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Sample records for anterior temporal lobe

  1. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  2. Cerebral metabolic changes (F-18-FDG PET) during selective anterior temporal lobe amobarbital test

    NARCIS (Netherlands)

    Khan, N; Hajek, M; Antonini, A; Maguire, P; Muller, S; Valavanis, A; Leenders, KL; Regard, M; Schiess, R; Wieser, HG

    1997-01-01

    Cerebral glucose utilisation using F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) was measured in 4 patients with temporal lobe epilepsy during a selective anterior temporal lobe (TL) amobarbital test (ATLAT) and compared with their baseline values. F-18-FDG was injected intrave

  3. White matter abnormalities in the anterior temporal lobe suggest the side of the seizure foci in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    White matter abnormalities in the anterior temporal lobe (WAATL) are sometimes observed on magnetic resonance (MR) images of patients with temporal lobe epilepsy (TLE). Our purpose was to determine whether WAATL could indicate if the seizure foci are ipsilateral on electroencephalograms (EEG) in TLE patients. We reviewed 112 consecutive patients with medically intractable TLE. We compared the side of seizure foci on EEG (preoperative and intraoperative) and MR images. Both loss of gray-white matter demarcation and increased signal intensity changes in the anterior white matter (positive WAATL) were observed in 54 of 112 patients (48.2%) with TLE. WAATL were present on the same side as the seizure foci on preoperative intracranial EEG with subdural electrodes (iEEG) and on intraoperative electrocorticography (ECG) in all the patients. In 47 patients, MR images showed WAATL and focal lesions that were possibly epileptogenic for TLE. In 2 of the 47 patients, the seizure foci on iEEG and ECG were contralateral to the focal lesion; in the remaining 45 patients, the seizure foci on surface EEG (sEEG) and ECG and the focal lesion were on the same side. In three patients, no focal lesions were seen but WAATL were present on the same side as the seizure foci on sEEG and ECG. In four patients, MR images showed focal lesions for which epileptogenicity was questionable, and WAATL on the same side as the seizure foci on EEG. WAATL are clinically useful because they indicate the side of the seizure foci. (orig.)

  4. White matter abnormalities in the anterior temporal lobe suggest the side of the seizure foci in temporal lobe epilepsy

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    Adachi, Y.; Yagishita, A. [Tokyo Metropolitan Neurological Hospital, Department of Neuroradiology, Fuchu, Tokyo (Japan); Arai, N. [Tokyo Metropolitan Neurological Institute, Department of Clinical Neuropathology, Fuchu, Tokyo (Japan)

    2006-07-15

    White matter abnormalities in the anterior temporal lobe (WAATL) are sometimes observed on magnetic resonance (MR) images of patients with temporal lobe epilepsy (TLE). Our purpose was to determine whether WAATL could indicate if the seizure foci are ipsilateral on electroencephalograms (EEG) in TLE patients. We reviewed 112 consecutive patients with medically intractable TLE. We compared the side of seizure foci on EEG (preoperative and intraoperative) and MR images. Both loss of gray-white matter demarcation and increased signal intensity changes in the anterior white matter (positive WAATL) were observed in 54 of 112 patients (48.2%) with TLE. WAATL were present on the same side as the seizure foci on preoperative intracranial EEG with subdural electrodes (iEEG) and on intraoperative electrocorticography (ECG) in all the patients. In 47 patients, MR images showed WAATL and focal lesions that were possibly epileptogenic for TLE. In 2 of the 47 patients, the seizure foci on iEEG and ECG were contralateral to the focal lesion; in the remaining 45 patients, the seizure foci on surface EEG (sEEG) and ECG and the focal lesion were on the same side. In three patients, no focal lesions were seen but WAATL were present on the same side as the seizure foci on sEEG and ECG. In four patients, MR images showed focal lesions for which epileptogenicity was questionable, and WAATL on the same side as the seizure foci on EEG. WAATL are clinically useful because they indicate the side of the seizure foci. (orig.)

  5. Unilateral Resection of the Anterior Medial Temporal Lobe Impairs Odor Identification and Valence Perception.

    Science.gov (United States)

    Juran, Stephanie A; Lundström, Johan N; Geigant, Michael; Kumlien, Eva; Fredrikson, Mats; Åhs, Fredrik; Olsson, Mats J

    2015-01-01

    The anterior medial temporal lobe (TL), including the amygdala, has been implicated in olfactory processing, e.g., coding for intensity and valence, and seems also involved in memory. With this background, the present study evaluated whether anterior medial TL-resections in TL epilepsy affected intensity and valence ratings, as well as free and cued identification of odors. These aspects of odor perception were assessed in 31 patients with unilateral anterior medial TL-resections (17 left, 14 right) and 16 healthy controls. Results suggest that the anterior medial TL is in particular necessary for free, but also cued, odor identification. TL resection was also found to impair odor valence, but not intensity ratings. Left resected patients rated nominally pleasant and unpleasant odors as more neutral suggesting a special role for the left anterior TL in coding for emotional saliency in response to odors. PMID:26779109

  6. Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes

    Directory of Open Access Journals (Sweden)

    Lars A Ross

    2011-10-01

    Full Text Available Evidence from neuroimaging and neuropsychology suggests that portions of the anterior temporal lobes play a critical role in proper name retrieval. We previously found that anodal transcranial direct current stimulation (tDCS to the anterior temporal lobes improved retrieval of proper names in young adult. Here we extend that finding to older adults who tend to experience greater proper-naming deficits than young adults. The task was to look at pictures of famous faces or landmarks and verbally recall the associated proper name. Our results show a numerical improvement in face naming after left or right anterior temporal lobe stimulation, but a statistically significant effect only after left-lateralized stimulation. The magnitude of the enhancing effect was similar in older and younger adults but the lateralization of the effect differed depending on age. These results provide evidence that tDCS may be a useful tool for the neurorehabilitation of cognitive function in healthy and pathological cognitive decline.

  7. Differential Involvement of the Anterior Temporal Lobes in Famous People Semantics.

    Science.gov (United States)

    Chedid, Georges; Wilson, Maximiliano A; Provost, Jean-Sebastien; Joubert, Sven; Rouleau, Isabelle; Brambati, Simona M

    2016-01-01

    The ability to recognize a famous person occurs through semantic memory. Previous neuroimaging studies have shown that the anterior temporal lobes (ATLs) are involved in the recognition of famous people. However, it is still a matter of debate whether the semantic processing of names or pictures of famous people has an impact on the activation of ATLs. The aim of this study was to explore the pattern of activation associated with a semantic processing of famous people based on face and written name stimuli. Fifteen healthy young individuals participated in our fMRI study, in which they were asked to perform a semantic categorization judgment task, based on profession, of visually presented pictures, and names of famous people. Neuroimaging findings showed a common pattern of activation for faces and names mainly involving the inferior frontal regions, the posterior temporal lobe, the visual cortex, and the ATLs. We found that the comparison names vs. pictures lead to significant activation in the anterior superior temporal gyrus. On the other hand, faces vs. names seemed associated with increased activation in the medial ATL. Moreover, our results demonstrated that the functional connectivity network anchored to the medial ATL, compared to the anterior STG, is more connected to the bilateral occipital lobe and fusiform gyrus that are regions implicated in the visual system and visual processing of faces. This study provides critical evidence of the differential involvement of ATL regions in semantics of famous people. PMID:27625630

  8. The Semantic Network at Work and Rest: Differential Connectivity of Anterior Temporal Lobe Subregions

    Science.gov (United States)

    Jackson, Rebecca L.; Hoffman, Paul; Pobric, Gorana

    2016-01-01

    The anterior temporal lobe (ATL) makes a critical contribution to semantic cognition. However, the functional connectivity of the ATL and the functional network underlying semantic cognition has not been elucidated. In addition, subregions of the ATL have distinct functional properties and thus the potential differential connectivity between these subregions requires investigation. We explored these aims using both resting-state and active semantic task data in humans in combination with a dual-echo gradient echo planar imaging (EPI) paradigm designed to ensure signal throughout the ATL. In the resting-state analysis, the ventral ATL (vATL) and anterior middle temporal gyrus (MTG) were shown to connect to areas responsible for multimodal semantic cognition, including bilateral ATL, inferior frontal gyrus, medial prefrontal cortex, angular gyrus, posterior MTG, and medial temporal lobes. In contrast, the anterior superior temporal gyrus (STG)/superior temporal sulcus was connected to a distinct set of auditory and language-related areas, including bilateral STG, precentral and postcentral gyri, supplementary motor area, supramarginal gyrus, posterior temporal cortex, and inferior and middle frontal gyri. Complementary analyses of functional connectivity during an active semantic task were performed using a psychophysiological interaction (PPI) analysis. The PPI analysis highlighted the same semantic regions suggesting a core semantic network active during rest and task states. This supports the necessity for semantic cognition in internal processes occurring during rest. The PPI analysis showed additional connectivity of the vATL to regions of occipital and frontal cortex. These areas strongly overlap with regions found to be sensitive to executively demanding, controlled semantic processing. SIGNIFICANCE STATEMENT Previous studies have shown that semantic cognition depends on subregions of the anterior temporal lobe (ATL). However, the network of regions

  9. Dissociating the semantic function of two neighbouring subregions in the left lateral anterior temporal lobe.

    Science.gov (United States)

    Sanjuán, Ana; Hope, Thomas M H; Jones, 'Ōiwi Parker; Prejawa, Susan; Oberhuber, Marion; Guerin, Julie; Seghier, Mohamed L; Green, David W; Price, Cathy J

    2015-09-01

    We used fMRI in 35 healthy participants to investigate how two neighbouring subregions in the lateral anterior temporal lobe (LATL) contribute to semantic matching and object naming. Four different levels of processing were considered: (A) recognition of the object concepts; (B) search for semantic associations related to object stimuli; (C) retrieval of semantic concepts of interest; and (D) retrieval of stimulus specific concepts as required for naming. During semantic association matching on picture stimuli or heard object names, we found that activation in both subregions was higher when the objects were semantically related (mug-kettle) than unrelated (car-teapot). This is consistent with both LATL subregions playing a role in (C), the successful retrieval of amodal semantic concepts. In addition, one subregion was more activated for object naming than matching semantically related objects, consistent with (D), the retrieval of a specific concept for naming. We discuss the implications of these novel findings for cognitive models of semantic processing and left anterior temporal lobe function. PMID:25496810

  10. Evidence for Integrated Visual Face and Body Representations in the Anterior Temporal Lobes.

    Science.gov (United States)

    Harry, Bronson B; Umla-Runge, Katja; Lawrence, Andrew D; Graham, Kim S; Downing, Paul E

    2016-08-01

    Research on visual face perception has revealed a region in the ventral anterior temporal lobes, often referred to as the anterior temporal face patch (ATFP), which responds strongly to images of faces. To date, the selectivity of the ATFP has been examined by contrasting responses to faces against a small selection of categories. Here, we assess the selectivity of the ATFP in humans with a broad range of visual control stimuli to provide a stronger test of face selectivity in this region. In Experiment 1, participants viewed images from 20 stimulus categories in an event-related fMRI design. Faces evoked more activity than all other 19 categories in the left ATFP. In the right ATFP, equally strong responses were observed for both faces and headless bodies. To pursue this unexpected finding, in Experiment 2, we used multivoxel pattern analysis to examine whether the strong response to face and body stimuli reflects a common coding of both classes or instead overlapping but distinct representations. On a voxel-by-voxel basis, face and whole-body responses were significantly positively correlated in the right ATFP, but face and body-part responses were not. This finding suggests that there is shared neural coding of faces and whole bodies in the right ATFP that does not extend to individual body parts. In contrast, the same approach revealed distinct face and body representations in the right fusiform gyrus. These results are indicative of an increasing convergence of distinct sources of person-related perceptual information proceeding from the posterior to the anterior temporal cortex. PMID:27054399

  11. Difference in temporal lobe dose between two radiotherapy techniques in the treatment of NPC with anterior nasal involvement

    International Nuclear Information System (INIS)

    Nasopharyngeal carcinoma with anterior extension are treated with special radiotherapy techniques. The purpose of this study is to investigate the difference of temporal lobe dose between two radiotherapy techniques (A and B) which are commonly used in the treatment of such condition in Hong Kong. The study is carried out by performing radiation treatments to a humanoid phantom under simulated conditions of the two techniques. The dose measurement is done by thermoluminescent dosimeters (TLD) which are placed inside the phantom. Both techniques employ a '3-field' arrangement: a heavy-weighted anterior facial fields with two lateral opposing facial fields. The main difference lies in the anterior facial field in which technique A uses electron beam throughout while technique B uses a mixture of photon and electron beams. The results demonstrates that technique A delivers higher dose to temporal lobe than technique B. In a course of radical external beam radiotherapy (66 Gy), the mean dose to inferior temporal lobe are 59.29 Gy in technique A and 34.06 Gy in technique B respectively (p < 0.0001). Furthermore, it is found that the temporal lobe dose difference between the two techniques is mainly due to their phase I treatment. (p < 0.0001 for phase I and p = 0.078 for phase II). (authors)

  12. Difference in temporal lobe dose between two radiotherapy techniques in the treatment of NPC with anterior nasal involvement

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    Wu, V.W.C.; Luk, J.H.Y.; Wong, S.F.T.; Lam, E.C.H.; Fung, M.C.Y.; Tong, S.M.; Ku, I.K.M. [Hong Kong Polytechnic University, Hong Kong, (Hong Kong). Department of Radiography and Optometry

    1997-04-01

    Nasopharyngeal carcinoma with anterior extension are treated with special radiotherapy techniques. The purpose of this study is to investigate the difference of temporal lobe dose between two radiotherapy techniques (A and B) which are commonly used in the treatment of such condition in Hong Kong. The study is carried out by performing radiation treatments to a humanoid phantom under simulated conditions of the two techniques. The dose measurement is done by thermoluminescent dosimeters (TLD) which are placed inside the phantom. Both techniques employ a `3-field` arrangement: a heavy-weighted anterior facial fields with two lateral opposing facial fields. The main difference lies in the anterior facial field in which technique A uses electron beam throughout while technique B uses a mixture of photon and electron beams. The results demonstrates that technique A delivers higher dose to temporal lobe than technique B. In a course of radical external beam radiotherapy (66 Gy), the mean dose to inferior temporal lobe are 59.29 Gy in technique A and 34.06 Gy in technique B respectively (p < 0.0001). Furthermore, it is found that the temporal lobe dose difference between the two techniques is mainly due to their phase I treatment. (p < 0.0001 for phase I and p = 0.078 for phase II). (authors). 14 refs., 3 tabs., 6 figs.

  13. Preoperative MR imaging-based volume measurements of the hippocampal formation and anterior temporal lobe in epileptic patients

    International Nuclear Information System (INIS)

    MR-based volume measurements of the anterior temporal lobe and hippocampal formation were performed in 36 patients who subsequently underwent surgery for medically refractory temporal lobe epilepsy. Seizure lateralization was based on standard clinical and electroencephalographic criteria. No surgical pathologic specimens contained structural lesions; epilepsy in these patients was therefore presumably due to mesial sclerosis. The right-minus-left hippocampal formation volume difference was greater than 0 in all 20 patients operated on the left side and less than 0 in all 16 patients operated on the right side. This difference completely separated the two surgical groups, while the same measurement in a group of 35 normal controls fell between the two surgical groups. Measurements of the anterior temporal to be showed a similar trend but incompletely separated controls, right- and left-sided epileptics. These results suggest that in a significant percentage of cases, MR-based volume measurements correctly identify the unilateral hippocampal atrophy that is known to occur in cases of mesial temporal sclerosis

  14. The 'when' and 'where' of semantic coding in the anterior temporal lobe: Temporal representational similarity analysis of electrocorticogram data.

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    Chen, Y; Shimotake, A; Matsumoto, R; Kunieda, T; Kikuchi, T; Miyamoto, S; Fukuyama, H; Takahashi, R; Ikeda, A; Lambon Ralph, M A

    2016-06-01

    Electrocorticograms (ECoG) provide a unique opportunity to monitor neural activity directly at the cortical surface. Ten patients with subdural electrodes covering ventral and lateral anterior temporal regions (ATL) performed a picture naming task. Temporal representational similarity analysis (RSA) was used, for the first time, to compare spatio-temporal neural patterns from the ATL surface with pre-defined theoretical models. The results indicate that the neural activity in the ventral subregion of the ATL codes semantic representations from 250 msec after picture onset. The observed activation similarity was not related to the visual similarity of the pictures or the phonological similarity of their names. In keeping with convergent evidence for the importance of the ATL in semantic processing, these results provide the first direct evidence of semantic coding from the surface of the ventral ATL and its time-course. PMID:27085891

  15. Imaging memory in temporal lobe epilepsy: predicting the effects of temporal lobe resection

    OpenAIRE

    Bonelli, S. B.; Powell, R. H. W.; Yogarajah, M.; Samson, R. S.; Symms, M.R.; Thompson, P J; Koepp, M J.; Duncan, J.S.

    2010-01-01

    Functional magnetic resonance imaging can demonstrate the functional anatomy of cognitive processes. In patients with refractory temporal lobe epilepsy, evaluation of preoperative verbal and visual memory function is important as anterior temporal lobe resections may result in material specific memory impairment, typically verbal memory decline following left and visual memory decline after right anterior temporal lobe resection. This study aimed to investigate reorganization of memory functi...

  16. Comprehension of Concrete and Abstract Words in Patients with Selective Anterior Temporal Lobe Resection and in Patients with Selective Amygdalo-Hippocampectomy

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    Loiselle, Magalie; Rouleau, Isabelle; Nguyen, Dang Khoa; Dubeau, Francois; Macoir, Joel; Whatmough, Christine; Lepore, Franco; Joubert, Sven

    2012-01-01

    The role of the anterior temporal lobe (ATL) in semantic memory is now firmly established. There is still controversy, however, regarding the specific role of this region in processing various types of concepts. There have been reports of patients suffering from semantic dementia (SD), a neurodegenerative condition in which the ATL is damaged…

  17. Magnetic resonance imaging of anterior temporal lobe cysts in children: discriminating special imaging features in a particular group of diseases

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    Hoffmann Nunes, Renato; Torres Pacheco, Felipe; Rocha, Antonio Jose da [Fleury Medicina e Saude, Division of Neuroradiology, Sao Paulo (Brazil); Servico de Diagnostico por Imagem, Division of Neuroradiology, Santa Casa de Misericordia de Sao Paulo Paulo, Sao Paulo (Brazil)

    2014-07-15

    We hypothesized that disorders with anterior temporal lobe (ATL) cysts might exhibit common peculiarities and distinguishable imaging features that could be useful for diagnosis. We reviewed a series of patients for neuroimaging contributions to specific diagnoses. A literature search was conducted, and institutional imaging files were reviewed to identify MR examinations with ATL cysts in children. Patients were divided according to head size, calcifications, white matter and cortical abnormalities. Unsupervised hierarchical clustering of patients on the basis of their MR and CT items was performed. We identified 23 patients in our database in whom MR revealed ATL cysts. Our series included five patients with congenital muscular dystrophy (05/23 = 21.7 %), six with megalencephalic leukoencephalopathy with subcortical cysts (06/23 = 26.1 %), three with non-megalencephalic leukoencephalopathy with subcortical cysts (03/23 = 13.1 %), seven with congenital cytomegalovirus disease (07/23 = 30.4 %) and two with Aicardi-Goutieres syndrome (02/23 = 8.7 %). After analysis, 11 clusters resulted in the highest discriminative indices. Thereafter, patients' clusters were linked to their underlying diseases. The features that best discriminated between clusters included brainstem abnormalities, cerebral calcifications and some peculiar grey and white matter abnormalities. A flow chart was drafted to guide the radiologist in these diagnoses. The authors encourage the combined interpretation of these features in the herein proposed approach that confidently predicted the final diagnosis in this particular group of disorders associated with ATL cysts. (orig.)

  18. Magnetic resonance imaging of anterior temporal lobe cysts in children: discriminating special imaging features in a particular group of diseases

    International Nuclear Information System (INIS)

    We hypothesized that disorders with anterior temporal lobe (ATL) cysts might exhibit common peculiarities and distinguishable imaging features that could be useful for diagnosis. We reviewed a series of patients for neuroimaging contributions to specific diagnoses. A literature search was conducted, and institutional imaging files were reviewed to identify MR examinations with ATL cysts in children. Patients were divided according to head size, calcifications, white matter and cortical abnormalities. Unsupervised hierarchical clustering of patients on the basis of their MR and CT items was performed. We identified 23 patients in our database in whom MR revealed ATL cysts. Our series included five patients with congenital muscular dystrophy (05/23 = 21.7 %), six with megalencephalic leukoencephalopathy with subcortical cysts (06/23 = 26.1 %), three with non-megalencephalic leukoencephalopathy with subcortical cysts (03/23 = 13.1 %), seven with congenital cytomegalovirus disease (07/23 = 30.4 %) and two with Aicardi-Goutieres syndrome (02/23 = 8.7 %). After analysis, 11 clusters resulted in the highest discriminative indices. Thereafter, patients' clusters were linked to their underlying diseases. The features that best discriminated between clusters included brainstem abnormalities, cerebral calcifications and some peculiar grey and white matter abnormalities. A flow chart was drafted to guide the radiologist in these diagnoses. The authors encourage the combined interpretation of these features in the herein proposed approach that confidently predicted the final diagnosis in this particular group of disorders associated with ATL cysts. (orig.)

  19. Apples are not the only fruit: The effects of concept typicality on semantic representation in the anterior temporal lobe

    Directory of Open Access Journals (Sweden)

    Anna M. Woollams

    2012-04-01

    Full Text Available Intuitively, an apple seems a fairly good example of a fruit, whereas an avocado seems less so. The extent to which an exemplar is representative of its category, a variable known as concept typicality, has long been thought to be a key dimension determining semantic representation. Concept typicality is, however, correlated with a number of other variables, in particular age of acquisition and name frequency. Consideration of picture naming accuracy from a large case-series of semantic dementia patients demonstrated strong effects of concept typicality that were maximal in the moderately impaired patients, over and above the impact of age of acquisition and name frequency. Induction of a temporary virtual lesion to the left anterior temporal lobe, the region most commonly affected in semantic dementia, via repetitive Transcranial Magnetic Stimulation produced an enhanced effect of concept typicality in the picture naming of normal participants, but did not affect the magnitude of the age of acquisition or name frequency effects. These results indicate that concept typicality exerts its influence on semantic representations themselves, as opposed to the strength of connections outside the semantic system. To date, there has been little direct exploration of the dimension of concept typicality within connectionist models of intact and impaired conceptual representation, and these findings provide a target for future computational simulation.

  20. Anterior temporal lobe white matter abnormal signal (ATLAS) as an indicator of seizure focus laterality in temporal lobe epilepsy: comparison of double inversion recovery, FLAIR and T2W MR imaging

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    Morimoto, Emiko; Kanagaki, Mitsunori; Okada, Tomohisa; Yamamoto, Akira; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan); Mori, Nobuyuki [Tenri Hospital, Department of Radiology, Tenri, Nara (Japan); Matsumoto, Riki; Ikeda, Akio; Takahashi, Ryosuke [Kyoto University Graduate School of Medicine, Department of Neurology, Kyoto (Japan); Mikuni, Nobuhiro [Sapporo Medical University, Department of Neurosurgery, Sapporo, Hokkaido (Japan); Kunieda, Takeharu; Miyamoto, Susumu [Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto (Japan); Paul, Dominik [Siemens AG Healthcare Sector, Erlangen (Germany)

    2013-01-15

    To investigate the diagnostic capability of anterior temporal lobe white matter abnormal signal (ATLAS) for determining seizure focus laterality in temporal lobe epilepsy (TLE) by comparing different MR sequences. This prospective study was approved by the institutional review board and written informed consent was obtained. Three 3D sequences (double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI)) and two 2D sequences (FLAIR and T2WI) were acquired at 3 T. Signal changes in the anterior temporal white matter of 21 normal volunteers were evaluated. ATLAS laterality was evaluated in 21 TLE patients. Agreement of independent evaluations by two neuroradiologists was assessed using {kappa} statistics. Differences in concordance between ATLAS laterality and clinically defined seizure focus laterality were analysed using McNemar's test with multiple comparisons. Pre-amygdala high signals (PAHS) were detected in all volunteers only on 3D-DIR. Inter-evaluator agreement was moderate to almost perfect for each sequence. Correct diagnosis of seizure laterality was significantly more frequent on 3D-DIR than on any other sequences (P {<=} 0.031 for each evaluator). The most sensitive sequence for detecting ATLAS laterality was 3D-DIR. ATLAS laterality on 3D-DIR can be a good indicator for determining seizure focus localization in TLE. (orig.)

  1. Anterior temporal lobe white matter abnormal signal (ATLAS) as an indicator of seizure focus laterality in temporal lobe epilepsy: comparison of double inversion recovery, FLAIR and T2W MR imaging

    International Nuclear Information System (INIS)

    To investigate the diagnostic capability of anterior temporal lobe white matter abnormal signal (ATLAS) for determining seizure focus laterality in temporal lobe epilepsy (TLE) by comparing different MR sequences. This prospective study was approved by the institutional review board and written informed consent was obtained. Three 3D sequences (double inversion recovery (DIR), fluid-attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI)) and two 2D sequences (FLAIR and T2WI) were acquired at 3 T. Signal changes in the anterior temporal white matter of 21 normal volunteers were evaluated. ATLAS laterality was evaluated in 21 TLE patients. Agreement of independent evaluations by two neuroradiologists was assessed using κ statistics. Differences in concordance between ATLAS laterality and clinically defined seizure focus laterality were analysed using McNemar's test with multiple comparisons. Pre-amygdala high signals (PAHS) were detected in all volunteers only on 3D-DIR. Inter-evaluator agreement was moderate to almost perfect for each sequence. Correct diagnosis of seizure laterality was significantly more frequent on 3D-DIR than on any other sequences (P ≤ 0.031 for each evaluator). The most sensitive sequence for detecting ATLAS laterality was 3D-DIR. ATLAS laterality on 3D-DIR can be a good indicator for determining seizure focus localization in TLE. (orig.)

  2. "That thing in New York": Impaired naming vs. preserved recognition of unique entities following an anterior temporal lobe lesion

    Directory of Open Access Journals (Sweden)

    Daniel Roberts

    2014-04-01

    Full Text Available Background Anterior temporal lobe (aTL damage often results in semantic impairment. As such, the contribution of this region to semantic processing has received considerable attention. Two theories exist to explain aTL function based on conflicting neuropsychological investigations. The first proposes bilateral aTLs form a “hub” implicated in multimodal semantics (for review see: Jefferies, 2013. The second assumes distinct functions. The left is thought to function as a repertoire for knowledge of entities with unique lexical-conceptual associations (for review: Ross & Olson, 2012. These items represent an extreme end of a continuum of semantic specificity spanning unique (e.g., Eiffel Tower over less specific (e.g., tower to nonspecific (e.g., landmark – often denoted by famous faces, landmarks and proper names. LaTL function, therefore, is to link semantics to language systems for naming, whilst RaTL is involved in familiarity and recognition (e.g., Eiffel Tower -> a building in Paris; Drane et al., 2013. Evidence for each theory has proceeded in parallel but there has been no attempt to directly test them in a patient (Simmons & Martin, 2009. The novelty of this study, therefore, was to determine whether LaTL lesions disproportionately affect unique entity naming vs. recognition. Method WRP, a 51year old right-handed male, three year post-HSVE has a LaTL lesion with destruction of the temporal pole, extending to medial temporal, amygdala and hippocampus and atypical connectivity particularly involving the uncinate fasciculas. There is no evidence of either cortical or white matter damage in the right hemisphere. Previous work with WRP revealed a mild/moderate category-specific semantic deficit (Roberts et al., 2012. This new study focuses on unique entity picture naming, recognition and word-to-picture matching (WPM. Results & Discussion As predicted, results (Table 1 show that WRP was severely impaired in naming different categories

  3. Temporal lobe epilepsy in children

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    Jayanti Mani

    2008-01-01

    Full Text Available Temporal lobe epilepsy is a fairly homogenous syndrome in adults, with hippocampal sclerosis being the commonest etiology. In children, temporal lobe epilepsy is more commonly due to cortical dysplasia or tumors. The semiology and electrophysiology of temporal lobe seizures in children are distinct from adults and have age-dependent variations. The first-line treatment option in children includes antiepileptic drugs. Ketogenic diet and surgery are therapeutic options in refractory pediatric temporal lobe epilepsy.

  4. Exploring the role of the posterior middle temporal gyrus in semantic cognition: Integration of anterior temporal lobe with executive processes.

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    Davey, James; Thompson, Hannah E; Hallam, Glyn; Karapanagiotidis, Theodoros; Murphy, Charlotte; De Caso, Irene; Krieger-Redwood, Katya; Bernhardt, Boris C; Smallwood, Jonathan; Jefferies, Elizabeth

    2016-08-15

    Making sense of the world around us depends upon selectively retrieving information relevant to our current goal or context. However, it is unclear whether selective semantic retrieval relies exclusively on general control mechanisms recruited in demanding non-semantic tasks, or instead on systems specialised for the control of meaning. One hypothesis is that the left posterior middle temporal gyrus (pMTG) is important in the controlled retrieval of semantic (not non-semantic) information; however this view remains controversial since a parallel literature links this site to event and relational semantics. In a functional neuroimaging study, we demonstrated that an area of pMTG implicated in semantic control by a recent meta-analysis was activated in a conjunction of (i) semantic association over size judgements and (ii) action over colour feature matching. Under these circumstances the same region showed functional coupling with the inferior frontal gyrus - another crucial site for semantic control. Structural and functional connectivity analyses demonstrated that this site is at the nexus of networks recruited in automatic semantic processing (the default mode network) and executively demanding tasks (the multiple-demand network). Moreover, in both task and task-free contexts, pMTG exhibited functional properties that were more similar to ventral parts of inferior frontal cortex, implicated in controlled semantic retrieval, than more dorsal inferior frontal sulcus, implicated in domain-general control. Finally, the pMTG region was functionally correlated at rest with other regions implicated in control-demanding semantic tasks, including inferior frontal gyrus and intraparietal sulcus. We suggest that pMTG may play a crucial role within a large-scale network that allows the integration of automatic retrieval in the default mode network with executively-demanding goal-oriented cognition, and that this could support our ability to understand actions and non

  5. Both the middle temporal gyrus and the ventral anterior temporal area are crucial for multimodal semantic processing: distortion-corrected fMRI evidence for a double gradient of information convergence in the temporal lobes.

    Science.gov (United States)

    Visser, Maya; Jefferies, Elizabeth; Embleton, Karl V; Lambon Ralph, Matthew A

    2012-08-01

    Most contemporary theories of semantic memory assume that concepts are formed from the distillation of information arising in distinct sensory and verbal modalities. The neural basis of this distillation or convergence of information was the focus of this study. Specifically, we explored two commonly posed hypotheses: (a) that the human middle temporal gyrus (MTG) provides a crucial semantic interface given the fact that it interposes auditory and visual processing streams and (b) that the anterior temporal region-especially its ventral surface (vATL)-provides a critical region for the multimodal integration of information. By utilizing distortion-corrected fMRI and an established semantic association assessment (commonly used in neuropsychological investigations), we compared the activation patterns observed for both the verbal and nonverbal versions of the same task. The results are consistent with the two hypotheses simultaneously: Both MTG and vATL are activated in common for word and picture semantic processing. Additional planned, ROI analyses show that this result follows from two principal axes of convergence in the temporal lobe: both lateral (toward MTG) and longitudinal (toward the anterior temporal lobe). PMID:22621260

  6. Microneurosurgical management of temporal lobe epilepsy by amygdalohippocampectomy (AH) plus standard anterior temporal lobectomy (ATL): a report of our initial five cases in Bangladesh

    OpenAIRE

    Chowdhury, F. H.; Haque, M R; Islam, M S; Sarker, MH; Kawsar, KA; Sarker, AC

    2010-01-01

    Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-Venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report five cases of surgically treated TLE that were due to a MTS, MTS with arachnoid cyst, low grade ganglioglioma, high grade ganglioglioma and a tuberculoma in t...

  7. Clinical curative effect analysis and predictors of prognosis in patients with temporal lobe epilepsy after anterior temporal lobectomy:results after five years

    Institute of Scientific and Technical Information of China (English)

    Sun Zhenxing; Yuan Dan; Sun Yaxing; Zhang Jianguo; Zuo Huancong; Zhang Kai

    2014-01-01

    Background Anterior temporal lobectomy (ATL) is the most common surgical treatment for temporal lobe epilepsy (TLE),although long-term prognosis is often less favorable than short-term outcomes.This study aimed to examine the outcomes of patients with TLE 5 years after undergoing ATL,and to seek possible predictors of prognosis.Methods We examined the clinical records of 121 patients with TLE who underwent ATL in our institution between January 2005 and December 2008.The Engel seizure classification was used to divide patients into "seizure free" and "non-seizure free" groups.Univariate and multivariate Logistic regression analyses were used to identify potential prognostic indicators,including history,clinical features of seizures,and magnetic resonance imaging (MRI) and videoelectroencephalography (EEG) findings.Results The majority of patients were seizure free during the follow-up period:71.9% 1 year after surgery; 71.6% after 2 years; 75.8% after 3 years; 78.8% after 4 years after surgery and 68.8% after 5 years.There were significant differences between seizure-free and non-seizure-free groups in terms of preoperative seizure duration,history of febrile seizures,type of seizure,and MRI and video-EEG findings (P <0.05),but not in terms of sex,age at seizure onset,age at surgery,side of surgery,auras,family history of seizure,or history of traumatic brain injury,perinatal anoxia or intracranial infection history (P >0.05).Multivariate Logistic regression analysis showed that a preoperative seizure duration <10 years,a history of febrile seizures,simple complex partial seizures,positive MRI findings,hippocampal sclerosis and unilateral localized video-EEG spikes predicted better outcome (P <0.05).Conclusions ATL appears to be an effective means of treating TLE.Patients undergoing ATL for TLE require careful and comprehensive assessment to ensure optimal outcomes and to allow patients to make informed decisions about their treatment.

  8. The neurobiology of cognitive disorders in temporal lobe epilepsy

    OpenAIRE

    Bell, Brian; Lin, Jack J.; Seidenberg, Michael; Hermann, Bruce

    2011-01-01

    Cognitive impairment and especially memory disruption is a major complicating feature of the epilepsies. In this review we begin with a focus on the problem of memory impairment in temporal lobe epilepsy. We start with a brief overview of the early development of knowledge regarding the anatomic substrates of memory disorder in temporal lobe epilepsy, followed by discussion of the refinement of that knowledge over time as informed by the outcomes of epilepsy surgery (anterior temporal lobecto...

  9. Endocrine abnormalities in human temporal lobe epilepsy.

    OpenAIRE

    Gallagher, B. B.

    1987-01-01

    Patients with temporal lobe epilepsy secrete ACTH at higher rates and in greater amounts than normal subjects. Temporal lobectomy restores ACTH secretion to normal amounts and rates. The ACTH secretion in temporal lobe epilepsy is independent of anticonvulsant drug effect and seizure frequency. Electrical stimulation of medial temporal lobe structures in patients with temporal lobe epilepsy affected ACTH secretion in a manner consistent with the hypothesis that ACTH secretion is regulated by ...

  10. Temporal Lobe Epilepsy in Children

    Directory of Open Access Journals (Sweden)

    Katherine C. Nickels

    2012-01-01

    Full Text Available The temporal lobe is a common focus for epilepsy. Temporal lobe epilepsy in infants and children differs from the relatively homogeneous syndrome seen in adults in several important clinical and pathological ways. Seizure semiology varies by age, and the ictal EEG pattern may be less clear cut than what is seen in adults. Additionally, the occurrence of intractable seizures in the developing brain may impact neurocognitive function remote from the temporal area. While many children will respond favorably to medical therapy, those with focal imaging abnormalities including cortical dysplasia, hippocampal sclerosis, or low-grade tumors are likely to be intractable. Expedient workup and surgical intervention in these medically intractable cases are needed to maximize long-term developmental outcome.

  11. Brain SPECT imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Temporal lobe epilepsy is diagnosed by clinical symptoms and signs and by localization of an epileptogenic focus. A brain SPECT study of two patients with temporal lobe epilepsy, using 99mTc-HMPAO, was used to demonstrate a perfusion abnormality in the temporal lobe, while brain CT and MRI were non-contributory. The electroencephalogram, though abnormal, did not localize the diseased area. The potential role of the SPECT study in diagnosis and localization of temporal lobe epilepsy is discussed. (orig.)

  12. 'Doctor' or 'darling'? Decoding the communication partner from ECoG of the anterior temporal lobe during non-experimental, real-life social interaction

    Directory of Open Access Journals (Sweden)

    Johanna eDerix

    2012-09-01

    Full Text Available Human brain processes underlying real-life social interaction in everyday situations have been difficult to study and have, until now, remained largely unknown. Here, we investigated whether electrocorticography (ECoG recorded for pre-neurosurgical diagnostics during the daily hospital life of epilepsy patients could provide a way to elucidate the neural correlates of non-experimental social interaction. We identified time periods in which patients were involved in conversations with either their respective life partners (Condition 1; C1 or attending physicians (Condition 2; C2. These two conditions can be expected to differentially involve subfunctions of social interaction which have been associated with activity in the anterior temporal lobe (ATL, including the temporal poles (TP. Therefore, we specifically focused on ECoG recordings from this brain region and investigated spectral power modulations in the alpha (8-12 Hz and theta (3-5 Hz frequency ranges, which have been previously assumed to play an important role in the processing of social interaction. We hypothesized that brain activity in this region might be sensitive to differences in the two interaction situations and tested whether these differences can be detected by single-trial decoding. Condition-specific effects in both theta and alpha bands were observed: the left and right TP exclusively showed increased power in C1 compared to C2, whereas more posterior parts of the ATL exhibited similar (C1 > C2 and also contrary (C2 > C1 effects. Single-trial decoding accuracies for classification of these effects were highly above chance. Our findings demonstrate that it is possible to study the neural correlates of human social interaction in non-experimental conditions. Decoding the identity of the communication partner and adjusting the speech output accordingly may be useful in the emerging field of brain- machine interfacing for restoration of expressive speech.

  13. Arousal Enhanced Memory Retention Is Eliminated Following Temporal Lobe Resection

    Science.gov (United States)

    Ahs, Fredrik; Kumlien, Eva; Fredrikson, Mats

    2010-01-01

    The amygdala, situated in the anterior medial temporal lobe (MTL), is involved in the emotional enhancement of memory. The present study evaluated whether anterior MTL-resections attenuated arousal induced memory enhancement for pictures. Also, the effect of MTL-resections on response latencies at retrieval was assessed. Thirty-one patients with…

  14. Preoperative amygdala fMRI in temporal lobe epilepsy

    OpenAIRE

    Bonelli, S. B.; Powell, R.; Yogarajah, M; Thompson, P.J.; Symms, M. R.; Koepp, M.J.; Duncan, J.S.

    2009-01-01

    Purpose: Anterior temporal lobe resections (ATLR) benefit 70% of patients with refractory mesial temporal lobe epilepsy (TLE), but may be complicated by emotional disturbances. We used functional magnetic resonance imaging (fMRI) to investigate the role of the amygdala in processing emotions in TLE and whether this may be a potential preoperative predictive marker for emotional disturbances following surgery. Methods: We studied 54 patients with refractory mesial TLE due to hippocampal sc...

  15. 功能磁共振成像观察左颞前部在汉语听觉词加工中的机制%Functional MRI observation on auditory Chinese lexical processing mechanism in left anterior temporal lobe

    Institute of Scientific and Technical Information of China (English)

    王晓怡; 卢洁; 李坤成; 张苗; 徐国庆; 舒华

    2011-01-01

    Objective To explore the neural mechanism for auditory Chinese lexical processing in the left anterior temporal lobe (ATL) of the healthy participants with functional magnetic imaging (fMRI). Methods Fifteen right-handed healthy participants, including 5 males and 10 females, were asked to repeat the auditory words or judge whether the auditory items were semantically dangerous. AFNI was used to process fMRI data and localize functional areas and the difference in the anterior temporal lobe. Results The results revealed the phonological processing on auditory Chinese lexical information was located in the anterior superior temporal gyrus, and the semantic processing was located in the anterior middle temporal gyrus. There existed segregation between the phonological processing and the semantic processing of the auditory Chinese words. Conclusion There was the function of semantic integration in the ATL. Two pathways to semantic access include the direct pathway in the dorsal temporal lobe for repetition task and the indirect in ventral temporal lobe for semantic judgment task.%目的 探讨左侧颞前部在汉语听觉信息加工中的作用机制.方法 应用3.0T磁共振成像系统与标准头线圈对15名健康志愿者(男5名,女10名)进行功能磁共振成像(fMRI).要求受试者完成听觉复述任务和听觉语义危险判断任务.应用软件包AFNI分析两种听觉任务在左颞前部的任务功能定位及其差异.结果 正常成人听觉语义判断任务相比听觉复述任务更多激活左侧颞中回及颞下回前部,而听觉语音复述任务相比听觉语义判断任务更多激活左侧颞上回前部.结论 脑内存在左颞前部对汉语听觉语音语义信息加工的分离,颞上前部对语音分析更强,颞前中下部对语义分析更强.

  16. PET imaging in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Semah, F. [Service Hospitalier Frederic Joliot, DSV-CEA, 91 Orsay (France)

    2006-07-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  17. PET imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  18. Multimodal emotion perception after anterior temporal lobectomy

    OpenAIRE

    Valérie Milesi; Chiara Cristinzio; Margitta Seeck

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed...

  19. Immunological perspectives of temporal lobe seizures.

    Science.gov (United States)

    Liimatainen, Suvi; Lehtimäki, Kai; Kai, Lehtimäki; Palmio, Johanna; Johanna, Palmio; Alapirtti, Tiina; Tiina, Alapirtti; Peltola, Jukka; Jukka, Peltola

    2013-10-15

    The temporal lobes are affected in many different neurological disorders, such as neurodegenerative diseases, viral and immunological encephalitides, and epilepsy. Both experimental and clinical evidence suggests a different inflammatory response to seizures in patients with temporal lobe epilepsy (TLE) in comparison to those with extra-TLE (XTLE). Proinflammatory cytokines and several autoantibodies have been shown to be associated with TLE compared to other epilepsy types suggesting the specific role and structure of the temporal lobe. Abundant experience suggests that activation of both innate and adaptive immunity is associated with epilepsy, particularly refractory focal epilepsy. Limbic encephalitis often triggers temporal lobe seizures, and a proportion of these disorders are immune-mediated. Histological evidence shows activation of specific inflammatory pathways in resected temporal lobes of epileptic patients, and certain epileptic disorders have shown increased incidence in patients with autoimmune diseases. Rapid activation of proinflammatory cytokines is observed after single seizures, but there is also evidence of chronic overproduction of cytokines and other inflammatory mediators in patients with TLE, suggesting a neuromodulatory role of inflammation in epilepsy. In this review we summarize current data on the presence and the role of immunological factors in temporal lobe seizures, and their possible involvement in epileptogenesis. PMID:23998423

  20. MRI in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The present study investigated magnetic resonance imaging (MRI) features in temporal lobe epilepsy and correlated them with clinical variables, such as age, illness duration, past history, and the frequency of seizure. Cerebral MRI was performed in 45 patients with temporal lobe epilepsy of unknown etiology, using a 0.5 T and/or a 1.5 T MRI systems. The temporal lobe was seen as high signal intensity on T2-weighted images and/or proton density-weighted images in 6 patients, although it was missed on CT and T1-weighted images. The high intensity area seemed to reflect sclerosis of the temporal lobe. This finding was significantly associated with partial seizure. Of these patients, 3 had a history of febrile convulsions. Ten patients had slight dilatation of the inferior horn of the lateral ventricle. They were significantly old at the time of onset and examination, as compared with those without dilatation. Furthermore, 6 patients with unilateral dilatation were significantly younger than the other 4 with bilateral dilatation. Nine patients had small multiple high signal areas in white matter, mainly in the parietal lobe, which suggested vascular origin. These patients were significantly old at the time of onset and examination, as compared with those having no such findings. In depicting high signal intensity areas, a 1.5 T MRI system was not always superior to a 0.5 T MRI system. Proton density-weighted images were better than T2-weighted images in some patients. (N.K.)

  1. Profiling cytokines in temporal lobe epilepsy

    NARCIS (Netherlands)

    Kan, A.A.

    2012-01-01

    Temporal lobe epilepsy (TLE) is one of the most common types of partial epilepsy. Because about 30% of the TLE patients poorly respond to medication, identification of new drug targets to treat TLE is imperative. This requires detailed knowledge of the pathophysiology of TLE . The aim of this thesis

  2. Limbic Network Synchronization and Temporal Lobe Epilepsy

    Czech Academy of Sciences Publication Activity Database

    Jefferys, J. G. R.; Jiruška, Přemysl; de Curtis, M.; Avoli, M.

    4. New York : Oxford University Press, 2012 - (Noebels, J.; Avoli, M.; Rogawski, M.; Olsen, R.; Delgado-Escueta, A.), s. 176-189. ISBN 978-0-19-974654-5 Institutional research plan: CEZ:AV0Z50110509 Keywords : synchronization * temporal lobe epilepsy * seizures Subject RIV: FH - Neurology

  3. Functional Connectome before and following Temporal Lobectomy in Mesial Temporal Lobe Epilepsy

    OpenAIRE

    Wei Liao; Gong-Jun Ji; Qiang Xu; Wei Wei; Jue Wang; Zhengge Wang; Fang Yang; Kangjian Sun; Qing Jiao; Richardson, Mark P; Yu-Feng Zang; Zhiqiang Zhang; Guangming Lu

    2016-01-01

    As mesial temporal lobe epilepsy (mTLE) has been recognized as a network disorder, a longitudinal connectome investigation may shed new light on the understanding of the underlying pathophysiology related to distinct surgical outcomes. Resting-state functional MRI data was acquired from mTLE patients before (n = 37) and after (n = 24) anterior temporal lobectomy. According to surgical outcome, patients were classified as seizure-free (SF, n = 14) or non-seizure-free (NSF, n = 10). First, we f...

  4. Dynamic perfusion patterns in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Dupont, Patrick; Paesschen, Wim van [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); Zaknun, John J. [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Maes, Alex [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); AZ Groeninge, Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn; Locharernkul, Chaichon [Chulalongkorn University, Nuclear Medicine and Neurology, Bangkok (Thailand); Vasquez, Silvia; Carpintiero, Silvina [Fleni Instituto de Investigaciones Neurologicas, Nuclear Medicine, Buenos Aires (Argentina); Bal, C.S. [All India Institute of Medical Sciences, Nuclear Medicine, New Delhi (India); Dondi, Maurizio [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); Ospedale Maggiore, Nuclear Medicine, Bologna (Italy)

    2009-05-15

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  5. MRI findings of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    MRI findings were analyzed retrospectively in 46 patients with temporal lobe epilepsy in which the side of epileptogenic focus had been confirmed by EEG studies. T1- and T2-weighted images were obtained by the use of a 1.0 or 1.5 T superconducting-type MRI machine with a coronal scan perpendicular to the axis of the temporal horn of the lateral ventricle. Additional axial and sagittal scans were performed in some cases. The area of the hippocampal body was measured quantitatively using a computerized image-analysis system in 26 cases in which the hippocampus had been visualized with enough contrast on T1-weighted coronal images. Abnormal findings were observed in 31/46 (67%) cases. Hippocampal (HC) and temporal lobe (TL) atrophy were observed in 18/46 (39%) and 23/46 (50%) cases respectively, and the side of the atrophy corresponded with the side of the epileptogenic focus, as confirmed by EEG studies, with specificities of 89% and 74% respectively. A quantitative measurement of the area of the hippocampal body showed unilateral hippocampal atrophy more than 10% in 18/25 (69%) cases (10-25%: 10 cases, 25-50%: 7 cases, 50%2 abnormality was observed in only 4 cases. Structural lesions were observed in 4 cases including an arachnoid cyst, an astrocytoma in amygdala, the Dandy-Walker syndrome, and tuberous sclerosis, using the more efficient imaging qualities than the CT scan. From these observations, it is apparant that superconducting MRI is extremely useful in the diagnosis of the epileptogenic topography of temporal lobe epilepsy. Particularly, hippocampal atrophy was found to correspond with the side of the epileptogenic focus on EEG with a high specificity; its quantitative evaluation could be one of the most important standards in detecting the operative indications for temporal lobe epilepsy. (author)

  6. MR imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    MR imaging examinations of 31 patients undergoing temporal lobe resection for refractory partial epilepsy were reviewed retrospectively for the presence of signal abnormalities as well as atrophy. High-signal abnormalities were present in only two of the described 31 patients (6.5%). Pathologically, these represented mesial temporal sclerosis and a hamartoma. Of the remaining 29 cases, 13 showed pathologically varying degrees of mesial temporal sclerosis and gliosis and 16 were pathologically normal. Atrophy, as determined by gross asymmetry, sulcal and temporal horn enlargement, and computer volume measurements, was observed in 23 of 31 patients, correlating with the clinically affected side in 20 and the contralateral side in three. In this series, in contrast to others reported, focal MR signal abnormalities were not detected in the vast majority of patients with mesial temporal sclerosis

  7. Video electroencephalogram telemetry in temporal lobe epilepsy

    OpenAIRE

    Jayanti Mani

    2014-01-01

    Temporal lobe epilepsy (TLE) is the most commonly encountered medically refractory epilepsy. It is also the substrate of refractory epilepsy that gives the most gratifying results in any epilepsy surgery program, with a minimum use of resources. Correlation of clinical behavior and the ictal patterns during ictal behavior is mandatory for success at epilepsy surgery. Video electroencephalogram (EEG) telemetry achieves this goal and hence plays a pivotal role in pre-surgical assessment. The ro...

  8. The Role of Amygdala in Emotional and Social Functions: Implications for Temporal Lobe Epilepsy

    OpenAIRE

    Cristinzio Perrin, Chiara; Vuilleumier, Patrik

    2007-01-01

    Temporal lobe epilepsy is among the most frequent causes of chronic and drug-resistant seizure disorders. It is typically associated with lesions involving critical limbic structures within the anterior medial temporal lobe, such as the amygdala and hippocampus. While the role of the hippocampus and adjacent cortical regions in memory function is now well established, the role of the amygdala and related brain circuits is still poorly known. The amygdala is a complex neural structure implicat...

  9. Famous face identification in temporal lobe epilepsy: Support for a multimodal integration model of semantic memory

    OpenAIRE

    Drane, Daniel L.; Ojemann, Jeffrey G.; Phatak, Vaishali; Loring, David W.; Gross, Robert E.; Hebb, Adam O.; Silbergeld, Daniel L; Miller, John W.; Voets, Natalie L.; Saindane, Amit M; Barsalou, Lawrence; Meador, Kimford J.; Ojemann, George A.; Tranel, Daniel

    2012-01-01

    This study aims to demonstrate that the left and right anterior temporal lobes (ATLs) perform critical but unique roles in famous face identification, with damage to either leading to differing deficit patterns reflecting decreased access to lexical or semantic concepts but not their degradation. Famous face identification was studied in 22 presurgical and 14 postsurgical temporal lobe epilepsy (TLE) patients and 20 healthy comparison subjects using free recall and multiple choice (MC) paradi...

  10. Magnetic resonance imaging in temporal lobe epilepsy. Usefulness for the etiological diagnosis of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    With improvement in magnetic resonance (MR) imaging techniques, the ability to identify lesions responsible for temporal lobe epilepsy has increased. MR imaging has also enabled the in vivo diagnosis of hippocampal sclerosis. Brain tumors are responsible for 2-4% of epilepsies in adult population and 10-20% of medically intractable epilepsy. The sensitivity of MR imaging in the diagnosis of tumors and other lesions of the temporal lobe (vascular malformations, etc.) is around 90%. Both hippocampal sclerosis and other temporal lobe lesions are amenable to surgical therapy with excellent postsurgical seizure outcome. In this article, we characterize and underline distinguishing features of the different pathological entities. We also suggest an approach to reviewing the MR images of an epileptic patient. (author)

  11. Right upper lobe lung cancer: Resection through left anterior mediastinotomy.

    Science.gov (United States)

    Sirois, Marco; Abu Arab, Walid; Turcotte, Eric; Poulin, Yannick

    2016-01-01

    There is sparse information concerning approaches to metachronous lung cancer in patients who had a previous pneumonectomy for lung carcinoma. We describe the case of a 55-year-old woman who underwent a left pneumonectomy for lung carcinoma. Four years later, a radiological examination revealed a hypermetabolic nodule in the right upper lobe, which was located in the left hemithorax because of right lung hyperinflation and a mediastinal shift to the left. Wedge resection was carried out through a left anterior mediastinotomy. We believe that an anterior mediastinotomy represents a valuable option for the management of recurrent lung cancer after previous surgery. PMID:26124429

  12. Both the middle temporal gyrus and the ventral anterior temporal area are crucial for multimodal semantic processing: Distortion-corrected fMRI evidence for a double gradient of information convergence in the temporal lobes.

    OpenAIRE

    M. Visser, E. Jefferies, K. Embleton, & M.A. Lambon Ralph

    2012-01-01

    Most contemporary theories of semantic memory assume that concepts are formed from the distillation of information arising in distinct sensory and verbal modalities. The neural basis of this distillation or convergence of information was the focus of this study. Specifically, we explored two commonly posed hypotheses: (a) that the human middle temporal gyrus (MTG) provides a crucial semantic interface given the fact that it interposes auditory and visual processing streams and (b) that the an...

  13. Spike voltage topography in temporal lobe epilepsy.

    Science.gov (United States)

    Asadi-Pooya, Ali A; Asadollahi, Marjan; Shimamoto, Shoichi; Lorenzo, Matthew; Sperling, Michael R

    2016-07-15

    We investigated the voltage topography of interictal spikes in patients with temporal lobe epilepsy (TLE) to see whether topography was related to etiology for TLE. Adults with TLE, who had epilepsy surgery for drug-resistant seizures from 2011 until 2014 at Jefferson Comprehensive Epilepsy Center were selected. Two groups of patients were studied: patients with mesial temporal sclerosis (MTS) on MRI and those with other MRI findings. The voltage topography maps of the interictal spikes at the peak were created using BESA software. We classified the interictal spikes as polar, basal, lateral, or others. Thirty-four patients were studied, from which the characteristics of 340 spikes were investigated. The most common type of spike orientation was others (186 spikes; 54.7%), followed by lateral (146; 42.9%), polar (5; 1.5%), and basal (3; 0.9%). Characteristics of the voltage topography maps of the spikes between the two groups of patients were somewhat different. Five spikes in patients with MTS had polar orientation, but none of the spikes in patients with other MRI findings had polar orientation (odds ratio=6.98, 95% confidence interval=0.38 to 127.38; p=0.07). Scalp topographic mapping of interictal spikes has the potential to offer different information than visual inspection alone. The present results do not allow an immediate clinical application of our findings; however, detecting a polar spike in a patient with TLE may increase the possibility of mesial temporal sclerosis as the underlying etiology. PMID:27288809

  14. Multimodal emotion perception after anterior temporal lobectomy (ATL)

    OpenAIRE

    Milesi, Valérie; Cekic, Sezen; Péron, Julie; Frühholz, Sascha; Cristinzio, Chiara; Seeck, Margitta; Grandjean, Didier

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed...

  15. Temporal lobe lesions and psychosis in multiple sclerosis

    OpenAIRE

    Yadav, R; Zigmond, A S

    2010-01-01

    Lesions in the temporal lobe are associated with psychiatric manifestations in multiple sclerosis. The authors describe this case of a young man with multiple sclerosis who presented with first-episode psychosis and had acute lesions in the temporal lobe. He was successfully treated with olanzapine and β-interferon.

  16. Organic mood disorder following left anterior temporal lobectomy with amygdalohippocampectomy

    Directory of Open Access Journals (Sweden)

    Nishanth J Haridas

    2015-01-01

    Full Text Available One third of patients with antiepileptic-resistant temporal lobe epilepsy (TLE will have to undergo surgery for a better seizure control. Anterior temporal lobectomy (ATL is done for mesial temporal sclerosis that is the most common histopathological lesion associated with TLE. Psychiatric manifestations following ATL are not uncommon with depressive symptoms more common with left ATL and manic symptoms following right ATL. Mr. A is a 42-year-old left cerebral dominant (Confirmed by WADA test male with no past history of psychiatric illness who had undergone anterior temporal lobectomy with amygdalohippocampectomy. He started having manic episodes post operatively which subsided with antipsychotics. He had multiple such episodes over the next 13 years with minimal inter episodic symptoms. This is a rare instance of manic symptoms following left-sided ATL that emphasizes the need for better understanding of the cerebral laterality of affective symptoms.

  17. Multimodal emotion perception after anterior temporal lobectomy

    Directory of Open Access Journals (Sweden)

    Valérie eMilesi

    2014-05-01

    Full Text Available In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed to both unimodal (vocal or visual and audiovisual emotional and neutral stimuli. In a classic paradigm, participants were asked to rate the emotional intensity of angry, fearful, joyful, and neutral stimuli on visual analog scales. Compared with matched controls, patients exhibited impaired categorization of joyful expressions, whether the stimuli were auditory, visual, or audiovisual. Patients confused joyful faces with neutral faces, and joyful prosody with surprise. In the case of fear, unlike matched controls, patients provided lower intensity ratings for visual stimuli than for vocal and audiovisual ones. Fearful faces were frequently confused with surprised ones. When we controlled for lesion size, we no longer observed any overall difference between patients and controls in their ratings of emotional intensity on the target scales. Lesion size had the greatest effect on intensity perceptions and accuracy in the visual modality, irrespective of the type of emotion. These new findings suggest that a damaged amygdala, or a disrupted bundle between the amygdala and the ventral part of the occipital lobe, has a greater impact on emotion perception in the visual modality than it does in either the vocal or audiovisual one. We can surmise that patients are able to use the auditory information contained in multimodal stimuli to compensate for difficulty processing visually conveyed emotion.

  18. Extrahippocampal Desynchronization in Nonlesional Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Jesús Pastor

    2012-01-01

    Full Text Available Although temporal lobe epilepsy (TLE is traditionally associated with both hypersynchronous activity in the form of interictal epileptic discharges and hippocampal sclerosis, recent findings suggest that desynchronization also plays a central role in the dynamics of this pathology. The objective of this work is to show the imbalance existing between mesial activities in patients suffering from mesial TLE, with normal mesial structures. Foramen ovale recordings from six patients with mesial TLE and one with lateral TLE were analyzed through a cluster analysis and synchronization matrices. None of the patients present findings in the MRI presurgical evaluation. Numerical analysis was carried out in three different situations: awake and sleep interictal and also during the preictal stage. High levels of desynchronization ipsilateral to the epileptic side were present in mesial TLE patients. Low levels of desynchronization were present in the lateral TLE patient during the interictal stage and almost zero in the preictal stage. Implications of these findings in relation with seizure spreading are discussed.

  19. Resting state networks in temporal lobe epilepsy

    Science.gov (United States)

    Cataldi, Mauro; Avoli, Massimo; de Villers-Sidani, Etienne

    2016-01-01

    Summary Temporal lobe epilepsy (TLE) is typically described as a neurologic disorder affecting a cerebral network comprising the hippocampus proper and several anatomically related extrahippocampal regions. A new level of complexity was recently added to the study of this disorder by the evidence that TLE also appears to chronically alter the activity of several brain-wide neural networks involved in the control of higher order brain functions and not traditionally linked to epilepsy. Recently developed brain imaging techniques such as functional magnetic resonance imaging (fMRI) analysis of resting state connectivity, have greatly contributed to these observations by allowing the precise characterization of several brain networks with distinct functional signatures in the resting brain, and therefore also known as “resting state networks.” These significant advances in imaging represent an opportunity to investigate the still elusive origins of the disabling cognitive and psychiatric manifestations of TLE, and could have important implications for its pathophysiology and, perhaps, its therapy. Herein we review recent studies in this field by focusing on resting state networks that have been implicated in the pathophysiology of psychiatric disorders and cognitive impairment in patients with epilepsy: the default mode network, the attention network, and the reward/emotion network. PMID:24117098

  20. Gangliogliomas: characteristic imaging findings and role in the temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Ganglioglioma is an uncommon neoplasm of the central nervous system, most frequently seen in the temporal lobe, and usually associated with medically refractory epilepsy in children and young adults. Few reports have considered ganglioglioma-associated epileptogenicity arising in the temporal lobe. The purpose of our study was to define the imaging features of ganglioglioma in the temporal lobe and their relation to the seizure foci revealed by electrocorticograms. We reviewed 24 patients with pathologically confirmed ganglioglioma in the temporal lobe. Computed tomography (CT) images showed gangliogliomas to be isodense (91.7%), and on T1-weighted images (T1-WI) most gangliogliomas (79.2%) were isointense to the gray matter. A cystic lesion was seen in 14 of 24 of the gangliogliomas (58.3%). Mass effects were not seen in any of the ten tumors without cystic components. One patient showed tumor recurrence. Dual pathology was seen in two cases (8.3%). In 23 cases, epileptogenicity was confirmed in the tumors by intraoperative electrocorticogram. The remaining case had no epileptogenicity. A tumor presenting isointensity to gray matter on T1-WI without mass effects in the medial temporal lobe in a young patient with temporal lobe epilepsy (TLE) might be the characteristic imaging of temporal lobe ganglioglioma. However, such tumors are not always associated with epileptogenicity, even if a ganglioglioma is found in a patient with TLE. The seizure foci may be contralateral to the ganglioglioma. Therefore, we need to investigate the hippocampus, white matter abnormalities of the ipsilateral and contralateral anterior temporal lobe, and other focal lesions closely. (orig.)

  1. MR characteristics of hippocampal sclerosis with ipsilateral anterior temporal abnormality in refractory temporal lobe epilepsy and the correlation with clinical manifestation%难治性颞叶癫痫海马和同侧前颞叶MRI特征及其与临床相关性

    Institute of Scientific and Technical Information of China (English)

    曹惠霞; 林笑丰; 谭伟杰; 王俊; 杜渭清; 韩立新; 王蔚; 王伟

    2014-01-01

    Objective:To investigate the MRI features of hippocampal sclerosis (HS)with ipsilateral anterior tempo-ral abnormality and correlation between which and clinical manifestation in refractory temporal lobe epilepsy (TLE).Meth-ods:34 patients with TLE including 15 females and 19 males,aged (22.4±8.2)years were included,and all patients were diagnosed with HS by pathology and/or MRI.25 patients underwent surgical treatment and pathological diagnosis was ob-tained.MRI changes of hippocampus and ipsilateral anterior temporal lobe abnormalities were observed.All patients were divided into two groups according to the presence/absence of MRI signs indicative of anterior temporal abnormality.The group of ipsilateral anterior temporal abnormality was divided into two subgroups on the basis of whether grey/white matter blurring and temporal lobe atrophy were present concomitantly or not.The clinical features were compared between the two groups and two subgroups respectively.Results:Of the 34 patients,22 (64.7%)had ipsilateral anterior temporal abnormali-ties besides HS.The age of first onset of TLE was younger in the anterior temporal abnormality group than the normal group (t= -3.438,P= 0.002)and the duration of TLE was longer than the normal group (t= 2.453,P= 0.020).No sig-nificant difference was observed in other clinical features between the two groups and two subgroups.Conclusion:TLE pa-tients with ipsilateral anterior temporal abnormality often had earlier epilepsy onset and longer epilepsy duration.MRI fea-tures are closely related with clinical severity of epilepsy,which is of great importance in defining the culprit side of epilepsy.%目的:探讨难治性颞叶癫痫海马硬化(HS)与同侧前颞叶 MRI特征及其与临床的相关性。方法:搜集经影像学或病理诊断为难治性颞叶癫痫 HS的34例患者的临床和影像资料,其中25例行手术治疗。34例中女15例,男19例,平均年龄(22.4±8.2)岁。

  2. Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

    Directory of Open Access Journals (Sweden)

    Aurélie Bidet-Caulet

    2009-11-01

    Full Text Available For patients with pharmaco-resistant temporal epilepsy, unilateral anterior temporal lobectomy (ATL - i.e. the surgical resection of the hippocampus, the amygdala, the temporal pole and the most anterior part of the temporal gyri - is an efficient treatment. There is growing evidence that anterior regions of the temporal lobe are involved in the integration and short-term memorization of object-related sound properties. However, non-verbal auditory processing in patients with temporal lobe epilepsy (TLE has raised little attention. To assess non-verbal auditory cognition in patients with temporal epilepsy both before and after unilateral ATL, we developed a set of non-verbal auditory tests, including environmental sounds. We could evaluate auditory semantic identification, acoustic and object-related short-term memory, and sound extraction from a sound mixture. The performances of 26 TLE patients before and/or after ATL were compared to those of 18 healthy subjects. Patients before and after ATL were found to present with similar deficits in pitch retention, and in identification and short-term memorisation of environmental sounds, whereas not being impaired in basic acoustic processing compared to healthy subjects. It is most likely that the deficits observed before and after ATL are related to epileptic neuropathological processes. Therefore, in patients with drug-resistant TLE, ATL seems to significantly improve seizure control without producing additional auditory deficits.

  3. Cerebral infarction secondary to temporal lobe herniation in head trauma: a CT study

    International Nuclear Information System (INIS)

    Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatic cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerebral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerebral infarctions were in the terrtiories of the posterior cerebral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction dose not greatly influence patient's mortality

  4. Cognitive impairments in patients with intractable temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Mahgol Tavakoli

    2011-01-01

    Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

  5. The role of GABAB receptors in temporal lobe epilepsy.

    OpenAIRE

    Chandler, K.

    2004-01-01

    Temporal lobe epilepsy is the most common partial epilepsy syndrome seen in adult humans. The hippocampus is a key structure in the evolution of temporal lobe seizures. The axons of the dentate granule cells, the mossy fibres, constitute a major hippocampal excitatory input. Inhibitory phenomena at mossy fibre synapses may therefore prevent seizure propagation through the hippocampus. One such inhibitory phenomenon is heterosynaptic depression. In this thesis I studied the role of GABAB recep...

  6. Triple pathological findings in a surgically amenable patient with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Fumin Tong

    2015-01-01

    Full Text Available Mesial temporal sclerosis (MTS is a well-recognized cause of intractable epilepsy; however, coexistence with focal cortical dysplasia (FCD is less common. Middle fossa epidermoid cysts are rare and may involve the temporal lobe. Most epidermoids are clinically silent, slow-growing, and seldom associated with overt symptomatology, including seizures. We describe a patient with multiple comorbidities including left MTS and a large epidermoid cyst involving the left quadrigeminal plate cistern compressing upon the cerebellar vermis and tail of the left hippocampus, resulting in refractory left temporal lobe epilepsy. The patient underwent left anterior temporal lobectomy. The surgical pathology demonstrated a third pathological finding of left temporal FCD type Ia. The patient has been seizure-free since the surgery. This case provides additional information with regard to the understanding of epileptogenicity and surgical planning in patients with MTS and epidermoid cysts.

  7. Radiosurgery in the Management of Intractable Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Peñagarícano, José; Serletis, Demitre

    2015-09-01

    Mesial temporal lobe epilepsy (MTLE) describes recurrent seizure activity originating from the depths of the temporal lobe. MTLE patients who fail two trials of medication now require testing for surgical candidacy at an epilepsy center. For these individuals, temporal lobectomy offers the greatest likelihood for seizure-freedom (up to 80-90%); unfortunately, this procedure remains largely underutilized. Moreover, for select patients unable to tolerate open surgery, novel techniques are emerging for selective ablation of the mesial temporal structures, including stereotactic radiosurgery (SRS). We present here a review of SRS as a potential therapy for MTLE, when open surgery is not an option. PMID:26390538

  8. Preoperative psychological adjustment and surgical outcome are determinants of psychosocial status after anterior temporal lobectomy.

    OpenAIRE

    Hermann, B.P.; Wyler, A R; Somes, G

    1992-01-01

    This investigation evaluated the role of preoperative psychological adjustment, degree of postoperative seizure reduction, and other relevant variables (age, education, IQ, age at onset of epilepsy, laterality of resection) in determining emotional/psychosocial outcome following anterior temporal lobectomy. Ninety seven patients with complex partial seizures of temporal lobe origin were administered the Minnesota Multiphasic Personality Inventory (MMPI), Washington Psychosocial Seizure Invent...

  9. Quantifying interictal metabolic activity in human temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The majority of patients with complex partial seizures of unilateral temporal lobe origin have interictal temporal hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (FDG PET) studies. Often, this hypometabolism extends to ipsilateral extratemporal sites. The use of accurately quantified metabolic data has been limited by the absence of an equally reliable method of anatomical analysis of PET images. We developed a standardized method for visual placement of anatomically configured regions of interest on FDG PET studies, which is particularly adapted to the widespread, asymmetric, and often severe interictal metabolic alterations of temporal lobe epilepsy. This method was applied by a single investigator, who was blind to the identity of subjects, to 10 normal control and 25 interictal temporal lobe epilepsy studies. All subjects had normal brain anatomical volumes on structural neuroimaging studies. The results demonstrate ipsilateral thalamic and temporal lobe involvement in the interictal hypometabolism of unilateral temporal lobe epilepsy. Ipsilateral frontal, parietal, and basal ganglial metabolism is also reduced, although not as markedly as is temporal and thalamic metabolism

  10. Disturbed temporal lobe circulation due to compression by pituitary adenoma

    International Nuclear Information System (INIS)

    The objective of this study was to clarify the pathophysiology of temporal lobe-related symptoms in pituitary adenoma by investigating temporal lobe circulation in pituitary adenoma with single photon emission computed tomography (SPECT). The subjects were 37 patients with pituitary adenoma (74 regions in the bilateral temporal lobes) who underwent 123I-iofetamine (IMP) SPECT before treatment. Using imaging analysis software 3D-SSP, the temporal lobes were evaluated in the bottom view on SPECT using the following method. Regions of interest (ROI) were established in the anteromedial (AM), posteromedial (PM), anterolateral (AL), and posterolateral (PL) regions of the temporal lobe, and the activity ratio (AR) of the counts/pixel in each ROI to those throughout the entire brain was determined. The AR in the 37 patients was compared with that in 37 healthy volunteers. Furthermore, the temporal lobes in patients with pituitary adenoma were classified according to the presence or absence of compression caused by the tumor, pituitary apoplexy, and hormone production, and evaluated. The AR in the AM and AL was significantly lower in the pituitary adenoma than in the healthy group (both, p<0.001). In the pituitary adenoma group, the AR in the AM, AL, and PL was significantly lower in the compression than in the non-compression group (p<0.05, p<0.05, and p<0.01, respectively). Classification based on the presence or absence of pituitary apoplexy or hormone production did not significantly differ with the AR values. We conclude that pituitary adenoma causes hypoperfusion in the temporal lobe at a high frequency, and direct compression by the tumor is a cause of regional cerebral blood flow (rCBF) reduction. (author)

  11. The morphology of the cephalic lobes and anterior pectoral fins in six species of batoids.

    Science.gov (United States)

    Mulvany, Samantha; Motta, Philip J

    2013-09-01

    Many benthic batoids utilize their pectoral fins for both undulatory locomotion and feeding. Certain derived, pelagic species of batoids possess cephalic lobes, which evolved from the anterior pectoral fins. These species utilize the pectoral fins for oscillatory locomotion while the cephalic lobes are used for feeding. The goal of this article was to compare the morphology of the cephalic lobes and anterior pectoral fins in species that possess and lack cephalic lobes. The skeletal elements (radials) of the cephalic lobes more closely resembled the radials in the pectoral fin of undulatory species. Second moment of area (I), calculated from cephalic lobe radial cross sections, and the number of joints revealed greater flexibility and resistance to bending in multiple directions as compared to pectoral fin radials of oscillatory species. The cephalic lobe musculature was more complex than the anterior pectoral fin musculature, with an additional muscle on the dorsal side, with fiber angles running obliquely to the radials. In Rhinoptera bonasus, a muscle presumably used to help elevate the cephalic lobes is described. Electrosensory pores were found on the cephalic lobes (except Mobula japonica) and anterior pectoral fins of undulatory swimmers, but absent from the anterior pectoral fins of oscillatory swimmers. Pore distributions were fairly uniform except in R. bonasus, which had higher pore numbers at the edges of the cephalic lobes. Overall, the cephalic lobes are unique in their anatomy but are more similar to the anterior pectoral fins of undulatory swimmers, having more flexibility and maneuverability compared to pectoral fins of oscillatory swimmers. The maneuverable cephalic lobes taking on the role of feeding may have allowed the switch to oscillatory locomotion and hence, a more pelagic lifestyle. PMID:23801572

  12. Usefulness of PET in non-lesional temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Objective. To evaluate the usefulness of PET in patients with refractory non-lesional temporal lobe epilepsy. Material and methods. We present three patients with features of temporal lobe epilepsy refractory to medication, where high definition MRI was normal. Results. These patients had PET hypometabolism in the temporal areas related to clinical and neurophysiological findings. Two of these patients were implanted with subdural grids to confirm the diagnosis and the third was operated directly based on the findings of PET. Encourage the presentation of the importance in recent years is acquiring the PET. Conclusion. In those patients in clinical neurophysiology and epilepsy with suspected temporal lobe, but in the MRI images show no structural lesions, PET can play an important role defining the diagnosis. (authors)

  13. Tractography of the parahippocampal gyrus and material specific memory impairment in unilateral temporal lobe epilepsy

    OpenAIRE

    Yogarajah, M.; Powell, H.W.R.; Parker, G J M; Alexander, D. C.; Thompson, P J; Symms, M.R.; Boulby, P.; Wheeler-Kingshott, C.A.; Barker, G.J.; Koepp, M J.; Duncan, J.S.

    2008-01-01

    Introduction: Temporal lobe epilepsy (TLE) is associated with disrupted memory function. The structural changes underlying this memory impairment have not been demonstrated previously with tractography.Methods: We performed a tractography analysis of diffusion magnetic resonance imaging scans in 18 patients with unilateral TLE undergoing presurgical evaluation, and in 10 healthy controls. A seed region in the anterior parahippocampal gyrus was selected from which to trace the white matter con...

  14. Temporal Lobe Cortical Electrical Stimulation during the Encoding and Retrieval Phase Reduces False Memories

    OpenAIRE

    Boggio, Paulo S.; Felipe Fregni; Claudia Valasek; Sophie Ellwood; Richard Chi; Jason Gallate; Alvaro Pascual-Leone; Allan Snyder

    2009-01-01

    A recent study found that false memories were reduced by 36% when low frequency repetitive transcranial magnetic stimulation (rTMS) was applied to the left anterior temporal lobe after the encoding (study) phase. Here we were interested in the consequences on a false memory task of brain stimulation throughout the encoding and retrieval task phases. We used transcranial direct current stimulation (tDCS) because it has been shown to be a useful tool to enhance cognition. Specifically, we exami...

  15. Mapping of potential neurogenic niche in the human temporal lobe

    Directory of Open Access Journals (Sweden)

    Adriano Barreto Nogueira

    2014-10-01

    Full Text Available The subgranular zone (SGZ of the dentate gyrus and the subventricular zone (SVZ are known neurogenic niches in adult mammals. Nonetheless, the existence of neurogenic niches in adult humans is controversial. We hypothesized that mapping neurogenic niches in the human temporal lobe could clarify this issue. Neurogenic niches and neurogenesis were investigated in 28 temporal lobes via immunostaining for nestin and doublecortin (DCX, respectively. Nestin was observed in a continuous layer formed by the SVZ, the subpial zone of the medial temporal lobe and the SGZ, terminating in the subiculum. In the subiculum, remarkable DCX expression was observed through the principal efferent pathway of the hippocampus to the fimbria. A possible explanation for the results is that the SVZ, the subpial zone of the medial temporal lobe and the SGZ form a unit containing neural stem cells that differentiate into neurons in the subiculum. Curiously, the area previously identified as the human rostral migratory stream may in truth be the fornix, which contains axons that originate in the subiculum. This study suggests that neurogenesis may occur in an orchestrated manner in a broad area of the human temporal lobe.

  16. Temporal lobe cortical electrical stimulation during the encoding and retrieval phase reduces false memories.

    Directory of Open Access Journals (Sweden)

    Paulo S Boggio

    Full Text Available A recent study found that false memories were reduced by 36% when low frequency repetitive transcranial magnetic stimulation (rTMS was applied to the left anterior temporal lobe after the encoding (study phase. Here we were interested in the consequences on a false memory task of brain stimulation throughout the encoding and retrieval task phases. We used transcranial direct current stimulation (tDCS because it has been shown to be a useful tool to enhance cognition. Specifically, we examined whether tDCS can induce changes in a task assessing false memories. Based on our preliminary results, three conditions of stimulation were chosen: anodal left/cathodal right anterior temporal lobe (ATL stimulation ("bilateral stimulation"; anodal left ATL stimulation (with a large contralateral cathodal electrode--referred as "unilateral stimulation" and sham stimulation. Our results showed that false memories were reduced significantly after the two active conditions (unilateral and bilateral stimulation as compared with sham stimulation. There were no significant changes in veridical memories. Our findings show that false memories are reduced by 73% when anodal tDCS is applied to the anterior temporal lobes throughout the encoding and retrieval stages, suggesting a possible strategy for improving certain aspects of learning.

  17. Atypical language representation in children with intractable temporal lobe epilepsy.

    Science.gov (United States)

    Maulisova, Alice; Korman, Brandon; Rey, Gustavo; Bernal, Byron; Duchowny, Michael; Niederlova, Marketa; Krsek, Pavel; Novak, Vilem

    2016-05-01

    This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed. Atypical receptive language cortex correlated with lower intellectual capacity, verbal abstract conceptualization, receptive language abilities, verbal working memory, and a history of status epilepticus but did not correlate with higher seizure frequency or early seizure onset. Histopathologic substrate had only a minor influence on neuropsychological status. Greater verbal comprehension deficits were noted in children with atypical receptive language representation, a risk factor for cognitive morbidity. PMID:27064828

  18. Late bilateral temporal lobe necrosis after conventional radiotherapy. Case report

    International Nuclear Information System (INIS)

    A 63-year-old woman presented with radionecrosis in the bilateral temporal lobes manifesting as dementia about 30 years after undergoing conventional radiotherapy for pituitary adenoma. Computed tomography and magnetic resonance (MR) imaging showed edema and cystic lesions in both temporal lobes. The mass in the left temporal lobe was excised. MR imaging 12 days after surgery showed reduced edema. Her dementia had improved. Radionecrosis usually occurs between several months and a few years after radiotherapy. The incidence of radionecrosis is estimated as 5%, but may be higher with longer follow-up periods. Clinical reports have suggested that larger total doses of radiation are associated with earlier onset of delayed necrosis and the fractional dose is the most significant factor causing cerebral radionecrosis. Radionecrosis can occur long after conventional radiotherapy or stereotactic radiosurgery using a linac-based system or a gamma knife unit. (author)

  19. Late bilateral temporal lobe necrosis after conventional radiotherapy. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, Michio; Hayashi, Toshiyuki; Kagami, Hiroshi; Murase, Ikurou; Nakatsukasa, Masashi [Saiseikai Utsunomiya Hospital (Japan)

    2003-04-01

    A 63-year-old woman presented with radionecrosis in the bilateral temporal lobes manifesting as dementia about 30 years after undergoing conventional radiotherapy for pituitary adenoma. Computed tomography and magnetic resonance (MR) imaging showed edema and cystic lesions in both temporal lobes. The mass in the left temporal lobe was excised. MR imaging 12 days after surgery showed reduced edema. Her dementia had improved. Radionecrosis usually occurs between several months and a few years after radiotherapy. The incidence of radionecrosis is estimated as 5%, but may be higher with longer follow-up periods. Clinical reports have suggested that larger total doses of radiation are associated with earlier onset of delayed necrosis and the fractional dose is the most significant factor causing cerebral radionecrosis. Radionecrosis can occur long after conventional radiotherapy or stereotactic radiosurgery using a linac-based system or a gamma knife unit. (author)

  20. [A Case of Musicophilia with Right Predominant Temporal Lobe Atrophy].

    Science.gov (United States)

    Shinagawa, Shunichiro; Nakayama, Kazuhiko

    2015-11-01

    A 68-year-old woman exhibiting musicophilia with right predominant temporal lobe atrophy happened to visit our clinic. She had no musical background, but beginning two years ago, she acquired a strong preference for especially popular music and sometimes sang at home. She did not exhibit obvious semantic aphasia or facial agnosia, and showed only mild behavioral changes including apathy. Her musicophilia can be explained as an instance of stereotypical behavior. Her right temporal lobe atrophy may have caused changes in her emotional and reward systems, resulting in her music specific behaviors. PMID:26560960

  1. Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    John D. Rolston

    2011-01-01

    Full Text Available Many patients with mesial temporal lobe epilepsy continue to have seizures despite medical therapy. For these patients, one recourse is surgical resection of the mesial temporal lobe, with its attendant risks. Noninvasive treatment with Gamma Knife radiosurgery is under active investigation as a possible alternative to open surgery. Accumulated evidence from multiple studies shows radiosurgery to be comparable in outcomes to surgical resection. A definitive randomized, controlled trial, the Radiosurgery or Open Surgery for Epilepsy (ROSE trial, is currently underway, and further investigation of this promising treatment is crucial in our advancement of alternative therapies to treat refractory epilepsy.

  2. Excitatory amino acid transporters EAAT-1 and EAAT-2 in temporal lobe and hippocampus in intractable temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Sarac, Sinan; Afzal, Shoaib; Broholm, Helle;

    2009-01-01

    Intractable temporal lobe epilepsy (TLE) is an invalidating disease and many patients are resistant to medical treatment. Increased glutamate concentration has been found in epileptogenic foci and may induce local over-excitation and cytotoxicity; one of the proposed mechanisms involves reduced...... extra-cellular clearance of glutamate by excitatory amino acid transporters (EAAT-1 to EAAT-5). EAAT-1 and EAAT-2 are mainly expressed on astroglial cells for the reuptake of glutamate from the extra-cellular space. We have studied the expression of EAAT-1 and EAAT-2 in the hippocampus and temporal lobe...

  3. Memory, Metamemory and Their Dissociation in Temporal Lobe Epilepsy

    Science.gov (United States)

    Howard, Charlotte E.; Andres, Pilar; Broks, Paul; Noad, Rupert; Sadler, Martin; Coker, Debbie; Mazzoni, Giuliana

    2010-01-01

    Patients with temporal-lobe epilepsy (TLE) present with memory difficulties. The aim of the current study was to determine to what extent these difficulties could be related to a metamemory impairment. Fifteen patients with TLE and 15 matched healthy controls carried out a paired-associates learning task. Memory recall was measured at intervals of…

  4. Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy

    Science.gov (United States)

    Trebuchon-Da Fonseca, Agnes; Guedj, Eric; Alario, F-Xavier; Laguitton, Virginie; Mundler, Olivier; Chauvel, Patrick; Liegeois-Chauvel, Catherine

    2009-01-01

    Word finding difficulties are often reported by epileptic patients with seizures originating from the language dominant cerebral hemisphere, for example, in temporal lobe epilepsy. Evidence regarding the brain regions underlying this deficit comes from studies of peri-operative electro-cortical stimulation, as well as post-surgical performance.…

  5. Human Herpesvirus-6 in Mesial Temporal Lobe Epilepsy

    OpenAIRE

    J Gordon Millichap

    2003-01-01

    Brain samples obtained from surgical resections in 8 patients with mesial temporal lobe epilepsy (MTLE) and 7 patients with neocortical epilepsy (NE) were quantitatively analyzed for HHV-6 in a study at the National Institute of Neurological Disorders and Stroke, Bethesda, MD.

  6. Coupled Shape Modeling of the Medial Temporal Lobe

    DEFF Research Database (Denmark)

    Dissing, Bjørn Skovlund; Larsen, Rasmus; Skimminge, Arnold Jesper Møller;

    Here we investigate how regions in the Medial Temporal Lobe(MTL) in a dataset consisting of 13 di®erent people changes us- ing a Principal Component Analysis(PCA). The regions investigated are the Temporopolar, Parahippocampal, Entorhinal, Hippocampal, Perirhi- nal and Amygdalar regions. The MTL is...

  7. Human Herpesvirus-6 in Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available Brain samples obtained from surgical resections in 8 patients with mesial temporal lobe epilepsy (MTLE and 7 patients with neocortical epilepsy (NE were quantitatively analyzed for HHV-6 in a study at the National Institute of Neurological Disorders and Stroke, Bethesda, MD.

  8. Differentiation of medial or lateral temporal lobe epilepsy by F-18-fluorodeoxyglucose positron emission tomography: comparative study with magnetic resonance imaging in 113 surgically and pathologically proven patients

    International Nuclear Information System (INIS)

    As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral temporal lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiate mesial from lateral TLE. In 113 patients (83 mesial TLE, 30 lateral TLE) who underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performed F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients with mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with lateral TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dysplasia. Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (62/83), respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30), respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of lateral temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as lateral temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients who showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% (9/ 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in lateral temporal lobe with normal uptake in medial temporal lobe

  9. Functional Connectome before and following Temporal Lobectomy in Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Liao, Wei; Ji, Gong-Jun; Xu, Qiang; Wei, Wei; Wang, Jue; Wang, Zhengge; Yang, Fang; Sun, Kangjian; Jiao, Qing; Richardson, Mark P; Zang, Yu-Feng; Zhang, Zhiqiang; Lu, Guangming

    2016-01-01

    As mesial temporal lobe epilepsy (mTLE) has been recognized as a network disorder, a longitudinal connectome investigation may shed new light on the understanding of the underlying pathophysiology related to distinct surgical outcomes. Resting-state functional MRI data was acquired from mTLE patients before (n = 37) and after (n = 24) anterior temporal lobectomy. According to surgical outcome, patients were classified as seizure-free (SF, n = 14) or non-seizure-free (NSF, n = 10). First, we found higher network resilience to targeted attack on topologically central nodes in the SF group compared to the NSF group, preoperatively. Next, a two-way mixed analysis of variance with between-subject factor 'outcome' (SF vs. NSF) and within-subject factor 'treatment' (pre-operation vs. post-operation) revealed divergent dynamic reorganization in nodal topological characteristics between groups, in the temporoparietal junction and its connection with the ventral prefrontal cortex. We also correlated the network damage score (caused by surgical resection) with postsurgical brain function, and found that the damage score negatively correlated with postoperative global and local parallel information processing. Taken together, dynamic connectomic architecture provides vital information for selecting surgical candidates and for understanding brain recovery mechanisms following epilepsy surgery. PMID:27001417

  10. Social conceptual impairments in frontotemporal lobar degeneration with right anterior temporal hypometabolism

    OpenAIRE

    Zahn, Roland; Moll, Jorge; Iyengar, Vijeth; Huey, Edward D.; Tierney, Michael; Krueger, Frank; Grafman, Jordan

    2009-01-01

    Inappropriate social behaviours are early and distinctive symptoms of the temporal and frontal variants of frontotemporal lobar degeneration (FTLD). Knowledge of social behaviour is essential for appropriate social conduct. It is unknown, however, in what way this knowledge is degraded in FTLD. In a recent functional MRI study, we have identified a right-lateralized superior anterior temporal lobe (aTL) region showing selective activation for ‘social concepts’ (i.e. concepts describing social...

  11. Psychosis and temporal lobe epilepsy-role of electroconvulsive therapy

    OpenAIRE

    Anderson, Naomi Mifflen; Gadit, Amin

    2012-01-01

    A 49-year-old female presented for admission with features of being withdrawn, inability to comprehend questions, auditory hallucinations and disorganised thoughts. She also had a previous diagnosis of temporal lobe epilepsy. She did not respond well to psychotropic medications. During her sleep deprived EEG, she had a brief episode of seizures. Following this, she showed improvement in psychosis for a day or so. Based on this finding, it was decided to initiate a course of electroconvulsive ...

  12. Quantitative analysis of structural neuroimaging of mesial temporal lobe epilepsy

    OpenAIRE

    Memarian, N; Thompson, PM; Engel, J.; Staba, RJ

    2013-01-01

    Mesial temporal lobe epilepsy (MTLE) is the most common of the surgically remediable drug-resistant epilepsies. MRI is the primary diagnostic tool to detect anatomical abnormalities and, when combined with EEG, can more accurately identify an epileptogenic lesion, which is often hippocampal sclerosis in cases of MTLE. As structural imaging technology has advanced the surgical treatment of MTLE and other lesional epilepsies, so too have the analysis techniques that are used to measure differen...

  13. Functional Connectivity Homogeneity Correlates with Duration of Temporal Lobe Epilepsy

    OpenAIRE

    Haneef, Zulfi; Chiang, Sharon; Yeh, Hsiang J.; Engel, Jerome; Stern, John M.

    2015-01-01

    Temporal lobe epilepsy (TLE) often is associated with progressive changes to seizures, memory, and mood during its clinical course. However, the cerebral changes related to this progression are not well understood. Because the changes may be related to changes in brain networks, we used functional connectivity MRI (fcMRI) to determine whether brain network parameters relate to the duration of TLE. Graph theory based analysis of the sites of reported regions of TLE abnormality, was performed o...

  14. The lateralising significance of hypergraphia in temporal lobe epilepsy

    OpenAIRE

    Roberts, JKA; Robertson, MM; Trimble, MR

    1982-01-01

    Six patients with hypergraphia and epilepsy are presented and their clinical features compared with other patients reported in the literature. It is suggested that hypergraphia occurs more frequently in patients with right-sided non-dominant temporal lobe lesions, in contrast for example to the schizophreniform presentation of left-sided lesions. Other features of psychopathology possibly associated with non-dominant lesions, including elation, hypereligiosity and déjà vu experiences, are als...

  15. Influence of anxiety on memory performance in temporal lobe epilepsy

    OpenAIRE

    Brown, Franklin C.; Westerveld, Michael; Langfitt, John T.; Hamberger, Marla; Hamid, Hamada; Shinnar, Shlomo; Sperling, Michael R.; Devinsky, Orrin; Barr, William; Tracy, Joseph; Masur, David; Bazil, Carl W; Spencer, Susan S.

    2013-01-01

    This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 temporal lobe epilepsy patients from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was lower for those with high versus low level of anxiety, but was not found to be related to side of TLE. Verbal memory on the California Verbal Learning Test (CVLT) was significantly lower for left than right TLE patients with low anxiety, ...

  16. Somnambulism Due to Temporal Lobe Epilepsy - A Case Report

    Directory of Open Access Journals (Sweden)

    Rajesh S

    2004-01-01

    Full Text Available Somnambulism (sleep walking is a disorder of arousal that falls under the parasomnia group. It is more common in children than in adults. (1. The onset of sleep walking in adult life is most unusual and suggests the presence of secondary causes rather than a primary sleep disorder (1. We report a 30-year-old male who presented with repeated episodes of sleep waling possibly due to nocturnal temporal lobe epilepsy.

  17. Temporal lobe necrosis in nasopharyngeal carcinoma: Pictorial essay

    International Nuclear Information System (INIS)

    Nasopharyngeal carcinoma (NPC) shows a high frequency of skull base erosion and intracranial spread. This tumour is usually treated with radiation therapy. The medial and inferior portions of both temporal lobes are included within the radiation portals. These areas are therefore potential sites of radiation-induced necrosis. It is important to recognize this complication and separate it from intracranial tumour recurrence because the treatments of these entities are different. (authors)

  18. Surgical management of epilepsy associated with temporal lobe tumors

    Directory of Open Access Journals (Sweden)

    Suresh Sankhla

    2008-01-01

    Full Text Available Object: Despite advancement in neuroimaging and improvement in the knowledge of tumor behavior, the optimal surgical treatment of patients with temporal-lobe tumors remains unclear. Controversies still exist regarding the type of tumor surgery, i.e., lesionectomy alone or in combination with resection of mesial temporal structures and epileptogenic cortex adjacent to the tumor and the extent of tumor removal. In this retrospective study, the authors have analyzed seizure outcome in a series of children with epileptogenic temporal lobe tumors who had been treated only by lesionectomy. Materials and Methods: Sixteen patients including 7 boys and 9 girls, with a mean age of 9.9 years (range: 5-17 years underwent lesionectomy as the only surgical treatment for temporal lobe tumor related epilepsy. The interval between onset of seizures and surgery ranged from 3 months to 7.5 year (mean 5.9 year. Ten patients (62.5% presented with complex partial seizures and the remaining 6 (37.5% had simple partial seizures with secondary generalization, with seizure frequency varying from several per day to only a few per month. All tumors were located within the temporal lobes: 8 temporomesial, 5 temporolateral and 3 temporobasal. Cortical dysplasia adjacent to tumor, hippocampal sclerosis or tumor infiltration was not demonstrated in any patient. Results: Gross total resection of the tumor was achieved in 11 (69% and subtotal resection in 5 (31% patients. The histopathological diagnosis was ganglioglioma in 6 (37.5% patients, dysembryoplastic neuroepithelial tumor in 5 (31.3%, low-grade astrocytoma in 2 (12.5%, juvenile pilocytic astrocytoma in 2 (12.5% and pleomorphic xanthoastrocytoma in 1 (6.3%. At a mean follow-up of 5.2 years (range, 1.4-9.3 years, 11 (69% patients were seizure-free (Engel class I and 4 (25% others had a significant improvement in the seizure frequency (Engel class II. Conclusions: The results of this study suggest that good long

  19. Visuomotor coordination and motor representation by human temporal lobe neurons.

    Science.gov (United States)

    Tankus, Ariel; Fried, Itzhak

    2012-03-01

    The division of cortical visual processing into distinct dorsal and ventral streams is a key concept in primate neuroscience [Goodale, M. A., & Milner, A. D. Separate visual pathways for perception and action. Trends in Neurosciences, 15, 20-25, 1992; Steele, G., Weller, R., & Cusick, C. Cortical connections of the caudal subdivision of the dorsolateral area (V4) in monkeys. Journal of Comparative Neurology, 306, 495-520, 1991]. The ventral stream is usually characterized as a "What" pathway, whereas the dorsal stream is implied in mediating spatial perception ("Where") and visually guided actions ("How"). A subpathway emerging from the dorsal stream and projecting to the medial-temporal lobe has been identified [Kravitz, D. J., Saleem, K. S., Baker, C. I., & Mishkin, M. A new neural framework for visuospatial processing. Nature Reviews Neuroscience, 12, 217-230, 2011; Cavada, C., & Goldman-Raiuc, P. S. Posterior parietal cortex in rhesus monkey: I. Parcellation of areas based on distinctive limbic and sensory cortico-cortical connections. Journal of Comparative Neurology, 287, 393-421, 1989]. The current article studies the coordination of visual information typically associated with the dorsal stream ("Where"), with planned movements, focusing on the temporal lobe. We recorded extracellular activity from 565 cells in the human medial-temporal and frontal lobes while 13 patients performed cued hand movements with visual feedback (visuomotor task), without feedback (motor task), or observed visual feedback without motor movement (visual-only task). We discovered two different neural populations in the human medial-temporal lobe. One consists of motor-like neurons representing hand position, speed or acceleration during the motor task but not during the visuomotor or visual tasks. The other is specific to the parahippocampal gyrus (an area known to process visual motion [Gur, M., & Snodderly, D. M. Direction selectivity in V1 of alert monkeys: Evidence for parallel

  20. Relation of callosal structure to cognitive abilities in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Christine eSchneider

    2014-02-01

    Full Text Available The main objective of this paper is to analyse the influence of mesial temporal lobe epilepsy (TLE on the morphology of the corpus callosum (CC and its relation to cognitive abilities. More specifically, we investigated correlations between intellectual abilities and callosal morphology, while additionally exploring the modulating impact of (a side of seizure onset (b age of disease onset.For this reason a large representative sample of patients with hippocampal sclerosis (n=79; 35 males; 44 females; age: 18-63 years with disease onset ranging from 0 to 50 years of age, and consisting of 46 left and 33 right TLE patients was recruited. Intelligence was measured using the Wechsler Adult Intelligence Scale Revised (WAIS-R.To get localizations of correlations with high anatomic precision, callosal morphology was examined using computational mesh-based modeling methods, applied to anatomical brain MRI scans.Intellectual performance was positively associated with callosal thickness in anterior and midcallosal callosal regions, with anterior parts being slightly more affected by age of disease onset and side of seizure onset than posterior parts. Earlier age at onset of epilepsy was associated with lower thickness in anterior and midcallosal regions. In addition, laterality of seizure onset had a significant influence on anterior CC morphology, with left hemispheric origin having stronger effects.We found that in TLE, anterior and midcallosal CC morphology are related to cognitive performance. The findings support recent findings of detrimental effects of early onset mTLE on anterior brain regions and of a distinct effect particularly of left TLE on frontal lobe functioning and structure. The causal nature of the relationship remains an open question, i.e., whether CC morphology impacts IQ development or whether IQ development impacts CC morphology, or both.

  1. "Pseudo-thyroid lobe": A diagnostic conundrum caused by ossified anterior longitudinal ligament on bone scan.

    Science.gov (United States)

    Zaman, Maseeh Uz; Fatima, Nosheen; Sajjad, Zafar; Zaman, Unaiza; Zaman, Areeba; Tahseen, Rabia

    2015-01-01

    Radionuclide bone imaging is one of the most commonly performed nuclear medicine procedure around the world and characterized by its high sensitivity and relatively low specificity. False positive findings on a bone scan are very common; however, dense uptake over unilateral ossified anterior longitudinal ligament appearing as single thyroid lobe on a bone scan has not been described in the literature. PMID:25589815

  2. The Role of Medial Temporal Lobe Regions in Incidental and Intentional Retrieval of Item and Relational Information in Aging.

    Science.gov (United States)

    Wang, Wei-Chun; Giovanello, Kelly S

    2016-06-01

    Considerable neuropsychological and neuroimaging work indicates that the medial temporal lobes are critical for both item and relational memory retrieval. However, there remain outstanding issues in the literature, namely the extent to which medial temporal lobe regions are differentially recruited during incidental and intentional retrieval of item and relational information, and the extent to which aging may affect these neural substrates. The current fMRI study sought to address these questions; participants incidentally encoded word pairs embedded in sentences and incidental item and relational retrieval were assessed through speeded reading of intact, rearranged, and new word-pair sentences, while intentional item and relational retrieval were assessed through old/new associative recognition of a separate set of intact, rearranged, and new word pairs. Results indicated that, in both younger and older adults, anterior hippocampus and perirhinal cortex indexed incidental and intentional item retrieval in the same manner. In contrast, posterior hippocampus supported incidental and intentional relational retrieval in both age groups and an adjacent cluster in posterior hippocampus was recruited during both forms of relational retrieval for older, but not younger, adults. Our findings suggest that while medial temporal lobe regions do not differentiate between incidental and intentional forms of retrieval, there are distinct roles for anterior and posterior medial temporal lobe regions during retrieval of item and relational information, respectively, and further indicate that posterior regions may, under certain conditions, be over-recruited in healthy aging. © 2016 Wiley Periodicals, Inc. PMID:26928884

  3. Left temporal lobe structural and functional abnormality underlying auditory hallucinations

    Directory of Open Access Journals (Sweden)

    Kenneth Hugdahl

    2009-05-01

    Full Text Available In this article, we review recent findings from our laboratory that auditory hallucinations in schizophrenia are internally generated speech mis-representations lateralized to the left superior temporal gyrus and sulcus. Such experiences are, moreover, not cognitively suppressed due to enhanced attention to the voices and failure of fronto-parietal executive control functions. An overview of diagnostic questionnaires for scoring of symptoms is presented, together with a review of behavioural, structural and functional MRI data. Functional imaging data have either shown increased or decreased activation depending on whether patients have been presented an external stimulus or not during scanning. Structural imaging data have shown reduction of grey matter density and volume in the same areas in the temporal lobe. The behavioral and neuroimaging findings are moreover hypothesized to be related to glutamate hypofunction in schizophrenia. We propose a model for the understanding of auditory hallucinations that trace the origin of auditory hallucinations to uncontrolled neuronal firing in the speech areas in the left temporal lobe, which is not suppressed by volitional cognitive control processes, due to dysfunctional fronto-parietal executive cortical networks.

  4. Episodic and Semantic Autobiographical Memory in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Claudia P. Múnera

    2014-01-01

    Full Text Available Autobiographical memory (AM is understood as the retrieval of personal experiences that occurred in specific time and space. To date, there is no consensus on the role of medial temporal lobe structures in AM. Therefore, we investigated AM in medial temporal lobe epilepsy (TLE patients. Twenty TLE patients candidates for surgical treatment, 10 right (RTLE and 10 left (LTLE, and 20 healthy controls were examined with a version of the Autobiographical Interview adapted to Spanish language. Episodic and semantic AM were analyzed during five life periods through two conditions: recall and specific probe. AM scores were compared with clinical and cognitive data. TLE patients showed lower performance in episodic AM than healthy controls, being significantly worst in RTLE group and after specific probe. In relation to semantic AM, LTLE retrieved higher amount of total semantic details compared to controls during recall, but not after specific probe. No significant differences were found between RTLE and LTLE, but a trend towards poorer performance in RTLE group was found. TLE patients obtained lower scores for adolescence period memories after specific probe. Our findings support the idea that the right hippocampus would play a more important role in episodic retrieval than the left, regardless of a temporal gradient.

  5. Temporal lobe epilepsy with hypothalamic hamartome:a rare case

    Institute of Scientific and Technical Information of China (English)

    YANG An-chao; ZHANG Kai; ZHANG Jian-guo; LIU Huan-guang; CHEN Ning; GE Ming; BAI Qin; MENG Fan-gang

    2011-01-01

    Refractory gelastic seizure is one of the most common clinical manifestations in patients with hypothalamic hamartoma (HH) and HH is usually regarded as the epileptogenic focus. A young female patient with a small HH and refractory seizures is reported here. However,both the seizure semiology and results of electroencephalogram monitoring indicated the right temporal region was the epileptogenic focus. Thus a standard right anterior temporal lobectomy was performed while the hamartoma preserved. There was a marked improvement in both seizure frequency and quality of life during a 13-month follow-up. The outcome supported the concept that independent epileptogenic focus outside of the hypothalamus might occur in patients with HH.

  6. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    Full Text Available A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG, but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale—III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures

  7. Characteristics and treatment of temporal lobe epilepsy with a history of complicated febrile convulsion

    OpenAIRE

    Kanemoto, K.; Takuji, N.; Kawasaki, J.; Kawai, I.

    1998-01-01

    This study aimed to examine the close correlation between complicated febrile convulsions (CFC) and medial temporal lobe epilepsy and to delineate characteristics of temporal lobe epilepsy with CFC. Patients with temporal lobe epilepsy were divided into those with a prior episode of CFC (n=52), those with febrile convulsions other than CFC, and those witout either (n=345). Clinical constellations, neuroimaging, drug resistance, and effects of temporal lobectomy of the three gro...

  8. Transsylvian selective amygdalohippocampectomy for treatment of medial temporal lobe epilepsy: Surgical technique and operative nuances to avoid complications

    Directory of Open Access Journals (Sweden)

    Timothy J Kovanda

    2014-01-01

    Full Text Available Background: A number of different surgical techniques are effective for treatment of drug-resistant medial temporal lobe epilepsy. Of these, transsylvian selective amygdalohippocampectomy (SA, which was originally developed to maximize temporal lobe preservation, is arguably the most technically demanding to perform. Recent studies have suggested that SA may result in better neuropsychological outcomes with similar postoperative seizure control as standard anterior temporal lobectomy, which involves removal of the lateral temporal neocortex. Methods: In this article, the authors describe technical nuances to improve the safety of SA. Results: Wide sylvian fissure opening and use of neuronavigation allows an adequate exposure of the amygdala and hippocampus through a corticotomy within the inferior insular sulcus. Avoidance of rigid retractors and careful manipulation and mobilization of middle cerebral vessels will minimize ischemic complications. Identification of important landmarks during amygdalohippocampectomy, such as the medial edge of the tentorium and the third nerve within the intact arachnoid membranes covering the brainstem, further avoids operator disorientation. Conclusion: SA is a safe technique for resection of medial temporal lobe epileptogenic foci leading to drug-resistant medial temporal lobe epilepsy.

  9. Memory in children with symptomatic temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Catarina A. Guimarães

    2014-03-01

    Full Text Available In children with temporal lobe epilepsy (TLE, memory deficit is not so well understood as it is in adults. The aim of this study was to identify and describe memory deficits in children with symptomatic TLE, and to verify the influence of epilepsy variables on memory. We evaluated 25 children with TLE diagnosed on clinical, EEG and MRI findings. Twenty-five normal children were compared with the patients. All children underwent a neuropsychological assessment to estimate intellectual level, attention, visual perception, handedness, and memory processes (verbal and visual: short-term memory, learning, and delayed recall. The results allowed us to conclude: besides memory deficits, other neuropsychological disturbances may be found in children with TLE such as attention, even in the absence of overall cognitive deficit; the earlier onset of epilepsy, the worse verbal stimuli storage; mesial lesions correlate with impairment in memory storage stage while neocortical temporal lesions correlate with retrieval deficits.

  10. Temporal lobe dysfunction in childhood autism: a PET study

    International Nuclear Information System (INIS)

    Childhood autism is a severe developmental disorder that impairs the acquisition of some of the most important skills in human life. Progress in understanding the neural basis of childhood autism requires clear and reliable data indicating specific neuro-anatomical or neuro-physiological abnormalities. The purpose of the present study was to research localized brain dysfunction in autistic children using functional brain imaging. Regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) in 21 primary autistic children and 10 age-matched non autistic children. A statistical parametric analysis of rCBF images revealed significant bilateral temporal hypoperfusion in the associative auditory cortex (superior temporal gyrus) and in the multimodal cortex (superior temporal sulcus) in the autistic group (p<0.001). In addition, temporal hypoperfusion was detected individually in 77% of autistic children. These findings provide robust evidence of well localized functional abnormalities in autistic children located in the superior temporal lobe. Such localized abnormalities were not detected with the low resolution PET camera (14-22). This study suggests that high resolution PET camera combined with statistical parametric mapping is useful to understand developmental disorders. (authors)

  11. Do children with aggressive behavior have temporal lobe changes?

    International Nuclear Information System (INIS)

    Aggressive behavior and mood disorders may afflict children. One problem is the lack of objective data to arrive at a specific clinical diagnosis. Abnormalities in neurotransmitters such as serotonin, dopamine, acetylcholine and gamma-aminobutyric acid have been reported to play an important role in the onset of these disorders. We studied 8 patients, 3 girls and 5 boys, ages ranging from 6 to 12, referred to us with the diagnosis of ADHD or autism and reported as having temper problems by their families. These patients were injected with a dose of Tc-99m HMPAO calculated according to patient age and weight and were imaged 1 hour later using a Picker camera with Fan Beam collimators. We analyzed the brain SPECT using 3D as well as the traditional transverse, coronal and sagittal images. With the help of surface rendered 3D images with a cut off of 88% (high) and 60-65% (lower value depending on the patient RCBF value), we observed increased perfusion or activation of either or both right and left temporal lobes in all 8 of the patients. This pattern was not seen in children whose parents did not report temper problems. Increase in perfusion to the temporal lobes may indicate an association with oppositional or aggressive behavior that may be amenable to treatment. Brain SPECT may be useful not only in early diagnosis, but also in guiding appropriate therapy

  12. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    International Nuclear Information System (INIS)

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  13. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deblaere, K.; Vandemaele, P.; Achten, E. [MRI Department -1 K12, Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Backes, W.H.; Hofman, P.; Wilmink, J. [Department of Neuroradiology, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht (Netherlands); Boon, P.A.; Vonck, K. [Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Boon, P. [Department of Medical Psychology, University Hospital Maastricht (Netherlands); Troost, J. [Department of Neurology, University Hospital Maastricht (Netherlands); Vermeulen, J. [S.E.I.N Heemstede, Psychological Laboratory, Achterweg 5, 2103 SW Heemstede (Netherlands); Aldenkamp, A. [Epilepsy Center ' Kempenhaeghe' , Postbus 61, 5900 AB Heeze (Netherlands)

    2002-08-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  14. [Unilateral auditory hallucinations due to left temporal lobe ischemia: a case report].

    Science.gov (United States)

    Anegawa, T; Hara, K; Yamamoto, K; Matsuda, M

    1995-10-01

    . The Wechsler adult intelligence scale revealed a verbal IQ of 91 and a performance IQ of 100. Pure tone audiometry revealed bilateral, mild peripheral sensorineural hearing loss. Brainstem auditory evoked potentials were unrevealing. The EEG showed slow activities in the left temporoparietal region. Magnetic resonance imaging of the brain failed to reveal any relevant abnormalities except for an old hemorrhagic parietal infarct. The SPECT with Tc99m-HMPAO, however, showed reduced blood flow in the left temporal lobe including the first temporal convolution as well as in the left parietal lobe. Based on the SPECT findings, unilateral auditory hallucinations in our patient are considered to have resulted from the left temporal lobe ischemia. Our case indicates that unilateral auditory hallucinations may have a clinicoanatomical correlation with contralateral temporal lobe lesions. PMID:8821499

  15. Asymmetry of medial and lateral temporal regional glucose metabolism in temporal lobe epilepsy by F-18-FDG PET

    International Nuclear Information System (INIS)

    We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral contralateral)/(ipsilateral + contralateral )]x200. ASI of medial and lateral lobes of mesial TLE was decreased (-16.4±8.3 and -12.7± 5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8± 4.7), whereas that of medial temporal lobe was not decreased (-4.6±6.3). ASI of medial lobe of lesional lateral TLE was -7.3±9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: -22±10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral

  16. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    International Nuclear Information System (INIS)

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[123I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  17. Clinical characteristics of patients with benign nonlesional temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Kim J

    2016-07-01

    Full Text Available Jiyeon Kim,1 Seong Hoon Kim,2 Sung Chul Lim,2 Woojun Kim,2 Young-Min Shon3 1Department of Neurology, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan, 2Department of Neurology, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seocho-gu, 3Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Purpose: To evaluate the evolution of nonlesional temporal lobe epilepsy (TLE-NL in patients treated exclusively with antiepileptic drugs and to elucidate clinical phenotypes related to the prognosis of these patients.Methods: Clinical, radiological, and electroencephalographic (EEG findings in 84 patients with TLE-NL were reviewed. A good response group (GRG and a poor response group (PRG were defined if the duration of their seizure-free period was >1 year, or <1 year, respectively.Results: There were 46 (54.8% patients in the GRG and 38 (45.2% patients in the PRG. The number of antiepileptic drugs administered was significantly lower in the GRG than that in the PRG (1.3±0.8 vs 2.8±1.0, respectively; P<0.05. The GRG had a significantly older age of onset than the PRG and a lower occurrence of initial precipitating events, such as febrile seizures, central nervous system infection, and head trauma (P<0.05. The prevalence of EEG abnormality, presence of aura, generalized seizures, and automatism was less frequently observed in the GRG (P<0.05. Multivariate analysis showed that the presence of automatism and initial precipitating events were significantly associated with a poor prognosis (P<0.05.Conclusion: In contrast to the commonly assumed intractability of TLE, we found that more than 54% of patients with TLE-NL achieved a long seizure-free period. Older age at onset of TLE-NL was associated with a better prognosis. However, the presence of automatism and initial precipitating events were related to a poor prognosis. Future prospective

  18. Subregional Mesiotemporal Network Topology Is Altered in Temporal Lobe Epilepsy.

    Science.gov (United States)

    Bernhardt, Boris C; Bernasconi, Neda; Hong, Seok-Jun; Dery, Sebastian; Bernasconi, Andrea

    2016-07-01

    Temporal lobe epilepsy (TLE) is the most frequent drug-resistant epilepsy in adults and commonly associated with variable degrees of mesiotemporal atrophy on magnetic resonance imaging (MRI). Analyses of inter-regional connectivity have unveiled disruptions in large-scale cortico-cortical networks; little is known about the topological organization of the mesiotemporal lobe, the limbic subnetwork central to the disorder. We generated covariance networks based on high-resolution MRI surface-shape descriptors of the hippocampus, entorhinal cortex, and amygdala in 134 TLE patients and 45 age- and sex-matched controls. Graph-theoretical analysis revealed increased path length and clustering in patients, suggesting a shift toward a more regularized arrangement; findings were reproducible after split-half assessment and across 2 parcellation schemes. Analysis of inter-regional correlations and module participation showed increased within-structure covariance, but decreases between structures, particularly with regards to the hippocampus and amygdala. While higher clustering possibly reflects topological consequences of axonal sprouting, decreases in interstructure covariance may be a consequence of disconnection within limbic circuitry. Preoperative network parameters, specifically the segregation of the ipsilateral hippocampus, predicted long-term seizure freedom after surgery. PMID:26223262

  19. Multimodal emotion perception after anterior temporal lobectomy (ATL).

    Science.gov (United States)

    Milesi, Valérie; Cekic, Sezen; Péron, Julie; Frühholz, Sascha; Cristinzio, Chiara; Seeck, Margitta; Grandjean, Didier

    2014-01-01

    In the context of emotion information processing, several studies have demonstrated the involvement of the amygdala in emotion perception, for unimodal and multimodal stimuli. However, it seems that not only the amygdala, but several regions around it, may also play a major role in multimodal emotional integration. In order to investigate the contribution of these regions to multimodal emotion perception, five patients who had undergone unilateral anterior temporal lobe resection were exposed to both unimodal (vocal or visual) and audiovisual emotional and neutral stimuli. In a classic paradigm, participants were asked to rate the emotional intensity of angry, fearful, joyful, and neutral stimuli on visual analog scales. Compared with matched controls, patients exhibited impaired categorization of joyful expressions, whether the stimuli were auditory, visual, or audiovisual. Patients confused joyful faces with neutral faces, and joyful prosody with surprise. In the case of fear, unlike matched controls, patients provided lower intensity ratings for visual stimuli than for vocal and audiovisual ones. Fearful faces were frequently confused with surprised ones. When we controlled for lesion size, we no longer observed any overall difference between patients and controls in their ratings of emotional intensity on the target scales. Lesion size had the greatest effect on intensity perceptions and accuracy in the visual modality, irrespective of the type of emotion. These new findings suggest that a damaged amygdala, or a disrupted bundle between the amygdala and the ventral part of the occipital lobe, has a greater impact on emotion perception in the visual modality than it does in either the vocal or audiovisual one. We can surmise that patients are able to use the auditory information contained in multimodal stimuli to compensate for difficulty processing visually conveyed emotion. PMID:24839437

  20. Characteristics and treatment of temporal lobe epilepsy with a history of complicated febrile convulsion.

    Science.gov (United States)

    Kanemoto, K; Takuji, N; Kawasaki, J; Kawai, I

    1998-02-01

    This study aimed to examine the close correlation between complicated febrile convulsions (CFC) and medial temporal lobe epilepsy and to delineate characteristics of temporal lobe epilepsy with CFC. Patients with temporal lobe epilepsy were divided into those with a prior episode of CFC (n=52), those with febrile convulsions other than CFC, and those without either (n=345). Clinical constellations, neuroimaging, drug resistance, and effects of temporal lobectomy of the three groups were compared. A close association between CFC and temporal lobe epilepsy was confirmed. The salient features of temporal lobe epilepsy with CFC were early age at onset of habitual seizures (about 10 years), the predominance of autonomic auras, and a high incidence of MRI evidence of unilateral medial temporal sclerosis. Patients with temporal lobe epilepsy with prior CFC had an excellent outcome after surgery, by contrast with an unfavourable response to drug therapy. The surgical results were discouraging in patients with temporal lobe epilepsy without history of any febrile convulsions and without solid brain tumours. These results indicate surgical intervention as the choice of therapy in a substantial number of patients with temporal lobe epilepsy with a history of CFC. PMID:9489540

  1. Feasibility of the Medial Temporal lobe Atrophy index (MTAi) and derived methods for measuring atrophy of the medial temporal lobe

    Science.gov (United States)

    Conejo Bayón, Francisco; Maese, Jesús; Fernandez Oliveira, Aníbal; Mesas, Tamara; Herrera de la Llave, Estibaliz; Álvarez Avellón, Tania; Menéndez-González, Manuel

    2014-01-01

    Introduction: The Medial Temporal-lobe Atrophy index (MTAi), 2D-Medial Temporal Atrophy (2D-MTA), yearly rate of MTA (yrRMTA) and yearly rate of relative MTA (yrRMTA) are simple protocols for measuring the relative extent of atrophy in the medial temporal lobe (MTL) in relation to the global brain atrophy. Albeit preliminary studies showed interest of these methods in the diagnosis of Alzheimer’s disease (AD), frontotemporal lobe degeneration (FTLD) and correlation with cognitive impairment in Parkinson’s disease (PD), formal feasibility and validity studies remained pending. As a first step, we aimed to assess the feasibility. Mainly, we aimed to assess the reproducibility of measuring the areas needed to compute these indices. We also aimed to assess the efforts needed to start using these methods correctly. Methods: A series of 290 1.5T-MRI studies from 230 subjects ranging 65–85 years old who had been studied for cognitive impairment were used in this study. Six inexperienced tracers (IT) plus one experienced tracer (ET) traced the three areas needed to compute the indices. Finally, tracers underwent a short survey on their experience learning to compute the MTAi and experience of usage, including items relative to training time needed to understand and apply the MTAi, time to perform a study after training and overall satisfaction. Results: Learning to trace the areas needed to compute the MTAi and derived methods is quick and easy. Results indicate very good intrarater Intraclass Correlation Coefficient (ICC) for the MTAi, good intrarater ICC for the 2D-MTA, yrMTA and yrRMTA and also good interrater ICC for the MTAi, 2D-MTA, yrMTA and yrRMTA. Conclusion: Our data support that MTAi and derived methods (2D-MTA, yrMTA and yrRTMA) have good to very good intrarater and interrater reproducibility and may be easily implemented in clinical practice even if new users have no experience tracing the area of regions of interest. PMID:25414666

  2. Temporal lobe epilepsy and surgery selectively alter the dorsal, not the ventral, default-mode network

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    GaelleEveDoucet

    2014-03-01

    Full Text Available The default-mode network (DMN is a major resting-state network. It can be divided in 2 distinct networks: one is composed of dorsal and anterior regions (referred to as the dorsal DMN, dDMN, while the other involves the more posterior regions (referred to as the ventral DMN, vDMN. To date, no studies have investigated the potentially distinct impact of temporal lobe epilepsy (TLE on these networks. In this context, we explored the effect of TLE and anterior temporal lobectomy (ATL on the dDMN and vDMN. We utilized 2 resting-state fMRI sessions from left, right TLE patients (pre-/post-surgery and normal controls (NCs, sessions 1/2. Using independent component analysis, we identified the 2 networks. We then evaluated for differences in spatial extent for each network between the groups, and across the scanning sessions. The results revealed that, pre-surgery, the dDMN showed larger differences between the three groups than the vDMN, and more particularly between right and left TLE than between the TLE patients and controls. In terms of change post-surgery, in both TLE groups, the dDMN also demonstrated larger changes than the vDMN. For the vDMN, the only changes involved the resected temporal lobe for each ATL group. For the dDMN, the left ATL group showed post-surgical increases in several regions outside the ictal temporal lobe. In contrast, the right ATL group displayed a large reduction in the frontal cortex. The results highlight that the 2 DMNs are not impacted by TLE and ATL in an equivalent fashion. Importantly, the dDMN was the more affected, with right ATL having a more deleterious effects on the dDMN than left ATL. We are the first to highlight that the dDMN more strongly bears the negative impact of TLE than the vDMN, suggesting there is an interaction between the side of pathology and DM subnetwork activity. Our findings have implications for understanding the impact TLE and subsequent ATL on the functions implemented by the distinct

  3. Trigeminal neuropathic pain as a complication of anterior temporal lobectomy: report of 2 cases.

    Science.gov (United States)

    Gill, Impreet; Parrent, Andrew G; Steven, David A

    2016-04-01

    Cranial nerve (CN) deficits following anterior temporal lobectomy (ATL) are an uncommon but well-recognized complication. The usual CNs implicated in post-ATL complications include the oculomotor, trochlear, and facial nerves. To the authors' knowledge, injury to the trigeminal nerve leading to neuropathic pain has not been previously described in the literature. This paper presents 2 cases of trigeminal neuropathic pain following temporal lobe resections for pharmacoresistant epilepsy. The possible pathophysiological mechanisms are discussed and the microsurgical anatomy of surgically relevant structures is reviewed. PMID:26517768

  4. Corpora amylacea in temporal lobe epilepsy associated with hippocampal sclerosis

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    Ribeiro Marlise de Castro

    2003-01-01

    Full Text Available Hippocampal sclerosis (HS is the commonest pathology in epileptic patients undergoing temporal lobe epilepsy surgery. Beside, there are an increased density of corpora amylacea (CA founded in 6 to 63% of those cases. OBJECTIVE: verify the presence of CA and the clinical correlates of their occurrence in a consective series of patients undergoing temporal surgery with diagnosis of HS. METHOD: We reviewed 72 hippocampus specimens from January 1997 to July 2000. Student's t test for independent, samples, ANOVA and Tukey test were performed for statistical analysis. RESULTS: CA were found in 35 patients (49%, whose mean epilepsy duration (28.7 years was significantly longer than that group of patients without CA (19.5 years, p= 0.001. Besides, when CA were found, duration was also significantly correlated with distribution within hippocampus: 28.7 years with diffuse distribution of CA, 15.4 with exclusively subpial and 17.4 years with distribution subpial plus perivascular (p= 0.001. CONCLUSION: Our findings corroborate the presence of CA in patients with HS and suggest that a longer duration of epilepsy correlate with a more distribution of CA in hippocampus.

  5. Can anterior junction line be used to distinguish right middle from right upper lobe on CT scan?

    International Nuclear Information System (INIS)

    To evalvate the usefulness on a CT chest scan, of the anterior junction line as an anatomical landmark to distinguish the right middle and the right upper lobe We found that the anterior junction line has a constant anatomical relationship with the right upper and middle lobe, and with this in mind, analysed connvcntional CT films of 86 patients with normal lung(group A) and 30 with architectural distortion(group B). On a series of slices, we compared the location of slice 1 with that of slice 2(slice 1:the slice which includes the lowest portion of the anterior junction line, slice 2:the initial slice, in which the right middle lobe occupies the whole of the lung anterior to the right major fissure). In group A(n=86), the right upper lobe, as seen in the anteromedial zone of slice 1, was present in 83 cases(96.5%). The right upper lobe on slice 1 was absent in two cases(2.3%) in which a minor fissure was almost completely abent. In group B(n=30), the right upper lobe on slice 1 was absent in 19 cases(63.3%). We suggest that on a CT chest scan, the anterior junction line can be used as an anatomical landmark in the differentiation of the right middle from the right upper lobe, and as an indicator of the presence of architectural distortion

  6. The COMT Val158Met Polymorphism and Temporal Lobe Morphometry in Healthy Adults

    OpenAIRE

    Taylor, Warren D.; Züchner, Stephan; Payne, Martha E.; Messer, Denise F.; Doty, Tracy J.; MacFall, James R.; BEYER, JOHN L.; Krishnan, K. Ranga R.

    2007-01-01

    We examined the relationship between COMT Val158Met genotype and temporal lobe volumes, including the caudate as a control region. 31 healthy subjects completed 1.5T brain MRI and genotyping. After controlling for demographics, Val158 allele homozygotes exhibited significantly smaller temporal lobe and hippocampal volumes, with a trend for smaller amygdala volumes.

  7. Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes

    Directory of Open Access Journals (Sweden)

    Yun-Jin Lee

    2013-07-01

    Full Text Available Temporal lobe epilepsy (TLE is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in seizure semiology have also been reported. Motor manifestations are prominent in infants and young children, but they become less obvious with increasing age. Further, automatisms tend to become increasingly complex with age. However, in childhood and especially in adolescence, the clinical manifestations are similar to those of the adult population. Selective amygdalohippocampectomy can lead to excellent postoperative seizure outcome in adults, but favorable results have been seen in children as well. Anterior temporal lobectomy may prove to be a more successful surgery than amygdalohippocampectomy in children with intractable TLE. The presence of a focal brain lesion on magnetic resonance imaging is one of the most reliable independent predictors of a good postoperative seizure outcome. Seizure-free status is the most important predictor of improved psychosocial outcome with advanced quality of life and a lower proportion of disability among adults and children. Since the brain is more plastic during infancy and early childhood, recovery is promoted. In contrast, long epilepsy duration is an important risk factor for surgically refractory seizures. Therefore, patients with medically intractable TLE should undergo surgery as early as possible.

  8. Plasticity of Interhemispheric Temporal Lobe White Matter Pathways Due to Early Disruption of Corpus Callosum Development in Spina Bifida.

    Science.gov (United States)

    Bradley, Kailyn A; Juranek, Jenifer; Romanowska-Pawliczek, Anna; Hannay, H Julia; Cirino, Paul T; Dennis, Maureen; Kramer, Larry A; Fletcher, Jack M

    2016-04-01

    Spina bifida myelomeningocele (SBM) is commonly associated with anomalous development of the corpus callosum (CC) because of congenital partial hypogenesis and hydrocephalus-related hypoplasia. It represents a model disorder to examine the effects of early disruption of CC neurodevelopment and the plasticity of interhemispheric white matter connections. Diffusion tensor imaging was acquired on 76 individuals with SBM and 27 typically developing individuals, aged 8-36 years. Probabilistic tractography was used to isolate the interhemispheric connections between the posterior superior temporal lobes, which typically traverse the posterior third of the CC. Early disruption of CC development resulted in restructuring of interhemispheric connections through alternate commissures, particularly the anterior commissure (AC). These rerouted fibers were present in people with SBM and both CC hypoplasia and hypogenesis. In addition, microstructural integrity was reduced in the interhemispheric temporal tract in people with SBM, indexed by lower fractional anisotropy, axial diffusivity, and higher radial diffusivity. Interhemispheric temporal tract volume was positively correlated with total volume of the CC, such that more severe underdevelopment of the CC was associated with fewer connections between the posterior temporal lobes. Therefore, both the macrostructure and microstructure of this interhemispheric tract were reduced, presumably as a result of more extensive CC malformation. The current findings suggest that early disruption in CC development reroutes interhemispheric temporal fibers through both the AC and more anterior sections of the CC in support of persistent hypotheses that the AC may serve a compensatory function in atypical CC development. PMID:26798959

  9. Do children with aggressive behavior have temporal lobe changes?

    International Nuclear Information System (INIS)

    Aggressive behavior and mood disorders frequently appear in childhood. There is often lack of objective data to support a specific clinical diagnosis. Ultimately it is likely that alterations in production, concentration, storage, release, reuptake and degradation of neurotransmitters such as serotonin, dopamine, acetylcholine and gamma-aminobutyric acid play key roles in the manifestations of mood disorders. We sought to determine if more gross anatomic patterns of regional brain activation in a 'baseline' state might also supply an objective means of verifying the presence of a mood disorder characterized by anger or aggressive behavior. We studied 8 patients, 3 girls and 5 boys, ages ranging from 6 to 12, referred for SPECT brain imaging with the diagnosis of an attention deficit disorder or autism. All had been reported as having temper problems on the routine questionnaire completed by the parents prior to SPECT imaging. The patients, who were not sedated, had absolute cerebral blood flow measured by the xenon 133 gas inhalation technique followed by intravenous injection of Tc-99m HMPAO with an administered dose calculated according to patient age and weight. One hour following the injection, high resolution brain SPECT imaging was performed using a Picker triple headed camera with fan beam collimators. We analyzed the brain SPECT studies using 3D volume rendered semi-transparent images with dual cut off windows of 88 percent (high) and 60-65 percent (lower value depending on the patient absolute mean cortical blood flow), as well as the traditional transverse, coronal and sagittal sections. The dual window 3D display helped demonstrate increased perfusion or activation of either or both right and left temporal lobes in all 8 of the patients. This pattern was not seen in children with similar clinical diagnoses but whose parents did not report temper problems. These preliminary findings support the proposition that an increase in perfusion to the temporal

  10. Temporal lobe epilepsy: etiology, fisiopathogeny and magnetic resonance imaging

    International Nuclear Information System (INIS)

    The seizures constitute one of the first causes of consultation in neurology and medical emergencies in all etary groups. The partial seizures are the most frequent form of clinical presentation specially those originated in the temporal lobes. In this revision article the author offers an update of the fisiopathogeny, the etiology and MRI findings in temporal epilepsy, and actualizes concepts derived from basic sciences. Selected cases of frequent pathologic causes contribute to illustrate this paper. In the physiopathology of the generalized seizures, alterations of the nets or thalamus cortical neuronal circuits and anomaly in the ionic canals functions have been demonstrated; in the partial seizures, particularly in the Mesial Temporal Sclerosis, alterations in the conformation of excitatory neo circuits have been verified. There are evidences of specific genetic seizures that express or appear sometime after birth, and others acquired, in which there is a variable time lapse between the action of a determined noxa and the installation of the clinical status, which suggest the existence of an epileptogenic mechanism as a gradual process in its development, and open a promissory field of investigation in search of preventive therapies. In many cases of acquired lesions seizures are related to the excitotoxicity mediated by glutamate as a possible trigger of the process. Besides, neuronal division has been demonstrated in the hippocampus, which could explain a neurogenic mechanism in the development of the seizures. The pathologic molecular findings in cortical malformations and the function of the glial cells in the neuronal homeostasis, contribute with data that sustain the neuro genesis of the seizures. The MRI provides a valuable information in Mesial Temporal Sclerosis, CNS tumoral lesions, neuronal migration disorders, vascular malformation, trauma and infections. Conclusion. The knowledge derived from areas as molecular biology, genetic and

  11. Language processing within the human medial temporal lobe.

    Science.gov (United States)

    Meyer, Patric; Mecklinger, Axel; Grunwald, Thomas; Fell, Juergen; Elger, Christian E; Friederici, Angela D

    2005-01-01

    Although the hippocampal formation is essential for verbal memory, it is not fully understood how it contributes to language comprehension. We recorded event-related potentials (ERPs) directly from two substructures of the medial temporal lobe (MTL), the rhinal cortex and the hippocampus proper, while epilepsy patients listened to sentences that either were correct or contained semantic or syntactic violations. Semantic violations elicited a large negative ERP response peaking at approximately 400 ms in the rhinal cortex. In contrast, syntactically incorrect sentences elicited a negative deflection of 500-800 ms in the hippocampus proper. The results suggest that functionally distinct aspects of integration in language comprehension are supported by different MTL structures: the rhinal cortex is involved in semantic integration, whereas the hippocampus proper subserves processes of syntactic integration. An analysis of phase synchronization within the gamma band between rhinal and hippocampal recording sites showed that both of the above-mentioned ERP components were preceded by an increase of phase synchronization. In contrast to these short phasic increases of phase synchronization in both violation conditions, correct sentences were associated with a long-lasting synchronization in a late time window, possibly reflecting the integration of semantic and syntactic information as required for normal comprehension. PMID:15714509

  12. Crucial role of astrocytes in temporal lobe epilepsy.

    Science.gov (United States)

    Steinhäuser, C; Grunnet, M; Carmignoto, G

    2016-05-26

    Astrocytes sense and respond to synaptic activity through activation of different neurotransmitter receptors and transporters. Astrocytes are also coupled by gap junctions, which allow these cells to redistribute through the glial network the K(+) ions excessively accumulated at sites of intense neuronal activity. Work over the past two decades has revealed important roles for astrocytes in brain physiology, and it is therefore not surprising that recent studies unveiled their involvement in the etiology of neurological disorders such as epilepsy. Investigation of specimens from patients with pharmacoresistant temporal lobe epilepsy and epilepsy models revealed alterations in expression, localization and function of astrocytic connexins, K(+) and water channels. In addition, disturbed gliotransmission as well as malfunction of glutamate transporters and of the astrocytic glutamate- and adenosine-converting enzymes - glutamine synthetase and adenosine kinase, respectively - have been observed in epileptic tissues. Accordingly, increasing evidence indicates that dysfunctional astrocytes are crucially involved in processes leading to epilepsy. These new insights might foster the search for new targets for the development of new, more efficient anti-epileptogenic therapies. PMID:25592426

  13. Functional connectivity homogeneity correlates with duration of temporal lobe epilepsy.

    Science.gov (United States)

    Haneef, Zulfi; Chiang, Sharon; Yeh, Hsiang J; Engel, Jerome; Stern, John M

    2015-05-01

    Temporal lobe epilepsy (TLE) is often associated with progressive changes to seizures, memory, and mood during its clinical course. However, the cerebral changes related to this progression are not well understood. Because the changes may be related to changes in brain networks, we used functional connectivity MRI (fcMRI) to determine whether brain network parameters relate to the duration of TLE. Graph theory-based analysis of the sites of reported regions of TLE abnormality was performed on resting-state fMRI data in 48 subjects: 24 controls, 13 patients with left TLE, and 11 patients with right TLE. Various network parameters were analyzed including betweenness centrality (BC), clustering coefficient (CC), path length (PL), small-world index (SWI), global efficiency (GE), connectivity strength (CS), and connectivity diversity (CD). These were compared for patients with TLE as a group, compared to controls, and for patients with left and right TLE separately. The association of changes in network parameters with epilepsy duration was also evaluated. We found that CC, CS, and CD decreased in subjects with TLE compared to control subjects. Analyzed according to epilepsy duration, patients with TLE showed a progressive reduction in CD. In conclusion, we found that several network parameters decreased in patients with TLE compared to controls, which suggested reduced connectivity in TLE. Reduction in CD associated with epilepsy duration suggests a homogenization of connections over time in TLE, indicating a reduction of the normal repertoire of stronger and weaker connections to other brain regions. PMID:25873437

  14. Medial temporal lobe roles in human path integration.

    Directory of Open Access Journals (Sweden)

    Naohide Yamamoto

    Full Text Available Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed.

  15. Hsp60 response in experimental and human temporal lobe epilepsy

    Science.gov (United States)

    Gammazza, Antonella Marino; Colangeli, Roberto; Orban, Gergely; Pierucci, Massimo; Di Gennaro, Giancarlo; Bello, Margherita Lo; D'Aniello, Alfredo; Bucchieri, Fabio; Pomara, Cristoforo; Valentino, Mario; Muscat, Richard; Benigno, Arcangelo; Zummo, Giovanni; de Macario, Everly Conway; Cappello, Francesco; Di Giovanni, Giuseppe; Macario, Alberto J. L.

    2015-01-01

    The mitochondrial chaperonin Hsp60 is a ubiquitous molecule with multiple roles, constitutively expressed and inducible by oxidative stress. In the brain, Hsp60 is widely distributed and has been implicated in neurological disorders, including epilepsy. A role for mitochondria and oxidative stress has been proposed in epileptogenesis of temporal lobe epilepsy (TLE). Here, we investigated the involvement of Hsp60 in TLE using animal and human samples. Hsp60 immunoreactivity in the hippocampus, measured by Western blotting and immunohistochemistry, was increased in a rat model of TLE. Hsp60 was also increased in the hippocampal dentate gyrus neurons somata and neuropil and hippocampus proper (CA3, CA1) of the epileptic rats. We also determined the circulating levels of Hsp60 in epileptic animals and TLE patients using ELISA. The epileptic rats showed circulating levels of Hsp60 higher than controls. Likewise, plasma post-seizure Hsp60 levels in patients were higher than before the seizure and those of controls. These results demonstrate that Hsp60 is increased in both animals and patients with TLE in affected tissues, and in plasma in response to epileptic seizures, and point to it as biomarker of hippocampal stress potentially useful for diagnosis and patient management. PMID:25801186

  16. Semantic Processing Impairment in Patients with Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Amanda G. Jaimes-Bautista

    2015-01-01

    Full Text Available The impairment in episodic memory system is the best-known cognitive deficit in patients with temporal lobe epilepsy (TLE. Recent studies have shown evidence of semantic disorders, but they have been less studied than episodic memory. The semantic dysfunction in TLE has various cognitive manifestations, such as the presence of language disorders characterized by defects in naming, verbal fluency, or remote semantic information retrieval, which affects the ability of patients to interact with their surroundings. This paper is a review of recent research about the consequences of TLE on semantic processing, considering neuropsychological, electrophysiological, and neuroimaging findings, as well as the functional role of the hippocampus in semantic processing. The evidence from these studies shows disturbance of semantic memory in patients with TLE and supports the theory of declarative memory of the hippocampus. Functional neuroimaging studies show an inefficient compensatory functional reorganization of semantic networks and electrophysiological studies show a lack of N400 effect that could indicate that the deficit in semantic processing in patients with TLE could be due to a failure in the mechanisms of automatic access to lexicon.

  17. Computer-assisted lateralization of unilateral temporal lobe epilepsy using Z-score parametric F-18 FDG PET images

    International Nuclear Information System (INIS)

    To evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric PET imaging (ZPET). 38 patients with histologically proven unilateral TLE due to pure hippocampal sclerosis, referred for pre-surgical PET evaluation of intractable seizure over a 5-year period, were included. The F-18 FDG images were oriented along temporal long axis and then transformed into ZPET images on a voxel by voxel basis. Multiple regions of interests (21 in total) were placed on cortical, subcortical and cerebellar structures on twenty-eight out of 38 patients with totally seizure-free (class I) outcome. Paired t-tests with Bonferroni correction were used to determine the location of the most asymmetric regions as variables for subsequent discriminant analysis of the entire group of the patients. The computer program identified the anterior half of the temporal lobe (p < 0.0005) and thalami (p = 0.021) as the most asymmetric regions in TLE patients with Class I outcome. Discriminant analysis using z-scores from a total of 8 ROIs (in 4 pairs) on these structures correctly lateralized thirty-seven out of 38 (97%) patients (sensitivity = 94%; specificity = 100%). The only false localization came from a patient with equivocal z-scores on the temporal lobes and this patient turned out to have poor outcome. The computer-assisted lateralization of TLE using ZPET provides an accurate, fast and objective way of seizure evaluation

  18. Predictors of outcome after anterior temporal lobectomy: the intracarotid amobarbital test.

    Science.gov (United States)

    Sperling, M R; Saykin, A J; Glosser, G; Moran, M; French, J A; Brooks, M; O'Connor, M J

    1994-12-01

    The intracarotid amobarbital test (IAT) examines hemispheric memory and language. We set out to determine whether memory performance on the IAT correlated with seizure relief after anterior temporal lobectomy in 117 patients with refractory epilepsy. The IAT assessed recognition memory performance for nine items with correction for false-positive recognitions. We then compared performance of one hemisphere with that of the other, defining a correctly lateralized memory deficit as worse performance when using the hemisphere containing the operated temporal lobe than when using the other hemisphere. The analysis included concurrent factors that might also affect outcome, such as age at first risk for epilepsy, presence or absence of tumor, and Full Scale IQ. A discriminant function analysis demonstrated that patients with a correctly lateralized memory deficit on the IAT had an increased probability of being seizure-free following surgery after controlling for other predictors. The performance of the nonoperated temporal lobe related to outcome, although less strongly. The magnitude of the difference in performance between the two hemispheres and the performance of the operated hemisphere did not relate to outcome. Patients who became seizure-free had an earlier age at first risk than did those with persistent seizures, and tumor presence weakly correlated with postoperative outcome. IQ did not correlate with outcome. We conclude that the IAT predicts seizure relief after anterior temporal lobectomy independent of other known risk factors we examined. PMID:7991120

  19. Interleukin-6 levels are increased in temporal lobe epilepsy but not in extra-temporal lobe epilepsy.

    Science.gov (United States)

    Liimatainen, Suvi; Fallah, Mahdi; Kharazmi, Elham; Peltola, Maria; Peltola, Jukka

    2009-05-01

    Previous studies have reported activation of inflammatory cytokines in seizures, but clinical characteristics of epilepsy associated with cytokine activation have not been well established. In this study, serum levels of interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1RA) were measured, and clinical characteristics of epilepsy were assessed in 86 well-evaluated patients with refractory focal epilepsy and in 5 patients with controlled focal epilepsy. Epilepsy was evaluated based on patient histories, electroclinical findings, and high-resolution brain MRI scans. Sixty-three healthy blood donors served as controls. IL-6 concentrations were chronically increased in epilepsy patients (11%) compared with healthy controls (0%) (P = 0.007). Increased levels of IL-6 were more prevalent in patients with temporal lobe epilepsy (TLE) compared to patients with extra-TLE (P = 0.028). Also the mean and the median serum levels of IL-6 were higher in patients with TLE than in patients with extra-TLE (P = 0.042). Concentrations of IL-1RA were not significantly different in patients compared with controls. Indicated by increased levels of IL-6 in TLE, epilepsy type is important in determining chronic overproduction of cytokines in refractory focal epilepsy. The results may reflect a chronic immunological process in the brain in patients with refractory epilepsy. PMID:19252806

  20. Feasibility of the Medial Temporal lobe Atrophy index (MTAi and derived methods for measuring atrophy of the medial temporal lobe

    Directory of Open Access Journals (Sweden)

    Francisco eConejo Bayón

    2014-11-01

    Full Text Available Introduction: the Medial Temporal-lobe Atrophy index (MTAi, 2D-Medial Temporal Atrophy (2D-MTA, yearly rate of MTA (yrRMTA and yearly rate of relative MTA (yrRMTA are simple protocols for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. Albeit preliminary studies showed interest of these methods in the diagnosis of AD, FTLD and correlation with cognitive impairment in PD, formal feasibility and validity studies remained pending. As a first step, we aimed to assess the feasibility. Mainly, we aimed to assess the reproducibility of measuring the areas needed to compute these indices. We also aimed to assess the efforts needed to start using these methods correctly. Methods: a series of 290 1.5T-MRI studies from 230 subjects ranging 65-85 years old who had been studied for cognitive impairment were used in this study. Six inexperienced tracers (IT plus one experienced tracer (ET traced the three areas needed to compute the indices. Finally, tracers underwent a short survey on their experience learning to compute the MTAi and experience of usage, including items relative to training time needed to understand and apply the MTAi, time to perform a study after training and overall satisfaction. Results: learning to trace the areas needed to compute the MTAi and derived methods is quick and easy. Results indicate very good intrarater ICC for the MTAi, good intrarater ICC for the 2D-MTA, yrMTA and yrRMTA and also good interrater ICC for the MTAi, 2D-MTA, yrMTA and yrRMTA.Conclusion: our data support that MTAi and derived methods (2D-MTA, yrMTA and yrRTMA have good to very good intrarater and interrater reproducibility and may be easily implemented in clinical practice even if new users have no experience tracing the area of regions of interest.

  1. Temporal Cortex Morphology in Mesial Temporal Lobe Epilepsy Patients and Their Asymptomatic Siblings.

    Science.gov (United States)

    Alhusaini, Saud; Whelan, Christopher D; Doherty, Colin P; Delanty, Norman; Fitzsimons, Mary; Cavalleri, Gianpiero L

    2016-03-01

    Temporal cortex abnormalities are common in patients with mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE+HS) and believed to be relevant to the underlying mechanisms. In the present study, we set out to determine the familiarity of temporal cortex morphologic alterations in a cohort of MTLE+HS patients and their asymptomatic siblings. A surface-based morphometry (SBM) method was applied to process MRI data acquired from 140 individuals (50 patients with unilateral MTLE+HS, 50 asymptomatic siblings of patients, and 40 healthy controls). Using a region-of-interest approach, alterations in temporal cortex morphology were determined in patients and their asymptomatic siblings by comparing with the controls. Alterations in temporal cortex morphology were identified in MTLE+HS patients ipsilaterally within the anterio-medial regions, including the entorhinal cortex, parahippocampal gyrus, and temporal pole. Subtle but similar pattern of morphology changes with a medium effect size were also noted in the asymptomatic siblings. These localized alterations were related to volume loss that appeared driven by shared contractions in cerebral cortex surface area. These findings indicate that temporal cortex morphologic alterations are common to patients and their asymptomatic siblings and suggest that such localized traits are possibly heritable. PMID:25576532

  2. Temporal lobe epilepsy: Comparison of CT and MR in 100 patients

    International Nuclear Information System (INIS)

    The value of CT and MR was studied in 100 patients with temporal lobe epilepsy. Axial CT scans were obtained before and after contrast injection. Coronary MR scans were carried out with T1-(SE 400/30, GE 315/14) and T2-weighted sequences (SE 1600/30 + 70). A circumscribed lesion was demonstrated in fifteen patients by CT and in 25 patients by MR. With the exception of a small area of calcification, all lesions seen on CT could also be recognized on MR. Better sensitivity and improved demonstration of the temporal lobes makes MR the method of choice in the diagnosis of temporal lobe epilepsy. (orig./GDG)

  3. Clinical characteristics of patients with benign nonlesional temporal lobe epilepsy

    Science.gov (United States)

    Kim, Jiyeon; Kim, Seong Hoon; Lim, Sung Chul; Kim, Woojun; Shon, Young-Min

    2016-01-01

    Purpose To evaluate the evolution of nonlesional temporal lobe epilepsy (TLE-NL) in patients treated exclusively with antiepileptic drugs and to elucidate clinical phenotypes related to the prognosis of these patients. Methods Clinical, radiological, and electroencephalographic (EEG) findings in 84 patients with TLE-NL were reviewed. A good response group (GRG) and a poor response group (PRG) were defined if the duration of their seizure-free period was >1 year, or <1 year, respectively. Results There were 46 (54.8%) patients in the GRG and 38 (45.2%) patients in the PRG. The number of antiepileptic drugs administered was significantly lower in the GRG than that in the PRG (1.3±0.8 vs 2.8±1.0, respectively; P<0.05). The GRG had a significantly older age of onset than the PRG and a lower occurrence of initial precipitating events, such as febrile seizures, central nervous system infection, and head trauma (P<0.05). The prevalence of EEG abnormality, presence of aura, generalized seizures, and automatism was less frequently observed in the GRG (P<0.05). Multivariate analysis showed that the presence of automatism and initial precipitating events were significantly associated with a poor prognosis (P<0.05). Conclusion In contrast to the commonly assumed intractability of TLE, we found that more than 54% of patients with TLE-NL achieved a long seizure-free period. Older age at onset of TLE-NL was associated with a better prognosis. However, the presence of automatism and initial precipitating events were related to a poor prognosis. Future prospective studies with a much larger population are warranted. PMID:27555776

  4. Temporal lobe signs: electroencephalographic validity and enhanced scores in special populations.

    Science.gov (United States)

    Makarec, K; Persinger, M A

    1985-06-01

    Internal and external validity tests were completed for an inventory that has been used to infer signs of temporal lobe lability. Strong, positive correlations were reported for a normal (reference) population between the numbers of responses that referred to paranormal experiences (including feelings of a "presence") and separately to religious beliefs and the numbers of spikes per minute within electroencephalographic recordings from the temporal lobe. Numbers of spikes were also correlated with the subjects' scores on the hysteria, schizophrenia, and psychasthenia scales from the MMPI. These clusters of items were not correlated with electrical activity from the occipital lobe (the comparison region). Numbers of responses to control clusters of mundane experiences were not correlated with the temporal lobe measures. A group of student poets scored higher on different subclusters of temporal lobe signs and on the schizophrenia and mania scales of the MMPI than the reference group. For both groups, there were positive correlations between the amount of alpha activity in the temporal lobe only and answers to items such as "hearing inner voices" and "feeling as if things were not real." These results demonstrate that quantitative measures of electrical changes in the temporal lobe are correlated with (or with the report of) specific experiences that are prevalent during surgical or epileptic stimulation of this brain region. PMID:3927256

  5. Ictal vomiting as a sign of temporal lobe epilepsy confirmed by stereo-EEG and surgical outcome.

    Science.gov (United States)

    Pietrafusa, Nicola; de Palma, Luca; De Benedictis, Alessandro; Trivisano, Marina; Marras, Carlo Efisio; Vigevano, Federico; Specchio, Nicola

    2015-12-01

    Vomiting is uncommon in patients with epilepsy and has been reported in both idiopathic and symptomatic epilepsies. It is presumed to originate in the anterior part of the temporal lobe or insula. To date, 44 cases of nonidiopathic focal epilepsy and seizures associated with ictal vomiting have been reported. Of the 44 cases, eight were studied using invasive exploration (3 stereo-EEG/5 subdural grids). Here, we report a 4-year-and-7-month-old patient with a history of febrile convulsion in the second year of life and who developed episodes of vomiting and complex partial seizures at 3 years of age. Scalp EEG showed no electrical modification during vomiting while the complex partial seizure displayed a clear right temporal origin. Brain MR showed hippocampal volume reduction with mild diffuse blurring of the temporal lobe. Stereoelectroencephalography study confirmed the mesiotemporal origin of the seizures and showed that the episodes of vomiting were strictly related to an ictal discharge originating in the mesial temporal structures without insular diffusion. The patient is now seizure-free (18 months) after removal of the right anterior and mesial temporal structures. In all the reported patients, seizures seemed to start in mesial temporal structures. The grid subgroup is more homogeneous, and the most prominent characteristic (4/5) is the involvement of both mesial and lateral temporal structures at the time of vomiting. In the S-EEG group, there is evidence of involvement of either the anterior temporal structures alone (2/3) or both insular cortices (1/3). Our case confirms that vomiting could occur when the ictal discharge is limited to the anterior temporal structure without insular involvement. Regarding the pathophysiology of vomiting, the role of subcortical structures such as the dorsal vagal complex and the central pattern generators (CPG) located in the reticular area is well established. Vomiting as an epileptic phenomenon seems to be related to

  6. Famous face identification in temporal lobe epilepsy: Support for a multimodal integration model of semantic memory

    Science.gov (United States)

    Drane, Daniel L.; Ojemann, Jeffrey G.; Phatak, Vaishali; Loring, David W.; Gross, Robert E.; Hebb, Adam O.; Silbergeld, Daniel L.; Miller, John W.; Voets, Natalie L.; Saindane, Amit M.; Barsalou, Lawrence; Meador, Kimford J.; Ojemann, George A.; Tranel, Daniel

    2012-01-01

    This study aims to demonstrate that the left and right anterior temporal lobes (ATLs) perform critical but unique roles in famous face identification, with damage to either leading to differing deficit patterns reflecting decreased access to lexical or semantic concepts but not their degradation. Famous face identification was studied in 22 presurgical and 14 postsurgical temporal lobe epilepsy (TLE) patients and 20 healthy comparison subjects using free recall and multiple choice (MC) paradigms. Right TLE patients exhibited presurgical deficits in famous face recognition, and postsurgical deficits in both famous face recognition and familiarity judgments. However, they did not exhibit any problems with naming before or after surgery. In contrast, left TLE patients demonstrated both pre-and postsurgical deficits in famous face naming but no significant deficits in recognition or familiarity. Double dissociations in performance between groups were alleviated by altering task demands. Postsurgical right TLE patients provided with MC options correctly identified greater than 70% of famous faces they initially rated as unfamiliar. Left TLE patients accurately chose the name for nearly all famous faces they recognized (based on their verbal description) but initially failed to name, although they tended to rapidly lose access to this name. We believe alterations in task demands activate alternative routes to semantic and lexical networks, demonstrating that unique pathways to such stored information exist, and suggesting a different role for each ATL in identifying visually presented famous faces. The right ATL appears to play a fundamental role in accessing semantic information from a visual route, with the left ATL serving to link semantic information to the language system to produce a specific name. These findings challenge several assumptions underlying amodal models of semantic memory, and provide support for the integrated multimodal theories of semantic memory

  7. New Learning of Music after Bilateral Medial Temporal Lobe Damage: Evidence from an Amnesic Patient

    Directory of Open Access Journals (Sweden)

    Jussi eValtonen

    2014-09-01

    Full Text Available Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly-identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ’s rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed, closely matched for factors contributing to a piece’s musical complexity. LSJ practiced playing two of the pieces, one in each of two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ’s complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

  8. Famous face identification in temporal lobe epilepsy: support for a multimodal integration model of semantic memory.

    Science.gov (United States)

    Drane, Daniel L; Ojemann, Jeffrey G; Phatak, Vaishali; Loring, David W; Gross, Robert E; Hebb, Adam O; Silbergeld, Daniel L; Miller, John W; Voets, Natalie L; Saindane, Amit M; Barsalou, Lawrence; Meador, Kimford J; Ojemann, George A; Tranel, Daniel

    2013-06-01

    This study aims to demonstrate that the left and right anterior temporal lobes (ATLs) perform critical but unique roles in famous face identification, with damage to either leading to differing deficit patterns reflecting decreased access to lexical or semantic concepts but not their degradation. Famous face identification was studied in 22 presurgical and 14 postsurgical temporal lobe epilepsy (TLE) patients and 20 healthy comparison subjects using free recall and multiple choice (MC) paradigms. Right TLE patients exhibited presurgical deficits in famous face recognition, and postsurgical deficits in both famous face recognition and familiarity judgments. However, they did not exhibit any problems with naming before or after surgery. In contrast, left TLE patients demonstrated both pre- and postsurgical deficits in famous face naming but no significant deficits in recognition or familiarity. Double dissociations in performance between groups were alleviated by altering task demands. Postsurgical right TLE patients provided with MC options correctly identified greater than 70% of famous faces they initially rated as unfamiliar. Left TLE patients accurately chose the name for nearly all famous faces they recognized (based on their verbal description) but initially failed to name, although they tended to rapidly lose access to this name. We believe alterations in task demands activate alternative routes to semantic and lexical networks, demonstrating that unique pathways to such stored information exist, and suggesting a different role for each ATL in identifying visually presented famous faces. The right ATL appears to play a fundamental role in accessing semantic information from a visual route, with the left ATL serving to link semantic information to the language system to produce a specific name. These findings challenge several assumptions underlying amodal models of semantic memory, and provide support for the integrated multimodal theories of semantic memory

  9. Large-scale intrinsic functional network organization along the long axis of the human medial temporal lobe.

    Science.gov (United States)

    Qin, Shaozheng; Duan, Xujun; Supekar, Kaustubh; Chen, Huafu; Chen, Tianwen; Menon, Vinod

    2016-07-01

    The medial temporal lobe (MTL), encompassing the hippocampus and parahippocampal gyrus (PHG), is a heterogeneous structure which plays a critical role in memory and cognition. Here, we investigate functional architecture of the human MTL along the long axis of the hippocampus and PHG. The hippocampus showed stronger connectivity with striatum, ventral tegmental area and amygdala-regions important for integrating reward and affective signals, whereas the PHG showed stronger connectivity with unimodal and polymodal association cortices. In the hippocampus, the anterior node showed stronger connectivity with the anterior medial temporal lobe and the posterior node showed stronger connectivity with widely distributed cortical and subcortical regions including those involved in sensory and reward processing. In the PHG, differences were characterized by a gradient of increasing anterior-to-posterior connectivity with core nodes of the default mode network. Left and right MTL connectivity patterns were remarkably similar, except for stronger left than right MTL connectivity with regions in the left MTL, the ventral striatum and default mode network. Graph theoretical analysis of MTL-based networks revealed higher node centrality of the posterior, compared to anterior and middle hippocampus. The PHG showed prominent gradients in both node degree and centrality along its anterior-to-posterior axis. Our findings highlight several novel aspects of functional heterogeneity in connectivity along the long axis of the human MTL and provide new insights into how its network organization supports integration and segregation of signals from distributed brain areas. The implications of our findings for a principledunderstanding of distributed pathways that support memory and cognition are discussed. PMID:26336951

  10. Temporal lobe epilepsy: a unique window into living human brain epigenetic gene regulation

    OpenAIRE

    Grote, Alexander; Schoch, Susanne; Becker, Albert J.

    2015-01-01

    This scientific commentary refers to ‘Differential DNA methylation profiles of coding and non-coding genes define hippocampal sclerosis in human temporal lobe epilepsy’ by Miller-Delaney et al. (10.1093/brain/awu373).

  11. Temporal Lobe Epilepsy: Quantitative MR Volumetry in Detection of Hippocampal Atrophy

    OpenAIRE

    Farid, Nikdokht; Girard, Holly M.; Kemmotsu, Nobuko; Smith, Michael E.; Magda, Sebastian W.; Lim, Wei Y.; Lee, Roland R.; McDonald, Carrie R.

    2012-01-01

    Quantitative MR imaging can enhance standard visual analysis, providing a viable means for translating volumetric analysis into clinical practice and increasing the detection of hippocampal atrophy in temporal lobe epilepsy in both community and tertiary care settings.

  12. Temporal and extra-temporal hypoperfusion in medial temporal lobe epilepsy evaluated by arterial-spin-labeling based MRI

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy (mTLE) by using arterial-spin-labeling (ASL) based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status. Methods: Twenty-five patients with left-sided and 23 with right-sided mTLE were enrolled, and 30 healthy volunteers were recruited. The cerebral blood flow (CBF) of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner. The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis. The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group. Results: Compared with the volunteers, the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal, the frontal and parietal regions relating to the default-mode network and more serious in lesion side. The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration (r=-0.51, P<0.01). The asymmetric index of CBF as-0.01 has a 76.0% (19/25) sensitivity and a 78.3% (18/23) specificity to distinguish the lesion side. Conclusions: The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE. The ASL technique is a useful tool for lateralizing the unilateral mTLE. (authors)

  13. Spatial memory deficits in juvenile rats with pilocarpine induced temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Orbán-Kis K

    2014-10-01

    Full Text Available One of the most frequent forms of epilepsy in humans is temporal lobe epilepsy. Characteristic to this form of the disease is the frequent pharmacoresistance and the association with behavioural disorders and cognitive impairment. The objective of our study was to establish the degree of cognitive impairment in a rat model of temporal lobe epilepsy after an initial epileptogenic exposure but before of the onset of the effect of long-duration epilepsy.

  14. Remote Hemorrhage in the Cerebellum and Temporal Lobe after Lumbar Spine Surgery

    OpenAIRE

    Shotaro Watanabe; Seiji Ohtori; Sumihisa Orita; Kazuyo Yamauchi; Yawara Eguchi; Yasuchika Aoki; Junichi Nakamura; Masayuki Miyagi; Miyako Suzuki; Gou Kubota; Kazuhide Inage; Takeshi Sainoh; Jun Sato; Yasuhiro Shiga; Koki Abe

    2015-01-01

    Cerebellar hemorrhage remote from the site of surgery can complicate neurosurgical procedures. However, this complication after lumbar surgery is rare. Furthermore, hemorrhage in both the cerebellum and the temporal lobe after spine surgery is rarer still. Herein we present a case of remote hemorrhage in both the cerebellum and the temporal lobe after lumbar spine surgery. A 79-year-old woman with a Schwannoma at the L4 level presented with low back and bilateral leg pain refractory to conser...

  15. Increased In Vivo Expression of an Inflammatory Marker in Temporal Lobe Epilepsy

    OpenAIRE

    Hirvonen, Jussi; Kreisl, William C; Fujita, Masahiro; Dustin, Irene; Khan, Omar; Appel, Shmuel; Zhang, Yi; Morse, Cheryl; Pike, Victor W.; Innis, Robert B.; Theodore, William H.

    2012-01-01

    Animal studies and clinical observations suggest that epilepsy is associated with inflammation. Translocator protein (TSPO) (18 kDa), a marker of inflammation, is increased in vitro in surgical samples from patients with temporal lobe epilepsy. TSPO can be measured in the living human brain with PET and the novel radioligand 11C-PBR28. In this study, we sought to determine whether in vivo expression of TSPO is increased ipsilateral to the seizure focus in patients with temporal lobe epilepsy.

  16. Hippocampal Volumetry and Memory fMRI in Temporal Lobe Epilepsy

    OpenAIRE

    Mechanic-Hamilton, Dawn; Korczykowski, Marc; Yushkevich, Paul A.; Lawler, Kathy; Pluta, John; Glynn, Simon; Tracy, Joseph I.; Wolf, Ronald L.; Sperling, Michael R.; French, Jacqueline A.; Detre, John A

    2009-01-01

    This study examined the utility of structural and functional MRI at 1.5 and 3 Tesla (T) in the pre-surgical evaluation and prediction of post-surgical cognitive outcome in temporal lobe epilepsy (TLE). Forty-nine patients undergoing presurgical evaluation for temporal lobe (TL) resection and twenty-five control subjects were studied. Patients completed standard pre-surgical evaluations including, intracarotid amobarbital test (IAT) and neuropsychological testing. During functional imaging, su...

  17. Glutamate Imaging (GluCEST) Lateralizes Epileptic Foci in Non-Lesional Temporal Lobe Epilepsy

    OpenAIRE

    Davis, Kathryn Adamiak; Nanga, Ravi Prakash Reddy; Das, Sandhitsu; Stephanie H Chen; Hadar, Peter N.; Pollard, John R.; Lucas, Timothy H.; Shinohara, Russell T.; Litt, Brian; Hariharan, Hari; Elliott, Mark A.; Detre, John A; Reddy, Ravinder

    2015-01-01

    When neuroimaging reveals a brain lesion, drug-resistant epilepsy patients show better outcomes after resective surgery than do the one-third of drug resistant epilepsy patients who have normal brain MRIs. We applied a glutamate imaging method, GluCEST (Glutamate Chemical Exchange Saturation Transfer), to patients with non-lesional temporal lobe epilepsy (TLE) based on conventional MRI. GluCEST correctly lateralized the temporal lobe seizure focus on visual and quantitative analysis in all pa...

  18. Chronic temporal lobe epilepsy: a neurodevelopmental or progressively dementing disease?

    Science.gov (United States)

    Helmstaedter, C; Elger, C E

    2009-10-01

    To what degree does the so-called 'initial hit' of the brain versus chronic epilepsy contribute towards the memory impairment observed in chronic temporal lobe epilepsy (TLE) patients? We examined cross-sectional comparisons of age-related regressions of verbal learning and memory in 1156 patients with chronic TLE (age range 6-68 years, mean epilepsy onset 14 +/- 11 years) versus 1000 healthy control subjects (age range 6-80 years) and tested the hypothesis that deviations of age regressions (i.e. slowed rise, accelerated decline) will reveal critical phases during which epilepsy interferes with cognitive development. Patients were recruited over a 20-year period at the Department of Epileptology, University of Bonn. Healthy subjects were drawn from an updated normative population of the Verbaler Lern- und Merkfähigkeitstest, the German pendant to the Rey Auditory Verbal learning Test. A significant divergence of age regressions indicates that patients fail to build up adequate learning and memory performance during childhood and particularly during adolescence. The learning peak (i.e. crossover into decline) is seen earlier in patients (at about the age of 16-17 years) than for controls (at about the age of 23-24 years). Decline in performance with ageing in patients and controls runs in parallel, but due to the initial distance between the groups, patients reach very poor performance levels much earlier than controls. Patients with left and right TLEs performed worse in verbal memory than controls. In addition, patients with left TLE performed worse than those with right TLE. However, laterality differences were evident only in adolescent and adult patients, and not (or less so) in children and older patients. Independent of age, hippocampal sclerosis was associated with poorer performance than other pathologies. The results indicate developmental hindrance plus a negative interaction of cognitive impairment with mental ageing, rather than a progressively

  19. Temporal lobe surgery in childhood and neuroanatomical predictors of long-term declarative memory outcome.

    Science.gov (United States)

    Skirrow, Caroline; Cross, J Helen; Harrison, Sue; Cormack, Francesca; Harkness, William; Coleman, Rosie; Meierotto, Ellen; Gaiottino, Johanna; Vargha-Khadem, Faraneh; Baldeweg, Torsten

    2015-01-01

    The temporal lobes play a prominent role in declarative memory function, including episodic memory (memory for events) and semantic memory (memory for facts and concepts). Surgical resection for medication-resistant and well-localized temporal lobe epilepsy has good prognosis for seizure freedom, but is linked to memory difficulties in adults, especially when the removal is on the left side. Children may benefit most from surgery, because brain plasticity may facilitate post-surgical reorganization, and seizure cessation may promote cognitive development. However, the long-term impact of this intervention in children is not known. We examined memory function in 53 children (25 males, 28 females) who were evaluated for epilepsy surgery: 42 underwent unilateral temporal lobe resections (25 left, 17 right, mean age at surgery 13.8 years), 11 were treated only pharmacologically. Average follow-up was 9 years (range 5-15). Post-surgical change in visual and verbal episodic memory, and semantic memory at follow-up were examined. Pre- and post-surgical T1-weighted MRI brain scans were analysed to extract hippocampal and resection volumes, and evaluate post-surgical temporal lobe integrity. Language lateralization indices were derived from functional magnetic resonance imaging. There were no significant pre- to postoperative decrements in memory associated with surgery. In contrast, gains in verbal episodic memory were seen after right temporal lobe surgery, and visual episodic memory improved after left temporal lobe surgery, indicating a functional release in the unoperated temporal lobe after seizure reduction or cessation. Pre- to post-surgical change in memory function was not associated with any indices of brain structure derived from MRI. However, better verbal memory at follow-up was linked to greater post-surgical residual hippocampal volumes, most robustly in left surgical participants. Better semantic memory at follow-up was associated with smaller resection

  20. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t21 = 1.99, P = 0.06), right amygdala (8%, t21 = 1.83, P = 0.08), left amygdala (5%, t21 = 1.78, P 0.09) and left hippocampus (9%, t21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  1. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Neurologia e Psicologia Medica]. E-mail: fgraeff@keynet.com.br; Santos, A.C. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Clinica Medica; Guimaraes, F.S. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Farmacologia

    2003-07-01

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t{sub 21} = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t{sub 21} = 1.99, P = 0.06), right amygdala (8%, t{sub 21} = 1.83, P = 0.08), left amygdala (5%, t{sub 21} = 1.78, P 0.09) and left hippocampus (9%, t{sub 21} = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  2. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-02-01

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones.

  3. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    International Nuclear Information System (INIS)

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones

  4. Expression of EF-Tumt and EF-Tsmt in brain tissues of patients with mesial temporal lobe epilepsy

    Institute of Scientific and Technical Information of China (English)

    Jun Lu; Qi-Chang Zeng; Qin Wang; Ya-Hui Huang; Qiong Peng

    2016-01-01

    Objective:To explore the expression of EF-Tumt and EF-Tsmt in brain tissue of patients with mesial temporal lobe epilepsy (MTLE). Methods:From January 2013 to January 2015, a total of 62 patients with MTLE who were treated with anterior temporal lobe resection in the Department of neurosurgery in Hunan Brain Hospital were selected and classified as the case group, at the same time, 48 patients with brain trauma were chosen and considered to be the control group. The expression of EF-Tumt and EF-Tsmt was detected and compared between the two groups. Results:EF-Tumt positive particles and EF-Tsmt positive particles were noticed in the mitochondria and cytoplasm of brain tissues of the medial temporal lobe in the two groups by election microscopic observation, and the number of the two types of positive particles in the case group was significantly more than that in the control group (P<0.05);similarly, EF-Tumt positive cells and EF-Tsmt positive cells were also observed in the neurons and astrocytes of brain tissues of the medial temporal lobe in the two groups by election microscopic observation, and the number of the above-mentioned positive cells in the case group was also significantly larger than that in the control group (P<0.05). Conclusions:The expression intensities of EF-Tsmt and EF-Tumt in patients with MTLE are higher than these in patients without epilepsy. Therefore, EF-Tsmt and EF-Tumt play important roles in MTLE.

  5. Evaluation of refractory temporal lobe epilepsy of nontumorous origin with qualitative and quantitative MR imaging

    International Nuclear Information System (INIS)

    This paper reports that although MR imaging is superior to CT in the detection of focal lesions in refractory temporal lobe epilepsy (TLE), its role in the detection of mesial temporal sclerosis remains controversial. This is significant, as the latter represents a frequent cause of TLE and manifests with only subtle atrophic changes and occasional high signal abnormalities. PReoperative MR images of 47 patients who had undergone temporal lobectomy for nontumoral TLE and of 20 control subjects were valuated for focal atrophy and hippocampal high signal abnormalities. Quantitative measurements were performed in 33 patients and 20 control subjects with use of a new brain volumetric analysis program to determine volumes of temporal lobes

  6. The study on temporal lobe epilepsy with single-voxel proton MR spectroscopy and chemical shift imaging

    International Nuclear Information System (INIS)

    Objective: To investigate the value of different proton MR spectroscopy techniques including single-voxel spectroscopy (SVS) and chemical shift imaging (CSI) in diagnosing patients with temporal lobe epilepsy. Methods: Sixty cases (40 normal, 20 temporal lobe epilepsy) experienced SVS and CSI. The volume of interest (VOI) of SVS was placed over the anterior hippocampus formation (HF) region, including part of the head and body of the HF. The VOI of CSI encompassed bilateral HF and the head, body and tail of HF. The VOI was divided into 5 voxels from anterior to posterior. The metabolite data of both SVS and CSI were obtained and the ratios of NAA/Cr and NAA/(Cho+Cr) were recorded or calculated. Results: The ipsilateral hippocampus to the seizure of TLE patients had lower ratios of NAA/(Cho+Cr) and NAA/Cr, and the differences compared with those of the normal group and contralateral subgroup were statistically significant (F=41.958, P1HMRS study improved the diagnostic yield of MR evaluation in TLE patients. There was a correlation between the ratio of NAA/(Cho+Cr) and the location of HF. Regional variation must be considered when interpreting proton spectra of the HF. (author)

  7. Temporal lobe volume predicts Wada memory test performance in patients with mesial temporal sclerosis.

    Science.gov (United States)

    Ding, Kan; Gong, Yunhua; Modur, Pradeep N; Diaz-Arrastia, Ramon; Agostini, Mark; Gupta, Puneet; McColl, Roderick; Hays, Ryan; Van Ness, Paul

    2016-02-01

    The Wada test is widely used in the presurgical evaluation of potential temporal lobectomy patients to predict postoperative memory function. Expected asymmetry (EA), defined as Wada memory lateralized to the nonsurgical hemisphere, or a higher score after injection of the surgical hemisphere would be considered favorable in terms of postoperative memory outcome. However, in some cases, nonlateralized memory (NM) results, with no appreciable asymmetry, may occur because of impaired scores after both injections, often leading to denial of surgery. The reason for such nonlateralized Wada memory in patients with intractable temporal lobe epilepsy (TLE) remains unclear. Given that quantitative morphometric magnetic resonance imaging studies in TLE patients have shown bilateral regional atrophy in temporal and extratemporal structures, we hypothesized that the volume loss in contralateral temporal structures could contribute to nonlateralized Wada memory performance. To investigate this, we examined the relationship between the volume changes of temporal structures and Wada memory scores in patients with intractable TLE with mesial temporal sclerosis (MTS) using an age- and gender-matched control group. Memory was considered nonlateralized if the absolute difference in the total correct recall scores between ipsilateral and contralateral injections was memory was lateralized in 15 and nonlateralized in 6 patients, with all the nonlateralized scores being observed in left TLE. The recall scores after ipsilateral injection were significantly lower in patients with an NM profile than an EA profile (23 ± 14% vs. 59 ± 18% correct recall, p ≤ 0.001). However, the recall scores after contralateral injection were low but similar between the two groups (25 ± 17% vs. 25 ± 15% correct recall, p=0.97). Compared to controls, all the patients showed greater volume loss in the temporal regions. However, patients with a NM profile showed significantly more volume loss than those

  8. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

    Directory of Open Access Journals (Sweden)

    P.G. Carrilho

    1994-06-01

    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  9. Role of HHV-6B Infection in Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    John J Millichap

    2015-05-01

    Full Text Available Investigators from Fujita Health University, Toyoake, and National Epilepsy Center, Shizuoka, Japan, studied the pathogenic role of HHV-6B in patients with mesial temporal lobe epilepsy (MTLE. Of 75 intractable MTLE patients, 52 had mesial temporal sclerosis (MTS and 23 were non-MTS patients.

  10. Hemispheric lateralization interrupted: Material-specific memory deficits in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Kim Celone Willment

    2013-09-01

    Full Text Available The hemispheric lateralization of memory has largely been informed through the study of patients with temporal lobe epilepsy originating from medial temporal sources (mTLE. The material-specific model of memory relies on the basic framework that the left temporal lobe mediates verbal memories, while the right temporal lobe mediates nonverbal memories. Over the years, this model has been refined, and even challenged, as our understanding of the material-specific memory deficits in mTLE has been further elaborated in the neuropsychological and neuroimaging literature. The first goal of this mini-review is to highlight the major findings in the mTLE literature that have advanced and expanded our understanding of material-specific memory deficits in mTLE. Second, we will review how functional neuroimaging patterns of material-specific hemispheric lateralization in mTLE are being translated into the innovative clinical application of preoperative fMRI memory mapping.

  11. Functional neuroimaging studies of episodic memory. Functional dissociation in the medial temporal lobe structures

    International Nuclear Information System (INIS)

    Previous functional neuroimaging studies have demonstrated the critical role of the medial temporal lobe (MTL) regions in the encoding and retrieval of episodic memory. It has also been shown that an emotional factor in human memory enhances episodic encoding and retrieval. However, there is little evidence regarding the specific contribution of each MTL region to the relational, contextual, and emotional processes of episodic memory. The goal of this review article is to identify differential activation patterns of the processes between MTL regions. Results from functional neuroimaging studies of episodic memory show that the hippocampus is involved in encoding the relation between memory items, whereas the entorhinal and perirhinal cortices (anterior parahippocampal gyrus) contribute to the encoding of a single item. Additionally, the parahippocampal cortex (posterior parahippocampal gyrus) is selectively activated during the processing of contextual information of episodic memory. A similar pattern of functional dissociation is found in episodic memory retrieval. Functional neuroimaging has also shown that emotional information of episodic memory enhances amygdala-MTL correlations and that this enhancement is observed during both the encoding and retrieval of emotional memories. These findings from pervious neuroimaging studies suggest that different MTL regions could organize memory for personally experienced episodes via the 'relation' and 'context' factors of episodic memory, and that the emotional factor of episodes could modulate the functional organization in the MTL regions. (author)

  12. Structural attributes of the temporal lobe predict face recognition ability in youth.

    Science.gov (United States)

    Li, Jun; Dong, Minghao; Ren, Aifeng; Ren, Junchan; Zhang, Jinsong; Huang, Liyu

    2016-04-01

    The face recognition ability varies across individuals. However, it remains elusive how brain anatomical structure is related to the face recognition ability in healthy subjects. In this study, we adopted voxel-based morphometry analysis and machine learning approach to investigate the neural basis of individual face recognition ability using anatomical magnetic resonance imaging. We demonstrated that the gray matter volume (GMV) of the right ventral anterior temporal lobe (vATL), an area sensitive to face identity, is significant positively correlated with the subject's face recognition ability which was measured by the Cambridge face memory test (CFMT) score. Furthermore, the predictive model established by the balanced cross-validation combined with linear regression method revealed that the right vATL GMV can predict subjects' face ability. However, the subjects' Cambridge face memory test scores cannot be predicted by the GMV of the face processing network core brain regions including the right occipital face area (OFA) and the right face fusion area (FFA). Our results suggest that the right vATL may play an important role in face recognition and might provide insight into the neural mechanisms underlying face recognition deficits in patients with pathophysiological conditions such as prosopagnosia. PMID:26802942

  13. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Calley, Cynthia S.J. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States)

    2015-02-01

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

  14. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    International Nuclear Information System (INIS)

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm3, or aV70 > 1.7 cm3. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm3 or aV70 > 1.7 cm3. Treatment planning goals should include constraints on the volume of temporal lobes receiving higher dose. The EC50

  15. Spatial memory for asymmetrical dot locations predicts lateralization among patients with presurgical mesial temporal lobe epilepsy.

    Science.gov (United States)

    Brown, Franklin C; Hirsch, Lawrence J; Spencer, Dennis D

    2015-11-01

    This study examined the ability of an asymmetrical dot location memory test (Brown Location Test, BLT) and two verbal memory tests (Verbal Selective Reminding Test (VSRT) and California Verbal Learning Test, Second Edition (CVLT-II)) to correctly lateralize left (LTLE) or right (RTLE) mesial temporal lobe epilepsy that was confirmed with video-EEG. Subjects consisted of 16 patients with medically refractory RTLE and 13 patients with medically refractory LTLE who were left hemisphere language dominant. Positive predictive values for lateralizing TLE correctly were 87.5% for the BLT, 72.7% for the VSRT, and 80% for the CVLT-II. Binary logistic regression indicated that the BLT alone correctly classified 76.9% of patients with left temporal lobe epilepsy and 87.5% of patients with right temporal lobe epilepsy. Inclusion of the verbal memory tests improved this to 92.3% of patients with left temporal lobe epilepsy and 100% correct classification of patients with right temporal lobe epilepsy. Though of a limited sample size, this study suggests that the BLT alone provides strong laterality information which improves with the addition of verbal memory tests. PMID:26398592

  16. The COMT Val108/158Met Polymorphism and Medial Temporal Lobe Volumetry in Patients with Schizophrenia and Healthy Adults

    OpenAIRE

    Ehrlich, Stefan; Morrow, Eric M; Roffman, Joshua L.; Wallace, Stuart R.; Naylor, Melissa; Bockholt, H. Jeremy; Lundquist, Antonia; Yendiki, Anastasia; Ho, Beng-Choon; White, Tonya; Manoach, Dara S.; Clark, Vincent P.; Calhoun, Vince D.; Gollub, Randy L.; Holt, Daphne. J.

    2009-01-01

    Abnormalities of the medial temporal lobe have been consistently demonstrated in schizophrenia. A common functional polymorphism, Val108/158Met, in the putative schizophrenia susceptibility gene, catechol-O-methyltransferase (COMT) has been shown to influence medial temporal lobe function. However, the effects of this polymorphism on volumes of medial temporal lobe structures, particularly in patients with schizophrenia, are less clear. Here we measured the effects of COMT Val108/158Met genot...

  17. Development of automated segmentation method for the posterior portion of the temporal lobe on coronal MR images

    International Nuclear Information System (INIS)

    Brain MRI is an important method for examining the diseases caused by various cerebral pathologies, and the measurement of temporal lobe volume is useful for identifying dementia and temporal lobe abnormalities. However, no segmentation algorithm for the temporal lobe on coronal MR images has been established. Such an algorithm is needed because the shape of the temporal lobe on coronal images varies from area to area. The purpose of this research was to develop a segmentation method for the posterior portion of the temporal lobe on coronal MR images. The subjects were 11 normal patients, whose coronal T1-weighted images were selected for this study. The preprocessing algorithm for segmentation consists of smoothing, binarization, and thinning. The first step of the segmentation process consists of recognition techniques for the temporal lobe region on thinning images. The next step is distance transformation on identified thinning images. Finally, the temporal lobe was segmented by using the original images and distance transformation images and employing the newly developed algorithm. The rate of accuracy of automated recognition was over 74% for all cases, while the average rate of accuracy was 83.2±4.0%. These results suggest that this segmentation method can clearly segment the temporal lobe and has potential for clinical use. Based on this study, although it included only 11 normal patients, we have started applying this segmentation method to many patients, with or without temporal lobe disease. (author)

  18. Novel assessment of global metabolism by 18F-FDG-PET for localizing affected lobe in temporal lobe epilepsy.

    Science.gov (United States)

    Peter, Jonah; Houshmand, Sina; Werner, Thomas J; Rubello, Domenico; Alavi, Abass

    2016-08-01

    The aim of this study was to develop a novel method of global quantitative analysis for use in the diagnosis and treatment evaluation of temporal lobe epilepsy (TLE). We studied 16 patients diagnosed with TLE who underwent fluorine-18 fluorodeoxyglucose-PET (F-FDG-PET) and MRI at the Hospital of the University of Pennsylvania. To quantify temporal lobe hypometabolism, we averaged the mean standardized uptake value across regions of interest (ROIs) encompassing each lobe in its entirety and calculated the metabolic ratios and lateralization indices for each patient on the basis of global measurements. For comparison, we carried out a traditional 'punch biopsy' ROI analysis by averaging the mean standardized uptake value within 1 cm diameter ROIs across select slices. Both techniques were performed twice by the same rater to test intraobserver variability. An expert observer carried out visual analyses of both F-FDG-PET and MRI for reference. The global quantitative analysis identified a seizure focus lateralization in agreement with clinical evaluations for 91% of patients on both trials, with intraclass correlation coefficients of 0.97 and 0.92 for metabolic ratios and lateralization indices, respectively. The punch biopsy analysis was in agreement for 91 and 82% of patients on respective trials, with intraclass correlation coefficients of 0.90 and 0.75. Expert visual analyses carried out on F-FDG-PET and MRI were in agreement for 64 and 9% of patients, respectively. The global quantitative analysis proved to be the most accurate and reliable of the methods tested. This technique has the potential to improve metabolic analysis in TLE and other neuropsychiatric disorders. PMID:27092666

  19. Time reversibility of intracranial human EEG recordings in mesial temporal lobe epilepsy

    Science.gov (United States)

    van der Heyden, M. J.; Diks, C.; Pijn, J. P. M.; Velis, D. N.

    1996-02-01

    Intracranial electroencephalograms from patients suffering from mesial temporal lobe epilepsy were tested for time reversibility. If the recorded time series is irreversible, the input of the recording system cannot be a realisation of a linear Gaussian random process. We confirmed experimentally that the measurement equipment did not introduce irreversibility in the recorded output when the input was a realisation of a linear Gaussian random process. In general, the non-seizure recordings are reversible, whereas the seizure recordings are irreversible. These results suggest that time reversibility is a useful property for the characterisation of human intracranial EEG recordings in mesial temporal lobe epilepsy.

  20. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E;

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  1. Alterations of pH and Pi in seizure foci of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Previous investigations with positron-emission tomography have demonstrated that glucose uptake is diminished in seizure foci. This paper reports on P-31 MR studies performed on patients with temporal lobe epilepsy in order to determine if metabolic alterations were detectablein seizure foci. In seven of eight patients, the pH of the seizure foci was significantly higher than the pH of the control temporal lobe. In addition, the inorganic phosphate (Pi) concentration was significantly higher in the seizure foci. These metabolic changes indicate that P-31 MR spectroscopymight be useful in the investigation of epilepsy

  2. Functional and structural correlates of motor speed in the cerebellar anterior lobe.

    Directory of Open Access Journals (Sweden)

    Uwe Wenzel

    Full Text Available In athletics, motor performance is determined by different abilities such as technique, endurance, strength and speed. Based on animal studies, motor speed is thought to be encoded in the basal ganglia, sensorimotor cortex and the cerebellum. The question arises whether there is a unique structural feature in the human brain, which allows "power athletes" to perform a simple foot movement significantly faster than "endurance athletes". We acquired structural and functional brain imaging data from 32 track-and-field athletes. The study comprised of 16 "power athletes" requiring high speed foot movements (sprinters, jumpers, throwers and 16 endurance athletes (distance runners which in contrast do not require as high speed foot movements. Functional magnetic resonance imaging (fMRI was used to identify speed specific regions of interest in the brain during fast and slow foot movements. Anatomical MRI scans were performed to assess structural grey matter volume differences between athletes groups (voxel based morphometry. We tested maximum movement velocity of plantarflexion (PF-Vmax and acquired electromyographical activity of the lateral and medial gastrocnemius muscle. Behaviourally, a significant difference between the two groups of athletes was noted in PF-Vmax and fMRI indicates that fast plantarflexions are accompanied by increased activity in the cerebellar anterior lobe. The same region indicates increased grey matter volume for the power athletes compared to the endurance counterparts. Our results suggest that speed-specific neuro-functional and -structural differences exist between power and endurance athletes in the peripheral and central nervous system.

  3. Whole-brain voxel-based morphometry of white matter in medial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Yu Aihong [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China)], E-mail: Likuncheng@vip.sina.com; Li Lin; Shan Baoci [Institute of High Energy Physics, Chinese Academy of Sciences (China); Wang Yuping; Xue Sufang [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

    2008-01-15

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods: We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion: VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE.

  4. Whole-brain voxel-based morphometry of white matter in medial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods: We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion: VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE

  5. Post-traumatic stress disorder: a right temporal lobe syndrome?

    Science.gov (United States)

    Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

    2010-12-01

    In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

  6. Hippocampal GABA transporter distribution in patients with temporal lobe epilepsy and hippocampal sclerosis

    NARCIS (Netherlands)

    Schijns, O.; Karaca, U.; Andrade, P.; Nijs, L. de; Kusters, B.; Peeters, A.; Dings, J.; Pannek, H.; Ebner, A.; Rijkers, K.; Hoogland, G.

    2015-01-01

    PURPOSE: To determine hippocampal expression of neuronal GABA-transporter (GAT-1) and glial GABA-transporter (GAT-3) in patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS). METHODS: Hippocampal sections were immunohistochemically stained for GABA-transporter 1 and GABA-transpor

  7. Temporal Lobe Anatomy and Psychiatric Symptoms in Velocardiofacial Syndrome (22Q11.2 Deletion Syndrome)

    Science.gov (United States)

    Kates, Wendy R.; Miller, Adam M.; Abdulsabur, Nuria; Antshel, Kevin M.; Conchelos, Jena; Fremont, Wanda; Roizen, Nancy

    2006-01-01

    Objective: To investigate the association between mesial temporal lobe morphology, ratios of prefrontal cortex to amygdala and hippocampus volumes, and psychiatric symptomatology in children and adolescents with velocardiofacial syndrome (VCFS). Method: Scores on behavioral rating scales and volumetric measures of the amygdala, hippocampus, and…

  8. Treatment of Proper Name Retrieval Deficits in an Individual with Temporal Lobe Epilepsy

    Science.gov (United States)

    Minkina, Irene; Ojemann, Jeffrey G.; Grabowski, Thomas J.; Silkes, JoAnn P.; Phatak, Vaishali; Kendall, Diane L.

    2013-01-01

    Purpose: Studies investigating language deficits in individuals with left temporal-lobe epilepsy have consistently demonstrated impairments in proper name retrieval. The aim of this Phase I rehabilitation study was to investigate the effects of a linguistically distributed word retrieval treatment on proper name retrieval in an individual with…

  9. Improved Cerebral Function in Mesial Temporal Lobe Epilepsy after Subtemporal Amygdalohippocampectomy

    Science.gov (United States)

    Takaya, Shigetoshi; Mikuni, Nobuhiro; Mitsueda, Takahiro; Satow, Takeshi; Taki, Junya; Kinoshita, Masako; Miyamoto, Susumu; Hashimoto, Nobuo; Ikeda, Akio; Fukuyama, Hidenao

    2009-01-01

    The functional changes that occur throughout the human brain after the selective removal of an epileptogenic lesion remain unclear. Subtemporal selective amygdalohippocampectomy (SAH) has been advocated as a minimally invasive surgical procedure for patients with medically intractable mesial temporal lobe epilepsy (MTLE). We evaluated the effects…

  10. The Consolidation of Object and Context Recognition Memory Involve Different Regions of the Temporal Lobe

    Science.gov (United States)

    Balderas, Israela; Rodriguez-Ortiz, Carlos J.; Salgado-Tonda, Paloma; Chavez-Hurtado, Julio; McGaugh, James L.; Bermudez-Rattoni, Federico

    2008-01-01

    These experiments investigated the involvement of several temporal lobe regions in consolidation of recognition memory. Anisomycin, a protein synthesis inhibitor, was infused into the hippocampus, perirhinal cortex, insular cortex, or basolateral amygdala of rats immediately after the sample phase of object or object-in-context recognition memory…

  11. Comparison of mesial versus neocortical onset temporal lobe seizures: neurodiagnostic findings and surgical outcome.

    Science.gov (United States)

    Burgerman, R S; Sperling, M R; French, J A; Saykin, A J; O'Connor, M J

    1995-07-01

    We compared historical features, surface EEG findings, results of intracarotid sodium amobarbital memory testing (IAT), and outcome after anterotemporal lobectomy (ATL) in patients with mesiotemporal lobe seizure onset with those with more diffuse temporal lobe seizure onset (intracranial EEG). Forty-eight patients evaluated consecutively between July 1985 and October 1991 with both scalp/sphenoidal and intracranial EEG were shown to have seizures originating in one temporal lobe. No patients had temporal lobe tumor or vascular malformation. Thirty-seven of the 48 patients had seizure onset in the amygdala/hippocampus (amyg/hipp). Eleven of the 48 had either temporal neocortical onset or simultaneous amyg/hipp and neocortical onset. Patients with mesial onset seizures were more likely to have lateralized memory impairment on IAT (p = 0.05). We noted a trend toward a difference in age of first risk for epilepsy between the two groups (p = 0.09) but not for a difference in any specific risk factor. There were no significant differences in surface EEG interictal findings. Unlike in previous studies, comparison of outcome between the two groups showed no difference in seizure-free outcome. Sudden unexpected death (SUD) was more frequent in neocortical seizure patients who were not seizure-free (p < 0.05). PMID:7555982

  12. Role of magnetic resonance spectroscopy (MRS in nonlesional temporal lobe ep

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    Abdel Aziz Kamal Aun

    2016-03-01

    Conclusion: MR spectroscopy is a very sensitive guiding tool in predicting the temporal lobe epilepsy (TLE and the side of involvement in patients with TLE even in patients with MR negative studies. It helps in detecting abnormal spectra of various brain metabolites. MR spectroscopy has demonstrated consistent metabolic abnormalities in partial seizures. MRS can also detect bilateral affection with the ipsilateral side more affected.

  13. Working Memory, Long-Term Memory, and Medial Temporal Lobe Function

    Science.gov (United States)

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance…

  14. Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa

    Czech Academy of Sciences Publication Activity Database

    Fábera, Petr; Krijtová, H.; Tomášek, M.; Krýsl, D.; Zámečník, J.; Mohapl, M.; Jiruška, Přemysl; Marusič, P.

    2015-01-01

    Roč. 31, Sep 2015 (2015), s. 120-123. ISSN 1059-1311 R&D Projects: GA MZd(CZ) NT14489 Institutional support: RVO:67985823 Keywords : familial temporal lobe epilepsy * focal cortical dysplasia * epilepsy surgery * genetics of epilepsy Subject RIV: FH - Neurology Impact factor: 1.822, year: 2014

  15. Peripheral inflammation acutely impairs human spatial memory via actions on medial temporal lobe glucose metabolism

    OpenAIRE

    Harrison, Neil A.; Doeller, Christian F.; Voon, Valerie; Burgess, Neil; Critchley, Hugo D

    2014-01-01

    BACKGROUND Inflammation impairs cognitive performance and is implicated in the progression of neurodegenerative disorders. Rodent studies demonstrated key roles for inflammatory mediators in many processes critical to memory, including long-term potentiation, synaptic plasticity, and neurogenesis. They also demonstrated functional impairment of medial temporal lobe (MTL) structures by systemic inflammation. However, human data to support this position are limited. METHODS Sequenti...

  16. Medial Temporal Lobe Activity during Source Retrieval Reflects Information Type, Not Memory Strength

    Science.gov (United States)

    Diana, Rachel A.; Yonelinas, Andrew P.; Ranganath, Charan

    2010-01-01

    The medial temporal lobes (MTLs) are critical for episodic memory but the functions of MTL subregions are controversial. According to memory strength theory, MTL subregions collectively support declarative memory in a graded manner. In contrast, other theories assert that MTL subregions support functionally distinct processes. For instance, one…

  17. Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

    Directory of Open Access Journals (Sweden)

    Okujava Michael

    2001-11-01

    Full Text Available Abstract Background and Purpose It is not known whether carbamazepine (CBZ; a drug widely used in neurology and psychiatry influences the blood oxygenation level dependent (BOLD contrast changes induced by neuronal activation and measured by functional MRI (fMRI. We aimed to investigate the influence of CBZ on memory induced activation of the mesial temporal lobes in patients with symptomatic temporal lobe epilepsy (TLE. Material and Methods Twenty-one individual patients with refractory symptomatic TLE with different CBZ serum levels and 20 healthy controls were studied using BOLD fMRI. Mesial temporal lobe (MTL activation was induced by a task that is based on the retrieval of individually familiar visuo-spatial knowledge. The extent of significant MTL fMRI activation was measured and correlated with the CBZ serum level. Results In TLE patients, the extent of significant fMRI activation over both MTL was negatively correlated to the CBZ serum level (Spearman r = -0.654, P Conclusions In TLE patients, carbamazepine reduces the fMRI-detectable changes within the mesial temporal lobes as induced by effortful memory retrieval. FMRI appears to be suitable to study the effects of chronic drug treatment in patients with epilepsy.

  18. Contribution of 99Tcm-HMPAO SPECT in the evaluation of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    99Tcm-HMPAO (hexamethylpropylene amine oxime) single photon emission computed tomography (SPECT) images were acquired for 31 patients with medically intractable epilepsy due to unilateral temporal lobe seizure focus to determine the contribution of these images to pre-surgical evaluation. Neuropsychological tests, electroencephalograms (EEGs) and magnetic resonance imaging (MRI) were also used to select the side of resection. Interictal SPECT scans showed temporal lobe hypoperfusion in the side selected for surgery in 21 cases, hypoperfusion in the opposite temporal lobe (false lateralization) in two cases and a normal perfusion pattern in eight cases. The sensitivity of interictal SPECT scans was 67.7%. Ten patients underwent SPECT imaging in the ictal/post-ictal state. Increased regional cerebral blood flow was demonstrated in eight cases and was in agreement with the side selected for surgery in all of them. The range of time delay from the end of the seizure to the tracer injection was 0-146 s (mean ± SD of 49 ± 50 s). Another two cases demonstrated hypoperfusion of the temporal lobe extending to the adjacent cortical area in the side corresponding to the eventual site of surgery. The delay from seizure to injection was 70 and 400 s. These data suggest that SPECT is a useful non-invasive method of localizing the seizure focus in patients with intractable temporal lobe who are being considered for surgery. When both interictal and ictal studies are performed, SPECT has a higher predictive value and is more sensitive for epileptogenic zone identification. (author). 18 refs, 2 figs, 2 tabs

  19. The relationship between frontal and temporal lobe lesions in traumatic brain injury and procedural memory

    International Nuclear Information System (INIS)

    We examined the correlation between the location of chronic phase brain damage identified by a head MRI and the procedural memory test results in patients who have sustained a traumatic brain injury (TBI). Subjects were 27 patients with TBI, who completed all of three procedural memory tasks (mirror-reading, mirror-drawing, and Tower of Toronto). Using a head MRI, the presence or absence of lesions in the frontal lobe and the temporal lobe were determined. To evaluate declarative memory, we implemented the Wechsler Memory Scale-Rivesed (WMS-R), Rivermead Behavioral Memory Test (RBMT), and Rey-Osterrieth Complex Figure Test (3-minute delayed recall). All three of procedural memory tasks were repeated 3 times a day for 3 consecutive days. The rate of improvement (%) of the procedural memory task was determined as {average of the results on the first day- average of the results on the third day)/average of the results on the first day} x 100. We obtained the rate of improvement for each of the three tasks. The patients were divided according to the existence of frontal and temporal lobe lesions in brain MRI, and then rates of improvement were compared by the existence of frontal or temporal lesion using the Mann-Whitney test. In result, the average value of the declarative memory test results was within the range of disorders for all items. On the procedural memory tasks, the rate of improvement did not significantly decrease by the presence of frontal or temporal lobe lesion. It is believed that the basal ganglia and the cerebellum are significantly involved in procedural memory. Also in TBI patients, the procedural memory tends to be retained. Our results suggest that frontal and temporal lobe lesions, which are frequently found in traumatic brain injury, are not likely to be related to procedural memory. (author)

  20. Ictal hyperperfusion of cerebellum and basal ganglia in temporal lobe epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring. SPGR MRI, and SPECT subtraction with MRI co-registration. The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH( 60.0%) and three bilateral hemispheric CH( 12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (15/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1 %). The basal ganglia hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH

  1. More Than Meets the Eye: The Merging of Perceptual and Conceptual Knowledge in the Anterior Temporal Face Area

    Science.gov (United States)

    Collins, Jessica A.; Koski, Jessica E.; Olson, Ingrid R.

    2016-01-01

    An emerging body of research has supported the existence of a small face sensitive region in the ventral anterior temporal lobe (ATL), referred to here as the “anterior temporal face area”. The contribution of this region in the greater face-processing network remains poorly understood. The goal of the present study was to test the relative sensitivity of this region to perceptual as well as conceptual information about people and objects. We contrasted the sensitivity of this region to that of two highly-studied face-sensitive regions, the fusiform face area (FFA) and the occipital face area (OFA), as well as a control region in early visual cortex (EVC). Our findings revealed that multivoxel activity patterns in the anterior temporal face area contain information about facial identity, as well as conceptual attributes such as one’s occupation. The sensitivity of this region to the conceptual attributes of people was greater than that of posterior face processing regions. In addition, the anterior temporal face area overlaps with voxels that contain information about the conceptual attributes of concrete objects, supporting a generalized role of the ventral ATLs in the identification and conceptual processing of multiple stimulus classes. PMID:27199711

  2. Large anterior temporal Virchow-Robin spaces: unique MR imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Anthony T. [Monash University, Neuroradiology Service, Monash Imaging, Monash Health, Melbourne, Victoria (Australia); Chandra, Ronil V. [Monash University, Neuroradiology Service, Monash Imaging, Monash Health, Melbourne, Victoria (Australia); Monash University, Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Melbourne (Australia); Trost, Nicholas M. [St Vincent' s Hospital, Neuroradiology Service, Melbourne (Australia); McKelvie, Penelope A. [St Vincent' s Hospital, Anatomical Pathology, Melbourne (Australia); Stuckey, Stephen L. [Monash University, Neuroradiology Service, Monash Imaging, Monash Health, Melbourne, Victoria (Australia); Monash University, Southern Clinical School, Faculty of Medicine, Nursing and Health Sciences, Melbourne (Australia)

    2015-05-01

    Large Virchow-Robin (VR) spaces may mimic cystic tumor. The anterior temporal subcortical white matter is a recently described preferential location, with only 18 reported cases. Our aim was to identify unique MR features that could increase prospective diagnostic confidence. Thirty-nine cases were identified between November 2003 and February 2014. Demographic, clinical data and the initial radiological report were retrospectively reviewed. Two neuroradiologists reviewed all MR imaging; a neuropathologist reviewed histological data. Median age was 58 years (range 24-86 years); the majority (69 %) was female. There were no clinical symptoms that could be directly referable to the lesion. Two thirds were considered to be VR spaces on the initial radiological report. Mean maximal size was 9 mm (range 5-17 mm); majority (79 %) had perilesional T2 or fluid-attenuated inversion recovery (FLAIR) hyperintensity. The following were identified as potential unique MR features: focal cortical distortion by an adjacent branch of the middle cerebral artery (92 %), smaller adjacent VR spaces (26 %), and a contiguous cerebrospinal fluid (CSF) intensity tract (21 %). Surgery was performed in three asymptomatic patients; histopathology confirmed VR spaces. Unique MR features were retrospectively identified in all three patients. Large anterior temporal lobe VR spaces commonly demonstrate perilesional T2 or FLAIR signal and can be misdiagnosed as cystic tumor. Potential unique MR features that could increase prospective diagnostic confidence include focal cortical distortion by an adjacent branch of the middle cerebral artery, smaller adjacent VR spaces, and a contiguous CSF intensity tract. (orig.)

  3. Large anterior temporal Virchow-Robin spaces: unique MR imaging features

    International Nuclear Information System (INIS)

    Large Virchow-Robin (VR) spaces may mimic cystic tumor. The anterior temporal subcortical white matter is a recently described preferential location, with only 18 reported cases. Our aim was to identify unique MR features that could increase prospective diagnostic confidence. Thirty-nine cases were identified between November 2003 and February 2014. Demographic, clinical data and the initial radiological report were retrospectively reviewed. Two neuroradiologists reviewed all MR imaging; a neuropathologist reviewed histological data. Median age was 58 years (range 24-86 years); the majority (69 %) was female. There were no clinical symptoms that could be directly referable to the lesion. Two thirds were considered to be VR spaces on the initial radiological report. Mean maximal size was 9 mm (range 5-17 mm); majority (79 %) had perilesional T2 or fluid-attenuated inversion recovery (FLAIR) hyperintensity. The following were identified as potential unique MR features: focal cortical distortion by an adjacent branch of the middle cerebral artery (92 %), smaller adjacent VR spaces (26 %), and a contiguous cerebrospinal fluid (CSF) intensity tract (21 %). Surgery was performed in three asymptomatic patients; histopathology confirmed VR spaces. Unique MR features were retrospectively identified in all three patients. Large anterior temporal lobe VR spaces commonly demonstrate perilesional T2 or FLAIR signal and can be misdiagnosed as cystic tumor. Potential unique MR features that could increase prospective diagnostic confidence include focal cortical distortion by an adjacent branch of the middle cerebral artery, smaller adjacent VR spaces, and a contiguous CSF intensity tract. (orig.)

  4. Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.

    Science.gov (United States)

    Errguig, L; Lahjouji, F; Belaidi, H; Jiddane, M; Elkhamlichi, A; Dakka, T; Ouazzani, R

    2013-11-01

    Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features. PMID:24138873

  5. Altered functional connectivity and small-world in mesial temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Wei Liao

    Full Text Available BACKGROUND: The functional architecture of the human brain has been extensively described in terms of functional connectivity networks, detected from the low-frequency coherent neuronal fluctuations that can be observed in a resting state condition. Little is known, so far, about the changes in functional connectivity and in the topological properties of functional networks, associated with different brain diseases. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we investigated alterations related to mesial temporal lobe epilepsy (mTLE, using resting state functional magnetic resonance imaging on 18 mTLE patients and 27 healthy controls. Functional connectivity among 90 cortical and subcortical regions was measured by temporal correlation. The related values were analyzed to construct a set of undirected graphs. Compared to controls, mTLE patients showed significantly increased connectivity within the medial temporal lobes, but also significantly decreased connectivity within the frontal and parietal lobes, and between frontal and parietal lobes. Our findings demonstrated that a large number of areas in the default-mode network of mTLE patients showed a significantly decreased number of connections to other regions. Furthermore, we observed altered small-world properties in patients, along with smaller degree of connectivity, increased n-to-1 connectivity, smaller absolute clustering coefficients and shorter absolute path length. CONCLUSIONS/SIGNIFICANCE: We suggest that the mTLE alterations observed in functional connectivity and topological properties may be used to define tentative disease markers.

  6. Distúrbios do sono na epilepsia do lobo temporal Sleep disorders in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Cláudia Ângela Vilela de Almeida

    2003-12-01

    Full Text Available A presença de distúrbios do sono e macroestrutura do sono foi avaliada em 39 pacientes com epilepsia do lobo temporal (ELT. Sonolência foi a queixa mais frequente (85%, seguida por despertares noturnos (75%, história de crise epiléptica durante o sono (69% e dificuldade de iniciar o sono (26%. As parassonias, síndrome de pernas inquietas, apnéia de sono e movimentos periódicos de membros inferiores foram os distúrbios de sono mais frequentes. Principais alterações da arquitetura de sono foram: fragmentação do sono, aumento do número de mudanças de estágios (100% e do tempo acordado após o início do sono (77% e redução do sono REM (92%. Houve correlação inversa entre a escala de sonolência de Epworth e o teste de latências múltiplas de sono (p The objective of this study was to evaluate sleep macrostructure and sleep disturbance in a group of 39 patients with temporal lobe epilepsy (TLE. Patients completed questionnaires to evaluate their sleep and subjective daytime sleepiness (Epworth Sleepiness Scale [ESS] and undergone Polysomnography and Multiple Sleep Latency Test (MSLT. Daytime sleepiness was the most frequent complaint (85%, followed by wakefulness during sleep, history of seizures during sleep (75% and initial insomnia (26%. Parassomnias (67%, obstructive sleep apneas (13%, restless legs syndrome (15% and periodic limb movements (5% were the most frequent sleep disorders. The most frequent changes of sleep patterns were: sleep architecture fragmentation (100%, decreased amount of REM sleep (92% and increase in time awake after sleep onset (77%. There were significative correlations between the ESS and the MSLT (p<0,05. In conclusion, TLE patients have fragmented sleep with increased sleep stages shifts, increased number of awakenings and in time awake after sleep onset. REM sleep was decreased. Daytime sleepiness was the most frequent complaint in TLE patients.

  7. Characterization of neurons in the cortical white matter in human temporal lobe epilepsy.

    Science.gov (United States)

    Richter, Zsófia; Janszky, József; Sétáló, György; Horváth, Réka; Horváth, Zsolt; Dóczi, Tamás; Seress, László; Ábrahám, Hajnalka

    2016-10-01

    The aim of the present work was to characterize neurons in the archi- and neocortical white matter, and to investigate their distribution in mesial temporal sclerosis. Immunohistochemistry and quantification of neurons were performed on surgically resected tissue sections of patients with therapy-resistant temporal lobe epilepsy. Temporal lobe tissues of patients with tumor but without epilepsy and that from autopsy were used as controls. Neurons were identified with immunohistochemistry using antibodies against NeuN, calcium-binding proteins, transcription factor Tbr1 and neurofilaments. We found significantly higher density of neurons in the archi- and neocortical white matter of patients with temporal lobe epilepsy than in that of controls. Based on their morphology and neurochemical content, both excitatory and inhibitory cells were present among these neurons. A subset of neurons in the white matter was Tbr-1-immunoreactive and these neurons coexpressed NeuN and neurofilament marker SMI311R. No colocalization of Tbr1 was observed with the inhibitory neuronal markers, calcium-binding proteins. We suggest that a large population of white matter neurons comprises remnants of the subplate. Furthermore, we propose that a subset of white matter neurons was arrested during migration, highlighting the role of cortical maldevelopment in epilepsy associated with mesial temporal sclerosis. PMID:27423628

  8. Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

    Directory of Open Access Journals (Sweden)

    Satoru Takeuchi

    2015-01-01

    Full Text Available Background: The superficial temporal artery (STA to proximal posterior cerebral artery (PCA (P2 segment bypass is one of the most difficult procedures to perform because the proximal PCA is located deep and high within the ambient cistern. STA to proximal PCA bypass is usually performed through a subtemporal approach or posterior transpetrosal approach, and rarely through a transsylvian approach. The aim of this study was to describe the operative technique of STA to proximal PCA bypass through a modified transsylvian approach (anterior temporal approach. Methods: STA to proximal PCA bypass was performed through an anterior temporal approach in three patients with intracranial aneurysm. We describe the details of the surgical technique. Results: The STA was successfully anastomosed to the proximal PCA in all cases. One patient suffered hemiparesis and aphasia due to infarction in the anterior thalamoperforating artery territory. Conclusions: STA to proximal PCA bypass can be performed through an anterior temporal approach in selected patients. We recommend that every precaution, including complete hemostasis, placement of cellulose sponges beneath the recipient artery to elevate the site of the anastomosis, and placement of a continuous drainage tube at the bottom of the operative field to avoid blood contamination during the anastomosis, should be taken to shorten the temporary occlusion time.

  9. Evaluation of ictal brain SPET using statistical parametric mapping in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    An automated voxel-based analysis of brain images using statistical parametric mapping (SPM) is accepted as a standard approach in the analysis of activation studies in positron emission tomography and functional magnetic resonance imaging. This study aimed to investigate whether or not SPM would increase the diagnostic yield of ictal brain single-photon emission tomography (SPET) in temporal lobe epilepsy (TLE). Twenty-one patients (age 27.14±5.79 years) with temporal lobe epilepsy (right in 8, left in 13) who had a successful seizure outcome after surgery and nine normal subjects were included in the study. The data of ictal and interictal brain SPET of the patients and baseline SPET of the normal control group were analysed using SPM96 software. The t statistic SPM(t) was transformed to SPM(Z) with various thresholds of P<0.05, 0.005 and 0.001, and corrected extent threshold P value of 0.05. The SPM data were compared with the conventional ictal and interictal subtraction method. On group comparison, ictal SPET showed increased uptake within the epileptogenic mesial temporal lobe. On single case analysis, ictal SPET images correctly lateralized the epileptogenic temporal lobe in 18 cases, falsely lateralized it in one and failed to lateralize it in two as compared with the mean image of the normal group at a significance level of P<0.05. Comparing the individual ictal images with the corresponding interictal group, 15 patients were correctly lateralized, one was falsely lateralized and four were not lateralized. At significance levels of P<0.005 and P<0.001, correct lateralization of the epileptogenic temporal lobe was achieved in 15 and 13 patients, respectively, as compared with the normal group. On the other hand, when comparison was made with the corresponding interictal group, only 7 out of 21 patients were correctly lateralized at the threshold of P<0.005 and five at P<0.001. The result of the subtraction method was close to the single case analysis on

  10. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    International Nuclear Information System (INIS)

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  11. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigo, S.; Oppenheim, C.; Meder, J.F. [Universite Paris-Descartes, Faculte de Medecine, Centre Hospitalier Sainte-Anne, Departement d' Imagerie Morphologique et Fonctionnelle, Paris (France); Chassoux, F. [Universite Paris-Descartes, Faculte de Medecine, Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris (France); Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D. [Service Hospitalier Frederic Joliot, CEA, Orsay (France)

    2007-07-15

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  12. Quantitative magnetic resonance imaging study on patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    In 30 patients with temporal lobe epilepsy who had no visual abnormality on either CT or MRI, cerebral changes especially in the mesial temporal region were examined. The findings were compared with those in 20 normal volunteers. In epileptic patients, the mesial temporal region was significantly smaller and T1-weighted values in this region were significantly higher, as compared with the controls. In the group of epilepsy, atrophy especially in the hippocampal and tonsillar regions and increased water content were suggested. Regarding the bilateral difference in the size of the mesial temporal region, there was no significant difference between the group of epilepsy and the control group. The group of epilepsy seemed to have bilateral changes in the mesial temporal region. In 9 patients with the present or past history of organic delusional (schizophrenia-like) disorder, the coronal section of the third ventricle was significantly large, suggesting the likelihood of structural changes surrounding the third ventricle. (N.K.)

  13. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    DEFF Research Database (Denmark)

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E;

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA was...... visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  14. Exaltation in temporal lobe epilepsy: neuropsychiatric symptom or portal to the divine?

    Science.gov (United States)

    McCrae, Niall; Whitley, Rob

    2014-09-01

    Religiosity is a prominent feature of the Geschwind syndrome, a behavioural pattern found in some cases of temporal lobe epilepsy. Since the 1950s, when Wilder Penfield induced spiritual feelings by experimental manipulation of the temporal lobes, development of brain imaging technology has revealed neural correlates of intense emotional states, spurring the growth of neurotheology. In their secular empiricism, psychiatry, neurology and psychology are inclined to pathologise deviant religious expression, thereby reinforcing the dualism of objective and phenomenal worlds. Considering theological perspectives and the idea of cosmic consciousness, the authors urge a holistic approach to the spiritual events of epileptic aura, potentially leading to a deeper understanding of the mind and its transcendent potential. PMID:25017116

  15. Ictus expectoratus: a sign of complex partial seizures usually of non-dominant temporal lobe origin.

    Science.gov (United States)

    Kaplan, P W; Kerr, D A; Olivi, A

    1999-12-01

    Spitting (or expectoration) is rarely seen with seizures. In Western society, spitting is a striking behavioral aberration. A 13-year-old child had intermittent agitated behavior, episodes of rage, spitting and confusion lasting up to 2 minutes. He stood up in church and told the preacher to 'shut up and sit down'. Epilepsy monitoring revealed spitting with polysharp and spike seizures resolved over the right temporal lobe. Magnetic resonance imaging revealed a right temporal lobe ganglioglioma. Spitting seizures resolved after resection. Ictal expectoration is rare. It may occur with epigastric aura, nausea, chewing, swallowing and fumbling. Literature review disclosed 17 cases, 12 of which arose from the non-dominant hemisphere. Most regressed with surgery and anticonvulsants. PMID:10627411

  16. Lateralization of Temporal Lobe Epilepsy by Imaging-Based Response-Driven Multinomial Multivariate Models

    OpenAIRE

    Nazem-Zadeh, Mohammad R.; Schwalb, Jason M.; Bagher-Ebadian, Hassan; Mahmoudi, Fariborz; Jafari-Khouzani, Kourosh; Elisevich, Kost V.; Soltanian-Zadeh, Hamid

    2014-01-01

    We have developed response-driven multinomial models, based on multivariate imaging features, to lateralize the epileptogenicity in temporal lobe epilepsy (TLE) patients. To this end, volumetrics and statistical quantities of FLAIR intensity and normalized ictal–interictal SPECT intensity on left and right hippocampi were extracted from preoperative images of forty-five retrospective TLE patients with surgical outcome of Engel class I. Using multinomial logistic function regression, the param...

  17. The Anticonvulsant and Antioxidant Effects of Berberine in Kainate-induced Temporal Lobe Epilepsy in Rats

    OpenAIRE

    Mojarad, Tourandokht Baluchnejad; Roghani, Mehrdad

    2014-01-01

    Introduction Temporal lobe epilepsy (TLE) is a long lasting neurological disorder in which patients suffer from spontaneous seizures. New treatments with novel mechanisms of action are needed to help those patients whose seizures are resistant to available drugs. In this study, we investigated the possible neuroprotective effect of berberine in an intrahippocampal kainate model of TLE in rat. Methods In the present study, the anticonvulsant and antioxidant effects of intraperitoneal administr...

  18. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy

    OpenAIRE

    Peng Fang; Jie An; Ling-Li Zeng; Hui Shen; Fanglin (Frank)Chen; Wensheng Wang; Shijun Qiu; Dewen Hu

    2015-01-01

    Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE), but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right) mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed fo...

  19. White Matter Abnormalities in Children with Temporal Lobe Epilepsy: A DTI and MEG Study

    OpenAIRE

    Lu Meng; Hong Zhao; Jingzhu Yang

    2010-01-01

    Background and Purpose: The widespread propagation of synchronized neuronal firing in seizure disorders may affect cortical and subcortical brain regions. Diffusion tensor imaging (DTI) can noninvasively quantify white matter integrity. The purpose of this study was to investigate the abnormal changes of white matter in children with focal temporal lobe epilepsy (TLE) using DTI. Materials and Methods: Eight children with clinically diagnosed TLE and eight age- and sex-matched healthy contro...

  20. Medial Temporal Lobe Contributions to Intra-Item Associative Recognition Memory in the Aging Brain

    OpenAIRE

    Dalton, Marshall Axel; Tu, Sicong; Hornberger, Michael; Hodges, John Russel; Piguet, Olivier

    2014-01-01

    Aging is associated with a decline in episodic memory function. This is accompanied by degradation of and functional changes in the medial temporal lobe (MTL) which subserves mnemonic processing. To date no study has investigated age-related functional change in MTL substructures during specific episodic memory processes such as intra-item associative memory. The aim of this study was to characterize age-related change in the neural correlates of intra-item associative memory processing. Sixt...

  1. Astrocyte control of synaptic NMDA receptors contributes to the progressive development of temporal lobe epilepsy

    OpenAIRE

    Clasadonte, Jerome; Dong, Jinghui; Hines, Dustin J.; Haydon, Philip G.

    2013-01-01

    Temporal lobe epilepsy (TLE) is a chronic brain disorder characterized by the occurrence of spontaneous recurrent seizures. Much of our knowledge of epilepsy is based on how neurons contribute to this disorder. Here we provide a view in which glial cells (astrocytes) contribute to the progressive development of TLE. We have combined a model of epilepsy that more closely mimics the complex features of seizures in epileptic patients, with astrocyte-specific molecular genetics to identify how as...

  2. Risk factors for spatial memory impairment in patients with temporal lobe epilepsy

    Czech Academy of Sciences Publication Activity Database

    Amlerová, J.; Laczó, J.; Vlček, Kamil; Javůrková, A.; Andel, R.; Marusič, P.

    2013-01-01

    Roč. 26, č. 1 (2013), s. 57-60. ISSN 1525-5050 R&D Projects: GA ČR(CZ) GA309/09/1053 Grant ostatní: GA MŠk(CZ) ED1.100/02/0123 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : spatial navigation * temporal lobe epilepsy * Morris water maze Subject RIV: FH - Neurology Impact factor: 2.061, year: 2013

  3. Detecting Differential Memory Performance Among Spanish-speaking Patients with Temporal Lobe Epilepsy

    OpenAIRE

    Marquez de la Plata, C.; Lacritz, L.H.; Mitschke, R.; Van Ness, P.; Agostini, M.; Diaz-Arrastia, R.; Cullum, C.M.

    2009-01-01

    There is relatively little research pertaining to neuropsychological assessment of Spanish-speaking individuals with intractable temporal lobe epilepsy (TLE). The current study examined verbal and visual memory performances in 38 primarily Spanish-speaking patients with TLE (Right = 15, Left = 23) of similar epilepsy duration to determine if lateralizing differences can be found using verbal and nonverbal memory tests. On a test specifically designed to assess auditory learning and memory amo...

  4. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    OpenAIRE

    Alexander Mironov; Sabu John; Jonathan Auerbach; Ghassan Jamaleddine

    2014-01-01

    Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  5. Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

    Directory of Open Access Journals (Sweden)

    Alexander Mironov

    2014-01-01

    Full Text Available Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

  6. Altered vesicular glutamate transporter expression in human temporal lobe epilepsy with hippocampal sclerosis

    OpenAIRE

    Van Liefferinge, J.; Jensen, C.J.; Albertini, G.; Bentea, E.; Demuyser, T.; Merckx, E.; Aronica, E.; Smolders, I; Massie, A.

    2015-01-01

    Vesicular glutamate transporters (VGLUTs) are responsible for loading glutamate into synaptic vesicles. Altered VGLUT protein expression has been suggested to affect quantal size and glutamate release under both physiological and pathological conditions. In this study, we investigated mRNA and protein expression levels of the three VGLUT subtypes in hippocampal tissue of patients suffering from temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS), International League Against Epilepsy...

  7. Relevance of the Glutathione System in Temporal Lobe Epilepsy: Evidence in Human and Experimental Models

    OpenAIRE

    Noemí Cárdenas-Rodríguez; Elvia Coballase-Urrutia; Claudia Pérez-Cruz; Hortencia Montesinos-Correa; Liliana Rivera-Espinosa; Aristides Sampieri; Liliana Carmona-Aparicio

    2014-01-01

    Oxidative stress, which is a state of imbalance in the production of reactive oxygen species and nitrogen, is induced by a wide variety of factors. This biochemical state is associated with diseases that are systemic as well as diseases that affect the central nervous system. Epilepsy is a chronic neurological disorder, and temporal lobe epilepsy represents an estimated 40% of all epilepsy cases. Currently, evidence from human and experimental models supports the involvement of oxidative stre...

  8. Ambiguous emotion recognition in temporal lobe epilepsy : the role of expression intensity.

    OpenAIRE

    Sedda, A; Rivolta, D.; SCARPA, P.; Burt, M.; Frigerio, E; Zanardi, G.; A. Piazzini; Turner, K.; Canevini, M P; Francione, S; Lo Russo, G; G. Bottini

    2013-01-01

    The lateralization of emotion processing is currently debated and may be further explored by examining facial expression recognition (FER) impairments in temporal lobe epilepsy (TLE). Furthermore, there is also debate in the literature whether FER deficits in individuals with TLE are more pronounced in the right than in the left hemisphere. Individuals with TLE were tested with an FER task designed to be more sensitive than those classically used to shed light on this issue. A total of 25 rig...

  9. Inhibition impairments in temporal lobe epilepsy patients: electroencephalography evidence from a Go/Nogo study

    OpenAIRE

    Yu, HM; Gao, JL; Chang, RSK; Mak, W; Cheung, RTF

    2016-01-01

    INTRODUCTION: Temporal lobe epilepsy (TLE) is a common type of epilepsy that easily run an intractable course. It can harm cognitive inhibition function, an essential executive function that enables us to suppress inappropriate actions in a given context at different levels. The aim of this study was to investigate whether TLE also affects related Go/Nogo-potentials related to the inhibition using high-resolution electroencephalography (EEG) technology ...

  10. Anomalous expression of chloride transporters in the sclerosed hippocampus of mesial temporal lobe epilepsy patients☆

    OpenAIRE

    Cai, Xiaodong; Yang, Libai; Zhou, Jueqian; Dan ZHU; Guo, Qiang; Chen, Ziyi; CHEN, SHUDA; Zhou, Liemin

    2013-01-01

    The Na+-K+-Cl- cotransporter 1 and K+-Cl- cotransporter 2 regulate the levels of intracellular chloride in hippocampal cells. Impaired chloride transport by these proteins is thought to be involved in the pathophysiological mechanisms of mesial temporal lobe epilepsy. Imbalance in the relative expression of these two proteins can lead to a collapse of Cl- homeostasis, resulting in a loss of gamma-aminobutyric acid-ergic inhibition and even epileptiform discharges. In this study, we investigat...

  11. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  12. Fractionated Stereotactic Gamma Knife Radiosurgery for Medial Temporal Lobe Epilepsy: A Case Report

    OpenAIRE

    Park, Hye Ran; Chung, Hyun-Tai; Lee, Sang Kun; Kim, Dong Gyu; Paek, Sun Ha

    2016-01-01

    An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could b...

  13. Caudate atrophy and impaired frontostriatal connections are linked to executive dysfunction in temporal lobe epilepsy.

    OpenAIRE

    Riley, Jeffrey D; Moore, Stephanie; Cramer, Steven C.; Jack J Lin

    2011-01-01

    This study tested the hypothesis that executive dysfunction, common in temporal lobe epilepsy (TLE), is associated with an abnormal frontostriatal network. Structural and diffusion tensor MR scans, the Wisconsin Card Sorting Test (WCST) targeting cognitive flexibility, and the Trail Making Test B examining parallel sequencing were obtained from 9 patients with left TLE and 17 healthy controls. The five major findings were: (1) Caudate volume is reduced on the left side in TLE. (2) The atrophy...

  14. Administration of Simvastatin after Kainic Acid-Induced Status Epilepticus Restrains Chronic Temporal Lobe Epilepsy

    OpenAIRE

    Xie, Chuncheng; Sun, Jiahang; Qiao, Weidong; Lu, Dunyue; Wei, Lanlan; NA, MENG; Song, Yuanyuan; Hou, Xiaohua; LIN, ZHIGUO

    2011-01-01

    In this study, we examined the effect of chronic administration of simvastatin immediately after status epilepticus (SE) on rat brain with temporal lobe epilepsy (TLE). First, we evaluated cytokines expression at 3 days post KA-lesion in hippocampus and found that simvastatin-treatment suppressed lesion-induced expression of interleukin (IL)-1β and tumor necrosis factor-α (TNF-α). Further, we quantified reactive astrocytosis using glial fibrillary acidic protein (GFAP) staining and neuron los...

  15. Neural Stem Cell Grafting in an Animal Model of Chronic Temporal Lobe Epilepsy

    OpenAIRE

    Hattiangady, Bharathi; Shetty, Ashok K.

    2011-01-01

    Neural stem cell (NSC) transplantation into the hippocampus could offer an alternative therapy to hippocampal resection in patients with drug-resistant chronic epilepsy, which afflicts ~30% of mesial temporal lobe epilepsy (TLE) cases. Multipotent, self-renewing NSCs could be expanded from multiple regions of the developing and adult brain, human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs). However, to provide a comprehensive methodology involved in testing the effica...

  16. Dissecting the human medial temporal lobe memory system by functional MRI

    OpenAIRE

    Weis, Christine Susanne

    2004-01-01

    The work presented in this thesis comprises two event-related functional magnetic resonance imaging (fMRI) studies, which aim at dissociating the contributions of different subregions of the human medial temporal lobe (MTL) to declarative memory processes. The first study examines common neural correlates of memory encoding and recognition. Healthy subjects were scanned both while they memorized photographs of buildings and landscapes and while they tried to recognize these pictures in a seri...

  17. Quantitative EEG and medial temporal lobe atrophy in Alzheimer's dementia: Preliminary study

    OpenAIRE

    Soo-Ji Lee; Min-Ho Park; Sang-Soon Park; Jin-Young Ahn; Jae-Hyeok Heo

    2015-01-01

    Backgrounds: The electroencephalogram (EEG) abnormalities in Alzheimer′s disease (AD) have been widely reported, and medial temporal lobe atrophy (MTLA) is one of the hallmarks in early stage of AD. We aimed to assess the relationship between EEG abnormalities and MTLA and its clinical validity. Materials and Methods: A total of 18 patients with AD were recruited (the mean age: 77.83 years). Baseline EEGs were analyzed with quantitative spectral analysis. MTLA was assessed by a T1-axial visua...

  18. A pavlovian model of the amygdala and its influence within the medial temporal lobe

    OpenAIRE

    Maxime Carrere; Frederic Alexandre

    2015-01-01

    Recent advances in neuroscience give us a better view of the inner structure of the amygdala, of its relations with other regions in the Medial Temporal Lobe (MTL) and of the prominent role of neuromodulation. They have particularly shed light on two kinds of neurons in the basal nucleus of the amygdala, the so-called fear neurons and extinction neurons. Fear neurons mediate context-dependent fear by receiving contextual information from the hippocampus, whereas extinctio...

  19. A pavlovian model of the amygdala and its influence within the medial temporal lobe

    OpenAIRE

    Carrere, Maxime; Alexandre, Frédéric

    2015-01-01

    Recent advances in neuroscience give us a better view of the inner structure of the amygdala, of its relations with other regions in the Medial Temporal Lobe (MTL) and of the prominent role of neuromodulation. They have particularly shed light on two kinds of neurons in the basal nucleus of the amygdala, the so-called fear neurons and extinction neurons. Fear neurons mediate context-dependent fear by receiving contextual information from the hippocampus, whereas extinction neurons are linked ...

  20. Pathology of temporal lobe epilepsy : An analysis of 100 consecutive surgical specimens from patients with medically refractory epilepsy.

    Directory of Open Access Journals (Sweden)

    Radhakrishnan V

    1999-07-01

    Full Text Available The neuropathological features of temporal lobe epilepsy were studied utilising 100 consecutive surgical specimens from patients with medically refractory complex partial seizures. A wide spectrum of neuropathological changes was recorded in 98 specimens. Fifty-eight specimens showed features of Ammon′s horn sclerosis. Diffuse accumulation of corpora amylacea were demonstrated in the resected temporal lobes from 54 patients. Six patients had neoplastic lesions of temporal lobe. One unique case of dysembryoplastic neuroepithelial tumour showed a melanotic component within the tumour. The neuropathological features were regarded as nonspecific in 31% of cases. Our results indicate that a majority of patients with medically intractable epilepsy of temporal lobe origin reveal significant neuropathological features. Careful documentation of the neuropathological features and its correlation with radiological, electrophysiological and pre- and post-surgical clinical features will help in predicting the seizure outcome after temporal lobectomy for medically refractory epilepsy.

  1. Effects of medial temporal lobe degeneration on brain perfusion in amnestic MCI of AD type: deafferentation and functional compensation?

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR CNRS 6612, Faculte de Medecine, Marseille (France); Barbeau, Emmanuel J. [CNRS - Universite Paul Sabatier Toulouse 3, Centre de Recherche Cerveau et Cognition, UMR-5549, Toulouse (France); Didic, Mira; Poncet, Michel; Ceccaldi, Mathieu [CHU Timone, Service de Neurologie et de Neuropsychologie, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Felician, Olivier [CHU Timone, Service de Neurologie et de Neuropsychologie, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Centre Saint-Charles, Laboratoire de Neurobiologie Integrative et Adaptative, UMR CNRS 6149, Marseille (France); Laforte, Catherine de; Mundler, Olivier [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France); Ranjeva, Jean-Philippe; Cozzone, Patrick J. [Universite de la Mediterranee Aix-Marseille II, Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR CNRS 6612, Faculte de Medecine, Marseille (France)

    2009-07-15

    Cortical atrophy is correlated with the progression of neuropathological lesions within the medial temporal lobes (MTL) in Alzheimer's disease (AD). Our aim was to determine which local and remote functional changes result from MTL volume loss at the predementia stage. We studied the relationship between entorhinal and hippocampal MR volumes and whole-brain SPECT perfusion via a voxel-based correlative analysis in 19 patients with amnestic mild cognitive impairment with a memory profile suggestive of early AD. Right MTL volumes were positively correlated with remote posterior perfusion of the posterior cingulate cortex, and negatively correlated with remote anterior perfusion of the right medial and dorsolateral prefrontal cortex. There was no local correlation between volumes and perfusion within the MTL. These findings provide further insight into functional changes that result from MTL volume loss during the predementia stage of AD. The positive correlation between MTL volumes and posterior cingulate perfusion may reflect the deafferentation of a temporocingulate network due to mediotemporal degeneration. The paradoxical negative correlation between MTL volumes and prefrontal perfusion may result from recruitment of an alternative anterior temporofrontal network. It remains to be investigated how the ''net sum'' of this perfusion modulation affects memory and other cognitive domains through a possible compensatory perspective. (orig.)

  2. Effects of prior exposure on music liking and recognition in patients with temporal lobe lesions.

    Science.gov (United States)

    Samson, Séverine; Peretz, Isabelle

    2005-12-01

    Prior exposure to music typically increases liking. This manifestation of implicit memory can be dissociated from explicit memory recognition. To examine the contribution of the medial temporal lobe to musical preference and recognition, we tested patients with either left (LTL) or right (RTL) temporal lobe lesions as well as normal control (NC) participants using the procedure of Peretz et al. The results in the affect task showed that NC and LTL participants preferred the studied over nonstudied melodies, thereby demonstrating an implicit exposure effect on liking judgments, whereas RTL patients failed to exhibit this effect. Explicit recognition was impaired in both LTL and RTL patients as compared to NC participants. On the basis of these findings, we suggest that RTL structures play a critical role in the formation of melody representations that support both priming and memory recognition, whereas LTL structures are more involved in the explicit retrieval of melodies. Furthermore, we were able to test an amnesic patient (PC) with bilateral lesions of the temporal lobe. In this case, the exposure effect on liking was also absent. However, repeated exposure to melodies was found to enhance both liking and recognition judgments. This remarkable sparing of memory observed through melody repetition suggests that extensive exposure may assist both implicit and explicit memory in the presence of global amnesia. PMID:16597796

  3. Emotion recognition and social cognition in temporal lobe epilepsy and the effect of epilepsy surgery.

    Science.gov (United States)

    Amlerova, Jana; Cavanna, Andrea E; Bradac, Ondrej; Javurkova, Alena; Raudenska, Jaroslava; Marusic, Petr

    2014-07-01

    The abilities to identify facial expression from another person's face and to attribute mental states to others refer to preserved function of the temporal lobes. In the present study, we set out to evaluate emotion recognition and social cognition in presurgical and postsurgical patients with unilateral refractory temporal lobe epilepsy (TLE). The aim of our study was to investigate the effects of TLE surgery and to identify the main risk factors for impairment in these functions. We recruited 30 patients with TLE for longitudinal data analysis (14 with right-sided and 16 with left-sided TLE) and 74 patients for cross-sectional data analysis (37 with right-sided and 37 with left-sided TLE) plus 20 healthy controls. Besides standard neuropsychological assessment, we administered an analog of the Ekman and Friesen test and the Faux Pas Test to assess emotion recognition and social cognition, respectively. Both emotion recognition and social cognition were impaired in the group of patients with TLE, irrespective of the focus side, compared with healthy controls. The performance in both tests was strongly dependent on the intelligence level. Beyond intelligence level, earlier age at epilepsy onset, longer disease duration, and history of early childhood brain injury predicted social cognition problems in patients with TLE. Epilepsy surgery within the temporal lobe seems to have neutral effect on patients' performances in both domains. However, there are a few individual patients who appear to be at risk of postoperative decline, even when seizure freedom is achieved following epilepsy surgery. PMID:24892754

  4. Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging

    International Nuclear Information System (INIS)

    The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal degeneration. In 17 of the 34 patients, MR images were also analyzed after selective amygdalo-hippocampectomy. Atrophy of the fornix, mamillary body, mamillothalamic tract (MTT), and thalamus ipsilateral to the epileptic focus was demonstrated on MR images in 14.7, 17.6, 8.8, and 11.8% of the 34 patients, respectively. Focal hyperintensity of the thalamus was found on T2-weighted images in 8.8% of the 34 patients. In 17 patients who were evaluated before and after surgery, transneuronal degeneration was seen more frequently after surgery: fornix (11.8 vs 29.4%), mamillary body (11.8 vs 52.9%), MTT (5.9 vs 11.8%), and thalamus (11.8 vs 11.8%). Transneuronal degeneration of the limbic system is clearly demonstrated by MR imaging in patients with temporal lobe epilepsy, and surgical intervention induces transneuronal degeneration more frequently. (orig.)

  5. Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kodama, Fumiko; Ogawa, Toshihide; Sugihara, Shuji; Kamba, Masayuki; Kinoshita, Toshibumi [Department of Radiology, Faculty of Medicine' ' Tottori University, 36-1 Nishi-cho, 683-8504, Yonago, Tottori (Japan); Kohaya, Norimasa; Kondo, Shinji [Department of Neurosurgery, Faculty of Medicine' ' Tottori University, 36-1 Nishi-cho, 683-8504, Yonago, Tottori (Japan)

    2003-09-01

    The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal degeneration. In 17 of the 34 patients, MR images were also analyzed after selective amygdalo-hippocampectomy. Atrophy of the fornix, mamillary body, mamillothalamic tract (MTT), and thalamus ipsilateral to the epileptic focus was demonstrated on MR images in 14.7, 17.6, 8.8, and 11.8% of the 34 patients, respectively. Focal hyperintensity of the thalamus was found on T2-weighted images in 8.8% of the 34 patients. In 17 patients who were evaluated before and after surgery, transneuronal degeneration was seen more frequently after surgery: fornix (11.8 vs 29.4%), mamillary body (11.8 vs 52.9%), MTT (5.9 vs 11.8%), and thalamus (11.8 vs 11.8%). Transneuronal degeneration of the limbic system is clearly demonstrated by MR imaging in patients with temporal lobe epilepsy, and surgical intervention induces transneuronal degeneration more frequently. (orig.)

  6. Aircraft noise exposure affects rat behavior, plasma norepinephrine levels, and cell morphology of the temporal lobe

    Institute of Scientific and Technical Information of China (English)

    Guo-qing DI; Bing ZHOU; Zheng-guang; LI, Qi-li LIN

    2011-01-01

    In order to investigate the physiological effects of airport noise exposure on organisms,in this study,we exposed Sprague-Dawley rats in soundproof chambers to previously recorded aircraft-related noise for 65 d.For comparison,we also used unexposed control rats.Noise was arranged according to aircraft flight schedules and was adjusted to its weighted equivalent continuous perceived noise levels (LwEcPN) of 75 and 80 dB for the two experimental groups.We examined rat behaviors through an open field test and measured the concentrations of plasma norepinephrine (NE) by high performance liquid chromatography-fluorimetric detection (HPLC-FLD).We also examined the morphologies of neurons and synapses in the temporal lobe by transmission electron microscopy (TEM).Our results showed that rats exposed to airport noise of 80 dB had significantly lower line crossing number (P<0.05) and significantly longer center area duration (P<0.05) than control animals.After 29 d of airport noise exposure,the concentration of plasma NE of exposed rats was significantly higher than that of the control group (P<0.05).We also determined that the neuron and synapsis of the temporal lobe of rats showed signs of damage after aircraft noise of 80 dB exposure for 65 d.In conclusion,exposing rats to long-term aircraft noise affects their behaviors,plasma NE levels,and cell morphology of the temporal lobe.

  7. Affectivity and Subjective Memory in Patients with Intractable Medial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Marilyn Zaldivar Bermúdez

    2014-12-01

    Full Text Available Background: in the literature related to intractable medial temporal lobe epilepsy, some divergence is observed in terms of the factors that may be leading to memory complaints in patients with this condition. Objective: to identify the relationship between some manifestations of affectivity and subjective memory in patients with intractable medial temporal lobe epilepsy. Methods: a case series study was conducted in 32 patients aged 15 to 60 years treated at the International Center for Neurological Restoration from January 2008 through September 2011. The State-Trait Anxiety Inventory, State-Trait Depression Inventory and Questionnaire of Memory Efficiency were applied. The variables studied were anxiety, depression and subjective memory. Descriptive statistics and the Spearman correlation were used to process the data. Results: a prevalence of mean levels of state-trait anxiety and state depression was observed; however, trait depression reached high levels. Patients reported complaints about their memory functioning. A negative relationship between trait depression and subjective memory (r = -0.36, p <0.05 was obtained.Conclusion: some manifestations of affectivity (anxiety and depression, subjective memory impairment regardless of the lateralization of the ictal onset zone, and the relationship between trait depression and subjective memory were observed in patients with intractable medial temporal lobe epilepsy.

  8. Evaluation of seizure propagation on ictal brain SPECT using statistical parametric mapping in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Ictal brain SPECT has a high diagnostic sensitivity exceeding 90 % in the localization of seizure focus, however, it often shows increased uptake within the extratemporal areas due to early propagation of seizure discharge. This study aimed to evaluate seizure propagation on ictal brian SPECT in patients with temporal lobe epilepsy (TLE) by statistical parametric mapping (SPM). Twenty-one patients (age 27.14 5.79 y) with temporal lobe epilepsy (right in 8, left in 13) who had successful seizure outcome after surgery and nine normal control were included. The data of ictal and interictal brain SPECT of the patients and baseline SPECT of normal control group were analyzed using automatic image registration and SPM96 softwares. The statistical analysis was performed to compare the mean SPECT image of normal group with individual ictal SPECT, and each mean image of the interictal groups of the right or left TLE with individual ictal scans. The t statistic SPM [t] was transformed to SPM [Z] with a threshold of 1.64. The statistical results were displayed and rendered on the reference 3 dimensional MRI images with P value of 0.05 and uncorrected extent threshold p value of 0.5 for SPM [Z]. SPM data demonstrated increased uptake within the epileptic lesion in 19 patients (90.4 %), among them, localized increased uptake confined to the epileptogenic lesion was seen in only 4 (19%) but 15 patients (71.4%) showed hyperperfusion within propagation sites. Bi-temporal hyperperfusion was observed in 11 out of 19 patients (57.9%, 5 in the right and 6 in the left); higher uptake within the lesion than contralateral side in 9, similar activity in 1 and higher uptake within contralateral lobe in one. Extra-temporal hyperperfusion was observed in 8 (2 in the right, 3 in the left, 3 in bilateral); unilateral hyperperfusion within the epileptogenic temporal lobe and extra-temporal area in 4, bi-temporal with extra-temporal hyperperfusion in remaining 4. Ictal brain SPECT is highly

  9. High-field magnetic resonance imaging of the human temporal lobe

    Directory of Open Access Journals (Sweden)

    Luis M. Colon-Perez

    2015-01-01

    Conclusions: Fresh ex vivo MR imaging, along with tractography, revealed complex intra-temporal structural variation corresponding to neuronal cell body layers, dendritic fields, and axonal projection systems evident histologically. This is the first study to describe in detail the human temporal lobe structural organization using high-field MR imaging and tractography. By preserving the 3-dimensional structures of the hippocampus and surrounding structures, specific changes in anatomy may inform us about the changes that occur in TLE in relation to the disease process and structural underpinnings in epilepsy-related memory dysfunction.

  10. Effects of selective neonatal temporal lobe lesions on socioemotional behavior in infant rhesus monkeys (Macaca mulatta).

    Science.gov (United States)

    Bachevalier, J; Málková, L; Mishkin, M

    2001-06-01

    Normal infant monkeys and infant monkeys with neonatal damage to either the medial temporal lobe or the inferior temporal visual area were assessed in dyadic social interactions at 2 and 6 months of age. Unlike the normal infant monkeys, which developed strong affiliative bonds and little or no behavioral disturbances, the lesioned monkeys (each of which was observed with an unoperated control) exhibited socioemotional abnormalities and aberrant behaviors. The socioemotional changes predominated at 6 months of age and were particularly severe in monkeys with medial temporal lesions. In both the pattern and time course, the socioemotional deficits produced by the neonatal medial temporal lesions bear a striking resemblance to the behavioral syndrome in children with autism. Further analysis of these lesion-induced abnormalities in nonhuman primates may therefore provide insight into this debilitating human developmental disorder. PMID:11439445

  11. Clinical value of scatter correction for interictal brain 99m Tc-HMPAO SPECT in mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Aim: It is well known that some patients with temporal lobe epilepsy (TLE) show normal perfusion during interictal SPECT study. The aim of this research was to evaluate if the scatter radiation has some influence on this kind of result. Materials and Methods: We studied 15 patients with TLE by clinical diagnosis and by video-EEG monitoring with surface electrodes (11 left TLE, 4 right TLE), which showed normal perfusion during interictal brain 99mTc-HMPAO SPECT. The SPECT data were reconstructed by filtered backprojection without scatter correction (A). The same SPECT data were reconstructed after the projections were corrected by dual energy window method of scatter correction (B). Attenuation was corrected in all cases using first order Chang Method. For A and B images groups, cerebellum perfusion ratios were calculated on irregular regions of interest (ROI) drawn on anterior (ATL), lateral (LTL), mesial (MTL) and whole temporal lobe (WTL). To evaluate the influence of scatter radiation, the cerebellum perfusion ratios of each subject were compared with a normal database of 10 normal subjects, with and without scatter correction, using z-score analysis. Results: In group A, the z-score was less than 2 in all cases. In group B, the z-score was more than 2 in 6 cases, 4 in MTL (3 left, 1 right) and 2 in left LTL, which were coincident with the EEG localization. All images of group B showed better contrast than images of group A. Conclusions: These results suggest that scatter correction could improve the sensitivity of interictal brain SPECT to identify epileptic focus in patients with TLE

  12. Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Wu; Wang, Xiaoyi; Xie, Fangfang; Liao, Weihua [Dept. of Radiology, Xiangya Hospital of Central South Univ., Changsha (China)], e-mail: doctoring@sina.com

    2013-02-15

    Background: Accurately locatithe epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were pared between the two groups. Results: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 {+-} 0.32, right 1.57 {+-} 0.28) or rCBF (left 99.00 {+-} 24.61, right 100.38 {+-} 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 {+-} 0.64 and 96.35 {+-} 22.63, respectively) were markedly lower than those of the contralateral side (2.01 {+-} 0.79 and 108.56 {+-} 26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03 {+-} 10.33) and the AI of the rCBF (AIrCBF; 11.24 {+-} 8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55 {+-} 3.74, AIrCBF 5.12 {+-} 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion: In

  13. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    International Nuclear Information System (INIS)

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  14. Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Eliane; Guerreiro, Carlos A.M.; Cendes, Fernando [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas. Dept. de Neurologia]. E-mail: fcendes@unicamp.br

    2001-06-01

    The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with al bendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T 2 signal in this patient has not, to date, been associated with a poor seizure control. Conclusions: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE. (author)

  15. Application of own computer program for assessment of brain-fluid index in the medial temporal lobe portions in patients with drug-resistant temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Background: Epilepsy resistant to pharmacological treatment still remains one of the main problems in contemporary epileptology. The problem most frequently concerns patients with focal epilepsy, with the seizure focus possible to localize. In case of drug-resistant epilepsy, both morphological imaging methods (MR) and manual measurements or volumetry are used. Also functional studies, such as MRS (magnetic resonance spectroscopy), fMRI (functional magnetic resonance), SPECT (single photon emission tomography) and PET (positron emission tomography) are performed. Material/Methods: The study presents application of own computer program based on the method of segmentation of the cerebrospinal fluid (CSF) and the brain tissue. The program calculates automatically the brain-fluin index in the hippocampal region. The material comprises the brain-fluin index results calculated with the presented program in comparison with the method of manual delineation in a group of 50 patients with drug-resistant temporal lobe epilepsy. The program is easy to use, it reads the MR data recorded in DICOM installed on a PC. Results: The brain-fluin index result (expressed as a decimal fraction) is calculated on the basis of 4 consecutive layers examined by MR (evaluating hippocampal structures) performed using SE sequence, and T2-weighted imaging in the frontal plane perpendicular to the long axis of the temporal lobes. The results obtained in epilepsy patients were compared with 24 control subjects. Conclusions: Detailed analysis of the obtained data allowed to conclude that precise hippocampal volume assessment can be obtained by combination of both methods, i.e. manual delineation and automatic calculation of brain-fluin index taking into consideration the total volume of cerebral structures. (authors)

  16. Differentiation of cryptogenic lateral from mesial temporal lobe epilepsy using regional asymmetric index of F-18-FDG PET

    International Nuclear Information System (INIS)

    We tried to find the possibility of utilization of F-18-FDG PET to differentiate lateral (neocortical) from mesial temporal lobe epilepsy(TLE) if we adopted quantitative comparison of regional metabolic activities using asymmetric index. We studied 22 pathologically proven mesial TLE(group C in Figure), and 27 lateral TLE patients. Lateral TLE patients were normal on MR(cryptogenic: 15; group A) or had structural lesions (12: group B). Asymmetric index (AI) was calculated as (ipsilateral -contralateral) / (ipsilateral + contralateral ) x 200. AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, > 0.05) and AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, >0.05) and AI of lateral lobe was decreased (-13.68.9). AI of medial and lateral lobes of mesial TLE was decreased (-3.44.7 and -16.58.9, respectively). AI of medial lobe of lesional lateral TLE was -7.39.1 (p<0.05 compared with mesial TEL). It was evident that lateral lobe of lesional lateral TLE had metabolic defect or decrease (AI: -21.410.4). While we could not find difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by AI quantitation. An AI value larger than -10 (cutoff: AI) predicted positively for lateral TLE(PPV:80%) and negatively for mesial TLE(NPV:77%). Asymmetry of metabolic activity in medial and not in lateral lobe of temporal lobe could give hints about whether the epileptogenic zones were mesial or lateral

  17. Endoscope-assisted supracerebellar transtentorial approach to the posterior medial temporal lobe for resection of cavernous malformation.

    Science.gov (United States)

    Kalani, M Yashar S; Lei, Ting; Martirosyan, Nikolay L; Oppenlander, Mark E; Spetzler, Robert F; Nakaji, Peter

    2016-01-01

    The mesial temporal lobe can be approached via a pterional or orbitozygomatic craniotomy, the subtemporal approach, or transcortically. Alternatively, the entire mesial temporal lobe can be accessed using a lateral supracerebellar transtentorial (SCTT) approach. Here we describe the technical nuances of patient positioning, craniotomy, supracerebellar dissection, and tentorial disconnection to traverse the tentorial incisura to arrive at the posterior mesial temporal lobe for a cavernous malformation. The SCTT approach is especially useful for lesions in the dominant temporal lobe where an anterolateral approach may endanger language centers or the vein of Labbé. The video can be found here: https://youtu.be/D8mIR5yeiVw . PMID:26722685

  18. Abnormality of cerebral cortical glucose metabolism in temporal lobe epilepsy with cognitive function impairment

    International Nuclear Information System (INIS)

    Objective: People with epilepsy commonly report having problems with their memory. Many indicate that memory difficulties significantly hinder their functioning at work, in school, and at home. Besides, some studies have reported that memory performance as a prognostic factor is of most value in patients with risk of refractory epilepsy and when used in a multidisciplinary setting. However, the cerebral cortical areas involving memory impairment in epilepsy is still unknown. The purpose of this study was to access changes of cerebral glucose metabolism of epilepsy patients using [F-18] fluorodeoxyglucose positron emission tomography (FDG PET). Method: Nine temporal lobe epilepsy patients were studied. Each patient was confirmed with lesions in right mesial temporal lobe by MRI, PET and EEG. Serial cognition function tests were performed. Regional cerebral glucose metabolism (rCMRglc) was measured by PET at 45 minutes after injection of 370 MBq of FDG. Parametric images were generated by grand mean scaling each scan to 50. The images were then transformed into standard stereotactic space. Statistical parametric mapping (SPM2) was applied to find the correlations between verbal memory, figure memory, perception intelligent quotation (PIQ) and rCMRglc in epilepsy patients. The changes of rCMRglc were significant if corrected p value was less than 0.05. Results: There was no significant relationship between figure memory score and verbal memory score. FDG-PET scan showed changes of rCMRglc positive related with verbal memory score in precentral gyms of right frontal lobe (Brodmann area 4, corrected p < 0.001, voxel size 240) and cingulated gyms of right limbic lobe (Brodmann area 32, corrected p=0.002, voxel size 143). No negative relationship was demonstrable between verbal memory and rCMRglc in this study. Besides, significanfiy positive correlation between figure memory was shown in cuneus of right occipital lobe (Brodmann area 18, corrected p < 0.001, voxel size

  19. Measuring the volume of temporal lobe in healthy Chinese adults of the Han nationality on the high-resolution MRI

    International Nuclear Information System (INIS)

    Objective: To explore the morphological features of temporal lobe of healthy Chinese Han adults on the high-resolution MRI and provide morphological data of temporal lobe for the construction of database for Chinese Standard Brain. Methods: This is a clinical multi-center study. Three hundred healthy Chinese volunteers (male 150, and female 150) recruited from 15 hospitals were divided equally into five groups according to their age, i.e., 18-30 (Group A), 31-40 (Group B), 41-50 (Group C), 51- 60(Group D), 61-70(Group E). All subjects were scanned using T1WI 3D MPRAGE sequence and volumes of standardized temporal lobe were collected. The bilateral volumes of standardized temporal lobe were compared by variance analysis between male and female subjects and among five age groups. Results: The mean volumes of left and right temporal lobe were (97 126±15 703) mm3 and (97 015 ± 15 545) mm3 respectively for men, and (95 123 ± 14 564) mm3 and (96 423 ± 13 407) mm3 for women. The difference temporal lobe volume between male and female wasn't significant on the same side (F=1.336, 0.127, P= 0.249, 0.722). The left temporal lobe volumes of Group A-E were (93 873±13 351), (95 566± 11 964), (10 1890 ± 14 511), (93 972 ± 14 050) and (95 636 ± 19 864) mm3 respectively, and those on the right side were (93 409 ± 10 984), (98 158 ± 16 392), (102 079 ± 15 112), (95 448 ± 11 123) and (94 658 ± 16 928) mm3. There were significant differences among 5 groups between left and right temporal lobe volume(F=2.940, 3.514, P=0.021, 0.008). Further pairwise comparison revealed that left and right temporal lobe volume in Group C is higher than those of Group A and D (P0.05). Conclusion: High-resolution MRI could offer detailed images and precise morphological data of temporal lobe, which provides morphological data of temporal lobe for the construction of database for Chinese Standard Brain. (authors)

  20. Absence seizures associated with panic attacks initially misdiagnosed as temporal lobe epilepsy: the importance of prolonged EEG monitoring in diagnosis.

    OpenAIRE

    McNamara, M E

    1993-01-01

    While temporal lobe epilepsy is often considered in the differential diagnosis of patients with anxiety or panic disorders, other types of epilepsy can confound the presentation or treatment of adults with panic disorders. The cases of two patients are presented who were initially thought to have temporal lobe epilepsy producing panic attacks, but who were subsequently found to have primary generalized seizures. The clinical implications are discussed.

  1. Association between serotonin transporter gene polymorphisms and non-lesional temporal lobe epilepsy in a Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    Fengyuan Che; Youyi Wei; Xueyuan Heng; Qingxi Fu; Jianzhang Jiang

    2010-01-01

    Serotonin(5-hydroxytryptamine,5-HT)influences the cortical and subcortical excitatory/inhibitory balance and participates in the pathophysiological processes of epilepsy.The serotonin transporter(5-HTT)is the most important factor in serotonin inactivation.We tested whether 5-HTT polymorphisms are involved in the pathogenesis of epilepsy in Chinese Han population.We did not find a significant difference in the frequencies of genotypes and alleles in the 5-HTT gene-linked polymorphic region(5-HTTLPR)in patients with non-lesional temporal lobe epilepsy and normal controls(P > 0.05).Frequencies of the 5-HTT intren 2 variable number tandem repeat(5-HTTVNTR)12/12 genotype and allele 12 were higher in the patients with non-lesional temporal lobe epilepsy than normal controls(P < 0.01).The odds ratio of affecting non-lesional temporal lobe epilepsy was1.435(95% Cl,1.096 1.880)in patients carrying allele 12(P < 0.05).Although the 5-HTFLPR may not be a genetic locus of non-lesional temporal lobe epilepsy in Chinese Han population,allele 12 in the 5-HTFVNTR may correlate with non-lesional temporal lobe epilepsy.The Stin2.12 allele and12/12 genotype could be predisposing to non-lesional temporal lobe epilepsy.

  2. Resection of the medial temporal lobe disconnects the rostral superior temporal gyrus from some of its projection targets in the frontal lobe and thalamus.

    Science.gov (United States)

    Muñoz, Monica; Mishkin, Mortimer; Saunders, Richard C

    2009-09-01

    Auditory memory in the monkey does not appear to extend beyond the limits of working memory. It is therefore surprising that this ability is impaired by medial temporal lobe (MTL) resections, because such lesions spare working memory in other sensory modalities. To determine whether MTL ablations might have caused the auditory deficit through inadvertent transection of superior temporal gyrus (STG) projections to its downstream targets, and, if so, which targets might have been compromised, we injected anterograde tracer (biotinylated dextran amine) in the STG of both the normal and MTL-lesioned hemispheres of split-brain monkeys. Interhemispheric comparison of label failed to show any effect of the MTL ablation on efferents from caudal STG, which projects to the inferior prefrontal convexity. However, the ablation did consistently interrupt the normally dense projections from rostral STG to both the ventral medial prefrontal cortex and medial thalamic nuclei. The findings support the possibility that the auditory working memory deficit after MTL ablation is due to transection of downstream auditory projections, and indicate that the candidate structures for mediating auditory working memory are the ventral medial prefrontal cortical areas, the medial thalamus, or both. PMID:19150921

  3. Computer aided diagnosis and localization of lateralized temporal lobe epilepsy using interictal FDG-PET

    Directory of Open Access Journals (Sweden)

    WesleyThomasKerr

    2013-04-01

    Full Text Available Interictal FDG-PET (iPET is a core tool for localizing the epileptogenic focus, potentially before structural MRI, that does not require rare and transient epileptiform discharges or seizures on EEG. The visual interpretation of iPET is challenging and requires years of epilepsy-specific expertise. We have developed an automated computer-aided diagnostic (CAD tool that has the potential to work both independent of and synergistically with expert analysis. Our tool operates on distributed metabolic changes across the whole brain measured by iPET to both diagnose and lateralize temporal lobe epilepsy. When diagnosing left temporal lobe epilepsy (LTLE or right TLE (RTLE versus non-epileptic seizures (NES, our accuracy in reproducing the results of the gold standard long term video-EEG monitoring was 82% (95% confidence interval [CI] 69-90% or 88% (95% CI 76-94%, respectively. The classifier that both diagnosed and lateralized the disease had overall accuracy of 76% (95% CI 66-84%, where 89% (95% CI 77-96% of patients correctly identified with epilepsy were correctly lateralized. When identifying LTLE, our CAD tool utilized metabolic changes across the entire brain. By contrast, only temporal regions and the right frontal lobe cortex, were needed to identify RTLE accurately, a finding consistent with clinical observations and indicative of a potential pathophysiological difference between RTLE and LTLE. The goal of CADs is to complement—not replace—expert analysis. In our dataset, the accuracy of manual analysis of iPET (~80% was similar to CAD. The square correlation between our CAD tool and manual analysis, however, was only 30%, indicating that our CAD tool does not recreate manual analysis. The addition of clinical information to our CAD, however, did not substantively change performance. These results suggest that automated analysis might provide clinically valuable information to focus treatment more effectively.

  4. Serious adverse effects of gamma knife radiosurgery for mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Gamma knife radiosurgery (GKRS) for mesial temporal lobe epilepsy (MTLE) has been proposed as an alternative to surgical resection. We report serious adverse effects of the treatment after follow-up periods over 9 years in 11 patients treated with GKRS between 1997 and 2000. The target volume of the entorhinoamygdalohippocampectomy area was 4.8-17.1 ml. Marginal dose of 20-25 Gy to the 50% isodose was delivered. One patient was drowned after suffering seizure 7 months after GKRS. Two patients did not show any reduction in seizure frequency over 9 and 18 months. Both patients requested open surgery and became seizure-free postoperatively. Four of the other eight patients were classified as Engel's class I within 4 years after GKRS. One of the four patients experienced symptomatic radiation-induced cerebral edema transiently, one developed radiation necrosis and required surgery 5 years after GKRS, and one developed cognitive impairment with hemiparesis 10 years after GKRS. Magnetic resonance (MR) imaging showed a large cyst in the irradiated temporal lobe. This patient recovered fully after the cyst excision. Only one patient became seizure-free and antiepileptic drug-free without symptomatic radiation-induced complications. However, MR imaging revealed abnormal enhancement, cyst formation, and diffuse white matter change in the irradiated temporal lobe 9 years after GKRS. GKRS for MTLE causes adverse effects of delayed seizure remission and symptomatic radiation-induced complications. Therefore, GKRS cannot be considered as an ideal alternative to surgery for MTLE. Long-term follow-up studies including MR imaging with contrast medium are required for the patients even after successful control of seizures. (author)

  5. Can FDG PET predict verbal specific memory decline after surgery for left temporal lobe epilepsy when MRI is normal?

    International Nuclear Information System (INIS)

    Full text: Temporal lobectomy gives excellent control of seizures in over 80% of patients with temporal lobe epilepsy. The left temporal lobe, particularly the left hippocampus, is primarily responsible for verbal memory. In most patients, the hippocampus which lies in the medial temporal lobe is abnormal and can be removed without loss of memory function. However, removal of the left hippocampus when it appears normal on MRI, often causes a significant decline in verbal specific memory (VSM) function. This paper explores the significance of pre-operative FDG-PET asymmetry in temporal lobe metabolism in predicting the VSM outcome after left temporal lobectomy when MRI demonstrates a normal hippocampus. Fifteen patients between 1993 and 2000, underwent left temporal lobectomy including left hippocampal resection, Pre-operatively all patients underwent 1.5T MRI, FDG PET and neuropsychological assessment. Neuropsychological assessment was repeated post-operatively. The left hippocampus was normal on MRI in nine and demonstrated mild T2 signal change without atrophy in six. FDG PET demonstrated temporal lobe hypometabolism in 12 patients. Post-operatively, neuropsychological evaluation documented a decline in verbal specific memory function in six patients, three with normal MRI and three with mild T2 change. We found that all patients with normal FDG PET studies (n=3) demonstrated significant verbal memory deterioration post-operatively. Nine of twelve patients (75%) with left temporal lobe hypometabolism did not show new verbal memory deficits. FDG PET improves the risk stratification for verbal specific memory decline with left temporal lobectomy in patients with normal hippocampi on MRI. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  6. Enhanced expression of potassium-chloride cotransporter KCC2 in human temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Karlócai, Mária R; Wittner, Lucia; Tóth, Kinga;

    2016-01-01

    volume. Using immunocytochemistry, we examined the cellular and subcellular levels of KCC2 in surgically removed hippocampi of temporal lobe epilepsy (TLE) patients and compared them to control human tissue. We also studied the distribution of KCC2 in a pilocarpine mouse model of epilepsy. An overall...... increase in KCC2-expression was found in epilepsy and confirmed by Western blots. The cellular and subcellular distributions in control mouse and human samples were largely similar; moreover, changes affecting KCC2-expression were also alike in chronic epileptic human and mouse hippocampi. At the...

  7. Fractionated Stereotactic Gamma Knife Radiosurgery for Medial Temporal Lobe Epilepsy: A Case Report.

    Science.gov (United States)

    Park, Hye Ran; Chung, Hyun-Tai; Lee, Sang Kun; Kim, Dong Gyu; Paek, Sun Ha

    2016-04-01

    An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm(3); total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE. PMID:27122996

  8. Aberrant Wnt signaling pathway in medial temporal lobe structures of Alzheimer's disease

    DEFF Research Database (Denmark)

    Riise, Jesper; Plath, Niels; Pakkenberg, Bente;

    2015-01-01

    hippocampus exhibiting most pronounced changes. Furthermore, the Wnt pathway constituents Wnt7b and Tcf7l1/Tcf3 showed overlapping gene expression alterations across both medial temporal lobe structures, while β-catenin was inversely expressed between brain regions. We also identified total protein......-targeted hyperphosphorylation at specific tau epitope in soluble pretangles and prominent tau aggregation exclusively in insoluble neurofibrillary tangles of AD subjects. The Wnt pathway-focused approach confirms altered Wnt signaling in the neurodegenerative AD brain and highlights the potential role of the pathway as a...

  9. Impact of expectation-maximization reconstruction iterations on the diagnosis of temporal lobe epilepsy with PET

    OpenAIRE

    Floberg, John M.; Struck, Aaron F; Peters, Brooke K; Jaskowiak, Christine J; Perlman, Scott B; Hall, Lance T

    2012-01-01

    There is a well known tradeoff between image noise and image sharpness that is dependent on the number of iterations performed in ordered subset expectation maximization (OSEM) reconstruction of PET data. We aim to evaluate the impact of this tradeoff on the sensitivity and specificity of 18F-FDG PET for the diagnosis of temporal lobe epilepsy. A retrospective blinded reader study was performed on two OSEM reconstructions, using either 2 or 5 iterations, of 32 18F-FDG PET studies acquired at ...

  10. The effects of age on functional specialization in the human medial temporal lobe

    DEFF Research Database (Denmark)

    Ramsøy, Thomas; Liptrot, Matthew; Skimminge, Arnold Jesper Møller;

    2009-01-01

    temporal lobe (MTL) have produced conflicting findings. Here, we report the results from a functional Magnetic Resonance Imaging (fMRI) study of the effect of age on functional specialization in the MTL region during intentional encoding and recognition of objects and positions. We applied a region of...... interest analysis in native space and corrected for the effects of gender and individual differences in cerebral blood flow. Behavioural results demonstrated that performance on both the object and position tasks declined equally with increasing age. Our fMRI results showed that during the encoding and...

  11. Savant-like skills exposed in normal people by suppressing the left fronto-temporal lobe.

    Science.gov (United States)

    Snyder, Allan W; Mulcahy, Elaine; Taylor, Janet L; Mitchell, D John; Sachdev, Perminder; Gandevia, Simon C

    2003-12-01

    The astonishing skills of savants have been suggested to be latent in everyone, but are not normally accessible without a rare form of brain impairment. We attempted to simulate such brain impairment in healthy people by directing low-frequency magnetic pulses into the left fronto-temporal lobe. Significant stylistic changes in drawing were facilitated by the magnetic pulses in four of our 11 participants. Some of these "facilitated" participants also displayed enhanced proofreading ability. Our conclusions are derived from 11 right-handed male university students, eight of whom underwent placebo stimulation. We examined performance before, during and after exposure to the stimulation. PMID:15011267

  12. Diagnosis and surgical treatment of temporal lobe epilepsy%颞叶癫痫的诊断和外科治疗

    Institute of Scientific and Technical Information of China (English)

    高翔; 江澄川; 史玉泉

    2001-01-01

    Objective To discuss the diagnosis and surgical treatment of temporal lobe epilepsy. Methods From 1996 to 1998, 36 patients presenting with medically intractable temporal lobe epilepsy were identified by EEG and MR, including volumetric MR, for hippocampal formation. Among them, 16 patients underwent anterior temporal lobectomy, while 20 patients accepted selective amygdalohippocampectomy. The results of surgical operation and follow-up are analyzed. Results With respect to seizure outcome, all patients benefited from surgery. The surgical results were satisfactory in 24 cases, notable in 11 cases, and good in 1 case, and there were no complications. Conclusion MR is beneficial for the localization of epileptic foci. Surgery is an effective method for the treatment of temporal lobe epilepsy; selective amygdalohippocampectomy is the first choice for medial temporal lobe epilepsy. The transzygmatic-temporal lobe base approach presented in this study improved the safety of the surgery.%目的探讨颞叶癫痫(TLE)的诊断和治疗方法。 方法 1996年至1998年,36例顽固性颞叶癫痫病例依据EEG和MR检查进行定位诊断,其中16例实施前颞叶切除术,另20例接受选择性海马杏仁切除术,分析其近期疗效及随访结果。 结果所有患者癫痫得到满意控制,其中手术疗效满意24例;显著11例;良好1例,术后无并发症发生。 结论 MR有助于对TLE的定位诊断;手术是治疗顽固性TLE的重要手段,颞叶内侧癫痫病例应选用选择性海马杏仁核切除,采用经颧弓颞底入路使手术更为安全。

  13. Comparison of rCBF between patients with medial temporal lobe epilepsy and normal controls using H215O PET

    International Nuclear Information System (INIS)

    The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using H215O-PET. 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was performed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Duirng the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal regions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal regions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Epilepsy induced changes were found not only in relative increase/ decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period

  14. Temporal lobe sulco-gyral pattern anomalies in schizophrenia: an in vivo MR three-dimensional surface rendering study.

    Science.gov (United States)

    Kikinis, R; Shenton, M E; Gerig, G; Hokama, H; Haimson, J; O'Donnell, B F; Wible, C G; McCarley, R W; Jolesz, F A

    1994-11-21

    Neuroanatomical and histological findings from post-mortem brains, as well as in vivo findings from magnetic resonance imaging (MRI) studies, suggest the presence of morphologic temporal lobe abnormalities in schizophrenia. To determine whether or not sulco-gyral pattern abnormalities in the temporal lobe could be detected in vivo, we applied computerized surface rendering techniques to MR data sets in order to make both qualitative and quantitative analyses of three-dimensional reconstructions of the temporal and frontal cortex in 15 schizophrenic patients and 15 normal controls. The qualitative analysis, based on a visual classification of the temporal lobe sulco-gyral pattern by 4 raters blind to diagnosis, showed that in schizophrenics there was a more vertical orientation to the sulci in the left temporal lobe, with an interrupted course of sulci due to gyri coursing across the sulci. Normal controls, in contrast, showed a more horizontal orientation with no interruptions. These findings were supported by the quantitative analysis, where more sulcal lines, representing an interrupted course of sulci, were observed in the temporal lobes (more pronounced on the left) in schizophrenics than in normal controls. These data suggest that some of the abnormalities observed in schizophrenia may have their origin in alterations occurring during the course of neurodevelopment when the sulco-gyral pattern is determined. PMID:7891892

  15. The Medial Temporal Lobe – Conduit of Parallel Connectivity: A model for Attention, Memory, and Perception.

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    Brian B. Mozaffari

    2014-11-01

    Full Text Available Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL – located deep in the hierarchy – serves as a bridge connecting supra to infra – MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL ‘bridge’ allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these ‘bridge’ predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC. In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

  16. Aircraft noise exposure affects rat behavior, plasma norepinephrine levels, and cell morphology of the temporal lobe.

    Science.gov (United States)

    Di, Guo-Qing; Zhou, Bing; Li, Zheng-Guang; Lin, Qi-Li

    2011-12-01

    In order to investigate the physiological effects of airport noise exposure on organisms, in this study, we exposed Sprague-Dawley rats in soundproof chambers to previously recorded aircraft-related noise for 65 d. For comparison, we also used unexposed control rats. Noise was arranged according to aircraft flight schedules and was adjusted to its weighted equivalent continuous perceived noise levels (L(WECPN)) of 75 and 80 dB for the two experimental groups. We examined rat behaviors through an open field test and measured the concentrations of plasma norepinephrine (NE) by high performance liquid chromatography-fluorimetric detection (HPLC-FLD). We also examined the morphologies of neurons and synapses in the temporal lobe by transmission electron microscopy (TEM). Our results showed that rats exposed to airport noise of 80 dB had significantly lower line crossing number (Paircraft noise of 80 dB exposure for 65 d. In conclusion, exposing rats to long-term aircraft noise affects their behaviors, plasma NE levels, and cell morphology of the temporal lobe. PMID:22135145

  17. Brain SPECT in mesial temporal lobe epilepsy: comparison between visual analysis and SPM (Statistical Parametric Mapping)

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    Amorim, Barbara Juarez; Ramos, Celso Dario; Santos, Allan Oliveira dos; Lima, Mariana da Cunha Lopes de; Camargo, Edwaldo Eduardo; Etchebehere, Elba Cristina Sa de Camargo, E-mail: juarezbarbara@hotmail.co [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Radiology; Min, Li Li; Cendes, Fernando [State University of Campinas (UNICAMP), SP (Brazil). School of Medical Sciences. Dept. of Neurology

    2010-04-15

    Objective: to compare the accuracy of SPM and visual analysis of brain SPECT in patients with mesial temporal lobe epilepsy (MTLE). Method: interictal and ictal SPECTs of 22 patients with MTLE were performed. Visual analysis were performed in interictal (VISUAL(inter)) and ictal (VISUAL(ictal/inter)) studies. SPM analysis consisted of comparing interictal (SPM(inter)) and ictal SPECTs (SPM(ictal)) of each patient to control group and by comparing perfusion of temporal lobes in ictal and interictal studies among themselves (SPM(ictal/inter)). Results: for detection of the epileptogenic focus, the sensitivities were as follows: VISUAL(inter)=68%; VISUAL(ictal/inter)=100%; SPM(inter)=45%; SPM(ictal)=64% and SPM(ictal/inter)=77%. SPM was able to detect more areas of hyperperfusion and hypoperfusion. Conclusion: SPM did not improve the sensitivity to detect epileptogenic focus. However, SPM detected different regions of hypoperfusion and hyperperfusion and is therefore a helpful tool for better understand pathophysiology of seizures in MTLE. (author)

  18. Anterior temporal face patches: A meta-analysis and empirical study

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    Rebecca J. Von Der Heide

    2013-02-01

    Full Text Available Studies of nonhuman primates have reported face sensitive patches in the ventral anterior temporal lobes (ATL. In humans, ATL resection or damage causes an associative prosopagnosia in which face perception is intact but face memory is compromised. Some fMRI studies have extended these findings using famous and familiar faces. However, it is unclear whether these regions in the human ATL are in locations comparable to those reported in non-human primates, typically using unfamiliar faces. We present the results of two studies of person memory: a meta-analysis of existing fMRI studies and an empirical fMRI study using optimized imaging parameters. Both studies showed left-lateralized ATL activations to familiar individuals while novel faces activated the right ATL. Activations to famous faces were quite ventral, similar to what has been reported in monkeys. These findings suggest that face memory-sensitive patches in the human ATL are in the ventral/polar ATL.

  19. [11C]WAY-100635 PET imaging of 5-HT1A receptor binding in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    To understand the role of 5-HT in human temporal lobe epilepsy, here we measured 5-HT1A receptor binding potential by positron emission tomography (PET) with [carbonyl-11C]WAY100635, a selective 5-HT1A receptor antagonist, in patients with temporal lobe epilepsy and normal controls. Twelve patients with temporal lobe epilepsy and seventeen healthy controls participated in the study. For each subject, we conducted PET and magnetic resonance imaging (MRI), by which we measured the 5-HT1A receptor binding potential, the R1-value, a relative indicator of cerebral blood flow in regions of interest, and the volume of gray matter. Patients with temporal lobe epilepsy showed significantly reduced 5-HT1A receptor binding potential in the temporal lobe. The laterality of the reduction was coincided with the epileptogenic foci estimated by a scalp electroencephalography (EEG). In contrast, the R1-value and gray matter volume showed no difference between the patient and control groups. Our study revealed that 5-HT1A receptor binding was reduced significantly at the epileptogenic foci. We suggest that PET imaging with [carbonyl-11C]WAY100635 is potentially a useful non-invasive method for determining the epileptogenic foci. (author)

  20. Correlation between chronological variables of the epileptic seizures and ictal perfusion patterns in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Ictal SPECT has a high sensitivity to localise the epileptogenic zone (EZ) in medically intractable temporal lobe epilepsies (TLE). Much is already known about timing of postictal perfusional patterns, while little data analysing ictal perfusion patterns under a chronological frame exists. This study addresses the issue of typical and atypical perfusion patterns in temporal lobes and correlates them with ictal chronological variables. We prospectively evaluated 53 patients (pts) with unilateral TLE through Video-EEG, MRI, ictal, postictal and interictal SPECT, neuropsychological, social and psychiatric evaluations. All patients underwent antero-mesial temporal lobectomy and had a good post surgical seizure outcome. We analysed 51 ictal and 2 postictal scans: 41 pts (77%) showed typical perfusional patterns (TPP, ie, ictal hyperperfusion or postictal hypoperfusion ipsilateral to the EZ); 12 pts (23%) exhibited atypical perfusion patterns (ATT): 7 pts (13%) with bitemporal hyperperfusion (4 pts showed asymmetric predominantly ipsilateral changes), other 4 pts (8%) had contralateral hyperperfusion (associated to ipsilateral hypoperfusion) and 1 patient (2%) had a normal ictal SPECT scan. The earlier injection group (up to 30 sec from seizure onset) had a greater percentage of TPP (p<0,05). There was a significantly greater ictal electroencephalographic pattern exceeding radionuclide injection in TPP than APP group (p<0,04). Later acquisition of SPECT images (between 2 and 6 hours after injection) did not influence the sensitivity of the SPECT. Ictal perfusion patterns in TLE needs detailed morphological analysis to determine TPP and APP. After electro-clinical correlation, APP discloses conspicuous findings that can also render them lateralising information of EZ. Early injection of radionuclide resulted in a greater percentage of TPP. Later SPECT acquisitions had similar sensitivity to the earlier ones. Finally, greater exceeding time of ictal EEG after radionuclide

  1. Epilepsia do lobo temporal: tratamento cirúrgico Temporal lobe epilepsy: surgical treatment

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    Aziz Rassi Neto

    1996-12-01

    Full Text Available Os autores apresentam 32 pacientes com crises epilépticas não controladas ou intratáveis mesmo fazendo uso de medicamentos em doses adequadas. O eletrencefalograma mostrou descargas paroxísticas focais na região temporal em todos os casos. O material foi dividido em dois grupos. O primeiro é composto de 18 pacientes em que os exames por neuroimagem (ressonância magnética e tomografia computadorizada craniana mostraram imagens compatíveis com lesões expansivas cerebrais (como gliomas, malformações artério-venosas, tumor epidermóide; foi realizada exérese da lesão em todos os casos, associada à área irritativa adjacente que foi identificada pela eletrocorticografia intraoperatória, em seis casos; só foi possível a exérese dessas áreas irritativas nos casos em que elas se localizavam em zonas não eloquentes. O segundo é composto de 14 pacientes nos quais a ressonância magnética não mostrou imagem compatível com processo expansivo cerebral; o exame histopatológico mostrou esclerose mesial temporal em nove casos e cérebro normal em cinco; todos os casos deste grupo foram submetidos a lobectomia temporal. Observamos que os casos com lesões expansivas cerebrais apresentaram melhor evolução em relação ao controle das crises epilépticas do que os casos sem estas lesões, pois 15 (83,4% dos 18 casos do primeiro grupo evoluíram sem crises e 10 (71,4% dos 14 casos do segundo grupo também evoluíram sem crises após a cirurgia.The authors report the surgical management of 32 patients with medically intractable seizures. In all cases the epileptiform focus present in the temporal region was demonstrated by electroencephalography. Our report was made up of 14 male patients and 18 female patients. Their ages ranged from 9 to 62 years. The material was divided into two groups. The first, with eighteen patients with cerebral lesion (like gliomas, arteriovenous malformation, epidermoid tumor demonstrated on the CT scan and MR

  2. How FDG-PET helps making decision for surgery in various difficult subgroups of temporal lobe epilepsy?

    International Nuclear Information System (INIS)

    Concordant pre-surgical data are the important predictors of good surgical outcome in patients with localization-related epilepsy. Medically intractable temporal lobe epilepsy with hippocampal sclerosis (HS) and concordant pre-surgical data is straightforward and may not need functional imaging. However, in other instances for example, HS with discordant data (HSD), bilateral HS with discordant data (BHSD), temporal lobe epilepsy with dual pathology (DP), non-lesional temporal lobe epilepsy (NL) are the difficult subgroups. In these groups, functional imaging eg. brain perfusion SPECT or brain PET may play a major role for surgical decision making. To our knowledge, there was no previous data in using FDG-PET in different subgroups as mentioned. Only some previous studies in single subgroup without analyzing impact of PET findings on decision-making have been reported. We thus aim to evaluate the usefulness of FDG-PET in these 4 subgroups

  3. Epilepsia do lobo temporal: tratamento cirúrgico Temporal lobe epilepsy: surgical treatment

    OpenAIRE

    Aziz Rassi Neto; Carlos J. Reis de Campos; Mauro Muszkat; Fernando P. Ferraz

    1996-01-01

    Os autores apresentam 32 pacientes com crises epilépticas não controladas ou intratáveis mesmo fazendo uso de medicamentos em doses adequadas. O eletrencefalograma mostrou descargas paroxísticas focais na região temporal em todos os casos. O material foi dividido em dois grupos. O primeiro é composto de 18 pacientes em que os exames por neuroimagem (ressonância magnética e tomografia computadorizada craniana) mostraram imagens compatíveis com lesões expansivas cerebrais (como gliomas, malform...

  4. Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

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    Lucas Crociati Meguins

    2015-12-01

    Full Text Available ABSTRACT Objective To investigate the surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS and neurocysticercosis (NCC. Methods A retrospective investigation of patients with TLE-HS was conducted in a tertiary center. Results Seventy-nine (62.2%, 37 (29.1%, 6 (4.7%, and 5 (3.9% patients were Engel class I, II, III, and IV, respectively. Fifty-two (71.2% patients with epilepsy durations ≤ 10 years prior to surgery were seizure-free 1 year after the operation compared to 27 (50.0% patients with epilepsy durations > 10 years (p = 0.0121. Forty-three (72.9% patients with three or fewer lobes affected by NCC were seizure-free one year after the operation, and 36 (52.9% patients with more than three involved lobes were seizure-free after surgery (p = 0.0163. Conclusions Longer epilepsy durations and multiple lobe involvement predicted worse seizure outcomes in TLE-HS plus NCC patients.

  5. Different effects of anterior temporal lobectomy and selective amygdalohippocampectomy on verbal memory performance of patients with epilepsy.

    Science.gov (United States)

    Boucher, Olivier; Dagenais, Emmanuelle; Bouthillier, Alain; Nguyen, Dang Khoa; Rouleau, Isabelle

    2015-11-01

    The advantage of selective amygdalohippocampectomy (SAH) over anterior temporal lobectomy (ATL) for the treatment of temporal lobe epilepsy (TLE) remains controversial. Because ATL is more extensive and involves the lateral and medial parts of the temporal lobe, it may be predicted that its impact on memory is more important than SAH, which involves resection of medial temporal structures only. However, several studies do not support this assumption. Possible explanations include task-specific factors such as the extent of semantic and syntactic information to be memorized and failure to control for main confounders. We compared preoperative vs. postoperative memory performance in 13 patients with SAH with 26 patients who underwent ATL matched on side of surgery, IQ, age at seizure onset, and age at surgery. Memory function was assessed using the Logical Memory subtest from the Wechsler Memory Scales - 3rd edition (LM-WMS), the Rey Auditory Verbal Learning Test (RAVLT), the Digit Span subtest from the Wechsler Adult Intelligence Scale, and the Rey-Osterrieth Complex Figure Test. Repeated measures analyses of variance revealed opposite effects of SAH and ATL on the two verbal learning memory tests. On the immediate recall trial of the LM-WMS, performance deteriorated after ATL in comparison with that after SAH. By contrast, on the delayed recognition trial of the RAVLT, performance deteriorated after SAH compared with that after ATL. However, additional analyses revealed that the latter finding was only observed when surgery was conducted in the right hemisphere. No interaction effects were found on other memory outcomes. The results are congruent with the view that tasks involving rich semantic content and syntactical structure are more sensitive to the effects of lateral temporal cortex resection as compared with mesiotemporal resection. The findings highlight the importance of task selection in the assessment of memory in patients undergoing TLE surgery. PMID

  6. Temporal-lobe morphology differs between healthy adolescents and those with early-onset of depression

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    Mahdi Ramezani

    2014-01-01

    Full Text Available Major depressive disorder (MDD has previously been linked to structural changes in several brain regions, particularly in the medial temporal lobes (Bellani, Baiano, Brambilla, 2010; Bellani, Baiano, Brambilla, 2011. This has been determined using voxel-based morphometry, segmentation algorithms, and analysis of shape deformations (Bell-McGinty et al., 2002; Bergouignan et al., 2009; Posener et al., 2003; Vasic et al., 2008; Zhao et al., 2008: these are methods in which information related to the shape and the pose (the size, and anatomical position and orientation of structures is lost. Here, we incorporate information about shape and pose to measure structural deformation in adolescents and young adults with and without depression (as measured using the Beck Depression Inventory and Diagnostic and Statistical Manual of Mental Disorders criteria. As a hypothesis-generating study, a significance level of p < 0.05, uncorrected for multiple comparisons, was used, so that subtle morphological differences in brain structures between adolescent depressed individuals and control participants could be identified. We focus on changes in cortical and subcortical temporal structures, and use a multi-object statistical pose and shape model to analyze imaging data from 16 females (aged 16–21 and 3 males (aged 18 with early-onset MDD, and 25 female and 1 male normal control participants, drawn from the same age range. The hippocampus, parahippocampal gyrus, putamen, and superior, inferior and middle temporal gyri in both hemispheres of the brain were automatically segmented using the LONI Probabilistic Brain Atlas (Shattuck et al., 2008 in MNI space. Points on the surface of each structure in the atlas were extracted and warped to each participant's structural MRI. These surface points were analyzed to extract the pose and shape features. Pose differences were detected between the two groups, particularly in the left and right putamina, right hippocampus

  7. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

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    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  8. Myocyte-specific enhancer binding factor 2A expression is downregulated during temporal lobe epilepsy.

    Science.gov (United States)

    Huang, Yunyi; Wu, Xuling; Guo, Jing; Yuan, Jinxian

    2016-09-01

    Myocyte-specific enhancer binding factor 2A (MEF2A) is a multifunctional nuclear protein that regulates synaptogenesis, dendritic morphogenesis, and neuronal survival. This study aimed to investigate the expression pattern of MEF2A in epileptogenic processes. MEF2A expression was detected in 20 temporal neocortex tissue samples from patients with temporal lobe epilepsy (TLE) and 20 samples from trauma patients without epilepsy by real-time quantitative polymerase chain reaction, immunohistochemistry, double-label immunofluorescent staining, and western blot analysis. In addition, the expression patterns of MEF2A in the hippocampus and adjacent cortex of a lithium-pilocarpine-induced TLE rat model and control rats were examined. MEF2A was found to be expressed in the nuclei of neurons but not in the dendrites of neurons and astrocytes. MEF2A expression was significantly downregulated in temporal neocortex of humans and rats with TLE compared to the control groups. In addition, in the lithium-pilocarpine-induced TLE model, MEF2A expression dynamically decreased within 2 months. Taken together, these data suggest that MEF2A is involved in the pathogenesis of TLE. PMID:26439092

  9. Arginine vasopressin in the pathogenesis of febrile convulsion and temporal lobe epilepsy.

    Science.gov (United States)

    Gulec, Guldal; Noyan, Behzat

    2002-11-15

    We aimed to investigate the possible convulsant action of arginine vasopressin (AVP) in both a febrile convulsion model in rat pups and a temporal lobe epilepsy model in adult rats and to define the receptor type which mediates this effect. In rat pups, 125 ng V2 receptor antagonist significantly prevented hyperthermic seizures, but did not affect seizure latency. In adult rats, the only effective dose and agent was 125 ng V2 receptor antagonist, which prevented pilocarpine-induced status epilepticus, extended the status epilepticus latency and improved the 24 h survival rate. These data suggest that AVP has a convulsant activity in febrile convulsions and also in seizures independent of fever, and this effect is mediated by V2 receptors. PMID:12438923

  10. Cognitive function fifty-six years after surgical treatment of temporal lobe epilepsy: A case study

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    Sarah Jane Banks

    2014-01-01

    Our investigation at 56 postoperative years focused on cognitive skills, with some emphasis on learning and memory; a clinical examination was also performed, and the anatomical extent of the resection was determined on 3-Tesla magnetic resonance imaging. Four age- and IQ-appropriate women were tested as healthy control subjects. The patient showed material-specific impairments in language and verbal memory compared with the control subjects and also compared with her own earlier performance, but her performance on other cognitive tasks did not differ from that of the control subjects. Thus, her specific deficits had worsened over time, and she was also impaired compared with healthy individuals of her age, but her deficits remained confined to the verbal sphere, consistent with her temporal lobe seizure focus and surgery.

  11. Spatio-Temporal Structuring of Brain Activity - Description of Interictal EEG in Paediatric Frontal Lobe Epilepsy

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    Bunk, W; Kluger, G; Springer, S

    2009-01-01

    A method for the quantitative assessment of spatio-temporal structuring of brain activity is presented. This approach is employed in a longitudinal case study of a child with frontal lobe epilepsy (FLE) and tested against an age-matched control group. Several correlation measures that are sensitive to linear and/or non-linear relations in multichannel scalp EEG are combined with an hierarchical cluster algorithm. Beside a quantitative description of the overall degree of synchronization the spatial relations are investigated by means of the cluster characteristics. The chosen information measures not only demonstrate their suitability in the characterization of the ictal and interictal phases but they also follow the course of delayed recovery of the psychiatric symptomatology during successful medication. The results based on this single case study suggest testing this approach for quantitative control of therapy in an extended clinical trial.

  12. A functional MRI study of language networks in left medial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

  13. Proton MR spectroscopy in the diagnosis of children with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of proton magnetic resonance spectroscopy (1H MRS) with combination of magnetic resonance imaging (MRI) and electroencephalogram (EEG) in the diagnosis of the changes of brain biochemistry in children with temporal lobe epilepsy (TLE). Methods: 1H MRS was performed in 10 children with TLE and 8 healthy volunteers on a 2.0 T MRI/MRS system. The metabolites included N-acetylaspartate (NAA), choline-containing compounds (Cho), creatine and phosphocreatine (Cr), myo-inositol (MI), glutamate and glutamine (Glu/Gln), and lactate (Lac). Results: The value of NAA/(Cr + Cho) of the abnormal side on EEG and the abnormal side of hippocampal sclerosis decreased evidently compared with that of the control group (P1H MRS is more sensitive than MRI in the diagnosis of children with TLE. Moreover, MRS is helpful for the localization of EEG

  14. Action-Based Learning of Multistate Objects in the Medial Temporal Lobe.

    Science.gov (United States)

    Hindy, Nicholas C; Turk-Browne, Nicholas B

    2016-05-01

    Actions constrain perception by changing the appearance of objects in the environment. As such, they provide an interactive basis for learning the structure of visual input. If an action systematically transforms one stimulus into another, then these stimuli are more likely to reflect different states of the same persisting object over time. Here we show that such multistate objects are represented in the human medial temporal lobe-the result of a mechanism in which actions influence associative learning of how objects transition between states. We further demonstrate that greater recruitment of these action-based representations during object perception is accompanied by attenuated activity in stimulus-selective visual cortex. In this way, our interactions with the environment help build visual knowledge that predictively facilitates perceptual processing. PMID:25754517

  15. Remission of lifelong episodic dyscontrol after bilateral dorsolateral temporal lobe damage.

    Science.gov (United States)

    Coutinho, Gabriel; Miele, Flavia; Moll, Jorge; Mattos, Paulo; de Oliveira-Souza, Ricardo

    2016-06-01

    A 45-year-old married woman with fits of episodic dyscontrol since an early age suffered a bilateral injury of the dorsolateral temporal lobe after which such episodes vanished for good. The remission of her lifelong proneness to aggression was so remarkable that her relatives and friends unanimously welcomed her "new personality". The post-traumatic taming in this case was an unanticipated collateral effect of brain damage with a salutary change of personality. This change possibly resulted from the release, due to the bitemporal injury, of inclinations that had not hitherto been fully expressed in the patient's mind and behavior due to the overriding influence of episodic dyscontrol on her ordinary conduct. PMID:27351865

  16. Moderating effect of optimism on emotional distress and seizure control in adults with temporal lobe epilepsy.

    Science.gov (United States)

    Donnelly, Kiely M; Schefft, Bruce K; Howe, Steven R; Szaflarski, Jerzy P; Yeh, Hwa-shain; Privitera, Michael D

    2010-08-01

    Stress is a commonly reported seizure precipitant among individuals with epilepsy. Yet, the relationship between stress and seizure susceptibility remains unclear. This study examined the relationship between emotional distress and lifetime seizure load in individuals with temporal lobe epilepsy (TLE), as well as the potential moderating effect of explanatory style on this relationship. Data were collected from 148 individuals with TLE. Scales 2 and 7 of the Minnesota Multiphasic Personality Inventory were used as a measure of emotional distress, and explanatory style was measured using the Revised Optimism-Pessimism Scale. Elevated Scale 2 scores were associated with an increase in seizure load only in subjects with Full Scale IQ scores> or =92. An interaction between emotional distress and explanatory style was not observed. Thus, for individuals with higher levels of intelligence, depression may be an important pathway in linking emotional distress to poor seizure control. PMID:20542740

  17. Associative learning beyond the medial temporal lobe: many actors on the memory stage

    Directory of Open Access Journals (Sweden)

    Giulio ePergola

    2013-11-01

    Full Text Available Decades of research have established a model that includes the medial temporal lobe, and particularly the hippocampus, as a critical node for episodic memory. Neuroimaging and clinical studies have shown the involvement of additional cortical and subcortical regions. Among these areas, the thalamus, the retrosplenial cortex and the prefrontal cortices have been consistently related to episodic memory performance.This article provides evidences that these areas are in different forms and degrees critical for human memory function rather than playing only an ancillary role. First we briefly summarize findings on the involvement of the hippocampus and the medial temporal lobe in recognition memory and recall. We then focus on the clinical and neuroimaging evidence available on thalamo-frontal and thalamo-retrosplenial networks. The role of these networks in episodic memory has been considered secondary, partly because disruption of these areas does not always lead to severe impairments; to account for this evidence, we discuss methodological issues related to the investigation of these regions. We propose that these networks contribute differently to recognition memory and recall, and also that the memory stage of their contribution shows specificity to encoding or retrieval in recall tasks. We note that the same mechanisms may be in force when humans perform non-episodic tasks, e.g., semantic retrieval and mental time travel. Functional disturbance of these networks is related to cognitive impairments not only in neurological disorders, but also in psychiatric medical conditions, such as schizophrenia. Finally we discuss possible mechanisms for the contribution of these areas to memory, including regulation of oscillatory rhythms and long-term potentiation. We conclude that integrity of the thalamo-frontal and the thalamo-retrosplenial networks is necessary for the manifold features of episodic memory.

  18. Neurocognitive functioning in patients with glioma of the left and right temporal lobes.

    Science.gov (United States)

    Noll, Kyle R; Ziu, Mateo; Weinberg, Jeffrey S; Wefel, Jeffrey S

    2016-06-01

    Patients with glioma frequently suffer from deficits of neurocognitive functioning (NCF), though few studies have assessed NCF in localized glioma patients prior to surgery. One hundred and three patients (M age = 52.0; M education = 14.6 years) with histologically confirmed glioma in the right (RTL: n = 30; 57 % glioblastoma) or left temporal lobe (LTL: n = 73; 49 % glioblastoma) completed presurgical neuropsychological assessment. Impairment of NCF was identified in 75 % of all patients. Notably, patients with RTL glioma were most frequently impaired on measures of verbal memory and executive functioning, and at similar rates as the LTL group. Nonetheless, χ(2) tests revealed that impairment rates were significantly higher in the LTL group on attention and object naming tests (p ≤ .05). Independent-samples t-tests revealed that mean performances of patients with LTL glioma were also significantly below RTL patients on measures of attention (p = .01), verbal learning and memory (p = .05), and language (p learning and medial LTL lesions with delayed recall problems, though patients with lesions involving multiple LTL regions exhibited the greatest difficulty across all verbal memory measures. Significant group differences in NCF performances remained so after controlling for FLAIR volume and tumor histology. These findings indicate that temporal lobe glioma frequently present with impaired NCF, though impairments are often milder in RTL compared to LTL patients. Nonetheless, the relatively frequent verbal memory impairment in the RTL group underscores the bilaterality of verbal memory processes. PMID:27022915

  19. Diffusion tensor imaging of dolphin brains reveals direct auditory pathway to temporal lobe.

    Science.gov (United States)

    Berns, Gregory S; Cook, Peter F; Foxley, Sean; Jbabdi, Saad; Miller, Karla L; Marino, Lori

    2015-07-22

    The brains of odontocetes (toothed whales) look grossly different from their terrestrial relatives. Because of their adaptation to the aquatic environment and their reliance on echolocation, the odontocetes' auditory system is both unique and crucial to their survival. Yet, scant data exist about the functional organization of the cetacean auditory system. A predominant hypothesis is that the primary auditory cortex lies in the suprasylvian gyrus along the vertex of the hemispheres, with this position induced by expansion of 'associative' regions in lateral and caudal directions. However, the precise location of the auditory cortex and its connections are still unknown. Here, we used a novel diffusion tensor imaging (DTI) sequence in archival post-mortem brains of a common dolphin (Delphinus delphis) and a pantropical dolphin (Stenella attenuata) to map their sensory and motor systems. Using thalamic parcellation based on traditionally defined regions for the primary visual (V1) and auditory cortex (A1), we found distinct regions of the thalamus connected to V1 and A1. But in addition to suprasylvian-A1, we report here, for the first time, the auditory cortex also exists in the temporal lobe, in a region near cetacean-A2 and possibly analogous to the primary auditory cortex in related terrestrial mammals (Artiodactyla). Using probabilistic tract tracing, we found a direct pathway from the inferior colliculus to the medial geniculate nucleus to the temporal lobe near the sylvian fissure. Our results demonstrate the feasibility of post-mortem DTI in archival specimens to answer basic questions in comparative neurobiology in a way that has not previously been possible and shows a link between the cetacean auditory system and those of terrestrial mammals. Given that fresh cetacean specimens are relatively rare, the ability to measure connectivity in archival specimens opens up a plethora of possibilities for investigating neuroanatomy in cetaceans and other species

  20. The Role of Skull Modeling in EEG Source Imaging for Patients with Refractory Temporal Lobe Epilepsy.

    Science.gov (United States)

    Montes-Restrepo, Victoria; Carrette, Evelien; Strobbe, Gregor; Gadeyne, Stefanie; Vandenberghe, Stefaan; Boon, Paul; Vonck, Kristl; Mierlo, Pieter van

    2016-07-01

    We investigated the influence of different skull modeling approaches on EEG source imaging (ESI), using data of six patients with refractory temporal lobe epilepsy who later underwent successful epilepsy surgery. Four realistic head models with different skull compartments, based on finite difference methods, were constructed for each patient: (i) Three models had skulls with compact and spongy bone compartments as well as air-filled cavities, segmented from either computed tomography (CT), magnetic resonance imaging (MRI) or a CT-template and (ii) one model included a MRI-based skull with a single compact bone compartment. In all patients we performed ESI of single and averaged spikes marked in the clinical 27-channel EEG by the epileptologist. To analyze at which time point the dipole estimations were closer to the resected zone, ESI was performed at two time instants: the half-rising phase and peak of the spike. The estimated sources for each model were validated against the resected area, as indicated by the postoperative MRI. Our results showed that single spike analysis was highly influenced by the signal-to-noise ratio (SNR), yielding estimations with smaller distances to the resected volume at the peak of the spike. Although averaging reduced the SNR effects, it did not always result in dipole estimations lying closer to the resection. The proposed skull modeling approaches did not lead to significant differences in the localization of the irritative zone from clinical EEG data with low spatial sampling density. Furthermore, we showed that a simple skull model (MRI-based) resulted in similar accuracy in dipole estimation compared to more complex head models (based on CT- or CT-template). Therefore, all the considered head models can be used in the presurgical evaluation of patients with temporal lobe epilepsy to localize the irritative zone from low-density clinical EEG recordings. PMID:26936594

  1. 海马硬化与颞叶癫癎的关系%Temporal Lobe Epilepsy and Hippocampus Sclerosis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Purpose To discuss the role of hippocampus sclerosis (HS) in temporal lobe epilepsy and temporal lobe epilepsy surgery. Methods 15 temporal lobe epilepsy patients with HS underwent selective amygdalohippocampectomy. Results Epileptiform discharge were found in the medial region of temporal lobe in all the patients by cortex EEG and depth EEG, epileptic seizures were controlled satisfactorily after operatio. All patients' neuropsychological state remained normal. Conclusions HS may be one of the maincauses of temporal lobe epilepsy, MR will provide critical information for location of epiletic temporal lobewhen HS is found, epileptic seizures can be treated by surgical removal of HS.%目的 探讨海马硬化与颈叶癫癎(TLE)关系及在TLE外科治疗中的作用。方法 对15例TLE并考虑海马硬化的病例实施选择性海马杏仁核切除。结果 全部病例术中在皮质脑电图(EEG)及深部EEG均发现颞叶内侧癎样放电,手术切除硬化海马后癫痫得到有效控制,术后患者神经心理正常。结论 海马硬化可能是TLE的主要病因,核磁共振(MR)发现海马硬化是TLE定位诊断的重要依据,手术切除硬化海马可对TLE起到治疗作用。

  2. Identification of febrile seizure susceptibility genes : studies in mouse chromosome substitution strains and temporal lobe epilepsy patients

    NARCIS (Netherlands)

    Hessel, E.V.S.

    2010-01-01

    Febrile Seizures (FS) are the most common seizure type in children and recurrent FS are a risk factor for developing temporal lobe epilepsy (TLE). Although the mechanisms underlying FS are largely unknown, recent family, twin and animal studies indicate that genetics are important in FS susceptibili

  3. Representing Representation: Integration between the Temporal Lobe and the Posterior Cingulate Influences the Content and Form of Spontaneous Thought.

    Directory of Open Access Journals (Sweden)

    Jonathan Smallwood

    Full Text Available When not engaged in the moment, we often spontaneously represent people, places and events that are not present in the environment. Although this capacity has been linked to the default mode network (DMN, it remains unclear how interactions between the nodes of this network give rise to particular mental experiences during spontaneous thought. One hypothesis is that the core of the DMN integrates information from medial and lateral temporal lobe memory systems, which represent different aspects of knowledge. Individual differences in the connectivity between temporal lobe regions and the default mode network core would then predict differences in the content and form of people's spontaneous thoughts. This study tested this hypothesis by examining the relationship between seed-based functional connectivity and the contents of spontaneous thought recorded in a laboratory study several days later. Variations in connectivity from both medial and lateral temporal lobe regions was associated with different patterns of spontaneous thought and these effects converged on an overlapping region in the posterior cingulate cortex. We propose that the posterior core of the DMN acts as a representational hub that integrates information represented in medial and lateral temporal lobe and this process is important in determining the content and form of spontaneous thought.

  4. Dentate gyrus progenitor cell proliferation after the onset of spontaneous seizures in the tetanus toxin model of temporal lobe epilepsy

    Czech Academy of Sciences Publication Activity Database

    Jiruška, Přemysl; Shtaya, A.B.Y.; Bodansky, D.M.S.; Chang, W.C.; Gray, W.P.; Jefferys, J. G. R.

    2013-01-01

    Roč. 54, Jun 2013 (2013), s. 492-498. ISSN 0969-9961 R&D Projects: GA ČR(CZ) GAP303/10/0999 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : spontaneous seizures * temporal lobe epilepsy * neurogenesis * tetanus toxin * apoptosis Subject RIV: FH - Neurology Impact factor: 5.202, year: 2013

  5. Radiation-induced bilateral cystic temporal lobe necrosis: Reversal of memory deficit after fenestration and internal shunting. Case report

    International Nuclear Information System (INIS)

    The authors report a case in which bilateral cystic temporal lobe necrosis developed after treatment of nasopharyngeal lymphoepithelioma with 7000 cGy of external beam radiation. The patient presented with an isolated memory deficit that was documented by neuropsychological testing. After fenestration and internal shunting of both cysts, there was striking resolution of the lesions and of the memory deficit

  6. Concomitant fractional anisotropy and volumetric abnormalities in temporal lobe epilepsy: cross-sectional evidence for progressive neurologic injury.

    Directory of Open Access Journals (Sweden)

    Simon S Keller

    Full Text Available BACKGROUND: In patients with temporal lobe epilepsy and associated hippocampal sclerosis (TLEhs there are brain abnormalities extending beyond the presumed epileptogenic zone as revealed separately in conventional magnetic resonance imaging (MRI and MR diffusion tensor imaging (DTI studies. However, little is known about the relation between macroscopic atrophy (revealed by volumetric MRI and microstructural degeneration (inferred by DTI. METHODOLOGY/PRINCIPAL FINDINGS: For 62 patients with unilateral TLEhs and 68 healthy controls, we determined volumes and mean fractional anisotropy (FA of ipsilateral and contralateral brain structures from T1-weighted and DTI data, respectively. We report significant volume atrophy and FA alterations of temporal lobe, subcortical and callosal regions, which were more diffuse and bilateral in patients with left TLEhs relative to right TLEhs. We observed significant relationships between volume loss and mean FA, particularly of the thalamus and putamen bilaterally. When corrected for age, duration of epilepsy was significantly correlated with FA loss of an anatomically plausible route - including ipsilateral parahippocampal gyrus and temporal lobe white matter, the thalamus bilaterally, and posterior regions of the corpus callosum that contain temporal lobe fibres - that may be suggestive of progressive brain degeneration in response to recurrent seizures. CONCLUSIONS/SIGNIFICANCE: Chronic TLEhs is associated with interrelated DTI-derived and volume-derived brain degenerative abnormalities that are influenced by the duration of the disorder and the side of seizure onset. This work confirms previously contradictory findings by employing multi-modal imaging techniques in parallel in a large sample of patients.

  7. Impaired Facial Expression Recognition in Children with Temporal Lobe Epilepsy: Impact of Early Seizure Onset on Fear Recognition

    Science.gov (United States)

    Golouboff, Nathalie; Fiori, Nicole; Delalande, Olivier; Fohlen, Martine; Dellatolas, Georges; Jambaque, Isabelle

    2008-01-01

    The amygdala has been implicated in the recognition of facial emotions, especially fearful expressions, in adults with early-onset right temporal lobe epilepsy (TLE). The present study investigates the recognition of facial emotions in children and adolescents, 8-16 years old, with epilepsy. Twenty-nine subjects had TLE (13 right, 16 left) and…

  8. Feasibility of T1rho MR imaging in identification of the epileptogenic zone in patients with mesial temporal lobe epilepsy

    OpenAIRE

    Chan, Q; Chang, RSK; Mak, W.; Li, X.; Lai, V.; Mak, HKF

    2013-01-01

    PURPOSE: T1rho is sensitive to physiochemical exchange and early molecular changes. We aim to investigate the feasibility and utility of T1rho MR imaging in identification of epileptogenic zone in patient with mesial temporal lobe epilepsy (MTLE). METHODS: 7 patients (male 28.6%, female 71.4%; mean age of 36.29±8.77 yrs) with estab…

  9. Middle components of the auditory evoked response in bilateral temporal lobe lesions. Report on a patient with auditory agnosia

    DEFF Research Database (Denmark)

    Parving, A; Salomon, G; Elberling, Claus;

    1980-01-01

    An investigation of the middle components of the auditory evoked response (10--50 msec post-stimulus) in a patient with auditory agnosia is reported. Bilateral temporal lobe infarctions were proved by means of brain scintigraphy, CAT scanning, and regional cerebral blood flow measurements. The mi...

  10. MRI-based brain structure volumes in temporal lobe epilepsy patients and their unaffected siblings: a preliminary study.

    LENUS (Irish Health Repository)

    Scanlon, Cathy

    2013-01-01

    Investigating the heritability of brain structure may be useful in simplifying complicated genetic studies in temporal lobe epilepsy (TLE). A preliminary study is presented to determine if volume deficits of candidate brain structures present at a higher rate in unaffected siblings than controls subjects.

  11. Temporal lobe epilepsy and GEFS+ phenotypes associated with SCN1B mutations.

    Science.gov (United States)

    Scheffer, Ingrid E; Harkin, Louise A; Grinton, Bronwyn E; Dibbens, Leanne M; Turner, Samantha J; Zielinski, Marta A; Xu, Ruwei; Jackson, Graeme; Adams, Judith; Connellan, Mary; Petrou, Steven; Wellard, R Mark; Briellmann, Regula S; Wallace, Robyn H; Mulley, John C; Berkovic, Samuel F

    2007-01-01

    SCN1B, the gene encoding the sodium channel beta 1 subunit, was the first gene identified for generalized epilepsy with febrile seizures plus (GEFS+). Only three families have been published with SCN1B mutations. Here, we present four new families with SCN1B mutations and characterize the associated phenotypes. Analysis of SCN1B was performed on 402 individuals with various epilepsy syndromes. Four probands with missense mutations were identified. Detailed electroclinical phenotyping was performed on all available affected family members including quantitative MR imaging in those with temporal lobe epilepsy (TLE). Two new families with the original C121W SCN1B mutation were identified; novel mutations R85C and R85H were each found in one family. The following phenotypes occurred in the six families with SCN1B missense mutations: 22 febrile seizures, 20 febrile seizures plus, five TLE, three other GEFS+ phenotypes, two unclassified and ten unaffected individuals. All individuals with confirmed TLE had the C121W mutation; two underwent temporal lobectomy (one with hippocampal sclerosis and one without) and both are seizure free. We confirm the role of SCN1B in GEFS+ and show that the GEFS+ spectrum may include TLE alone. TLE with an SCN1B mutation is not a contraindication to epilepsy surgery. PMID:17020904

  12. MRI in temporal lobe epilepsy. Correlation between EEG, SPECT and clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Uesugi, Hideji; Onuma, Teiichi; Matsuda, Hiroshi; Ishida, Shiro [National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan)

    1996-02-01

    The relationship between MRI, SPECT, EEG and clinical features in temporal lobe epilepsy was investigated. Subjects were 162 patients (84 males, 78 females) whose average age was 38.1{+-}12.1 years. SPECT was carried out in 45 patients. The results were as follows: abnormal MR images were obtained in 36% of the group without epileptic discharge, and in 42% of the group with temporal spikes. There was no correlation between epileptic discharge in EEG and MRI abnormality. The lateralities of epileptic discharge and MRI were in disagreement in 9 of 39 patients (23%), indicating that determining the epileptic focus from scalp EEG was difficult. There was no correlation between the basic activity in EEG and abnormality in MRI. The rate of abnormal SPECT (89%) was higher than that of abnormal MRI (40%). The rate of the group with ictal automatism (52%) was higher than that of the group without ictal automatism (35%). The rate of abnormal MR images was high in the group with encephalitis (73%). The rate was higher in the group with febrile convulsion (62%) than in the group without it (28%). The rate of the abnormal MR images was higher in the group with a seizure frequency of at least several mal/month (48%) than in the group with a seizure frequency of less than several mal/year (29%). (author).

  13. Does ROI analysis of functional studies assist in temporal lobe seizure focus lateralisation?

    International Nuclear Information System (INIS)

    Full text: In 35 patients with refractory temporal lobe epilepsy (TLE), visual and region of interest (ROI) analysis of ictal 99mTc-HMPAO SPECT and interictal 18F-fluorodeoxyglucose positron emission tomography (FDG PET) studies was performed to determine the value of semiquantitation in seizure focus lateralisation. Each of two observers lateralised the functional studies and scored their level of confidence on a five-point scale (positive > 4). Percentage differences in mean side-to-side ROI counts were calculated over the mesial, lateral and posterior temporal cortex and a threshold of 10% selected. SPECT ROI analysis did not assist in lateralising the two false positive cases on visual interpretation. The equivocal SPECT cases were correctly lateralised on ROI analysis. In 17 equivocal or falsely lateralising FDG PET interpretations involving 11 patients, ROI analysis was helpful in lateralising 9 patients. In the two false lateralisations, ROI analysis demonstrated bilateral changes in one and correctly lateralised the other. In the equivocal cases, ROI analysis assisted in lateralising seven of nine patients. ROI analysis of functional studies provides similar lateralising information to qualitative interpretation by experienced observers. In equivocal or conflicting cases, ROI analysis assists in lateralisation of the seizure focus

  14. Does ROI analysis of functional studies assist in temporal lobe seizure focus lateralisation?

    Energy Technology Data Exchange (ETDEWEB)

    Berlangieri, S.U.; Ho, S.S.; Newton, M.R.; Thomas, D.L.; Chan, C.G.; Egan, G.F.; Tochon-Danguy, H.J.; Berkovic, S.F.; McKay, W.J. [Austin Hospital, Melbourne, VIC (Australia). Centre for PET and Depts of Nuclear Medicine and Neurology

    1998-03-01

    Full text: In 35 patients with refractory temporal lobe epilepsy (TLE), visual and region of interest (ROI) analysis of ictal {sup 99m}Tc-HMPAO SPECT and interictal {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG PET) studies was performed to determine the value of semiquantitation in seizure focus lateralisation. Each of two observers lateralised the functional studies and scored their level of confidence on a five-point scale (positive > 4). Percentage differences in mean side-to-side ROI counts were calculated over the mesial, lateral and posterior temporal cortex and a threshold of 10% selected. SPECT ROI analysis did not assist in lateralising the two false positive cases on visual interpretation. The equivocal SPECT cases were correctly lateralised on ROI analysis. In 17 equivocal or falsely lateralising FDG PET interpretations involving 11 patients, ROI analysis was helpful in lateralising 9 patients. In the two false lateralisations, ROI analysis demonstrated bilateral changes in one and correctly lateralised the other. In the equivocal cases, ROI analysis assisted in lateralising seven of nine patients. ROI analysis of functional studies provides similar lateralising information to qualitative interpretation by experienced observers. In equivocal or conflicting cases, ROI analysis assists in lateralisation of the seizure focus.

  15. {sup 1}H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Hajek, Milan; Dezortova, Monika [Institute for Clinical and Experimental Medicine, MR Unit, Department of Diagnostic and Interventional Radiology, Prague (Czech Republic); Krsek, Pavel; Komarek, Vladimir [Charles University, Department of Pediatric Neurology, Prague 5 (Czech Republic); Marusic, Petr; Tomasek, Martin; Krijtova, Hana [Charles University, Department of Neurology, Prague (Czech Republic); Zamecnik, Josef [Charles University, Department of Pathology and Molecular Medicine, Prague (Czech Republic); Kyncl, Martin [Charles University, Department of Radiology, Prague (Czech Republic)

    2009-02-15

    The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy ({sup 1}H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal {sup 1}H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and {sup 1}H MRS 83%. MRI together with {sup 1}H MRS correctly lateralized 100% of patients. Nineteen subjects had 'classical' hippocampal sclerosis (HS), whereas the remaining 16 patients had 'mild' HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in {sup 1}H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that {sup 1}H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized {sup 1}H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral {sup 1}H MRS abnormality on post-surgical seizure outcome. (orig.)

  16. MRI in temporal lobe epilepsy. Correlation between EEG, SPECT and clinical features

    International Nuclear Information System (INIS)

    The relationship between MRI, SPECT, EEG and clinical features in temporal lobe epilepsy was investigated. Subjects were 162 patients (84 males, 78 females) whose average age was 38.1±12.1 years. SPECT was carried out in 45 patients. The results were as follows: abnormal MR images were obtained in 36% of the group without epileptic discharge, and in 42% of the group with temporal spikes. There was no correlation between epileptic discharge in EEG and MRI abnormality. The lateralities of epileptic discharge and MRI were in disagreement in 9 of 39 patients (23%), indicating that determining the epileptic focus from scalp EEG was difficult. There was no correlation between the basic activity in EEG and abnormality in MRI. The rate of abnormal SPECT (89%) was higher than that of abnormal MRI (40%). The rate of the group with ictal automatism (52%) was higher than that of the group without ictal automatism (35%). The rate of abnormal MR images was high in the group with encephalitis (73%). The rate was higher in the group with febrile convulsion (62%) than in the group without it (28%). The rate of the abnormal MR images was higher in the group with a seizure frequency of at least several mal/month (48%) than in the group with a seizure frequency of less than several mal/year (29%). (author)

  17. 1H MR spectroscopy in histopathological subgroups of mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    The aim of the study was to analyze the lateralizing value of proton magnetic resonance spectroscopy (1H MRS) in histopathologically different subgroups of mesial temporal lobe epilepsies (MTLE) and to correlate results with clinical, MRI and seizure outcome data. A group of 35 patients who underwent resective epilepsy surgery was retrospectively studied. Hippocampal 1H MR spectra were evaluated. Metabolite concentrations were obtained using LCModel and NAA/Cr, NAA/Cho, NAA/(Cr+Cho), Cho/Cr ratios and coefficients of asymmetry were calculated. MRI correctly lateralized 89% of subjects and 1H MRS 83%. MRI together with 1H MRS correctly lateralized 100% of patients. Nineteen subjects had ''classical'' hippocampal sclerosis (HS), whereas the remaining 16 patients had ''mild'' HS. Nineteen patients had histopathologically proven malformation of cortical development (MCD) in the temporal pole; 16 subjects had only HS. No difference in 1H MRS findings was found between patients in different histopathological subgroups of MTLE. Our results support the hypothesis that 1H MRS abnormalities do not directly reflect histopathological changes in MTLE patients. Subjects with non-lateralized 1H MRS abnormalities did not have a worse postoperative seizure outcome. We found no significant impact of contralateral 1H MRS abnormality on post-surgical seizure outcome. (orig.)

  18. Cerebral blood flow in temporal lobe epilepsy: a partial volume correction study

    International Nuclear Information System (INIS)

    Previous studies in temporal lobe epilepsy (TLE) have shown that, owing to brain atrophy, positron emission tomography (PET) can overestimate deficits in measures of cerebral function such as glucose metabolism (CMRglu) and neuroreceptor binding. The magnitude of this effect on cerebral blood flow (CBF) is unexplored. The aim of this study was to assess CBF deficits in TLE before and after magnetic resonance imaging-based partial volume correction (PVC). Absolute values of CBF for 21 TLE patients and nine controls were computed before and after PVC. In TLE patients, quantitative CMRglu measurements also were obtained. Before PVC, regional values of CBF were significantly (pglu in middle and inferior temporal cortex, fusiform gyrus and hippocampus both before and after PVC. A significant positive relationship between disease duration and AIs for CMRglu, but not CBF, was detected in hippocampus and amygdala, before but not after PVC. PVC should be used for PET CBF measurements in patients with TLE. Reduced blood flow, in contrast to glucose metabolism, is mainly due to structural changes. (orig.)

  19. Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography

    OpenAIRE

    Idil Gunes Tatar; Elif Altin; Volkan Kizilgoz; Nilay Aydin Oktay; Hasan Aydin; Baki Hekimoglu

    2012-01-01

    Background: Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be correctly diagnosed and properly treated. Up to now, several diagnostic approaches have been processed to determine the epileptic focus.Objectives: The aim of this study was to discover whether proton-MR-spectroscopic imaging (MRSI) aids in the diagnosis of temporal lobe epilepsy in conjunction with classical electroencephalography (EEG) findings.Patients and Methods: Totally, 70 mesial temporal zones consisti...

  20. Association between medial temporal lobe atrophy on CT and parietotemporal uptake decrease on SPECT in Alzheimer's disease

    OpenAIRE

    Lavenu, I.; Pasquier, F; Lebert, F.; Jacob, B.; Petit, H

    1997-01-01

    OBJECTIVES—Alzheimer's disease is the most frequent cause of degenerative dementia. Despite the available diagnostic criteria, improvement of diagnosic accuracy is still required. The aim of this prospective study was to assess in a large population of patients referred to a memory clinic the diagnostic value of the combination of medial temporal lobe atrophy on temporal oriented CT and decreased temporoparietal uptake on HMPAO single photon emission tomography (SPECT).
M...

  1. Extratemporal abnormalities of brain parenchyma in young adults with temporal lobe epilepsy: A diffusion tensor imaging study

    International Nuclear Information System (INIS)

    Aim: To examine extratemporal abnormalities of the cerebral parenchyma in young adult temporal lobe epilepsy (TLE) patients using diffusion tensor imaging (DTI). Materials and methods: The study comprised 20 adults with unilateral TLE and 20 controls. The fractional anisotropy (FA), apparent diffusion coefficient (ADC), parallel eigenvalue (λ∥), and perpendicular eigenvalue (λ⊥) were calculated in the regions of interest (ROIs) using a 3 T MRI system. ROIs included the anterior/posterior limb of the internal capsule (AIC/PIC), external capsule (EC), head of caudate nucleus (HCN), lenticular nucleus (LN), thalamus (TL), and genu/body/splenium of the corpus callosum (GCC/BCC/SCC). Results: Compared to controls, TLE patients showed lower FA in all ROIs; higher ADC in bilateral ECs, HCNs, TLs, and BCC; lower λ∥ in the ipsilateral LN and bilateral AICs, TL, and GCC; and higher λ⊥ in all ROIs except the bilateral PICs. In TLE patients, the ipsilateral TL had decreased FA compared with the contralateral TL. Pearson correlation analysis revealed a negative correlation between the ADC of the GCC and the age at onset of epilepsy; the λ∥ of the ipsilateral PIC and age at onset of epilepsy; the λ⊥ of the contralateral AIC and duration of epilepsy, respectively; and a positive correlation between the ADC of the GCC and the duration of epilepsy and the λ⊥ of the GCC and the duration of epilepsy, respectively. Conclusion: The study revealed bilateral extratemporal abnormalities in young adult TLE patients compared with controls. In addition, TLE patients with younger age at onset or longer duration of epilepsy may have more serious extratemporal changes

  2. Different types of working memory binding in epilepsy patients with unilateral anterior temporal lobectomy

    NARCIS (Netherlands)

    Geldorp, B. van; Bouman, Z.; Hendriks, M.P.H.; Kessels, R.P.C.

    2014-01-01

    The medial temporal lobe is an important structure for long-term memory formation, but its role in working memory is less clear. Recent studies have shown hippocampal involvement during working memory tasks requiring binding of information. It is yet unclear whether this is limited to tasks containi

  3. Relationship between imaging and pathological features and clinical factors in surgical cases of temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Uesugi, Hideji; Matsuda, Hiroshi; Onuma, Teiichi [National Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan); Shimizu, Hiroyuki; Arai, Nobutaka; Nakayama, Hiroshi; Maehara, Taketoshi; Yanashita, Akira

    1998-03-01

    The relationships between imaging, pathology and presumed causes in surgical cases of temporal lobe epilepsy (TLE) was studied. The subject was 62 patients. MRI, PET and SPECT were performed. Hematoxylin and eosin was used for pathological judgement. On MRI, mesial temporal sclerosis (MTS) was detected in 48 of 52 patients (92%); 32 (62%) had high-signal intensity on T2-weighted images; 31 (60%) had atrophy {l_brace}23 (44%) had high-signal intensity on T2+atrophy{r_brace}; 5 (10%) had calcified lesions; and 2 (4%) had cystic lesions. On PET and SPECT, abnormal cerebral blood flow was noted in 33 of 36 (92%). On pathological findings (61 cases), Ammon`s horn sclerosis (AHS), tumors, gliosis in lateral temporal and meningeal inflammatory finding were detected in 42 (69%), 10 (23%) and 8 (13%) cases, respectively, whereas 2 showed no abnormalities. The 2 patients with normal pathology showed both high-signal intensity and atrophy on MRI. The presumed causes of TLE were encephalitis/meningitis and/or suspected of these diseases in 15 patients (24%), injuries at birth in 5 (8%), and none in 42 (68%). The presumed causes in the 43 patients with AHS were encephalitis/meningitis in 11, injuries at birth in 3, and none in 29. Of the 15 patients in whom encephalitis/meningitis was estimated as the causes of TLE, only 6 (40%) had pathological evidence of meningeal inflammatory finding. Of the 42 patients in whom cause could not be determined, 2 had pathological evidence of meningeal inflammatory finding. (K.H.)

  4. Preservation of episodic memory in semantic dementia: The importance of regions beyond the medial temporal lobes.

    Science.gov (United States)

    Irish, Muireann; Bunk, Steffie; Tu, Sicong; Kamminga, Jody; Hodges, John R; Hornberger, Michael; Piguet, Olivier

    2016-01-29

    Episodic memory impairment represents one of the hallmark clinical features of patients with Alzheimer's disease (AD) attributable to the degeneration of medial temporal and parietal regions of the brain. In contrast, a somewhat paradoxical profile of relatively intact episodic memory, particularly for non-verbal material, is observed in semantic dementia (SD), despite marked atrophy of the hippocampus. This retrospective study investigated the neural substrates of episodic memory retrieval in 20 patients with a diagnosis of SD and 21 disease-matched cases of AD and compared their performance to that of 35 age- and education-matched healthy older Controls. Participants completed the Rey Complex Figure and the memory subscale of the Addenbrooke's Cognitive Examination-Revised as indices of visual and verbal episodic recall, respectively. Relative to Controls, AD patients showed compromised memory performance on both visual and verbal memory tasks. In contrast, memory deficits in SD were modality-specific occurring exclusively on the verbal task. Controlling for semantic processing ameliorated these deficits in SD, while memory impairments persisted in AD. Voxel-based morphometry analyses revealed significant overlap in the neural correlates of verbal episodic memory in AD and SD with predominantly anteromedial regions, including the bilateral hippocampus, strongly implicated. Controlling for semantic processing negated this effect in SD, however, a distributed network of frontal, medial temporal, and parietal regions was implicated in AD. Our study corroborates the view that episodic memory deficits in SD arise very largely as a consequence of the conceptual loading of traditional tasks. We propose that the functional integrity of frontal and parietal regions enables new learning to occur in SD in the face of significant hippocampal and anteromedial temporal lobe pathology, underscoring the inherent complexity of the episodic memory circuitry. PMID:26683384

  5. Cerebral blood flow in temporal lobe epilepsy: a partial volume correction study

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    Giovacchini, Giampiero [University Milano-Bicocca, Milan (Italy); Bonwetsch, Robert; Theodore, William H. [National Institute of Neurological Diseases and Strokes, Clinical Epilepsy Section, Bethesda, MD (United States); Herscovitch, Peter [National Institutes of Health, PET Department, Clinical Center, Bethesda, MD (United States); Carson, Richard E. [Yale PET Center, New Haven, CT (United States)

    2007-12-15

    Previous studies in temporal lobe epilepsy (TLE) have shown that, owing to brain atrophy, positron emission tomography (PET) can overestimate deficits in measures of cerebral function such as glucose metabolism (CMR{sub glu}) and neuroreceptor binding. The magnitude of this effect on cerebral blood flow (CBF) is unexplored. The aim of this study was to assess CBF deficits in TLE before and after magnetic resonance imaging-based partial volume correction (PVC). Absolute values of CBF for 21 TLE patients and nine controls were computed before and after PVC. In TLE patients, quantitative CMR{sub glu} measurements also were obtained. Before PVC, regional values of CBF were significantly (p<0.05) lower in TLE patients than in controls in all regions, except the fusiform gyrus contralateral to the epileptic focus. After PVC, statistical significance was maintained in only four regions: ipsilateral inferior temporal cortex, bilateral insula and contralateral amygdala. There was no significant difference between patients and controls in CBF asymmetry indices (AIs) in any region before or after PVC. In TLE patients, AIs for CBF were significantly smaller than for CMR{sub glu} in middle and inferior temporal cortex, fusiform gyrus and hippocampus both before and after PVC. A significant positive relationship between disease duration and AIs for CMR{sub glu}, but not CBF, was detected in hippocampus and amygdala, before but not after PVC. PVC should be used for PET CBF measurements in patients with TLE. Reduced blood flow, in contrast to glucose metabolism, is mainly due to structural changes. (orig.)

  6. Improvement in the performance of CAD for the Alzheimer-type dementia based on automatic extraction of temporal lobe from coronal MR images

    International Nuclear Information System (INIS)

    In this study, we extracted whole brain and temporal lobe images from MR images (26 healthy elderly controls and 34 Alzheimer-type dementia patients) by means of binarize, mask processing, template matching, Hough transformation, and boundary tracing etc. We assessed the extraction accuracy by comparing the extracted images to images extracts by a radiological technologist. The results of assessment by consistent rate; brain images 91.3±4.3%, right temporal lobe 83.3±6.9%, left temporal lobe 83.7±7.6%. Furthermore discriminant analysis using 6 textural features demonstrated sensitivity and specificity of 100% when the healthy elderly controls were compared to the Alzheimer-type dementia patients. Our research showed the possibility of automatic objective diagnosis of temporal lobe abnormalities by automatic extracted images of the temporal lobes. (author)

  7. Reduction in temporal N-acetylaspartate and creatine (or choline) ratio in temporal lobe epilepsy: does this 1H-magnetic resonance spectroscopy finding mean poor seizure control?

    OpenAIRE

    Mendes-Ribeiro, J.; Soares, R.,; Simoes-Ribeiro, F.; Guimaraes, M

    1998-01-01

    BACKGROUND—Proton magnetic resonance spectroscopy (1H-MRS) is a potentially useful tool in the in vivo investigation of brain metabolites in intractable temporal lobe epilepsy (TLE). Focal N-acetylaspartatate (NAA) reductions have been correlated with mesial temporal sclerosis (MTS) in surgically resected epileptogenic foci.
OBJECTIVE—To evaluate the abnormalities in the metabolites NAA, creatine+ phosphocreatine (Cr), and choline containing compounds (Cho) in the tempora...

  8. Mapping the spatio-temporal pattern of the mammalian target of rapamycin (mTOR activation in temporal lobe epilepsy.

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    Long-Ze Sha

    Full Text Available Growing evidence from rodent models of temporal lobe epilepsy (TLE indicates that dysregulation of the mammalian target of rapamycin (mTOR pathway is involved in seizures and epileptogenesis. However, the role of the mTOR pathway in the epileptogenic process remains poorly understood. Here, we used an animal model of TLE and sclerotic hippocampus from patients with refractory TLE to determine whether cell-type specific activation of mTOR signaling occurs during each stage of epileptogenesis. In the TLE mouse model, we found that hyperactivation of the mTOR pathway is present in distinct hippocampal subfields at three different stages after kainate-induced seizures, and occurs in neurons of the granular and pyramidal cell layers, in reactive astrocytes, and in dispersed granule cells, respectively. In agreement with the findings in TLE mice, upregulated mTOR was observed in the sclerotic hippocampus of TLE patients. All sclerotic hippocampus (n = 13 exhibited widespread reactive astrocytes with overactivated mTOR, some of which invaded the dispersed granular layer. Moreover, two sclerotic hippocampus exhibited mTOR activation in some of the granule cells, which was accompanied by cell body hypertrophy. Taken together, our results indicate that mTOR activation is most prominent in reactive astrocytes in both an animal model of TLE and the sclerotic hippocampus from patients with drug resistant TLE.

  9. Rundown of GABA type A receptors is a dysfunction associated with human drug-resistant mesial temporal lobe epilepsy

    Science.gov (United States)

    Ragozzino, D.; Palma, E.; Di Angelantonio, S.; Amici, M.; Mascia, A.; Arcella, A.; Giangaspero, F.; Cantore, G.; Di Gennaro, G.; Manfredi, M.; Esposito, V.; Quarato, P. P.; Miledi, R.; Eusebi, F.

    2005-01-01

    Pharmacotherapeutic strategies have been difficult to develop for several forms of temporal lobe epilepsy, which are consequently treated by surgical resection. To examine this problem, we have studied the properties of transmitter receptors of tissues removed during surgical treatment. We find that when cell membranes, isolated from the temporal neocortex of patients afflicted with drug-resistant mesial temporal lobe epilepsy (TLE), are injected into frog oocytes they acquire GABA type A receptors (GABAA-receptors) that display a marked rundown during repetitive applications of GABA. In contrast, GABAA-receptor function is stable in oocytes injected with cell membranes isolated from the temporal lobe of TLE patients afflicted with neoplastic, dysgenetic, traumatic, or ischemic temporal lesions (lesional TLE, LTLE). Use-dependent GABAA-receptor rundown is also found in the pyramidal neurons of TLE neocortical slices and is antagonized by BDNF. Pyramidal neurons in cortical slices of a traumatic LTLE patient did not show GABAA-receptor rundown. However, the apparent affinity of GABAA-receptor in oocytes microtransplanted with membranes from all of the epileptic patients studied was smaller than the affinity of receptors transplanted from the nonepileptic brain. We conclude that the use-dependent rundown of neocortical GABAA-receptor represents a TLE-specific dysfunction, whereas the reduced affinity may be a general feature of brains of both TLE and LTLE patients, and we speculate that our findings may help to develop new treatments for TLE and LTLE. PMID:16217016

  10. Task-Related Dynamic Division of Labor Between Anterior Temporal and Lateral Occipital Cortices in Representing Object Size

    Science.gov (United States)

    2016-01-01

    Object size is represented by functionally distinct sectors along the ventral visual pathway. The early visual cortex encodes objects' sensory-retinal size. Subsequently, the occipitotemporal cortex computes objects' canonical size based on statistical regularities of visual features. Although the neurocomputation of size has been studied in a “bottom-up” sensory-driven framework, little is known about how perceptual size information is transformed into conceptual knowledge and how this computation is modulated by “top-down” goal-driven signals. Using continuous theta burst stimulation, we demonstrated that behavioral goal shapes the neurocognitive network underpinning object size. We manipulated the congruency of perceptual versus conceptual object size, which provides a robust behavioral probe reflecting implicit size knowledge. Neurostimulation was targeted at the lateral occipital cortex (LOC), a key region for object perception, or the anterior temporal lobe (ATL), a “hub” of supramodal conceptual processing. We observed striking contextual modulation of the neurocognitive architecture: when human participants judged perceptual size, the congruency effect was significantly attenuated by LOC stimulation but stayed resilient to ATL stimulation. By contrast, when they judged conceptual size, both LOC and ATL stimulation eradicated the otherwise robust effect. Our findings demonstrate disparate functional profiles of the LOC and ATL, providing the first evidence of a malleable network adaptively altering its division of labor with top-down states. The LOC, regardless of task demand, automatically represents “bottom-up” statistical regularities of visual conformation (reflecting typical object size), whereas the ATL contributes to this computation when the context requires semantically based linkage of visual attributes to object recognition. SIGNIFICANCE STATEMENT In the present study, we provide compelling evidence that the

  11. Temporal and spatial requirements for Nodal-induced anterior mesendoderm and mesoderm in anterior neurulation.

    Science.gov (United States)

    Gonsar, Ngawang; Coughlin, Alicia; Clay-Wright, Jessica A; Borg, Bethanie R; Kindt, Lexy M; Liang, Jennifer O

    2016-01-01

    Zebrafish with defective Nodal signaling have a phenotype analogous to the fatal human birth defect anencephaly, which is caused by an open anterior neural tube. Previous work in our laboratory found that anterior open neural tube phenotypes in Nodal signaling mutants were caused by lack of mesendodermal/mesodermal tissues. Defects in these mutants are already apparent at neural plate stage, before the neuroepithelium starts to fold into a tube. Consistent with this, we found that the requirement for Nodal signaling maps to mid-late blastula stages. This timing correlates with the timing of prechordal plate mesendoderm and anterior mesoderm induction, suggesting these tissues act to promote neurulation. To further identify tissues important for neurulation, we took advantage of the variable phenotypes in Nodal signaling-deficient sqt mutant and Lefty1-overexpressing embryos. Statistical analysis indicated a strong, positive correlation between a closed neural tube and presence of several mesendoderm/mesoderm-derived tissues (hatching glands, cephalic paraxial mesoderm, notochord, and head muscles). However, the neural tube was closed in a subset of embryos that lacked any one of these tissues. This suggests that several types of Nodal-induced mesendodermal/mesodermal precursors are competent to promote neurulation. genesis 54:3-18, 2016. © 2016 Wiley Periodicals, Inc. PMID:26528772

  12. Predicting the laterality of temporal lobe epilepsy from PET, MRI, and DTI: A multimodal study

    Directory of Open Access Journals (Sweden)

    Dorian Pustina

    2015-01-01

    Full Text Available Pre-surgical evaluation of patients with temporal lobe epilepsy (TLE relies on information obtained from multiple neuroimaging modalities. The relationship between modalities and their combined power in predicting the seizure focus is currently unknown. We investigated asymmetries from three different modalities, PET (glucose metabolism, MRI (cortical thickness, and diffusion tensor imaging (DTI; white matter anisotropy in 28 left and 30 right TLE patients (LTLE and RTLE. Stepwise logistic regression models were built from each modality separately and from all three combined, while bootstrapped methods and split-sample validation verified the robustness of predictions. Among all multimodal asymmetries, three PET asymmetries formed the best predictive model (100% success in full sample, >95% success in split-sample validation. The combinations of PET with other modalities did not perform better than PET alone. Probabilistic classifications were obtained for new clinical cases, which showed correct lateralization for 7/7 new TLE patients (100% and for 4/5 operated patients with discordant or non-informative PET reports (80%. Metabolism showed closer relationship with white matter in LTLE and closer relationship with gray matter in RTLE. Our data suggest that metabolism is a powerful modality that can predict seizure laterality with high accuracy, and offers high value for automated predictive models. The side of epileptogenic focus can affect the relationship of metabolism with brain structure. The data and tools necessary to obtain classifications for new TLE patients are made publicly available.

  13. Reversible MRI abnormalities in mesial temporal lobe epilepsy: a case report

    Directory of Open Access Journals (Sweden)

    Chiara Pizzanelli

    2013-12-01

    Full Text Available The question regarding  the existence of abnormalities in the neuroimaging exams immediately after status epilecticus or epileptic seizures, but showing complete reversibility after a proper antiepileptic therapy, has long been debated. The first reports attempting to demonstrate their existence date back to the 1980s, and relied upon computed tomography as the imaging method of choice. After the introduction of MRI, a more appropriate characterization of these abnormalities was obtained along with the description of their most frequent features: (a T2 signal hyperintensity in the white matter and, occasionally, (b reduced apparent diffusion coefficient (ADC and increased signal in DWI sequences.The MRI abnormalities induced by epileptic activity pose a broad differential diagnosis including infections, inflammatory autoimmune encephalopathies, neoplasms. It remains a diagnosis of exclusion and requires proper diagnostic iter in order to reduce the risk of misdiagnosis and unnecessary intervention.In this case report, a thorough presentation will be outlined about MRI alterations in the left mesial temporal lobe, which resulted completely reversible after a proper antiepileptic therapy.

  14. Hippocampal internal architecture and postoperative seizure outcome in temporal lobe epilepsy due to hippocampal sclerosis

    Science.gov (United States)

    Elkommos, Samia; Weber, Bernd; Niehusmann, Pitt; Volmering, Elisa; Richardson, Mark P.; Goh, Yen Y.; Marson, Anthony G.; Elger, Christian; Keller, Simon S.

    2016-01-01

    Purpose Semi-quantitative analysis of hippocampal internal architecture (HIA) on MRI has been shown to be a reliable predictor of the side of seizure onset in patients with temporal lobe epilepsy (TLE). In the present study, we investigated the relationship between postoperative seizure outcome and preoperative semi-quantitative measures of HIA. Methods We determined HIA on high in-plane resolution preoperative T2 short tau inversion recovery MR images in 79 patients with presumed unilateral mesial TLE (mTLE) due to hippocampal sclerosis (HS) who underwent amygdalohippocampectomy and postoperative follow up. HIA was investigated with respect to postoperative seizure freedom, neuronal density determined from resected hippocampal specimens, and conventionally acquired hippocampal volume. Results HIA ratings were significantly related to some neuropathological features of the resected hippocampus (e.g. neuronal density of selective CA regions, Wyler grades), and bilaterally with preoperative hippocampal volume. However, there were no significant differences in HIA ratings of the to-be-resected or contralateral hippocampus between patients rendered seizure free (ILAE 1) compared to those continuing to experience seizures (ILAE 2-5). Conclusions This work indicates that semi-quantitative assessment of HIA on high-resolution MRI provides a surrogate marker of underlying histopathology, but cannot prospectively distinguish between patients who will continue to experience postoperative seizures and those who will be rendered seizure free. The predictive power of HIA for postoperative seizure outcome in non-lesional patients with TLE should be explored. PMID:26803053

  15. Neural Stem Cell Grafting in an Animal Model of Chronic Temporal Lobe Epilepsy

    Science.gov (United States)

    Hattiangady, Bharathi; Shetty, Ashok K.

    2016-01-01

    Neural stem cell (NSC) transplantation into the hippocampus could offer an alternative therapy to hippocampal resection in patients with drug-resistant chronic epilepsy, which afflicts ~30% of mesial temporal lobe epilepsy (TLE) cases. Multipotent, self-renewing NSCs could be expanded from multiple regions of the developing and adult brain, human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs). However, to provide a comprehensive methodology involved in testing the efficacy of transplantation of NSCs in a rat model of chronic TLE, NSCs derived from the embryonic medial ganglionic eminence (MGE) are taken as an example in this article. The topics comprise description of the required materials, reagents and equipment, and protocols for expanding MGE-NSCs in culture, generating chronically epileptic rats, the intrahippocampal grafting, the post-grafting evaluation of the effects of NSC grafts on spontaneous recurrent seizures and cognitive impairments, analyses of the yield and the fate of graft-derived cells, and the effects of NSC grafts on the host hippocampus. PMID:21913169

  16. Apoptosis through Death Receptors in Temporal Lobe Epilepsy-Associated Hippocampal Sclerosis

    Science.gov (United States)

    Teocchi, Marcelo Ananias; D'Souza-Li, Lília

    2016-01-01

    Seizure models have demonstrated that neuroinflammation and neurodegeneration are preponderant characteristics of epilepsy. Considering the lack of clinical studies, our aim is to investigate the extrinsic pathway of apoptosis in pharmacoresistant temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) patients, TLE(HS). By a specific death receptor-mediated apoptosis array plate, 31 upregulated targets were revealed in the sclerotic hippocampus from TLE(HS) patients. Amongst them are the encoding genes for ligands (FASLG, TNF, and TNFSF10) and death receptors (FAS, TNFRSF1A, TNFRSF10A, and TNFRSF10B). In addition, we evaluated the hippocampal relative mRNA expression of the two TNF receptors, TNFRSF1A and TNFRSF1B, in patients, being both upregulated (n = 14; P < 0.01 and P < 0.04, resp.) when compared to the post mortem control group (n = 4). Our results have clearly suggested that three different death receptor apoptotic systems may be associated with the maintenance and progression of TLE-associated HS: (1) TNF-TNFRSF1A, (2) FASLG-FAS, and (3) TNFSF10-TNFRSF10A/B. Their effects on epilepsy are still scarcely comprehended. Our study points out to TNF and TNF receptor superfamily pathways as important targets for pharmacological studies regarding the benefits of an anti-inflammatory therapy in these patients. PMID:27006531

  17. Medial Temporal Lobe Contributions to Future Thinking: Evidence from Neuroimaging and Amnesia

    Directory of Open Access Journals (Sweden)

    Mieke Verfaellie

    2012-09-01

    Full Text Available Following early amnesic case reports, there is now considerable evidence suggesting a link between remembering the past and envisioning the future. This link is evident in the overlap in neural substrates as well as cognitive processes involved in both kinds of tasks. While constructing a future narrative requires multiple processes, neuroimaging and lesion data converge on a critical role for the medial temporal lobes (MTL in retrieving and recombining details from memory in the service of novel simulations. Deficient detail retrieval and recombination may lead to impairments not only in episodic, but also in semantic prospection. MTL contributions to scene construction and mental time travel may further compound impairments in amnesia on tasks that pose additional demands on these processes, but are unlikely to form the core deficit underlying amnesics' cross-domain future thinking impairment. Future studies exploring the role of episodic memory in other forms of self-projection or future-oriented behaviour may elucidate further the adaptive role of memory.

  18. Computational modeling of epileptiform activities in medial temporal lobe epilepsy combined with in vitro experiments.

    Science.gov (United States)

    Ahn, Sora; Jun, Sang Beom; Lee, Hyang Woon; Lee, Seungjun

    2016-10-01

    In this paper, we propose a comprehensive computational model that is able to reproduce three epileptiform activities. The model targets a hippocampal formation that is known to be an important lesion in medial temporal lobe epilepsy. It consists of four sub-networks consisting of excitatory and inhibitory neurons and well-known signal pathways, with consideration of propagation delay. The three epileptiform activities involve fast and slow interictal discharge and ictal discharge, and those activities can be induced in vitro by application of 4-Aminopyridine in entorhinal cortex combined hippocampal slices. We model the three epileptiform activities upon previously reported biological mechanisms and verify the simulation results by comparing them with in vitro experimental data obtained using a microelectrode array. We use the results of Granger causality analysis of recorded data to set input gains of signal pathways in the model, so that the compatibility between the computational and experimental models can be improved. The proposed model can be expanded to evaluate the suppression effect of epileptiform activities due to new treatment methods. PMID:27416961

  19. A functional MRI study of language networks in left medial temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Yu Aihong, E-mail: yuaihong163@tom.com [Department of Radiology, the 4th Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Wang Xiaoyi; Xu Guoqing [Beijing Normal University, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing 100875 (China); Li Yongjie [Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Qin Wen; Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences (China); Wang, Yuping [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

    2011-11-15

    Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

  20. Are vesicular neurotransmitter transporters potential treatment targets for temporal lobe epilepsy?

    Directory of Open Access Journals (Sweden)

    Joeri eVan Liefferinge

    2013-08-01

    Full Text Available The vesicular neurotransmitter transporters (VNTs are small proteins responsible for packing synaptic vesicles with neurotransmitters thereby determining the amount of neurotransmitter released per vesicle through fusion in both neurons and glial cells. Each transporter subtype was classically seen as a specific neuronal marker of the respective nerve cells containing that particular neurotransmitter or structurally related neurotransmitters. More recently, however, it has become apparent that common neurotransmitters can also act as co-transmitters, adding complexity to neurotransmitter release and suggesting intriguing roles for VNTs therein. We will first describe the current knowledge on vesicular glutamate transporters (VGLUT1/2/3, the vesicular excitatory amino acid transporter (VEAT, the vesicular nucleotide transporter (VNUT, vesicular monoamine transporters (VMAT1/2, the vesicular acetylcholine transporter (VAChT and the vesicular γ-aminobutyric acid (GABA transporter (VGAT in the brain. We will focus on evidence regarding transgenic mice with disruptions in VNTs in different models of seizures and epilepsy. We will also describe the known alterations and reorganizations in the expression levels of these VNTs in rodent models for temporal lobe epilepsy (TLE and in human tissue resected for epilepsy surgery. Finally, we will discuss perspectives on opportunities and challenges for VNTs as targets for possible future epilepsy therapies.

  1. Scene complexity: influence on perception, memory, and development in the medial temporal lobe

    Directory of Open Access Journals (Sweden)

    Xiaoqian J Chai

    2010-03-01

    Full Text Available Regions in the medial temporal lobe (MTL and prefrontal cortex (PFC are involved in memory formation for scenes in both children and adults. The development in children and adolescents of successful memory encoding for scenes has been associated with increased activation in PFC, but not MTL, regions. However, evidence suggests that a functional subregion of the MTL that supports scene perception, located in the parahippocampal gyrus (PHG, goes through a prolonged maturation process. Here we tested the hypothesis that maturation of scene perception supports the development of memory for complex scenes. Scenes were characterized by their levels of complexity defined by the number of unique object categories depicted in the scene. Recognition memory improved with age, in participants ages 8-24, for high, but not low, complexity scenes. High-complexity compared to low-complexity scenes activated a network of regions including the posterior PHG. The difference in activations for high- versus low- complexity scenes increased with age in the right posterior PHG. Finally, activations in right posterior PHG were associated with age-related increases in successful memory formation for high-, but not low-, complexity scenes. These results suggest that functional maturation of the right posterior PHG plays a critical role in the development of enduring long-term recollection for high-complexity scenes.

  2. Temporal Lobe Epilepsy Alters Auditory-motor Integration For Voice Control

    Science.gov (United States)

    Li, Weifeng; Chen, Ziyi; Yan, Nan; Jones, Jeffery A.; Guo, Zhiqiang; Huang, Xiyan; Chen, Shaozhen; Liu, Peng; Liu, Hanjun

    2016-01-01

    Temporal lobe epilepsy (TLE) is the most common drug-refractory focal epilepsy in adults. Previous research has shown that patients with TLE exhibit decreased performance in listening to speech sounds and deficits in the cortical processing of auditory information. Whether TLE compromises auditory-motor integration for voice control, however, remains largely unknown. To address this question, event-related potentials (ERPs) and vocal responses to vocal pitch errors (1/2 or 2 semitones upward) heard in auditory feedback were compared across 28 patients with TLE and 28 healthy controls. Patients with TLE produced significantly larger vocal responses but smaller P2 responses than healthy controls. Moreover, patients with TLE exhibited a positive correlation between vocal response magnitude and baseline voice variability and a negative correlation between P2 amplitude and disease duration. Graphical network analyses revealed a disrupted neuronal network for patients with TLE with a significant increase of clustering coefficients and path lengths as compared to healthy controls. These findings provide strong evidence that TLE is associated with an atypical integration of the auditory and motor systems for vocal pitch regulation, and that the functional networks that support the auditory-motor processing of pitch feedback errors differ between patients with TLE and healthy controls. PMID:27356768

  3. Machine learning approach for the outcome prediction of temporal lobe epilepsy surgery.

    Directory of Open Access Journals (Sweden)

    Rubén Armañanzas

    Full Text Available Epilepsy surgery is effective in reducing both the number and frequency of seizures, particularly in temporal lobe epilepsy (TLE. Nevertheless, a significant proportion of these patients continue suffering seizures after surgery. Here we used a machine learning approach to predict the outcome of epilepsy surgery based on supervised classification data mining taking into account not only the common clinical variables, but also pathological and neuropsychological evaluations. We have generated models capable of predicting whether a patient with TLE secondary to hippocampal sclerosis will fully recover from epilepsy or not. The machine learning analysis revealed that outcome could be predicted with an estimated accuracy of almost 90% using some clinical and neuropsychological features. Importantly, not all the features were needed to perform the prediction; some of them proved to be irrelevant to the prognosis. Personality style was found to be one of the key features to predict the outcome. Although we examined relatively few cases, findings were verified across all data, showing that the machine learning approach described in the present study may be a powerful method. Since neuropsychological assessment of epileptic patients is a standard protocol in the pre-surgical evaluation, we propose to include these specific psychological tests and machine learning tools to improve the selection of candidates for epilepsy surgery.

  4. Differences in graph theory functional connectivity in left and right temporal lobe epilepsy

    Science.gov (United States)

    Chiang, Sharon; Stern, John M.; Engel, Jerome; Levin, Harvey S.; Haneef, Zulfi

    2016-01-01

    Summary Purpose To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Methods Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Results Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Conclusion Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. PMID:25445238

  5. Threat of punishment motivates memory encoding via amygdala, not midbrain, interactions with the medial temporal lobe.

    Science.gov (United States)

    Murty, Vishnu P; Labar, Kevin S; Adcock, R Alison

    2012-06-27

    Neural circuits associated with motivated declarative encoding and active threat avoidance have both been described, but the relative contribution of these systems to punishment-motivated encoding remains unknown. The current study used functional magnetic resonance imaging in humans to examine mechanisms of declarative memory enhancement when subjects were motivated to avoid punishments that were contingent on forgetting. A motivational cue on each trial informed participants whether they would be punished or not for forgetting an upcoming scene image. Items associated with the threat of shock were better recognized 24 h later. Punishment-motivated enhancements in subsequent memory were associated with anticipatory activation of right amygdala and increases in its functional connectivity with parahippocampal and orbitofrontal cortices. On a trial-by-trial basis, right amygdala activation during the motivational cue predicted hippocampal activation during encoding of the subsequent scene; across participants, the strength of this interaction predicted memory advantages due to motivation. Of note, punishment-motivated learning was not associated with activation of dopaminergic midbrain, as would be predicted by valence-independent models of motivation to learn. These data are consistent with the view that motivation by punishment activates the amygdala, which in turn prepares the medial temporal lobe for memory formation. The findings further suggest a brain system for declarative learning motivated by punishment that is distinct from that for learning motivated by reward. PMID:22745496

  6. Asymmetrical hippocampal connectivity in mesial temporal lobe epilepsy: evidence from resting state fMRI

    Directory of Open Access Journals (Sweden)

    Castellano Gabriela

    2010-06-01

    Full Text Available Abstract Background Mesial temporal lobe epilepsy (MTLE, the most common type of focal epilepsy in adults, is often caused by hippocampal sclerosis (HS. Patients with HS usually present memory dysfunction, which is material-specific according to the hemisphere involved and has been correlated to the degree of HS as measured by postoperative histopathology as well as by the degree of hippocampal atrophy on magnetic resonance imaging (MRI. Verbal memory is mostly affected by left-sided HS, whereas visuo-spatial memory is more affected by right HS. Some of these impairments may be related to abnormalities of the network in which individual hippocampus takes part. Functional connectivity can play an important role to understand how the hippocampi interact with other brain areas. It can be estimated via functional Magnetic Resonance Imaging (fMRI resting state experiments by evaluating patterns of functional networks. In this study, we investigated the functional connectivity patterns of 9 control subjects, 9 patients with right MTLE and 9 patients with left MTLE. Results We detected differences in functional connectivity within and between hippocampi in patients with unilateral MTLE associated with ipsilateral HS by resting state fMRI. Functional connectivity resulted to be more impaired ipsilateral to the seizure focus in both patient groups when compared to control subjects. This effect was even more pronounced for the left MTLE group. Conclusions The findings presented here suggest that left HS causes more reduction of functional connectivity than right HS in subjects with left hemisphere dominance for language.

  7. Adhesio interthalamica and cavum septum pellucidum in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Trzesniak, Clarissa; Linares, Ila M; Coimbra, Érica R; Júnior, Alexandre Veriano; Velasco, Tonicarlo R; Santos, Antonio C; Hallak, Jaime E; Sakamoto, Americo C; Busatto, Geraldo F; Crippa, José A

    2016-09-01

    The absence of the adhesio interthalamica (AI; also called interthalamic adhesion or massa intermedia) and the presence of a large cavum septum pellucidum (CSP) later in life have been related to neurodevelopmental alterations and have not been systematically investigated in epilepsy to date. This study carried out a MRI evaluation of the AI and CSP in a large sample with mesial temporal lobe epilepsy (MTLE). A total of 179 patients, classified according to the side of the epileptogenic focus, and 156 age- and sex-balanced healthy controls were assessed. Between-group comparisons of the prevalence and length of both AI and CSP were conducted. Neuropsychological assessments were also performed in 160 MTLE patients. The patients exhibited reduction in the AI prevalence (P AI showed lower scores in a proportion of neuropsychological tests than patients with AI. No CSP differences were found between MTLE patients and controls. These results support that AI anomalies have clinical significance in MTLE, as well as indicate that neurodevelopmental alterations may be implicated in this disorder. PMID:26497889

  8. Neuronal Injury, Gliosis, and Glial Proliferation in Two Models of Temporal Lobe Epilepsy.

    Science.gov (United States)

    Loewen, Jaycie L; Barker-Haliski, Melissa L; Dahle, E Jill; White, H Steve; Wilcox, Karen S

    2016-04-01

    It is estimated that 30%-40% of epilepsy patients are refractory to therapy and animal models are useful for the identification of more efficacious therapeutic agents. Various well-characterized syndrome-specific models are needed to assess their relevance to human seizure disorders and their validity for testing potential therapies. The corneal kindled mouse model of temporal lobe epilepsy (TLE) allows for the rapid screening of investigational compounds, but there is a lack of information as to the specific inflammatory pathology in this model. Similarly, the Theiler murine encephalomyelitis virus (TMEV) model of TLE may prove to be useful for screening, but quantitative assessment of hippocampal pathology is also lacking. We used immunohistochemistry to characterize and quantitate acute neuronal injury and inflammatory features in dorsal CA1 and dentate gyrus regions and in the directly overlying posterior parietal cortex at 2 time points in each of these TLE models. Corneal kindled mice were observed to have astrogliosis, but not microgliosis or neuron cell death. In contrast, TMEV-injected mice had astrogliosis, microgliosis, neuron death, and astrocyte and microglial proliferation. Our results suggest that these 2 animal models might be appropriate for evaluation of distinct therapies for TLE. PMID:26945036

  9. Hippocampus shape analysis for temporal lobe epilepsy detection in magnetic resonance imaging

    Science.gov (United States)

    Kohan, Zohreh; Azmi, Reza

    2016-03-01

    There are evidences in the literature that Temporal Lobe Epilepsy (TLE) causes some lateralized atrophy and deformation on hippocampus and other substructures of the brain. Magnetic Resonance Imaging (MRI), due to high-contrast soft tissue imaging, is one of the most popular imaging modalities being used in TLE diagnosis and treatment procedures. Using an algorithm to help clinicians for better and more effective shape deformations analysis could improve the diagnosis and treatment of the disease. In this project our purpose is to design, implement and test a classification algorithm for MRIs based on hippocampal asymmetry detection using shape and size-based features. Our method consisted of two main parts; (1) shape feature extraction, and (2) image classification. We tested 11 different shape and size features and selected four of them that detect the asymmetry in hippocampus significantly in a randomly selected subset of the dataset. Then, we employed a support vector machine (SVM) classifier to classify the remaining images of the dataset to normal and epileptic images using our selected features. The dataset contains 25 patient images in which 12 cases were used as a training set and the rest 13 cases for testing the performance of classifier. We measured accuracy, specificity and sensitivity of, respectively, 76%, 100%, and 70% for our algorithm. The preliminary results show that using shape and size features for detecting hippocampal asymmetry could be helpful in TLE diagnosis in MRI.

  10. Quantitative EEG and medial temporal lobe atrophy in Alzheimer′s dementia: Preliminary study

    Directory of Open Access Journals (Sweden)

    Soo-Ji Lee

    2015-01-01

    Full Text Available Backgrounds: The electroencephalogram (EEG abnormalities in Alzheimer′s disease (AD have been widely reported, and medial temporal lobe atrophy (MTLA is one of the hallmarks in early stage of AD. We aimed to assess the relationship between EEG abnormalities and MTLA and its clinical validity. Materials and Methods: A total of 18 patients with AD were recruited (the mean age: 77.83 years. Baseline EEGs were analyzed with quantitative spectral analysis. MTLA was assessed by a T1-axial visual rating scale (VRS. Results: In relative power spectrum analysis according to the right MTLA severity, the power of theta waves in C4, T4, F4, F8, and T5 increased significantly and the power of beta waves in T6, C4, T4, F8, T5, P3, T3, and F7 decreased significantly in severe atrophy group. In relative power spectrum analysis according to the left MTLA severity, the power of theta waves in T3 increased significantly and that of beta waves in P4, T6, C4, F4, F8, T5, P3, C3, T3, F3, and F7 decreased significantly in severe atrophy group. Conclusion: The severe MTLA group, regardless of laterality, showed more severe quantitative EEG alterations. These results suggest that quantitative EEG abnormalities are correlated with the MTLA, which may play an important role in AD process.

  11. Prevalence of psychiatric comorbidities in temporal lobe epilepsy in a Southern Brazilian population

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    José Augusto Bragatti

    2011-04-01

    Full Text Available A great prevalence of psychiatric disorders in epilepsy is well demonstrated, although most studies have used unstructured psychiatric interviews for diagnosis. Here we present a study evaluating the prevalence of psychiatric comorbidities in a cohort of Southern Brazilian patients with temporal lobe epilepsy (TLE using a structured clinical interview. We analyzed 166 patients with TLE regarding neuropsychiatric symptoms through the Structured Clinical Interview for DSM-IV. One hundred-six patients (63.9% presented psychiatric comorbidities. Mood disorders were observed in 80 patients (48.2%, anxiety disorders in 51 patients (30.7%, psychotic disorders in 14 (8.4%, and substance abuse in 8 patients (4.8% respectively. Our results agree with literature data where most authors detected mental disorders in 10 to 60% of epileptic patients. This wide variation is probably attributable to different patient groups investigated and to the great variety of diagnostic methods. Structured psychiatric interviews might contribute to a better evaluation of prevalence of psychiatric comorbidities in TLE.

  12. The medial temporal lobe supports sensing-based visual working memory.

    Science.gov (United States)

    Goodrich, Robin I; Yonelinas, Andrew P

    2016-08-01

    It is well established that the medial temporal lobe (MTL), including the hippocampus, is essential for long-term memory. In addition, recent studies suggest that the MTL may also support visual working memory (VWM), but the conditions under which the MTL plays a critical role are not yet clear. To address this issue, we used a color change detection paradigm to examine the effects of MTL damage on VWM by analyzing the receiver operating characteristics of patients with MTL damage and healthy age- and education-matched controls. Compared to controls, patients with MTL damage demonstrated significant reductions in VWM accuracy. Importantly, the patients were not impaired at making accurate high-confidence judgments that a change had occurred; however, they were impaired when making low-confidence responses indicating that they sensed whether or not there had been a visual change. Moreover, these impairments were observed under conditions that emphasized the retrieval of complex bindings or the retrieval of high-resolution bindings. That is, patients with MTL damage exhibited VWM impairments when they were required to remember either a larger number of low-resolution bindings (i.e., set size of 5 and obvious color changes) or a smaller number of high-resolution bindings (i.e., set size of 3 and subtle color changes). The results indicate that only some VWM processes are dependent on the MTL, and are consistent with the proposal that the MTL plays a critical role in forming complex, high-resolution bindings. PMID:27417038

  13. Ictal central apnea and bradycardia in temporal lobe epilepsy complicated by obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Yoko Nishimura

    2015-01-01

    Full Text Available We describe the case of a 12-year-old boy who developed temporal lobe epilepsy (TLE with daily complex partial seizures (CPS and monthly generalized seizures. Moreover, he frequently snored while asleep since early childhood. Polysomnography (PSG revealed severe obstructive sleep apnea with apnea–hypopnea index (AHI of 37.8/h. Video-PSG with simultaneous electroencephalography (EEG recording captured two ictal apneic episodes during sleep, without any motor manifestations. The onset of rhythmic theta activity in the midtemporal area on EEG was preceded by the onset of apnea by several seconds and disappeared soon after cessation of central apnea. One episode was accompanied by ictal bradycardia of <48 beats/min which persisted for 50 s beyond the end of epileptic activity. After treatment with carbamazepine and tonsillectomy/adenoidectomy, the seizures were well controlled and AHI decreased to 2.5/h. Paroxysmal discharges also disappeared during this time. Uncontrolled TLE complicated by sleep apnea should be evaluated for the presence of ictal central apnea/bradycardia.

  14. Clinical characteristics and surgical outcome of patients with temporal lobe tumors and epilepsy

    Directory of Open Access Journals (Sweden)

    JORGE CARMEN LISA

    2000-01-01

    Full Text Available This is a retrospective study of 21 surgically treated patients with temporal lobe tumors and epilepsy. Evaluation included clinical data, EEG findings, structural scans, pathological diagnosis and post-surgical follow-up. There were 9 cases of ganglioglioma, 5 pilocytic astrocytoma, 3 ganglioneuroma, 2 dysembryoplastic neuroepithelial tumor, 1 pleomorphic xantoastrocytoma, and 1 meningioangiomatosis. Mean follow-up time was 22 months and outcome was evaluated according to Engel's classification; 76.2% were classified in class I and 23.8% in II and III. All patients classes II and III had been submitted to mesial and neocortical resections. There were no differences related to clinical characteristics, pathological diagnosis or duration of follow-up in patients seizure-free or not. All patients had abnormal MRI and ten of these had normal CT; the MRI characteristics were compared to pathological diagnosis and specific histological characteristics of the tumors were not discernible by MRI. We concluded that MRI was essential for the diagnosis and precise location of TL tumors. Ganglioglioma was the most frequent tumor and lesionectomy associated to mesial resection doesn't guarantee a better prognosis.

  15. Molecular analysis of acute and chronic reactive astrocytes in the pilocarpine model of temporal lobe epilepsy.

    Science.gov (United States)

    Clasadonte, Jerome; Morel, Lydie; Barrios-Camacho, Camila M; Chiang, Ming Sum R; Zhang, Jinhua; Iyer, Lakshmanan; Haydon, Philip G; Yang, Yongjie

    2016-07-01

    Astroglia, the most abundant glial cells in the mammalian central nervous system (CNS), are considered an emerging key player in seizure induction and progression. Although astrocytes undergo reactive gliosis in temporal lobe epilepsy (TLE) with dramatic morphological and molecular changes, specific astrocyte targets/molecular pathways that contribute to the induction and progression of seizure remain largely unknown. By combining translating ribosomal affinity purification (TRAP) with the pilocarpine model of TLE in BAC aldh1l1 TRAP mice, we profiled translating mRNAs from hippocampal or cortical astrocytes at different phases (3days, 30days, and 60days post-pilocarpine injections) of pilocarpine-induced epilepsy models. Our results found that hippocampal (but not cortical) astrocytes undergo early and unique molecular changes at 3days post-pilocarpine injections. These changes indicate a potentially primary pathogenic role of hippocampal astrocytes in seizure induction and progression and provide new insights about the involvement of specific astrocytic pathways/targets in epilepsy. In particular, we validated expression changes of ocrl and aeg1 in pilocarpine models. Follow-up studies on these genes may reveal new roles of hippocampal astrocytes in TLE. PMID:27060558

  16. Predicting Surgery Targets in Temporal Lobe Epilepsy through Structural Connectome Based Simulations.

    Directory of Open Access Journals (Sweden)

    Frances Hutchings

    2015-12-01

    Full Text Available Temporal lobe epilepsy (TLE is a prevalent neurological disorder resulting in disruptive seizures. In the case of drug resistant epilepsy resective surgery is often considered. This is a procedure hampered by unpredictable success rates, with many patients continuing to have seizures even after surgery. In this study we apply a computational model of epilepsy to patient specific structural connectivity derived from diffusion tensor imaging (DTI of 22 individuals with left TLE and 39 healthy controls. We validate the model by examining patient-control differences in simulated seizure onset time and network location. We then investigate the potential of the model for surgery prediction by performing in silico surgical resections, removing nodes from patient networks and comparing seizure likelihood post-surgery to pre-surgery simulations. We find that, first, patients tend to transit from non-epileptic to epileptic states more often than controls in the model. Second, regions in the left hemisphere (particularly within temporal and subcortical regions that are known to be involved in TLE are the most frequent starting points for seizures in patients in the model. In addition, our analysis also implicates regions in the contralateral and frontal locations which may play a role in seizure spreading or surgery resistance. Finally, the model predicts that patient-specific surgery (resection areas chosen on an individual, model-prompted, basis and not following a predefined procedure may lead to better outcomes than the currently used routine clinical procedure. Taken together this work provides a first step towards patient specific computational modelling of epilepsy surgery in order to inform treatment strategies in individuals.

  17. [Motor amusia following a right temporal lobe hemorrhage--a case report].

    Science.gov (United States)

    Takeda, K; Bandou, M; Nishimura, Y

    1990-01-01

    A 65-year-old female was admitted to our hospital because of left hemiparesis with sudden onset one week before. She was congenitally right-handed. She had been a teacher of Japanese string instrument (samisen) playing and been able to sing Japanese traditional songs well. A tape on which she had recorded her songs one year before the admission also proved her to be a good singer. Neurological examination on admission revealed almost normal findings except for minimal weakness in her left hand fingers. Right temporal lobe hemorrhage was revealed by CT scan. One month after the admission, she complained that she was unable to sing her songs and to play samisen as she used to do. Her intelligence was normal (WAIS VIQ116, PIQ108) and there were no abnormal findings as follows: aprosodia, aphasia, agraphia, memory disturbance, agnosia and ideational, ideomotor, constructional or limb-kinetic apraxia. She could point out her errors while singing. However, musical receptive function was slightly disturbed with tonal memory in Seashore test. When she was asked to sing a song without any instrumental support, she hummed a melody occasionally with wrong pitch, but rhythmically. After hearing a song she knew well, she reproduced it with slight improvement. With the vocal or the instrumental accompaniment, she could sing fairly well. She had some mistakes of pitch while playing a samisen. MRI was performed one year and a half after the brain hemorrhage. It displayed a thin linear of hematoma in the white matter of the right upper temporal and transverse gyrus. It was proved in our case that motor amusia with minimal musical receptive dysfunction could appear following a cerebral lesion and musical function might be independent of intelligence or verbal function. PMID:2184966

  18. DIFFERENCES IN INTERICTAL PERFUSION PATTERNS BETWEEN REFRACTORY AND NON-REFRACTORY TEMPORAL LOBE EPILEPSIES EVALUATED WITH FAIR AT 3.0T

    Institute of Scientific and Technical Information of China (English)

    Hui You; Jing-jing Lu; Lian-kun Ren; Xiao-zhen Li; Feng Feng; Chun-ling Meng; Zheng-yu Jin

    2006-01-01

    Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence.Methods Nine patients with refractory temporal lobe epilepsy,21 patients with non-refractory temporal lobe epilepsy,and 13 normal volunteers underwent FAIR MR scanning.The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured.And we also calculated the asymmetry index (AI) values.Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029,respectively).There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049),while no significant difference between refractory epilepsy patients and volunteers.Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients.Although the hypoperfusion tends to extend out of temporal lobes in all patients,the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion,which may be valuable for evaluating prognosis.

  19. Linking DMN connectivity to episodic memory capacity: What can we learn from patients with medial temporal lobe damage?

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    Cornelia McCormick

    2014-01-01

    Full Text Available Computational models predict that focal damage to the Default Mode Network (DMN causes widespread decreases and increases of functional DMN connectivity. How such alterations impact functioning in a specific cognitive domain such as episodic memory remains relatively unexplored. Here, we show in patients with unilateral medial temporal lobe epilepsy (mTLE that focal structural damage leads indeed to specific patterns of DMN functional connectivity alterations, specifically decreased connectivity between both medial temporal lobes (MTLs and the posterior part of the DMN and increased intrahemispheric anterior–posterior connectivity. Importantly, these patterns were associated with better and worse episodic memory capacity, respectively. These distinct patterns, shown here for the first time, suggest that a close dialogue between both MTLs and the posterior components of the DMN is required to fully express the extensive repertoire of episodic memory abilities.

  20. Radiation induced temporal lobe necrosis in patients with nasopharyngeal carcinoma: a review of new avenues in its management

    International Nuclear Information System (INIS)

    Temporal lobe necrosis (TLN) is the most debilitating late-stage complication after radiation therapy in patients with nasopharyngeal cancer (NPC). The bilateral temporal lobes are inevitably encompassed in the radiation field and are thus prone to radiation induced necrosis. The wide use of 3D conformal and intensity-modulated radiation therapy (IMRT) in the treatment of NPC has led to a dwindling incidence of TLN. Yet, it still holds great significance due to its incapacitating feature and the difficulties faced clinically and radiologically in distinguishing it from a malignancy. In this review, we highlight the evolution of different imaging modalities and therapeutic options. FDG PET, SPECT and Magnetic Spectroscopy are among the latest imaging tools that have been considered. In terms of treatment, Bevacizumab remains the latest promising breakthrough due to its ability to reverse the pathogenesis unlike conventional treatment options including large doses of steroids, anticoagulants, vitamins, hyperbaric oxygen and surgery

  1. Spatio-temporal Expression Study of Phosphorylated 70-kDa Ribosomal S6 Kinase (p70S6k)in Mesial Temporal Lobe Epilepsy

    Institute of Scientific and Technical Information of China (English)

    Xiao-liang Xing; Long-ze Sha; Yuan Yao; Yan Shen; Li-wen Wu; Qi Xu

    2012-01-01

    To determine the spatio-temporal expression of p70S6k activation in hippocampus in mesial temporal lobe epilepsy.Methods Temporal lobe epilepsy model was established by stereotaxically unilateral and intrahippocampal injection of kainite acid (KA) in adult male C57BL/6 mice.Latent and chronic epileptogenesis were represented by mice 5 days after KA injection (n=5) and mice 5 weeks after KA injection (n=8),respectively.Control mice (n=5) were injected with saline.Immunohistochemical assays were performed on brain sections of the mice.Results Hippocampus both ipsilateral and contralateral to the KA injection displayed significantly up-regulated pS6 immunoreactivity in dispersed granule cells in 5-day and 5-week model mice.Conclusion The activation of p70S6k is mainly located in the dentate gyrus in KA-induced mouse model of temporal lobe epilepsy,indicating that the activation may be related with the disperse degree and hypertrophy of granule cells.

  2. Relationships between personality traits, medial temporal lobe atrophy and white matter lesion in subjects suffering from mild cognitive impairment

    OpenAIRE

    Emmanuelle Duron; Sana Ben Ahmed

    2014-01-01

    Mild Cognitive Impairment (MCI) is a heterogeneous cognitive status that can be a prodromal stage of Alzheimer‘s disease (AD). It is particularly relevant to focus on prodromal stages of AD such as MCI, because pathophysiological abnormalities of AD start years before the dementia stage. Medial temporal lobe atrophy (MTL) resulting from AD lesions and cerebrovascular lesions (i.e. white matter lesions (WML), lacunar strokes and strokes) are often revealed concurrently on Magnetic Resonance Im...

  3. Relationships between Personality Traits, Medial Temporal Lobe Atrophy, and White Matter Lesion in Subjects Suffering from Mild Cognitive Impairment

    OpenAIRE

    Duron, Emmanuelle; Vidal, Jean-Sébastien; Bounatiro, Samira; Ben Ahmed, Sana; Seux, Marie-Laure; Rigaud, Anne-Sophie; Hanon, Olivier; Viollet, Cécile; Epelbaum, Jacques; Martel, Guillaume

    2014-01-01

    Mild cognitive impairment (MCI) is a heterogeneous cognitive status that can be a prodromal stage of Alzheimer’s disease (AD). It is particularly relevant to focus on prodromal stages of AD such as MCI, because patho-physiological abnormalities of AD start years before the dementia stage. Medial temporal lobe (MTL) atrophy resulting from AD lesions and cerebrovascular lesions [i.e., white matter lesions (WML), lacunar strokes, and strokes] are often revealed concurrently on magnetic resonance...

  4. Characterization of the Gene Expression Profile of Human Hippocampus in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis

    OpenAIRE

    Julio Lachos; Michela Zattoni; Heinz-Gregor Wieser; Jean-Marc Fritschy; Thomas Langmann; Gerd Schmitz; Mariella Errede; Daniela Virgintino; Yasuhiro Yonekawa; Karl Frei

    2011-01-01

    One of the main putative causes of therapy refractory epilepsy in mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis is the overexpression of multidrug transporters (MDTs) at the blood-brain barrier (BBB). It steps up the removal of antiepileptic drugs (AEDs) out of the brain cells across the BBB resulting in a low concentration of AEDs within the target cells. Some of the mechanisms of AED resistance are most likely to be genetically determined. To obtain more information about ...

  5. Medial Temporal Lobe Damage Causes Deficits in Episodic Memory and Episodic Future Thinking Not Attributable to Deficits in Narrative Construction

    OpenAIRE

    Race, Elizabeth; Keane, Margaret M.; Verfaellie, Mieke

    2011-01-01

    The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL i...

  6. Analysis of dosimetric factors associated with temporal lobe necrosis (TLN) in patients with nasopharyngeal carcinoma (NPC) after intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    The radiation tolerance dose-volume in brain remains unclear for nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiotherapy (IMRT). We performed this study to investigate dosimetric factors associated with temporal lobe necrosis (TLN) in NPC patients treated with IMRT. From 2001 to 2008, 870 NPC patients were treated with IMRT. For the whole group, 40 patients have developed MRI-diagnosed TLN, and 219 patients were followed-up more than 60 months. Predictive dosimetric factors for TLN were identified by using univariate and multivariate analysis in these 259 patients. By univariate analyses, rVX (percent of temporal lobes receiving ≥ X Gy) and aVX (absolute volumes of temporal lobes receiving ≥ X Gy, values of X considered were 10, 20, 30, 40, 50, 60, 66 and 70) were all significantly associated with TLN. Multivariate analysis by logistic regression showed that rV40 and aV40 were significant factors for TLN. All dosimetric factors in current serials were highly correlated one another (p < 0.001). The 5-year incidence of TLN for rV40 <10% or aV40 <5 cc is less than 5%. The incidence for rV40 ≥ 15% or aV40c ≥ 10c is increased significantly and more than 20%. In this study, all dosimetric factors were highly correlated, rV40 and aV40 were independent predictive factors for TLN, IMRT with rV40 <10% or aV40 <5 cc in temporal lobe is relatively safe

  7. Anterior Temporal Lobe Connectivity Correlates with Functional Outcome after Aphasic Stroke

    Science.gov (United States)

    Warren, Jane E.; Crinion, Jennifer T.; Ralph, Matthew A. Lambon; Wise, Richard J. S.

    2009-01-01

    Focal brain lesions are assumed to produce language deficits by two basic mechanisms: local cortical dysfunction at the lesion site, and remote cortical dysfunction due to disruption of the transfer and integration of information between connected brain regions. However, functional imaging studies investigating language outcome after aphasic…

  8. The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

    OpenAIRE

    Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

    2014-01-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory?verbal comprehension is significantly impaired in Wernicke?s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke?s aphasia, with the wider ai...

  9. Psychomotor seizures, Penfield, Gibbs, Bailey and the development of anterior temporal lobectomy: A historical vignette

    OpenAIRE

    Vannemreddy Prasad; Stone James; Vannemreddy Siddharth; Slavin Konstantin

    2010-01-01

    Psychomotor seizures, referred to as limbic or partial complex seizures, have had an interesting evolution in diagnosis and treatment. Hughlings Jackson was the first to clearly relate the clinical syndrome and likely etiology to lesions in the uncinate region of the medial temporal lobe. With the application of electroencephalography (EEG) to the study of human epilepsy as early as 1934 by Gibbs, Lennox, and Davis in Boston, electrical recordings have significantly advanced the study of epil...

  10. Association between Vitamin D Receptor Gene Polymorphisms with Childhood Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Pei Jiang

    2015-10-01

    Full Text Available Vitamin D (VD is implicated in multiple aspects of human physiology and vitamin D receptor (VDR polymorphisms are associated with a variety of neuropsychiatric disorders. Although VD deficiency is highly prevalent in epilepsy patients and converging evidence indicates a role for VD in the development of epilepsy, no data is available on the possible relationship between epilepsy and genetic variations of VDR. In this study, 150 controls and 82 patients with temporal lobe epilepsy (TLE were genotyped for five common VDR polymorphisms (Cdx-2, FokI, BsmI, ApaI and TaqI by the polymerase chain reaction-ligase detection reaction method. Our results revealed that the frequency of FokI AC genotype was significantly higher in the control group than in the patients (p = 0.003, OR = 0.39, 95% CI = 0.21–0.73, whereas the AA genotype of ApaI SNP was more frequent in patients than in controls (p = 0.018, OR = 2.92, 95% CI = 1.2–7.1. However, no statistically significant association was found between Cdx-2, BsmI and TaqI polymorphisms and epilepsy. Additionally, in haplotype analysis, we found the haplotype GAT (BsmI/ApaI/TaqI conferred significantly increased risk for developing TLE (p = 0.039, OR = 1.62, 95% CI = 1.02–2.56. As far as we know, these results firstly underline the importance of VDR polymorphisms for the genetic susceptibility to epilepsy.

  11. Neuropathological signs of inflammation correlate with mitochondrial DNA deletions in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Volmering, Elisa; Niehusmann, Pitt; Peeva, Viktoriya; Grote, Alexander; Zsurka, Gábor; Altmüller, Janine; Nürnberg, Peter; Becker, Albert J; Schoch, Susanne; Elger, Christian E; Kunz, Wolfram S

    2016-08-01

    Accumulation of mitochondrial DNA (mtDNA) deletions has been proposed to be responsible for the presence of respiratory-deficient neurons in several CNS diseases. Deletions are thought to originate from double-strand breaks due to attack of reactive oxygen species (ROS) of putative inflammatory origin. In epileptogenesis, emerging evidence points to chronic inflammation as an important feature. Here we aimed to analyze the potential association of inflammation and mtDNA deletions in the hippocampal tissue of patients with mesial temporal lobe epilepsy (mTLE) and hippocampal sclerosis (HS). Hippocampal and parahippocampal tissue samples from 74 patients with drug-refractory mTLE served for mtDNA analysis by multiplex PCR as well as long-range PCR, single-molecule PCR and ultra-deep sequencing of mtDNA in selected samples. Patients were sub-classified according to neuropathological findings. Semi-quantitative assessment of neuronal cell loss was performed in the hippocampal regions CA1-CA4. Inflammatory infiltrates were quantified by cell counts in the CA1, CA3 and CA4 regions from well preserved hippocampal samples (n = 33). Samples with HS showed a significantly increased frequency of a 7436-bp mtDNA deletion (p T transversions compared to mTLE patients with different histopathology. Interestingly, the number of T-lymphocytes in the hippocampal CA1, CA3 and CA4 regions was, similar to the 7436-bp mtDNA deletion, significantly increased in samples with HS compared to other subgroups. Our findings show a coincidence of HS, increased somatic G>T transversions, the presence of a specific mtDNA deletion, and increased inflammatory infiltrates. These results support the hypothesis that chronic inflammation leads to mitochondrial dysfunction by ROS-mediated mtDNA mutagenesis which promotes epileptogenesis and neuronal cell loss in patients with mTLE and HS. PMID:26993140

  12. Dystrophin Distribution and Expression in Human and Experimental Temporal Lobe Epilepsy

    Science.gov (United States)

    Hendriksen, Ruben G. F.; Schipper, Sandra; Hoogland, Govert; Schijns, Olaf E. M. G.; Dings, Jim T. A.; Aalbers, Marlien W.; Vles, Johan S. H.

    2016-01-01

    Objective: Dystrophin is part of a protein complex that connects the cytoskeleton to the extracellular matrix. In addition to its role in muscle tissue, it functions as an anchoring protein within the central nervous system such as in hippocampus and cerebellum. Its presence in the latter regions is illustrated by the cognitive problems seen in Duchenne Muscular Dystrophy (DMD). Since epilepsy is also supposed to constitute a comorbidity of DMD, it is hypothesized that dystrophin plays a role in neuronal excitability. Here, we aimed to study brain dystrophin distribution and expression in both, human and experimental temporal lobe epilepsy (TLE). Method: Regional and cellular dystrophin distribution was evaluated in both human and rat hippocampi and in rat cerebellar tissue by immunofluorescent colocalization with neuronal (NeuN and calbindin) and glial (GFAP) markers. In addition, hippocampal dystrophin levels were estimated by Western blot analysis in biopsies from TLE patients, post-mortem controls, amygdala kindled (AK)-, and control rats. Results: Dystrophin was expressed in all hippocampal pyramidal subfields and in the molecular-, Purkinje-, and granular cell layer of the cerebellum. In these regions it colocalized with GFAP, suggesting expression in astrocytes such as Bergmann glia (BG) and velate protoplasmic astrocytes. In rat hippocampus and cerebellum there were neither differences in dystrophin positive cell types, nor in the regional dystrophin distribution between AK and control animals. Quantitatively, hippocampal full-length dystrophin (Dp427) levels were about 60% higher in human TLE patients than in post-mortem controls (p < 0.05), whereas the level of the shorter Dp71 isoform did not differ. In contrast, AK animals showed similar dystrophin levels as controls. Conclusion: Dystrophin is ubiquitously expressed by astrocytes in the human and rat hippocampus and in the rat cerebellum. Hippocampal full-length dystrophin (Dp427) levels are upregulated

  13. Recognition memory and the medial temporal lobe: from monkey research to human pathology.

    Science.gov (United States)

    Meunier, M; Barbeau, E

    2013-01-01

    This review provides a historical overview of decades of research on recognition memory, the process that allows both humans and animals to tell familiar from novel items. The emphasis is put on how monkey research improved our understanding of the medial temporal lobe (MTL) role and how tasks designed for monkeys influenced research in humans. The story starts in the early 1950s. Back then, memory was not a fashionable scientific topic. It was viewed as a function of the whole brain and not of specialized brain areas. All that changed in 1957-1958 when Brenda Milner, a neuropsychologist from Montreal, described patient H.M. He forgot all events as he lived them despite a fully preserved intelligence. He had received a MTL resection to relieve epilepsy. H.M. (1926-2008) would become the most influential patient in brain science. Which structures among those included in H.M.'s large lesion were important for recognition memory could not be evaluated in humans. It was gradually understood only after the successful development of a monkey model of human amnesia by Mishkin in 1978. Selective lesions and two behavioral tasks, delayed nonmatching-to-sample and visual paired comparison, were used to distinguish the contribution of the hippocampus from that of adjacent cortical areas. Driven by findings in non-human primates, human research on recognition memory is now trying to solve the question of whether the different structures composing MTL contributes to familiarity and recollection, the two possible forms taken by recognition. We described in particular two French patients, FRG and JMG, whose deficits support the currently dominant model attributing to the perirhinal cortex a critical role in recognition memory. Research on recognition memory has implications for the clinician as it may help understanding the cognitive deficits observed in different diseases. An illustration of such approach, linking basic and applied research, is provided for Alzheimer's disease

  14. Multivariate pattern analysis reveals anatomical connectivity differences between the left and right mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Peng Fang

    2015-01-01

    Full Text Available Previous studies have demonstrated differences of clinical signs and functional brain network organizations between the left and right mesial temporal lobe epilepsy (mTLE, but the anatomical connectivity differences underlying functional variance between the left and right mTLE remain uncharacterized. We examined 43 (22 left, 21 right mTLE patients with hippocampal sclerosis and 39 healthy controls using diffusion tensor imaging. After the whole-brain anatomical networks were constructed for each subject, multivariate pattern analysis was applied to classify the left mTLE from the right mTLE and extract the anatomical connectivity differences between the left and right mTLE patients. The classification results reveal 93.0% accuracy for the left mTLE versus the right mTLE, 93.4% accuracy for the left mTLE versus controls and 90.0% accuracy for the right mTLE versus controls. Compared with the right mTLE, the left mTLE exhibited a different connectivity pattern in the cortical-limbic network and cerebellum. The majority of the most discriminating anatomical connections were located within or across the cortical-limbic network and cerebellum, thereby indicating that these disease-related anatomical network alterations may give rise to a portion of the complex of emotional and memory deficit between the left and right mTLE. Moreover, the orbitofrontal gyrus, cingulate cortex, hippocampus and parahippocampal gyrus, which exhibit high discriminative power in classification, may play critical roles in the pathophysiology of mTLE. The current study demonstrated that anatomical connectivity differences between the left mTLE and the right mTLE may have the potential to serve as a neuroimaging biomarker to guide personalized diagnosis of the left and right mTLE.

  15. A pavlovian model of the amygdala and its influence within the medial temporal lobe.

    Science.gov (United States)

    Carrere, Maxime; Alexandre, Frédéric

    2015-01-01

    Recent advances in neuroscience give us a better view of the inner structure of the amygdala, of its relations with other regions in the Medial Temporal Lobe (MTL) and of the prominent role of neuromodulation. They have particularly shed light on two kinds of neurons in the basal nucleus of the amygdala, the so-called fear neurons and extinction neurons. Fear neurons mediate context-dependent fear by receiving contextual information from the hippocampus, whereas extinction neurons are linked with the medial prefrontal cortex (mPFC) and involved in fear extinction. The computational model of the amygdala that we describe in this paper is primarily a model of pavlovian conditioning, but its architecture also emphasizes the central role of the amygdala in the MTL memory processes through three main information flows. (i) Thalamic and higher order sensory cortical inputs including from the perirhinal cortex are received in the lateral amygdalar nucleus, where CS-US associations can be acquired. (ii) These associations are subsequently modulated, in the basal nucleus of the amygdala, by contextual inputs coming from the hippocampus and the mPFC. Basal fear and extinction neurons indicate the currently valid association to their main targets including in the MTL and the mPFC. (iii) The competition for the choice of the pavlovian response is ultimately performed by projection of these amygdalar neurons in the central nucleus of the amygdala where, beyond motor responding, a hormonal response, including cholinergic modulation, is also triggered via the basal forebrain. In turn, acetylcholine modulates activation in the basal nucleus and facilitates learning in the hippocampus. Based on biologically founded arguments, our model replicates a number of biological experiments, proposes some predictions about the role of amygdalar regions and describes pavlovian conditioning as a distributed systemic learning, binding memory processes in the MTL. PMID:25852499

  16. 1H MR spectroscopy of mesial temporal lobe epilepsies treated with Gamma knife

    International Nuclear Information System (INIS)

    Proton MR spectroscopy was used to observe long-term post-irradiation metabolic changes in epileptogenic tissue and in the contralateral parts of the brain which are not available with conventional imaging methods. We studied these changes in the temporal lobe in six patients, following radiosurgery on the amygdala and hippocampus. 1H MR spectroscopy at 1.5 T with short and long echo times (TE=10 and 135 ms) were used together with standard MR imaging sequences (T1-, T2-weighted). The treatment was performed by Leksell Gamma Knife with a dose of 50 Gy to the center and a 50% isodose to the margin of the target, represented by the mean volume of approximately 7.5 ml. Magnetic resonance imaging and MR spectroscopy examinations were performed at least once per year for 3 years. The most significant changes in spectra were observed approximately 1 year after the irradiation when edema in irradiated area was observed and strong signal of lipids was identified. Later, edema and lipid signals disappeared and follow-up was characterized by a decrease of NAA, Cr, and Cho concentrations in the ipsilateral region of the brain to the irradiation (LCModel calculation from voxel of interest 3.8-4.5 ml positioned into the centrum of target volume). The concentration of NAA, Cr, and Cho after radiosurgery was significantly different from control values (p<0.05) and also from concentrations in the contralateral part of the brain (p<0.05). In the contralateral part, the concentration of NAA was significantly increased (p<0.05) (NAA: before treatment 8.81, after treatment 11.33 mM). No radiotoxic changes were observed in the contralateral part of the brain or behind the area of target volume. The MR spectroscopy findings precluded MRI observation and MRS results completed data about the development of radiotoxic changes in the target volume. (orig.)

  17. Contribution of amygdala pathology to comorbid emotional disturbances in temporal lobe epilepsy.

    Science.gov (United States)

    Yilmazer-Hanke, Deniz; O'Loughlin, Elaine; McDermott, Kieran

    2016-06-01

    The amygdala contributes to the generation and propagation of epileptiform activity in temporal lobe epilepsy (TLE). Ictal symptoms such as fear, dreamy states (déjà vu, memory flashbacks, experiential hallucinations), epigastric auras, or sympathetic outflow with cardiovascular changes are often linked to a seizure focus in the amygdala. However, the amygdala may also play a role in comorbid anxiety, depression, and other psychiatric symptoms experienced in the interictal phase, especially in pharmacoresistant TLE. The few studies available on TLE-related alterations in surgical amygdala specimens indicate loss of both excitatory spiny projection neurons as well as interneurons in nuclei with a cortex-like architecture, which may influence mechanisms of feedforward and feedback inhibition. Studies of the human amygdala indicate global alterations in the density of AMPA/kainate, metabotropic glutamate, γ-aminobutyric acid type A (GABAA ), muscarinic M2 and M3, serotonergic 5-HT1A, and adrenergic α1 receptors. Also, amygdala GABAergic and neuropeptide Y (NPY) systems affected in human TLE are both involved in antiepileptic and anxiolytic effects. Experimental and human positron emission tomography studies indicate changes in amygdala serotonergic, NPY Y1 receptor, neurokinin, and opioid systems in emotional disturbances in TLE. Of particular interest is the reduction in amygdala volume in conjunction with ictal fear, seizure focus in the amygdala, and amygdala and hippocampal sclerosis in TLE patients. In contrast, patients with interictal depression often have an intact or even enlarged amygdala and a negative MRI associated with amygdala hypometabolism, which can be associated with limbic autoimmune encephalitis. These findings suggest a differential role of TLE-related amygdala changes in ictal and interictal emotional disturbances. © 2015 Wiley Periodicals, Inc. PMID:26525920

  18. Angiogenesis is associated with blood-brain barrier permeability in temporal lobe epilepsy.

    Science.gov (United States)

    Rigau, Valérie; Morin, Mélanie; Rousset, Marie-Claude; de Bock, Frédéric; Lebrun, Aurore; Coubes, Philippe; Picot, Marie-Christine; Baldy-Moulinier, Michel; Bockaert, Joël; Crespel, Arielle; Lerner-Natoli, Mireille

    2007-07-01

    Previous studies from our group, focusing on neuro-glial remodelling in human temporal lobe epilepsy (TLE), have shown the presence of immature vascular cells in various areas of the hippocampus. Here, we investigated angiogenic processes in hippocampi surgically removed from adult patients suffering from chronic intractable TLE, with various aetiologies. We compared hippocampi from TLE patients to hippocampi obtained after surgery or autopsy from non-epileptic patients (NE). We quantified the vascular density, checked for the expression of angiogenic factors and their receptors and looked for any blood-brain barrier (BBB) leakage. We used a relevant model of rat limbic epilepsy, induced by lithium-pilocarpine treatment, to understand the sequence of events. In humans, the vessel density was significantly higher in TLE than in NE patients. This was neither dependent on the aetiology nor on the degree of neuronal loss, but was positively correlated with seizure frequency. In the whole hippocampus, we observed many complex, tortuous microvessels. In the dentate gyrus, when the granular layer was dispersed, long microvessels appeared radially orientated. Vascular endothelial factor (VEGF) and tyrosine kinase receptors were detected in different types of cells. An impairment of the BBB was demonstrated by the loss of tight junctions and by Immunoglobulines G (IgG) leakage and accumulation in neurons. In the rat model of TLE, VEGF over-expression and BBB impairment occurred early after status epilepticus, followed by a progressive increase in vascularization. In humans and rodents, angiogenic processes and BBB disruption were still obvious in the chronic focus, probably activated by recurrent seizures. We suggest that the persistent leakage of serum IgG in the interstitial space and their uptake by neurons may participate in hypoperfusion and in neuronal dysfunction occurring in TLE. PMID:17533168

  19. Mesial temporal lobe morphology in intractable pediatric epilepsy: so-called hippocampal malrotation, associated findings, and relevance to presurgical assessment.

    Science.gov (United States)

    Leach, James L; Awwad, Reem; Greiner, Hansel M; Vannest, Jennifer J; Miles, Lili; Mangano, Francesco T

    2016-06-01

    OBJECTIVE Diagnostic criteria for hippocampal malrotation (HIMAL) on brain MRI typically include a rounded hippocampus, vertical collateral sulcus, and architectural blurring. Relationship to epileptogenesis remains speculative, and usefulness for surgical guidance is unknown. The study was performed to determine the prevalence of hippocampal rotational anomalies in a cohort of pediatric patients with intractable epilepsy undergoing evaluation for surgery and to determine the significance of this finding in the context of surgical planning. METHODS Forty-eight surgically treated children with intractable epilepsy were compared with matched healthy subjects; reviewers were blinded to surgical side. Each temporal lobe was evaluated for rounded hippocampus, blurring, vertical collateral sulcus, wide choroidal fissure, enlarged temporal horn, low fornix, hippocampal signal, and findings of hippocampal sclerosis. A mesial temporal lobe (MTL) score was calculated by summing the number of features, and the collateral sulcus angle (CSA) was measured in each temporal lobe. Surgical side, pathological diagnosis, and imaging findings elsewhere in the brain were tabulated. Presence of HIMAL, associated imaging features, and MTL score were compared between sides, between epilepsy and control groups, in relationship to side of surgery, and in relationship to postoperative outcome. RESULTS Only 3 epilepsy patients (6.2%) and no controls exhibited all 3 features of HIMAL (p = 0.12). Eight of 48 (16.7%) epilepsy versus 2 of 48 (4.6%) control subjects had both a rounded hippocampus and vertical collateral sulcus (suggesting HIMAL) (p = 0.045). In control and epilepsy subjects, most findings were more prevalent on the left, and the left CSA was more vertical (p prevalent and MTL scores were higher in patients with resections involving the temporal lobes. On group analysis, HIMAL findings did not predict eventual surgical side and did not predict outcome, although the numbers are

  20. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    Energy Technology Data Exchange (ETDEWEB)

    Zaknun, John J. [University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria); IAEA, Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, P.O. Box 100, Wien (Austria); Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Maes, Alex [Katholieke Universiteit Leuven, Leuven (Belgium); AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn [Chulalongkorn University, Nuclear Medicine Division, Department of Radiology, Bangkok (Thailand); Vazquez, Silvia [Instituto de Investigaciones Neurologicas, FLENI, Department of Radiology, Buenos Aires (Argentina); Dupont, Patrick [Katholieke Universiteit Leuven, Leuven (Belgium); Dondi, Maurizio [Ospedale Maggiore, Department of Nuclear Medicine, Bologna (Italy); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria)

    2008-01-15

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  1. A comparison among 123I-IMP SPECT, EEG and MRI in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT), electroencephalography (EEG), and magnetic resonance imaging (MRI) were performed in 19 patients with temporal lobe epilepsy during interictal stage. MRI demonstrated abnormal signal in mesial temporal lobe (hippocampus) in 10 of 19 patients and 123I-IMP SPECT showed a hypoperfusion area in 15 of 19 patients. When compared with EEG and MRI data, disagreement of the affected area was observed in 3 cases. In comparison of EEG and 123I-IMP SPECT data, disagreement of the affected area was observed in 6 cases. Although there was no disagreement in comparison of MRI and 123I-IMP SPECT. We made a reprojection data parallel to the hippocampus in 123I-IMP SPECT. These data demonstrated obviously a hypoperfusion area around the hippocampus. In cases within one month from seizure attack, wide hypoperfusion area was showed on 123I-IMP SPECT in comparison of abnormal signal area on MRI. It could be considered that a reprojection data parallel to the hippocampus was useful to know extent of hypoperfusion area in temporal lobe epilepsy. (author)

  2. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    International Nuclear Information System (INIS)

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  3. Cerebral Hemispheric Lateralization Associated with Hippocampal Sclerosis May Affect Interictal Cardiovascular Autonomic Functions in Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Rokia Ghchime

    2016-01-01

    Full Text Available It is well established that the temporal lobe epilepsy (TLE is linked to the autonomic nervous system dysfunctions. Seizures alter the function of different systems such as the respiratory, cardiovascular, gastrointestinal, and urogenital systems. The aim of this work was to evaluate the possible factors which may be involved in interictal cardiovascular autonomic function in temporal lobe epilepsy with complex partial seizures, and with particular attention to hippocampal sclerosis. The study was conducted in 30 patients with intractable temporal lobe epilepsy (19 with left hippocampal sclerosis, 11 with right hippocampal sclerosis. All subjects underwent four tests of cardiac autonomic function: heart rate changes in response to deep breathing, heart rate, and blood pressure variations throughout resting activity and during hand grip, mental stress, and orthostatic tests. Our results show that the right cerebral hemisphere predominantly modulates sympathetic activity, while the left cerebral hemisphere mainly modulates parasympathetic activity, which mediated tachycardia and excessive bradycardia counterregulation, both of which might be involved as a mechanism of sudden unexpected death in epilepsy patients (SUDEP.

  4. Comparison of manual tracing versus a semiautomatic radial measurement method in temporal lobe MRI volumetry for pharmacoresistant epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Christian-Andreas; Scorzin, Jasmin; Schramm, Johannes [University of Bonn, Department of Neurosurgery, Bonn (Germany); Koenig, Roy; Urbach, Horst [University of Bonn, Department of Radiology Neuroradiology, Bonn (Germany); Fimmers, Rolf [University of Bonn, Institute of Medical Biometry, Informatics and Epidemiology, Bonn (Germany); Zentner, Josef [University of Freiburg, Department of Neurosurgery, Freiburg (Germany); Lehmann, Thomas-Nicolas [Charite-University Medicine Berlin, Department of Neurosurgery, Berlin (Germany)

    2007-03-15

    The aim of this study was to test a modified radial semiautomated volumetry technique (radial divider technique, RDT) versus the manual volumetry technique (MVT) for proportionality of temporal subvolumes in 30 patients with drug-resistant temporal lobe epilepsy. Included in the study were 30 patients (15 female, 15 male; mean age 39.6 years) with pharmacoresistant epilepsy (mean duration 26.6 years). MRI studies were performed preoperatively on a 1.5-T scanner. All image processing steps and volume measurements were performed using ANALYZE software. The volumes of six subregions were measured bilaterally; these included the superior temporal gyrus (STG), middle + inferior temporal gyrus (MITG), fusiform gyrus (FG), parahippocampal gyrus (PHG), amygdala (AM), and hippocampus (HP). Linear regression was used to investigate the relationship between the comparable subvolumes obtained with MVT and RDT. Very high correlations (R {sup 2} >0.95) between RDT and MVT were observed for the STG + MITG and the STG + MITG + FG, but low correlations for the PHG subvolumes and the combined PHG + HP + AM subvolumes. These observations were independent of the side of the pathology and of hemisphere. The two measurement techniques provided highly reliable proportional results. This series in a homogeneous group of TLE patients suggests that the much quicker RDT is suitable for determining the volume of temporolateral and laterobasal temporal lobe compartments, of both the affected and the non-affected side and the right and left hemisphere. (orig.)

  5. The evolution of anterior sector venous drainage in right lobe living donor liver transplantation: does one technique fit all?

    Science.gov (United States)

    Tokat, Yaman

    2016-01-01

    In living donor liver transplantation (LDLT), an adequate hepatic venous outflow constitutes one of the basic principles of a technically successful procedure. The issue of whether the anterior sector (AS) of the right lobe (RL) graft should or should not be routinely drained has been controversial. The aim of this 10-year, single-center, retrospective cohort study was to review the evolution of our hepatic venous outflow reconstruction technique in RL grafts and evaluate the impact of routine AS drainage strategy on the outcome. The study group consisted of 582 primary RL LDLT performed between July 2004 and December 2014. The cases were divided into 3 consecutive periods with different AS venous outflow reconstruction techniques, which included middle hepatic vein (MHV) drainage in Era 1 (n=119), a more selective AS drainage with cryopreserved homologous grafts in Era 2 (n=391), and routine segment 5 and/or 8 oriented AS drainage with synthetic grafts in Era 3 (n=72). Intraoperative portal flow measurement with routine splenic artery ligation (SAL) technique (in RL grafts with a portal flow of ≥ 250 mL/min/100 g liver tissue) was added later in Era 3. These 3 groups were compared in terms of recipient and donor demographics, surgical characteristics and short-term outcome. The rate of AS venous drainage varied from 58.8% in Era 1 and 35.0% in Era 2 to 73.6% in Era 3 (Precipients significantly decreased over the years (15.1% in Era 1 and 8.7% in Era 2 vs. 2.8% in Era 3, P=0.01). After the addition of SAL technique in the 45 cases, there was only 1 graft loss and no perioperative mortality. One-year recipient survival rate was also significantly higher in Era 3 (79.6% in Era 1 and 86.1% in Era 2 vs. 92.1% in Era 3, P=0.002). Routine AS drainage via segment 5 and/or 8 veins using synthetic grafts is a technique to fit all RL grafts in LDLT. Addition of SAL effectively prevents early graft dysfunction and significantly improves the outcome. PMID:27115010

  6. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  7. The Research on the Memory Impairment in Temporal Lobe Epilepsy P atients%颞叶癫痫患者记忆损害的研究

    Institute of Scientific and Technical Information of China (English)

    俞志鹏; 王文敏; 王荪

    2002-01-01

    Objective: This paper reviewed recent resear ch on memory impairments in temporal lobe epilepsy patients, including clinical features of spatial, ver bal, visual and semantic memory disorders, as well as their mechanisms and clini cal significance.

  8. Interictal noninvasive measurements of regional cerebral blood flow using technetium-99m hexamethylprophylene amine oxime in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Interictal noninvasive measurements of regional cerebral blood flow (rCBF) using 99mTc-HMPAO SPECT were performed on 43 patients with temporal lobe epilepsy. Mean cerebral blood flow (mCBF) showed significant negative correlation with advancing age and duration of illness and mean cerebellar blood flow (mCblBF) showed weak negative correlation with duration of illness. Patients taking phenytoin had significantly lower mCBF and lower mCblBF than those not taking phenytoin. Patients with both visually detected temporal hypoperfusion on SPECT and hippocampal sclerosis on MRI showed quantitatively lower rCBF in the temporal region and more wide-spread hypoperfusion than patients without the both of image findings. Our results suggest that interictal noninvasive cerebral blood flow measurements using 99mTc-HMPAO may give useful information about not only cerebral blood flow in the epileptic focus and its adjacent area but also the effects of antiepileptic drugs on brain function in temporal lobe epilepsy. (author)

  9. Brain-derived neurotrophic factor ameliorates brain stem cardiovascular dysregulation during experimental temporal lobe status epilepticus.

    Directory of Open Access Journals (Sweden)

    Ching-Yi Tsai

    Full Text Available BACKGROUND: Status epilepticus (SE is an acute, prolonged epileptic crisis with a mortality rate of 20-30%; the underlying mechanism is not completely understood. We assessed the hypothesis that brain stem cardiovascular dysregulation occurs during SE because of oxidative stress in rostral ventrolateral medulla (RVLM, a key nucleus of the baroreflex loop; to be ameliorated by brain-derived neurotrophic factor (BDNF via an antioxidant action. METHODOLOGY/PRINCIPAL FINDINGS: In a clinically relevant experimental model of temporal lobe SE (TLSE using Sprague-Dawley rats, sustained hippocampal seizure activity was accompanied by progressive hypotension that was preceded by a reduction in baroreflex-mediated sympathetic vasomotor tone; heart rate and baroreflex-mediated cardiac responses remained unaltered. Biochemical experiments further showed concurrent augmentation of superoxide anion, phosphorylated p47(phox subunit of NADPH oxidase and mRNA or protein levels of BDNF, tropomyosin receptor kinase B (TrkB, angiotensin AT1 receptor subtype (AT1R, nitric oxide synthase II (NOS II or peroxynitrite in RVLM. Whereas pretreatment by microinjection bilaterally into RVLM of a superoxide dismutase mimetic (tempol, a specific antagonist of NADPH oxidase (apocynin or an AT1R antagonist (losartan blunted significantly the augmented superoxide anion or phosphorylated p47(phox subunit in RVLM, hypotension and the reduced baroreflex-mediated sympathetic vasomotor tone during experimental TLSE, pretreatment with a recombinant human TrkB-Fc fusion protein or an antisense bdnf oligonucleotide significantly potentiated all those events, alongside peroxynitrite. However, none of the pretreatments affected the insignificant changes in heart rate and baroreflex-mediated cardiac responses. CONCLUSIONS/SIGNIFICANCE: We conclude that formation of peroxynitrite by a reaction between superoxide anion generated by NADPH oxidase in RVLM on activation by AT1R and NOS II

  10. A componential analysis of proverb interpretation in patients with frontal lobe epilepsy and temporal lobe epilepsy: relationships with disease-related factors.

    Science.gov (United States)

    McDonald, Carrie R; Delis, Dean C; Kramer, Joel H; Tecoma, Evelyn S; Iragui, Vicente J

    2008-05-01

    The ability to interpret nonliteral, metaphoric language was explored in patients with frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE), and matched control participants, to determine (1) if patients with FLE were impaired in their interpretations relative to those with TLE and controls, and (2) if disease-related variables (e.g., age of seizure onset) predicted performances in either patient group. A total of 22 patients with FLE, 20 patients with TLE, and 23 controls were administered a test of proverb interpretation to assess their ability to grasp the abstract meaning of nonliteral language. Participants were presented with a series of proverbs and asked to provide an oral interpretation of each. Responses to each proverb were scored according to their accuracy and level of abstractness. Patients with FLE, but not TLE, were impaired relative to controls in their overall interpretation of proverbs. However, a subgroup analysis revealed that only patients with left FLE showed impaired interpretation accuracy relative to the other groups, whereas patients with both left FLE and left TLE showed impaired abstraction. Patients with FLE were also impaired when they were asked to select the best interpretation of the proverb from response alternatives. In patients with FLE, only a left-sided seizure focus was associated with poorer performance. In patients with TLE, both an early age of onset and a left-sided seizure focus predicted poorer performance. Overall, FLE patients exhibit greater impairment than TLE patients in interpreting proverbs. However, the nature and disease-specific correlates of impaired performances in proverb interpretation differ between the groups. PMID:17853125

  11. Bringing memory fMRI to the clinic: comparison of seven memory fMRI protocols in temporal lobe epilepsy.

    Science.gov (United States)

    Towgood, Karren; Barker, Gareth J; Caceres, Alejandro; Crum, William R; Elwes, Robert D C; Costafreda, Sergi G; Mehta, Mitul A; Morris, Robin G; von Oertzen, Tim J; Richardson, Mark P

    2015-04-01

    fMRI is increasingly implemented in the clinic to assess memory function. There are multiple approaches to memory fMRI, but limited data on advantages and reliability of different methods. Here, we compared effect size, activation lateralisation, and between-sessions reliability of seven memory fMRI protocols: Hometown Walking (block design), Scene encoding (block design and event-related design), Picture encoding (block and event-related), and Word encoding (block and event-related). All protocols were performed on three occasions in 16 patients with temporal lobe epilepsy (TLE). Group T-maps showed activity bilaterally in medial temporal lobe for all protocols. Using ANOVA, there was an interaction between hemisphere and seizure-onset lateralisation (P = 0.009) and between hemisphere, protocol and seizure-onset lateralisation (P = 0.002), showing that the distribution of memory-related activity between left and right temporal lobes differed between protocols and between patients with left-onset and right-onset seizures. Using voxelwise intraclass Correlation Coefficient, between-sessions reliability was best for Hometown and Scenes (block and event). The between-sessions spatial overlap of activated voxels was also greatest for Hometown and Scenes. Lateralisation of activity between hemispheres was most reliable for Scenes (block and event) and Words (event). Using receiver operating characteristic analysis to explore the ability of each fMRI protocol to classify patients as left-onset or right-onset TLE, only the Words (event) protocol achieved a significantly above-chance classification of patients at all three sessions. We conclude that Words (event) protocol shows the best combination of between-sessions reliability of the distribution of activity between hemispheres and reliable ability to distinguish between left-onset and right-onset patients. PMID:25727386

  12. A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

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    Jianhong Ye

    Full Text Available PURPOSE: To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients. METHODS AND MATERIALS: Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals. RESULTS: Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001. CONCLUSION: Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

  13. The evaluation of FDG-PET imaging for epileptogenic focus localization in patients with MRI positive and MRI negative temporal lobe epilepsy

    International Nuclear Information System (INIS)

    We studied the contribution of interictal FDG-PET ([18 F] fluorodeoxyglucose-positron emission tomography) in epileptic focus identification in temporal lobe epilepsy patients with positive, equivocal and negative magnetic resonance imaging (MRI). Ninety-eight patients who underwent surgical treatment for drug resistant temporal lobe epilepsy after neuropsychological evaluation, scalp video EEG monitoring, FDG-PET, MRI and/or long-term intracranial EEG and with >12 months clinical follow-up were included in this study. FDG-PET findings were compared to MRI, histopathology, scalp video EEG and long-term intracranial EEG monitoring. FDG-PET lateralized the seizure focus in 95 % of MRI positive, 69 % of MRI equivocal and 84 % of MRI negative patients. There was no statistically significant difference between the surgical outcomes among the groups with Engel class I and II outcomes achieved in 86 %, 86 %, 84 % of MRI positive, equivocal and negative temporal lobe epilepsy patients, respectively. The patients with positive unilateral FDG-PET demonstrated excellent postsurgical outcomes, with 96 % Engel class I and II. Histopathology revealed focal lesions in 75 % of MRI equivocal, 84 % of MRI positive, and 23 % of MRI negative temporal lobe epilepsy cases. FDG-PET is an accurate noninvasive method in lateralizing the epileptogenic focus in temporal lobe epilepsy, especially in patients with normal or equivocal MRIs, or non-lateralized EEG monitoring. Very subtle findings in MRI are often associated with histopathological lesions and should be described in MRI reports. The patients with negative or equivocal MRI temporal lobe epilepsy are good surgical candidates with comparable postsurgical outcomes to patients with MRI positive temporal lobe epilepsy. (orig.)

  14. The evaluation of FDG-PET imaging for epileptogenic focus localization in patients with MRI positive and MRI negative temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Gok, Beril [Drexel University, Department of Radiology, Mercy Catholic Medical Center, Philadelphia, PA (United States); Johns Hopkins University, Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Jallo, George [Johns Hopkins University, Department of Neurosurgery, Baltimore, MD (United States); Hayeri, Reza [Drexel University, Department of Radiology, Mercy Catholic Medical Center, Philadelphia, PA (United States); Wahl, Richard [Johns Hopkins University, Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Aygun, Nafi [Johns Hopkins University, Division of Neuroradiology, Department of Radiology and Radiological Sciences, Baltimore, MD (United States)

    2013-05-15

    We studied the contribution of interictal FDG-PET ([18 F] fluorodeoxyglucose-positron emission tomography) in epileptic focus identification in temporal lobe epilepsy patients with positive, equivocal and negative magnetic resonance imaging (MRI). Ninety-eight patients who underwent surgical treatment for drug resistant temporal lobe epilepsy after neuropsychological evaluation, scalp video EEG monitoring, FDG-PET, MRI and/or long-term intracranial EEG and with >12 months clinical follow-up were included in this study. FDG-PET findings were compared to MRI, histopathology, scalp video EEG and long-term intracranial EEG monitoring. FDG-PET lateralized the seizure focus in 95 % of MRI positive, 69 % of MRI equivocal and 84 % of MRI negative patients. There was no statistically significant difference between the surgical outcomes among the groups with Engel class I and II outcomes achieved in 86 %, 86 %, 84 % of MRI positive, equivocal and negative temporal lobe epilepsy patients, respectively. The patients with positive unilateral FDG-PET demonstrated excellent postsurgical outcomes, with 96 % Engel class I and II. Histopathology revealed focal lesions in 75 % of MRI equivocal, 84 % of MRI positive, and 23 % of MRI negative temporal lobe epilepsy cases. FDG-PET is an accurate noninvasive method in lateralizing the epileptogenic focus in temporal lobe epilepsy, especially in patients with normal or equivocal MRIs, or non-lateralized EEG monitoring. Very subtle findings in MRI are often associated with histopathological lesions and should be described in MRI reports. The patients with negative or equivocal MRI temporal lobe epilepsy are good surgical candidates with comparable postsurgical outcomes to patients with MRI positive temporal lobe epilepsy. (orig.)

  15. Decreased expression of thyroid receptor-associated protein 220 in temporal lobe tissue of patients with refractory epilepsy

    International Nuclear Information System (INIS)

    Purpose: TRAP220 (thyroid hormone receptor-associated protein) functions as a coactivator for nuclear receptors and stimulates transcription by recruiting the TRAP mediator complex to hormone responsive promoter regions. Thus, TRAP220 enhances the function of thyroid/steroid hormone receptors such as thyroid hormone and oestrogen receptors. This study investigated the expression of TRAP220 mRNA and protein level in epileptic brains comparing with human control. Methods: We examined the expression of TRAP220 mRNA and protein levels in temporal lobes from patients with chronic pharmacoresistant epilepsy who have undergone surgery. Results: Expression of TRAP220 mRNA and protein was shown to be decreased significantly in the temporal cortex of the patients with epilepsy. Conclusions: Our work showed that a decrease in TRAP220 mRNA and protein levels may be involved in the pathophysiology of epilepsy and may be associated with impairment of the brain caused by frequent seizures

  16. Effects of Swimming Exercise on Limbic and Motor Cortex Neurogenesis in the Kainate-Lesion Model of Temporal Lobe Epilepsy

    Science.gov (United States)

    Gorantla, Vasavi R.; Sirigiri, Amulya; Volkova, Yulia A.; Millis, Richard M.

    2016-01-01

    Temporal lobe epilepsy (TLE) is a common neurological disease and antiseizure medication is often inadequate for preventing apoptotic cell death. Aerobic swimming exercise (EX) augments neurogenesis in rats when initiated immediately in the postictal period. This study tests the hypothesis that aerobic exercise also augments neurogenesis over the long term. Male Wistar rats (age of 4 months) were subjected to chemical lesioning using KA and to an EX intervention consisting of a 30 d period of daily swimming for 15 min, in one experiment immediately after KA lesioning (immediate exposure) and in a second experiment after a 60 d period of normal activity (delayed exposure). Morphometric counting of neuron numbers (NN) and dendritic branch points and intersections (DDBPI) was performed in the CA1, CA3, and dentate regions of hippocampus, in basolateral nucleus of amygdala, and in several areas of motor cortex. EX increased NN and DDBPI in the normal control and the KA-lesioned rats in all four limbic and motor cortex areas studied, after both immediate and 60 d delayed exposures to exercise. These findings suggest that, after temporal lobe epileptic seizures in rats, swimming exercise may improve neural plasticity in areas of the brain involved with emotional regulation and motor coordination, even if the exercise treatment is delayed. PMID:27313873

  17. Detection of whole-brain abnormalities in temporal lobe epilepsy using tensor-based morphometry with DARTEL

    Science.gov (United States)

    Li, Wenjing; He, Huiguang; Lu, Jingjing; Lv, Bin; Li, Meng; Jin, Zhengyu

    2009-10-01

    Tensor-based morphometry (TBM) is an automated technique for detecting the anatomical differences between populations by examining the gradients of the deformation fields used to nonlinearly warp MR images. The purpose of this study was to investigate the whole-brain volume changes between the patients with unilateral temporal lobe epilepsy (TLE) and the controls using TBM with DARTEL, which could achieve more accurate inter-subject registration of brain images. T1-weighted images were acquired from 21 left-TLE patients, 21 right-TLE patients and 21 healthy controls, which were matched in age and gender. The determinants of the gradient of deformation fields at voxel level were obtained to quantify the expansion or contraction for individual images relative to the template, and then logarithmical transformation was applied on it. A whole brain analysis was performed using general lineal model (GLM), and the multiple comparison was corrected by false discovery rate (FDR) with p<0.05. For left-TLE patients, significant volume reductions were found in hippocampus, cingulate gyrus, precentral gyrus, right temporal lobe and cerebellum. These results potentially support the utility of TBM with DARTEL to study the structural changes between groups.

  18. Combined effect between two functional polymorphisms of SLC6A12 gene is associated with temporal lobe epilepsy

    Indian Academy of Sciences (India)

    Jingyun Li; Hua Lin; Fenghe Niu; Xilin Zhu; Ning Shen; Xin Wang; Liping Li; Aihua Liu; Xiaopan Wu; Wei Sun; Yuping Wang; Ying Liu

    2015-12-01

    Temporal lobe epilepsy (TLE) is the most common epilepsy subtype with complex genetic structure. A recent study in four populations (Ireland, UK, Australia and Finland) reported an allelic association between betaine/GABA transporter-1 (-1 or 612) and mesial temporal lobe epilepsy with hippocampal sclerosis. To demonstrate the association between 612 gene polymorphisms and TLE, TaqMan method was used to genotype five single-nucleotide polymorphisms of 612 gene in 358 TLE patients and 596 nonepileptic control subjects of Chinese Han origin. Real-time PCR was used to detect the effects of variations on gene expression associated with TLE. Though, the single-marker analysis did not demonstrate allelic association with TLE, rs542736–rs557881 interaction showed significant association. The 612 expression levels in peripheral blood mononuclear cells were significantly higher in TLE patients than in control subjects and were correlated to rs542736 G–rs557881 A haplotypes. Our preliminary results suggested combined effect of two common polymorphisms on SLC6A12 gene may be associated with TLE, but the precise mechanism needs further investigation.

  19. MTA index: a simple 2D-method for assessing atrophy of the medial temporal lobe using clinically available neuroimaging

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    Manuel eMenéndez-González

    2014-03-01

    Full Text Available Background and purpose: Despite a strong correlation between severity of Alzheimer disease (AD pathology and medial temporal lobe atrophy (MTA, its measurement has not been widely used in daily clinical practice as a criterion in the diagnosis of prodromal and probable AD. This is mainly because the methods available to date are sophisticated and difficult to implement for routine use in most hospitals. In this pilot study we aim to describe a novel, simple and objective method for measuring the rate of MTA in relation to the global atrophy using clinically available neuroimaging and describe the rationale behind this method.Description: This method consists of calculating a ratio of 3 regions traced manually on one single coronal MRI slide at the level of the interpeduncular fossa: i the medial temporal lobe region (A; ii the parenchyma within the medial temporal region, that includes the hippocampus and the parahippocampal gyrus -the fimbriae taenia and choroid plexus are excluded- (B; and iii the body of the ipsilateral lateral ventricle (C. Therefore we can compute the ratio Medial Temporal Atrophy index at both sides as follows: MTAi = (A-B x10/C.Conclusions: The MTAi is a simple 2D-method for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. This method can be useful for a more accurate diagnosis of AD in routine clinical practice. Further studies are needed to assess the usefulness of MTAi in the diagnosis of early AD, in tracking the progression of AD and in the differential diagnosis of AD with other dementias.

  20. Síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante: relato de caso Interictal personality syndrome in temporal lobe epilepsy: case report

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    PAULO C. TREVISOL-BITTENCOURT

    2000-06-01

    Full Text Available A síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante consiste de hipossexualidade, hiperreligiosidade, alteração do humor e hipergrafia. Sua descrição, em 1974, foi seguida de extensa busca por estes sinais em uma vasta população de pacientes epilépticos. No entanto, estes estudos científicos fracassaram em encontrar este síndrome na epilepsia do lobo temporal em geral. Sua existência foi, por conseguinte, posta em dúvida. Apresentamos o caso de um senhor de 35 anos cuja peculiaridade hipergráfica é o desenho de plantas de construção civil em grande quantidade, além de hiperreligiosidade, hipossexualidade e circunstancialidade. É o primeiro relato deste tipo de expressão gráfica associada à epilepsia parcial complexa e esclerose mesial temporal. Dentre os mecanismos fisiopatológicos propostos, o mais coerente é o da hiperconexão temporal. Embora as crises possam ser controladas em grande parte dos casos com tratamento clínico ou cirúrgico, a sintomatologia comportamental é refratária ao tratamento psicoterápico.The syndrome of interictal personality in non-dominant temporal lobe epilepsy consists of hyposexuality, hyperreligiosity, humorlessness and hypergraphia. Its notification, in 1974, was followed by an extensive search for these traits in broad epileptic populations. Nevertheless, these statistical studies failed to match this syndrome in general temporal lobe epileptics, and its existence became then target of doubt. We report the case of a 35 year-old man presenting partial complex epilepsy, whose singularity lies in his sophisticated drawing abilities. The large amount of buildings and houses he paints expresses his hypergraphia. He also presents hyposexuality and hyperreligiosity. MRI shows right mesial temporal sclerosis. Temporal hyperconnection, caused by a basal temporal irritative focus, is the most probable pathophysiological mechanism. Epileptic fits can be controlled

  1. Relationship between remnant hippocampus and amygdala and memory outcomes after stereotactic surgery for mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Malikova H

    2015-11-01

    Full Text Available Hana Malikova,1,2,* Lenka Kramska,3,* Zdenek Vojtech,4,5 Jan Sroubek,6 Jiri Lukavsky,7 Roman Liscak8 1Department of Radiology, Na Homolce Hospital, 2Institute of Anatomy, Second Medical Faculty, Charles University in Prague, 3Department of Clinical Psychology, Na Homolce Hospital, 4Department of Neurology, Na Homolce Hospital, 5Department of Neurology, 3rd Medical Faculty, Charles University in Prague, 6Department of Neurosurgery, Na Homolce Hospital, 7Institute of Psychology, Academy of Sciences of the Czech Republic, 8Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic *These authors contributed equally to this work Background and purpose: Mesial temporal structures play an important role in human memory. In mesial temporal lobe epilepsy (MTLE, seizure activity is generated from the same structures. Surgery is the definitive treatment for medically intractable MTLE. In addition to standard temporal lobe microsurgical resection, stereotactic radiofrequency amygdalohippocampectomy (SAHE is used as an alternative MTLE treatment. While memory impairments after standard epilepsy surgery are well known, it has been shown that memory decline is not a feature of SAHE. The aim of the present study was to correlate the volume of the remnant hippocampus and amygdala in patients treated by SAHE with changes in memory parameters.Materials and methods: Thirty-seven MTLE patients treated by SAHE (ten right, 27 left were included. Patients underwent magnetic resonance imaging examinations including hippocampal and amygdalar volumetry and neuropsychological evaluation preoperatively and 1 year after surgery.Results: Using Spearman correlation analyses, larger left-sided hippocampal reductions were associated with lower verbal memory performance (ρ=-0.46; P=0.02. On the contrary, improvement of global memory quotient (MQ was positively correlated with larger right-sided hippocampal reduction (ρ=0.66; P=0

  2. Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography

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    Idil Gunes Tatar

    2012-03-01

    Full Text Available Background: Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be correctly diagnosed and properly treated. Up to now, several diagnostic approaches have been processed to determine the epileptic focus.Objectives: The aim of this study was to discover whether proton-MR-spectroscopic imaging (MRSI aids in the diagnosis of temporal lobe epilepsy in conjunction with classical electroencephalography (EEG findings.Patients and Methods: Totally, 70 mesial temporal zones consisting of 39 right hippocampi and 31 left hippocampi of 46 patients (25 male, 21 female were analysed by proton MRSI. All patients underwent a clinical neurologic examination, scalp EEG recording and prolonged video EEG monitoring. Partial seizures on the right, left or both sides were recorded in all patients. All patients were under medical treatment and none of the patients underwent amygdalohippocampectomy and similar surgical procedures.Results: The normal average lactate (Lac, phosphocreatine, N-acetyl aspartate (NAA, creatine (Cr, choline (Cho, myo-inositol, glutamate and glutamine (Glx peaks and Nacetyl aspartate/Cr, NAA/ Cho + Cr, Cho/Cr ratios were measured from the healthy opposite hippocampi or from the control subjects. The Lac, glutamate and glutamine (Glx, myo-inositol, phosphocreatine and NAA metabolites plus Cho/Cr ratio showed statisticaldifference between the normal and the epileptic hippocampi. Cho, Cr metabolites plus NAA/Cr, NAA/ Cho + Cr ratios were almost the same between the groups. The sensitivity of Proton-MR-Spectroscopy for lateralization of the epileptic foci in all patients was 96% and the specificity was 50%.Conclusions: Proton-MRSI can easily be considered as an alternative modality of choice in the diagnosis of temporal lobe epilepsy and in the future; Proton-MR-Spectroscopy may become the most important technique used in epilepsy centers.

  3. Value of Proton-MR-Spectroscopy in the Diagnosis of Temporal Lobe Epilepsy; Correlation of Metabolite Alterations With Electroencephalography

    International Nuclear Information System (INIS)

    Epilepsy, a well-known mostly idiopathic neurologic disorder, has to be correctly diagnosed and properly treated. Up to now, several diagnostic approaches have been processed to determine the epileptic focus. The aim of this study was to discover whether proton-MR-spectroscopic imaging (MRSI) aids in the diagnosis of temporal lobe epilepsy in conjunction with classical electroencephalography (EEG) findings. Totally, 70 mesial temporal zones consisting of 39 right hippocampi and 31 left hippocampi of 46 patients (25 male, 21 female) were analyzed by proton MRSI. All patients underwent a clinical neurologic examination, scalp EEG recording and prolonged video EEG monitoring. Partial seizures on the right, left or both sides were recorded in all patients. All patients were under medical treatment and none of the patients underwent amygdalohippocampectomy and similar surgical procedures. The normal average lactate (Lac), phosphocreatine, N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), myo-inositol, glutamate and glutamine (Glx) peaks and Nacetyl aspartate/Cr, NAA/ Cho + Cr, Cho/Cr ratios were measured from the healthy opposite hippocampi or from the control subjects. The Lac, glutamate and glutamine (Glx), myo-inositol, phosphocreatine and NAA metabolites plus Cho/Cr ratio showed statistical difference between the normal and the epileptic hippocampi. Cho, Cr metabolites plus NAA/Cr, NAA/ Cho + Cr ratios were almost the same between the groups. The sensitivity of Proton-MR-Spectroscopy for lateralization of the epileptic foci in all patients was 96% and the specificity was 50%. Proton-MRSI can easily be considered as an alternative modality of choice in the diagnosis of temporal lobe epilepsy and in the future; Proton-MR-Spectroscopy may become the most important technique used in epilepsy centers

  4. Quantification of 18F-FDG PET images using probabilistic brain atlas: clinical application in temporal lobe epilepsy patients

    International Nuclear Information System (INIS)

    A probabilistic atlas of the human brain (Statistical Probability Anatomical Maps: SPAM) was developed by the international consortium for brain mapping (ICBM). After calculating the counts in volume of interest (VOI) using the product of probability of SPAM images and counts in FDG images, asymmetric indexes(AI) were calculated and used for finding epileptogenic zones in temporal lobe epilepsy (TLE). FDG PET images from 28 surgically confirmed TLE patients and 12 age-matched controls were spatially normalized to the averaged brain MRI atlas of ICBM. The counts from normalized PET images were multiplied with the probability of 12 VOIs (superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, hippocampus, parahippocampal gyrus, and amygdala in each hemisphere) of SPAM images of Montreal Neurological Institute. Finally AI was calculated on each pair of VOI, and compared with visual assessment. If AI was deviated more than 2 standard deviation of normal controls, we considered epileptogenic zones were found successfully. The counts of VOIs in normal controls were symmetric (AI 0.05) except those of inferior temporal gyrus (p<0.01). AIs in 5 pairs of VOI excluding inferior temporal gyrus were deviated to one side in TLE (p<0.05). Lateralization was correct in 23/28 of patients by AI, but all of 28 were consistent with visual inspection. In 3 patients with normal AI was symmetric on visual inspection. In 2 patients falsely lateralized using AI, metabolism was also decreased visually on contra-lateral side. Asymmetric index obtained by the product of statistical probability anatomical map and FDG PET correlated well with visual assessment in TLE patients. SPAM is useful for quantification of VOIs in functional images

  5. The Anterior Temporal Face Area Contains Invariant Representations of Face Identity That Can Persist Despite the Loss of Right FFA and OFA.

    Science.gov (United States)

    Yang, Hua; Susilo, Tirta; Duchaine, Bradley

    2016-03-01

    Macaque neurophysiology found image-invariant representations of face identity in a face-selective patch in anterior temporal cortex. A face-selective area in human anterior temporal lobe (fATL) has been reported, but has not been reliably identified, and its function and relationship with posterior face areas is poorly understood. Here, we used fMRI adaptation and neuropsychology to ask whether fATL contains image-invariant representations of face identity, and if so, whether these representations require normal functioning of fusiform face area (FFA) and occipital face area (OFA). We first used a dynamic localizer to demonstrate that 14 of 16 normal subjects exhibit a highly selective right fATL. Next, we found evidence that this area subserves image-invariant representation of identity: Right fATL showed repetition suppression to the same identity across different images, while other areas did not. Finally, to examine fATL's relationship with posterior areas, we used the same procedures with Galen, an acquired prosopagnosic who lost right FFA and OFA. Despite the absence of posterior face areas, Galen's right fATL preserved its face selectivity and showed repetition suppression comparable to that in controls. Our findings suggest that right fATL contains image-invariant face representations that can persist despite the absence of right FFA and OFA, but these representations are not sufficient for normal face recognition. PMID:25527821

  6. Crossed cerebellar hyperperfusion on ictal Tc-99m HMPAO brain SPECT: clinical significance for differentiation of mesial or lateral temporal lobe epilepsy and related factors for development

    International Nuclear Information System (INIS)

    The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4±7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class 1, 2). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6±19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propatation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=3D0.01) and age (p=3D0.02) were related to the development of CCH. Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral remporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.=20

  7. Increased expression of BDNF transcript with exon VI in hippocampi of patients with pharmaco-resistant temporal lobe epilepsy.

    Science.gov (United States)

    Martínez-Levy, G A; Rocha, L; Lubin, F D; Alonso-Vanegas, M A; Nani, A; Buentello-García, R M; Pérez-Molina, R; Briones-Velasco, M; Recillas-Targa, F; Pérez-Molina, A; San-Juan, D; Cienfuegos, J; Cruz-Fuentes, C S

    2016-02-01

    A putative role of the brain-derived neurotrophic factor (BDNF) in epilepsy has emerged from in vitro and animal models, but few studies have analyzed human samples. We assessed the BDNF expression of transcripts with exons I (BDNFI), II (BDNFII), IV (BDNFIV) and VI (BDNFVI) and methylation levels of promoters 4 and 6 in the hippocampi of patients with pharmaco-resistant temporal lobe epilepsy (TLE) (n=24). Hippocampal sclerosis (HS) and pre-surgical pharmacological treatment were considered as clinical independent variables. A statistical significant increase for the BDNFVI (pTPM) (N=3) was associated to a decrease in BDNFVI expression (pTPM. These results suggest an up-regulated expression of a specific BDNF transcript in patients with TLE, an effect that seems to be dependent on the use of specific drugs. PMID:26621122

  8. Interstitial deletion of chromosome 4p associated with mild mental retardation, epilepsy and polymicrogyria of the left temporal lobe

    DEFF Research Database (Denmark)

    Møller, R S; Hansen, C P; Jackson, G D;

    2007-01-01

    In this study, we present a 38-year-old woman with an interstitial deletion of 4p15.1-15.3, mild mental retardation, epilepsy and polymicrogyria adjacent to an arachnoid cyst of the left temporal lobe. The deletion was ascertained through array-comparative genome hybridization screening of patients...... with epilepsy and brain malformations. To date, about 35 patients with cytogenetically visible deletions involving 4p15 and without Wolf-Hirschhorn syndrome have been described, but the extent of the deletions has not been determined in the majority of these cases. The clinical manifestations of the...... patient described in this study were similar but not identical to the previously reported cases with 4p15 interstitial deletions. This finding indicates the presence of one or more genes involved in brain development and epilepsy in this chromosome region....

  9. Clinico-pathological subtypes of hippocampal sclerosis in temporal lobe epilepsy and their differential impact on memory impairment.

    Science.gov (United States)

    Coras, R; Blümcke, I

    2015-11-19

    Hippocampal anatomy and network organization are capable to generate drug-resistant temporal lobe epilepsy (TLE) in humans and particularly vulnerable to segmental neuronal cell loss. Surgical hippocampectomy has been proven successful in treatment and available human tissue specimens allow systematic clinico-pathological examination. Different patterns of hippocampal cell loss have been identified in TLE patients and are recently classified by the International League against Epilepsy (ILAE) into four distinct subtypes in order to stratify the heterogenous group of TLE patients also with respect to postsurgical outcome. Another important aim of the international consensus classification system of hippocampal sclerosis (HS) is to gain further insights into the morpho-functional organization of human memory frequently compromised in TLE patients. PMID:26254830

  10. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

    International Nuclear Information System (INIS)

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE

  11. Multimedia human brain database system for surgical candidacy determination in temporal lobe epilepsy with content-based image retrieval

    Science.gov (United States)

    Siadat, Mohammad-Reza; Soltanian-Zadeh, Hamid; Fotouhi, Farshad A.; Elisevich, Kost

    2003-01-01

    This paper presents the development of a human brain multimedia database for surgical candidacy determination in temporal lobe epilepsy. The focus of the paper is on content-based image management, navigation and retrieval. Several medical image-processing methods including our newly developed segmentation method are utilized for information extraction/correlation and indexing. The input data includes T1-, T2-Weighted MRI and FLAIR MRI and ictal and interictal SPECT modalities with associated clinical data and EEG data analysis. The database can answer queries regarding issues such as the correlation between the attribute X of the entity Y and the outcome of a temporal lobe epilepsy surgery. The entity Y can be a brain anatomical structure such as the hippocampus. The attribute X can be either a functionality feature of the anatomical structure Y, calculated with SPECT modalities, such as signal average, or a volumetric/morphological feature of the entity Y such as volume or average curvature. The outcome of the surgery can be any surgery assessment such as memory quotient. A determination is made regarding surgical candidacy by analysis of both textual and image data. The current database system suggests a surgical determination for the cases with relatively small hippocampus and high signal intensity average on FLAIR images within the hippocampus. This indication pretty much fits with the surgeons" expectations/observations. Moreover, as the database gets more populated with patient profiles and individual surgical outcomes, using data mining methods one may discover partially invisible correlations between the contents of different modalities of data and the outcome of the surgery.

  12. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-06-01

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

  13. Sequential {sup 123}I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and {sup 18}F-FDG PET imaging)

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed, Armin [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Royal Prince Alfred Hospital, Comprehensive Epilepsy Service, Camperdown, NSW (Australia); University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Eberl, Stefan; Henderson, David; Beveridge, Scott; Constable, Chris [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Fulham, Michael J. [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); Kassiou, Michael [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Camperdown, NSW (Australia); University of Sydney, Department of Pharmacology, Sydney, NSW (Australia); Zaman, Aysha [University of Sydney, Faculty of Medicine, Sydney, NSW (Australia); Lo, Sing Kai [University of Sydney, Institute of International Health, Sydney, NSW (Australia)

    2005-02-01

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with {sup 123}I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; {kappa}=0.83, p=0.003) was superior to the 0-h (36%; {kappa}=0.01, p>0.05), 3-h (55%; {kappa}=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; {kappa}=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  14. Sequential 123I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18F-FDG PET imaging)

    International Nuclear Information System (INIS)

    Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with 123I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci. We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation. The 6-h IDEX scan (92%; κ=0.83, p=0.003) was superior to the 0-h (36%; κ=0.01, p>0.05), 3-h (55%; κ=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; κ=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy. The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE. (orig.)

  15. Frequent seizures are associated with a network of gray matter atrophy in temporal lobe epilepsy with or without hippocampal sclerosis.

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    Ana C Coan

    Full Text Available OBJECTIVE: Patients with temporal lobe epilepsy (TLE with hippocampal sclerosis (HS have diffuse subtle gray matter (GM atrophy detectable by MRI quantification analyses. However, it is not clear whether the etiology and seizure frequency are associated with this atrophy. We aimed to evaluate the occurrence of GM atrophy and the influence of seizure frequency in patients with TLE and either normal MRI (TLE-NL or MRI signs of HS (TLE-HS. METHODS: We evaluated a group of 172 consecutive patients with unilateral TLE-HS or TLE-NL as defined by hippocampal volumetry and signal quantification (122 TLE-HS and 50 TLE-NL plus a group of 82 healthy individuals. Voxel-based morphometry was performed with VBM8/SPM8 in 3T MRIs. Patients with up to three complex partial seizures and no generalized tonic-clonic seizures in the previous year were considered to have infrequent seizures. Those who did not fulfill these criteria were considered to have frequent seizures. RESULTS: Patients with TLE-HS had more pronounced GM atrophy, including the ipsilateral mesial temporal structures, temporal lobe, bilateral thalami and pre/post-central gyri. Patients with TLE-NL had more subtle GM atrophy, including the ipsilateral orbitofrontal cortex, bilateral thalami and pre/post-central gyri. Both TLE-HS and TLE-NL showed increased GM volume in the contralateral pons. TLE-HS patients with frequent seizures had more pronounced GM atrophy in extra-temporal regions than TLE-HS with infrequent seizures. Patients with TLE-NL and infrequent seizures had no detectable GM atrophy. In both TLE-HS and TLE-NL, the duration of epilepsy correlated with GM atrophy in extra-hippocampal regions. CONCLUSION: Although a diffuse network GM atrophy occurs in both TLE-HS and TLE-NL, this is strikingly more evident in TLE-HS and in patients with frequent seizures. These findings suggest that neocortical atrophy in TLE is related to the ongoing seizures and epilepsy duration, while thalamic

  16. Anterior temporal white matter lesions in myotonic dystrophy with intellectual impairment: an MRI and neuropathological study

    International Nuclear Information System (INIS)

    We studied 12 patients with myotonic dystrophy using MRI and the Mini-mental state examination (MMSE), to see it specific MRI findings were associated with intellectual impairment. We also compared them with the neuropathological findings in an autopsy case of MD with intellectual impairment. Mild intellectual impairment was found in 8 of the 12 patients. On T 2-weighted and proton density-weighted images, high-intensity areas were seen in cerebral white matter in 10 of the 12 patients. In seven of these, anterior temporal white-matter lesions (ATWML) were found; all seven had mild intellectual impairment (MMSE 22-26), whereas none of the four patients with normal mentation had ATWML. In only one of the eight patients with intellectual impairment were white-matter lesions not found. Pathological findings were severe loss and disordered arrangement of myelin sheaths and axons in addition to heterotopic neurons within anterior temporal white matter. Bilateral ATWML might be a factor for intellectual impairment in MD. The retrospective pathological study raised the possibility that the ATWML are compatible with focal dysplasia of white matter. (orig.)

  17. Alteration of Interictal Brain Activity in Patients with Temporal Lobe Epilepsy in the Left Dominant Hemisphere: A Resting-State MEG Study

    Directory of Open Access Journals (Sweden)

    Haitao Zhu

    2014-01-01

    Full Text Available Resting MEG activities were compared between patients with left temporal lobe epilepsy (LTLE and normal controls. Using SAMg2, the activities of MEG data were reconstructed and normalized. Significantly elevated SAMg2 signals were found in LTLE patients in the left temporal lobe and medial structures. Marked decreases of SAMg2 signals were found in the wide extratemporal lobe regions, such as the bilateral visual cortex. The study also demonstrated a positive correlation between the seizure frequency and brain activities of the abnormal regions after the multiple linear regression analysis. These results suggested that the aberrant brain activities not only were related to the epileptogenic zones, but also existed in other extratemporal regions in patients with LTLE. The activities of the aberrant regions could be further damaged with the increase of the seizure frequency. Our findings indicated that LTLE could be a multifocal disease, including complex epileptic networks and brain dysfunction networks.

  18. The Executive Functions in Frontal and Temporal Lobes: A Flanker Task Intracerebral Recording Study

    Czech Academy of Sciences Publication Activity Database

    Rusnáková, S.; Daniel, P.; Chládek, Jan; Jurák, Pavel; Rektor, I.

    2011-01-01

    Roč. 28, č. 1 (2011), s. 30-35. ISSN 0736-0258 R&D Projects: GA ČR(CZ) GA102/05/0402 Institutional research plan: CEZ:AV0Z20650511 Keywords : generator of P3 * temporal neocortex * orbitofrontal cortex * flanker test * neurocognitive network Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.451, year: 2011

  19. Effect of partial volume correction on muscarinic cholinergic receptor imaging with single-photon emission tomography in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Animal experiments and preliminary results in humans have indicated alterations of hippocampal muscarinic acetylcholine receptors (mAChR) in temporal lobe epilepsy. Patients with temporal lobe epilepsy often present with a reduction in hippocampal volume. The aim of this study was to investigate the influence of hippocampal atrophy on the quantification of mAChR with single photon emission tomography (SPET) in patients with temporal lobe epilepsy. Cerebral uptake of the muscarinic cholinergic antagonist [123I]4-iododexetimide (IDex) was investigated by SPET in patients suffering from temporal lobe epilepsy of unilateral (n=6) or predominantly unilateral (n=1) onset. Regions of interest were drawn on co-registered magnetic resonance images. Hippocampal volume was determined in these regions and was used to correct the SPET results for partial volume effects. A ratio of hippocampal IDex binding on the affected side to that on the unaffected side was used to detect changes in muscarinic cholinergic receptor density. Before partial volume correction a decrease in hippocampal IDex binding on the focus side was found in each patient. After partial volume no convincing differences remained. Our results indicate that the reduction in hippocampal IDex binding in patients with epilepsy is due to a decrease in hippocampal volume rather than to a decrease in receptor concentration. (orig.). With 2 figs., 2 tabs

  20. High frequency localised "hot spots" in temporal lobes of patients with intractable tinnitus: a quantitative electroencephalographic (QEEG) study.

    Science.gov (United States)

    Ashton, Heather; Reid, Keith; Marsh, Richard; Johnson, Ian; Alter, Kai; Griffiths, Tim

    2007-10-01

    Tinnitus, the perception of noise in the absence of an external auditory stimulus, is common, frequently distressing and often intractable. It is associated with a number of conditions including deafness but may arise spontaneously. Brain imaging studies indicate increased neuronal excitability and decreased density of benzodiazepine receptors in temporal (auditory) cortex but the source and mechanism of such changes are unknown. Various electroencephalographic (EEG) abnormalities involving temporal lobe and other brain areas have been described but recordings have been limited to standard EEG wave bands up to frequencies of 22Hz. This clinical study of otherwise healthy patients with intractable unilateral tinnitus, using quantitative EEG power spectral mapping (QEEG), identified discrete localised unilateral foci of high frequency activity in the gamma range (>40-80Hz) over the auditory cortex in eight patients experiencing tinnitus during recording. These high frequency "hot spots" were not present in 25 subjects without tinnitus. The results suggest that further EEG investigations should include recordings in the gamma frequency range since such high frequency oscillations are believed to be necessary for perception. Identification of "hot spots" in tinnitus patients would provide a means for monitoring the effects of new treatments. These findings may also provide a model for exploration of more complex phenomena such as verbal and musical hallucinations. PMID:17888572

  1. Elevated serum neuron-specific enolase in patients with temporal lobe epilepsy: a video-EEG study.

    Science.gov (United States)

    Palmio, Johanna; Keränen, Tapani; Alapirtti, Tiina; Hulkkonen, Janne; Mäkinen, Riikka; Holm, Päivi; Suhonen, Jaana; Peltola, Jukka

    2008-10-01

    Established markers of brain damage, neuron-specific enolase (NSE) and S-100b protein (S-100), may increase after status epilepticus, but whether a single tonic-clonic or complex partial seizure induces elevation of these markers is not known. Furthermore, it is unclear whether the risk of seizure-related neuronal damage in temporal lobe epilepsy (TLE) differs from that in extratemporal lobe epilepsies (XTLE). The aim of this study was to analyze NSE and S-100 in patients with TLE and XTLE after acute seizures. The levels of NSE and S-100 were measured in serum before (0h) and at 3, 6, 12, and 24h after acute seizures in 31 patients during inpatient video-EEG monitoring. The patients were categorized into the TLE and the XTLE group based on video-EEG recordings and MRI findings. Fifteen patients had TLE and 16 XTLE. Index seizures were mainly complex partial seizures (n=21). In TLE mean+/-S.D. values for NSE levels (mug/L) were 8.36+/-2.64 (0h), 11.35+/-3.84 (3h), 13.48+/-4.49 (6h), 12.95+/-5.46 (12h) and 10.33+/-3.13 (24h) (p=0.006, ANOVA). In XTLE the changes were not significant (p=0.3). There was less increase in the levels of S-100 in TLE (p=0.05) and no significant change in XTLE (p=0.4). The levels of markers of neuronal damage were increased in patients with TLE, not only after tonic-clonic but also after complex partial seizures. These data suggest that TLE may be associated with brain damage. PMID:18595663

  2. Material specific lateralization of medial temporal lobe function: An fMRI investigation.

    Science.gov (United States)

    Dalton, Marshall A; Hornberger, Michael; Piguet, Olivier

    2016-03-01

    The theory of material specific lateralization of memory function posits that left and right MTL regions are asymmetrically involved in mnemonic processing of verbal and nonverbal material respectively. Lesion and functional imaging (fMRI) studies provide robust evidence for a left MTL asymmetry in the verbal memory domain. Evidence for a right MTL/nonverbal asymmetry is not as robust. A handful of fMRI studies have investigated this issue but have generally utilised nonverbal stimuli which are amenable to semantic elaboration. This fMRI study aimed to investigate the neural correlates of recognition memory processing in 20 healthy young adults (mean age = 26 years) for verbal stimuli and nonverbal stimuli that were specifically designed to minimize verbalisation. Analyses revealed that the neural correlates of recognition memory processing for verbal and nonverbal stimuli were differentiable and asymmetrically recruited the left and right MTL respectively. The right perirhinal cortex and hippocampus were preferentially involved in successful recognition memory of items devoid of semantic information. In contrast, the left anterior hippocampus was preferentially involved in successful recognition memory of stimuli which contained semantic meaning. These results suggest that the left MTL is preferentially involved in mnemonic processing of verbal/semantic information. In contrast, the right MTL is preferentially involved in visual/non-semantic mnemonic processing. We propose that during development, the left MTL becomes specialised for verbal mnemonic processing due to its proximity with left lateralised cortical language processing areas while visual/non-semantic mnemonic processing gets 'crowded out' to become predominantly, but not completely, the domain of the right MTL. PMID:26700110

  3. Trait-level temporal lobe hypoactivation to social exclusion in unaffected siblings of children and adolescents with autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Danielle Z. Bolling

    2015-06-01

    Full Text Available Social exclusion elicits powerful feelings of negative affect associated with rejection. Additionally, experiencing social exclusion reliably recruits neural circuitry associated with emotion processing. Recent work has demonstrated abnormal neural responses to social exclusion in children and adolescents with autism spectrum disorders (ASD. However, it remains unknown to what extent these abnormalities are due to atypical social experiences versus genetic predispositions to atypical neural processing. To address this question, the current study investigated brain responses to social exclusion compared to a baseline condition of fair play in unaffected siblings of youth with ASD using functional magnetic resonance imaging. We identified common deviations between unaffected siblings and ASD probands that might represent trait-level abnormalities in processing Social Exclusion vs. Fair Play, specifically in the right anterior temporoparietal junction extending into posterior superior temporal sulcus. Thus, hypoactivation to Social Exclusion vs. Fair Play in this region may represent a shared genetic vulnerability to developing autism. In addition, we present evidence supporting the idea that one's status as an unaffected sibling moderates the relationship between IQ and neural activation to Social Exclusion vs. Fair Play in anterior cingulate cortex. These results are discussed in the context of previous literature on neural endophenotypes of autism.

  4. The feeling of familiarity for music in patients with a unilateral temporal lobe lesion: A gating study.

    Science.gov (United States)

    Huijgen, Josefien; Dellacherie, Delphine; Tillmann, Barbara; Clément, Sylvain; Bigand, Emmanuel; Dupont, Sophie; Samson, Séverine

    2015-10-01

    Previous research has indicated that the medial temporal lobe (MTL), and more specifically the perirhinal cortex, plays a role in the feeling of familiarity for non-musical stimuli. Here, we examined contribution of the MTL to the feeling of familiarity for music by testing patients with unilateral MTL lesions. We used a gating paradigm: segments of familiar and unfamiliar musical excerpts were played with increasing durations (250, 500, 1000, 2000, 4000 ms and complete excerpts), and participants provided familiarity judgments for each segment. Based on the hypothesis that patients might need longer segments than healthy controls (HC) to identify excerpts as familiar, we examined the onset of the emergence of familiarity in HC, patients with a right MTL resection (RTR), and patients with a left MTL resection (LTR). In contrast to our hypothesis, we found that the feeling of familiarity was relatively spared in patients with a right or left MTL lesion, even for short excerpts. All participants were able to differentiate familiar from unfamiliar excerpts as early as 500 ms, although the difference between familiar and unfamiliar judgements was greater in HC than in patients. These findings suggest that a unilateral MTL lesion does not impair the emergence of the feeling of familiarity. We also assessed whether the dynamics of the musical excerpt (linked to the type and amount of information contained in the excerpts) modulated the onset of the feeling of familiarity in the three groups. The difference between familiar and unfamiliar judgements was greater for high than for low-dynamic excerpts for HC and RTR patients, but not for LTR patients. This indicates that the LTR group did not benefit in the same way from dynamics. Overall, our results imply that the recognition of previously well-learned musical excerpts does not depend on the integrity of either right or the left MTL structures. Patients with a unilateral MTL resection may compensate for the effects of

  5. A Novel Method of Quantitative Anterior Chamber Depth Estimation Using Temporal Perpendicular Digital Photography

    Science.gov (United States)

    Zamir, Ehud; Kong, George Y.X.; Kowalski, Tanya; Coote, Michael; Ang, Ghee Soon

    2016-01-01

    Purpose We hypothesize that: (1) Anterior chamber depth (ACD) is correlated with the relative anteroposterior position of the pupillary image, as viewed from the temporal side. (2) Such a correlation may be used as a simple quantitative tool for estimation of ACD. Methods Two hundred sixty-six phakic eyes had lateral digital photographs taken from the temporal side, perpendicular to the visual axis, and underwent optical biometry (Nidek AL scanner). The relative anteroposterior position of the pupillary image was expressed using the ratio between: (1) lateral photographic temporal limbus to pupil distance (“E”) and (2) lateral photographic temporal limbus to cornea distance (“Z”). In the first chronological half of patients (Correlation Series), E:Z ratio (EZR) was correlated with optical biometric ACD. The correlation equation was then used to predict ACD in the second half of patients (Prediction Series) and compared to their biometric ACD for agreement analysis. Results A strong linear correlation was found between EZR and ACD, R = −0.91, R2 = 0.81. Bland-Altman analysis showed good agreement between predicted ACD using this method and the optical biometric ACD. The mean error was −0.013 mm (range −0.377 to 0.336 mm), standard deviation 0.166 mm. The 95% limits of agreement were ±0.33 mm. Conclusions Lateral digital photography and EZR calculation is a novel method to quantitatively estimate ACD, requiring minimal equipment and training. Translational Relevance EZ ratio may be employed in screening for angle closure glaucoma. It may also be helpful in outpatient medical clinic settings, where doctors need to judge the safety of topical or systemic pupil-dilating medications versus their risk of triggering acute angle closure glaucoma. Similarly, non ophthalmologists may use it to estimate the likelihood of acute angle closure glaucoma in emergency presentations. PMID:27540496

  6. An Exploratory Study of the Relationship between Face Recognition Memory and the Volume of Medial Temporal Lobe Structures in Healthy Young Males

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    Clare E. Mackay

    1998-01-01

    Full Text Available A rigorous new methodology was applied to the study of structure function relationships in the living human brain. Face recognition memory (FRM and other cognitive measures were made in 29 healthy young male subjects (mean age = 21.7 years and related to volumetric measurements of their cerebral hemispheres and of structures in their medial temporal lobes, obtained using the Cavalieri method in combination with high resolution Magnetic Resonance Imaging (MRI. Greatest proportional variability in volumes was found for the lateral ventricles (57% for the cerebral hemispheres (8% in the mean volumes of the hippocampus, parahippocampal gyrus, amygdala, caudate nucleus, temporal pole and temporal lobe on the right and left sides of the brain. The volumes of the right and left parahippocampal gyrus, temporal pole, temporal lobe, and left hippocampus were, prior to application of the Bonferroni correction to take account of 12 multiple comparisons, significantly correlated with the volume of the corresponding hemisphere (p < 0.05. The volumes of all structures were highly correlated (p < 0.0002 for all comparisons between the two cerebral hemispheres. There were no positive relationships between structure volumes and FRM score. However, the volume of the right amygdala was, prior to application of the Bonferroni correction to take account of 38~multiple comparisons, found to be significantly smaller in the five most consistent high scorers compared to the five most consistent low scorers (t = 2.77, p = 0.025. The implications for possible relationships between healthy medial temporal lobe structures and memory are discussed.

  7. Bradicardia como manifestação epiléptica em epilepsia temporal: relato de caso Bradycardia during temporal lobe seizure: case report

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    CARMEN L. JORGE

    2000-09-01

    Full Text Available Descrevemos um caso de arritmia cardíaca como manifestação epiléptica. A monitorização video-eletrencefalográfica de uma paciente com 34 anos de idade que apresentava episódios de perda de consciência permitiu a detecção de períodos de assistolia como principal manifestação clínica, exigindo a implantação de marca-passo. O registro eletrencefalográfico concomitante mostrou atividade rítmica a 6-7 Hz de projeção na região temporal esquerda. A ressonância magnética mostrou lesão expansiva no giro para-hipocampal esquerdo. Alterações do ritmo cardíaco como taquicardia sinusal são frequentes em crises epilépticas. A descrição de bradicardia e/ou assistolia é rara. As conexões das estruturas mesiais temporais com estruturas profundas como o hipotálamo devem ser responsáveis pelas manifestações vegetativas durante crises epilépticas temporais.We describe a patient who had cardiac arrhythmia as epileptic manifestation. In a 34-year-old woman who had many episodes of loss of consciousness, the simultaneous ECG and video-EEG monitoring recorded bradycardia with a short episode of asystolia (4 seconds and left temporal rhythmic teta activity on EEG. MRI showed a small mass lesion in the left parahippocampal gyrus. Alterations in cardiac rhythm have been reported in epileptic seizures and taquycardia is the most common finding associated with them; bradyarrhythmia during seizures was uncommon. Many interconnections among insular cortex, limbic system and hypothalamus, may be responsible for vegetative manifestations in temporal lobe epilepsy.

  8. Total thoracoscopic lung segmentectomy of anterior basal segment of the right lower lobe (RS8 for NSCLC stage IA (case report

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    Nakajiima Tomohiro

    2011-09-01

    Full Text Available Abstract A 69-year-old woman with a pulmonary nodule in anterior basal segment of the right lower lobe (RS8 was referred to our department. The diameter of the tumor was 12 mm, and it had increased over a few months. First, video-assisted thoracoscopic lung surgery (VATS biopsy of the pulmonary nodule was carried out. Frozen section examination of this nodule confirmed the diagnosis of bronchioloalveolar carcinoma (BAC. Segmentectomy of RS8 with lower mediastinal node dissection (ND2a-1 was performed. The intersegmental plane was identified using the intersegmental veins as landmarks and the demarcation between the resected (inflated and preserved (collapsed lungs. Electrocautery at 70 watts was used to divide the intersegmental plane. A vessel sealing system was used to seal and cut the pulmonary arteries. Postoperative histopathological examination revealed that the tumor was T1aN0M0 BAC, and the minimal distance between the surgical margin and the tumor edge was 15 mm. The patient was discharged from hospital on postoperative day 5 without any complications.

  9. Gray Matter Abnormalities in Temporal Lobe Epilepsy: Relationships with Resting-State Functional Connectivity and Episodic Memory Performance

    Science.gov (United States)

    Doucet, Gaelle E.; He, Xiaosong; Sperling, Michael; Sharan, Ashwini; Tracy, Joseph I.

    2016-01-01

    Temporal lobe epilepsy (TLE) affects multiple brain regions through evidence from both structural (gray matter; GM) and functional connectivity (FC) studies. We tested whether these structural abnormalities were associated with FC abnormalities, and assessed the ability of these measures to explain episodic memory impairments in this population. A resting-state and T1 sequences were acquired on 94 (45 with mesial temporal pathology) TLE patients and 50 controls, using magnetic resonance imaging (MRI) technique. A voxel-based morphometry analysis was computed to determine the GM volume differences between groups (right, left TLE, controls). Resting-state FC between the abnormal GM volume regions was computed, and compared between groups. Finally, we investigated the relation between EM, GM and FC findings. Patients with and without temporal pathology were analyzed separately. The results revealed reduced GM volume in multiple regions in the patients relative to the controls. Using FC, we found the abnormal GM regions did not display abnormal functional connectivity. Lastly, we found in left TLE patients, verbal episodic memory was associated with abnormal left posterior hippocampus volume, while in right TLE, non-verbal episodic memory was better predicted by resting-state FC measures. This study investigated TLE abnormalities using a multi-modal approach combining GM, FC and neurocognitive measures. We did not find that the GM abnormalities were functionally or abnormally connected during an inter-ictal resting state, which may reflect a weak sensitivity of functional connectivity to the epileptic network. We provided evidence that verbal and non-verbal episodic memory in left and right TLE patients may have distinct relationships with structural and functional measures. Lastly, we provide data suggesting that in the setting of occult, non-lesional right TLE pathology, a coupling of structural and functional abnormalities in extra-temporal/non-ictal regions is

  10. Variations of ATP and its metabolites in the hippocampus of rats subjected to pilocarpine-induced temporal lobe epilepsy.

    Science.gov (United States)

    Doná, Flávia; Conceição, Isaltino Marcelo; Ulrich, Henning; Ribeiro, Eliane Beraldi; Freitas, Thalma Ariani; Nencioni, Ana Leonor Abrahao; da Silva Fernandes, Maria José

    2016-06-01

    Although purinergic receptor activity has lately been associated with epilepsy, little is known about the exact role of purines in epileptogenesis. We have used a rat model of temporal lobe epilepsy induced by pilocarpine to study the dynamics of purine metabolism in the hippocampus during different times of status epilepticus (SE) and the chronic phase. Concentrations of adenosine 5'-triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), and adenosine in normal and epileptic rat hippocampus were determined by microdialysis in combination with high-performance liquid chromatography (HPLC). Extracellular ATP concentrations did not vary along 4 h of SE onset. However, AMP concentration was elevated during the second hour, whereas ADP and adenosine concentrations augmented during the third and fourth hour following SE. During chronic phase, extracellular ATP, ADP, AMP, and adenosine concentrations decreased, although these levels again increased significantly during spontaneous seizures. These results suggest that the increased turnover of ATP during the acute period is a compensatory mechanism able to reduce the excitatory role of ATP. Increased adenosine levels following 4 h of SE may contribute to block seizures. On the other hand, the reduction of purine levels in the hippocampus of chronic epileptic rats may result from metabolic changes and be part of the mechanisms involved in the onset of spontaneous seizures. This work provides further insights into purinergic signaling during establishment and chronic phase of epilepsy. PMID:26939579

  11. Visual rating of medial temporal lobe metabolism in mild cognitive impairment and Alzheimer's disease using FDG-PET

    International Nuclear Information System (INIS)

    This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD) using FDG-PET scans. Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MRglc) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings. For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values glc measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified. This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD. (orig.)

  12. Chronic treatment with levetiracetam reverses deficits in hippocampal LTP in vivo in experimental temporal lobe epilepsy rats.

    Science.gov (United States)

    Ge, Yu-Xing; Tian, Xiang-Zhu; Lin, Ying-Ying; Liu, Xue-Yuan

    2016-08-15

    Temporal lobe epilepsy (TLE), the common form of epilepsy in adults, often displays complex partial seizures and cognitive deficits. The underlying mechanisms of such deficits are not yet well understood. Many contributing factors, such as initial epileptogenic lesion, seizure type, age of onset, and treatment side effects have been proposed. Levetiracetam (LEV) is a novel anti-epileptic drug (AED) used to treat partial seizures and idiopathic generalized epilepsy. It has been suggested that LEV exerts antiepileptic properties by modulation of synaptic release of neurotransmitters. However, its neuroprotective effects on learning and memory are not yet well demonstrated. Here we showed the impairment of spatial memory in the pilocarpine-induced experimental TLE rats, which can be improved by LEV. Furthermore, we found chronic LEV treatment partially reversed the SE-induced synaptic dysfunction in hippocampal LTP induction in vivo. In addition, LEV treatment can alleviate the SE-induced abnormal GluR1 phosphorylation at Ser(831) site, which may contribute to the rescue of synaptic transmission. These results indicate the neuroprotective role for LEV while it exhibits an antiseizure effect on experimental epileptic models. PMID:27345386

  13. Epigenetic Suppression of GADs Expression is Involved in Temporal Lobe Epilepsy and Pilocarpine-Induced Mice Epilepsy.

    Science.gov (United States)

    Wang, Jin-Gang; Cai, Qing; Zheng, Jun; Dong, Yu-Shu; Li, Jin-Jiang; Li, Jing-Chen; Hao, Guang-Zhi; Wang, Chao; Wang, Ju-Lei

    2016-07-01

    Recent studies have shown that histone acetylation is involved with the regulation of enzyme glutamate decarboxylases (GADs), including GAD67 and GAD65. Here, we investigated the histone acetylation modifications of GADs in the pathogenesis of epilepsy and explored the therapeutic effect of a novel second-generation histone deacetylase inhibitor (HDACi) JNJ-26481585 in epilepsy animals. We revealed the suppression of GADs protein and mRNA level, and histone hypoacetylation in patients with temporal lobe epilepsy and pilocarpine-induced epilepsy mice model. Double-immunofluorescence also indicated that the hypoacetyl-H3 was located in hippocampal GAD67/GAD65 positive neurons in epilepsy mice. JNJ-26481585 significantly reversed the decrease of the GAD67/GAD65 both protein and mRNA levels, and the histone hypoacetylation of GABAergic neurons in epilepsy mice. Meanwhile, single-cell real-time PCR performed in GFP-GAD67/GAD65 transgenic mice demonstrated that JNJ-26481585 induced increase of GAD67/GAD65 mRNA level in GABAergic neurons. Furthermore, JNJ-26481585 significantly alleviated the epileptic seizures in mice model. Together, our findings demonstrate inhibition of GADs gene via histone acetylation plays an important role in the pathgenesis of epilepsy, and suggest JNJ-26481585 as a promising therapeutic strategy for epilepsy. PMID:27220336

  14. A new method for assessing the impact of medial temporal lobe amnesia on the characteristics of generated autobiographical events.

    Science.gov (United States)

    Lenton-Brym, Ariella; Kurczek, Jake; Rosenbaum, R Shayna; Sheldon, Signy

    2016-05-01

    Constructing autobiographical events involves an initial phase of event selection, in which a memory or imagined future event is initially brought to mind, followed by a phase of elaboration, in which an individual accesses detailed knowledge specific to the event. While considerable research demonstrates the importance of the medial temporal lobes (MTL) in the later phase, its role in initial event selection is unknown. The present study is the first to investigate the role of the MTL in event selection by assessing whether individuals with MTL lesions select qualitatively different events for remembering and imagining than matched control participants. To do so, we created "event captions" that reflected the type of events selected for an autobiographical event narrative task by four individuals with MTL amnesia and control counterparts. Over 450 online raters assessed these event captions on qualitative dimensions known to vary with autobiographical recall (frequency, significance, emotionality, imageability, and uniqueness). Our critical finding was that individuals with MTL amnesia were more prone to select events that were rated as more frequently occurring than healthy control participants. We interpret this finding as evidence that people with impaired episodic memory from MTL damage compensate for their compromised ability to recall detailed information by relying more heavily on semantic memory processes to select generalized events. We discuss the implications for theoretical models of memory and methodological approaches to studying autobiographical memory. PMID:26951933

  15. Naringin attenuates granule cell dispersion in the dentate gyrus in a mouse model of temporal lobe epilepsy.

    Science.gov (United States)

    Jang, Hannah; Jeong, Kyoung Hoon; Kim, Sang Ryong

    2016-07-01

    Morphological abnormalities of the dentate gyrus (DG) are an important phenotype in the hippocampus of patients with temporal lobe epilepsy. We recently reported that naringin, a bioflavonoid in grapefruit and citrus fruits, exerts beneficial effects in the kainic acid (KA) mouse model of epilepsy. We found that naringin treatment reduced seizure activities and decreased autophagic stress and neuroinflammation in the hippocampus following in vivo lesion with KA. However, it remains unclear whether naringin may also attenuate seizure-induced morphological changes in the DG, collectively known as granule cell dispersion (GCD). To clarify whether naringin treatment reduces GCD, we evaluated the effects of intraperitoneal injection of naringin on GCD and activation of mammalian target of rapamycin complex 1 (mTORC1), an important regulator of GCD, following intrahippocampal injection of KA. Our results showed that naringin treatment significantly reduced KA-induced GCD and mTORC1 activation, which was confirmed by assessing the phosphorylated form of the mTORC1 substrate, 4E-BP1, in the hippocampus. These results suggest that naringin treatment may help prevent epilepsy-induced hippocampal injury by inhibiting mTORC1 activation and thereby reducing GCD in the hippocampus in vivo. PMID:27040812

  16. Biopsychosocial approaches to a patient with vomiting of 10 years' duration – a case of temporal lobe epilepsy

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    Kitamura Kana

    2009-01-01

    Full Text Available Abstract Background Vomiting is commonly encountered in clinical medicine. When organic gastrointestinal, metabolic, and brain diseases are ruled out, many cases are considered to be functional. We experienced an adult patient with epilepsy whose main symptom was vomiting. Biopsychosocial approaches were needed to control the symptoms. Case presentation A 26-year-old female with a 10-year history of persistent vomiting was found to have temporal lobe epilepsy (TLE. Throughout this time, during which the vomiting had become part of a vicious cycle, her epilepsy was poorly controlled by medication. Biopsychosocial approaches were employed successfully and the patient subsequently undertook training to become a home-helper, started a job, and was able to leave her parents' house and live independently. All of her symptoms resolved after she became self-sufficient. Discussion Vomiting without impaired consciousness is seldom considered to be a manifestation of epilepsy. Difficulty in recording an electroencephalogram (EEG because of the presence of persistent vomiting delayed the diagnosis. The improvement of symptoms was thought to have been due to the patient's emotional stabilization and physical improvement, which may have stabilized the limbic system. Conclusion When an illness persists for many years and conditioning and a vicious cycle occur secondarily, systematic biopsychosocial approaches are needed in addition to general treatment. Also, secondary symptoms make the diagnosis more difficult when efforts at treatment are ineffective.

  17. Relationships between personality traits, medial temporal lobe atrophy and white matter lesion in subjects suffering from mild cognitive impairment

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    Emmanuelle eDuron

    2014-07-01

    Full Text Available Mild Cognitive Impairment (MCI is a heterogeneous cognitive status that can be a prodromal stage of Alzheimer‘s disease (AD. It is particularly relevant to focus on prodromal stages of AD such as MCI, because pathophysiological abnormalities of AD start years before the dementia stage. Medial temporal lobe atrophy (MTL resulting from AD lesions and cerebrovascular lesions (i.e. white matter lesions (WML, lacunar strokes and strokes are often revealed concurrently on Magnetic Resonance Imaging (MRI in MCI subjects. Personality changes have been reported to be associated with MCI status and early AD. More specifically, an increase in neuroticism and a decrease in conscientiousness have been reported, suggesting that higher and lower scores, respectively in neuroticism and conscientiousness are associated with an increased risk of developing the disease. However, personality changes have not been studied concomitantly with pathological structural brain alterations detected on MRI in patients suffering from MCI. Therefore, the objective of the present study was to assess the relationship between MTL atrophy, WML, lacunar strokes and personality traits in such patients. The severity of WML was strongly associated with lower levels of conscientiousness and higher levels of neuroticism. Conversely, no association was detected between personality traits and the presence of lacunar strokes or MTL atrophy. Altogether, these results strongly suggest that personality changes occurring in a MCI population, at high risk of AD, are associated with WML, which can induce executive dysfunctions, rather than with MTL atrophy.

  18. The effect of Vitamin E on learning and memory deficits in intrahippocampal kainate-induced temporal lobe epilepsy in rats

    Science.gov (United States)

    Kiasalari, Zahra; Khalili, Mohsen; Shafiee, Samaneh; Roghani, Mehrdad

    2016-01-01

    Objective: Since temporal lobe epilepsy (TLE) is associated with learning and memory impairment, we investigated the beneficial effect of Vitamin E on the impaired learning and memory in the intrahippocampal kainate model of TLE in rats. Materials and Methods: Rats were divided into sham, Vitamin E-treated sham, kainate, and Vitamin E-treated kainate. Intrahippocampal kainate was used for induction of epilepsy. Vitamin E was injected intraperitoneal (i.p.) at a dose of 200 mg/kg/day started 1 week before surgery until 1 h presurgery. Initial and step-through latencies in the passive avoidance test and alternation behavior percentage in Y-maze were finally determined in addition to measurement of some oxidative stress markers. Results: Kainate injection caused a higher severity and rate of seizures and deteriorated learning and memory performance in passive avoidance paradigm and spontaneous alternation as an index of spatial recognition memory in Y-maze task. Intrahippocampal kainate also led to the elevation of malondialdehyde (MDA) and nitrite and reduced activity of superoxide dismutase (SOD). Vitamin E pretreatment significantly attenuated severity and incidence rate of seizures, significantly improved retrieval and recall in passive avoidance, did not ameliorate spatial memory deficit in Y-maze, and lowered MDA and enhanced SOD activity. Conclusion: Vitamin E improves passive avoidance learning and memory and part of its beneficial effect is due to its potential to mitigate hippocampal oxidative stress. PMID:26997715

  19. Treatment of Epilepsy with Bipolar Electro-coagulation: An Analysis of Cortical Blood Flow and Histological Change in Temporal Lobe

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    Zhi-Qiang Cui

    2015-01-01

    Full Text Available Background: Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection. However, the mechanisms of bipolar electro-coagulation are not completely known. We studied the acute cortical blood flow and histological changes after bipolar electro-coagulation in 24 patients with intractable temporal lobe epilepsy. Methods: Twenty-four patients were consecutively enrolled, and divided into three groups according to the date of admission. The regional cortical blood flow (rCBF, electrocorticography, the depth of cortex damage, and acute histological changes (H and E staining, neuronal staining and neurofilament (NF staining were analyzed before and after the operation. The t-test analysis was used to compare the rCBF before and after the operation. Results: The rCBF after coagulation was significantly reduced (P < 0.05. The spikes were significantly reduced after electro-coagulation. For the temporal cortex, the depth of cortical damage with output power of 2-9 W after electro-coagulation was 0.34 ± 0.03, 0.48 ± 0.06, 0.69 ± 0.06, 0.84 ± 0.09, 0.98 ± 0.08, 1.10 ± 0.11, 1.11 ± 0.09, and 1.22 ± 0.11 mm, respectively. Coagulation with output power of 4-5 W completely damaged the neurons and NF protein in the molecular layer, external granular layer, and external pyramidal layer. Conclusions: The electro-coagulation not only destroyed the neurons and NF protein, but also reduced the rCBF. We concluded that the injuries caused by electro-coagulation would prevent horizontal synchronization and spread of epileptic discharges, and partially destroy the epileptic focus.

  20. Temporal Lobe Reactions After Carbon Ion Radiation Therapy: Comparison of Relative Biological Effectiveness–Weighted Tolerance Doses Predicted by Local Effect Models I and IV

    International Nuclear Information System (INIS)

    Purpose: To compare the relative biological effectiveness (RBE)–weighted tolerance doses for temporal lobe reactions after carbon ion radiation therapy using 2 different versions of the local effect model (LEM I vs LEM IV) for the same patient collective under identical conditions. Methods and Materials: In a previous study, 59 patients were investigated, of whom 10 experienced temporal lobe reactions (TLR) after carbon ion radiation therapy for low-grade skull-base chordoma and chondrosarcoma at Helmholtzzentrum für Schwerionenforschung (GSI) in Darmstadt, Germany in 2002 and 2003. TLR were detected as visible contrast enhancements on T1-weighted MRI images within a median follow-up time of 2.5 years. Although the derived RBE-weighted temporal lobe doses were based on the clinically applied LEM I, we have now recalculated the RBE-weighted dose distributions using LEM IV and derived dose-response curves with Dmax,V-1 cm³ (the RBE-weighted maximum dose in the remaining temporal lobe volume, excluding the volume of 1 cm³ with the highest dose) as an independent dosimetric variable. The resulting RBE-weighted tolerance doses were compared with those of the previous study to assess the clinical impact of LEM IV relative to LEM I. Results: The dose-response curve of LEM IV is shifted toward higher values compared to that of LEM I. The RBE-weighted tolerance dose for a 5% complication probability (TD5) increases from 68.8 ± 3.3 to 78.3 ± 4.3 Gy (RBE) for LEM IV as compared to LEM I. Conclusions: LEM IV predicts a clinically significant increase of the RBE-weighted tolerance doses for the temporal lobe as compared to the currently applied LEM I. The limited available photon data do not allow a final conclusion as to whether RBE predictions of LEM I or LEM IV better fit better clinical experience in photon therapy. The decision about a future clinical application of LEM IV therefore requires additional analysis of temporal lobe reactions in a comparable

  1. Lateralisation with magnetic resonance spectroscopic imaging in temporal lobe epilepsy: an evaluation of visual and region-of-interest analysis of metabolite concentration images

    International Nuclear Information System (INIS)

    We carried out spectroscopic imaging (MRSI) on nine consecutive patients with temporal lobe epilepsy being assessed for epilepsy surgery, and nine neurologically healthy, age-matched volunteers. A volume of interest (VOI) was angled along the temporal horns on axial and sagittal images, and symmetrically over the temporal lobes on coronal images. Images showing the concentrations of N-acetylaspartate (NAA) and of choline-containing compounds plus creatine and phosphocreatine (Cho + Cr) were used for lateralisation. We compared assessment by visual inspection and by signal analysis from regions of interest (ROI) in different positions, where side-to-side differences in NAA/(Cho + Cr) ratio were used for lateralisation. The NAA/(Cho + Cr) ratio from the different ROI was also compared with that in the brain stem to assess if the latter could be used as an internal reference, e. g., for identification of bilateral changes. The metabolite concentration images were found useful for lateralisation of temporal lobe abnormalities related to epilepsy. Visual analysis can, with high accuracy, be used routinely. ROI analysis is useful for quantifying changes, giving more quantitative information about spatial distribution and the degree of signal loss. There was a large variation in NAA/(Cho + Cr) values in both patients and volunteers. The brain stem may be used as a reference for identification of bilateral changes. (orig.)

  2. Lateralisation with magnetic resonance spectroscopic imaging in temporal lobe epilepsy: an evaluation of visual and region-of-interest analysis of metabolite concentration images

    Energy Technology Data Exchange (ETDEWEB)

    Vikhoff-Baaz, B. [Sahlgrenska University Hospital, Goeteborg (Sweden); Div. of Medical Physics and Biomedical Engineering, Goeteborg Univ. (Sweden); Goeteborg Univ. (Sweden). Dept. of Radiation Physics; Malmgren, K. [Dept. of Neurology, Goeteborg Univ. (Sweden); Joensson, L.; Ekholm, S. [Dept. of Radiology, Goeteborg Univ. (Sweden); Starck, G. [Div. of Medical Physics and Biomedical Engineering, Goeteborg Univ. (Sweden); Ljungberg, M.; Forssell-Aronsson, E. [Goeteborg Univ. (Sweden). Dept. of Radiation Physics; Uvebrant, P. [Dept. of Paediatrics, Goeteborg Univ. (Sweden)

    2001-09-01

    We carried out spectroscopic imaging (MRSI) on nine consecutive patients with temporal lobe epilepsy being assessed for epilepsy surgery, and nine neurologically healthy, age-matched volunteers. A volume of interest (VOI) was angled along the temporal horns on axial and sagittal images, and symmetrically over the temporal lobes on coronal images. Images showing the concentrations of N-acetylaspartate (NAA) and of choline-containing compounds plus creatine and phosphocreatine (Cho + Cr) were used for lateralisation. We compared assessment by visual inspection and by signal analysis from regions of interest (ROI) in different positions, where side-to-side differences in NAA/(Cho + Cr) ratio were used for lateralisation. The NAA/(Cho + Cr) ratio from the different ROI was also compared with that in the brain stem to assess if the latter could be used as an internal reference, e. g., for identification of bilateral changes. The metabolite concentration images were found useful for lateralisation of temporal lobe abnormalities related to epilepsy. Visual analysis can, with high accuracy, be used routinely. ROI analysis is useful for quantifying changes, giving more quantitative information about spatial distribution and the degree of signal loss. There was a large variation in NAA/(Cho + Cr) values in both patients and volunteers. The brain stem may be used as a reference for identification of bilateral changes. (orig.)

  3. Ictal ECG changes in temporal lobe epilepsy Alterações eletrocardiográficas ictais em epilepsia do lobo temporal

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    L.M. Li

    1995-09-01

    Full Text Available Changes in cardiac rhythm may occur during epileptic seizures and this has been suggested as a possible mechanism for sudden unexpected death amongst patients with chronic epilepsy (SUDEP. We have studied ECG changes during 61 complex partial seizures of temporal lobe origin in 20 patients. Tachycardia was observed in 24/61 (39% and bradycardia in 3/61 (5%. The mean and median tachycardia rate was 139 and 140 beats/min (range 120-180. The longest R-R interval observed was 9 seconds. No difference was found in regard to the lateralisation of seizures and cardiac arrhytmia. One of the patients with bradycardia was fitted with a demand cardiac pacemaker, which appeared to decrease the number of his falls. In conclusion, ictal cardiac changes which may be seen in temporal lobe epilepsy (TLE are sinus tachycardia and occasionally sinus bradycardia. Patients presenting vague complains suggestive of either TLE or cardiac dysrhythmia, simultaneous monitoring with EEG/ECG is required, and if the episodes are frequent, video-EEG should be considered. Further studies on this subject are warranted as this may shed some light on possible mechanisms for SUDEP.Alterações no ritmo cardíaco podem ocorrer durante crises epilépticas. Estas alterações têm sido sugeridas como possível mecanismo para explicar morte súbita em pacientes com epilepsia crônica. Analisamos o eltrocardiograma (ECG em 61 crises parciais complexas do lobo temporal de 20 pacientes. Taquicardia foi observada em 24/61 (39% e bradicardia em 3/61 (5%. A média e a mediana da taquicardia foram 139 e 140 batimentos por minuto (variando de 120-180. O intervalo R-R mais longo foi 9 segundos. Não houve diferença em relação a lateralisação das crises e alteração do ritmo cardíaco. Um paciente com bradicardia recebeu marcapasso de demanda, com diminuição importante das suas quedas durante as crises. Em conclusão, as alterações cardíacas ictais em crises do lobo temporal mais

  4. New avenue in the treatment of temporal lobe epilepsy by classical anti-epileptics: A hypothetical establishment of executioner Caspase 3 inactivation by molecular modeling

    OpenAIRE

    M Vijey Aanandhi; Debojit Bhattacherjee; Anirban Ray; P Samuel Gideon George

    2015-01-01

    Patients with temporal lobe epilepsy (TLE) are prescribed first-line antiepileptic drugs and surgery to the management of this disorder. Unfortunately, the surgical treatment has been shown to be beneficial for the selected patients but fails to provide a seizure-free outcome in 20–30% of TLE patients. In our present study, we investigate the possibilities of marketed antiepileptic drugs in a different manner to improve the present situation in TLE. Molecular docking simulation study and vari...

  5. White Matter Atrophy in Patients with Mesial Temporal Lobe Epilepsy: Voxel-Based Morphometry Analysis of T1- and T2-Weighted MR Images

    OpenAIRE

    Barbara Braga; Yasuda, Clarissa L.; Fernando Cendes

    2012-01-01

    Introduction. Mesial temporal lobe epilepsy (MTLE) associated with hippocampal sclerosis is highly refractory to clinical treatment. MRI voxel-based morphometry (VBM) of T1-weighted images has revealed a widespread pattern of gray matter (GM) and white matter (WM) atrophy in MTLE. Few studies have investigated the role of T2-weighted images in revealing WM atrophy using VBM. Objectives. To compare the results of WM atrophy between T1- and T2-weighted images through VBM. Methods. We selected 2...

  6. Correlation between IL-10 and microRNA-187 expression in epileptic rat hippocampus and patients with temporal lobe epilepsy

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    Walid A. Alsharafi

    2015-12-01

    Full Text Available Accumulating evidence is emerging that microRNAs (miRs are key regulators controlling neuroinflammatory processes, which are known to play a potential role in the pathogenesis of temporal lobe epilepsy (TLE. The aim of the present study was to investigate the dynamic expression pattern of interleukin (IL–10 as an anti-inflammatory cytokine and miR-187 and post-transcriptional inflammation-related miRNA in the hippocampus of a rat model of status epilepticus (SE and patients with TLE. We performed a real-time quantitative PCR and western blot on rat hippocampus (2 hours, 7 days, 21 days and 60 days following pilocarpine-induced SE, and on hippocampus obtained from TLE patients and normal controls. To detect the relationship between IL-10 and miR-187 on neurons, lipopolysaccharide (LPS and IL-10-stimulated neurons were prepared. Furthermore, we identified the effect of antagonizing of miR-187 by its antagomir on IL-10 secretion. Here we reported that that IL-10 secretion and miR-187 expression levels are inversely correlated after SE.. In patients with TLE, the expression levels of IL-10 was also significantly upregulated, whereas miR-187 expression was significantly downregulated. Moreover, miR-187 expression was significantly reduced following IL-10 stimulation in an IL-10–dependent manner. On the other hand, antagonizing miR-187 reduced the production of IL-10 in hippocampal tissues of rat model of SE. Our findings demonstrate a critical role of miR-187 in the physiological regulation of IL-10 anti-inflammatory responses and elucidate the role of neuro-inflammation in the pathogenesis of TLE. Therefore, modulation of the IL-10 / miR-187 axis may be a new therapeutic approach for TLE.

  7. Changes in the sensitivity of GABAA current rundown to drug treatments in a model of temporal lobe epilepsy

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    Pierangelo eCifelli

    2013-07-01

    Full Text Available The pharmacological treatment of mesial temporal lobe epilepsy (mTLE, the most common epileptic syndrome in adults, is still unsatisfactory, as one third of the patients are or become refractory to antiepileptic agents. Refractoriness may depend upon drug-induced alterations, but the disease per se may also undergo a progressive evolution that affects the sensitivity to drugs. mTLE has been shown to be associated with a dysfunction of the inhibitory signaling mediated by GABAA receptors. In particular, the repetitive activation of GABAA receptors produces a use-dependent decrease (rundown of the evoked currents (IGABA, which is markedly enhanced in the hippocampus and cortex of drug-resistant mTLE patients. This phenomenon has been also observed in the pilocarpine model, where the increased IGABA rundown is observed in the hippocampus at the time of the first spontaneous seizure, then extends to the cortex and remains constant in the chronic phase of the disease. Here, we examined the sensitivity of IGABA to pharmacological modulation. We focused on the antiepileptic agent levetiracetam and on the neurotrophin BDNF, which were previously reported to attenuate mTLE-induced increased rundown in the chronic human tissue. In the pilocarpine model, BDNF displayed a paramount effect, decreasing rundown in the hippocampus at the time of the first seizure, as well as in the hippocampus and cortex in the chronic period. In contrast, levetiracetam did not affect rundown in the hippocampus, but attenuated it in the cortex. Interestingly, this effect of levetiracetam was also observed on the still unaltered rundown observed in the cortex at the time of the first spontaneous seizure. These data suggest that the sensitivity of GABAA receptors to pharmacological interventions undergoes changes during the natural history of mTLE, implicating that the site of seizure initiation and the timing of treatment may highly affect the therapeutic outcome.

  8. Value of Functionalized Superparamagnetic Iron Oxide Nanoparticles in the Diagnosis and Treatment of Acute Temporal Lobe Epilepsy on MRI

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    Tingting Fu

    2016-01-01

    Full Text Available Purpose. Although active targeting of drugs using a magnetic-targeted drug delivery system (MTDS with superparamagnetic iron oxide nanoparticles (SPIONs is a very effective treatment approach for tumors and other illnesses, successful results of drug-resistant temporal lobe epilepsy (TLE are unprecedented. A hallmark in the neuropathology of TLE is brain inflammation, in particular the activation of interleukin-1β (IL-1β induced by activated glial cells, which has been considered a new mechanistic target for treatment. The purpose of this study was to determine the feasibility of the functionalized SPIONs with anti-IL-1β monoclonal antibody (mAb attached to render MRI diagnoses and simultaneously provide targeted therapy with the neutralization of IL-1β overexpressed in epileptogenic zone of an acute rat model of TLE. Experimental Design. The anti-IL-1β mAb-SPIONs were studied in vivo versus plain SPIONs and saline. Lithium-chloride pilocarpine-induced TLE models (n=60 were followed by Western blot, Perl’s iron staining, Nissl staining, and immunofluorescent double-label staining after MRI examination. Results. The magnetic anti-IL-1β mAb-SPION administered intravenously, which crossed the BBB and was concentrated in the astrocytes and neurons in epileptogenic tissues, rendered these tissues visible on MRI and simultaneously delivered anti-IL-1β mAb to the epileptogenic focus. Conclusions. Our study provides the first evidence that the novel approach enhanced accumulation and the therapeutic effect of anti-IL-1β mAb by MTDS using SPIONs.

  9. MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

    International Nuclear Information System (INIS)

    The paucity of morphometric markers for hemispheric asymmetries and gender variations in hippocampi and amygdalae in temporal lobe epilepsy (TLE) calls for better characterization of TLE by finding more useful prognostic MRI parameter(s). T1-weighted MRI (3 T) morphometry using multiple parameters of hippocampus-parahippocampus (angular and linear measures, volumetry) and amygdalae (volumetry) including their hemispheric asymmetry indices (AI) were evaluated in both genders. The cutoff values of parameters were statistically estimated from measurements of healthy subjects to characterize TLE (57 patients, 55 % male) alterations. TLE had differential categories with hippocampal atrophy, parahippocampal angle (PHA) acuteness, and several other parametric changes. Bilateral TLE categories were much more prevalent compared to unilateral TLE categories. Female patients were considerably more disposed to bilateral TLE categories than male patients. Male patients displayed diverse categories of unilateral abnormalities. Few patients (both genders) had combined bilateral appearances of hippocampal atrophy, amygdala atrophy, PHA acuteness, and increase in hippocampal angle (HA) where medial distance ratio (MDR) varied among genders. TLE had gender-specific and hemispheric dominant alterations in AI of parameters. Maximum magnitude of parametric changes in TLE includes (a) AI increase in HA of both genders, (b) HA increase (bilateral) in female patients, and (c) increase in ratio of amygdale/hippocampal volume (unilateral, right hemispheric), and AI decrease in MDR, in male patients. Multiparametric MRI studies of hippocampus and amygdalae, including their hemispheric asymmetry, underscore better characterization of TLE. Rapidly measurable single-slice parameters (HA, PHA, MDR) can readily delineate TLE in a time-constrained clinical setting, which contrasts with customary three-dimensional hippocampal volumetry that requires many slice computation. (orig.)

  10. Expression of human epileptic temporal lobe neurotransmitter receptors in Xenopus oocytes: An innovative approach to study epilepsy

    Science.gov (United States)

    Palma, Eleonora; Esposito, Vincenzo; Mileo, Anna Maria; Di Gennaro, Giancarlo; Quarato, Pierpaolo; Giangaspero, Felice; Scoppetta, Ciriaco; Onorati, Paolo; Trettel, Flavia; Miledi, Ricardo; Eusebi, Fabrizio

    2002-01-01

    Poly(A+) RNA was extracted from the temporal lobe (TL) of medically intractable epileptic patients which underwent surgical TL resection. Injection of this mRNA into Xenopus oocytes led to the expression of ionotropic receptors for γ-aminobutyric acid (GABA), kainate (KAI) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA). Membrane currents elicited by GABA inverted polarity at −15 mV, close to the oocyte's chloride equilibrium potential, were inhibited by bicuculline, and were potentiated by pentobarbital and flunitrazepam. These basic characteristics were also displayed by GABA currents elicited in oocytes injected with mRNAs isolated from human TL glioma (TLG) or from mouse TL. However, the GABA receptors expressed by the epileptic TL mRNA exhibited some unusual properties, consisting in a rapid current run-down after repetitive GABA applications and a large EC50 (125 μM). AMPA alone evoked very small or nil currents, whereas KAI induced larger currents. Nevertheless, upon cyclothiazide treatment, AMPA elicited substantial currents that, like the KAI currents, were inhibited by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). Furthermore, the glutamate receptor 5 (GluR5) agonist, ATPA, failed to evoke an obvious current although both RT-PCR and Western blot analyses showed GluR5 expression in the epileptic TL. Oocytes injected with mouse TL or human TLG mRNAs generated KAI and AMPA currents similar to those evoked in oocytes injected with epileptic TL mRNA but, in contrast to these, the mouse TL and human TLG oocytes were also responsive to ATPA. Our findings are in accord with the concept that both a depression of GABA inhibition and a dysfunction of the KAI-receptor system maintain a high neuronal excitability that results in epileptic seizures. PMID:12409614

  11. Loss of resting-state posterior cingulate flexibility is associated with memory disturbance in left temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Linda Douw

    Full Text Available The association between cognition and resting-state fMRI (rs-fMRI has been the focus of many recent studies, most of which use stationary connectivity. The dynamics or flexibility of connectivity, however, may be seminal for understanding cognitive functioning. In temporal lobe epilepsy (TLE, stationary connectomic correlates of impaired memory have been reported mainly for the hippocampus and posterior cingulate cortex (PCC. We therefore investigate resting-state and task-based hippocampal and PCC flexibility in addition to stationary connectivity in left TLE (LTLE patients. Sixteen LTLE patients were analyzed with respect to rs-fMRI and task-based fMRI (t-fMRI, and underwent clinical neuropsychological testing. Flexibility of connectivity was calculated using a sliding-window approach by determining the standard deviation of Fisher-transformed Pearson correlation coefficients over all windows. Stationary connectivity was also calculated. Disturbed memory was operationalized as having at least one memory subtest score equal to or below the 5th percentile compared to normative data. Lower PCC flexibility, particularly in the contralateral (i.e. right hemisphere, was found in memory-disturbed LTLE patients, who had up to 22% less flexible connectivity. No significant group differences were found with respect to hippocampal flexibility, stationary connectivity during both rs-fMRI and t-fMRI, or flexibility during t-fMRI. Contralateral resting-state PCC flexibility was able to classify all but one patient with respect to their memory status (94% accuracy. Flexibility of the PCC during rest relates to memory functioning in LTLE patients. Loss of flexible connectivity to the rest of the brain originating from the PCC, particularly contralateral to the seizure focus, is able to discern memory disturbed patients from their preserved counterparts. This study indicates that the dynamics of resting-state connectivity are associated with cognitive status

  12. Studying memory encoding to promote reliable engagement of the medial temporal lobe at the single-subject level.

    Directory of Open Access Journals (Sweden)

    Marta Simó

    Full Text Available The medial temporal lobe (MTL—comprising hippocampus and the surrounding neocortical regions—is a targeted brain area sensitive to several neurological diseases. Although functional magnetic resonance imaging (fMRI has been widely used to assess brain functional abnormalities, detecting MTL activation has been technically challenging. The aim of our study was to provide an fMRI paradigm that reliably activates MTL regions at the individual level, thus providing a useful tool for future research in clinical memory-related studies. Twenty young healthy adults underwent an event-related fMRI study consisting of three encoding conditions: word-pairs, face-name associations and complex visual scenes. A region-of-interest analysis at the individual level comparing novel and repeated stimuli independently for each task was performed. The results of this analysis yielded activations in the hippocampal and parahippocampal regions in most of the participants. Specifically, 95% and 100% of participants showed significant activations in the left hippocampus during the face-name encoding and in the right parahippocampus, respectively, during scene encoding. Additionally, a whole brain analysis, also comparing novel versus repeated stimuli at the group level, showed mainly left frontal activation during the word task. In this group analysis, the face-name association engaged the HP and fusiform gyri bilaterally, along with the left inferior frontal gyrus, and the complex visual scenes activated mainly the parahippocampus and hippocampus bilaterally. In sum, our task design represents a rapid and reliable manner to study and explore MTL activity at the individual level, thus providing a useful tool for future research in clinical memory-related fMRI studies.

  13. Association between prefrontal activity and volume change in prefrontal and medial temporal lobes in aging and dementia: a review.

    Science.gov (United States)

    Maillet, David; Rajah, M Natasha

    2013-03-01

    Functional neuroimaging studies have consistently reported age-related changes in prefrontal cortex (PFC) activity during a variety of cognitive tasks, including episodic memory. These changes are often interpreted within the context of one of the following three neural models of age-related changes in brain function: dedifferentiation, neural inefficiency, and neural plasticity and compensation models. Distinguishing between these competing models has proven difficult when interpreting results using functional imaging data alone. In this paper we suggest that a more accurate interpretation of age-related changes in PFC activity requires consideration of age-related differences in gray matter volume (GMv) in PFC and the medial temporal lobes (MTL). We review fMRI studies of cognitive aging that have directly examined the relationship between PFC activity and both local (PFC) and distal (MTL) GMv in older versus younger adults. We also considered how structure-function relationships may be further modified in pathological aging (i.e. mild cognitive impairment (MCI) and Alzheimer's disease (AD)). We found that when task performance was matched between age-groups there was a negative association between regional PFC volume and activity in older adults. However, when older adults performed worse than young adults we observed a positive association between volume and activity in right lateral PFC. Additionally during memory tasks, several studies revealed that PFC activity is positively related to GM volume in MTL in healthy older adults, but negatively related in MCI and AD patients. We conclude that PFC activity is related to age-related changes in local and distal GM volume reductions and that consideration of these structural measures aids the interpretation of fMRI results. Furthermore, the study of structure-function relationships may provide important insights into the biological mechanisms underlying healthy versus pathological aging. PMID:23183352

  14. MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features

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    Datta, Siddhartha; Chakrabarti, Nilkanta [University of Calcutta, Department of Physiology and UGC-CPEPA Centre for ' ' Electro-physiological and Neuro-imaging studies including Mathematical Modelling' ' , Kolkata (India); Sarkar, Sudipta; Chakraborty, Sumit; Basu, Swadhapriya [IPGME and R, SSKM Hospital, Department of Radiodiagnosis, Kolkata (India); Mulpuru, Sai Krishna [National Brain Research Centre, National Neuro-Imaging Facility, Manesar (India); Tiwary, Basant K. [Pondicherry University, Centre for Bioinformatics, School of Life Sciences, Pondicherry (India); Roy, Prasun Kumar [National Brain Research Centre, Computational Neuroimaging Division, Manesar (India); National Brain Research Centre, Clinical Neuroscience Unit, Gurgaon (India)

    2015-09-15

    The paucity of morphometric markers for hemispheric asymmetries and gender variations in hippocampi and amygdalae in temporal lobe epilepsy (TLE) calls for better characterization of TLE by finding more useful prognostic MRI parameter(s). T1-weighted MRI (3 T) morphometry using multiple parameters of hippocampus-parahippocampus (angular and linear measures, volumetry) and amygdalae (volumetry) including their hemispheric asymmetry indices (AI) were evaluated in both genders. The cutoff values of parameters were statistically estimated from measurements of healthy subjects to characterize TLE (57 patients, 55 % male) alterations. TLE had differential categories with hippocampal atrophy, parahippocampal angle (PHA) acuteness, and several other parametric changes. Bilateral TLE categories were much more prevalent compared to unilateral TLE categories. Female patients were considerably more disposed to bilateral TLE categories than male patients. Male patients displayed diverse categories of unilateral abnormalities. Few patients (both genders) had combined bilateral appearances of hippocampal atrophy, amygdala atrophy, PHA acuteness, and increase in hippocampal angle (HA) where medial distance ratio (MDR) varied among genders. TLE had gender-specific and hemispheric dominant alterations in AI of parameters. Maximum magnitude of parametric changes in TLE includes (a) AI increase in HA of both genders, (b) HA increase (bilateral) in female patients, and (c) increase in ratio of amygdale/hippocampal volume (unilateral, right hemispheric), and AI decrease in MDR, in male patients. Multiparametric MRI studies of hippocampus and amygdalae, including their hemispheric asymmetry, underscore better characterization of TLE. Rapidly measurable single-slice parameters (HA, PHA, MDR) can readily delineate TLE in a time-constrained clinical setting, which contrasts with customary three-dimensional hippocampal volumetry that requires many slice computation. (orig.)

  15. A cross-sectional MRI study of brain regional atrophy and clinical characteristics of temporal lobe epilepsy with hippocampal sclerosis.

    LENUS (Irish Health Repository)

    2012-02-01

    PURPOSE: Applying a cross-sectional design, we set out to further characterize the significance of extrahippocampal brain atrophy in a large sample of \\'sporadic\\' mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE+HS). By evaluating the influence of epilepsy chronicity on structural atrophy, this work represents an important step towards the characterization of MRI-based volumetric measurements as genetic endophenotypes for this condition. METHODS: Using an automated brain segmentation technique, MRI-based volume measurements of several brain regions were compared between 75 patients with \\'sporadic\\' MTLE+HS and 50 healthy controls. Applying linear regression models, we examined the relationship between structural atrophy and important clinical features of MTLE+HS, including disease duration, lifetime number of partial and generalized seizures, and history of initial precipitating insults (IPIs). RESULTS: Significant volume loss was detected in ipsilateral hippocampus, amygdala, thalamus, and cerebral white matter (WM). In addition, contralateral hippocampal and bilateral cerebellar grey matter (GM) volume loss was observed in left MTLE+HS patients. Hippocampal, amygdalar, and cerebral WM volume loss correlated with duration of epilepsy. This correlation was stronger in patients with prior IPIs history. Further, cerebral WM, cerebellar GM, and contralateral hippocampal volume loss correlated with lifetime number of generalized seizures. CONCLUSION: Our findings confirm that multiple brain regions beyond the hippocampus are involved in the pathogenesis of MTLE+HS. IPIs are an important factor influencing the rate of regional atrophy but our results also support a role for processes related to epilepsy chronicity. The consequence of epilepsy chronicity on candidate brain regions has important implications on their application as genetic endophenotypes.

  16. Dysregulation of Autophagy, Mitophagy, and Apoptotic Genes in the Medial Temporal Lobe Cortex in an Ischemic Model of Alzheimer’s Disease

    Science.gov (United States)

    Ułamek-Kozioł, Marzena; Kocki, Janusz; Bogucka-Kocka, Anna; Petniak, Alicja; Gil-Kulik, Paulina; Januszewski, Sławomir; Bogucki, Jacek; Jabłoński, Mirosław; Furmaga-Jabłońska, Wanda; Brzozowska, Judyta; Czuczwar, Stanisław J.; Pluta, Ryszard

    2016-01-01

    Ischemic brain damage is a pathological incident that is often linked with medial temporal lobe cortex injury and finally its atrophy. Post-ischemic brain injury associates with poor prognosis since neurons of selectively vulnerable ischemic brain areas are disappearing by apoptotic program of neuronal death. Autophagy has been considered, after brain ischemia, as a guardian against neurodegeneration. Consequently, we have examined changes in autophagy (BECN 1), mitophagy (BNIP 3), and apoptotic (caspase 3) genes in the medial temporal lobe cortex with the use of quantitative reverse-transcriptase PCR following transient 10-min global brain ischemia in rats with survival 2, 7, and 30 days. The intense significant overexpression of BECN 1 gene was noted on the 2nd day, while on days 7–30 the expression of this gene was still upregulated. BNIP 3 gene was downregulated on the 2nd day, but on days 7–30 post-ischemia, there was a significant reverse tendency. Caspase 3 gene, associated with apoptotic neuronal death, was induced in the same way as BNIP 3 gene after brain ischemia. Thus, the demonstrated changes indicate that the considerable dysregulation of expression of BECN 1, BNIP 3, and caspase 3 genes may be connected with a response of neuronal cells in medial temporal lobe cortex to transient complete brain ischemia. PMID:27472881

  17. Avaliação neuropsicológica em portadores de epilepsia do lobo temporal Neuropsychological assessment in patients with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Alisson N.S. Silva

    2007-06-01

    Full Text Available Investigamos a cognição de pacientes com epilepsia de lobo temporal que apresentavam ou não lesão mesial segundo exame de ressonância magnética. Utilizamos testes neuropsicológicos clássicos e ecológicos com objetivo de identificar possíveis alterações funcionais, e comparar resultados entre instrumentos tradicionais e ecológicos. Trinta e quatro pessoas pareadas em idade e escolaridade foram separadas em três grupos: 12 pacientes com lesão mesial; 12 sem lesão e 10 pessoas saudáveis. Para a avaliação funcional utilizamos: subtestes da escala de inteligência para adultos e de memória de Wechsler; fluência verbal, e o teste comportamental de memória de Rivermead. Os pacientes com lesão apresentaram desempenho cognitivo rebaixado em relação aos controles em diversas atividades: span atencional, memória, linguagem, resolução de problemas do cotidiano, enquanto os pacientes sem lesão mostraram-se mais compensados, apenas com alterações atencionais sutis. Tanto os testes tradicionais de memória, quanto os ecológicos foram eficientes para descrever o perfil cognitivo de pacientes com epilepsia.We investigated the patient cognition with temporal lobe epilepsy that presented or no mesial injury in magnetic resonance exam. We used classics and ecological neuropsychological tests to indicate possible functional alterations, and to compare results between ecological and traditional instruments. Thirty-four people match in age and study year were separate in three groups: 12 patients with mesial injury; 12 without injury and 10 health people. We used for functional evaluation: Wechsler adult intelligence and memory scales subtests, verbal fluency and Rivermead behavior memory test. The patients with injuries presented low cognitive performance when compared with control groups in various tasks: attentional span, memory, speech, daily problems resolution, while the patients without injury showed more compensated with mild

  18. Increased anterior cingulate and temporal lobe activity during visuospatial working memory in children and adolescents with schizophrenia

    NARCIS (Netherlands)

    T.J.H. White (Tonya); D. Hongwanishkul (Donaya); M. Schmidt (Manfred)

    2011-01-01

    textabstractObjective: Similar to adults, children and adolescents with schizophrenia present with significant working memory (WkM) deficits. However, unlike adults, findings of abnormal activity in the prefrontal cortex in early-onset schizophrenia (EOS) are not consistently reported. Since WkM con

  19. More consistently altered connectivity patterns for cerebellum and medial temporal lobes than for amygdala and striatum in schizophrenia

    Directory of Open Access Journals (Sweden)

    Henning ePeters

    2016-02-01

    Full Text Available Background: Brain architecture can be divided into a cortico-thalamic system and modulatory ‘subcortical-cerebellar’ systems containing key structures such as striatum, medial temporal lobes (MTLs, amygdala, and cerebellum. Subcortical-cerebellar systems are known to be altered in schizophrenia. In particular, intrinsic functional brain connectivity (iFC between these systems has been consistently demonstrated in patients. While altered connectivity is known for each subcortical-cerebellar system separately, it is unknown whether subcortical-cerebellar systems’ connectivity patterns with the cortico-thalamic system are comparably altered across systems, i.e., if separate subcortical-cerebellar systems’ connectivity patterns are consistent across patients. Methods: To investigate this question, 18 patients with schizophrenia (3 unmedicated, 15 medicated with atypical antipsychotics and 18 healthy controls were assessed by resting-state functional magnetic resonance imaging (fMRI. Independent component analysis of fMRI data revealed cortical intrinsic brain networks (NWs with time courses representing proxies for cortico-thalamic system activity. Subcortical-cerebellar systems’ activity was represented by fMRI-based time courses of selected regions-of-interest (ROIs (i.e., striatum, MTL, amygdala, cerebellum. Correlation analysis among ROI- and NWs-time courses yielded individual connectivity matrices (i.e. connectivity between NW and ROIs (allROIs-NW, separateROI-NW, only NWs (NWs-NWs, and only ROIs (allROIs-allROIs as main outcome measures, which were classified by support-vector-machine-based leave-one-out cross-validation. Differences in classification accuracy were statistically evaluated for consistency across subjects and systems. Results: Correlation matrices based on allROIs-NWs yielded 91% classification accuracy, which was significantly superior to allROIs-allROIs and NWs-NWs (56% and 74%, respectively. Considering separate

  20. Functional variant in complement C3 gene promoter and genetic susceptibility to temporal lobe epilepsy and febrile seizures.

    Directory of Open Access Journals (Sweden)

    Sarah Jamali

    Full Text Available BACKGROUND: Human mesial temporal lobe epilepsies (MTLE represent the most frequent form of partial epilepsies and are frequently preceded by febrile seizures (FS in infancy and early childhood. Genetic associations of several complement genes including its central component C3 with disorders of the central nervous system, and the existence of C3 dysregulation in the epilepsies and in the MTLE particularly, make it the C3 gene a good candidate for human MTLE. METHODOLOGY/PRINCIPAL FINDINGS: A case-control association study of the C3 gene was performed in a first series of 122 patients with MTLE and 196 controls. Four haplotypes (HAP1 to 4 comprising GF100472, a newly discovered dinucleotide repeat polymorphism [(CA8 to (CA15] in the C3 promoter region showed significant association after Bonferroni correction, in the subgroup of MTLE patients having a personal history of FS (MTLE-FS+. Replication analysis in independent patients and controls confirmed that the rare HAP4 haplotype comprising the minimal length allele of GF100472 [(CA8], protected against MTLE-FS+. A fifth haplotype (HAP5 with medium-size (CA11 allele of GF100472 displayed four times higher frequency in controls than in the first cohort of MTLE-FS+ and showed a protective effect against FS through a high statistical significance in an independent population of 97 pure FS. Consistently, (CA11 allele by its own protected against pure FS in a second group of 148 FS patients. Reporter gene assays showed that GF100472 significantly influenced C3 promoter activity (the higher the number of repeats, the lower the transcriptional activity. Taken together, the consistent genetic data and the functional analysis presented here indicate that a newly-identified and functional polymorphism in the promoter of the complement C3 gene might participate in the genetic susceptibility to human MTLE with a history of FS, and to pure FS. CONCLUSIONS/SIGNIFICANCE: The present study provides important

  1. Hippocampal volume in children with temporal lobe epilepsy compared to healthy children : A magnetic resonance imaging study

    Directory of Open Access Journals (Sweden)

    Yu-Zhen Zhang

    2012-01-01

    Full Text Available Context : There are currently few published studies that compare hippocampal volume (HCV in children with temporal lobe epilepsy (TLE. Aims : T0 o compare HCVs in children with TLE and in relation to normal controls (NC, and to analyze HCV change in the acute phase in pediatric subjects using magnetic resonance imaging (MRI. Setting and Design : T0 he case group (n=24 was matched in gender and age range with NC subjects (n=24. Subjects were divided into three groups according to age: 2-5.9 years, 6-8.9 years and 9-13 years. Materials and Methods : M0 anual measurements were used to obtain HCVs on oblique coronary MRI images obtained by three-dimensional magnetization-prepared rapid gradient-echo (3D-MPRAGE sequence. Statistical Analyses : T0 he HCV was calculated and normalized. Paired t-tests were used to compare the right and left HCVs within each study group. Analysis of covariance (ANCOVA was used to consider the impact of age and gender on HCVs. Results : T0 wenty-two patients were diagnosed with definite/probable TLE, and two were non-syndromic focal epilepsy which was distributed in the 2-5.9 years group. The range of left to right mean HCVs of the case and NC group aged 2-13 years was 2014.14 ± 54.32 mm 3 to 2165.31 ± 80.99 mm 3 and 2015.46 ± 26.97 mm 3 to 2100.93 ± 57.33 mm 3 respectively. There were age-related differences in left and right HCV, but no effect of gender. Relative to NC subjects, cases group aged 2-5.9 years had significantly different HCVs, while no significant difference was found in the other two groups. There was significant difference in the right to left HCVs in the case subjects aged 2-5.9 years, but not in the other age groups. Conclusions : T0 he heterogeneity in the 2-5.9 years age cohort may relate to the increased HCVs. The HCV data from NC subjects may be used as a reference to assess hippocampal abnormalities in clinical practice.

  2. Surviving mossy cells enlarge and receive more excitatory synaptic input in a mouse model of temporal lobe epilepsy.

    Science.gov (United States)

    Zhang, Wei; Thamattoor, Ajoy K; LeRoy, Christopher; Buckmaster, Paul S

    2015-05-01

    Numerous hypotheses of temporal lobe epileptogenesis have been proposed, and several involve hippocampal mossy cells. Building on previous hypotheses we sought to test the possibility that after epileptogenic injuries surviving mossy cells develop into super-connected seizure-generating hub cells. If so, they might require more cellular machinery and consequently have larger somata, elongate their dendrites to receive more synaptic input, and display higher frequencies of miniature excitatory synaptic currents (mEPSCs). To test these possibilities pilocarpine-treated mice were evaluated using GluR2-immunocytochemistry, whole-cell recording, and biocytin-labeling. Epileptic pilocarpine-treated mice displayed substantial loss of GluR2-positive hilar neurons. Somata of surviving neurons were 1.4-times larger than in controls. Biocytin-labeled mossy cells also were larger in epileptic mice, but dendritic length per cell was not significantly different. The average frequency of mEPSCs of mossy cells recorded in the presence of tetrodotoxin and bicuculline was 3.2-times higher in epileptic pilocarpine-treated mice as compared to controls. Other parameters of mEPSCs were similar in both groups. Average input resistance of mossy cells in epileptic mice was reduced to 63% of controls, which is consistent with larger somata and would tend to make surviving mossy cells less excitable. Other intrinsic physiological characteristics examined were similar in both groups. Increased excitatory synaptic input is consistent with the hypothesis that surviving mossy cells develop into aberrantly super-connected seizure-generating hub cells, and soma hypertrophy is indirectly consistent with the possibility of axon sprouting. However, no obvious evidence of hyperexcitable intrinsic physiology was found. Furthermore, similar hypertrophy and hyper-connectivity has been reported for other neuron types in the dentate gyrus, suggesting mossy cells are not unique in this regard. Thus

  3. Significant effects of sex, strain, and anesthesia in the intrahippocampal kainate mouse model of mesial temporal lobe epilepsy.

    Science.gov (United States)

    Twele, Friederike; Töllner, Kathrin; Brandt, Claudia; Löscher, Wolfgang

    2016-02-01

    The intrahippocampal kainate mouse model of mesial temporal lobe epilepsy is increasingly being used for studies on epileptogenesis and antiepileptogenesis. Almost all previous studies used male mice for this purpose, and no study is available in this or other models of acquired epilepsy that directly compared epileptogenesis in female and male rodents. Epidemiological studies suggest that gender may affect susceptibility to epilepsy and its prognosis; therefore, one goal of this study was to investigate whether sex has an influence on latent period and epileptogenesis in the intrahippocampal kainate model in mice. Another aspect that was examined in the present study was whether mouse strain differences in epileptogenesis exist. Finally, we examined the effects of different types of anesthesia (chloral hydrate, isoflurane) on kainate-induced status epilepticus (SE) and epileptogenesis. Continuous (24/7) video-EEG monitoring was used during SE and the 2weeks following SE as well as 4-6weeks after SE. In male NMRI mice with chloral hydrate anesthesia during kainate injection, SE was followed by a seizure-free latent period of 10-14days if hippocampal paroxysmal discharges (HPDs) recorded from the kainate focus were considered the onset of epilepsy. Anesthesia with isoflurane led to a more rapid onset and higher severity of SE, and not all male NMRI mice exhibited a seizure-free latent period. Female NMRI mice differed from male animals in the lack of any clear latent period, independently of anesthesia type. Furthermore, HPDs were only rarely observed. These problems were not resolved by decreasing the dose of kainate or using other strains (C57BL/6, FVB/N) of female mice. The present data are the first to demonstrate marked sex-related differences in the latent period following brain injury in a rodent model of acquired epilepsy. Furthermore, our data demonstrate that the choice of anesthestic agent during kainate administration affects SE severity and as a

  4. Differing contributions of inferior prefrontal and anterior temporal cortex to concrete and abstract conceptual knowledge.

    Science.gov (United States)

    Hoffman, Paul; Binney, Richard J; Lambon Ralph, Matthew A

    2015-02-01

    Semantic cognition is underpinned by regions involved in representing conceptual knowledge and executive control areas that provide regulation of this information according to current task requirements. Using distortion-corrected fMRI, we investigated the contributions of these two systems to abstract and concrete word comprehension. We contrasted semantic decisions made either with coherent contextual support, which encouraged retrieval of a rich conceptual representation, or with irrelevant contextual information, which instead maximised demands on control processes. Inferior prefrontal cortex was activated more when decisions were made in the presence of irrelevant context, suggesting that this region is crucial for the semantic control functions required to select appropriate aspects of meaning in the face of competing information. It also exhibited greater activation for abstract words, which reflects the fact that abstract words tend to have variable, context-dependent meanings that place higher demands on control processes. In contrast, anterior temporal regions (ATL) were most active when decisions were made with the benefit of a coherent context, suggesting a representational role. There was a graded shift in concreteness effects in this region, with dorsolateral areas particularly active for abstract words and ventromedial areas preferentially activated by concrete words. This supports the idea that concrete concepts are closely associated with visual experience and abstract concepts with auditory-verbal information; and that sub-regions of the ATL display graded specialisation for these two types of knowledge. Between these two extremes, we identified significant activations for both word types in ventrolateral ATL. This area is known to be involved in representing knowledge for concrete concepts; here we established that it is also activated by abstract concepts. These results converge with data from rTMS and neuropsychological investigations in

  5. Learning increases stimulus salience in anterior inferior temporal cortex of the macaque.

    Science.gov (United States)

    Jagadeesh, B; Chelazzi, L; Mishkin, M; Desimone, R

    2001-07-01

    With experience, an object can become behaviorally relevant and thereby quickly attract our interest when presented in a visual scene. A likely site of these learning effects is anterior inferior temporal (aIT) cortex, where neurons are thought to participate in the filtering of irrelevant information out of complex visual displays. We trained monkeys to saccade consistently to one of two pictures in an array, in return for a reward. The array was constructed by pairing two stimuli, one of which elicited a good response from the cell when presented alone ("good" stimulus) and the other of which elicited a poor response ("poor" stimulus). The activity of aIT cells was recorded while monkeys learned to saccade to either the good or poor stimulus in the array. We found that neuronal responses to the array were greater (before the saccade occurred) when training reinforced a saccade to the good stimulus than when training reinforced a saccade to the poor stimulus. This difference was not present on incorrect trials, i.e., when saccades to the incorrect stimulus were made. Thus the difference in activity was correlated with performance. The response difference grew over the course of the recording session, in parallel with the improvement in performance. The response difference was not preceded by a difference in the baseline activity of the cells, unlike what was found in studies of cued visual search and working memory in aIT cortex. Furthermore, we found similar effects in a version of the task in which any of 10 possible pairs of stimuli, prelearned before the recording session, could appear on a given trial, thereby precluding a working memory strategy. The results suggest that increasing the behavioral significance of a stimulus through training alters the neural representation of that stimulus in aIT cortex. As a result, neurons responding to features of the relevant stimulus may suppress neurons responding to features of irrelevant stimuli. PMID:11431510

  6. Post-traumatic temporal lobe lesions: surgical decision making based on CT scan findings Lesões traumáticas do lobo temporal: indicações cirúrgicas baseadas na tomografia computadorizada

    OpenAIRE

    Alexandre Varella Giannetti; Mirto Nelso Prandini; Audrey Beatriz Santos Araujo; Lina Márcia de Araujo Herval

    2005-01-01

    BACKGROUND: The indication for surgical treatment of post-traumatic parenchymal lesions in the temporal lobe remains controversial. OBJECTIVE: We reviewd the tomographic parameters that might be useful in making surgical decisions. METHOD: The tomographic findings of 69 patients were analyzed in a retrospective manner considering: 1) the effects of the lesion (classified into 4 variables: midline shift, status of the cisterns, status of the ventricles, and status of the peripheral sulci); and...

  7. Quantification of respiratory parameters in patients with temporal lobe epilepsy Quantificação de parâmetros respiratórios em pacientes com epilepsia do lobo temporal

    OpenAIRE

    Fulvio Alexandre Scorza; Ana Maria Fonseca Abreu; Marly de Albuquerque; Julio B Cota Pacheco; Renato Breviglieri; Josemir Wanderley Sander; Antônio Carlos da Silva; Esper Abrão Cavalheiro; Ricardo Mario Arida

    2007-01-01

    Dysfunction affecting cardiac or pulmonary systems has been postulated as a major factor in sudden death in epilepsy (SUDEP). Whilst the majority of studies of cardiorespiratory function have focused on changes during seizures, here we investigate whether epilepsy influences basal respiratory parameters in patients with temporal lobe epilepsy (TLE) during the interictal period. Spirometry was performed in 10 females and 10 males. Measurements of Vital Capacity (VC), Forced Vital Capacity (FVC...

  8. Insights into Intrinsic Brain Networks based on Graph Theory and PET in right- compared to left-sided Temporal Lobe Epilepsy

    Science.gov (United States)

    Vanicek, Thomas; Hahn, Andreas; Traub-Weidinger, Tatjana; Hilger, Eva; Spies, Marie; Wadsak, Wolfgang; Lanzenberger, Rupert; Pataraia, Ekaterina; Asenbaum-Nan, Susanne

    2016-01-01

    The human brain exhibits marked hemispheric differences, though it is not fully understood to what extent lateralization of the epileptic focus is relevant. Preoperative [18F]FDG-PET depicts lateralization of seizure focus in patients with temporal lobe epilepsy and reveals dysfunctional metabolic brain connectivity. The aim of the present study was to compare metabolic connectivity, inferred from inter-regional [18F]FDG PET uptake correlations, in right-sided (RTLE; n = 30) and left-sided TLE (LTLE; n = 32) with healthy controls (HC; n = 31) using graph theory based network analysis. Comparing LTLE and RTLE and patient groups separately to HC, we observed higher lobar connectivity weights in RTLE compared to LTLE for connections of the temporal and the parietal lobe of the contralateral hemisphere (CH). Moreover, especially in RTLE compared to LTLE higher local efficiency were found in the temporal cortices and other brain regions of the CH. The results of this investigation implicate altered metabolic networks in patients with TLE specific to the lateralization of seizure focus, and describe compensatory mechanisms especially in the CH of patients with RTLE. We propose that graph theoretical analysis of metabolic connectivity using [18F]FDG-PET offers an important additional modality to explore brain networks. PMID:27349503

  9. Comparative studies of '18F-FDG PET/CT brain imaging and EEG in preoperative localization of temporal lobe epileptic focus

    International Nuclear Information System (INIS)

    Objective: To compare the value of 18F-FDG PET/CT brain imaging and EEG in preoperative localization of the epileptic focus at the temporal lobe. Methods: A total of 152 patients (108 males, 44 females, age ranged from 3 to 59 years old) with past history of temporal lobe epilepsy were included.All patients underwent 18F-FDG PET/CT brain imaging and long-range or video EEG, and 29 patients underwent intracranial electrode EEG due to the failure to localize the disease focus by non-invasive methods.Histopathologic findings after operative treatment were considered the gold standard for disease localization. All patients were followed up for at least six months after the operation. The accuracy of the 18F-FDG PET/CT brain imaging and long-range or video EEG examination were compared using χ2 test. Results: The accuracy of locating the epileptic focus was 80.92% (123/152) for 18F-FDG PET/CT brain imaging and 43.42% (66/152) for long-range or video EEG (χ2=22.72, P<0.01). The accuracy of locating the epileptic focus for the 29 cases with intracranial electrode EEG was 100%. Conclusions: Interictal 18F-FDG PET/CT brain imaging is a sensitive and effective method to locate the temporal lobe epileptic focus and is better than long-range or video EEG. The combination of 18F-FDG PET/CT brain imaging and intracranial electrode EEG examination can further improve the accuracy of locating the epileptic focus. (authors)

  10. Altered Resting State Brain Dynamics in Temporal Lobe Epilepsy Can Be Observed in Spectral Power, Functional Connectivity and Graph Theory Metrics

    OpenAIRE

    Quraan, Maher A; McCormick, Cornelia; Cohn, Melanie; Valiante, Taufik A.; McAndrews, Mary Pat

    2013-01-01

    Despite a wealth of EEG epilepsy data that accumulated for over half a century, our ability to understand brain dynamics associated with epilepsy remains limited. Using EEG data from 15 controls and 9 left temporal lobe epilepsy (LTLE) patients, in this study we characterize how the dynamics of the healthy brain differ from the “dynamically balanced” state of the brain of epilepsy patients treated with anti-epileptic drugs in the context of resting state. We show that such differences can be ...

  11. Temporal lobe dysfunction in childhood autism: a PET study; Dysfonctionnement bitemporal dans l'autisme infantile: etude en tomographie par emission de positons

    Energy Technology Data Exchange (ETDEWEB)

    Boddaert, N.; Poline, J.B.; Brunelle, F.; Zilbovicius, M. [Service Hospitalier Frederic Joliot, ER-M INSERM 0205, DSV, DRM CEA, 91 - Orsay (France); Brunelle, F. [Centre Hospitalier Universitaire Necker-Enfants-Malades, Service de Radiologie Pediatrique, 75 - Paris (France); Chabane, N. [Hopital Robert-Debre, Service de Pedopsychiatrie, 75 - Paris (France); Barthelemy, C.; Zilbovicius, M. [Centre Hospitalier Universitaire Bretonneau, INSERM Unite 316, 37 - Tours (France); Bourgeois, M. [Centre Hospitalier Universitaire Necker-Enfants-Malades, Dept. de Pediatrie, 75 - Paris (France); Samson, Y. [Centre Hospitalier Universitaire Pitie-Salpetriere, Service des Urgences Cerebraux Vasculaires, 75 - Paris (France)

    2002-12-01

    Childhood autism is a severe developmental disorder that impairs the acquisition of some of the most important skills in human life. Progress in understanding the neural basis of childhood autism requires clear and reliable data indicating specific neuro-anatomical or neuro-physiological abnormalities. The purpose of the present study was to research localized brain dysfunction in autistic children using functional brain imaging. Regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) in 21 primary autistic children and 10 age-matched non autistic children. A statistical parametric analysis of rCBF images revealed significant bilateral temporal hypoperfusion in the associative auditory cortex (superior temporal gyrus) and in the multimodal cortex (superior temporal sulcus) in the autistic group (p<0.001). In addition, temporal hypoperfusion was detected individually in 77% of autistic children. These findings provide robust evidence of well localized functional abnormalities in autistic children located in the superior temporal lobe. Such localized abnormalities were not detected with the low resolution PET camera (14-22). This study suggests that high resolution PET camera combined with statistical parametric mapping is useful to understand developmental disorders. (authors)

  12. LASSO-based NTCP model for radiation-induced temporal lobe injury developing after intensity-modulated radiotherapy of nasopharyngeal carcinoma

    Science.gov (United States)

    Kong, Cheng; Zhu, Xiang-zhi; Lee, Tsair-Fwu; Feng, Ping-bo; Xu, Jian-hua; Qian, Pu-dong; Zhang, Lan-fang; He, Xia; Huang, Sheng-fu; Zhang, Yi-qin

    2016-01-01

    We investigated the incidence of temporal lobe injury (TLI) in 132 nasopharyngeal carcinoma (NPC) patients who had undergone intensity-modulated radiotherapy (IMRT) in our hospital between March 2005 and November 2009; and identified significant dosimetric predictors of TLI development. Contrast-enhanced lesions or cysts in the temporal lobes, as detected by magnetic resonance imaging (MRI), were regarded as radiation-induced TLIs. We used the least absolute shrinkage and selection operator (LASSO) method to select Dmax (the maximum point dose) and the D1cc (the top dose delivered to a 1-mL volume) from 15 dose-volume-histogram-associated and four clinically relevant candidate factors; the Dmax and the D1cc were the most significant predictors of TLI development. We drew dose-response curves for Dmax and D1cc. The tolerance dose (TD) for the 5% and 50% probabilities of TLI development were 69.0 ± 1.6 and 82.1 ± 2.4 Gy for Dmax and 62.8 ± 2.2 and 80.9 ± 3.4 Gy for D1cc, respectively. The incidence of TLI in NPC patients after IMRT was higher than expected because the therapeutic window is narrow. High-quality longitudinal studies are needed to gain further insight into the complex spatiotemporal effects of non-uniform irradiation on TLI development in NPC patients. PMID:27210263

  13. The efficacy of a voxel-based morphometry on the analysis of imaging in schizophrenia, temporal lobe epilepsy, and Alzheimer's disease/mild cognitive impairment: a review

    International Nuclear Information System (INIS)

    Voxel-based morphometry (VBM) done by means of MRI have provided new insights into the neuroanatomical basis for subjects with several conditions. Recently, VBM has been applied to investigate not only regional volumetric changes but also voxel-wise maps of fractional anisotropy (FA) computed from diffusion tensor imaging (DTI). The aim of this article is to review the recent work using VBM technique in particular focusing on schizophrenia, temporal lobe epilepsy (TLE), and Alzheimer's disease (AD)/mild cognitive impairment (MCI). In patients with schizophrenia, VBM approach detects the structural brain abnormalities that appear normal on conventional MRI. Moreover, this technique also has the potential to emerge as a useful clinical tool for early detection and monitoring of disease progression and treatment response in patients with schizophrenia or AD/MCI. In TLE, VBM approach may help elucidate some unresolved important research questions such as how recurrent temporal lobe seizures affect hippocampal and extrahippocampal morphology. Thus, in the future, large cohort studies to monitor whole brain changes on a VBM basis will lead to a further understanding of the neuropathology of several conditions. (orig.)

  14. Monoamine oxidase B single-photon emission tomography with [123I]Ro 43-0463: imaging in volunteers and patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Imaging of monoamine oxidase of subtype B (MAO B) is of interest in various neurological diseases. In the past non-invasive assessment of MAO B has only been possible with positron emission tomography (PET) ligands. Given the limited availability of PET, a single-photon emission tomography (SPET) ligand would be desirable. In this study SPET imaging with the new MAO B inhibitor [123I]Ro 43-0463 was performed in five volunteers and nine patients with temporal lobe epilepsy (TLE). In two volunteers a second study was performed 12 h following blockade with deprenyl. In the TLE patients the tracer was administered as bolus (n = 4) or as prolonged infusion (n = 5). The regional uptake pattern correlated well with the known distribution of MAO B. In the two blocking studies ligand uptake was substantially reduced compared with baseline. In the TLE patients increased uptake was found in the ipsilateral mesial temporal lobe and, surprisingly, in the ipsilateral putamen. This study indicates the potential of the new SPET ligand [123I]Ro 43-0463 to map MAO B concentration in the human brain. The new finding of increased MAO B in the putamen of TLE patients needs further studies to elucidate its exact pathophysiology. (orig.)

  15. Monoamine oxidase B single-photon emission tomography with [{sup 123}I]Ro 43-0463: imaging in volunteers and patients with temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Buck, A. [Division of Nuclear Medicine, University Hospital Zurich (Switzerland); Frey, L.D. [Department of Nuclear Medicine, Kantonsspital Aarau (Switzerland); Blaeuenstein, P.; Schubiger, P. [Paul Scherrer Institut, Radiopharmacy Division, Villigen (Switzerland); Kraemer, G. [Swiss Epilepsy Clinic, Zurich (Switzerland); Siegel, A.; Weber, B.; Wieser, H.G. [Department of Neurology, University Hospital Zurich (Switzerland)

    1998-05-01

    Imaging of monoamine oxidase of subtype B (MAO B) is of interest in various neurological diseases. In the past non-invasive assessment of MAO B has only been possible with positron emission tomography (PET) ligands. Given the limited availability of PET, a single-photon emission tomography (SPET) ligand would be desirable. In this study SPET imaging with the new MAO B inhibitor [{sup 123}I]Ro 43-0463 was performed in five volunteers and nine patients with temporal lobe epilepsy (TLE). In two volunteers a second study was performed 12 h following blockade with deprenyl. In the TLE patients the tracer was administered as bolus (n = 4) or as prolonged infusion (n = 5). The regional uptake pattern correlated well with the known distribution of MAO B. In the two blocking studies ligand uptake was substantially reduced compared with baseline. In the TLE patients increased uptake was found in the ipsilateral mesial temporal lobe and, surprisingly, in the ipsilateral putamen. This study indicates the potential of the new SPET ligand [{sup 123}I]Ro 43-0463 to map MAO B concentration in the human brain. The new finding of increased MAO B in the putamen of TLE patients needs further studies to elucidate its exact pathophysiology. (orig.) With 3 figs., 3 tabs., 28 refs.

  16. A locus identified on chromosome18p11.31 is associated with hippocampal abnormalities in a family with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    IsciaLopes-Cendes

    2012-08-01

    Full Text Available We aimed to identify the region harboring a putative candidate gene associated with hippocampal abnormalities (HAb in a family with mesial temporal lobe epilepsy (MTLE. Genome-wide scan was performed in one large kindred with MTLE using a total of 332 microsatellite markers at ~12cM intervals. An additional 13 markers were genotyped in the candidate region. Phenotypic classes were defined according to the presence of hippocampal atrophy and/or hyperintense hippocampal T2 signal detected on magnetic resonance imaging. We identified a significant positive LOD score on chromosome 18p11.31 with a Zmax of 3.12 at D18S452. Multipoint LOD scores and haplotype analyses localized the candidate locus within a 6cM interval flanked by D18S976 and D18S967. We present here evidence that HAb, which were previously related mainly to environmental risk factors, may be influenced by genetic predisposition. This finding may have major impact in the study of the mechanisms underlying abnormalities in mesial temporal lobe structures and their relationship with MTLE.

  17. Repeated low-dose kainate administration in C57BL/6J mice produces temporal lobe epilepsy pathology but infrequent spontaneous seizures.

    Science.gov (United States)

    Umpierre, Anthony D; Bennett, Isaiah V; Nebeker, Lismore D; Newell, Thomas G; Tian, Bruce B; Thomson, Kyle E; White, H Steve; White, John A; Wilcox, Karen S

    2016-05-01

    More efficient or translationally relevant approaches are needed to model acquired temporal lobe epilepsy (TLE) in genetically tractable mice. The high costs associated with breeding and maintaining transgenic, knock-in, or knock-out lines place a high value on the efficiency of induction and animal survivability. Herein, we describe our approaches to model acquired epilepsy in C57BL/6J mice using repeated, low-dose kainate (KA) administration paradigms. Four paradigms (i.p.) were tested for their ability to induce status epilepticus (SE), temporal lobe pathology, and the development of epilepsy. All four paradigms reliably induce behavioral and/or electrographic SE without mortality over a 7d period. Two of the four paradigms investigated produce features indicative of TLE pathology, including hippocampal cell death, widespread astrogliosis, and astrocyte expression of mGluR5, a feature commonly reported in TLE models. Three of the investigated paradigms were able to produce aberrant electrographic features, such as interictal spiking in cortex. However, only one paradigm, previously published by others, produces spontaneous recurrent seizures over an eight week period. Presentation of spontaneous seizures is rare (N=2/14), with epilepsy preferentially developing in animals having a high number of seizures during SE. Overall, repeated, low-dose KA administration improves the efficiency and pathological relevance of a systemic KA insult, but does not produce a robust epilepsy phenotype under the experimental paradigms described herein. PMID:26896834

  18. Differential contribution of right and left temporo-occipital and anterior temporal lesions to face recognition disorders

    Directory of Open Access Journals (Sweden)

    Guido Gainotti

    2011-06-01

    The implications of our review are, therefore, the following: (1 to consider the components of visual agnosia often observed in prosopagnosic patients with bilateral temporo-occipital lesions as part of a semantic defect, resulting from left-sided lesions (and not from prosopagnosia proper; (2 to systematically investigate voice recognition disorders in patients with right anterior temporal lesions to determine whether the face recognition defect should be considered a form of ‘associative prosopagnosia’ or a form of the ‘multimodal people recognition disorder’.

  19. Comparison of benzodiazepine receptor SPECT and 18F-FDG PET using a coincidence detection camera in patients with temporal lobe epilepsy: preliminary results

    International Nuclear Information System (INIS)

    Full text: The aim of this preliminary study was to compare the results of benzodiazepine receptor (BDR) SPECT using 123I-Iomazenil with those of 18F-FDG (FDG) PET obtained on a double-headed gamma camera with a coincidence detection system in patients with temporal lobe epilepsy (TLE). We evaluated 6 patients (4 female, 2 male; age range 26-54 years, average 43.5 years) with therapy-refractory TLE due to mesiotemporal sclerosis or other focal brain anomalies. To delineate the epileptogenic zone, clinical evaluation, ictal and interictal surface EEG using the international 10-20 system, brain MRI, interictal CBF SPECT using 99mTc-ECD, BDR SPECT and FDG coincidence PET were performed. The CBF SPECT, BDR SPECT and coincidence PET scans were viewed independently by 2 observers considering the regional cerebral blood flow, BDR density and FDG uptake asymmetry in the temporal lobe visually as none (0), low (1), moderate (2) and high (3). Ictal and interictal EEG recordings located the epileptogenic focus in all patients in the temporal region. Both the BDR SPECT and the FDG coincidence PET located the epileptogenic focus correctly in circumscribed areas of the temporal lobe in all patients, whereas brain MRI revealed focal anomalies only in 5 of 6 cases . The lateralization to the right (n=4) and left hemisphere (n=2) by interictal CBF SPECT, BDR SPECT and FDG coincidence PET corresponded to the EEG findings in all patients. The visual consideration of the asymmetry revealed a slightly but not statistically significant higher value for the FDG coincidence PET (observer 1: mean 2.333, SD 0.516; observer 2: mean 2.000, SD 0.632) than for the BDR SPECT (observer 1: mean 1.667, SD 1.033; observer 2: mean 1.833, SD 0.753). Visual consideration of the interictal CBF SPECT revealed mean values of 2.000 for both observers. The inter-observer variability was higher in the BDR SPECT than in the FDG coincidence PET and the interictal CBF SPECT, but the difference was not

  20. Localization of Epileptic Foci in Temporal Lobe Epilepsy by MR and EEG%颞叶癫 的EEG和MR术前定位研究

    Institute of Scientific and Technical Information of China (English)

    高翔; 江澄川; 洪震; 俞丽云

    2000-01-01

    Aim:To discuss pre-operative localization of epileptic foci in intractable temporal epilepsy by EEG and MR. Meth-ods: MR and EEG were used to localize the epileptic foci in 20 patients with intractable temporal lobe epilepsy (TLE)pre-oper-atively,all the patients had intra-operative cortical EEG examination and post-operative follow-up. Restults: 17 patients' seizurefoci were localized by MR and EEG examination ,among them l 0 patients have hippocampus sclerosis, 3 cases tephromalacia, 2cases arachnoid cyst, 1 case glioma. Another 3 cases were localized hy repetitive EEG examinaticm while MR examinationswere normal. All patients were followed up after operation,the result was satisfactory. Conclusion:EEG is the most importantlocalizing method for temporal lobe epilepsy,MR is useful for the secondary TLE.Examination of hippocampus for HS will behelpful while the ordinary MR examination is normal.%目的:探讨EEG、MR对颞叶癫 (TLE)术前定位。方法:用MR、EEG对20例TLE病例进行术前定位与术中EEG和术后随访结果比较。结果:20例病例中17例依据MR及EEG获得定位,主要在海马区域病变12例,前颞叶5例,另3例MR检查正常,依据多次EEG检查获得定位,随访疗效满意。结论:EEG是诊断TLE的重要手段,MR可对继发性TLE作出正确诊断,MR对海马硬化检查可协助EEG对TLE定位诊断。

  1. Frontopolar and anterior temporal cortex activation in a moral judgment task. Preliminary functional MRI results in normal subjects

    International Nuclear Information System (INIS)

    The objective was to study the brain areas which are activated when normal subjects make moral judgments. Ten normal adults underwent BOLD functional magnetic resonance imaging (fMRI) during the auditory presentation of sentences that they were instructed to silently judge as either 'right' or 'wrong'. Half of the sentences had an explicit moral content ('We break the law when necessary'), the other half comprised factual statements devoid of moral connotation ('Stones are made of water'). After scanning, each subject rated the moral content, emotional valence, and judgment difficulty of each sentence on Likert-like scales. To exclude the effect of emotion on the activation results, individual responses were hemo dynamically modeled for event-related f MRI analysis. The general linear model was used to evaluate the brain areas activated by moral judgment. Regions activated during moral judgment included the frontopolar cortex (FPC), medial frontal gyrus, right anterior temporal cortex, lenticular nucleus, and cerebellum. Activation of FPC and medial frontal gyrus (B A 10/46 and 9) were largely independent of emotional experience and represented the largest areas of activation. These results concur with clinical observations assigning a critical role for the frontal poles and right anterior temporal cortex in the mediation of complex judgment processes according to moral constraints. The FPC may work in concert with the orbitofrontal and dorsolateral cortex in the regulation of human social conduct. (author)

  2. Frontopolar and anterior temporal cortex activation in a moral judgment task. Preliminary functional MRI results in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Moll, Jorge [LABS and Rede D' Or Hospitais, Rio de Janeiro RJ (Brazil). Grupo de Neuroimagem e Neurologia do Comportamento; Eslinger, Paul J. [Pensylvania State Univ. (United States). College of Medicine. Div. of Neurology and Behavioral Science; The Milton S. Hershey Medical Center, Hershey, PN (United States); Oliveira-Souza, Ricardo de [Universidade do Rio de Janeiro (UNI-Rio), RJ (Brazil). Hospital Universitario Gaffree e Guinle]. E-mail: neuropsychiatry@hotmail.com

    2001-09-01

    The objective was to study the brain areas which are activated when normal subjects make moral judgments. Ten normal adults underwent BOLD functional magnetic resonance imaging (fMRI) during the auditory presentation of sentences that they were instructed to silently judge as either 'right' or 'wrong'. Half of the sentences had an explicit moral content ('We break the law when necessary'), the other half comprised factual statements devoid of moral connotation ('Stones are made of water'). After scanning, each subject rated the moral content, emotional valence, and judgment difficulty of each sentence on Likert-like scales. To exclude the effect of emotion on the activation results, individual responses were hemo dynamically modeled for event-related f MRI analysis. The general linear model was used to evaluate the brain areas activated by moral judgment. Regions activated during moral judgment included the frontopolar cortex (FPC), medial frontal gyrus, right anterior temporal cortex, lenticular nucleus, and cerebellum. Activation of FPC and medial frontal gyrus (B A 10/46 and 9) were largely independent of emotional experience and represented the largest areas of activation. These results concur with clinical observations assigning a critical role for the frontal poles and right anterior temporal cortex in the mediation of complex judgment processes according to moral constraints. The FPC may work in concert with the orbitofrontal and dorsolateral cortex in the regulation of human social conduct. (author)

  3. MRI与MR扩散成像在颞叶癫痫中临床应用价值%MRI and diffusion-weighted imaging in temporal lobe epilepsy

    Institute of Scientific and Technical Information of China (English)

    李豪刚; 郭学军; 刘海辉; 李兴荣; 刘丽娟; 张玉忠; 曹火乃

    2013-01-01

    Objective To assess the value of conventional MRI and diffusion MR imaging in temporal lobe epilepsy.Methods Thirty patients underwent conventional MRI including oblique coronal FLAIR-weighted sequence perpendicular to the long axis of the hippocampus and diffusion-weighted MR imaging (DWI) for assessment of the hippocampal size and shape in correlation with EEG and histology.Results Of 30 patients with unilateral hippocampal sclerosis (18 right-sided,12 left-sided),EEG showed slow wave or crest wave in the ipsilateral temporal lobes.There was smaller ipsilateral hippocampal volume in 26 patients and no significant difference in 4 patients.The ipsilateral hippocampi were hyperintense on T2WI (11),FLAIR-weighted images (16),and DWI (4)as well as high ADC (26).Other MRI findings included loss of the groove between the head and neck of the ipsilateral hippocampi (26),atrophy of the ipsilateral temporal lobe and adjacent white matter (10),dilatation of the temporal horn of the ipsilateral lateral ventricle (12),widening of the ambient cistern (10).Conclusions The combination of oblique coronal FLAIR-weighted sequence,DWI,ADC and hippocampal volume determination can provide more accurate diagnosis of hippocampal sclerosis in temporal lobe epilepsy.%目的 探讨MRI与MR扩散成像在颞叶癫痫中临床应用价值.方法 选取30例癫痫患者行MRI常规序列(含垂直于海马长轴斜冠状位FLAIR序列)及扩散加权成像(DWI)检查,分析海马大小形态信号影像表现,并与脑电图、手术病理对照.结果 30例患者经手术病理证实均为单侧海马硬化,右侧18例,左侧12例,脑电图表现提示相应颞叶慢波或嵴波,MRI表现患侧海马体积缩小26例,4例海马双侧体积无明显变化,T2WI序列高信号11例,FLAIR序列高信号16例,DWI序列异常高信号4例,ADC值升高26例,1例同时有DI高信号和ADC值升高;海马头部浅沟消失26例,患侧颞叶及邻近白质萎缩10例,患侧颞角扩大12

  4. Deficit of decision-making in patients with temporal lobe cerebral infarction%颞叶脑梗死患者的决策认知障碍

    Institute of Scientific and Technical Information of China (English)

    宋道辉; 朱幼玲; 席春华; 唐南

    2012-01-01

    Objective To investigate the ability of decision making in patients with temporal lobe cerebral infarction. Methods Fifteen patients with temporal lobe cerebral infarction (TLCI) and twenty healthy controls ( HC) were examined with the Iowa gambling task (ICT) to assess decision making based on feedback processing. Results The result showed that TLCI group impaired not only on the subcomponent of executive task but also decision making on the IGT compared with the HC group. In Iowa gambling task, the TLCI group selected less advantageous cards and less total amount of gained money than health controls (P < 0. 05). The study indicated that the health controls gradually shifted their selections toward the good decks as the game progressed, but the TLCI group did not exhibit this advantageous shift in decision making. Conclusion The present study suggests that the decision making impairment is in patients with TLCI, and indicates that temporal lobe might be involved in decision making processes.%目的 探讨颞叶脑梗死(TLCI)患者的社会决策认知能力.方法 将15例TLCI患者以及20例与其人口学资料相匹配的健康人作为被试,采用爱荷华博弈任务(iowa gambling task)对上述两组进行社会决策行为能力的测试.结果 与正常对照组相比,TLCI患者不仪存在数字广度及执行功能障碍,还存在决策认知障碍.在博弈任务中有利选择的次数以及金钱总收益明显减少,差异有统计学意义(P<0.05).随着博弈任务卡片选择数的增多,正常埘照组逐渐倾向于对自己有利的选择;而TLCI患者却不具有这种决策模式.结论 TLCI患者存在决策认知功能障碍,提示颞叶可能参与了人类的决策认知加工过程.

  5. Atividade eletromiográfica dos músculos temporal anterior e masseter em crianças respiradoras bucais e em respiradoras nasais Electrical Activity of the Anterior Temporal and Masseter Muscles in Mouth and Nasal Breathing Children

    Directory of Open Access Journals (Sweden)

    Aline Ferla

    2008-08-01

    Full Text Available A respiração bucal tem sido estudada por causar sérios efeitos no desenvolvimento do sistema estomatognático. OBJETIVO: Estudar, através da análise eletromiográfica, o padrão de atividade elétrica dos músculos temporal anterior e masseter em crianças com respiração bucal, comparando-os com o de crianças com respiração nasal. MATERIAL E MÉTODO: Foram estudados dois grupos de crianças: 17 respiradoras bucais (RB e 12 respiradoras nasais (RN. As crianças foram submetidas à avaliação eletromiográfica bilateral dos músculos supracitados nas situações de máxima intercuspidação e mastigação habitual. Utilizou-se o eletromiógrafo Myosystem Br-1, com 12 canais de aquisição, amplificação com ganho total de 5938, taxa de aquisição de 4000Hz e filtro passa-faixa de 20-1000Hz. O sinal foi processado em RMS, mensurado em µV e analisado e expresso em %, normalizado. Os dados foram tratados estatisticamente através do Teste t (Student. RESULTADOS: Observou-se que o nível de atividade elétrica do grupo RB foi inferior para todos os músculos e estatisticamente significante somente para o temporal esquerdo; os respiradores bucais apresentaram predomínio de atividade elétrica no lado direito e no músculo temporal durante a mastigação habitual. CONCLUSÃO: A respiração bucal interferiu na atividade elétrica dos músculos estudados nas situações funcionais de máxima intercuspidação e mastigação habitual.Mouth breathing has been associated with severe impact on the development of the stomatognathic system. AIM: This paper aims to analyze the electromyographical findings and patterns of electrical activity of the anterior temporal and masseter muscles in mouth and nasal breathing children. MATERIAL AND METHOD: The patients were divided into two groups: mouth breathers (n=17 and nasal breathers (n=12. The children underwent bilateral electromyographic examination of the anterior temporal and masseter muscles at

  6. Time course of the involvement of the right anterior superior temporal gyrus and the right fronto-parietal operculum in emotional prosody perception.

    Directory of Open Access Journals (Sweden)

    Marjolijn Hoekert

    Full Text Available In verbal communication, not only the meaning of the words convey information, but also the tone of voice (prosody conveys crucial information about the emotional state and intentions of others. In various studies right frontal and right temporal regions have been found to play a role in emotional prosody perception. Here, we used triple-pulse repetitive transcranial magnetic stimulation (rTMS to shed light on the precise time course of involvement of the right anterior superior temporal gyrus and the right fronto-parietal operculum. We hypothesized that information would be processed in the right anterior superior temporal gyrus before being processed in the right fronto-parietal operculum. Right-handed healthy subjects performed an emotional prosody task. During listening to each sentence a triplet of TMS pulses was applied to one of the regions at one of six time points (400-1900 ms. Results showed a significant main effect of Time for right anterior superior temporal gyrus and right fronto-parietal operculum. The largest interference was observed half-way through the sentence. This effect was stronger for withdrawal emotions than for the approach emotion. A further experiment with the inclusion of an active control condition, TMS over the EEG site POz (midline parietal-occipital junction, revealed stronger effects at the fronto-parietal operculum and anterior superior temporal gyrus relative to the active control condition. No evidence was found for sequential processing of emotional prosodic information from right anterior superior temporal gyrus to the right fronto-parietal operculum, but the results revealed more parallel processing. Our results suggest that both right fronto-parietal operculum and right anterior superior temporal gyrus are critical for emotional prosody perception at a relatively late time period after sentence onset. This may reflect that emotional cues can still be ambiguous at the beginning of sentences, but become