Language representation and presurgical language mapping in pediatric epilepsy: A narrative review

AbstractAs one of the most common neurological diseases in children, epilepsy affects 0.9–2% of children. Complex interactions among the etiologies of the epilepsy, interictal discharges, seizures and antiepileptic drugs lead to cognitive impairments in children with epilepsy. Since epilepsy is considered as a network disorder that seizures have widespread impact on many parts of the brain, childhood epilepsy can even affect the normal development of language. About 25% of children with epilepsy do not respond to medications, therefore brain surgery is considered as a treatment option for some of them. Presurgical neuropsychological evaluations including language mapping is recommended to preserve cognitive and language abilities of patients after surgery.  Functional magnetic resonance imaging as a non-invasive technique for presurgical language mapping   has been widely recommended in many epileptic centers. The present study reviewed language representation and presurgical language mapping in children with epilepsy. In addition, mapping language in children with epilepsy helps to localize epileptogenic zone, to predict cognitive outcome of epilepsy surgery, and possible cognitive rehabilitation. This review gathered information about language representation and language mapping in pediatric   epilepsy settings. Key Words: pediatric epilepsy, language development, presurgical evaluation, language lateralit

Effect of Aqua Training on Cortisol and Plasma Insulin in Patients with Panic Disorder

Introduction: Cortisol is reported to be a factor for the hypothalamic–pituitary–adrenal axis (HPA axis) in patients affected by panic disorders. On the other hand, HPA disorders can increase insulin resistance. The effect of intense aerobic exercise on the cortisol levels has also been reported on the patients with mental disorders. However, no study has yet investigated the effects of exercises in water on the cortisol and blood insulin levels in the patients affected by panic disorder. Hence, the purpose of this article was to review the effects of aqua training on cortisol and insulin levels of patients with panic disorder. Methods: Thirty six women affected by panic disorder with the average (age 38.6 ± 6.45 years and weight 70.64 ± 11.04 kg) were randomly divided in two groups of aqua training group (n=18) and the control group (n=18).The aqua training group participated in a 12-week program for water exercises (three sessions a week, each session lasting one hour, and with the intensity of 50- 85 % of maximum heart rate) and the control group continued their normal life. Pretest and posttest blood samples were taken for measuring the cortisol and blood insulin levels. Data were statistically analyzed by independent and paired sample t tests (p≤0.05). Results: The results showed that aqua training has significant effect on reduction of insulin of patients with panic disorder (p=0.001), nevertheless it has no significant effect on cortisol of patients with panic disorder (p=0.52). Conclusion: It appears that aqua training could improve the insulin levels of patients with panic disorder

Predictors for surgical outcome in patients with Tumor-Associated epilepsy

This study aimed to evaluate possible predictors for postoperative outcome in patients with tumorassociated epilepsy. Methods: In this study, patients with tumor-associated epilepsy who were candidates for epilepsy surgery were included. After required presurgical evaluations, they underwent surgical resection of the tumor. Patients were followed 24-57 months after the surgery and were divided to two groups of seizure-free and not-seizure-free. Demographic data, medical history, seizure characteristics and tumor features were compared between the two groups to find possible predictors. Findings: Thirty-five patients (17 men and 18 women) with the mean age of 22.8 years (8 to 45 years) were enrolled this study. Most of the patients had temporal lobe tumors (68.0%) followed by frontal and parietal lobe tumors. Ganglioglioma was seen in 62.9% of the patients, followed by astrocytoma and dysembryoplastic neuroepithelial tumour (DNET). We found a non-significant positive correlation between better surgical outcome and being male, younger age at epilepsy onset, longer duration of epilepsy, more seizure frequency, tumors in right hemisphere, tumor type of ganglioglioma, and seizures with secondary generalization. Furthermore, we found that history of head trauma, infection of centeral nervous system (CNS), febrile convulsion, natural vaginal delivery, familial history of epilepsy, tumors in temporal lobe, having auras, developing more seizure types and ipsilateral temporal spikes on preoperative electroencephalogram (EEG) were associated with worst surgical outcome (P > 0.05 for all). Conclusion: In this study, we found no statistically significant predicting factor for surgical outcome; however, we found that being male, smaller ages at seizure onset, longer duration of epilepsy, higher seizure frequency before surgery, involvement of right hemisphere, ganglioglioma, and secondary generalization are more seen in patients with better surgical outcome while history of head trauma, CNS infection, family history of epilepsy, temporal lobe tumors, presence of aura, having multiple types of seizures, and epileptic discharges from temporal lobe in preoperative EEG were seen more in patients with poor outcome. Studies with larger sample sizes are suggested to confirm these findings

An Undiagnosed Case of Hypothalamic Hamartoma with a Rare Presentation.

Background. Hypothalamic hamartomas (HHs) are rare tumor-like malformations that may present with complex partial seizures refractory to anticonvulsants in adulthood. The condition may be misdiagnosed because of rarity. Case Presentation. We report a 25-year-old man with complaint of seizures presented by falling, tonic spasm of limbs, oral automatism, vocalization, and hypermotor activities. His seizures started at the age of one month and presented as eye deviation and upper limbs myoclonic jerk, followed by frequent seizures with variable frequency. The patient had delayed developmental milestones and was mentally retarded. He was hospitalized and underwent video-EEG monitoring and neuroimaging, and the diagnosis of HH was made. The patient became candidate for surgery after that. Conclusion. In this case, the underlying etiology of seizures was diagnosed after 25 years. HH is a rare condition and neurologists may encounter very small number of these cases during their practice. Therefore, they should consider it in patients who present with suspected signs and symptoms

Cognitive impairments in patients with intractable temporal lobe epilepsy

Citation for the original published paper (version of record): Tavakoli, M., Barekatain, M., Doust, H., Molavi, H., Kormi Nouri, R. et al. (2011) Cognitive impairments in patients with intractable temporal lobe epilepsy. Sciences, 16(11): 1466Sciences, 16(11): -1472 Access to the published version may require subscription. N.B. When citing this work, cite the original published paper. Cognitive impairment associated with temporal lobe epilepsy (TLE) has been recognized in multiple studies. We designed this study to find a specific cognitive profile in patients with TLE who were candidates for epilepsy surgery. We also sought to find if neuropsychological assessment could differentiate left TLE, right TLE and normal subjects. Journal of Research in Medica

Automatic diagnosis of mild cognitive impairment using electroencephalogram spectral features

Alzheimer's disease (AD) is one of the most expensive and fatal diseases in the elderly population. Up to now, no cure have been found for AD, so early stage diagnosis is the only way to control it. Mild cognitive impairment (MCI) usually is the early stage of AD which is defined as decreasing in mental abilities such a cognition, memory, and speech not too severe to interfere daily activities. MCI diagnosis is rather hard and usually assumed as normal consequences of aging. This study proposes an accurate, mobile, and nonexpensive diagnostic approach based on electroencephalogram (EEG) signal. EEG signals were recorded using 19 electrodes positioned according to the 10–20 International system at resting eyes closed state from 16 normal and 11 MCI participants. Nineteen Spectral features are computed for each channel and examined using a correlation based algorithm to select the best discriminative features. Selected features are classified using a combination of neurofuzzy system and k-nearest neighbor classifier. Final results reach 88.89%, 100%, and 83.33% for accuracy, sensitivity, and specificity, respectively, which shows the potential of proposed method to be used as an MCI diagnostic tool, especially for screening a large population

Outcome of single manic episode in bipolar I disorder: A six-month follow-up after hospitalization

Background: Bipolar I Disorder (BID) considered as the sixth leading cause of disability worldwide. After remission of a manic episode, most of patients spend about 50% of the following time with mood or cognitive symptoms. The aim of this study was to investigate the 6-month outcome of BID patients following their single manic episode. Methods: Adult bipolar patients (n = 13) with single manic episode admitted to Noor Hospital, Isfahan, Iran, from December 6 2008 to June 5 2009 were evaluated using diagnostic, symptomatic, and functional assessments. Patients were also evaluated monthly for six months to assess syndromic, symptomatic, and functional outcomes, self reported treatment adherence, and serum levels of major mood stabilizers. The Kaplan-Meier method and log-rank test at a significance level of < 0.05 were used. Results: Kaplan-Meier estimates of the cumulative probabilities of syndromal, symptomatic, and functional recovery during the first 6 months after admission for single manic episode were 0.89, 0.75, and 0.64, respectively. At the 3rd month 54% of BID patients reported full medication adherence while it decreased to 38% at the 6th month. Patients with full adherence revealed shortened time to functional recovery based on LIFE-RIFT compared with non-adherent patients (log rank: χ2 = 4.5, df = 1, p = 0.03). Substance abuse also associated with longer time to functional recovery based on LIFE-RIFT (log rank: χ2 = 4.36, p = 0.037). Conclusions: Despite high rates of experienced syndromic and symptomatic recoveries for BID patients in single manic episode, functional recovery was much lower following hospitalization

The effect of chronic periodontitis on serum levels of tumor necrosis factor-alpha in Alzheimer disease

Background: Despite the outbreak in dental science, oral and dental complications in Alzheimer are of the unsolved problems. It is assumed that tumor necrosis factor-α, which is a key factor in Alzheimer, has a relation with periodontal complications in patients with Alzheimer disease. The present study evaluated the effect of chronic periodontitis on serum levels of tumor necrosis factor-α in Alzheimer disease. Materials and Methods: This case-control study was performed on 80 patients with Alzheimer disease seeking medical care at Nour Hospital, Isfahan, Iran. Eighty patients with Alzheimer disease between 40 and 70 years old attended this study. Forty had chronic periodontitis (case group), and 40 patients had healthy periodontium (control group). Blood sample was taken, and serum levels of tumor necrosis factor-α were measured by means of an ELISA Reader device. Independent T-Test was used to analyze data, and P < 0.05 was considered significant. Results: The mean of tumor necrosis factor-α was 749.1 ng/μL in case group and 286.8 ng/μL in control group. Independent t-test showed that the mean of tumor necrosis factor-α in patients with Alzheimer and periodontitis was approximately three folds higher than the patients only with Alzheimer, and this difference was statistically significant (P < 0.001). Conclusion: According to the results of this study, it seems that there is a difference between serum levels of tumor necrosis factor-α in patient with Alzheimer and chronic periodontitis and patients with Alzheimer disease and healthy periodontium. Tumor necrosis factor-α level in serum may act as a diagnostic marker of periodontal disease in patients with Alzheimer diseas

The The Effectiveness of Emotion Efficacy Therapy on Entrapment, Guiltin Caregivers of the Patients with Dementia

Background and Aim:Considering the growth of the population and the consequent high growth rate of elderely individuals, there is a great need to attend and recognize the problems related to the physical and psychological health of patients with dementia and their caregivers. Therefore, the present study aimed to find the effect of emotion efficacy therapy on entrapment and guilt in caregivers of patients with dementia. Materials and Methods:It was a quasi-experimental study with a pre-test, post-test, follow-up, and control group. The statistical population of the study included the caregivers of patients with dementia who were referred to neurology clinics in Isfahan in 2022, among whom 30 were selected by purposive sampling, taking into account the inclusion and exclusion criteria and randomly assigned to experimental and control groups each comprising 15 caregivers. The experimental group underwent eight sessions of 90-minute emotion efficacy therapy, and the control group was placed on the waiting list without intervention. The data were collected by Entrapment Scale and Caregiver Guilt Questionnaire and were analyzed by multivariate analysis of covariance. Results:The results showed that emotion efficacy therapy significantly affected entrapment and guilt in caregivers of patients with dementia (p&lt;0.05). Furthermore, the interaction of the effect of time and group membership was also significant for entrapment (internal, external), guilt (guilt about self-care, guilt about doing wrong by the care recipient, and guilt about not rising to the occasion as caregivers) except for the factor of guilt about having negative feelings towards other people and guilt about neglecting other relatives (p&gt;0.05). It showed that the changes in the pre-test, post-test, and follow-up stages were significant in each group. The level of difference between the groups in the entrapment was 37.4%, and it was 49.3% for the guilt. Conclusion:Emotion efficacy therapy affects and changes the stimuli and underlying factors, including ineffective beliefs and thoughts; as a result, it can be used to decrease the entrapment and the guilt in the caregivers of patients with dementia

Effects of grinding and pelleting condition on efficiency of full-fat canola seed for replacing supplemental oil in broiler chicken diets

Hihglights: • The effect of feed processing on utilization of canola seed was studied in broilers. • Canola seed either intact or ground was compared with canola meal and oil. • Pelleting condition effect was examined by comparison of cold and steam pelleting. • Grinding of canola seed did not produce additional improvement for bird performance. • Steam pelleting reduced fat digestibility in finisher diets containing canola seed