Testing the importance of the Medial Temporal Lobes in human interoception: Does it matter if there is a memory component to the task?

Interoception is the ability to consciously perceive internal bodily states. Neuroimaging suggests that the insula (IC) and anterior cingulate cortex (ACC) mediate interoception, while studies involving patients/animals with brain lesions suggest the medial temporal lobe (MTL) is particularly important. One reason for these contrasting conclusions may lie in the types of interoceptive task used by these different approaches.

Frequency of a false positive diagnosis of epilepsy: A systematic review of observational studies.

Purpose: To determine the frequency of false positive diagnoses of epilepsy and to explore its imitators and consequences.

Method: A systematic review of all published observational studies (to November 2015) was conducted to determine the proportion of false positive diagnoses of epilepsy. We included studies of people of all ages receiving a diagnosis of epilepsy.

Imagining future events in patients with unilateral temporal lobe epilepsy.

Objectives: Imagining future events, which contain episodic and non-episodic details, has been found to (1) engage the temporal lobes bilaterally and (2) be impaired in patients with bilateral temporal lobe pathology. Here, we examined whether unilateral temporal lobe dysfunction also impairs the ability to generate future events.

Design: Prospective cross-sectional.

Determining the relationship between sleep architecture, seizure variables and memory in patients with focal epilepsy.

Sleep has been shown to be important to memory. Both sleep and memory have been found to be abnormal in patients with epilepsy. In this study, we explored the effects that nocturnal epileptiform discharges and the presence of a hippocampal lesion have on sleep patterns and memory.

Disruption of learning and long-term retention of prose passages in patients with focal epilepsy.

Recent investigations of accelerated long-term forgetting, a condition in which newly acquired memory is normal initially but decays rapidly over days or weeks, indicate that multiple factors might influence whether this phenomenon is seen in patients with epilepsy. Test-based differences such as learning condition or type of memory measure (e.g.

Old dogs with new tricks: Detecting accelerated long-term forgetting by extending traditional measures.

Accelerated long-term forgetting (ALF) is a condition in which normal memory performance is displayed after short delays, but significant memory loss is detected when memory is tested after several days or weeks. This condition has been reported in patients with epilepsy, but there are few normative scores available for its detection in clinical practice. In the present study, we assessed 60 healthy control subjects 18-60years of age on three memory measures [Rey Auditory Verbal Learning (RAVLT), Logical Memory (LM), and Aggie Figures] at delays of 30min and 7days.

The relationship between neuropsychological functioning and FDG-PET hypometabolism in intractable mesial temporal lobe epilepsy.

We examined the relationship between baseline neuropsychological functioning and 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in intractable mesial temporal lobe epilepsy (MTLE). We hypothesized relationships between dominant temporal lobe hypometabolism and verbal memory and between nondominant temporal lobe hypometabolism and nonverbal memory in line with the lateralized material-specific model of memory deficits in MTLE. We also hypothesized an association between performance on frontal lobe neuropsychological tests and prefrontal hypometabolism.

Anxiety in epilepsy: a neglected disorder.

Objective: Anxiety disorders and symptoms are highly prevalent and problematic comorbidities in people with epilepsy (PWE), yet they remain poorly understood and often go undetected. This research aimed to further our understanding about anxiety in PWE.

Methods: Study 1 assessed the effectiveness of the commonly utilised yet unvalidated measure (Hospital Anxiety Depression Scale-Anxiety subscale; HADS-A) to identify DSM-IV anxiety disorders in 147 adult epilepsy outpatients.

Baló's concentric sclerosis and tumefactive demyelination: a shared immunopathogenesis?

Baló's concentric sclerosis (BCS) and tumefactive demyelination (TD) are considered atypical forms of multiple sclerosis (MS). Baló lesions are characterized by concentric rings corresponding to alternating bands of demyelination and relatively preserved myelin (Hu and Lucchinetti, 2009). Tumefactive lesions are pseudotumoural demyelinating lesions of >2 cm and may have an open ring-enhancing magnetic resonance imaging appearance (Hu and Lucchinetti, 2009; Lucchinetti et al.

The impact of epileptiform abnormalities and hippocampal lesions on retention of recent autobiographical experiences: Adding insult to injury?

Accelerated long term forgetting (ALF), whereby information is rapidly lost over days or weeks has been noted in patients with epileptic conditions. The present study sought to determine which clinical factors underlie such consolidation failure for recent autobiographical experiences in patients with focal epilepsy. We enrolled 21 patients with temporal lobe epilepsy (TLE), with and without hippocampal lesions (TLE(+)=12; TLE(-)=9, respectively), 11 patients with extratemporal epilepsy (ETE) and 29 controls (NC).

Metabolic changes in occipital lobe epilepsy with automatisms.

Purpose: Some studies suggest that the pattern of glucose hypometabolism relates not only to the ictal-onset zone but also reflects seizure propagation. We investigated metabolic changes in patients with occipital lobe epilepsy (OLE) that may reflect propagation of ictal discharge during seizures with automatisms.

Methods: Fifteen patients who had undergone epilepsy surgery for intractable OLE and had undergone interictal Fluorine-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) between 1994 and 2004 were divided into two groups (with and without automatisms during seizure).

The cognitive profile of occipital lobe epilepsy and the selective association of left temporal lobe hypometabolism with verbal memory impairment.

We investigated the cognitive profile of structural occipital lobe epilepsy (OLE) and whether verbal memory impairment is selectively associated with left temporal lobe hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Nine patients with OLE, ages 8-29 years, completed presurgical neuropsychological assessment. Composite measures were calculated for intelligence quotient (IQ), speed, attention, verbal memory, nonverbal memory, and executive functioning.

Cognitive behaviour therapy to improve mood in people with epilepsy: a randomised controlled trial.

This study compared a 9-week individualised Cognitive Behaviour Therapy (CBT) programme for people with epilepsy (PWE), with a wait-list control. Fifty-nine PWE were randomised and 45 (75%) completed post-treatment outcomes. People with lower quality of life (QoL), particularly for cognitive functioning, were more likely to drop out.

Accelerated long-term forgetting of verbal information in unilateral temporal lobe epilepsy: Is it related to structural hippocampal abnormalities and/or incomplete learning?

The factors contributing to accelerated long-term forgetting (ALF) are not yet clear. In this study, a 12-item word list was presented repeatedly to 23 patients with temporal lobe epilepsy (TLE) and 27 control participants (NC) until it was recalled completely on two consecutive trials or until 12 trials were undertaken. Compared to NCs, patients with hippocampal lesions and those who failed to learn the list showed ALF by one day post learning, but the alternative patient groups also showed ALF when tested after seven days.

Accelerated long-term forgetting: a newly identified memory impairment in epilepsy.

Recently, a pattern referred to as accelerated long-term forgetting (ALF) has been described in patients with epilepsy. In ALF, acquisition and retention over standard delayed recall intervals (up to 30 minutes) tend to be intact, but there is an abnormally rapid rate of forgetting over delays of days or weeks. ALF is associated with everyday memory complaints as well as impairments in autobiographical memory, but goes largely undetected by traditional neuropsychological measures.

Early predictors of remission in newly diagnosed epilepsy: a systematic approach to reviewing prognostic factor studies.

Background: It is necessary to select a range of consistently identified prognostic factors from exploratory studies to include in multivariate models of confirmatory studies. We illustrate a systematic approach to selecting consistently identified prognostic factors using the example of predictors of remission in newly diagnosed epilepsy.

Methods: Medline and Embase were searched for reports of cohort studies enrolling at least 100 people with epilepsy within 1 year of diagnosis, and followed up for at least 1 year.

Frequency-moment signatures: a method for automated seizure detection from scalp EEG.

Objectives: To investigate patient-specific automated epileptic seizure detection from scalp EEG using a new technique: frequency-moment signatures.

Methods: Signatures were calculated from 32s blocks of data of electrode differences from the right (RH) and left hemisphere (LH). Discrete Fourier transforms of 15 data subsets were calculated per block per hemisphere.

Withdrawal of anti-epileptic medications during video EEG monitoring does not alter ECG parameters or HRV.

Purpose: To assess if anti-epileptic drug (AED) withdrawal/cessation results in changes in ECG parameters and/or measures of heart rate variability (HRV), in patients having VEEG monitoring, that might affect susceptibility to sudden death in epilepsy.

Methods: In this study, we included 36 patients with medically refractory epilepsy undergoing continuous video-EEG-ECG monitoring in hospital for pre-surgical assessment. We recorded and analysed multiple 10-min epochs of 2-lead ECG during periods when the subjects were awake and in REM and non-REM sleep, both on admission, and after the subjects had been partially or completely weaned from their AEDs.

The utility of ambulatory electroencephalography in routine clinical practice: a critical review.

Over the last four decades, ambulatory electroencephalography (EEG) has evolved to be a useful tool in the diagnosis of epilepsy and certain nonepileptic paroxysmal disorders. Most of the initial technological drawbacks of ambulatory EEG have been circumvented by incorporating digital and computer technology. It appears superior to routine EEG in capturing interictal abnormalities particularly in relation to natural sleep, circadian variations and the patient's typical daily lifestyle.

Examining factors related to accelerated long-term forgetting in epilepsy using ambulatory EEG monitoring.

Purpose: Some patients with epilepsy demonstrate normal memory when this is tested at relatively short intervals (e.g., 30 min), but substantial loss over longer delay periods (e.

Investigating the role of combined acoustic-visual feedback in one-dimensional synchronous brain computer interfaces, a preliminary study.

Feedback plays an important role when learning to use a brain computer interface (BCI), particularly in the case of synchronous feedback that relies on the interaction subject. In this preliminary study, we investigate the role of combined auditory-visual feedback during synchronous μ rhythm-based BCI sessions to help the subject to remain focused on the selected imaginary task. This new combined feedback, now integrated within the general purpose BCI2000 software, has been tested on eight untrained and three trained subjects during a monodimensional left-right control task.

Severe Bickerstaff's encephalitis treated with Rituximab: serum and CSF GQ1b antibodies.

Bickerstaff's encephalitis is a syndrome of ophthalmoplegia, ataxia and impaired consciousness commonly associated with serum GQ1b antibodies. We describe a patient with seropositive Bickerstaff's encephalitis who did not respond either to plasma exchange or intravenous immunoglobulin but recovered following adjunct treatment with the anti-CD 20 monoclonal antibody, Rituximab. There was a concomitant reduction in serum GQ1b antibodies associated with improvement.