Epilepsy & behavior : E&B
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Our understanding of the mechanisms of loss and recovery of consciousness, following severe brain injury or during anesthesia, is changing rapidly. Recent neuroimaging studies have shown that patients with chronic disorders of consciousness and subjects undergoing general anesthesia present a complex dysfunctionality in the architecture of brain connectivity. ⋯ Despite ongoing efforts, the mechanisms underlying the emergence of consciousness after severe brain injury are not thoroughly understood. Important questions remain unanswered: What triggers the connectivity impairment leading to disorders of consciousness? Why do some patients recover from coma, while others with apparently similar brain injuries do not? Understanding these mechanisms could lead to a better comprehension of brain function and, hopefully, lead to new therapeutic strategies in this challenging patient population.
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Epilepsy & behavior : E&B · Dec 2013
Alterations in functional connectivity between the hippocampus and prefrontal cortex as a correlate of depressive symptoms in temporal lobe epilepsy.
Depression is a common comorbidity in temporal lobe epilepsy (TLE) that is thought to have a neurobiological basis. This study investigated the functional connectivity (FC) of medial temporal networks in depression symptomatology of TLE and the relative contribution of structural versus FC measures. Volumetric MRI and functional connectivity MRI (fcMRI) were performed on nineteen patients with TLE and 20 controls. ⋯ Frontolimbic network dysfunction is a strong contributor to levels of depressive symptoms in TLE and a better contributor than HA in LTLE. In addition, the right amygdala may play a role in depression symptomatology regardless of the side of the epileptogenic focus. These findings may inform the treatment of depressive symptoms in TLE and inspire future research to help guide surgical planning.
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Epilepsy & behavior : E&B · Dec 2013
Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy.
Severe childhood epilepsies are characterized by frequent seizures, neurodevelopmental delays, and impaired quality of life. In these treatment-resistant epilepsies, families often seek alternative treatments. This survey explored the use of cannabidiol-enriched cannabis in children with treatment-resistant epilepsy. ⋯ Because of the increasing number of states that allow access to medical cannabis, its use will likely be a growing concern for the epilepsy community. Safety and tolerability data for cannabidiol-enriched cannabis use among children are not available. Objective measurements of a standardized preparation of pure cannabidiol are needed to determine whether it is safe, well tolerated, and efficacious at controlling seizures in this pediatric population with difficult-to-treat seizures.
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Epilepsy & behavior : E&B · Dec 2013
Validating a natural language processing tool to exclude psychogenic nonepileptic seizures in electronic medical record-based epilepsy research.
As electronic health record (EHR) systems become more available, they will serve as an important resource for collecting epidemiologic data in epilepsy research. However, since clinicians do not have a systematic method for coding psychogenic nonepileptic seizures (PNES), patients with PNES are often misclassified as having epilepsy, leading to sampling error. This study validates a natural language processing (NLP) tool that uses linguistic information to help identify patients with PNES. ⋯ Our study demonstrates that the YTEX NLP tool and classifier is highly accurate in excluding PNES, diagnosed with VEEG, in EHR systems. The tool may be very valuable in preventing false positive identification of patients with epilepsy in EHR-based epidemiologic research.