Epilepsy research
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Review Meta Analysis
A meta-analysis of voxel-based morphometry studies on gray matter volume alteration in juvenile myoclonic epilepsy.
The findings of structural neuroimaging studies on gray matter volume (GMV) of juvenile myoclonic epilepsy (JME) with voxel-based morphometry (VBM) were inconsistent. We aim to evaluate consistent gray matter changes in JME quantitatively. A systematic review of VBM studies on GMV of patients with JME and healthy control (HC) subjects indexed in PubMed and EMBASE from January 1990 to June 2012 was conducted. ⋯ Increased GMV were observed in the bilateral medial frontal gyrus and anterior cingulate, whereas decreased GMV in the bilateral thalamus. The findings remain largely unchanged in the jackknife sensitivity analyses. The meta-analysis not only identified consistent changes in some regions of gray matter in patients with JME, but also supports the notion of thalamocortical circuitry involved in the pathogenesis of JME.
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Cerebral metabolism of ketones is a normal part of the process of brain development. While the mature brain relies on glucose as a primary fuel source, metabolism of ketone bodies remains an alternative energy source under conditions of starvation. The neuroprotective properties of brain ketone metabolism make this alternative substrate a viable therapeutic option for various pathologies. Since the ability to revert to utilizing ketones as an alternative substrate is greatest in the younger post-weaned brain, this particular therapeutic approach remains an untapped resource particularly for pediatric pathological conditions.
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Review
Reflex seizures and reflex epilepsies: old models for understanding mechanisms of epileptogenesis.
Reflex seizures and epilepsies represent an ancient human model to understand basic mechanisms of epilepsy. The increase of light stimulation makes this issue extremely actual and interesting. In addition, a lot of observations show the frequent occurrence of provoked seizures in malformations of cortical development and in recently defined conditions such as familial or sporadic lateral temporal epilepsy. Advances in morphological and functional neuroimaging techniques, and the possibility of their fusion with EEG (e.g., fMRI-EEG co-registration) offer a unique non-invasive opportunity to investigate cortical areas and brain networks involved in cerebral functions and in epileptic discharges.
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Epilepsy is a chronic condition that may be associated with several other diseases. Psychiatric comorbidities are highly prevalent and depression is the most common type of psychiatric comorbidity in people with epilepsy. The beneficial effects of exercise for people with epilepsy have been increasingly reported, including reduction of seizure susceptibility, improvement of quality of life and reduction of depression. In this regard, we propose in this article the potential role of physical exercise to minimize depression in people with epilepsy. ⋯ The significance of such a relationship has a marked impact on the development and implementation of appropriate coadjutant treatments to improve functional outcomes and quality of life in people with epilepsy.
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In contrast to the well studied long-term memory dysfunction of temporal lobe epilepsy (TLE) syndromes, data on memory performance of frontal lobe epilepsy (FLE) patients are limited and controversial. Behavioural and functional neuroimaging findings suggest that different regions within the frontal lobes contribute to long-term memory functioning, offering an explanation for the variability on memory function observed on patients with frontal lobe damage. ⋯ Variability on memory performance reported in FLE studies suggest this deficit may be dependant on the areas involved in seizure generation and spread. Recent research findings and the application of cognitive fMRI paradigms to FLE patients holds the promise of increasing understanding further.