Changes in the duration and frequency of deviant stimuli engender different mismatch negativity patterns in temporal lobe epilepsy

Test-retest reliability of duration-related and frequency-related mismatch negativity

OBJECTIVES

-Mismatch negativity (MMN) has been demonstrated as a potential biomarker for pre-attentive processing and prognosis in patients with psychosis. However, previous studies mainly evaluated the reliability of MMN across only two repeated sessions, which is inadequate to draw a convincing conclusion. The current study aimed to assess multi-session test-retest reliability in duration-related MMN (dMMN) and frequency-related MMN (fMMN).

METHODS

-We recorded four repeated sessions of electroencephalography (EEG) from 16 healthy participants in an oddball task. MMNs were extracted and their reliability was evaluated by intra-class coefficient (ICC). We also analyzed the correlation between fMMN and dMMN.

RESULTS

-Both dMMN and fMMN amplitudes exhibited good test-retest reliability, and fMMN had better reliability (average ICC = 0.7279) than dMMN (average ICC = 0.6974). Moreover, dMMN and fMMN showed more than moderate linear correlation in amplitudes (r = 0.598, CI: [0.100, 0.857]).

CONCLUSION

-Both the duration- and frequency-related MMN amplitudes were highly reliable across four-session experiments. These results provide further evidence for the potential utility of MMNs as biomarkers in research into brain function, and prognosis in psychotic illness.

Monaural 40-Hz auditory steady-state magnetic responses can be useful for identifying epileptic focus in mesial temporal lobe epilepsy

OBJECTIVE

Patients with mesial temporal lobe epilepsy (mTLE) often exhibit central auditory processing (CAP) dysfunction. Monaural 40-Hz auditory steady-state magnetic responses (ASSRs) were recorded to explore the pathophysiology of mTLE.

METHODS

Eighteen left mTLE patients, 11 right mTLE patients and 16 healthy controls (HCs) were examined. Monaural clicks were presented at a rate of 40 Hz. Phase-locking factor (PLF) and power values were analyzed within bilateral Heschl's gyri.

RESULTS

Monaural 40-Hz ASSR demonstrated temporal frequency dynamics in both PLF and power data. Symmetrical hemispheric contralaterality was revealed in HCs. However, predominant contralaterality was absent in mTLE patients. Specifically, right mTLE patients exhibited a lack of contralaterality in response to left ear but not right ear stimulation, and vice versa in left mTLE patients.

CONCLUSION

This is the first study to use monaural 40-Hz ASSR with unilateral mTLE patients to clarify the relationship between CAP and epileptic focus. CAP dysfunction was characterized by a lack of contralaterality corresponding to epileptic focus.

SIGNIFICANCE

Monaural 40-Hz ASSR can provide useful information for localizing epileptic focus in mTLE patients.

Mismatch negativity is abnormal but not lateralizing in temporal lobe epilepsy

We investigated the changes of mismatch negativity (MMN) in patients with temporal lobe epilepsy (TLE) and explored the possible role of MMN in lateralizing their seizure focus. Thirty patients with TLE and thirty healthy controls were included. MMN was elicited in each subject. Patients with TLE were divided into three subgroups: unilateral left TLE; unilateral right TLE, and bilateral TLE. MMN amplitudes and latencies were compared between the patients with TLE and the control group, and also among the three subgroups of TLE, using repeated measures analyses of variance (ANOVA). To assess the lateralizing value of MMN, MMN latencies and amplitudes at the mastoid sites between the ipsilateral and contralateral sides of epileptic focus in patients with unilateral TLE were compared using t-test. Compared with controls, each subgroup of patients with TLE had longer latencies of MMN at both fronto-central and mastoid sites, but the amplitudes of MMN were not significantly different. The amplitudes and latencies of MMN were not significantly different between the ipsilateral and contralateral sides of seizure focus at mastoid sites. The present findings of prolonged latencies of MMN are suggestive of cognitive impairment in TLE. Both the mastoid sites and the fronto-central sites are involved, which likely reflect widespread cortical abnormalities in TLE. However, the changes of MMN during the interictal phase are not useful for lateralizing the seizure focus in patients with TLE.

The mismatch negativity (MMN) potential as a tool for the functional mapping of temporal lobe epilepsies

Temporal lobe epilepsies are associated with cognitive dysfunctions in memory which are important clues currently used clinically for the lateralization of the epileptic focus in evaluations for epilepsy surgery. Because these lobes also contain the primary auditory cortex, the study of auditory evoked potentials (AEPs) is a candidate, not yet established, complementary method to characterize epilepsy-induced dysfunction. We aimed to establish the clinical usefulness of auditory evoked potentials for the study of pediatric symptomatic temporal lobe epilepsies. A group of 17 patients (ages 4-16) with symptomatic epilepsies undergoing evaluation for epilepsy surgery epilepsy was submitted to auditory evoked potentials using 35-channel scalp EEG recordings. A control group of 10 healthy volunteers was studied with the same protocol. The P100 and mismatch negativity (MMN) potential latencies and normalized amplitudes were studied. We also performed a voxel-based lesion-symptom mapping (VLSM) to determine the anatomical areas associated with changes in the AEPs. Eleven patients had temporal lobe epilepsy, three had frontal lobe epilepsy, and three had occipital lobe epilepsy. Latencies for the P100 were normal in 15/17 and in 11/17 for the MMN, with no consistent correlation with the epilepsy type. The MMN amplitude was abnormal in 7/17 patients, all with temporal lobe epilepsies (sensitivity of 64%). Of these patients, four had a decreased MMN associated with a Heschl's gyrus lesion in the VLSM, and three had an increased MMN associated with hippocampal lesion. No extratemporal epilepsy showed MMN amplitude abnormalities (specificity of 100%). The P100 amplitude was abnormal in 3/17, two with temporal and one with frontal lobe epilepsies. The auditory MMN has a high specificity but a low sensitivity for temporal lobe epilepsy in symptomatic pediatric epilepsies. Amplitude decreases of the MMN are associated with homolateral Heschl's gyrus lesions, and MMN increases with hippocampal lesions.