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Tillman Herndon posted an update 1 year, 7 months ago
Reduced engagement of neural circuits relevant to processing socioemotional cues may be markers of risk for social cognitive deficits in youth with focal epilepsy.
The objective of this study was to explore the prevalence and predictors of limitations causing disability in patients treated for seizures or epilepsy compared with patients without epilepsy.
This was a retrospective cross-sectional study using the National Health and Nutrition Examination Survey (NHANES). We included all participants ≥20 years old for 2013-2018. We classified patients as having epilepsy if they reported taking at least one prescription medication to treat seizures or epilepsy. Physical, mental, and social limitations were determined from interview questions. We report the prevalence of any limitation and total number of limitations for participants without vs. with epilepsy using serial negative binomial regressions and severity of individual limitations according to epilepsy status.
We included 17,057 participants, of whom 148 (0.8%) had epilepsy. Overall, 80% (95% confidence interval [CI] 73%-86%) with epilepsy vs. 38% (95% CI 36%-39%) without epilepsy reported at least 1 limitationtargeting mood, weight, and lifestyle as potential leverage points towards alleviating epilepsy-related disability.
Patients with epilepsy had 3.1 times as many physical, mental, or social limitations compared with those without epilepsy, and disability severity was consistently higher. This effect was attenuated after considering baseline variables such as smoking and depression severity. Our work implies the importance of structured mental health screening and self-management programs targeting mood, weight, and lifestyle as potential leverage points towards alleviating epilepsy-related disability.
We investigated cognitive task-related functional connectivity (FC) in patients with temporal lobe epilepsy (TLE). Using a visual three-stimulus paradigm (VTSP), we studied cognitive large-scale networks and the impact of TLE on connectivity outside the temporal lobe.
High-density electroencephalography (EEG) was recorded during the paradigm from nineteen patients with epilepsy with hippocampal sclerosis (HS) and ten healthy controls (HCs). Scalp data were reconstructed into the source space, and FC was computed. Correlating with the neuropsychological data, possible compensatory mechanisms were investigated.
Significant changes were found in the FC of regions outside the epileptogenic network, particularly in the attentional network. These changes were more widespread in left TLE (LTLE). There were no significant differences in task performance (accuracy, time response) in comparison with HCs, implying that there must be some mechanism reducing the impact of connectivity changes on brain functions. When correlated with neuropsychological data, we found stronger compensatory mechanisms in right TLE (RTLE).
Our findings confirm the hypothesis that LTLE is the more pervasive form of the disease. Even though the network alterations in TLE are severe, some mechanisms reduce the impact of epilepsy on cognitive functions; these mechanisms are more potent in RTLE. We also suggest that there are maladaptive mechanisms in LTLE.
Calixarene 0118 confirm the hypothesis that LTLE is the more pervasive form of the disease. Even though the network alterations in TLE are severe, some mechanisms reduce the impact of epilepsy on cognitive functions; these mechanisms are more potent in RTLE. We also suggest that there are maladaptive mechanisms in LTLE.
Temporal lobe encephaloceles (TE) are increasingly recognized as a cause of drug-resistant temporal lobe epilepsy. Improved recognition of these lesions offers an opportunity to treat them with a limited resection sparing the hippocampus. However, as they can be difficult to identify on imaging, additional clues pointing to the diagnosis can be helpful. We sought to understand the baseline cognitive/neuropsychological profile in patients with left temporal lobe epilepsy caused by encephaloceles compared with that caused by mesial temporal sclerosis (MTS), a common entity in the differential diagnosis.
Neuropsychological testing, including language (semantic and phonemic fluency and naming), verbal memory, intelligence quotient (IQ), and executive function measures were compared across two groups (five patients with left TE and five age- and gender-matched patients with left MTS). #link# Other clinical variables related to cognition, including patient age, electroencephalographic characteristics, epilepsy duratiobaseline global IQ and VCI scores in patients with left TE compared with patients with MTS may be attributable to longer duration of epilepsy in patients with left MTS. Future work with a larger sample size will focus on establishing a unique neuropsychological profile related to epilepsy due to TE.
This pilot study demonstrates few significant differences between the groups with left MTS and TE surveyed. A higher rate of atypical language lateralization was noted in patients with left MTS. The higher baseline global IQ and VCI scores in patients with left TE compared with patients with MTS may be attributable to longer duration of epilepsy in patients with left MTS. Future work with a larger sample size will focus on establishing a unique neuropsychological profile related to epilepsy due to TE.
The aim of the study was to determine if corticothalamic responsive stimulation targeting the centromedian nucleus of the thalamus (CMT) is a potential treatment for neocortical epilepsies with regional onsets.
We assessed efficacy and safety of CMT and neocortical responsive stimulation, detection, and stimulation programming, methods for implantation, and location and patterns of electrographic seizure onset and spread in 7 patients with medically intractable focal seizures with a regional neocortical onset.
The median follow-up duration was 17 months (average 17 months, range 8-28 months). The median % reduction in disabling seizures (excludes auras) in the 7 patients was 88% (mean 80%, range 55-100%). The median % reduction in all seizure types (disabling + auras) was 73% (mean 67%, range 15-94%). There were no adverse events related to implantation of the responsive neurostimulator and leads or related to the delivery of responsive stimulation. Stimulation-related contralateral paresthesias were addressed by adjusting stimulation parameters in the clinic during stimulation testing.

