the local field potential (LFP) is thought to be a marker of cognitive processes. To understand how it differentiates tasks and brain areas in humans, we recorded LFPs in 15 adults with intracranial depth electrodes, as they performed visual-spatial and shape working memory tasks. Stimulus appearance produced widespread, broad-band activation, including in occipital, parietal, temporal, insular, and prefrontal cortex, and the amygdala and hippocampus. Occipital cortex was characterized by most elevated power in the high-gamma (100-150 Hz) range during the visual stimulus presentation. The most consistent feature of the delay period was a systematic pattern of modulation in the beta frequency (16-40 Hz), which included a decrease in power of variable timing across areas, and rebound during the delay period. These results reveal the widespread nature of oscillatory activity across a broad brain network and region-specific signatures of oscillatory processes associated with visual working memory.
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Affiliation(s)
- Balbir Singh
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Zhengyang Wang
- Neuroscience Program, Vanderbilt University, Nashville, TN, USA
| | - Leen M. Madiah
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - S. Elizabeth Gatti
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Jenna N. Fulton
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Graham W. Johnson
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rui Li
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Benoit M. Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Dario J. Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah K. Bick
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shawniqua Williams Roberson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christos Constantinidis
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Neuroscience Program, Vanderbilt University, Nashville, TN, USA
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Süß AM, Hug M, Conradi N, Kienitz R, Rosenow F, Rampp S, Merkel N. Lateralization of delta band power in magnetoencephalography (MEG) in patients with unilateral focal epilepsy and its relation to verbal fluency. Brain Behav 2023; 13:e3257. [PMID: 37752097 PMCID: PMC10636394 DOI: 10.1002/brb3.3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/22/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Delta power is a clinically established biomarker for abnormal brain processes. However, in patients with unilateral focal epilepsy (FE) it is still not well understood, how it relates to the epileptogenic zone and to neurocognitive functioning. The aim of the present study was thus to assess how delta power relates to the affected hemisphere, whether lateralization strength differs between the patients, and how changes in delta power correlate with cognitive functioning. METHOD We retrospectively studied patients with left (LFE) and right FE (RFE) who had undergone a resting-state magnetoencephalography measurement. We computed global and hemispheric delta power and lateralization indices and examined whether delta power correlates with semantic and letter verbal fluency (former being a marker for language and verbal memory, latter for executive functions) in 26 FE patients (15 LFE, 11 RFE) and 10 healthy controls. RESULTS Delta power was increased in FE patients compared to healthy controls. However, the increase across hemispheres was related to the site of the epileptic focus: On group level, LFE patients showed higher delta power in both hemispheres, whereas RFE patients primarily exhibited higher delta power in the ipsilateral right hemisphere. Both groups showed co-fluctuations of delta power between the hemispheres. Besides, delta power correlated negatively only with letter verbal fluency. CONCLUSION The findings confirm and provide further evidence that delta power is a marker of pathological activity and abnormal brain processes in FE. Delta power dynamics differ between patient groups, indicating that delta power could offer additional diagnostic value. The negative association of delta power and letter verbal fluency suggests that executive dysfunctions are related to low frequency abnormalities.
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Affiliation(s)
- Annika Melissa Süß
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Marion Hug
- Department of NeurologyUniversity Hospital Frankfurt and Goethe UniversityFrankfurt am MainGermany
| | - Nadine Conradi
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Ricardo Kienitz
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
| | - Stefan Rampp
- Department of NeurosurgeryUniversity Hospital ErlangenErlangenGermany
- Department of NeurosurgeryUniversity Hospital Halle (Saale)Halle (Saale)Germany
| | - Nina Merkel
- Epilepsy Center Frankfurt Rhine‐MainCenter of Neurology and NeurosurgeryUniversity Hospital FrankfurtFrankfurt am MainGermany
- Ernst Strüngmann Institute for Neuroscience in Cooperation with Max Planck SocietyFrankfurt am MainGermany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University FrankfurtFrankfurt am MainGermany
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Sarkis RA. Update in Progress: Cognitive Phenotypes in Temporal Lobe Epilepsy. Epilepsy Curr 2023; 23:363-365. [PMID: 38269342 PMCID: PMC10805095 DOI: 10.1177/15357597231211446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Moving Towards a Taxonomy of Cognitive Impairments in Epilepsy: Application of Latent Profile Analysis to 1178 Patients With Temporal Lobe Epilepsy Reyes A, Hermann BP, Busch RM, Drane DL, Barr WB, Hamberger MJ, Roesch SC, McDonald CR. Brain Commun . 2022;4(6):fcac289. doi:10.1093/braincomms/fcac289 In efforts to understand the cognitive heterogeneity within and across epilepsy syndromes, cognitive phenotyping has been proposed as a new taxonomy aimed at developing a harmonized approach to cognitive classification in epilepsy. Data- and clinically driven approaches have been previously used with variability in the phenotypes derived across studies. In our study, we utilize latent profile analysis to test several models of phenotypes in a large multicentre sample of patients with temporal lobe epilepsy and evaluate their demographic and clinical profiles. For the first time, we examine the added value of replacing missing data and examine factors that may be contributing to missingness. A sample of 1178 participants met the inclusion criteria for the study, which included a diagnosis of temporal lobe epilepsy and the availability of comprehensive neuropsychological data. Models with two to five classes were examined using latent profile analysis and the optimal model was selected based on fit indices, posterior probabilities and proportion of sample sizes. The models were also examined with imputed data to investigate the impact of missing data on model selection. Based on the fit indices, posterior probability and distinctiveness of the latent classes, a three-class solution was the optimal solution. This three-class solution comprised a group of patients with multidomain impairments, a group with impairments predominantly in language and a group with no impairments. Overall, the multidomain group demonstrated a worse clinical profile and comprised a greater proportion of patients with mesial temporal sclerosis, a longer disease duration and a higher number of anti-seizure medications. The four-class and five-class solutions demonstrated the lowest probabilities of a group membership. Analyses with imputed data demonstrated that the four-class solution was the optimal solution; however, there was a weak agreement between the missing and imputed data sets for the four-Class solutions (κ = 0.288, P < 0.001). This study represents the first to use latent profile analysis to test and compare multiple models of cognitive phenotypes in temporal lobe epilepsy and to determine the impact of missing data on model fit. We found that the three-phenotype model was the most meaningful based on several fit indices and produced phenotypes with unique demographic and clinical profiles. Our findings demonstrate that latent profile analysis is a rigorous method to identify phenotypes in large, heterogeneous epilepsy samples. Furthermore, this study highlights the importance of examining the impact of missing data in phenotyping methods. Our latent profile analysis-derived phenotypes can inform future studies aimed at identifying cognitive phenotypes in other neurological disorders.
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Affiliation(s)
- Rani A Sarkis
- Epilepsy Division, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School
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Soncin LD, Belquaid S, McGonigal A, Giusiano B, Bartolomei F, Faure S. Post-traumatic stress disorder (PTSD), cognitive control, and perceived seizure control in patients with epilepsy: An exploratory study. Epilepsy Behav 2023; 147:109396. [PMID: 37619461 DOI: 10.1016/j.yebeh.2023.109396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023]
Abstract
Epilepsy is often linked to various psychiatric symptoms, with anxiety, depression, and interictal dysphoric disorders being the most prevalent. Few studies have investigated posttraumatic stress disorder (PTSD) in epilepsy, but they suggest a notable prevalence of PTSD. PTSD is known to be associated with cognitive impairments, particularly memory and executive functions. Our proposed exploratory study aims to investigate executive attentional control and emotional inhibition in patients with drug-resistant epilepsy (DRE) who exhibit PTSD symptoms compared with a healthy control group. Additionally, some PWE can manage their seizures using emotional and cognitive strategies, we find it relevant to explore the connection between their regulation abilities, cognitive control performance, and PTSD symptoms. We included 54 PWE and 60 healthy participants. They completed anxiety and depression scales as well as two questionnaires assessing PTSD symptoms and a questionnaire that measured the perceived self-control of seizures. We measured executive control using an executive control task (Attention Network Test, ANT) and an emotional Go/No-Go task. We found a positive correlation between PTSD scores (PDS-5) and performance at the ANT task. In contrast, in the emotional inhibition (Go/No-Go) task, behavioral inhibition errors were positively correlated with PTSD scores, specifically with hypervigilance symptoms in PTSD+ patients. There was a positive correlation between response reaction times in an aversive condition and PTSD scores: the more severe the PTSD symptoms, the faster the PWE identified stimuli in the angry face condition of the Go/No-Go task. Regarding perceived seizure control, we found correlations between alertness and PTSD symptoms associated with seizure anticipation during the inter- and peri-ictal periods. Patients with PTSD symptoms reported better seizure control. Our findings suggest that epilepsy patients with PTSD experience cognitive changes such as heightened executive attentional control, weakened emotional inhibition, and improved seizure control perception.
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Affiliation(s)
- Lisa-Dounia Soncin
- Université Côte d'Azur, LAPCOS, France; Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
| | | | - Aileen McGonigal
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Mater Hospital and Faculty of Medicine, University of Queensland, Brisbane, Australia; Queensland Brain Institute, University of Queensland and Mater Hospital, Brisbane, Queensland, Australia.
| | - Bernard Giusiano
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France; APHM, Timone Hospital, Public Health department, Marseille, France.
| | - Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
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Allebone J, Kanaan RA, Rayner G, Maller J, O'Brien TJ, Mullen SA, Cook M, Adams SJ, Vogrin S, Vaughan DN, Kwan P, Berkovic SF, D'Souza WJ, Jackson G, Velakoulis D, Wilson SJ. Neuropsychological function in psychosis of epilepsy. Epilepsy Res 2023; 196:107222. [PMID: 37717505 DOI: 10.1016/j.eplepsyres.2023.107222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/25/2023] [Accepted: 09/13/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE The neuropsychological profile of patients with psychosis of epilepsy (POE) has received limited research attention. Recent neuroimaging work in POE has identified structural network pathology in the default mode network and the cognitive control network. This study examined the neuropsychological profile of POE focusing on cognitive domains subserved by these networks. METHODS Twelve consecutive patients with a diagnosis of POE were prospectively recruited from the Comprehensive Epilepsy Programmes at The Royal Melbourne, Austin and St Vincent's Hospitals, Melbourne, Australia between January 2015 and February 2017. They were compared to 12 matched patients with epilepsy but no psychosis and 42 healthy controls on standardised neuropsychological tests of memory and executive functioning in a case-control design. RESULTS Mean scores across all cognitive tasks showed a graded pattern of impairment, with the POE group showing the poorest performance, followed by the epilepsy without psychosis and the healthy control groups. This was associated with significant group-level differences on measures of working memory (p = < 0.01); immediate (p = < 0.01) and delayed verbal recall (p = < 0.01); visual memory (p < 0.001); and verbal fluency (p = 0.02). In particular, patients with POE performed significantly worse than the healthy control group on measures of both cognitive control (p = .005) and memory (p < .001), whereas the epilepsy without psychosis group showed only memory difficulties (delayed verbal recall) compared to healthy controls (p = .001). CONCLUSION People with POE show reduced performance in neuropsychological functions supported by the default mode and cognitive control networks, when compared to both healthy participants and people with epilepsy without psychosis.
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Affiliation(s)
- James Allebone
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Richard A Kanaan
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Department of Psychiatry, University of Melbourne, Austin Health, Melbourne, Australia.
| | - Genevieve Rayner
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Comprehensive Epilepsy Program, Austin Health, University of Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Jerome Maller
- ANU College of Health and Medicine, Australian National University, Canberra, Victoria, Australia; Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Terence J O'Brien
- Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Neuroscience, Alfred Hospital, Monash University, Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Saul A Mullen
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Mark Cook
- Graeme Clark Institute, University of Melbourne, Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Sophia J Adams
- Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Simon Vogrin
- St Vincent's Hospital, Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - David N Vaughan
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Comprehensive Epilepsy Program, Austin Health, University of Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Patrick Kwan
- Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Neuroscience, Alfred Hospital, Monash University, Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Samuel F Berkovic
- Comprehensive Epilepsy Program, Austin Health, University of Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Wendyl J D'Souza
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Graeme Jackson
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Comprehensive Epilepsy Program, Austin Health, University of Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne, Health, Melbourne, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; Comprehensive Epilepsy Program, Austin Health, University of Melbourne, Victoria, Australia; Department of Clinical Neuropsychology, Austin Health, Heidelberg, Victoria, Australia
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Singh B, Wang Z, Madiah LM, Gatti SE, Fulton JN, Johnson GW, Li R, Dawant BM, Englot DJ, Bick SK, Roberson SW, Constantinidis C. Brain-wide human oscillatory LFP activity during visual working memory. bioRxiv 2023:2023.09.06.556554. [PMID: 37732263 PMCID: PMC10508766 DOI: 10.1101/2023.09.06.556554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Oscillatory activity is thought to be a marker of cognitive processes, although its role and distribution across the brain during working memory has been a matter of debate. To understand how oscillatory activity differentiates tasks and brain areas in humans, we recorded local field potentials (LFPs) in 12 adults as they performed visual-spatial and shape-matching memory tasks. Tasks were designed to engage working memory processes at a range of delay intervals between stimulus delivery and response initiation. LFPs were recorded using intracranial depth electrodes implanted to localize seizures for management of intractable epilepsy. Task-related LFP power analyses revealed an extensive network of cortical regions that were activated during the presentation of visual stimuli and during their maintenance in working memory, including occipital, parietal, temporal, insular, and prefrontal cortical areas, and subcortical structures including the amygdala and hippocampus. Across most brain areas, the appearance of a stimulus produced broadband power increase, while gamma power was evident during the delay interval of the working memory task. Notable differences between areas included that occipital cortex was characterized by elevated power in the high gamma (100-150 Hz) range during the 500 ms of visual stimulus presentation, which was less pronounced or absent in other areas. A decrease in power centered in beta frequency (16-40 Hz) was also observed after the stimulus presentation, whose magnitude differed across areas. These results reveal the interplay of oscillatory activity across a broad network, and region-specific signatures of oscillatory processes associated with visual working memory.
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Affiliation(s)
- Balbir Singh
- Department of Biomedical Engineering, Vanderbilt University
| | | | - Leen M Madiah
- Department of Biomedical Engineering, Vanderbilt University
| | | | - Jenna N Fulton
- Department of Neurology, Vanderbilt University Medical Center
| | - Graham W Johnson
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Rui Li
- Department of Electrical and Computer Engineering, Vanderbilt University
| | - Benoit M Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University
| | - Dario J Englot
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Sarah K Bick
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Shawniqua Williams Roberson
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurology, Vanderbilt University Medical Center
| | - Christos Constantinidis
- Department of Biomedical Engineering, Vanderbilt University
- Neuroscience Program, Vanderbilt University
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center
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Patrikelis P, Messinis L, Kimiskidis V, Gatzonis S. Neuropsychology of epilepsy surgery and theory-based practice: an opinion review. Arq Neuropsiquiatr 2023; 81:835-843. [PMID: 37793405 PMCID: PMC10550352 DOI: 10.1055/s-0043-1770349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/15/2023] [Indexed: 10/06/2023]
Abstract
The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.
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Affiliation(s)
- Panayiotis Patrikelis
- University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
- Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
| | - Lambros Messinis
- Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
- University Hospital of Patras, School of Medicine, Neuropsychology Section, Departments of Neurology and Psychiatry, Patras, Greece.
| | - Vasileios Kimiskidis
- Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, 1st Department of Neurology, Thessaloniki, Greece.
| | - Stylianos Gatzonis
- University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
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Yu H, Gao J, Chang RSK, Mak W, Thach TQ, Cheung RTF. Inhibitory dysfunction may cause prospective memory impairment in temporal lobe epilepsy (TLE) patients: an event-related potential study. Front Hum Neurosci 2023; 17:1006744. [PMID: 37565055 PMCID: PMC10410078 DOI: 10.3389/fnhum.2023.1006744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Prospective memory (PM) is the ability to remember future intentions, and PM function is closely related to independence in daily life, particularly in patients with temporal lobe epilepsy (TLE). As PM involves various cognitive components of attention, working memory, inhibition and other executive functions, this study investigated how TLE may affect PM components and the underlying neural mechanisms. Methods Sixty-four subjects were recruited, including 20 refractory TLE patients, 18 well-controlled TLE patients and 26 age-matched healthy controls. A set of neuropsychological tests was administered to assess specific brain functions. An event-related potential (ERP) task was used to further explore how PM and its components would be differentially affected in the two TLE types. Results Our findings revealed that: (1) refractory TLE patients scored lower than the healthy controls in the digit span, Verbal Fluency Test and Symbol Digit Modalities Test; (2) refractory TLE patients exhibited impaired PM performance and reduced prospective positivity amplitudes over the frontal, central and parietal regions in ERP experiments when compared to the healthy controls; and (3) decreased P3 amplitudes in the nogo trials were observed over the frontal-central sites in refractory but not in well-controlled TLE patients. Discussion To our knowledge, this is the first ERP study on PM that has specifically identified PM impairment in refractory but not in well-controlled TLE patients. Our finding of double dissociation in PM components suggests that inhibition dysfunction may be the main reason for PM deficit in refractory TLE patients. The present results have clinical implications for neuropsychological rehabilitation in TLE patients.
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Affiliation(s)
- Hemei Yu
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Junling Gao
- Centre of Buddhist Studies, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Windsor Mak
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Thuan-Quoc Thach
- Department of Psychiatry, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Raymond Tak Fai Cheung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
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10
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Petrillo K, Javed B, Toosizadeh N. Association between dual-task function and neuropsychological testing in older adults with cognitive impairment. Exp Gerontol 2023; 178:112223. [PMID: 37244373 DOI: 10.1016/j.exger.2023.112223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Despite the current high prevalence of dementia, more than half of older adult patients never receive an evaluation. Current evaluation methods are lengthy, cumbersome, and not viable for busy clinics. This indicates that, despite recent improvements, a quick and objective routine test for screening cognitive decline in older adults is still needed. Poor dual-task gait performance has been previously associated with decreased executive and neuropsychological function. However, gait tests are not always viable for clinics or older patients. METHODS The aim of this study was to assess the relationship between a novel upper-extremity function (UEF) dual-task performance and neuropsychological test results in older adults. For UEF dual-tasks, participants performed a consistent elbow flexion and extension, while counting backwards in increments of threes or ones. Wearable motion sensors were attached to the forearm and upper-arm to measure accuracy and speed of elbow flexion kinematics to calculate a UEF cognitive score. RESULTS We recruited older adults at three stages: cognitively normal (CN) (n = 35), mild cognitively impaired (MCI) of the Alzheimer's type (n = 34), and Alzheimer's disease (AD) (n = 22). The results demonstrate significant correlations between UEF cognitive score and mini-mental state examination (MMSE), Mini-Cog, Category fluency, Benson complex figure copy, Trail making test, and Montreal cognitive assessment (MOCA) (r values between -0.2355 and -0.6037 and p < 0.0288). DISCUSSION UEF dual-task was associated with executive function, orientation, repetition, abstraction, verbal recall, attention and calculation, language and visual construction. Of the associated brain domains, UEF dual-task was most significantly associated with executive function, visual construction, and delayed recall. The results from this study convey potential for UEF dual-task as a safe and convenient cognitive impairment screening method.
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Affiliation(s)
- Kelsi Petrillo
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America
| | - Bilaval Javed
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America; Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, United States of America
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America; Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, United States of America; Arizona Center on Aging, Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States of America.
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11
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Lopes-Santos LE, de Angelis G, Nakano FN, Thome U, Velasco TR, Santos MV, Machado HR, Hamad APA, Sakamoto AC, Wichert-Ana L. Executive functioning in children with posterior cortex epilepsy compared to temporal and frontal lobe epilepsies. Epilepsy Res 2023; 192:107141. [PMID: 37062183 DOI: 10.1016/j.eplepsyres.2023.107141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE People with epilepsy are at an increased risk of experiencing executive dysfunction, particularly those with frontal lobe epilepsy (FLE). The literature has also demonstrated alterations in executive functioning (EF) in patients with temporal lobe epilepsy (TLE). However, few studies have examined the neuropsychological profile of posterior cortex epilepsy (PCE), and little attention has been given to cognitive impairments in the pediatric population with PCE. This study aims to investigate EF performance in children with drug-resistant PCE compared to patients with FLE and TLE. METHODS We analyzed neuropsychological data from 217 patients aged 6-18 years who underwent preoperative evaluation for epilepsy surgery. The EF of patients with PCE was compared to patients with FLE and TLE. RESULTS There was no significant difference in Full-Scale Intelligence Quotient (FSIQ) means between groups. However, we found a significant effect of brain region on the Coding task, in which patients with PCE and FLE performed worse than those with TLE (p = 0.034). We also observed performance differences between groups on the Stroop test (p = 0.005), with patients with PCE and FLE performing worse than the TLE group. SIGNIFICANCE These findings suggest that children with PCE have alterations in their EF that are similar to the deficits found in FLE compared to patients with TLE. This emphasizes the importance of understanding the neuroanatomy of executive functions and the model of neural networks extending beyond the prefrontal cortex.
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Affiliation(s)
- Lucas Emmanuel Lopes-Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Geisa de Angelis
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Frederico Nakane Nakano
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ursula Thome
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Tonicarlo Rodrigues Velasco
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcelo Volpon Santos
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Hélio Rubens Machado
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ana Paula Andrade Hamad
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Américo Ceiki Sakamoto
- Epilepsy Surgery Center (CIREP), Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Lauro Wichert-Ana
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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12
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McDonald CR, Busch RM, Reyes A, Arrotta K, Barr W, Block C, Hessen E, Loring DW, Drane DL, Hamberger MJ, Wilson SJ, Baxendale S, Hermann BP. Development and application of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE): Initial results from a multi-center study of adults with temporal lobe epilepsy. Neuropsychology 2023; 37:301-314. [PMID: 35084879 PMCID: PMC9325925 DOI: 10.1037/neu0000792] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
[Correction Notice: An Erratum for this article was reported online in Neuropsychology on Sep 15 2022 (see record 2023-01997-001). In the original article, there was an error in Figure 2. In the box at the top left of the figure, the fourth explanation incorrectly stated, "Generalized impairment = At least one test < -1.0 or -1.5SD in three or more domains." The correct wording is "Generalized impairment = At least two tests < -1.0 or -1.5SD in each of three or more domains." All versions of this article have been corrected.] Objective: To describe the development and application of a consensus-based, empirically driven approach to cognitive diagnostics in epilepsy research-The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) and to assess the ability of the IC-CoDE to produce definable and stable cognitive phenotypes in a large, multi-center temporal lobe epilepsy (TLE) patient sample. METHOD Neuropsychological data were available for a diverse cohort of 2,485 patients with TLE across seven epilepsy centers. Patterns of impairment were determined based on commonly used tests within five cognitive domains (language, memory, executive functioning, attention/processing speed, and visuospatial ability) using two impairment thresholds (≤1.0 and ≤1.5 standard deviations below the normative mean). Cognitive phenotypes were derived across samples using the IC-CoDE and compared to distributions of phenotypes reported in existing studies. RESULTS Impairment rates were highest on tests of language, followed by memory, executive functioning, attention/processing speed, and visuospatial ability. Application of the IC-CoDE using varying operational definitions of impairment (≤ 1.0 and ≤ 1.5 SD) produced cognitive phenotypes with the following distribution: cognitively intact (30%-50%), single-domain (26%-29%), bi-domain (14%-19%), and generalized (10%-22%) impairment. Application of the ≤ 1.5 cutoff produced a distribution of phenotypes that was consistent across cohorts and approximated the distribution produced using data-driven approaches in prior studies. CONCLUSIONS The IC-CoDE is the first iteration of a classification system for harmonizing cognitive diagnostics in epilepsy research that can be applied across neuropsychological tests and TLE cohorts. This proof-of-principle study in TLE offers a promising path for enhancing research collaborations globally and accelerating scientific discoveries in epilepsy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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13
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Wee RWS, Nash A, Angus-Leppan H. Deep phenotyping of frontal lobe epilepsy compared to other epilepsy syndromes. J Neurol 2023; 270:3072-3081. [PMID: 36847847 DOI: 10.1007/s00415-023-11639-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 03/01/2023]
Abstract
AIMS Frontal lobe epilepsy (FLE) is understudied and often misdiagnosed. We sought to comprehensively phenotype FLE and to differentiate FLE from other focal and generalised epilepsy syndromes. METHODS This was a retrospective, observational cohort study of 1078 cases of confirmed epilepsy in a tertiary neurology centre in London. Data sources were electronic health records, investigation reports and clinical letters. RESULTS 166 patients had FLE based on clinical findings and investigations-97 with identifiable electroencephalography (EEG) foci in frontal areas (definite FLE), while 69 had no frontal EEG foci (probable FLE). Apart from EEG findings, probable and definite FLE did not differ in other features. FLE was distinct from generalized epilepsy, which tended to present with tonic-clonic seizures and be due to genetic causes. FLE and temporal lobe epilepsy (TLE) both featured focal unaware seizures and underlying structural or metabolic aetiology. FLE, TLE and generalized epilepsy differed in their EEG (P = 0.0003) and MRI (P = 0.002) findings, where FLE had a higher rate of normal EEG and abnormal MRI findings compared to TLE. CONCLUSIONS EEG is often normal for FLE, and abnormalities are commonly identified with MRI. There was no difference in the clinical features of definite and probable FLE, suggesting they represent the same clinical entity. The diagnosis of FLE can be made even when scalp EEG is normal. This large medical cohort provides hallmark features of FLE that differentiate it from TLE and other epilepsy syndromes.
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Affiliation(s)
- Ryan W S Wee
- Barnet Hospital, London, UK.,Epilepsy Initiative Group, Royal Free London NHS Foundation Trust, Pond St, London, NW3 2QG, UK
| | - Adina Nash
- Epilepsy Initiative Group, Royal Free London NHS Foundation Trust, Pond St, London, NW3 2QG, UK
| | - Heather Angus-Leppan
- Epilepsy Initiative Group, Royal Free London NHS Foundation Trust, Pond St, London, NW3 2QG, UK. .,UCL Queen Square Institute of Neurology, London, UK.
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14
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Au Yong HM, Clough M, Perucca P, Malpas CB, Kwan P, O'Brien TJ, Fielding J. Ocular motility as a measure of cerebral dysfunction in adults with focal epilepsy. Epilepsy Behav 2023; 141:109140. [PMID: 36812874 DOI: 10.1016/j.yebeh.2023.109140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Using objective oculomotor measures, we aimed to: (1) compare oculomotor performance in patients with drug-resistant focal epilepsy to healthy controls, and (2) investigate the differential impact of epileptogenic focus laterality and location on oculomotor performance. METHODS We recruited 51 adults with drug-resistant focal epilepsy from the Comprehensive Epilepsy Programs of two tertiary hospitals and 31 healthy controls to perform prosaccade and antisaccade tasks. Oculomotor variables of interest were latency, visuospatial accuracy, and antisaccade error rate. Linear mixed models were performed to compare interactions between groups (epilepsy, control) and oculomotor tasks, and between epilepsy subgroups and oculomotor tasks for each oculomotor variable. RESULTS Compared to healthy controls, patients with drug-resistant focal epilepsy exhibited longer antisaccade latencies (mean difference = 42.8 ms, P = 0.001), poorer spatial accuracy for both prosaccade (mean difference = 0.4°, P = 0.002), and antisaccade tasks (mean difference = 2.1°, P < 0.001), and more antisaccade errors (mean difference = 12.6%, P < 0.001). In the epilepsy subgroup analysis, left-hemispheric epilepsy patients exhibited longer antisaccade latencies compared to controls (mean difference = 52.2 ms, P = 0.003), while right-hemispheric epilepsy was the most spatially inaccurate compared to controls (mean difference = 2.5°, P = 0.003). The temporal lobe epilepsy subgroup displayed longer antisaccade latencies compared to controls (mean difference = 47.6 ms, P = 0.005). SIGNIFICANCE Patients with drug-resistant focal epilepsy exhibit poor inhibitory control as evidenced by a high percentage of antisaccade errors, slower cognitive processing speed, and impaired visuospatial accuracy on oculomotor tasks. Patients with left-hemispheric epilepsy and temporal lobe epilepsy have markedly impaired processing speed. Overall, oculomotor tasks can be a useful tool to objectively quantify cerebral dysfunction in drug-resistant focal epilepsy.
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Affiliation(s)
- Hue Mun Au Yong
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
| | - Meaghan Clough
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia.
| | - Piero Perucca
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia; Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg, Victoria, Australia.
| | - Charles B Malpas
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
| | - Patrick Kwan
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
| | - Terence J O'Brien
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
| | - Joanne Fielding
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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15
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Yoganathan K, Malek N, Torzillo E, Paranathala M, Greene J. Neurological update: structural and functional imaging in epilepsy surgery. J Neurol 2023; 270:2798-2808. [PMID: 36792721 PMCID: PMC10130132 DOI: 10.1007/s00415-023-11619-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
Structural and functional imaging prior to surgery in drug-resistant focal epilepsy, has an important role to play alongside electroencephalography (EEG) techniques, in planning the surgical approach and predicting post-operative outcome. This paper reviews the role of structural and functional imaging of the brain, namely computed tomography (CT), magnetic resonance imaging (MRI), functional MRI (fMRI), single photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging in the preoperative work-up of people with medically refractory epilepsy. In MRI-negative patients, the precise localisation of the epileptogenic zone may be established by demonstrating hypometabolism on PET imaging or hyperperfusion on SPECT imaging in the area surrounding the seizure focus. These imaging modalities are far less invasive than intracranial EEG, which is the gold standard but requires surgical placement of electrodes or recording grids. Even when intracranial EEG is needed, PET or SPECT imaging can assist in the planning of EEG electrode placement, due to its' limited spatial sampling. Multimodal imaging techniques now allow the multidisciplinary epilepsy surgery team to identify and better characterise focal pathology, determine its' relationship to eloquent areas of the brain and the degree of interconnectedness within both physiological and pathological networks, as well as improve planning and surgical outcomes for patients. This paper will update the reader on this whole field and provide them with a practical guide, to aid them in the selection of appropriate investigations, interpretation of the findings and facilitating patient discussions in individuals with drug-resistant focal epilepsy.
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Affiliation(s)
- Katie Yoganathan
- University of Oxford and Oxford University Hospitals, Oxford, UK. .,Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
| | - Naveed Malek
- Department of Neurology, Queen's Hospital, Romford, UK
| | - Emma Torzillo
- Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | | | - John Greene
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
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16
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D'Aprano F, Malpas CB, Roberts S, Saling MM. Verbosity with retelling: Narrative discourse production in temporal lobe epilepsy. Epilepsy Res 2023; 189:107069. [PMID: 36603454 DOI: 10.1016/j.eplepsyres.2022.107069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022]
Abstract
To examine micro- and macrolinguistic underpinnings of circumstantiality in temporal lobe epilepsy (TLE), we examined the elicited narrative output of 15 individuals with TLE and 14 controls. To replicate and extend Field and colleagues' (2000) work, participants were asked to produce five immediately consecutive elicitations of an eight-frame cartoon "Cowboy Story" (Joanette et al., 1986). Following transcription and coding, detailed multi-level discourse analysis demonstrated a typical pattern of compression in controls. The narratives produced by individuals with TLE were less fluent, cohesive, and coherent across trials: producing fewer novel units and more repetitive and extraneous content. Significant group by trial interactions in sample length, spontaneous duration, and statements, were not explained by seizure burden, age, or lexical retrieval deficits. These findings suggest that they do not benefit from repeated engagement with a narrative in the same manner as controls. Disturbed social cognition and pragmatics in TLE might underpin communication inefficiencies.
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Affiliation(s)
- Fiore D'Aprano
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia.
| | - Charles B Malpas
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Stefanie Roberts
- Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Michael M Saling
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Clinical Neuropsychology, The Austin Hospital, Australia.
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17
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Reyes A, Hermann BP, Busch RM, Drane DL, Barr WB, Hamberger MJ, Roesch SC, McDonald CR. Moving towards a taxonomy of cognitive impairments in epilepsy: application of latent profile analysis to 1178 patients with temporal lobe epilepsy. Brain Commun 2022; 4:fcac289. [PMID: 36447559 PMCID: PMC9692194 DOI: 10.1093/braincomms/fcac289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/07/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
In efforts to understand the cognitive heterogeneity within and across epilepsy syndromes, cognitive phenotyping has been proposed as a new taxonomy aimed at developing a harmonized approach to cognitive classification in epilepsy. Data- and clinically driven approaches have been previously used with variability in the phenotypes derived across studies. In our study, we utilize latent profile analysis to test several models of phenotypes in a large multicentre sample of patients with temporal lobe epilepsy and evaluate their demographic and clinical profiles. For the first time, we examine the added value of replacing missing data and examine factors that may be contributing to missingness. A sample of 1178 participants met the inclusion criteria for the study, which included a diagnosis of temporal lobe epilepsy and the availability of comprehensive neuropsychological data. Models with two to five classes were examined using latent profile analysis and the optimal model was selected based on fit indices, posterior probabilities and proportion of sample sizes. The models were also examined with imputed data to investigate the impact of missing data on model selection. Based on the fit indices, posterior probability and distinctiveness of the latent classes, a three-class solution was the optimal solution. This three-class solution comprised a group of patients with multidomain impairments, a group with impairments predominantly in language and a group with no impairments. Overall, the multidomain group demonstrated a worse clinical profile and comprised a greater proportion of patients with mesial temporal sclerosis, a longer disease duration and a higher number of anti-seizure medications. The four-class and five-class solutions demonstrated the lowest probabilities of a group membership. Analyses with imputed data demonstrated that the four-class solution was the optimal solution; however, there was a weak agreement between the missing and imputed data sets for the four-Class solutions (κ = 0.288, P < 0.001). This study represents the first to use latent profile analysis to test and compare multiple models of cognitive phenotypes in temporal lobe epilepsy and to determine the impact of missing data on model fit. We found that the three-phenotype model was the most meaningful based on several fit indices and produced phenotypes with unique demographic and clinical profiles. Our findings demonstrate that latent profile analysis is a rigorous method to identify phenotypes in large, heterogeneous epilepsy samples. Furthermore, this study highlights the importance of examining the impact of missing data in phenotyping methods. Our latent profile analysis-derived phenotypes can inform future studies aimed at identifying cognitive phenotypes in other neurological disorders.
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Affiliation(s)
- Anny Reyes
- Center for Multimodal Imaging and Genetics, University of CaliforniaSan Diego, La Jolla, CA 92093, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
| | - Robyn M Busch
- Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH 44106, USA
- Department of Neurology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Neurology, University of Washington, Seattle, WA 98195, USA
| | - William B Barr
- Department of Neurology, NYU-Langone Medical Center and NYU School of Medicine, New York, NY 10016, USA
- Department of Psychiatry, NYU-Langone Medical Center and NYU School of Medicine, New York, NY 10016, USA
| | - Marla J Hamberger
- Department of Neurology, Columbia University, New York, NY 10027, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA 92182, USA
| | - Carrie R McDonald
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92093, USA
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18
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Vilà-Balló A, De la Cruz-Puebla M, López-Barroso D, Miró J, Sala-Padró J, Cucurell D, Falip M, Rodríguez-Fornells A. Reward-based decision-making in mesial temporal lobe epilepsy patients with unilateral hippocampal sclerosis pre- and post-surgery. Neuroimage Clin 2022; 36:103251. [PMID: 36510413 PMCID: PMC9668642 DOI: 10.1016/j.nicl.2022.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Correct functioning of the reward processing system is critical for optimizing decision-making as well as preventing the development of addictions and/or neuropsychiatric symptoms such as depression, apathy, and anhedonia. Consequently, patients with mesial temporal lobe epilepsy due to unilateral hippocampal sclerosis (mTLE-UHS) represent an excellent opportunity to study the brain networks involved in this system. OBJECTIVE The aim of the current study was to evaluate decision-making and the electrophysiological correlates of feedback processing in a sample of mTLE-UHS patients, compared to healthy controls. In addition, we assessed the impact of mesial temporal lobe surgical resection on these processes, as well as general, neuropsychological functioning. METHOD 17 mTLE-UHS patients and 17 matched healthy controls completed: [1] a computerized version of the Game of Dice Task, [2] a Standard Iowa Gambling Task, and [3] a modified ERP version of a probabilistic gambling task coupled with multichannel electroencephalography. Neuropsychological scores were also obtained both pre- and post-surgery. RESULTS Behavioral analyses showed a pattern of increased risk for the mTLE-UHS group in decision-making under ambiguity compared to the control group. A decrease in the amplitude of the Feedback Related Negativity (FRN), a weaker effect of valence on delta power, and a general reduction of delta and theta power in the mTLE-UHS group, as compared to the control group, were also found. The beta-gamma activity associated with the delivery of positive reward was similar in both groups. Behavioral performance and electrophysiological measures did not worsen post-surgery. CONCLUSIONS Patients with mTLE-UHS showed impairments in decision-making under ambiguity, particularly when they had to make decisions based on the outcomes of their choices, but not in decision-making under risk. No group differences were observed in decision-making when feedbacks were random. These results might be explained by the abnormal feedback processing seen in the EEG activity of patients with mTLE-UHS, and by concomitant impairments in working memory, and memory. These impairments may be linked to the disruption of mesial temporal lobe networks. Finally, feedback processing and decision-making under ambiguity were already affected in mTLE-UHS patients pre-surgery and did not show evidence of clear worsening post-surgery.
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Affiliation(s)
- Adrià Vilà-Balló
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain,Department of Psychology, Faculty of Education and Psychology, University of Girona, Girona, Spain,Corresponding authors.
| | - Myriam De la Cruz-Puebla
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Department of Cellular Biology, Physiology, and Immunology, Neurosciences Institute, Autonomous University of Barcelona, Barcelona, Spain,Department of Equity in Brain Health, Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), CA, USA,Department of Internal Medicine, Health Sciences Faculty, Technical University of Ambato, Tungurahua, Ecuador,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Málaga, Málaga, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Júlia Miró
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Epilepsy Unit, Neurological Service, Neurology and Genetics Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Jacint Sala-Padró
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Dept. of Psychobiology and Methodology of Behavioural Sciences, Faculty of Psychology, University of Málaga, Málaga, Spain
| | - David Cucurell
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mercè Falip
- Epilepsy Unit, Neurological Service, Neurology and Genetics Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Rodríguez-Fornells
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
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19
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Najafi T, Jaafar R, Remli R, Wan Zaidi WA. A Classification Model of EEG Signals Based on RNN-LSTM for Diagnosing Focal and Generalized Epilepsy. Sensors (Basel) 2022; 22:7269. [PMID: 36236368 PMCID: PMC9571034 DOI: 10.3390/s22197269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Epilepsy is a chronic neurological disorder caused by abnormal neuronal activity that is diagnosed visually by analyzing electroencephalography (EEG) signals. BACKGROUND Surgical operations are the only option for epilepsy treatment when patients are refractory to treatment, which highlights the role of classifying focal and generalized epilepsy syndrome. Therefore, developing a model to be used for diagnosing focal and generalized epilepsy automatically is important. METHODS A classification model based on longitudinal bipolar montage (LB), discrete wavelet transform (DWT), feature extraction techniques, and statistical analysis in feature selection for RNN combined with long short-term memory (LSTM) is proposed in this work for identifying epilepsy. Initially, normal and epileptic LB channels were decomposed into three levels, and 15 various features were extracted. The selected features were extracted from each segment of the signals and fed into LSTM for the classification approach. RESULTS The proposed algorithm achieved a 96.1% accuracy, a 96.8% sensitivity, and a 97.4% specificity in distinguishing normal subjects from subjects with epilepsy. This optimal model was used to analyze the channels of subjects with focal and generalized epilepsy for diagnosing purposes, relying on statistical parameters. CONCLUSIONS The proposed approach is promising, as it can be used to detect epilepsy with satisfactory classification performance and diagnose focal and generalized epilepsy.
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Affiliation(s)
- Tahereh Najafi
- Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Rosmina Jaafar
- Department of Electrical, Electronics and Systems Engineering, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Rabani Remli
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia
| | - Wan Asyraf Wan Zaidi
- Department of Medicine, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia
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20
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Ge H, Di G, Yan Z, Liu D, Liu Y, Song K, Yang K, Hu X, Jiang Z, Hu X, Tian L, Xiao C, Zou Y, Liu H, Chen J. Does epilepsy always indicate worse outcomes? A longitudinal follow-up analysis of 485 glioma patients. World J Surg Oncol 2022; 20:297. [PMID: 36117154 PMCID: PMC9484070 DOI: 10.1186/s12957-022-02772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epilepsy is one of the most common glioma complications, and the two may be connected in more ways than we understand. We aimed to investigate the clinical features of glioma-associated epilepsy and explore the risk factors associated with it. METHODS We collected clinical information from 485 glioma patients in the Nanjing Brain Hospital and conducted 4 periodic follow-up visits. Based on the collected data, we analyzed the clinical characteristics of glioma patients with or without epilepsy and their relationship with survival. RESULTS Among glioma patients, younger people were more likely to have epilepsy. However, epilepsy incidence was independent of gender. Patients with grade II gliomas were most likely to develop epilepsy, while those with grade IV gliomas were least likely. There was no difference in Karnofsky Performance Status scores between patients with glioma-associated epilepsy and those without epilepsy. Additionally, epilepsy was independently associated with longer survival in the World Health Organization grade IV glioma patients. For grades II, III, and IV tumors, the 1-year survival rate of the epilepsy group was higher than that of the non-epilepsy group. CONCLUSIONS Epilepsy did not lead to worse admission performance and correlated with a better prognosis for patients with grade IV glioma.
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Affiliation(s)
- Honglin Ge
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Guangfu Di
- Department of Neurosurgery, the First Affiliated Hospital (Yijishan Hospital), Wannan Medical College, Wuhu, China
| | - Zheng Yan
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Dongming Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yong Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Kun Song
- Department of Pathology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Kun Yang
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Xinhua Hu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zijuan Jiang
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Xiao Hu
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Lei Tian
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Chaoyong Xiao
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yuanjie Zou
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Hongyi Liu
- Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jiu Chen
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, 210029, Jiangsu, China. .,Institute of Neuropsychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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21
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Xu K, Wei Y, Liu C, Zhao L, Geng B, Mai W, Zhang S, Liang L, Zeng X, Deng D, Liu P. Effect of Moxibustion Treatment on Degree Centrality in Patients With Mild Cognitive Impairment: A Resting-State Functional Magnetic Resonance Imaging Study. Front Hum Neurosci 2022; 16:889426. [PMID: 35982690 PMCID: PMC9378775 DOI: 10.3389/fnhum.2022.889426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is a common neurological disorder. Moxibustion has been shown to be effective in treating MCI, but its therapeutic mechanisms still remain unclear. This study mainly aimed to investigate the modulation effect of moxibustion treatment for patients with MCI by functional magnetic resonance imaging (fMRI). Methods A total of 47 patients with MCI and 30 healthy controls (HCs) participated in resting-state fMRI imaging (rs-fMRI) scans. Patients with MCI were randomly divided into true moxibustion group (TRUE, n = 30) and sham moxibustion group (SHAM, n = 17). The degree centrality (DC) approach was applied to distinguish altered brain functions. Correlation analysis was then performed to examine the relationships between the neuroimaging findings and clinical symptoms. Results Compared with HCs, patients with MCI mainly showed decreased DC in the left middle frontal cortex (MFC) and bilateral middle cingulate cortex (MCC). After moxibustion treatment, the SHAM group had no significant DC findings, while TRUE group mainly showed significant increased DC in the bilateral MFC and MCC, as well as decreased DC in the left middle occipital cortex (MOC). Repeated measures analysis of variance (ANOVA) showed significant interactions between the two groups of patients with MCI. In addition, the higher Mini-Mental State Examination (MMSE) score was significantly positively correlated with increased DC in the right MFC and left MCC after moxibustion treatment. Conclusion Our findings demonstrate that the potential value of moxibustion treatment on MCI, which adds new insights into the popular view that moxibustion treatment may slow cognitive decline in patients with MCI.
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Affiliation(s)
- Ke Xu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Yichen Wei
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Chengxiang Liu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Lihua Zhao
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, China
| | - Bowen Geng
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Wei Mai
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, China
| | - Shuming Zhang
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Lingyan Liang
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao Zeng
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Demao Deng
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- *Correspondence: Demao Deng,
| | - Peng Liu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi’an, China
- Peng Liu,
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22
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Xu K, Wei Y, Zhang S, Zhao L, Geng B, Mai W, Li P, Liang L, Chen D, Zeng X, Deng D, Liu P. Percentage amplitude of fluctuation and structural covariance changes of subjective cognitive decline in patients: A multimodal imaging study. Front Neurosci 2022; 16:888174. [PMID: 35937877 PMCID: PMC9354620 DOI: 10.3389/fnins.2022.888174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Back ground Subjective cognitive decline (SCD) may be the first clinical sign of Alzheimer’s disease (AD). The possible neural mechanisms of SCD are not well known. This study aimed to compare percent amplitude of fluctuation (PerAF) and structural covariance patterns in patients with SCD and healthy controls (HCs). Methods We enrolled 53 patients with SCD and 65 HCs. Resting-state functional magnetic resonance imaging (MRI) data and T1-weighted anatomical brain 3.0-T MRI scans were collected. The PerAF approach was applied to distinguish altered brain functions between the two groups. A whole-brain voxel-based morphometry analysis was performed, and all significant regions were selected as regions of interest (ROIs) for the structural covariance analysis. Statistical analysis was performed using two-sample t-tests, and multiple regressions were applied to examine the relationships between neuroimaging findings and clinical symptoms. Results Functional MRI results revealed significantly increased PerAF including the right hippocampus (HIPP) and right thalamus (THA) in patients with SCD relative to HCs. Gray matter volume (GMV) results demonstrated decreased GMV in the bilateral ventrolateral prefrontal cortex (vlPFC) and right insula in patients with SCD relative to HCs. Taking these three areas including the bilateral vlPFC and right insula as ROIs, differences were observed in the structural covariance of the ROIs with several regions between the two groups. Additionally, significant correlations were observed between neuroimaging findings and clinical symptoms. Conclusion Our study investigated the abnormal PerAF and structural covariance patterns in patients with SCD, which might provide new insights into the pathological mechanisms of SCD.
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Affiliation(s)
- Ke Xu
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Yichen Wei
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shuming Zhang
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Lihua Zhao
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, China
| | - Bowen Geng
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Wei Mai
- Department of Acupuncture, First Affiliated Hospital, Guangxi University of Chinese Medicine, Nanning, China
| | - Pengyu Li
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Lingyan Liang
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Duoli Chen
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Xiao Zeng
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
| | - Demao Deng
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- Demao Deng,
| | - Peng Liu
- School of Life Sciences and Technology, Life Science Research Center, Xidian University, Xi’an, China
- School of Life Sciences and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi’an, China
- *Correspondence: Peng Liu,
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23
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Yang F, Jia W, Kukun H, Ding S, Zhang H, Wang Y. A Study of Spontaneous Brain Activity on Resting-State Functional Magnetic Resonance Imaging in Adults with MRI-Negative Temporal Lobe Epilepsy. Neuropsychiatr Dis Treat 2022; 18:1107-1116. [PMID: 35677937 PMCID: PMC9170234 DOI: 10.2147/ndt.s366189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE-N) represent an important subgroup of temporal lobe epilepsy (TLE). Here, we aimed to combine three voxel-based local brain area analysis methods of resting-state functional MRI (rs-fMRI), to examine the TLE-N patients' resting brain function based on neural synchronization and intensity of local brain areas. Methods The study included 47 patients with TLE, including 28 cases of drug-controlled TLE (cTLE-N) and 19 cases of drug-resistant TLE-N (rTLE-N), as well as 30 participants in the healthy control (HC) group. To comprehensively assess the altered brain function associated with TLE-N patients, we analyzed three data-driven rs-fMRI algorithms for amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo). Results Compared to the HC group, the distribution of abnormal functional brain areas in cTLE-N patients was dominated by occipital lobe activation, as measured by increased fALFF values in the superior occipital gyrus (SOG) and increased ReHo values in the lingual gyrus (Lin), fusiform gyrus, and middle occipital gyrus. Patients with rTLE-N exhibited a diffuse distribution of abnormal functional brain areas, showing increased fALFF values in the SOG, Lin, superior temporal gyrus, and postcentral gyrus, and decreased fALFF values in the inferior frontal gyrus orbital, parahippocampal gyrus, and superior frontal gyrus orbital. The ReHo values were reduced in the orbital region of the middle frontal gyrus, the precuneus, and the parietal inferior angular gyrus; while ReHo values were elevated values in several frontal, temporal, occipital, and subcortical brain areas. Conclusion Patients with rTLE-N have local brain activity changes in the prefrontal limbic system and default model network dysfunction, while cTLE-N patients have local brain activity changes in the visual functional areas. Different epilepsy networks exist between cTLE-N and rTLE-N.
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Affiliation(s)
- Fan Yang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Wenxiao Jia
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Hanjiaerbieke Kukun
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Shuang Ding
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Haotian Zhang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Yunling Wang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
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24
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Caciagli L, Paquola C, He X, Vollmar C, Centeno M, Wandschneider B, Braun U, Trimmel K, Vos SB, Sidhu MK, Thompson PJ, Baxendale S, Winston GP, Duncan JS, Bassett DS, Koepp MJ, Bernhardt BC. Disorganization of language and working memory systems in frontal versus temporal lobe epilepsy. Brain 2022; 146:935-953. [PMID: 35511160 PMCID: PMC9976988 DOI: 10.1093/brain/awac150] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 02/28/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
Cognitive impairment is a common comorbidity of epilepsy and adversely impacts people with both frontal lobe (FLE) and temporal lobe (TLE) epilepsy. While its neural substrates have been investigated extensively in TLE, functional imaging studies in FLE are scarce. In this study, we profiled the neural processes underlying cognitive impairment in FLE and directly compared FLE and TLE to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE and 52 controls) using neuropsychological tests and four functional MRI tasks probing expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-seizure medication load. We devised a multiscale approach to map brain activation and deactivation during cognition and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects across established motifs of functional brain organization: (i) canonical resting-state functional systems; and (ii) the principal functional connectivity gradient, which encodes a continuous transition of regional connectivity profiles, anchoring lower-level sensory and transmodal brain areas at the opposite ends of a spectrum. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, as well as reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. The imaging signatures of dysfunction in FLE are broadly similar to those in TLE, but some patterns are syndrome-specific: altered default-mode deactivation is more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands is more marked in TLE. Functional abnormalities in FLE and TLE appear overall modulated by disease load. On balance, our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies and sheds light on system behaviour that may be amenable to future remediation strategies.
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Affiliation(s)
- Lorenzo Caciagli
- Correspondence to: Lorenzo Caciagli, MD, PhD Department of Bioengineering University of Pennsylvania, 240 Skirkanich Hall 210 South 33rd Street, Philadelphia, PA 19104, USA E-mail: ;
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec H3A 2B4, Canada
| | - Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Christian Vollmar
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Ludwig-Maximilians-Universität, 81377 Munich, Germany
| | - Maria Centeno
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Epilepsy Unit, Hospital Clínic de Barcelona, IDIBAPS, 08036 Barcelona, Spain
| | - Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Urs Braun
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karin Trimmel
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, 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
| | - Meneka K Sidhu
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Gavin P Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK,Department of Medicine, Division of Neurology, Queen’s University, Kingston, Ontario, Canada
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK,MRI Unit, Epilepsy Society,Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
| | - Dani S Bassett
- Correspondence may also be addressed to: Dani S. Bassett, PhD E-mail:
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25
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Simsekoglu R, Tombul T, Demirci H, Özdemir M, Ankaralı H. Comparison of decision-making under ambiguity in patients with temporal lobe and frontal lobe epilepsy. Epilepsy Behav 2022; 129:108636. [PMID: 35259626 DOI: 10.1016/j.yebeh.2022.108636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The effect of the frontal lobe on cognitive functions is a subject that has been studied frequently. However, cognitive impairments that can be seen in frontal lobe epilepsy are less addressed. In previous studies on decision-making disorders in patients with epilepsy, patients with temporal lobe epilepsy (TLE) were frequently studied, and it was reported that decision-making disorders could be encountered in this patient group. In this study, we aimed to compare the decision-making performance of patients with cryptogenic frontal lobe epilepsy (FLE) and TLE in ambiguous situations. METHODS Twenty patients with TLE (mean age: 34.10 ± 11.71 years) and 20 patients with FLE (mean age: 32.25 ± 11.92 years) were enrolled in the study and their cognitive performance was compared with 20 healthy controls (mean age: 33.15 ± 13.66 years). Neuropsychological tests were performed on the participants for sleep, depression, anxiety, impulsivity, intelligence, attention, language functions, memory and learning, and frontal axis functions. Decision-making performance in ambiguous situations was studied using the Iowa Gambling Task (IGT). RESULTS Iowa Gambling Task performances of patients with FLE and TLE were found to be worse than in healthy controls (p = 0.049). Although there was no statistically significant difference when the decision-making of patients with TLE and FLE was compared, it was observed that patients with FLE chose higher risk cards compared with those with TLE. The performances of the neuropsychological subgroup tests of patients with TLE and FLE in attention, language functions, memory and learning, and frontal axis functions were found to be significantly worse than in healthy subjects. CONCLUSION Decision-making in patients with TLE and FLE in ambiguous situations is similarly impaired compared with healthy controls.
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Affiliation(s)
- Ruken Simsekoglu
- Istanbul Medeniyet University, Göztepe City Hospital, Neurology Department, Turkey.
| | - Temel Tombul
- Istanbul Medeniyet University, Göztepe City Hospital, Neurology Department, Turkey
| | - Hasan Demirci
- Department of Psychology, University of Health Sciences, Turkey
| | - Mehtap Özdemir
- Istanbul Medeniyet University, Göztepe City Hospital, Neurology Department, Turkey
| | - Handan Ankaralı
- Istanbul Medeniyet University, Medical Faculty, Biostatistics and Medical Informatics Department, Turkey
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Joplin S, Gascoigne M, Barton B, Webster R, Gill D, Lawson JA, Mandalis A, Sabaz M, McLean S, Gonzalez L, Smith ML, Lah S. Accelerated long-term forgetting in children with temporal lobe epilepsy: A timescale investigation of material specificity and executive skills. Epilepsy Behav 2022; 129:108623. [PMID: 35259627 DOI: 10.1016/j.yebeh.2022.108623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/15/2022]
Abstract
Recently, children with temporal lobe epilepsy (TLE) were found to be at risk of accelerated long-term forgetting (ALF). In this study, we examined the temporal trajectory of ALF, while exploring the relationship between ALF, executive skills, and epilepsy variables. Fifty-one children, (23 with TLE and 28 typically developing) completed a battery of neuropsychological tests of verbal and visual memory, executive skills, and two experimental memory tasks (verbal and visual) involving recall after short (30-min) and extended (1-day and 2-week) delays. Side of seizure focus and hippocampal integrity were considered. On the visual task (Scene Memory), children with TLE performed comparably to typically developing children following a 30-min and 1-day delay, although worse than typically developing children at 2 weeks: ALF was observed in children with right TLE focus. The two groups did not differ on the experimental verbal memory task. Children with TLE also had worse performance than typically developing children on standardized verbal memory test and on tests of executive skills (i.e., verbal generativity, inhibition, working memory, complex attention). Only complex attention was associated with visual ALF. ALF was present for visuo-spatial materials in children with TLE at two weeks, and children with right TLE were most susceptible. A relationship was identified between complex attention and long-term forgetting. The findings extend our understanding of difficulties in long-term memory formation experienced by children with TLE.
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Affiliation(s)
- Samantha Joplin
- School of Psychology, The University of Sydney, NSW 2006, Australia.
| | - Michael Gascoigne
- School of Psychology and Translational Health Research Institute, Western Sydney University, NSW 2751, Australia
| | - Belinda Barton
- Children's Hospital Education Research Institute and the Kids Neuroscience Centre, The Children's Hospital at Westmead, NSW 2145, Australia; Children's Hospital Westmead Clinical School, Westmead, NSW 2145, Australia
| | - Richard Webster
- TY Nelson Department of Neurology, Kids Neuroscience Centre, The Children's Hospital at Westmead, NSW 2145, Australia
| | - Deepak Gill
- TY Nelson Department of Neurology, Kids Neuroscience Centre, The Children's Hospital at Westmead, NSW 2145, Australia
| | - John A Lawson
- School of Women and Children's Health, UNSW, Department of Neurology SCHN, Randwick, NSW 2031, Australia
| | - Anna Mandalis
- Department of Psychology, Sydney Children's Hospital, Randwick, NSW 2031, Australia
| | - Mark Sabaz
- Department of Psychology, Sydney Children's Hospital, Randwick, NSW 2031, Australia
| | - Samantha McLean
- TY Nelson Department of Neurology, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia
| | - Linda Gonzalez
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Mary-Lou Smith
- Department of Psychology, University of Toronto Mississauga and Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Suncica Lah
- School of Psychology, The University of Sydney, NSW 2006, Australia.
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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. Appl Neuropsychol 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bakhtiari A, Bjørke AB, Larsson PG, Olsen KB, Nævra MCJ, Taubøll E, Heuser K, Østby Y. Episodic Memory Dysfunction and Effective Connectivity in Adult Patients With Newly Diagnosed Nonlesional Temporal Lobe Epilepsy. Front Neurol 2022; 13:774532. [PMID: 35222242 PMCID: PMC8866246 DOI: 10.3389/fneur.2022.774532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Epilepsy is associated with both changes in brain connectivity and memory function, usually studied in the chronic patients. The aim of this study was to explore the presence of connectivity alterations measured by EEG in the parietofrontal network in patients with temporal lobe epilepsy (TLE), and to examine episodic memory, at the time point of diagnosis. Methods The parietofrontal network of newly diagnosed patients with TLE (N = 21) was assessed through electroencephalography (EEG) effective connectivity and compared with that of matched controls (N = 21). Furthermore, we assessed phenomenological aspects of episodic memory in both groups. Association between effective connectivity and episodic memory were assessed through correlation. Results Patients with TLE displayed decreased episodic (p ≤ 0.001, t = −5.18) memory scores compared with controls at the time point of diagnosis. The patients showed a decreased right parietofrontal connectivity (p = 0.03, F = 4.94) compared with controls, and significantly weaker connectivity in their right compared with their left hemisphere (p = 0.008, t = −2.93). There were no significant associations between effective connectivity and episodic memory scores. Conclusions We found changes in both memory function and connectivity at the time point of diagnosis, supporting the notion that TLE involves complex memory functions and brain networks beyond the seizure focus to strongly interconnected brain regions, already early in the disease course. Whether the observed connectivity changes can be interpreted as functionally important to the alterations in memory function, it remains speculative.
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Affiliation(s)
- Aftab Bakhtiari
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Agnes Balint Bjørke
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Division of Neurology, Rheumatology and Habilitation, Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål Gunnar Larsson
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Ketil Berg Olsen
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Marianne C. Johansen Nævra
- Section of Clinical Neurophysiology, Division of Clinical Neuroscience, Department of Neurosurgery, Oslo University Hospital–Rikshospitalet, Oslo, Norway
| | - Erik Taubøll
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Division of Neurology, Rheumatology and Habilitation, Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Kjell Heuser
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- *Correspondence: Kjell Heuser
| | - Ylva Østby
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Ylva Østby
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Tung H, Pan SY, Lan TH, Lin YY, Peng SJ. Characterization of Hippocampal-Thalamic-Cortical Morphometric Reorganization in Temporal Lobe Epilepsy. Front Neurol 2022; 12:810186. [PMID: 35222230 PMCID: PMC8866816 DOI: 10.3389/fneur.2021.810186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
IntroductionBrain cortico-subcortical connectivity has been investigated in epilepsy using the functional MRI (MRI). Although structural images cannot demonstrate dynamic changes, they provide higher spatial resolution, which allows exploration of the organization of brain in greater detail.MethodsWe used high-resolution brain MRI to study the hippocampal-thalamic-cortical networks in temporal lobe epilepsy (TLE) using a volume-based morphometric method. We enrolled 22 right-TLE, 33 left-TLE, and 28 age/gender-matched controls retrospectively. FreeSurfer software was used for the thalamus segmentation.ResultsAmong the 50 subfields, ipsilateral anterior, lateral, and parts of the intralaminar and medial nuclei, as well as the contralateral parts of lateral nuclei had significant volume loss in both TLE. The anteroventral nucleus was most vulnerable. Most thalamic subfields were susceptible to seizure burden, especially the left-TLE. SPM12 was used to conduct an analysis of the gray matter density (GMD) maps. Decreased extratemporal GMD occurred bilaterally. Both TLE demonstrated significant GMD loss over the ipsilateral inferior frontal gyrus, precentral gyrus, and medial orbital cortices.SignificanceThalamic subfield atrophy was related to the ipsilateral inferior frontal GMD changes, which presented positively in left-TLE and negatively in right-TLE. These findings suggest prefrontal-thalamo-hippocampal network disruption in TLE.
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Affiliation(s)
- Hsin Tung
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center of Faculty Development, Taichung Veterans General Hospital, Taichung, Taiwan
- Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Szu-Yen Pan
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
- Department of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Yang Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Syu-Jyun Peng
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Fallahi A, Pooyan M, Habibabadi JM, Hashemi-Fesharaki SS, Tabatabaei NH, Ay M, Nazem-Zadeh MR. A novel approach for extracting functional brain networks involved in mesial temporal lobe epilepsy based on self organizing maps. Informatics in Medicine Unlocked 2022. [DOI: 10.1016/j.imu.2022.100876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bolocan M, Iacob CI, Avram E. Working Memory and Language Contribution to Verbal Learning and Memory in Drug-Resistant Unilateral Focal Temporal Lobe Epilepsy. Front Neurol 2021; 12:780086. [PMID: 34956061 PMCID: PMC8692669 DOI: 10.3389/fneur.2021.780086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
We aimed to investigate the working memory (WM) and language separate contributions to verbal learning and memory in patients with unilateral drug-resistant temporal lobe epilepsy (drTLE); additionally, we explored the mediating role of WM on the relationship between the number of antiepileptic drugs (AEDs) and short-term verbal memory. We retrospectively enrolled 70 patients with left (LTLE; n = 44) and right (RTLE; n = 26) drTLE. About 40 similar (age and education) healthy controls were used to determine impairments of groups at WM, language (naming and verbal fluency), and verbal learning and memory (five trials list-learning, story memory-immediate recall). To disentangle the effect of learning from the short-term memory, we separately analyzed performances at the first trial, last trial, and delayed-recall list-learning measures, in addition to the total learning capacity (the sum of the five trials). Correlation and regression analyses were used to assess the contribution of potential predictors while controlling for main clinical and demographic variables, and ascertain the mediating role of WM. All patients were impaired at WM and story memory, whereas only LTLE showed language and verbal learning deficits. In RTLE, language was the unique predictor for the most verbal learning performances, whereas WM predicted the results at story memory. In LTLE, WM was the sole predictor for short-term verbal learning (list-learning capacity; trial 1) and mediated the interaction between AED number and the performance at these measures, whereas language predicted the delayed-recall. Finally, WM confounded the performance at short-term memory in both groups, although at different measures. WM is impaired in drTLE and contributes to verbal memory and learning deficits in addition to language, mediating the relationship between AED number and short-term verbal memory in LTLE. Clinicians should consider this overlap when interpreting poor performance at verbal learning and memory in drTLE.
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Affiliation(s)
- Monica Bolocan
- Laboratory of Health Psychology and Clinical Neuropsychology, Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Claudia I Iacob
- Laboratory of Health Psychology and Clinical Neuropsychology, Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Eugen Avram
- Laboratory of Health Psychology and Clinical Neuropsychology, Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
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Hermann BP, Struck AF, Busch RM, Reyes A, Kaestner E, McDonald CR. Neurobehavioural comorbidities of epilepsy: towards a network-based precision taxonomy. Nat Rev Neurol 2021; 17:731-746. [PMID: 34552218 PMCID: PMC8900353 DOI: 10.1038/s41582-021-00555-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 02/06/2023]
Abstract
Cognitive and behavioural comorbidities are prevalent in childhood and adult epilepsies and impose a substantial human and economic burden. Over the past century, the classic approach to understanding the aetiology and course of these comorbidities has been through the prism of the medical taxonomy of epilepsy, including its causes, course, characteristics and syndromes. Although this 'lesion model' has long served as the organizing paradigm for the field, substantial challenges to this model have accumulated from diverse sources, including neuroimaging, neuropathology, neuropsychology and network science. Advances in patient stratification and phenotyping point towards a new taxonomy for the cognitive and behavioural comorbidities of epilepsy, which reflects the heterogeneity of their clinical presentation and raises the possibility of a precision medicine approach. As we discuss in this Review, these advances are informing the development of a revised aetiological paradigm that incorporates sophisticated neurobiological measures, genomics, comorbid disease, diversity and adversity, and resilience factors. We describe modifiable risk factors that could guide early identification, treatment and, ultimately, prevention of cognitive and broader neurobehavioural comorbidities in epilepsy and propose a road map to guide future research.
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Affiliation(s)
- Bruce P. Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,
| | - Aaron F. Struck
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,William S. Middleton Veterans Administration Hospital, Madison, WI, USA
| | - Robyn M. Busch
- Epilepsy Center and Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Anny Reyes
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Erik Kaestner
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Carrie R. McDonald
- Department of Psychiatry and Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
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Tan JK, Khoo CS, Beh HC, Hod R, Baharudin A, Yahya WNNW, Tan HJ. Prevalence and associated risk factors of undiagnosed depression among people with epilepsy in a multiethnic society. Epilepsy Res 2021; 178:106772. [PMID: 34763265 DOI: 10.1016/j.eplepsyres.2021.106772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/17/2021] [Accepted: 09/19/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Depression is the most frequent psychiatric comorbidity of epilepsy. However, clinicians often neglect to screen for depressive symptoms among patients with epilepsy and, therefore, fail to detect depression. Many studies have described the risks associated with depression in patients with epilepsy, but few studies have elaborated whether these risks are similar in those with undiagnosed depression, especially in a multiethnic community. METHODS In the present cross-sectional study conducted at a tertiary teaching hospital, we aimed to investigate the prevalence and associated risk factors of undiagnosed depression in patients with epilepsy. We recruited patients with epilepsy aged 18-65 years after excluding those with background illnesses that may have contributed to the depressive symptoms. In total, 129 participants were recruited. We collected their demographic and clinical details before interviewing them using two questionnaires-the Neurological Disorders Depression Inventory for Epilepsy and Beck's Depression Inventory-II. Subsequently, if a participant screened positive for depression, the diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders questionnaire, and a psychiatric clinic referral was offered. RESULTS Among the 129 participants, 9.3 % had undiagnosed major depressive disorder, and there was a female preponderance (66.7 %). The risk factors for undiagnosed depression among patients with epilepsy included low socioeconomic background (p = 0.026), generalized epilepsy (p = 0.036), and temporal lobe epilepsy (p = 0.010). Other variables such as being underweight and unmarried were more common among patients diagnosed with depression than without but no statistically significant relationship was found. CONCLUSION The prevalence of undiagnosed depression among patients with epilepsy was higher than that in population-based studies conducted in Western countries. Although questionnaires to screen for depression are widely available, some clinicians rarely use them and, therefore, fail to identify patients who may benefit from psychosocial support and treatment that would improve their disease outcomes and quality of life. The present study indicated that clinicians should use screening questionnaires to identify undiagnosed depression in people with epilepsy.
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Affiliation(s)
- Juen Kiem Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Chien Beh
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azlin Baharudin
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Wan Nur Nafisah Wan Yahya
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Jan Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
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Lv Z, Chen Z, Ye W, Pang X, Nie L, Chang W, Long Q, Zheng J. Disruption in Surface-Based Functional Connectivity in the Right Posterior Hippocampal CA3 Subfield: A Probable Neural Basis of Visuospatial Working Memory Impairment in Patients With Right Temporal Lobe Epilepsy. Front Neurol 2021; 12:735689. [PMID: 34712198 PMCID: PMC8545809 DOI: 10.3389/fneur.2021.735689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022] Open
Abstract
Visuospatial working memory (VSWM) impairment is common in patients with right temporal lobe epilepsy (rTLE). The posterior hippocampus is critical for spatial memory, but the contributions of the different subfields to VSWM deficits remain unclear. Forty-six rTLE patients and 42 healthy controls (HCs) were recruited. Resting-state fMRI (rsfMRI) and structural MRI scans were administered, followed by a VSWM_Nback test. The right posterior hippocampus was automatically segmented, and the surface-based functional connectivity (SBFC) of the subiculum (Sub), CA1, CA3, dentate gyrus (DG), hippocampal tail, and right entorhinal cortex (EC) were compared between groups. Correlation analysis was performed between the altered SBFC and VSWM_Nback scores for rTLE patients. The results showed that rTLE patients underperformed in the VSWM_Nback test, with longer mean reaction time of accurate response (ACCmeanRT) in 0back and 2back condition, lower hit rate (HR) and higher false alarm rate (FAR) in 2back condition. Compared with HCs, the rCA3 in the rTLE group exhibited decreased SBFC with inferior parietal cortex (IPC), temporal lateral cortex (TLC), and posterior visual cortex (PVC) in the right hemisphere as well as the bilateral dorsolateral prefrontal cortex (DLPFC). The SBFC of the rEC and right anterior cingulate cortex (rACC) increased in the rTLE group. Within the rTLE group, the decreased SBFC of the rCA3-rIPC and rCA3-rLTC were correlated with worse VSWM performance. Therefore, the decreased SBFC of the rCA3-rIPC and rCA3-rLTC might be the critical aberrant FC pattern reflecting VSWM impairment in rTLE patients. The mechanism might involve functional disruption between the core subsystem and the medial temporal subsystem of the default mode network (DMN).
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Affiliation(s)
- Zongxia Lv
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zirong Chen
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wei Ye
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liluo Nie
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiwei Chang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qijia Long
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Mikula B, Lencsés A, Borbély C, Demeter G. Emotion recognition and theory of mind after temporal lobe epilepsy surgery: A systematic review. Seizure 2021; 93:63-74. [PMID: 34710833 DOI: 10.1016/j.seizure.2021.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/13/2021] [Accepted: 10/04/2021] [Indexed: 01/14/2023] Open
Abstract
In order to navigate in our complex social world successfully, it is crucial to maintain and practice cognitive skills that are dedicated to adaptive social functioning. Emerging evidence suggests that besides deficits in declarative memory, executive functions, and language, impairments in social cognition (SC, e.g., emotion recognition, theory of mind) are also present in temporal lobe epilepsy (TLE). The organic and psycho-social consequences of epilepsy surgery might have additional implications regarding this deficit. Here we qualitatively synthesize longitudinal and cross-sectional findings on SC after TLE surgery. A literature search using PubMed and Scopus identified 275 potential articles. Studies were eligible if they (1) included patients with a diagnosis of TLE, (2) included a healthy comparison group, (3) reported original research, (4) were published in peer-reviewed journals and in English language, (5) reported the intervention of epilepsy surgery. Articles that (1) were case studies, (2) did not focus on SC abilities, (3) used interviews or self-report questionnaires to examine SC functions were excluded. A total of 16 original studies assessing emotion recognition (ER) and/or theory of mind (ToM) matched our criteria. The literature suggests that neither ER nor ToM abilities change after surgery: post-surgery patients show similar impairment patterns to pre-surgery patients. Nevertheless, individual improvement or decline could be masked by group comparisons and results should be considered in light of methodological heterogeneity among studies.
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Affiliation(s)
- Bernadett Mikula
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.
| | - Anita Lencsés
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
| | - Csaba Borbély
- National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Gyula Demeter
- Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Rehabilitation Department of Brain Injuries, National Institute of Medical Rehabilitation, Budapest, Hungary
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Guerrero-Molina MP, Rodriguez-López C, Panadés-de Oliveira L, Uriarte-Pérez de Urabayen D, Garzo-Caldas N, García-Cena CE, Saiz-Díaz RA, Benito-León J, Gonzalez de la Aleja J. Antisaccades and memory-guided saccades in genetic generalized epilepsy and temporal lobe epilepsy. Epilepsy Behav 2021; 123:108236. [PMID: 34419714 DOI: 10.1016/j.yebeh.2021.108236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Oculomotor tasks can be used to measure volitional control of behavior sensitive to frontal dysfunction. This study aimed to examine the saccadic eye movement in Genetic Generalized Epilepsy (GGE) which could correlate with the abnormality of the frontal lobe or the thalamo-frontal network. METHODS Twenty-one patients with GGE were compared with 22 patients with Temporal Lobe Epilepsy (TLE) and 39 healthy controls. Visual-guided saccades, Antisaccades, and Memory-guided saccades as oculomotor tasks were performed using a novel gaze-tracker designed for clinical practice use. RESULTS Patients with epilepsy (either GEE or TLE) had similar latency, accuracy, and velocity in visual-guided saccades and memory-guided saccades. Patients with epilepsy had similar latencies and correct antisaccade number. However, healthy volunteers, matched by age, had faster responses and more accurate results than patients with epilepsy. CONCLUSIONS Our investigations did not reveal differences between TLE and GGE patients' groups in visually guided saccades, antisaccades, and memory-guided saccades, thus suggesting that the frontal cortical mechanisms responsible for them are not explicitly impaired in patients with GGE.
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Affiliation(s)
| | | | | | | | | | - Cecilia E García-Cena
- Centre for Automation and Robotics, Universidad Politécnica de Madrid, 28012 Madrid, Spain.
| | - Rosa A Saiz-Díaz
- 12th of October University Hospital, Avenida Córdoba S/N, 28041 Madrid, Spain
| | - Julián Benito-León
- 12th of October University Hospital, Avenida Córdoba S/N, 28041 Madrid, Spain
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Heaney D, Baxendale S. Epilepsy & gambling: Risk factors for problem gambling behaviors in people with epilepsy. Epilepsy Behav 2021; 122:108082. [PMID: 34147882 DOI: 10.1016/j.yebeh.2021.108082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Problem gambling results from the complex interaction of neurological factors with psychological, demographic, and socioeconomical influences. The vulnerabilities of people with epilepsy to many of these influences may increase their susceptibility to developing problematic gambling behaviors. The aim of this study was to establish the frequency of gambling participation and the clinical correlates of problem gambling behaviors in people with epilepsy. METHODS Lifestyle questions, including the Lie/Bet screening questionnaire were administered to 250 consecutive attendees at a neurology clinic. Valid data were available for 174 adults with epilepsy and 65 adults with other neurological conditions. RESULTS With the exception of people with frontal lobe epilepsy (FLE), gambling participation rates in people with epilepsy and those with other neurological conditions were lower than those reported in the general population. While the overall levels of gambling participation were relatively low in this sample, the number of gamblers who responded positively to the lie/bet questionnaire was ten times higher than that seen in the general population, with one in three gamblers in our series reporting signs of escalation. All had epilepsy and were more likely to be taking Levetiracetam or Brivaracetam than the other gamblers in our series. While epilepsy classification was not related to gambling escalation, patients with FLE were overrepresented in this group due to their significantly higher baseline levels of participation in gambling. CONCLUSIONS People with FLE may have a heightened vulnerability to developing problem gambling behaviors. The role of the neurological consultation in managing these risks is discussed.
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Affiliation(s)
| | - Sallie Baxendale
- University College Hospital, London, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL, Queen Square, Institute of Neurology, London, United Kingdom.
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Avvaru S, Peled N, Provenza NR, Widge AS, Parhi KK. Region-Level Functional and Effective Network Analysis of Human Brain During Cognitive Task Engagement. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1651-1660. [PMID: 34398758 PMCID: PMC8428572 DOI: 10.1109/tnsre.2021.3105432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mental disorders are a major source of disability, with few effective treatments. It has recently been argued that these diseases might be effectively treated by focusing on decision-making, and specifically remediating decision-making deficits that act as "ingredients" in these disorders. Prior work showed that direct electrical brain stimulation can enhance human cognitive control, and consequently decision-making. This raises a challenge of detecting cognitive control lapses directly from electrical brain activity. Here, we demonstrate approaches to overcome that challenge. We propose a novel method, referred to as maximal variance node merging (MVNM), that merges nodes within a brain region to construct informative inter-region brain networks. We employ this method to estimate functional (correlational) and effective (causal) networks using local field potentials (LFP) during a cognitive behavioral task. The effective networks computed using convergent cross mapping differentiate task engagement from background neural activity with 85% median classification accuracy. We also derive task engagement networks (TENs): networks that constitute the most discriminative inter-region connections. Subsequent graph analysis illustrates the crucial role of the dorsolateral prefrontal cortex (dlPFC) in task engagement, consistent with a widely accepted model for cognition. We also show that task engagement is linked to prefrontal cortex theta (4-8 Hz) oscillations. We, therefore, identify objective biomarkers associated with task engagement. These approaches may generalize to other cognitive functions, forming the basis of a network-based approach to detecting and rectifying decision deficits.
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Elsherif M, Esmael A. Hippocampal atrophy and quantitative EEG markers in mild cognitive impairment in temporal lobe epilepsy versus extra-temporal lobe epilepsy. Neurol Sci 2021; 43:1975-1986. [PMID: 34406537 DOI: 10.1007/s10072-021-05540-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive impairment in temporal lobe epilepsy is widely acknowledged as one of the most well-known comorbidities. This study aimed to explore cognitive impairment and to determine the potential clinical, radiological, and quantitative electroencephalography markers for cognitive impairment in temporal lobe epilepsy patients versus extra-temporal lobe epilepsy. METHODS Forty-five patients with temporal lobe epilepsy and forty-five patients with extra-temporal lobe epilepsy were recruited for an administered digit span test, verbal fluency test, mini-mental state examination, digital symbol test, and Montreal cognitive assessment. Also, they were subjected to magnetic resonance imaging assessment for hippocampal atrophy and a quantitative electroencephalography assessment for electroencephalography markers (median frequency, peak frequency, and the alpha-to-theta ratio). RESULTS Patients with extra-temporal lobe epilepsy showed non-significant higher epilepsy durations and a higher frequency of seizures. Temporal lobe epilepsy patients showed a more statistically significant family history of epilepsy (37.7%), more history of febrile convulsions (13.3%), higher hippocampal atrophy (17.8%), and lower cognitive scales, especially mini-mental state examination and Montreal cognitive assessment; lower digital symbol test, verbal fluency test, and backward memory of digit span test. Also, temporal lobe epilepsy patients had a strong negative correlation with electroencephalography markers: median frequency, peak frequency, and the alpha-to-theta ratio (r = - 0.68, P < 0.005 and r = - 0.64, P < 0.005 and r = - 0.66, P < 0.005 respectively). CONCLUSION Cognitive impairment in patients with temporal lobe epilepsy was correlated with hippocampal atrophy and quantitative electroencephalography abnormalities, especially peak frequency, median frequency, and alpha-to-theta ratio that could be used alone for the identification of early cognitive impairment. TRIAL REGISTRATION Clinicaltrials.gov: NCT04376671.
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Affiliation(s)
- Mohammed Elsherif
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt.
| | - Ahmed Esmael
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt
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Doherty C, Kinzy TG, Ferguson L, Altemus J, Hermann BP, Eng C, Najm I, Busch RM. The role of genetic polymorphisms in executive functioning performance in temporal lobe epilepsy. Epilepsy Behav 2021; 121:108088. [PMID: 34102472 PMCID: PMC8238870 DOI: 10.1016/j.yebeh.2021.108088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the role of several genetic polymorphisms (APOE ε4, BDNF Met, and COMT Val) in executive functioning performance in patients with pharmacoresistant temporal lobe epilepsy (TLE). METHODS Ninety-three adults (51 female, mean age = 39 years) with TLE completed executive functioning measures as part of a comprehensive preoperative neuropsychological evaluation, including Trail Making Test (Part B), Wisconsin Card Sorting Test (Conceptual Level Responses and Perseverative Errors), Color Word Interference from the Delis Kaplan Executive Function System, and measures of phonemic and semantic verbal fluency. Genotyping of the APOE, BDNF, and COMT genes was conducted using DNA extracted from peripheral blood or brain tissue (from epilepsy surgery). RESULTS After adjustment for general cognitive ability, COMT Val carriers showed poorer performance on semantic verbal fluency and color word interference than non-carriers, and BDNF Met carriers showed poorer performance on phonemic verbal fluency than those without a Met allele. SIGNIFICANCE Results suggest that COMT and BDNF polymorphisms are associated with performance on several EF measures in patients with TLE, including tasks assessing verbal fluency and response inhibition and account for up to 16% of the variance in test performance. The APOE polymorphism was not significantly associated with any of the executive function measures analyzed.
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Affiliation(s)
- Christine Doherty
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
| | - Tyler G Kinzy
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Ferguson
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.
| | - Jessica Altemus
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin, Madison, WI, USA.
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
| | - Imad Najm
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA; Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Robyn M Busch
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA; Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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Pan L, Guo D, Wang J, Hao Y, Zhang L, Qin X, Song Y. Alterations in neural oscillations related to working memory deficit in temporal lobe epilepsy. Epilepsy Behav 2021; 121:108063. [PMID: 34052633 DOI: 10.1016/j.yebeh.2021.108063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/21/2021] [Accepted: 05/10/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Working memory (WM) is critical for higher level cognition, but the underlying neural mechanisms are not fully understood. Impaired WM affects routine daily activities and is observed in patients with temporal lobe epilepsy (TLE). This study investigated neural oscillations associated with different WM phases, to determine the specific neural activity linked with the phases of WM impairment. METHODS Patients with TLE (n = 52) and healthy volunteers (n = 35) completed a WM task, during which 34-channel electroencephalogram signals were recorded. Characteristic neural oscillation patterns during each WM phase were compared between the 2 groups. RESULTS Patients with TLE showed decreased theta power during the encoding phase of WM, which was associated with reduced accuracy in the WM task. Altered theta power in the frontal region of the brain during the encoding phase was associated with a longer reaction time. CONCLUSIONS Alterations in theta oscillation are related to WM impairment in patients with TLE and may serve as an early marker for evaluating WM deficits. SIGNIFICANCE This study provides an early marker for evaluating WM deficits in TLE.
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Affiliation(s)
- Liping Pan
- General Medicine Department, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin 300052, China
| | - Dandan Guo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jiajing Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China; Second Clinical Medical College of Tianjin Medical University, Tianjin 300211, China
| | - Yuhan Hao
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lulin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xiao Qin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yijun Song
- General Medicine Department, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin 300052, China.
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Poole BJ, Phillips NL, Stewart E, Harris IM, Lah S. Working Memory in Pediatric Epilepsy: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 31:569-609. [PMID: 33818735 DOI: 10.1007/s11065-021-09491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley's working memory model includes four components: the phonological loop, visuo-spatial sketchpad, the central executive, and episodic buffer. The aim of this review was to establish the gravity and pattern of working memory deficits in pediatric epilepsy. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided electronic searches. Sixty-five studies were included in the review. Meta-analyses revealed significant impairments across each working memory component: phonological loop (g = 0.739), visuo-spatial sketchpad (g = 0.521), and central executive (g = 0.560) in children with epilepsy compared to controls. The episodic buffer was not examined. The pattern of impairments, however, differed according to the site and side of seizure focus. This suggests that working memory components are differentially vulnerable to the location of seizure focus in the developing brain.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Natalie L Phillips
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Elizabeth Stewart
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia
| | - Irina M Harris
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia. .,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, 2109, Australia.
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DiFrancesco JC, Isella V, Licciardo D, Crivellaro C, Musarra M, Guerra L, Salvadori N, Chipi E, Calvello C, Costa C, Ferrarese C. Temporal lobe dysfunction in late-onset epilepsy of unknown origin. Epilepsy Behav 2021; 117:107839. [PMID: 33611099 DOI: 10.1016/j.yebeh.2021.107839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Epilepsy with onset in the adulthood is an increasing health problem, due to the progressive aging of the worldwide population. Whether the causes remain undetermined, the disease is defined as Late-Onset Epilepsy of Unknown origin (LOEU). The aim of this study was to evaluate the semiological, electroencephalographic, metabolic, and neuropsychological features of LOEU. METHODS We selected patients with late-onset epilepsy (LOE) (≥55 years), whose causes of the disease have been excluded with a deep clinical-instrumental characterization, including brain MRI, EEG, 18F-labeled fluoro-2-deoxyglucose positron emission tomography (FDG-PET), and neuropsychological assessment. RESULTS Twenty-three LOEU cases were retrospectively recruited. Half presented focal-onset seizures (FOS), the others focal to bilateral tonic-clonic seizures (FBTCS). All demonstrated a mild phenotype, with no recurrence of seizures on single antiseizure treatment at prolonged follow-up. Brain MRI scans were normal in 12 patients (52.3%) and showed nonspecific gliosis or mild atrophy in ten (43.5%); hippocampal sclerosis (HS) was observed in one. In 17/23 (73.9%), the EEG showed slow and/or epileptiform activity of the temporal areas. Brain FDG-PET revealed temporal lobe hypometabolism, mostly ipsilateral to EEG abnormal activity, or multifocal temporal and extra-temporal (cortical, subcortical and subtentorial) clusters of hypometabolism. The neuropsychological analysis demonstrated three different profiles: normal (43.5%), with focal deficits (39.1%) or mild multidomain impairment (17.4%). SIGNIFICANCE Late-Onset Epilepsy of Unknown origin can present as FOS or FBTCS, both with good prognosis. The application of metabolic imaging and neurophysiology techniques in these patients points to the dysfunction of the temporal structures, whose role in the pathogenetic process of the disease remains to be clarified.
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Affiliation(s)
- Jacopo C DiFrancesco
- Department of Neurology, ASST S. Gerardo Hospital, University of Milano - Bicocca, Monza, Italy; Milan Center for Neuroscience (NeuroMI), Italy.
| | - Valeria Isella
- Department of Neurology, ASST S. Gerardo Hospital, University of Milano - Bicocca, Monza, Italy; Milan Center for Neuroscience (NeuroMI), Italy.
| | - Daniele Licciardo
- Department of Neurology, ASST S. Gerardo Hospital, University of Milano - Bicocca, Monza, Italy; Milan Center for Neuroscience (NeuroMI), Italy
| | - Cinzia Crivellaro
- Milan Center for Neuroscience (NeuroMI), Italy; Nuclear Medicine Unit, ASST S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Monica Musarra
- Milan Center for Neuroscience (NeuroMI), Italy; Nuclear Medicine Unit, ASST S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Luca Guerra
- Milan Center for Neuroscience (NeuroMI), Italy; Nuclear Medicine Unit, ASST S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Nicola Salvadori
- Neurology Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Elena Chipi
- Neurology Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Carmen Calvello
- Neurology Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Cinzia Costa
- Neurology Unit, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Carlo Ferrarese
- Department of Neurology, ASST S. Gerardo Hospital, University of Milano - Bicocca, Monza, Italy; Milan Center for Neuroscience (NeuroMI), Italy
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Li HL, Chou XM, Liang Y, Pan T, Zhou Q, Pei CG, Jiang J, Li B, Shao Y. Use of rsfMRI-fALFF for the detection of changes in brain activity in patients with normal-tension glaucoma. Acta Radiol 2021; 62:414-422. [PMID: 32571098 DOI: 10.1177/0284185120926901] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We know little about the changes of brain activity in patients with normal-tension glaucoma (NTG). PURPOSE To investigate the altered spontaneous brain activity in patients with NTG through the resting state functional magnetic resonance imaging-fractional amplitude of low-frequency fluctuation (rsfMRI-fALFF) technique, and to explore the relationship with optical coherence tomography (OCT) and field of vision. MATERIAL AND METHODS Twenty patients with NTG and 20 healthy controls (HCs) (matched for sex, age, and level of education) were enrolled. Spontaneous cerebral activity variations were investigated using the rsfMRI-fALFF technique in all individuals. The average fALFF values of patients with NTG and HCs were compared. RESULTS Compared with HCs, patients with NTG had significantly lower fALFF values in the right angular gyrus and precuneus; however, higher fALFF values in the brain regions were not observed. The values showed statistically significant negative correlation with those of the retinal nerve fiber layer (right angular gyrus: r = -0.607, P = 0.010; right precuneus: r = -0.504, P = 0.020). There was no significant correlation between the fALFF value and cup-disc ratio (right angular gyrus: r = 0.158, P = 0.494; right precuneus: r = -0.087, P = 0.706), mean deviation (right angular gyrus: r = 0.096, P = 0.468; right precuneus: r = 0.026, P = 0.845), and pattern SD value (right angular gyrus: r = 0.064, P = 0.626; right precuneus: r = -0.145, P = 0.268). CONCLUSION Abnormal spontaneous activities were detected in numerous brain regions of patients with NTG, which may provide useful information for understanding the dysfunction in NTG. These activity changes in brain regions may be used as effective clinical indicators for NTG.
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Affiliation(s)
- Han-Lin Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Xue-Mei Chou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Ying Liang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Tong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Qiong Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Chong-Gang Pei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, PR China
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Bjørke AB, Østby Y, Grahl SG, Larsson PG, Olsen KB, Johansen Nævra MC, Ringstad GA, Bjørnerud A, Gjerstad L, Taubøll E, Heuser K. Cognition in adult patients with newly diagnosed non-lesional temporal lobe epilepsy. Epilepsy Behav 2021; 116:107771. [PMID: 33545650 DOI: 10.1016/j.yebeh.2021.107771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate whether cognitive performance is affected in newly diagnosed temporal lobe epilepsy (TLE) and to determine the most vulnerable cognitive domains. METHODS In this baseline longitudinal study, differences in memory and non-memory cognitive functions were assessed using comprehensive neuropsychological test batteries in 21 adult patients with newly diagnosed non-lesional TLE and individually matched controls. In addition, the analyses included ratings of self-perceived emotional status. RESULTS The patients performed more poorly than the control group regarding delayed visual memory (p = 0.013) and executive function tasks related to switching (Trail Making Test and verbal fluency shifting; p = 0.025 and p = 0.03, respectively). We found no differences in verbal learning and memory, attention/working memory/processing speed, and other executive functions. SIGNIFICANCE Our results show that patients with TLE often have specific cognitive deficits at time of diagnosis, even in the absence of structural brain abnormalities. This supports the hypothesis that memory dysfunction is linked to an underlying pathology rather than to the effect of recurrent seizures, long-term use of anti-seizure medication, or other epilepsy-related factors. As certain executive functions are affected at an early stage, the pathology may involve brain regions beyond the temporal lobe and may comprise larger brain networks. These results indicate the need for greater awareness of cognition at the time of diagnosis of TLE and before initiation of treatment, and integration of neuropsychological assessment into early routine clinical care.
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Affiliation(s)
- Agnes Balint Bjørke
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Neurology, Division of Neurology, Rheumatology and Habilitation, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ylva Østby
- Institute of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Simon Gevert Grahl
- Institute of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Pål Gunnar Larsson
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ketil Berg Olsen
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Marianne C Johansen Nævra
- Section of Clinical Neurophysiology, Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Geir Andre Ringstad
- Department of Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Atle Bjørnerud
- The Intervention Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Leif Gjerstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Erik Taubøll
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjell Heuser
- Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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Arski ON, Young JM, Smith ML, Ibrahim GM. The Oscillatory Basis of Working Memory Function and Dysfunction in Epilepsy. Front Hum Neurosci 2021; 14:612024. [PMID: 33584224 PMCID: PMC7874181 DOI: 10.3389/fnhum.2020.612024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
Working memory (WM) deficits are pervasive co-morbidities of epilepsy. Although the pathophysiological mechanisms underpinning these impairments remain elusive, it is thought that WM depends on oscillatory interactions within and between nodes of large-scale functional networks. These include the hippocampus and default mode network as well as the prefrontal cortex and frontoparietal central executive network. Here, we review the functional roles of neural oscillations in subserving WM and the putative mechanisms by which epilepsy disrupts normative activity, leading to aberrant oscillatory signatures. We highlight the particular role of interictal epileptic activity, including interictal epileptiform discharges and high frequency oscillations (HFOs) in WM deficits. We also discuss the translational opportunities presented by greater understanding of the oscillatory basis of WM function and dysfunction in epilepsy, including potential targets for neuromodulation.
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Affiliation(s)
- Olivia N. Arski
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Julia M. Young
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
| | - Mary-Lou Smith
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - George M. Ibrahim
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Division of Neurosurgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Gaston TE, Allendorfer JB, Nair S, Bebin EM, Grayson LP, Martin RC, Szaflarski JP; UAB CBD Program. Effects of highly purified cannabidiol (CBD) on fMRI of working memory in treatment-resistant epilepsy. Epilepsy Behav 2020; 112:107358. [PMID: 32871501 DOI: 10.1016/j.yebeh.2020.107358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We aimed to determine changes in working memory and functional connectivity via functional magnetic resonance imaging (fMRI)-modified Sternberg task after treatment with highly purified cannabidiol (CBD, Epidiolex®; 100 mg/mL) in patients with treatment-resistant epilepsy (TRE). METHODS Twenty patients with TRE (mean age: 35.8 years; 7 male) performed fMRI Sternberg task before receiving CBD ("PRE") and after reaching stable dosage of CBD (15-25 mg/kg/day; "ON"). Each patient performed 2 runs of the modified Sternberg task during PRE and ON fMRI. Twenty-three healthy controls (HCs; mean age: 25 years; 11 M) also completed the task. All were presented with a sequence of 2 or 6 letters and instructed to remember them (encoding). After a delay, a single letter was shown, and participants recalled if letter was shown in sequence (retrieval). Paired t-tests were used to analyze accuracy/response times. For each subject, event-related modeling of encoding (2 and 6 letters) and retrieval was performed. Paired t-tests controlling for seizure frequency change and scanner type were performed to assess changes in neural recruitment during encoding and retrieval in key regions of interest. RESULTS There was nonsignificant increase in mean modified Sternberg task accuracy from PRE to ON-CBD (28.6 vs. 32.1%). PRE and ON accuracy was worse than HCs (75.5%, p < 0.001). ON-PRE comparison revealed increased activation in the right inferior frontal gyrus (IFG) during 6-letter encoding. ON-HC comparison revealed increased activation in bilateral IFG and insula during 2-letter encoding. PRE-HC comparison revealed decreased activation in the left middle frontal gyrus during 6-letter encoding. None of these activations were associated with working memory performance. SIGNIFICANCE Treatment-resistant epilepsy results in poorer working memory performance and lower neural recruitment compared with HCs. Treatment with CBD results in no significant changes in working memory performance and in significant increases in neural activity in regions important for verbal memory and attention compared with HCs during memory encoding.
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Singh TB, Aisikaer A, He C, Wu Y, Chen H, Ni H, Song Y, Yin J. The Assessment of Brain Functional Changes in the Temporal Lobe Epilepsy Patient with Cognitive Impairment by Resting-state Functional Magnetic Resonance Imaging. J Clin Imaging Sci 2020; 10:50. [PMID: 32874755 PMCID: PMC7451150 DOI: 10.25259/jcis_55_2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The objective of the study was to detect functional changes in the brain of cognitive impairment-temporal lobe epilepsy (CI-TLE) patient and to sort out the possible mechanism involved in CI in CI-TLE patients using resting-state functional magnetic resonance imaging (RS-fMRI). Material and Methods Fifty-eight TLE cases were included, which was divided into 44 TLE patients without CI (cognitive not impairment [CNI]-TLE) and 14 TLE patients with CI (CI-TLE). The normal control (NC) group consisted of 40 participants. RS-fMRI data preprocessing was carried out in statistical parametric mapping (SPM) software. The data were realigned, coregistered, normalized, and finally smoothened and then were taken for amplitude of low-frequency fluctuation (ALFF) calculation in RS-fMRI data analysis toolkit (REST) software. For data analysis, voxel-wise two-sample t-test was carried out between TLE group and NC group; CI-TLE group and cognitive not impairment-TLE (CNI-TLE) group in SPM software, a cluster >10 voxels and P < 0.01 was considered to be significant. Results Compared to NC, the TLE patients showed increased ALFF activation mostly in parahippocampal gyrus (PG), frontal lobe, midbrain, pons, insula, inferior temporal gyrus, and anterior cingulate gyrus (ACG) while decreased ALFF value was seen in posterior cingulate gyrus, cuneus, cerebellum posterior lobe, inferior parietal lobule (IPL), and superior temporal gyrus. Compared to CNI-TLE, CI-TLE patients showed increased ALFF in middle temporal gyrus (MTG), cuneus, ACG, IPL, middle frontal gyrus (MFG), superior frontal gyrus (SFG), cerebellum posterior lobe, and decreased ALFF cluster in the corpus callosum and MFG. Conclusion Between TLE and NC, we found increased ALFF activation in PG, frontal lobe, thalamus, insula, midbrain, and pons in TLE patient. Between CI and CNI TLE, area of executive control network and default model network, especially in MTG, ACG, IPL, MFG, and SFG, had increased ALFF value in CI-TLE patient. Activation of these areas should be because of the decompensation mechanism.
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Affiliation(s)
| | - Aikedan Aisikaer
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Che He
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Yalin Wu
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Hong Chen
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Hongyan Ni
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
| | - Yijun Song
- Department of Radiology, Tianjin Medical University General Hospital, Heping, Tianjin
| | - Jianzhong Yin
- Department of Radiology, Tianjin First Central Hospital, Nankai, China
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Yurchenko A, Golovteev A, Dragoy O. Single-word, sentence, and discourse comprehension in individuals with temporal lobe epilepsy. Epilepsy Behav 2020; 110:107140. [PMID: 32454295 DOI: 10.1016/j.yebeh.2020.107140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to systematically investigate language comprehension in individuals with left and right temporal lobe epilepsy (TLE) at different language levels - single word (noun and verb), sentence, and discourse. Neither of the groups with TLE showed difficulties with noun comprehension, whereas verb comprehension performance was significantly lower in individuals with left, but not right TLE as compared to healthy controls. In contrast, sentence and discourse comprehension was overall impaired, irrespective of the lateralization of the epileptogenic focus. Education level and age at seizure onset were also found correlating with language comprehension in our tested cohort. The results, firstly, confirm that the verb comprehension task is more sensitive for assessment of single-word comprehension in individuals with TLE. Secondly, they indicate that language comprehension in left and right TLE is mostly impaired at the sentence and discourse levels, which may be associated with low working memory capacities.
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Hermann B, Conant LL, Cook CJ, Hwang G, Garcia-Ramos C, Dabbs K, Nair VA, Mathis J, Bonet CNR, Allen L, Almane DN, Arkush K, Birn R, DeYoe EA, Felton E, Maganti R, Nencka A, Raghavan M, Shah U, Sosa VN, Struck AF, Ustine C, Reyes A, Kaestner E, McDonald C, Prabhakaran V, Binder JR, Meyerand ME. Network, clinical and sociodemographic features of cognitive phenotypes in temporal lobe epilepsy. Neuroimage Clin 2020; 27:102341. [PMID: 32707534 PMCID: PMC7381697 DOI: 10.1016/j.nicl.2020.102341] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/10/2020] [Accepted: 07/03/2020] [Indexed: 01/14/2023]
Abstract
This study explored the taxonomy of cognitive impairment within temporal lobe epilepsy and characterized the sociodemographic, clinical and neurobiological correlates of identified cognitive phenotypes. 111 temporal lobe epilepsy patients and 83 controls (mean ages 33 and 39, 57% and 61% female, respectively) from the Epilepsy Connectome Project underwent neuropsychological assessment, clinical interview, and high resolution 3T structural and resting-state functional MRI. A comprehensive neuropsychological test battery was reduced to core cognitive domains (language, memory, executive, visuospatial, motor speed) which were then subjected to cluster analysis. The resulting cognitive subgroups were compared in regard to sociodemographic and clinical epilepsy characteristics as well as variations in brain structure and functional connectivity. Three cognitive subgroups were identified (intact, language/memory/executive function impairment, generalized impairment) which differed significantly, in a systematic fashion, across multiple features. The generalized impairment group was characterized by an earlier age at medication initiation (P < 0.05), fewer patient (P < 0.001) and parental years of education (P < 0.05), greater racial diversity (P < 0.05), and greater number of lifetime generalized seizures (P < 0.001). The three groups also differed in an orderly manner across total intracranial (P < 0.001) and bilateral cerebellar cortex volumes (P < 0.01), and rate of bilateral hippocampal atrophy (P < 0.014), but minimally in regional measures of cortical volume or thickness. In contrast, large-scale patterns of cortical-subcortical covariance networks revealed significant differences across groups in global and local measures of community structure and distribution of hubs. Resting-state fMRI revealed stepwise anomalies as a function of cluster membership, with the most abnormal patterns of connectivity evident in the generalized impairment group and no significant differences from controls in the cognitively intact group. Overall, the distinct underlying cognitive phenotypes of temporal lobe epilepsy harbor systematic relationships with clinical, sociodemographic and neuroimaging correlates. Cognitive phenotype variations in patient and familial education and ethnicity, with linked variations in total intracranial volume, raise the question of an early and persisting socioeconomic-status related neurodevelopmental impact, with additional contributions of clinical epilepsy factors (e.g., lifetime generalized seizures). The neuroimaging features of cognitive phenotype membership are most notable for disrupted large scale cortical-subcortical networks and patterns of functional connectivity with bilateral hippocampal and cerebellar atrophy. The cognitive taxonomy of temporal lobe epilepsy appears influenced by features that reflect the combined influence of socioeconomic, neurodevelopmental and neurobiological risk factors.
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Affiliation(s)
- Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Lisa L Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Cole J Cook
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Gyujoon Hwang
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Camille Garcia-Ramos
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kevin Dabbs
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Veena A Nair
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jedidiah Mathis
- Department of Radiology Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA
| | - Charlene N Rivera Bonet
- Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Linda Allen
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Dace N Almane
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Karina Arkush
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Rasmus Birn
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Edgar A DeYoe
- Department of Radiology Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Elizabeth Felton
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rama Maganti
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Andrew Nencka
- Department of Radiology Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA
| | - Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Umang Shah
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Veronica N Sosa
- Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Aaron F Struck
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Candida Ustine
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anny Reyes
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Erik Kaestner
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Carrie McDonald
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Vivek Prabhakaran
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jeffrey R Binder
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mary E Meyerand
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Neuroscience Training Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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