Widespread Neuronal Dysfunction in Temporal Lobe Epilepsy

To the Editor.— The report by Herzog and colleagues, Neuroendocrine Dysfunction in Temporal Lobe Epilepsy (Archives1982;39:133-135), offers a potential neuroendocrinologic basis for impaired fertility in epileptic women 1 and the frequent occurrence of hyposexuality—primarily erectile dysfunction—in men with temporal lobe epilepsy (TLE). 2 We would be interested to know whether the patient who had an elevated serum prolactin level had recently experienced a seizure. Although we agree that interictal prolactin studies are normal in this clinical population, we found postictal hyperprolactinemia after complex partial seizures in all cases studied 3 ; thus, the temporal relationship between serum prolactin determinations and the occurrence of seizures is critical. Although the clinical consequences of episodic hyperprolactinemia are uncertain, impotence and decreased libido are the most common accompaniments of sustained hyperprolactinemia in men. 4 Further studies of prolactin secretion in TLE seem warranted. Using an intravenous (IV) bolus of luteinizing hormone-releasing hormone (LH-RH) in

Epilepsy patients face significantly elevated cardiovascular risks, with cardiac arrhythmias occurring 2-3 times more frequently than in the general population. Current knowledge of brain-heart functional coupling abnormalities in epilepsy, particularly during interictal periods, remains limited. We investigated brain-heart interplay characteristics in temporal lobe epilepsy through synchronized electroencephalographic-electrocardiographic analysis using a synthetic data generation model and microstate analysis. We enrolled 52 patients with temporal lobe epilepsy (mean age = 33.4 ± 12.7 years) and 42 age-matched healthy controls (mean age = 31.95 ± 11.03 years). Twenty-minute artifact-free electroencephalographic segments were analyzed during resting states. Four directional brain-heart coupling sequences were extracted: CBrain→HF, CBrain→LF, CHF→Brain, and CLF→Brain, representing bidirectional interactions between brain activity and cardiac components. Six microstate topologies were consistently identified across all brain-heart interplay sequences, with temporal lobe epilepsy patients demonstrating significantly more complex and unstable topological characteristics compared to healthy controls. For CBrain→HF coupling, patients exhibited significantly reduced mean duration of microstate 3 (.34 ± .09 s vs. .38 ± .07 s, p = .02), increased occurrence rates of microstates 3 and 4 (both p < .001), and altered temporal coverage patterns. Similar abnormalities were observed across all sequences, with patients showing shortened microstate durations, altered occurrence rates, and disrupted temporal coverage. Spatial dissimilarity analysis revealed significant topological abnormalities across all microstates. A logistic regression model incorporating microstate parameters achieved 94.7% diagnostic accuracy for temporal lobe epilepsy, with an F1 score of .952 and an area under the curve of .932. Temporal lobe epilepsy is characterized by profound disruptions in brain-heart functional coupling during interictal periods, manifesting as altered microstate topographies and temporal dynamics. These findings establish microstate-based analysis as a promising framework for characterizing brain-heart axis dysfunction in epilepsy.

SummaryTemporal lobe epilepsy (TLE) is typically associated with long-term memory dysfunction. The frontal lobes support high-level cognition comprising executive skills and working memory that is vital for daily life functioning. Deficits in these functions have been increasingly reported in TLE. Evidence from both the neuropsychological and neuroimaging literature suggests both executive function and working memory are compromised in the presence of TLE. In relation to executive impairment, particular focus has been paid to set shifting as measured by the Wisconsin Card Sorting Task. Other discrete executive functions such as decision-making and theory of mind also appear vulnerable but have received little attention. With regard to working memory, the medial temporal lobe structures appear have a more critical role, but with emerging evidence of hippocampal dependent and independent processes. The relative role of underlying pathology and seizure spread is likely to have considerable bearing upon the cognitive phenotype and trajectory in TLE. The identification of the nature of frontal lobe dysfunction in TLE thus has important clinical implications for prognosis and surgical management. Longitudinal neuropsychological and neuroimaging studies assessing frontal lobe function in TLE patients pre- and postoperatively will improve our understanding further.

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.

Category-specific naming impairment in temporal lobe epilepsy through cortical electrical stimulation: Case report

The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy (TLE) patients using (1)H magnetic resonance spectroscopic imaging. (1)H spectroscopic images from the hippocampus and thalamus of controls and patients with TLE were acquired at 4 T. The spectroscopic imaging data were reconstructed using an automated voxel-shifting method based on anatomic landmarks providing four, six, and three loci for the hippocampus, thalamus, and putamen, respectively. For correlation analysis, the hippocampal and striatal loci were averaged to provide single estimates of the entire structure, whereas the thalamus was divided into two regions, an anterior and posterior measure, using the average of three loci each. The ratio of N-acetyl aspartate to creatine (NAA/Cr), a measure of neuronal injury/loss, was significantly reduced in both the ipsilateral and contralateral hippocampi and thalami. NAA/Cr in the ipsilateral hippocampus was significantly correlated with the ipsilateral and contralateral anterior and posterior thalami, putamen, and contralateral hippocampus. In control subjects, the hippocampi were only correlated with each other. The data demonstrate that there is significant neuronal injury/loss in both the ipsilateral and contralateral thalami in temporal lobe epilepsy patients, with greater impairment in the anterior portions of the ipsilateral thalamus. The degree of injury/loss in the ipsilateral and contralateral thalamus and putamen is directly correlated with that of the ipsilateral hippocampus. This is consistent with the hypothesis that the impairment and damage associated with recurrent seizures as measured by N-acetyl aspartate originating in the hippocampus results in injury and impairment in other subcortical structures.

SummaryNeural stem cells (NSCs) are one of the candidates for grafting in the realm of cell‐based therapy for temporal lobe epilepsy (TLE). Because NSCs can produce neurons synthesizing the inhibitory neurotransmitter γ‐aminobutyric acid (GABA) and cells secreting multiple neurotrophic factors, NSC grafting therapy has promise for restraining seizures and easing cognitive dysfunction in TLE. For an expanded treatment of this topic see Jasper’s Basic Mechanisms of the Epilepsies, Fourth Edition (Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado‐Escueta AV, eds) published by Oxford University Press (available on the National Library of Medicine Bookshelf [NCBI] at http://www.ncbi.nlm.nih.gov/books).

Neuron–astrocyte signaling and epilepsy

Education section – The Cochrane Collaboration

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2007 Focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention

Health Information & Libraries JournalVolume 18, Issue 2 p. 125-125 Free Access Introduction First published: 18 July 2008 https://doi.org/10.1046/j.1471-1842.2001.d01-22.xCitations: 2AboutSections ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Betsy Anagnostelis, Librarian, Medical Library, Royal Free Hampstead NHS Trust and Royal Free and University College Medical School of UCL, Rowland Hill Street, London NW3 2PF, UK Several services have recently become available which aim to provide access to journal electronic tables of contents. Some of the better known products, such as Current Contents, UnCoverWeb, zetoc, etc., offer a current awareness service across several thousand journals and cover all major disciplines. Although such services are fairly up-to-date in their coverage, nonetheless e-mail table of content (e-toc) alerts received directly from publishers’ sites are often far more so, occasionally providing information in advance of publication. A further major advantage of registering to receive e-toc alerts directly from the publisher is the ability to click and go from the e-mail message straight to the full text of selected journal articles, wherever hypertext links are provided from the e-toc alert message. This ability to directly view a full text article of interest makes for a service that is becoming increasingly popular with researchers and scientists in biomedicine. In the article that follows, Steven Glover describes precisely how such publisher-based e-toc alert services have been promoted in a busy research institute environment, with the Library taking a lead in integrating them with the range of full text journals to which a subscription is available. With the model described here, the level of current awareness service provision is developed beyond that possible with a traditional paper-based approach. Furthermore, such a model is also capable of generating information that may be used by the Library in maintaining or expanding its existing journal subscription base. The benefits to the user are particularly highlighted below. References 1 Current Contents . <http://www.isinet.com/isi/products/>. Google Scholar 2 UnCoverWeb . <http://uncweb.carl.org/>. Google Scholar 3 zetoc . Electronic table of contents from the British Library. <http://zetoc.mimas.ac.uk/>. Google Scholar Citing Literature Volume18, Issue2June 2001Pages 125-125 ReferencesRelatedInformation

EpilepsiaVolume 5, Issue 4 p. 307-320 Evaluation of Insular Ablation in Surgical Treatment of Temporal Lobe Epilepsy H. SILFVENIUS, H. SILFVENIUS Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada) *Department of Neurosurgery, Lasarettet, Lund, Sweden.Search for more papers by this authorP. GLOOR, P. GLOOR Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada)Search for more papers by this authorT. RASMUSSEN, T. RASMUSSEN Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada)Search for more papers by this author H. SILFVENIUS, H. SILFVENIUS Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada) *Department of Neurosurgery, Lasarettet, Lund, Sweden.Search for more papers by this authorP. GLOOR, P. GLOOR Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada)Search for more papers by this authorT. RASMUSSEN, T. RASMUSSEN Department of Neurology and Neurosurgery, McGill University and the Montreal Neurological Institute and Hospital, Montreal (Canada)Search for more papers by this author First published: December 1964 https://doi.org/10.1111/j.1528-1157.1964.tb03338.xCitations: 90 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume5, Issue4December 1964Pages 307-320 RelatedInformation

Acta Psychiatrica ScandinavicaVolume 33, Issue S120 p. 1-14 THE CONCEPT OF TEMPORAL LOBE EPILEPSY First published: April 1958 https://doi.org/10.1111/j.1600-0447.1958.tb01037.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume33, IssueS120April 1958Pages 1-14 RelatedInformation

The Journal of PhysiologyVolume 98, Issue 4 p. 454-459 ArticleFree Access The time course of evolution of oxidative recovery heat of frog's muscle D. K. Hill, D. K. HillSearch for more papers by this author D. K. Hill, D. K. HillSearch for more papers by this author First published: 14 September 1940 https://doi.org/10.1113/jphysiol.1940.sp003863Citations: 16AboutRelatedInformationPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessClose modalShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Citation StatementsbetaSmart citations by scite.ai include citation statements extracted from the full text of the citing article. The number of the statements may be higher than the number of citations provided by Wiley Online Library if one paper cites another multiple times or lower if scite has not yet processed some of the citing articles.SupportingSupporting0MentioningMentioning8ContrastingContrasting0Explore this article's citation statements on scite.aipowered by Volume98, Issue4September 14, 1940Pages 454-459 Citation StatementsbetaSmart citations by scite.ai include citation statements extracted from the full text of the citing article. The number of the statements may be higher than the number of citations provided by Wiley Online Library if one paper cites another multiple times or lower if scite has not yet processed some of the citing articles.SupportingSupporting0MentioningMentioning8ContrastingContrasting0Explore this article's citation statements on scite.aipowered by RelatedInformation Metrics All-time Citations: 16 Details © 1940 The Physiological Society Publication History Issue Online: 14 September 1940 Version of Record online: 14 September 1940