Relationship of white matter hyperintensities with clinical features of seizures in patients with epilepsy

ABSTRACT Background: Although epilepsy is primarily known as a cortical disorder, there is growing body of research demonstrating white matter alterations in patients with epilepsy. Objective: To investigate the prevalence of white matter hyperintensities (WMH) and its association with seizure characteristics in patients with epilepsy. Methods: The prevalence of WMH in 94 patients with epilepsy and 41 healthy controls were compared. Within the patient sample, the relationship between the presence of WMH and type of epilepsy, frequency of seizures, duration of disease and the number of antiepileptic medications were investigated. Results: The mean age and sex were not different between patients and healthy controls (p>0.2). WMH was present in 27.7% of patients and in 14.6% of healthy controls. Diagnosis of epilepsy was independently associated with the presence of WMH (ß=3.09, 95%CI 1.06-9.0, p=0.039). Patients with focal epilepsy had higher prevalence of WMH (35.5%) than patients with generalized epilepsy (14.7%). The presence of WMH was associated with older age but not with seizure characteristics. Conclusions: WMH is more common in patients with focal epilepsy than healthy controls. The presence of WMH is associated with older age, but not with seizure characteristics.

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Chronotypes in Patients with Epilepsy: Does the Type of Epilepsy Make a Difference?

Behavioural Neurology ◽

10.1155/2015/941354 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Hallie Kendis ◽

Kelly Baron ◽

Stephan U. Schuele ◽

Bhavita Patel ◽

Hrayr Attarian

Keyword(s):

Seizure Control ◽

Focal Epilepsy ◽

Healthy Controls ◽

Circadian Misalignment ◽

Age Related ◽

Primary Generalized Epilepsy ◽

Generalized Epilepsy ◽

Patients With Epilepsy ◽

The Impact ◽

Related Increase

Circadian rhythms govern all biological functions. Circadian misalignment has a major impact on health. Late chronotype is a risk factor for circadian misalignment which in turn can affect the control of seizures in epilepsy patients. We compared a group of 87 confirmed epilepsy patients regardless of subtypes with age- and sex-matched healthy controls. We compared generalized epilepsy patients with localization related epilepsy patients and with healthy controls. We found that primary generalized epilepsy patients were 5 times more likely to have a late chronotype than healthy controls. We did not find any significant differences between localization related epilepsy patients and healthy controls or between the overall epilepsy cohort and healthy controls. Generalized epilepsy patients are more likely to be evening types as compared to those with focal epilepsy or subjects without epilepsy. Epilepsy patients do not experience the same age related increase in morningness as do age-matched healthy controls. This is important in regard to timing of AED, identifying and preventing sleep deprivation, and integrating chronotype evaluations and chronotherapy in comprehensive epilepsy care. Further studies, using objective phase markers or the impact of chronotherapy on seizure control, are necessary.

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Altered Functional Connectivity Patterns of Parietal Subregions Contribute to Cognitive Dysfunction in Patients with White Matter Hyperintensities

Journal of Alzheimer s Disease ◽

10.3233/jad-210315 ◽

2021 ◽

pp. 1-11

Author(s):

Qiang Wei ◽

Shanshan Cao ◽

Yang Ji ◽

Jun Zhang ◽

Chen Chen ◽

...

Keyword(s):

White Matter ◽

Functional Connectivity ◽

White Matter Hyperintensities ◽

Parietal Lobe ◽

Small Vessel Disease ◽

Anterior Cingulate ◽

Healthy Controls ◽

Cingulate Gyrus ◽

Anterior Cingulate Gyrus ◽

Resting State Functional Connectivity

Background: The white matter hyperintensities (WMHs) are considered as one of the core neuroimaging findings of cerebral small vessel disease and independently associated with cognitive deficit. The parietal lobe is a heterogeneous area containing many subregions and play an important role in the processes of neurocognition. Objective: To explore the relationship between parietal subregions alterations and cognitive impairments in WHMs. Methods: Resting-state functional connectivity (rs-FC) analyses of parietal subregions were performed in 104 right-handed WMHs patients divided into mild (n = 39), moderate (n = 37), and severe WMHs (n = 28) groups according to the Fazekas scale and 36 healthy controls. Parietal subregions were defined using tractographic Human Brainnetome Atlas and included five subregions for superior parietal lobe, six subregions for inferior parietal lobe (IPL), and three subregions for precuneus. All participants underwent a neuropsychological test battery to evaluate emotional and general cognitive functions. Results: Differences existed between the rs-FC strength of IPL_R_6_2 with the left anterior cingulate gyrus, IPL_R_6_3 with the right dorsolateral superior frontal gyrus, and the IPL_R_6_5 with the left anterior cingulate gyrus. The connectivity strength between IPL_R_6_3 and the left anterior cingulate gyrus were correlated with AVLT-immediate and AVLT-recognition test in WMHs. Conclusion: We explored the roles of parietal subregions in WMHs using rs-FC. The functional connectivity of parietal subregions with the cortex regions showed significant differences between the patients with WMHs and healthy controls which may be associated with cognitive deficits in WMHs.

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Polygenic risk scores of several subtypes of epilepsies in a founder population

Neurology Genetics ◽

10.1212/nxg.0000000000000416 ◽

2020 ◽

Vol 6 (3) ◽

pp. e416

Author(s):

Claudia Moreau ◽

Rose-Marie Rébillard ◽

Stefan Wolking ◽

Jacques Michaud ◽

Frédérique Tremblay ◽

...

Keyword(s):

Mixed Model ◽

Focal Epilepsy ◽

Population Based ◽

Risk Scores ◽

Founder Population ◽

Idiopathic Generalized Epilepsy ◽

Polygenic Risk ◽

Generalized Epilepsy ◽

Patients With Epilepsy ◽

Variance Explained

ObjectivePolygenic risk scores (PRSs) are used to quantify the cumulative effects of a number of genetic variants, which may individually have a very small effect on susceptibility to a disease; we used PRSs to better understand the genetic contribution to common epilepsy and its subtypes.MethodsWe first replicated previous single associations using 373 unrelated patients. We then calculated PRSs in the same French Canadian patients with epilepsy divided into 7 epilepsy subtypes and population-based controls. We fitted a logistic mixed model to calculate the variance explained by the PRS using pseudo-R2 statistics.ResultsWe show that the PRS explains more of the variance in idiopathic generalized epilepsy than in patients with nonacquired focal epilepsy. We also demonstrate that the variance explained is different within each epilepsy subtype.ConclusionsGlobally, we support the notion that PRSs provide a reliable measure to rightfully estimate the contribution of genetic factors to the pathophysiologic mechanism of epilepsies, but further studies are needed on PRSs before they can be used clinically.

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Brain Volumetric Changes and Cognitive Functions in Epileptic Patients

QJM ◽

10.1093/qjmed/hcaa054 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A Ashour ◽

A M A Nassef ◽

E M Awad ◽

A M Hazzou ◽

M A Nada ◽

...

Keyword(s):

Cognitive Functions ◽

Brain Volume ◽

Control Group ◽

Healthy Controls ◽

Whole Brain ◽

Significant Difference ◽

Epileptic Patients ◽

Generalized Epilepsy ◽

Patients With Epilepsy ◽

And Control

Abstract Background Epilepsy is a serious common neurological disorder that can affect any age. Cognitive functions are highly prevalent in patients with epilepsy and is more likely to occur in patients with idiopathic generalized epilepsy (IGE). Associations were found between cognitive functions and brain volume loss in patients with epilepsy. Objective This work was carried out to assess the volumetric changes in brain of epileptic patients to use it as a biomarker for cognitive dysfunction in adult and adolescent patients with epilepsy. Patients and Methods A case control study was conducted to include 61 patients, 20 of which diagnosed with idiopathic generalized epilepsy (IGE), 21 with temporal lobe epilepsy (TLE) and 20 with frontal lobe epilepsy (FLE) who were selected from the epilepsy outpatient clinic in Ain Shams university hospitals along with 23 age and sex matched healthy controls. Both cases and control groups were subjected to Magnetic resonance imaging MRI brain volumetry and detailed cognitive testing. An informed consent was taken from each adult patient, guardian of adolescent patient and healthy control. Results Statistically significant difference in comprehension subcategory of the Wechsler adult intelligence scale (WAIS) between patients with IGE and healthy controls denoting poorer social judgment in the IGE group. The IGE group also showed poorer performance in digit symbol subcategory of the same test denoting worse psychomotor speed and sustained attention. Also, significant difference in similarities subcategory was found between TLE group and control group denoting poorer abstract thinking among the TLE group. The IGE and TLE groups also showed lower attention and concentration than control group in the mental control subcategory of the Wechsler memory scale (WMS) yet failed to show superiority over each other. No statistically significant difference was found on comparing the whole brain volume between cases and control groups. A statistically significant direct relationship was found between the arithmetic subcategory of WAIS and the whole brain volume of the patients among the patients of the FLE group. Conclusion Patients with IGE had worse psychomotor speed, sustained attention and concentration than healthy controls in addition to poorer social judgment. Also, patients with TLE showed lower attention and concentration together with poorer abstract thinking despite normal IQ. The study also concluded that increased whole brain volume in patients with frontal lobe epilepsy is associated with better mathematical problem solving.

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Relationship of white matter hyperintensities to cerebrospinal fluid glucose polyol pathway metabolites—a pilot study in treatment-resistant affective disorder patients

Journal of Affective Disorders ◽

10.1016/j.jad.2004.10.010 ◽

2005 ◽

Vol 85 (3) ◽

pp. 341-350 ◽

Cited By ~ 13

Author(s):

William T. Regenold ◽

K. Calvin Hisley ◽

Abraham Obuchowski ◽

David M. Lefkowitz ◽

Christopher Marano ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

White Matter ◽

Pilot Study ◽

Affective Disorder ◽

White Matter Hyperintensities ◽

Polyol Pathway ◽

Treatment Resistant ◽

Relationship Of

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The relationship of regional frontal hypometabolism to executive function: A resting fluorodeoxyglucose PET study of patients with epilepsy and healthy controls

Epilepsy & Behavior ◽

10.1016/j.yebeh.2006.04.007 ◽

2006 ◽

Vol 9 (1) ◽

pp. 58-67 ◽

Cited By ~ 30

Author(s):

Carrie R. McDonald ◽

Barbara E. Swartz ◽

Eric Halgren ◽

Ashok Patell ◽

Richard Daimes ◽

...

Keyword(s):

Executive Function ◽

Healthy Controls ◽

Patients With Epilepsy ◽

Relationship Of ◽

The Relationship ◽

Fluorodeoxyglucose Pet

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Patterns of depressive symptoms in epilepsy

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130004 ◽

2013 ◽

Vol 71 (4) ◽

pp. 213-215

Author(s):

Nikolaos I. Triantafyllou ◽

Stergios Gatzonis ◽

Evangelia Kararizou ◽

Charalampos C. Papageorgiou

Keyword(s):

Depressive Symptoms ◽

Rating Scale ◽

Focal Epilepsy ◽

Self Rating ◽

Increasing Trend ◽

Epileptic Patients ◽

Generalized Epilepsy ◽

Patients With Epilepsy

Objective: The purpose of this study was to determine the nature and extent of depressive symptoms among patients with epilepsy. Methods: Ninety patients were investigated over a three-month period: 42 were suffering from generalized epilepsy, 29 from focal epilepsy and 19 from undetermined epilepsy. All completed the Zung self-rating scale for assessment of the depressive symptoms. Results: Sixty-seven patients felt stigmatized because of epilepsy (67%): 73.6% in the undetermined epilepsy group, 55.1% in the focal epilepsy group and 88% in the generalized epilepsy group. Moreover, among the 90 epileptic patients studied, symptoms of irritability, indecisiveness, personal devaluation and emptiness showed a constant increasing trend for their presence from the undetermined epilepsy group through the generalized epilepsy group to the focal epilepsy group. Conclusions: These findings indicate that although the focal epilepsy patients felt less stigmatized, they did not differ greatly in terms of depressive symptoms, in relation to the undetermined epilepsy and generalized epilepsy patients.

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