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1.
Ideggyogy Sz ; 72(9-10): 304-314, 2019 Sep 30.
Artigo em Húngaro | MEDLINE | ID: mdl-31625697

RESUMO

Aims - Overview of the new data about the strong link of sleep and epilepsy and conjoining cognitive impairment. Methods - Search for relevant references and summary of our own research activity on the topic. Results - Strong interrealtionship exists between epilepsy and plastic brain functions (memory processing and synaptic homeostasis) and the working modes of NREM sleep. In the most frequent childhood and adult epilepsy networks responsible for plastic functions can be derailed to an epileptic level of excitability, and suffer a transitory or permanent epileptic transformation. Exampling on the three big epilepsies: absence epilepsy; medial temporal lobe epilepsy; and childhood idiopathic focal age dependent epilepsy spectrum we demonstrate the most important features of this epileptic transformation. The association of cognitive impairment to certain sleep dependent epilepsies gains explanation by the epilepsy caused interference with slow wave decline (ICFE) and memory consolidation (MTLE) during NREM sleep. This paper serves also to introduce the concept of sleep dependent system epilepsies. Conclusions - We provide evidences about shared mechanisms among sleep related epilepsies being the derailment of sleep plastic funcions toward exaggerated excitability determined by the inherent possibilities of the signal transduction properties.


Assuntos
Disfunção Cognitiva/fisiopatologia , Epilepsias Parciais/fisiopatologia , Epilepsia/fisiopatologia , Sono/fisiologia , Adulto , Criança , Eletroencefalografia , Humanos , Plásticos , Fases do Sono/fisiologia
2.
Psychiatr Danub ; 31(Suppl 3): 467-474, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488774

RESUMO

Music is a very important factor in everyday life, involving mood, emotions and memories. The effect of music on the brain is very debated. Certainly, music activates a complex network of neurones in auditory areas, mesolimbic areas, cerebellum and multisensory areas. In particular, music exerts its effects on the brain of patients with epilepsy, having a dichotomous influence: it can either be seizure-promoting in musicogenic epilepsy or antiepileptic. Several studies have shown that seizure-prone neural networks may be stimulated by certain periodicities while other frequencies may prevent seizure activity. There are a lot of data in the literature about the so-called "Mozart effect" (Rauscher et al. 1993). In previous studies we observed that in institutionalized subjects with severe/profound intellectual disability and drug-resistant epilepsy, a systematic music listening protocol reduced the frequency of seizures in about 50% of the cases. In this study we are conducting a survey on the observation of what happens to the brain of patients suffering from drug-resistant epilepsy through electroencephalographic investigations, brain MRI and behavioural analysis before and after six months of listening to Mozart music (Sonata K.448). The first step is to present the data of the first patient under investigation.


Assuntos
Epilepsia/fisiopatologia , Epilepsia/reabilitação , Musicoterapia , Música/psicologia , Convulsões/prevenção & controle , Convulsões/fisiopatologia , Estimulação Acústica , Mapeamento Encefálico , Eletroencefalografia , Epilepsia/complicações , Humanos , Convulsões/complicações
3.
Nat Commun ; 10(1): 3096, 2019 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-31363096

RESUMO

Natural communication often occurs in dialogue, differentially engaging auditory and sensorimotor brain regions during listening and speaking. However, previous attempts to decode speech directly from the human brain typically consider listening or speaking tasks in isolation. Here, human participants listened to questions and responded aloud with answers while we used high-density electrocorticography (ECoG) recordings to detect when they heard or said an utterance and to then decode the utterance's identity. Because certain answers were only plausible responses to certain questions, we could dynamically update the prior probabilities of each answer using the decoded question likelihoods as context. We decode produced and perceived utterances with accuracy rates as high as 61% and 76%, respectively (chance is 7% and 20%). Contextual integration of decoded question likelihoods significantly improves answer decoding. These results demonstrate real-time decoding of speech in an interactive, conversational setting, which has important implications for patients who are unable to communicate.


Assuntos
Mapeamento Encefálico/métodos , Córtex Cerebral/fisiologia , Fala/fisiologia , Interfaces Cérebro-Computador , Eletrocorticografia/instrumentação , Eletrocorticografia/métodos , Eletrodos Implantados , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Fatores de Tempo
4.
Artigo em Russo | MEDLINE | ID: mdl-31407677

RESUMO

AIM: To study the specificity of physiological mechanisms determining the efficiency of modelled purposeful activity in healthy people and patients with epilepsy. MATERIAL AND METHODS: The sample consisted of 235 people, including 72 healthy people (47 men and 25 women) and 163 patients with epilepsy (84 men and 79 women). Emotional and cognitive disorders were scored. Purposeful activity was modelled using the Gorbov-Shulte test. EEG, visual and auditory evoked potentials, P300 wave were recorded. The 'NS-Psychotest' complex was used to record a simple visual-motor reaction, a choice of difference and finger-tapping test. Heart rate variability and external breath functions were studied. An artificial neural network method was used for the prognosis of purposeful activity. RESULTS AND CONCLUSION: The 'resultative' and 'low resultative' groups were selected on the basis of the Gorbov-Shulte test performance. Patients with symptomatic forms of epilepsy, higher frequency of generalized seizures and cognitive disorders were mostly represented in the low resultative group. Artificial neural network classification into groups with different efficiency of activity reveals the greater role of the parameters of afferent and associative mechanisms in healthy people, parameters of cross correlation function of EEG and motor system function in patients with epilepsy.


Assuntos
Transtornos Cognitivos , Epilepsia , Potenciais Evocados Auditivos , Transtornos Cognitivos/fisiopatologia , Emoções , Epilepsia/fisiopatologia , Feminino , Frequência Cardíaca , Humanos , Masculino
5.
J Headache Pain ; 20(1): 64, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146673

RESUMO

BACKGROUND: Migraine aura (MA) is a common and disabling neurological condition, characterized by transient visual, and less frequently sensory and dysphasic aura disturbances. MA is associated with an increased risk of cardiovascular disorders and is often clinically difficult to distinguish from other serious neurological disorders such as transient ischemic attacks and epilepsy. Optimal clinical classification of MA symptoms is important for more accurate diagnosis and improved understanding of the pathophysiology of MA through clinical studies. MAIN BODY: A systematic review of previous prospective and retrospective systematic recordings of visual aura symptoms (VASs) was performed to provide an overview of the different types of visual phenomena occurring during MA and their respective frequencies in patients. We found 11 retrospective studies and three prospective studies systematically describing VASs. The number of different types of VASs reported by patients in the studies ranged from two to 23. The most common were flashes of bright light, "foggy" vision, zigzag lines, scotoma, small bright dots and 'like looking through heat waves or water'. CONCLUSIONS: We created a comprehensive list of VAS types reported by migraine patients based on all currently available data from clinical studies, which can be used for testing and validation in future studies. We propose that, based on this work, an official list of VAS types should be developed, preferably within the context of the International Classification of Headache Disorders of the International Headache Society.


Assuntos
Enxaqueca com Aura/diagnóstico , Enxaqueca com Aura/fisiopatologia , Visão Ocular/fisiologia , Adulto , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Epilepsia/fisiopatologia , Feminino , Alucinações/diagnóstico , Alucinações/epidemiologia , Alucinações/fisiopatologia , Humanos , Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/fisiopatologia , Masculino , Enxaqueca com Aura/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos
6.
Biol Psychol ; 145: 211-223, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31129312

RESUMO

How emotions unfold through time in the brain, and how fast they can be regulated by voluntary control, remain unresolved. Psychological accounts of emotion regulation posit cognitive reappraisal mechanisms may alter early emotion generative processes directly, whereas suppression impacts only later processing stages, after emotion has arisen. However, to date, there is no neurophysiological data concerning the precise latency of emotion regulation effects on the amygdala, a major emotion processing relay in the brain. Here we record amygdala activity from six patients undergoing surgery for pharmaco-resistant epilepsy during both reappraisal and suppression. We find that emotion reappraisal strategy, but not suppression, modulates early neural responses to emotional scenes during an extended period of time, starting 130 ms post-stimulus onset. Further, reappraisal produced earlier impact on amygdala responses to positive compared to negative scenes. Our results provide the first neurophysiological support for theoretical accounts of emotion regulation that postulate an early modulation of emotion generative processes by reappraisal.


Assuntos
Tonsila do Cerebelo/fisiologia , Emoções/fisiologia , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Mapeamento Encefálico , Epilepsia/diagnóstico por imagem , Epilepsia/fisiopatologia , Epilepsia/psicologia , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade
7.
Nat Commun ; 10(1): 2255, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113952

RESUMO

Theoretical models of episodic memory have proposed that retrieval depends on interactions between the hippocampus and neocortex, where hippocampal reinstatement of item-context associations drives neocortical reinstatement of item information. Here, we simultaneously recorded intracranial EEG from hippocampus and lateral temporal cortex (LTC) of epilepsy patients who performed a virtual reality spatial navigation task. We extracted stimulus-specific representations of both item and item-context associations from the time-frequency patterns of activity in hippocampus and LTC. Our results revealed a double dissociation of representational reinstatement across time and space: an early reinstatement of item-context associations in hippocampus preceded a later reinstatement of item information in LTC. Importantly, reinstatement levels in hippocampus and LTC were correlated across trials, and the quality of LTC reinstatement was predicted by the magnitude of phase synchronization between hippocampus and LTC. These findings confirm that episodic memory retrieval in humans relies on coordinated representational interactions within a hippocampal-neocortical network.


Assuntos
Hipocampo/fisiologia , Memória Episódica , Rememoração Mental/fisiologia , Lobo Temporal/fisiologia , Adulto , Mapeamento Encefálico/métodos , Eletrocorticografia , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiologia , Adulto Jovem
8.
Rev. neurol. (Ed. impr.) ; 68(9): 369-374, 1 mayo, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-180673

RESUMO

Introducción. El síndrome de Panayiotopulos (SP) es un síndrome epiléptico sobre el que hasta la fecha se ha publicado únicamente un pequeño número de estudios. Objetivo. Estudiar la frecuencia, la semiología y el pronóstico del SP. Pacientes y métodos. Todos los pacientes con una o más crisis epilépticas no provocadas que consultaron en nuestro hospital entre el 1 de junio de 1994 y el 1 de marzo de 2011 (n = 827) fueron incluidos y seguidos prospectivamente hasta el 30 de abril de 2018. Se diagnosticó de SP a los pacientes que cumplieron los siguientes criterios a los seis meses de evolución: una o más crisis no provocadas con síntomas predominantemente autonómicos, presencia de complejos de puntas y ondas lentas focales de gran amplitud y «morfología funcional», ausencia de déficit neurológico previo y neuroimagen normal. Resultados. Cumplieron los criterios de SP 27 casos (3,3%). La semiología de las crisis fue similar a la descrita por otros autores. Un 88% de casos alcanzó una remisión inicial de tres años sin tratamiento antiepiléptico (sin crisis y sin tratamiento durante tres años). Sesenta y dos pacientes (7,5%) cumplieron todos los criterios de SP, a excepción de la presencia de las típicas alteraciones en el electroencefalograma. La semiología de estos casos fue similar, y un 85% alcanzó una remisión inicial de tres años sin tratamiento antiepiléptico. Conclusiones. En la práctica diaria son frecuentes los pacientes con crisis sugestivas de SP, pero sin las típicas alteraciones en el electroencefalograma. Este grupo de pacientes también presenta un buen pronóstico


Introduction. Panayiotopoulos syndrome (PS) is an epileptic syndrome of childhood. Until now only a small number of studies have been published about this syndrome. Aim. To study the frequency, semiology and prognosis of PS. Patients and methods. all patients with one or more unprovoked seizures seen at our hospital between 1 June 1994 and 1 March 2011 (n = 827) were included and prospectively followed until 30 April 2018. A diagnosis of PS was made in patients that fulfilled all the following criteria at six month of evolution: seizures with predominantly autonomic symptoms, presence of high amplitude, ‘functional morphology’, focal spikes and slow wave complexes in any location, absence of previous neurological deficit and normal neuroimaging. Results. 27 cases (3,3%) met the diagnostic criteria. Semiology of the seizures was similar to that described by other authors. 88% of these cases attained a 3-year initial remission without antiepileptic treatment (three years both without seizures and without treatment). 62 cases (7,5%) met all the diagnostic criteria with the exception of the presence of the EEG features. Semiology of these cases was similar and 85% attained a 3-year initial remission without antiepileptic treatment. Conclusions. In daily practice, patients with a clinical picture suggestive of PS but without the typical EEG features are common. This group of patients also have a good outcome


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Epilepsia/fisiopatologia , Epilepsia/terapia , Prognóstico , Síndrome , Estudos Prospectivos , Seguimentos
9.
Molecules ; 24(8)2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31013866

RESUMO

Cannabidiol (CBD) is one of the cannabinoids with non-psychotropic action, extracted from Cannabis sativa. CBD is a terpenophenol and it has received a great scientific interest thanks to its medical applications. This compound showed efficacy as anti-seizure, antipsychotic, neuroprotective, antidepressant and anxiolytic. The neuroprotective activity appears linked to its excellent anti-inflammatory and antioxidant properties. The purpose of this paper is to evaluate the use of CBD, in addition to common anti-epileptic drugs, in the severe treatment-resistant epilepsy through an overview of recent literature and clinical trials aimed to study the effects of the CBD treatment in different forms of epilepsy. The results of scientific studies obtained so far the use of CBD in clinical applications could represent hope for patients who are resistant to all conventional anti-epileptic drugs.


Assuntos
Ansiolíticos/uso terapêutico , Anticonvulsivantes/uso terapêutico , Antipsicóticos/uso terapêutico , Canabidiol/uso terapêutico , Cannabis/química , Epilepsia/tratamento farmacológico , Convulsões/tratamento farmacológico , Ansiolíticos/efeitos adversos , Ansiolíticos/química , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/química , Antipsicóticos/efeitos adversos , Antipsicóticos/química , Canabidiol/efeitos adversos , Canabidiol/química , Ensaios Clínicos como Assunto , Epilepsia/patologia , Epilepsia/fisiopatologia , Humanos , Convulsões/patologia , Convulsões/fisiopatologia
10.
Expert Opin Drug Saf ; 18(4): 273-283, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30943798

RESUMO

INTRODUCTION: Epilepsy is a serious chronic neurological disorder manifested by an enduring symptomatic predisposition to seizures. Newly diagnosed individuals face increased morbidity, mortality, and socioeconomic costs. Anti-epileptic drug therapy is the treatment usually prescribed, which has efficacy in seizure control and mitigating long-term mortality. AREAS COVERED: Safety of anti-epileptic drug therapy in adults with a focus in newly diagnosed patients. Areas covered include the most commonly experienced adverse drug effects, as well as those with the highest impacts on drug tolerability, quality of life, morbidity and mortality. Evidence was also reviewed to identify clinical strategies to improve the safety of anti-epileptic drug therapy. EXPERT OPINION: Anti-epileptic drugs (AEDs) are mostly effective and well tolerated. However, a lack of standardised reporting of adverse drug effects in trials and in clinical practice provides an obstacle for evaluation of which adverse drug effects need to be prioritised in management. Improvement in the reporting of cognitive and other effects, as well as improved precision medicine and pharmacogenomics to target the incidence of high-mortality idiosyncratic reactions, will help to reduce the harm of AEDs in people newly diagnosed with epilepsy.


Assuntos
Anticonvulsivantes/administração & dosagem , Epilepsia/tratamento farmacológico , Qualidade de Vida , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos , Anticonvulsivantes/efeitos adversos , Epilepsia/genética , Epilepsia/fisiopatologia , Humanos , Farmacogenética , Medicina de Precisão/métodos
11.
J Clin Neurosci ; 65: 87-99, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30955950

RESUMO

Functional magnetic resonance imaging (fMRI) is a non-invasive imaging modality that enables the assessment of neural connectivity and oxygen utility of the brain using blood oxygen level dependent (BOLD) imaging sequence. Electroencephalography (EEG), on the other hands, looks at cortical electrical impulses of the brain thus detecting brainwave patterns during rest and thought processing. The combination of these two modalities is called fMRI with simultaneous EEG (fMRI-EEG), which has emerged as a new tool for experimental neuroscience assessments and has been applied clinically in many settings, most commonly in epilepsy cases. Recent advances in imaging has led to fMRI-EEG being utilized in behavioural studies which can help in giving an objective assessment of ambiguous cases and help in the assessment of response to treatment by providing a non-invasive biomarker of the disease processes. We aim to review the role and interpretation of fMRI-EEG in studies pertaining to psychiatric disorders and behavioral abnormalities.


Assuntos
Eletroencefalografia/métodos , Imagem por Ressonância Magnética/métodos , Adulto , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Ondas Encefálicas/fisiologia , Neurônios Dopaminérgicos , Epilepsia/fisiopatologia , Humanos , Masculino , Oxigênio/sangue , Descanso
12.
Epileptic Disord ; 21(2): 206-208, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977727

RESUMO

Hemimegalencephaly is a malformation of cortical development that normally manifests in childhood with seizures and cognitive impairment. We present a case of hemimegalencephaly in a 55-year-old developmentally-normal woman who developed focal impaired awareness seizures with bilateral tonic-clonic spread. Her interictal EEG showed left-sided multifocal spikes, and ictal EEG showed seizures starting in the left hemisphere. Imaging showed hemimegalencephaly. This case may represent the oldest age for a first seizure in a patient with hemimegalencephaly.


Assuntos
Epilepsia/diagnóstico , Hemimegalencefalia/diagnóstico , Idade de Início , Eletroencefalografia , Epilepsia/etiologia , Epilepsia/fisiopatologia , Feminino , Hemimegalencefalia/complicações , Humanos , Pessoa de Meia-Idade
13.
Int J Mol Sci ; 20(8)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31018519

RESUMO

Epilepsy is a common neurological disorder associated with increased morbidity and mortality. Sudden unexpected death in epilepsy, also known as SUDEP, is the main cause of death in patients with epilepsy. SUDEP has an incidence of 1.2 per 1000 person-years in adults and 0.2 per 1000 person-years in children. SUDEP accounts for 8-17% of deaths in patients with epilepsy. It is commonly associated with a history of generalized tonic-clonic seizures, and its risk may be increased by other factors such as postictal electroencephalographic suppression, prone sleeping position, altered heart rate variability, conduction abnormalities, gender, or antiepileptic medications. Recently, electrocardiograms, electroencephalograms, and imaging markers have helped clinicians stratify SUDEP risk and identify patients in need of close monitoring. However, the pathophysiology of SUDEP is likely multifactorial and still unknown. Improving the knowledge of SUDEP incidence, risk factors, and biomarkers can help design and implement effective prevention strategies.


Assuntos
Morte Súbita/epidemiologia , Epilepsia/genética , Animais , Arritmias Cardíacas/complicações , Arritmias Cardíacas/genética , Arritmias Cardíacas/patologia , Arritmias Cardíacas/fisiopatologia , Morte Súbita/patologia , Epilepsia/epidemiologia , Epilepsia/patologia , Epilepsia/fisiopatologia , Predisposição Genética para Doença , Humanos , Fatores de Risco
14.
Epileptic Disord ; 21(2): 141-153, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31017575

RESUMO

It is unknown whether treatment with antiepileptic drugs in children with epilepsy with a presumed good prognosis is always necessary. We aimed to study the course of newly diagnosed epilepsy in children with a presumed good prognosis who are managed without AED treatment. A total of 151 children (one month to 12 years of age) with two to five lifetime unprovoked seizures (excluding febrile convulsions), were followed for three years. Treatment was initially withheld. Children with symptomatic epilepsy, or absence or myoclonic epilepsy, were excluded. AED treatment was started after >10 lifetime seizures or an episode of status epilepticus during follow-up, or if the parents or treating physician deemed it otherwise necessary. During follow-up, 113 children continued to meet our criteria for refraining from treatment with antiepileptic drugs, yet 30 started treatment at the request of the parents. Thirty-eight children at some time met the criteria to start treatment, but the parents of 16 declined treatment. In all, 99 (66%) children maintained the no-treatment regime. Ninety-eight children (65% of 151) reached terminal remission for at least one year, including 83 who did not receive antiepileptic drug treatment (84% of the untreated 99). Mean terminal remission was significantly longer in the group with a total of <10 seizures compared to those with >10 seizures. Treatment did not increase the length of terminal remission. Adverse events, including traumatic injury, occurred equally in the treated and untreated children. Measures of quality of life suggested a better outcome in those without treatment. Children with newly diagnosed epilepsy with a presumed good prognosis may not need immediate AED treatment. Postponing treatment does not alter the chance of remission or the risk of accidents and adverse events and appears to be associated with a good quality of life.


Assuntos
Anticonvulsivantes/administração & dosagem , Epilepsia/tratamento farmacológico , Criança , Pré-Escolar , Epilepsia/complicações , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Prognóstico , Estudos Prospectivos , Indução de Remissão , Remissão Espontânea
15.
Ideggyogy Sz ; 72(3-4): 111-114, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-30957465

RESUMO

Background and purpose: Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods: We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results: Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Conclusion: Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method.


Assuntos
Eletroencefalografia , Epilepsia/diagnóstico , Síncope/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Convulsões , Síncope/fisiopatologia
16.
BMC Neurosci ; 20(1): 8, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832562

RESUMO

BACKGROUND: The electroencephalogram (EEG) is a widely used laboratory technique in rodent models of epilepsy, traumatic brain injury (TBI), and other neurological diseases accompanied by seizures. Obtaining prolonged continuous EEG tracings over weeks to months is essential to adequately answer research questions related to the chronobiology of seizure emergence, and to the effect of potential novel treatment strategies. Current EEG recording methods include wired and the more recent but very costly wireless technologies. Wired continuous long-term EEG in rodents remains the mainstay approach but is often technically challenging due to the notorious frequent EEG cable disconnections from the rodent's head, and to poor signal-to-noise ratio especially when simultaneously monitoring multiple animals. Premature EEG cable disconnections and cable movement-related artifacts result from the animal's natural mobility, and subsequent tension on the EEG wires, as well as from potential vigorous and frequent seizures. These challenges are often accompanied by injuries to the scalp, and result in early terminations of costly experiments. RESULTS: Here we describe an enhanced customized swivel-balance EEG-cage system that allows tension-free rat mobility. The cage setup markedly improves the safety and longevity of current existing wired continuous long-term EEG. Prevention of EEG cable detachments is further enhanced by a special attention to surgical electrode anchoring to the skull. In addition to mechanically preventing premature disconnections, the detailed stepwise approach to the electrical shielding, wiring and grounding required for artifact-free high signal-to-noise ratio recordings is also included. The successful application of our EEG cage system in various rat models of brain insults and epilepsy is described with illustrative high quality tracings of seizures and electrographic patterns obtained during continuous and simultaneous monitoring of multiple rats early and up to 3 months post-brain insult. CONCLUSION: Our simple-to-implement key modifications to the EEG cage setup allow the safe acquisition of substantial high quality wired EEG data without resorting to the still costly wireless technologies.


Assuntos
Eletroencefalografia/instrumentação , Modelos Animais , Animais , Encéfalo/crescimento & desenvolvimento , Encéfalo/fisiopatologia , Eletrodos Implantados , Epilepsia/fisiopatologia , Desenho de Equipamento , Abrigo para Animais , Masculino , Movimento , Ratos , Ratos Sprague-Dawley , Convulsões/fisiopatologia
17.
Neurol Sci ; 40(Suppl 1): 31-37, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30923987

RESUMO

Migraine is a pure human neurovascular disorder with no reliable corresponding animal model. The cerebral cortex (CC) has long been discussed as a crucial element of its complex mechanism. The present review considers the state of the art of experimental evidence on the involvement of CC in migraine. An ample series of research data points to a role of CC in the migraine process, also at the beginning of the attack, especially in the form with aura. However, in spite of several CC, peculiarities emerged in experimental settings, the enigma on their significance (cause or consequence of the disease?) remains. All in all, we believe that pure clinical observations and reasoning, i.e., its exclusive human nature and the precipitating role of stress, are still the most persuasive cues supporting the CC involvement in migraine.


Assuntos
Córtex Cerebral/fisiopatologia , Epilepsia/fisiopatologia , Transtornos de Enxaqueca/fisiopatologia , Enxaqueca com Aura/fisiopatologia , Estresse Fisiológico/fisiologia , Animais , Epilepsia/complicações , Humanos , Transtornos de Enxaqueca/etiologia , Enxaqueca com Aura/complicações , Rede Nervosa/fisiopatologia
18.
Trends Pharmacol Sci ; 40(4): 267-277, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30853109

RESUMO

The endocannabinoid (eCB) signaling system modulates neurotransmission and inflammation, among other physiological functions. Its newest member, α/ß-hydrolase domain-containing 6 (ABHD6), has emerged as a promising therapeutic target to treat several devastating diseases, including epilepsy. Here, we review the molecular mechanisms that mediate and control eCB signaling and, within it, the specific role of ABHD6. We also discuss how ABHD6 controls the abundance of additional lipids and the trafficking of ionotropic receptors to plasma membranes. We finish with several unexplored questions regarding this novel enzyme. Our current understanding of the molecular mechanism and biological function of ABHD6 provides a strong foundation for the development of small-molecule therapeutics to treat devastating diseases.


Assuntos
Desenvolvimento de Medicamentos/métodos , Endocanabinoides/metabolismo , Monoacilglicerol Lipases/metabolismo , Animais , Membrana Celular/metabolismo , Epilepsia/tratamento farmacológico , Epilepsia/fisiopatologia , Humanos , Transdução de Sinais/fisiologia , Transmissão Sináptica/fisiologia
19.
Geriatr Psychol Neuropsychiatr Vieil ; 17(S1): 21-24, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30916647

RESUMO

Epileptic seizures and epilepsy appear frequent in the elderly. The diagnosis is often more difficult and therapeutic decisions are often debated. In this context, the implementation of a rigorous analysis and reasoning to correctly determine the various components at the origin of the epileptic seizure is fundamental. Some data are in favor of a decrease of the epileptogenic threshold with advancing age. But, this is in no way sufficient to account for the occurrence of a seizure. It is necessary to add to aging factor a chronic pathology responsible for brain lesions (micro or macroscopic: stroke, Alzheimer's disease, brain tumors...) and/or acute aggression (trauma, central nervous system infection, metabolic or toxic disorders...) to trigger a seizure. It is notable that an association of some mild brain lesions and a weak metabolic disturbance could trigger a seizure. In these cases, the probability of trigger a new seizure with another mild precipitant factor appears very high. This analysis is necessary and particularly useful in these multi-pathological patients. It also makes it easier to decide whether to start antiepileptic treatment. In case of a triggering factor such as hyponatremia, for example, in the absence of associated underlying lesions, it seems legitimate not to start treatment at the first epileptic seizure. On the other hand, if hyponatremia (often less deep than in the previous case) is associated with sequel of stroke or Alzheimer's disease, it seems reasonable to start treatment quickly.


Assuntos
Epilepsia/terapia , Geriatria , Convulsões/terapia , Idoso , Idoso de 80 Anos ou mais , Gerenciamento Clínico , Eletroencefalografia , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Convulsões/fisiopatologia
20.
Seizure ; 66: 76-80, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30818180

RESUMO

PURPOSE: Electroencephalography (EEG) remains the gold standard for identifying rhythmic and periodic patterns in critically ill patients. Residents have frequent exposures to EEG and critically ill patients during their training. Our study aimed to assess resident competency in the use of the American Clinical Neurophysiology Society (ACNS) critical care EEG terminology. METHODS: After self-guided reading and a 2-hour session reviewing the ACNS critical care EEG Terminology training slides, 16 adult neurology residents (PGY 2-4) completed the ACNS certification test. Performance scores were reported as average percent agreement (PA%) with a previously established 5-member expert panel. Interrater agreement was calculated to gauge consensus among peers within the resident cohort. Self-reported comfort levels using the terminology were also obtained. RESULTS: The overall pass rate for our cohort was 50% and the median score was 74%. The terms with the highest PA% were: seizures (86.4%), main term 1 (78%), main term 2 (74%). Interrater agreement scores (kappa values) were almost perfect for seizure, and substantial for main terms 1 and 2. CONCLUSIONS: Our data suggests that with minimal investment, adult neurology residents at various stages of training can effectively learn the ACNS critical care EEG Terminology.


Assuntos
Cuidados Críticos , Eletroencefalografia/métodos , Epilepsia/fisiopatologia , Internato e Residência , Neurologia/educação , Terminologia como Assunto , Ondas Encefálicas/fisiologia , Epilepsia/diagnóstico , Feminino , Humanos , Masculino , Estados Unidos
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