scholarly journals A study of brain functional network and alertness changes in temporal lobe epilepsy with and without focal to bilateral tonic–clonic seizures

BMC Neurology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Liluo Nie ◽  
Yanchun Jiang ◽  
Zongxia Lv ◽  
Xiaomin Pang ◽  
Xiulin Liang ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Information Integration ◽  
Refractory Epilepsy ◽  
Brain Network ◽  
Clustering Coefficient ◽  
Global Network ◽  
Seizure Type ◽  
Topological Properties ◽  
Clonic Seizures

Abstract Background Temporal lobe epilepsy (TLE) is commonly refractory. Epilepsy surgery is an effective treatment strategy for refractory epilepsy, but patients with a history of focal to bilateral tonic-clonic seizures (FBTCS) have poor outcomes. Previous network studies on epilepsy have found that TLE and idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTCS) showed altered global and nodal topological properties. Alertness deficits also were found in TLE. However, FBTCS is a common type of seizure in TLE, and the implications for alertness as well as the topological rearrangements associated with this seizure type are not well understood. Methods We obtained rs-fMRI data and collected the neuropsychological assessment data from 21 TLE patients with FBTCS (TLE- FBTCS), 18 TLE patients without FBTCS (TLE-non- FBTCS) and 22 controls, and constructed their respective functional brain networks. The topological properties were analyzed using the graph theoretical approach and correlations between altered topological properties and alertness were analyzed. Results We found that TLE-FBTCS patients showed more serious impairment in alertness effect, intrinsic alertness and phasic alertness than the patients with TLE-non-FBTCS. They also showed significantly higher small-worldness, normalized clustering coefficient (γ) and a trend of higher global network efficiency (gE) compared to TLE-non-FBTCS patients. The gE showed a significant negative correlation with intrinsic alertness for TLE-non-FBTCS patients. Conclusion Our findings show different impairments in brain network information integration, segregation and alertness between the patients with TLE-FBTCS and TLE-non-FBTCS, demonstrating that impairments of the brain network may underlie the disruptions in alertness functions.

The Influence of Seizure Type and Medication on Psychiatric Symptoms in Epileptic Patients

1986 ◽  
Vol 148 (3) ◽  
pp. 300-304 ◽  
Author(s):  
S. W. Brown ◽  
M. E. L. McGowan ◽  
E. H. Reynolds
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Sleep Disturbance ◽  
Temporal Lobe ◽  
Psychiatric Symptoms ◽  
Seizure Type ◽  
Psychiatric Interview ◽  
Epileptic Patients ◽  
Clonic Seizures ◽  
Psychological Disability

The influence of type of seizure and medication on psychological disability was assessed using the Standard Psychiatric Interview in matched epileptic patients. In comparison to patients with idiopathic tonic-clonic seizures, those with temporal lobe epilepsy complained of more irritability and impaired concentration, and were rated as more depressed and slowed up. Compared to patients on phenytoin, those on carbamazepine complained of more sleep disturbance and were more likely to be taking an hypnotic.

scholarly journals Topological Aberrance of Structural Brain Network Provides Quantitative Markers of post-TBI Attention Deficits in Children

2020 ◽  
Author(s):  
Meng Cao ◽  
Yuyang Luo ◽  
Ziyan Wu ◽  
Catherine A. Mazzola ◽  
Arlene Goodman ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Critical Role ◽  
Brain Network ◽  
Attention Problems ◽  
Clustering Coefficient ◽  
Attention Deficits ◽  
Topological Properties ◽  
Local Efficiency ◽  
Structural Brain Network ◽  
Structural Brain

ABSTRACTTraumatic brain injury (TBI)-induced attention deficits are among the most common long-term cognitive consequences in children. Most of the existing studies attenpting to understand the neuropathological underpinnings of cognitive and behavioral impairments in TBI have utilized heterogeneous samples and resulted in inconsistent findings. The current research proposed to investigate topological properties of the structural brain network in children with TBI and their associations with TBI-induced attention problems in a more homogeneous subgroup of children who had severe post-TBI attention deficits (TBI-A).A total of 31 children with TBI-A and 35 group-matched controls were involved in the study. Diffusion tensor imaging-based probabilistic tractography and graph theoretical techniques were used to construct the structural brain network in each subject. Network topological properties were calculated in both global level and regional (nodal) level. Between-group comparisons among the topological network measures and analyses for searching brain-behavioral associations were all corrected for multiple comparisons using Bonferroni method.Compare to controls, the TBI-A group showed significantly higher nodal local efficiency and nodal clustering coefficient in left inferior frontal gyrus and right transverse temporal gyrus, while significantly lower nodal clustering coefficient in left supramarginal gyrus as well as lower nodal local efficiency in left parahippocampal gyrus. The temporal lobe topological alterations were significantly associated with the post-TBI inattentive and hyperactive symptoms in the TBI-A group.The results suggest that TBI-related structural re-modularity in the WM subnetworks associated with temporal lobe may play a critical role in the onset of severe post-TBI attention deficits in children. These findings provide valuable input for understanding the neurobiological substrates of TBI-A, and have the potential to serve as a biomarker guiding the development of more timely and tailored strategies for diagnoses and treatments to the affected individuals.

scholarly journals Multi-scale image analysis and prediction of visual field defects after selective amygdalohippocampectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bastian David ◽  
Jasmine Eberle ◽  
Daniel Delev ◽  
Jennifer Gaubatz ◽  
Conrad C. Prillwitz ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Global Network ◽  
Visual Field Defects ◽  
Whole Brain ◽  
Network Analyses ◽  
Postoperative Mri ◽  
Selective Amygdalohippocampectomy

AbstractSelective amygdalohippocampectomy is an effective treatment for patients with therapy-refractory temporal lobe epilepsy but may cause visual field defect (VFD). Here, we aimed to describe tissue-specific pre- and postoperative imaging correlates of the VFD severity using whole-brain analyses from voxel- to network-level. Twenty-eight patients with temporal lobe epilepsy underwent pre- and postoperative MRI (T1-MPRAGE and Diffusion Tensor Imaging) as well as kinetic perimetry according to Goldmann standard. We probed for whole-brain gray matter (GM) and white matter (WM) correlates of VFD using voxel-based morphometry and tract-based spatial statistics, respectively. We furthermore reconstructed individual structural connectomes and conducted local and global network analyses. Two clusters in the bihemispheric middle temporal gyri indicated a postsurgical GM volume decrease with increasing VFD severity (FWE-corrected p < 0.05). A single WM cluster showed a fractional anisotropy decrease with increasing severity of VFD in the ipsilesional optic radiation (FWE-corrected p < 0.05). Furthermore, patients with (vs. without) VFD showed a higher number of postoperative local connectivity changes. Neither in the GM, WM, nor in network metrics we found preoperative correlates of VFD severity. Still, in an explorative analysis, an artificial neural network meta-classifier could predict the occurrence of VFD based on presurgical connectomes above chance level.

scholarly journals Remote preoperative tonic-clonic seizures do not influence outcome after surgery for temporal lobe epilepsy

2016 ◽  
Vol 369 ◽  
pp. 330-332
Author(s):  
Ali A. Asadi-Pooya ◽  
Amin H. Rabiei ◽  
Edward J. Gracely ◽  
Michael R. Sperling
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Clonic Seizures

scholarly journals Disrupted basal ganglia—thalamocortical loops in focal to bilateral tonic-clonic seizures

2019 ◽  
Author(s):  
Xiaosong He ◽  
Ganne Chaitanya ◽  
Burcu Asma ◽  
Lorenzo Caciagli ◽  
Danielle S. Bassett ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Temporal Lobe Epilepsy ◽  
Globus Pallidus ◽  
Temporal Lobe ◽  
Functional Organization ◽  
Globus Pallidus Internus ◽  
Effective Control ◽  
Thalamocortical Connections ◽  
Clonic Seizures ◽  
Current History

AbstractFocal to bilateral tonic-clonic seizures are associated with lower quality of life, higher risk of seizure-related injuries, increased chance of sudden unexpected death, as well as unfavorable treatment outcomes. Achieving greater understanding of its underlying circuitry offers better opportunity to control these particularly serious seizures. Towards this goal, we provide a network science perspective of the interactive pathways among basal ganglia, thalamus and the cortex, to explore the imprinting of secondary seizure generalization on the mesoscale brain network in temporal lobe epilepsy. Specifically, we parameterized the functional organization of both the thalamocortical network and the basal ganglia—thalamus network with resting-state functional magnetic resonance imaging in three groups of patients with different focal to bilateral tonic-clonic seizure histories. Using the participation coefficient to describe the pattern of thalamocortical connections among different cortical networks, we showed that, compared to patients with no previous history, those with positive histories of focal to bilateral tonic-clonic seizures, including both remote (none for over one year) and current (within the past year) histories, presented more uniform distribution patterns of thalamocortical connections in the ipsilateral medial-dorsal thalamic nuclei. As a sign of greater thalamus mediated cortico-cortical communication, this result comports with greater susceptibility to secondary seizure generalization from the epileptogenic temporal lobe to broader brain networks in these patients. Using interregional integration to characterize the functional interaction between basal ganglia and thalamus, we demonstrated that patients with current history presented increased interaction between putamen and globus pallidus internus, and decreased interaction between the latter and the thalamus, compared to the other two patient groups. Importantly, through a series of “disconnection” simulations, we showed that these changes in interactive profiles of the basal ganglia—thalamus network in the current history group mainly depended upon the direct but not the indirect basal ganglia pathway. It is intuitively plausible that such disruption in the striatum modulated tonic inhibition of the thalamus from the globus pallidus internus could lead to an under-suppressed thalamus, which in turn may account for their greater vulnerability to secondary seizure generalization. Collectively, these findings suggest that the broken balance between the basal ganglia inhibition and thalamus synchronization can inform the presence and effective control of focal to bilateral tonic-clonic seizures. The mechanistic underpinnings we uncover may shed light on the development of new treatment strategies for patients with temporal lobe epilepsy.

Asymmetric termination of secondarily generalized tonic-clonic seizures in temporal lobe epilepsy

Neurology ◽  
2002 ◽  
Vol 59 (8) ◽  
pp. 1254-1256 ◽  
Author(s):  
E. Trinka ◽  
G. Walser ◽  
I. Unterberger ◽  
G. Luef ◽  
T. Benke ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Clonic Seizures

scholarly journals A method for placing Heschl gyrus depth electrodes

2010 ◽  
Vol 112 (6) ◽  
pp. 1301-1307 ◽  
Author(s):  
Chandan G. Reddy ◽  
Nader S. Dahdaleh ◽  
Gregory Albert ◽  
Fangxiang Chen ◽  
Daniel Hansen ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Refractory Epilepsy ◽  
Brain Regions ◽  
Frameless Stereotaxy ◽  
Functional Connections ◽  
Depth Electrodes ◽  
Wide Range ◽  
Implantation Method ◽  
Heschl Gyrus

A wide range of devices is used to obtain intracranial electrocorticography recordings in patients with medically refractory epilepsy, including subdural strip and grid electrodes and depth electrodes. Penetrating depth electrodes are required to access some brain regions, and 1 target site that presents a particular technical challenge is the first transverse temporal gyrus, or Heschl gyrus (HG). The HG is located within the supratemporal plane and has an oblique orientation relative to the sagittal and coronal planes. Large and small branches of the middle cerebral artery abut the pial surface of the HG and must be avoided when planning the electrode trajectory. Auditory cortex is located within the HG, and there are functional connections between this dorsal temporal lobe region and medial sites commonly implicated in the pathophysiology of temporal lobe epilepsy. At some surgical centers, depth electrodes are routinely placed within the supratemporal plane, and the HG, in patients who require intracranial electrocorticography monitoring for presumed temporal lobe epilepsy. Information from these recordings is reported to facilitate the identification of seizure patterns in patients with or without auditory auras. To date, only one implantation method has been reported to be safe and effective for placing HG electrodes in a large series of patients undergoing epilepsy surgery. This well-established approach involves inserting the electrodes from a lateral trajectory while using stereoscopic stereotactic angiography to avoid vascular injury. In this report, the authors describe an alternative method for implantation. They use frameless stereotaxy and an oblique insertion trajectory that does not require angiography and allows for the simultaneous placement of subdural grid arrays. Results in 19 patients demonstrate the safety and efficacy of the method.

Executive functions in children with frontal and temporal lobe epilepsy

2002 ◽  
Vol 8 (5) ◽  
pp. 623-632 ◽  
Author(s):  
Kathleen Culhane-Shelburne ◽  
Lynn Chapieski ◽  
Merrill Hiscock ◽  
Daniel Glaze
Keyword(s):  
Executive Functioning ◽  
Temporal Lobe Epilepsy ◽  
Executive Functions ◽  
Temporal Lobe ◽  
Cognitive Deficits ◽  
Adaptive Functioning ◽  
Seizure Type ◽  
Opposite Pattern ◽  
Nonverbal Memory ◽  
Psychometric Studies

AbstractEven though frontal lobe epilepsy (FLE) is a relatively common seizure type, no formal psychometric studies of children with FLE have been reported. We compared 12 children with FLE and 15 children with temporal lobe epilepsy (TLE) on neuropsychological tests of attention, memory, executive functioning, and adaptive functioning. The results of these tests indicated that the children with FLE had deficits in planning and executive functions, whereas their verbal and nonverbal memory was intact. The opposite pattern was observed in children with TLE. Measures of executive functioning and impulse control were the best predictors of adaptive functioning. The findings suggest that children with FLE have a pattern of cognitive deficits that differs markedly from the pattern seen in children with TLE. Children with FLE have prominent deficits in executive functioning that appear to be related to poor behavioral adaptation.

scholarly journals Role of the Nucleus Basalis as a Key Network Node in Temporal Lobe Epilepsy

Neurology ◽  
2021 ◽  
Vol 96 (9) ◽  
pp. e1334-e1346 ◽  
Author(s):  
Hernán F.J. González ◽  
Saramati Narasimhan ◽  
Graham W. Johnson ◽  
Kristin E. Wills ◽  
Kevin F. Haas ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Resting State Fmri ◽  
Clustering Coefficient ◽  
Nucleus Basalis ◽  
Core Network ◽  
Neurocognitive Deficits ◽  
Network Nodes ◽  
Healthy Control

ObjectiveTo determine whether the nucleus basalis of Meynert (NBM) may be a key network structure of altered functional connectivity in temporal lobe epilepsy (TLE), we examined fMRI with network-based analyses.MethodsWe acquired resting-state fMRI in 40 adults with TLE and 40 matched healthy control participants. We calculated functional connectivity of NBM and used multiple complementary network-based analyses to explore the importance of NBM in TLE networks without biasing our results by our approach. We compared patients to controls and examined associations of network properties with disease metrics and neurocognitive testing.ResultsWe observed marked decreases in connectivity between NBM and the rest of the brain in patients with TLE (0.91 ± 0.88, mean ± SD) vs controls (1.96 ± 1.13, p < 0.001, t test). Larger decreases in connectivity between NBM and fronto-parietal-insular regions were associated with higher frequency of consciousness-impairing seizures (r = −0.41, p = 0.008, Pearson). A core network of altered nodes in TLE included NBM ipsilateral to the epileptogenic side and bilateral limbic structures. Furthermore, normal community affiliation of ipsilateral NBM was lost in patients, and this structure displayed the most altered clustering coefficient of any node examined (3.46 ± 1.17 in controls vs 2.23 ± 0.93 in patients). Abnormal connectivity between NBM and subcortical arousal community was associated with modest neurocognitive deficits. Finally, a logistic regression model incorporating connectivity properties of ipsilateral NBM successfully distinguished patients from control datasets with moderately high accuracy (78%).ConclusionsThese results suggest that while NBM is rarely studied in epilepsy, it may be one of the most perturbed network nodes in TLE, contributing to widespread neural effects in this disabling disorder.

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