Dural Arteriovenous Fistulas: Baseline Cognitive Changes and Changes following Treatment: A Prospective Longitudinal Study.

Background And Purpose: Dural arteriovenous fistulas (DAVFs) exhibit varied clinical manifestations, and high-grade cases are associated with both a risk of hemorrhage and (in certain cases) dementia. Less known, however, is the association between DAVF and more subtle cognitive changes, which might not be clinically apparent without formal neurocognitive testing. This study prospectively assesses baseline cognitive changes in patients with unruptured DAVFs and looks at the effects of treatment on any such changes.

Mechanical pain sensitivity is associated with hippocampal structural integrity.

Rodents and human studies indicate that the hippocampus, a brain region necessary for memory processing, responds to noxious stimuli. However, the hippocampus has yet to be considered a key brain region directly involved in the human pain experience. One approach to answer this question is to perform quantitative sensory testing on patients with hippocampal damage-ie, medial temporal lobe epilepsy.

Slow wave sleep is associated with forgetting in patients with temporal lobe epilepsy.

While time spent in slow wave sleep (SWS) after learning promotes memory consolidation in the healthy brain, it is unclear if the same benefit is obtained in patients with temporal lobe epilepsy (TLE). Interictal epileptiform discharges (IEDs) are potentiated during SWS and thus may disrupt memory consolidation processes thought to depend on hippocampal-neocortical interactions. Here, we explored the relationship between SWS, IEDs, and overnight forgetting in patients with TLE.

Cognitive Outcomes After Antidepressant Pharmacotherapy for Late-Life Depression: A Systematic Review and Meta-Analysis.

Objective: The authors evaluated whether treatment of late-life depression (LLD) with antidepressants leads to changes in cognitive function.

Methods: A systematic review and meta-analysis of prospective studies of antidepressant pharmacotherapy for adults age 50 or older (or mean age of 65 or older) with LLD was conducted. MEDLINE, EMBASE, and PsycInfo were searched through December 31, 2022.

Emergence Patterns from General Anesthesia after Epilepsy Surgery: An Observational Pilot Study.

Emergence from anesthesia starts from the limbic structures and then spreads outwards to brainstem, reticular activating systems, and then to the cortex. Epilepsy surgery often involves resection of limbic structures and hence may disrupt the pattern of emergence. The aim of this study was to explore the pattern of emergence from anesthesia following epilepsy surgery and to determine associated variables affecting the emergence pattern.

Leveraging the resting brain to predict memory decline after temporal lobectomy.

Objective: Predicting memory morbidity after temporal lobectomy in patients with temporal lobe epilepsy (TLE) relies on indices of preoperative temporal lobe structural and functional integrity. However, epilepsy is increasingly considered a network disorder, and memory a network phenomenon. We assessed the utility of functional network measures to predict postoperative memory changes.

Exploring the merits of research performance measures that comply with the San Francisco Declaration on Research Assessment and strategies to overcome barriers of adoption: qualitative interviews with administrators and researchers.

Background: In prior research, we identified and prioritized ten measures to assess research performance that comply with the San Francisco Declaration on Research Assessment, a principle adopted worldwide that discourages metrics-based assessment. Given the shift away from assessment based on Journal Impact Factor, we explored potential barriers to implementing and adopting the prioritized measures.

Methods: We identified administrators and researchers across six research institutes, conducted telephone interviews with consenting participants, and used qualitative description and inductive content analysis to derive themes.

DORA-compliant measures of research quality and impact to assess the performance of researchers in biomedical institutions: Review of published research, international best practice and Delphi survey.

Objective: The San Francisco Declaration on Research Assessment (DORA) advocates for assessing biomedical research quality and impact, yet academic organizations continue to employ traditional measures such as Journal Impact Factor. We aimed to identify and prioritize measures for assessing research quality and impact.

Methods: We conducted a review of published and grey literature to identify measures of research quality and impact, which we included in an online survey.

Subcortical language localization using sign language and awake craniotomy for dominant posterior temporal glioma resection in a hearing-impaired patient.

Intraoperative direct cortical stimulation (DCS) is the gold standard technique to maximize the extent of resection of tumors located in eloquent areas. To date, there are three cases reported of awake mapping for language centers in deaf patients who could communicate only with sign language. We present the case of DCS in a deaf patient who could communicate vocally, native to American Sign Language and English, that underwent intraoperative awake mapping.

Age-related effects on the anterior and posterior hippocampal volumes in 6-21 year olds: A model selection approach.

Although recent studies support significant differences in intrinsic structure, function, and connectivity along the longitudinal axis of the hippocampus, few studies have investigated the normative development of this dimension. In addition, factors known to influence hippocampal structure, such as sex or puberty, have yet to be characterized when assessing age-related effects on its subregions. This study addresses this gap by investigating the relationship of the anterior (antHC) and posterior (postHC) hippocampus volumes with age, and how these are moderated by sex or puberty, in structural magnetic resonance imaging scans from 183 typically developing participants aged 6-21 years.

Schemas provide a scaffold for neocortical integration of new memories over time.

Memory transformation is increasingly acknowledged in theoretical accounts of systems consolidation, yet how memory quality and neural representation change over time and how schemas influence this process remains unclear. We examined the behavioral quality and neural representation of schema-congruent and incongruent object-scene pairs retrieved across 10-minutes and 72-hours using fMRI. When a congruent schema was available, memory became coarser over time, aided by post-encoding coupling between the anterior hippocampus and medial prefrontal cortex (mPFC).

Imaging in medically refractory epilepsy at 3 Tesla: a 13-year tertiary adult epilepsy center experience.

Objectives: MRI negative epilepsy has evolved through increased usage of 3 T and insights from surgically correlated studies. The goal of this study is to describe dedicated 3 T epilepsy MRI findings in medically refractory epilepsy (MRE) patients at a tertiary epilepsy center to familiarize radiologists with an updated spectrum and frequency of potential imaging findings in the adult MRE population.

Methods: Included were all patients with MRE admitted to the epilepsy monitoring unit who were discussed at weekly interdisciplinary imaging conferences at Toronto Western Hospital with MRI studies (3 T with dedicated epilepsy protocol) performed between January 2008 and January 2021.

I remember therefore I am: Episodic memory retrieval and self-reported trait empathy judgments in young and older adults and individuals with medial temporal lobe excisions.

How do we know what sort of people we are? Do we reflect on specific past instances of our own behaviour, or do we just have a general idea? Previous work has emphasized the role of personal semantic memory (general autobiographical knowledge) in how we assess our own personality traits. Using a standardized trait empathy questionnaire, we show in four experiments that episodic autobiographical memory (memory for specific personal events) is associated with people's judgments of their own trait empathy. Specifically, neurologically healthy young adults rated themselves as more empathic on questionnaire items that cued episodic memories of events in which they behaved empathically.

Baseline resting-state functional connectivity determines subsequent pain ratings to a tonic ecologically valid experimental model of orofacial pain.

Pain is a subjective experience with significant individual differences. Laboratory studies investigating pain thresholds and experimental acute pain have identified structural and functional neural correlates. However, these types of pain stimuli have limited ecological validity to real-life pain experiences.

Impact of Mesial Temporal Lobe Resection on Brain Structure in Medically Refractory Epilepsy.

Objective: Surgical resection can decrease seizure frequency in medically intractable temporal lobe epilepsy. However, the functional and structural consequences of this intervention on brain circuitry are poorly understood. We investigated structural changes that occur in brain circuits after mesial temporal lobe resection for refractory epilepsy.

Nomograms to Predict Verbal Memory Decline After Temporal Lobe Resection in Adults With Epilepsy.

Objective: To develop and externally validate models to predict the probability of postoperative verbal memory decline in adults after temporal lobe resection (TLR) for epilepsy using easily accessible preoperative clinical predictors.

Methods: Multivariable models were developed to predict delayed verbal memory outcome on 3 commonly used measures: Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) and Verbal Paired Associates (VPA) subtests from Wechsler Memory Scale-Third Edition. With the use of the Harrell step-down procedure for variable selection, models were developed in 359 adults who underwent TLR at the Cleveland Clinic and validated in 290 adults at 1 of 5 epilepsy surgery centers in the United States or Canada.

The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review.

Background: Waiting for procedures delayed by COVID-19 may cause anxiety and related adverse consequences.

Objective: To synthesize research on the mental health impact of waiting and patient-centred mitigation strategies that could be applied in the COVID-19 context.

Methods: Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes.

An exploratory study into the influence of laterality and location of hippocampal sclerosis on seizure prognosis and global cortical thinning.

In mesial temporal lobe epilepsy (mTLE), the correlation between disease duration, seizure laterality, and rostro-caudal location of hippocampal sclerosis has not been examined in the context of seizure severity and global cortical thinning. In this retrospective study, we analyzed structural 3 T MRI from 35 mTLE subjects. Regions of FLAIR hyperintensity (as an indicator of sclerosis)-based on 2D coronal FLAIR sequences-in the hippocampus were manually segmented, independently and in duplicate; degree of segmentation agreement was confirmed using the DICE index.

Lateralizing magnetic resonance imaging findings in mesial temporal sclerosis and correlation with seizure and neurocognitive outcome after temporal lobectomy.

Background: Mesial temporal sclerosis (MTS) is the most common cause of temporal lobe epilepsy (TLE). While MTS is associated with a high cure rate after temporal lobectomy (TL), postoperative neurocognitive deficits are common, and a subset of patients may continue to have refractory seizures.

Objective: To use magnetic resonance (MR) volumetry to identify features of the mesial temporal lobe in patients with MTS that correlate with seizure and neurocognitive outcome after temporal lobectomy.

Predicting mood decline following temporal lobe epilepsy surgery in adults.

Objective: To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy.

Methods: Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100).

Sleep Fragmentation and Cognitive Trajectories After Critical Illness.

Background: ICU survivors can experience both cognitive dysfunction and persistent sleep disturbances after hospitalization. Sleep disturbances have been linked with cognitive impairment in various patient populations, and the apolipoprotein E (APOE) genotype has been linked to sleep-related impairments in cognition.

Research Question: Is there an association between sleep, long-term cognition, and APOE status in ICU survivors?

Study Design And Methods: We enrolled 150 patients from five centers who had been mechanically ventilated for at least 3 days; 102 patients survived to ICU discharge.