Cerebellar culmen-substantia nigra tract assisted rehabilitation post stroke: a case report

An 88-year-old right-handed man was admitted to our hospital for cognitive impairment and right-sided paralysis. His head non-contrast computed tomography (CT) showed large low-density areas (LDA) and fibrous structures in the left occipital and temporal lobe regions. Despite the fact that it had been more than 10 years since his stroke, rehabilitation was effective. This is a rare case in which cerebellar culmen -substantia nigra tract assisted rehabilitation after stroke.

Expression Profile of miRs in Mesial Temporal Lobe Epilepsy: Systematic Review

Temporal lobe epilepsy (TLE) is one of the most common forms of focal epilepsy in children and adults. TLE is characterized by variable onset and seizures. Moreover, this form of epilepsy is often resistant to pharmacotherapy. The search for new mechanisms for the development of TLE may provide us with a key to the development of new diagnostic methods and a personalized approach to the treatment. In recent years, the role of non-coding ribonucleic acids (RNA) has been actively studied, among which microRNA (miR) is of the greatest interest. (1) Background: The purpose of the systematic review is to analyze the studies carried out on the role of miRs in the development of mesial TLE (mTLE) and update the existing knowledge about the biomarkers of this disease. (2) Methods: The search for publications was carried out in the databases PubMed, Springer, Web of Science, Clinicalkeys, Scopus, OxfordPress, Cochrane. The search was carried out using keywords and combinations. We analyzed publications for 2016‒2021, including original studies in an animal model of TLE and with the participation of patients with TLE, thematic and systemic reviews, and Cochrane reviews. (3) Results: this thematic review showed that miR‒155, miR‒153, miR‒361‒5p, miR‒4668‒5p, miR‒8071, miR‒197‒5p, miR‒145, miR‒181, miR‒199a, miR‒1183, miR‒129‒2‒3p, miR‒143‒3p (upregulation), miR–134, miR‒0067835, and miR‒153 (downregulation) can be considered as biomarkers of mTLE. However, the roles of miR‒146a, miR‒142, miR‒106b, and miR‒223 are questionable and need further study. (4) Conclusion: In the future, it will be possible to consider previously studied miRs, which have high specificity and sensitivity in mTLE, as prognostic biomarkers (predictors) of the risk of developing this disease in patients with potentially epileptogenic structural damage to the mesial regions of the temporal lobe of the brain (congenital disorders of the neuronal migration and neurogenesis, brain injury, neuro-inflammation, tumor, impaired blood supply, neurodegeneration, etc.).

Right Superior Temporal Gyrus Altered Functional Activity in Patients With Definite Vestibular Migraine

The study aimed to investigate resting-state functional brain activity alterations in patients with definite vestibular migraine (dVM). Seventeen patients with dVM, 8 patients with migraine, 17 health controls (HCs) were recruited. The amplitude of low frequency fluctuation (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo) were calculated to observe the changes in spontaneous brain activity. Then brain regions with altered fALFF were selected for seed-based functional connectivity analysis. Compared with HCs, VM patients showed significantly increased ALFF values in the right temporal lobe (Cluster size = 91 voxels, P=0.002, FWE corrected), and significantly increased ReHo values in the right superior temporal gyrus (STG), middle temporal gyrus (MTG) and inferior temporal gyrus (ITG) (Cluster size = 136 voxels, P=0.013, FWE corrected). Compared with patients with migraine, patients with VM showed significantly increased fALFF values in the right parietal lobe (Cluster size = 43 voxels, P=0.011, FWE corrected) and right frontal lobe (Cluster size =36 voxels, P=0.026, FWE corrected), significantly increased ReHo values in the right thalamus (Cluster size = 92 voxels, P=0.043, FWE corrected). Our findings documented that patients with VM showed enhanced spontaneous functional activity in the right temporal lobe (STG, MTG, and ITG) compared with HCs, and increased spontaneous activity in the right parietal lobe-frontal lobe-thalamus compared with patients with migraine. Patients with VM and migraine both had altered brain function, but the regions involved are different.

More Than Spikes: On the Added Value of Non-linear Intracranial EEG Analysis for Surgery Planning in Temporal Lobe Epilepsy

Epilepsy surgery can be a very effective therapy in medication refractory patients. During patient evaluation intracranial EEG is analyzed by clinical experts to identify the brain tissue generating epileptiform events. Quantitative EEG analysis increasingly complements this approach in research settings, but not yet in clinical routine. We investigate the correspondence between epileptiform events and a specific quantitative EEG marker. We analyzed 99 preictal epochs of multichannel intracranial EEG of 40 patients with mixed etiologies. Time and channel of occurrence of epileptiform events (spikes, slow waves, sharp waves, fast oscillations) were annotated by a human expert and non-linear excess interrelations were calculated as a quantitative EEG marker. We assessed whether the visually identified preictal events predicted channels that belonged to the seizure onset zone, that were later resected or that showed strong non-linear interrelations. We also investigated whether the seizure onset zone or the resection were predicted by channels with strong non-linear interrelations. In patients with temporal lobe epilepsy (32 of 40), epileptic spikes and the seizure onset zone predicted the resected brain tissue much better in patients with favorable seizure control after surgery than in unfavorable outcomes. Beyond that, our analysis did not reveal any significant associations with epileptiform EEG events. Specifically, none of the epileptiform event types did predict non-linear interrelations. In contrast, channels with strong non-linear excess EEG interrelations predicted the resected channels better in patients with temporal lobe epilepsy and favorable outcome. Also in the small number of patients with seizure onset in the frontal and parietal lobes, no association between epileptiform events and channels with strong non-linear excess EEG interrelations was detectable. In contrast to patients with temporal seizure onset, EEG channels with strong non-linear excess interrelations did neither predict the seizure onset zone nor the resection of these patients or allow separation between patients with favorable and unfavorable seizure control. Our study indicates that non-linear excess EEG interrelations are not strictly associated with epileptiform events, which are one key concept of current clinical EEG assessment. Rather, they may provide information relevant for surgery planning in temporal lobe epilepsy. Our study suggests to incorporate quantitative EEG analysis in the workup of clinical cases. We make the EEG epochs and expert annotations publicly available in anonymized form to foster similar analyses for other quantitative EEG methods.