Modulation of epileptic networks by transient interictal epileptic activity: A dynamic approach to simultaneous EEG-fMRI.

Epileptic networks, defined as brain regions involved in epileptic brain activity, have been mapped by functional connectivity in simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI) recordings. This technique allows to define brain hemodynamic changes, measured by the Blood Oxygen Level Dependent (BOLD) signal, associated to the interictal epileptic discharges (IED), which together with ictal events constitute a signature of epileptic disease. Given the highly time-varying nature of epileptic activity, a dynamic functional connectivity (dFC) analysis of EEG-fMRI data appears particularly suitable, having the potential to identify transitory features of specific connections in epileptic networks. In the present study, we propose a novel method, defined dFC-EEG, that integrates dFC assessed by fMRI with the information recorded by simultaneous scalp EEG, in order to identify the connections characterised by a dynamic profile correlated with the occurrence of IED, forming the dynamic epileptic subnetwork. Ten patients with drug-resistant focal epilepsy were included, with different aetiology and showing a widespread (or multilobar) BOLD activation, defined as involving at least two distinct clusters, located in two different lobes and/or extended to the hemisphere contralateral to the epileptic focus. The epileptic focus was defined from the IED-related BOLD map. Regions involved in the occurrence of interictal epileptic activity; i.e., forming the epileptic network, were identified by a general linear model considering the timecourse of the fMRI-defined focus as main regressor. dFC between these regions was assessed with a sliding-window approach. dFC timecourses were then correlated with the sliding-window variance of the IED signal (VarIED), to identify connections whose dynamics related to the epileptic activity; i.e., the dynamic epileptic subnetwork. As expected, given the very different clinical picture of each individual, the extent of this subnetwork was highly variable across patients, but was but was reduced of at least 30% with respect to the initially identified epileptic network in 9/10 patients. The connections of the dynamic subnetwork were most commonly close to the epileptic focus, as reflected by the laterality index of the subnetwork connections, reported higher than the one within the original epileptic network. Moreover, the correlation between dFC timecourses and VarIED was predominantly positive, suggesting a strengthening of the dynamic subnetwork associated to the occurrence of IED. The integration of dFC and scalp IED offers a more specific description of the epileptic network, identifying connections strongly influenced by IED. These findings could be relevant in the pre-surgical evaluation for the resection or disconnection of the epileptogenic zone and help in reaching a better post-surgical outcome. This would be particularly important for patients characterised by a widespread pathological brain activity which challenges the surgical intervention.

The network integration of epileptic activity in relation to surgical outcome.

OBJECTIVE: Epilepsy is a network disease with epileptic activity and cognitive impairment involving large-scale brain networks. A complex network is involved in the seizure and in the interictal epileptiform discharges (IEDs). Directed connectivity analysis, describing the information transfer between brain regions, and graph analysis are applied to high-density EEG to characterise networks. METHODS: We analysed 19 patients with focal epilepsy who had high-density EEG containing IED and underwent surgery. We estimated cortical activity during IED using electric source analysis in 72 atlas-based cortical regions of the individual brain MRI. We applied directed connectivity analysis (information Partial Directed Coherence) and graph analysis on these sources and compared patients with good vs poor post-operative outcome at global, hemispheric and lobar level. RESULTS: We found lower network integration reflected by global, hemispheric, lobar efficiency during the IED (p < 0.05) in patients with good post-surgical outcome, compared to patients with poor outcome. Prediction was better than using the IED field or the localisation obtained by electric source imaging. CONCLUSIONS: Abnormal network patterns in epilepsy are related to seizure outcome after surgery. SIGNIFICANCE: Our finding may help understand networks related to a more "isolated" epileptic activity, limiting the extent of the epileptic network in patients with subsequent good post-operative outcome.

[The regularization of foreign workers under law 489/1995, in the context of migration in Italy]. / La regolarizzazione dei lavoratori extracomunitari ex decreto-legge 489/1995 nel panorama delle migrazioni in Italia.

PIP: "Between November 1995 and March 1996, Italy enacted a new programme for the regularization of foreigners in an irregular situation.... The programme had major consequences not only on foreign population size, since more than one million immigrants held residence permits at the end of 1996, but also on the labour market, by considerably reducing the illegal labour force.... The first part [of the essay] deals with legal provisions under which regularization could be granted, the success in combating illegal situations..., a comparison with previous regularization programmes and the geographical distribution of regularized immigrants. The second part analyses the specific relationship between regularization and labour market taking into account foreigners registered as unemployed, those employed under new contracts, and relevant percentages according to sectors of activity and regions. A final section is dedicated to the study of similarities and differences between present and past employment of foreign workers." (EXCERPT)^ieng

[Regional tables on immigration in Italy]. / Schede regionali sull'immigrazione in Italia.

PIP: A summary of immigration into the various regions of Italy is presented by the organization Caritas of Rome; most of the data, taken from official sources, are from 1994. The data, presented in separate tables by region, include the immigrants' continent of origin, sex distribution, age distribution, family situation, religious affiliation, and labor status.^ieng

Itchy dermatitis from Gynaikothrips ficorum March in a family group.

This study reports on the occurrence of an itchy dermatitis in all 4 adult members of a family, 2 men and 2 women, following infestation in the family environment with Gynaikothrips ficorum. The skin manifestations and the environmental study are described.

[Recent migration to Europe from the third world and the East: the Italian case and its impact on social security]. / Le nuove migrazioni in Europa dal terzo mondo e dall'Est: il caso italiano e il suo impatto previdenziale.

PIP: The impact of immigration from developing countries and from Eastern Europe on social security systems in the rest of Europe during the 1980s and early 1990s is examined using the example of Italy.^ieng

[Foreign immigration in Italy. Forecasts from decree law 410 of 1989]. / L'immigrazione estera in Italia. Previsioni del decreto-legge 410/1989.

PIP: The background to changes in immigration law in Italy adopted in 1989 is described, and the provisions of the law are outlined. The authors conclude that these changes are an effective and comprehensive response to the needs of the immigrant population. (SUMMARY IN ENG)^ieng

[Migration]. / Migrazioni.

PIP: This is a collection of 11 individual articles on aspects of current migration problems affecting developed countries. The geographical focus is on immigration in Europe, with particular reference to Italy, although one paper is concerned with Quebec. The topical focus is on the social problems associated with immigration. The articles are in Italian, with one exception, which is in French.^ieng

[A new migration scenario: the labor market in Italy, demographic trends in Europe, and the expansion of the European Community to the Mediterranean countries]. / Nuovi scenari migratori: mercato occupazionale in Italia, tendenza demografica in Europa e allargamento della CEE ai paesi Mediterranei.

PIP: The author analyzes migration trends in Italy resulting from the joining of Greece, Spain, and Portugal with the European Community. It is noted that most of the flow of immigration to Italy comes from Northern Africa but that the expansion of the Community may encourage more migration from the countries of Southern Europe.^ieng