Epileptiform Activity in Alcohol Dependent Patients and Possibilities of Its Indirect Measurement

Background: Alcohol dependence during withdrawal and also in abstinent period in many cases is related to reduced inhibitory functions and kindling that may appear in the form of psychosensory symptoms similar to temporal lobe epilepsy frequently in conditions of normal EEG and without seizures. Because temporal lobe epileptic activity tend to spread between hemispheres, it is possible to suppose that measures reflecting interhemispheric information transfer such as electrodermal activity (EDA) might be related to the psychosensory symptoms. Methods and Findings: We have performed measurement of bilateral EDA, psychosensory symptoms (LSCL-33) and alcohol craving (ACQ) in 34 alcohol dependent patients and 32 healthy controls. The results in alcohol dependent patients show that during rest conditions the psychosensory symptoms (LSCL-33) are related to EDA transinformation (PTI) between left and right EDA records (Spearman r = 0.44, p,0.01). Conclusions: The result may present potentially useful clinical finding suggesting a possibility to indirectly assess epileptiform changes in alcohol dependent patients

Subclinical Epileptiform Process in Patients with Unipolar Depression and Its Indirect Psychophysiological Manifestations

BACKGROUND: According to recent clinical findings epileptiform activity in temporolimbic structures may cause depressive and other psychiatric symptoms that may occur independently of any seizure in patient's history. In addition in these patients subclinical seizure-like activity with indirect clinical manifestations likely may occur in a form of various forms of cognitive, affective, memory, sensory, behavioral and somatic symptoms (the so-called complex partial seizure-like symptoms). A typical characteristic of epileptiform changes is increased neural synchrony related to spreading of epileptiform activity between hemispheres even in subclinical conditions i.e. without seizures. These findings suggest a hypothesis that measures reflecting a level of synchronization and information transfer between hemispheres could reflect spreading of epileptiform activity and might be related to complex partial seizure-like symptoms. METHODS AND FINDINGS: Suitable data for such analysis may provide various physiological signals reflecting brain laterality, as for example bilateral electrodermal activity (EDA) that is closely related to limbic modulation influences. With this purpose we have performed measurement and analysis of bilateral EDA and compared the results with psychometric measures of complex partial seizure-like symptoms, depression and actually experienced stress in 44 patients with unipolar depression and 35 healthy controls. The results in unipolar depressive patients show that during rest conditions the patients with higher level of complex partial seizure like symptoms (CPSI) display increased level of EDA transinformation (PTI) calculated between left and right EDA records (Spearman correlation between CPSI and PTI is r = 0.43, p = 0.004). CONCLUSIONS: The result may present potentially useful clinical finding suggesting that increased EDA transinformation (PTI) could indirectly indicate increased neural synchrony as a possible indicator of epileptiform activity in unipolar depressive patients treated by serotoninergic antidepresants

Evaluation of sub-acute changes in cardiac function after cisplatin-based combination chemotherapy for testicular cancer

Long-term cardiovascular morbidity is increasingly observed in chemotherapy-treated testicular cancer survivors, but little is known of early sub-clinical changes in cardiac function. We prospectively evaluated cardiac function in testicular cancer patients by echocardiography. Systolic (Wall Motion Score Index) and diastolic (E/A-ratio and Tissue Velocity Imaging (TVI)) parameters, and serum levels of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) were assessed before the start of chemotherapy and 1 year later. Echocardiography data were compared with an age-matched group of healthy controls. Forty-two patients treated with bleomycin, etoposide and cisplatin were evaluated (median age 27 years, range 18–50). Systolic function and E/A-ratio did not change, whereas the median TVI decreased (12.0 vs 10.0 cms−1; P=0.002). Median levels of NT-proBNP increased (5 vs 18 pmoll−1, P=0.034). Compared with controls, TVI before the start of chemotherapy was not significantly different. In conclusion, we found that at a median of 10 months after cisplatin-based treatment for testicular cancer, TVI decreased significantly, indicating a deterioration of diastolic cardiac function. Serum levels of NT-proBNP increased. The prognostic significance of these changes for future cardiovascular morbidity is not clear

NEURAL CORRELATES OF "ANALYTICAL-SPECIFIC VISUAL PERCEPTION" AND DEGREE OF TASK DIFFICULTY AS INVESTIGATED BY THE MANGINA-TEST: A FUNCTIONAL MAGNETIC RESONANCE IMAGING (FMRI) STUDY IN YOUNG HEALTHY ADULTS

The Mangina-Test is a neuropsychometric method for evaluating varying degrees of "analytical-specific perception" as they relate to learning abilities and disabilities. It consists of the identification of simple stimuli which are masked within a complex configuration according to their exact size, dimension, direction, spatial orientation, and shape within a limited span of time. This test has been successfully applied in clinical settings for the assessment of cognitive abilities and disorders in young and elderly populations. This investigation aimed to examine the neural correlates of analytical-specific visual perceptual processes as measured by the Mangina-Test. Functional Magnetic Resonance Imaging (fMRI) was recorded during the administration of a computer-adapted version of the Mangina-Test in twelve young healthy adults. Multiple linear regression analysis was applied to estimate the overall brain activation during task accomplishment. In addition, the fMRI response area was correlated with task difficulty, in order to explore the spatial distribution of brain regions modulated by increasing task demand. Results indicate that a widely distributed bilateral network of brain regions, including the ventral and dorsal occipital cortex, parietal lobule, frontal and supplementary eye field, dorsolateral prefrontal cortex, and supplementary motor area, was significantly activated during test performance. Moreover, increasing difficulty significantly enhanced the neural response of ventral and dorsal occipital regions, frontal eye field, and superior parietal sulcus bilaterally, as well as the right dorsolateral prefrontal cortex. Conversely, neural activity in the left temporo-parietal junction, inferior frontal gyrus, and bilateral middle-superior temporal cortex was inversely correlated with task difficulty. Results also indicate that performance in the Mangina-Test requires an optimal integration between the enhancement of activity in specific task-related cortical areas and suppression of interfering noise from unrelated brain regions

Modulation of specific brain activity by the perceptual analysis of very subtle geometrical relationships of the Mangina-Test stimuli: a functional magnetic resonance imaging (fMRI) investigation in young healthy adults

The Mangina-Test provides a neuropsychometric assessment of varying degrees of "Analytical-Specific Visual Perception", i.e., the ability to identify simple stimuli inserted into more complex ones according to their exact geometrical properties in a limited span of time. Perceptual analysis of stimuli dealing with the exact discrimination of size and dimension is related more to mathematical abilities (MATH), while perceptual analysis of direction and spatial orientation is related more to abilities in reading and reading comprehension (READ). Some stimuli are MIXED since they deal with both of the above features combined. We previously determined the distributed neuronal network of analytical-specific visual perceptual processes as measured by the Mangina-Test. Here, we aim at further assessing as to how brain activity is differentially modulated by the discrimination of very subtle category-specific perceptual relationships. Brain activity was measured by functional magnetic resonance imaging in 12 young healthy subjects while they performed a computer-adapted version of the Mangina-Test. Behavioral results of the present study indicate that performance was not different among stimulus categories. However, brain functional data show that analytical-specific perceptual processes for MATH, READ and MIXED stimuli rely on partially distinct brain circuits. Bilateral posterior parietal, premotor and prefrontal regions along with the anterior cingulate appeared to be more activated by MATH stimuli, while READ stimuli predominantly activated bilateral medial occipito-temporal, amygdala/parahippocampal and sensorimotor cortices, and the right inferior frontal cortex. Moreover, the posterior parahippocampal cortex showed a higher activity specifically for MIXED stimuli. Altogether, these findings demonstrate that in the Mangina-Test, the exact discrimination of very subtle perceptual relationships between geometrical stimuli distinctly modulates cerebral activity, so that category-specific brain responses can be related to identifiable cognitive abilities