Insular Role in Blood Pressure and Systemic Vascular Resistance Regulation.

Objectives: The insula is a brain area involved in the modulation of autonomic responses. Previous studies have focused mainly on its heart rate regulatory function, but its role in vascular control is not well defined. Ictal/postictal blood pressure (BP) fluctuations may have a role in the pathogenesis of sudden unexpected death in epilepsy.

Validation of direct cortical stimulation in presurgical evaluation of epilepsy.

Objective: Direct cortical stimulation (DCS) is standard for intracranial presurgical evaluation in drug-resistant epilepsy (DRE). Few studies have reported levels of concordance between spontaneous seizure generators and triggered seizures during DCS. The present work reports validity measures of DCS for detecting the seizure onset zone (SOZ) during stereoelectroencephalography (SEEG).

Characterization of the Insular Role in Cardiac Function through Intracranial Electrical Stimulation of the Human Insula.

Objective: The link between brain function and cardiovascular dynamics is an important issue yet to be elucidated completely. The insula is a neocortical brain area that is thought to have a cardiac chronotropic regulatory function, but its role in cardiac contractility is unknown. We aimed to analyze the variability in heart rate and cardiac contractility after functional activation of different insular regions through direct electrical stimulation (E-stim) in humans.

SUDEP in Spain: An Epilepsy Monitoring Unit based case series.

Purpose: SUDEP is the first cause of mortality related to epilepsy. However, in Spain there are no published cases or series from Epilepsy Monitoring Units that could expose the characteristics of SUDEP in our population.

Method: We reviewed all patients treated at our Spanish Epilepsy Reference Centre who died between 2010-2018.

Prediction error connectivity: A new method for EEG state analysis.

Several models have been proposed to explain brain regional and interregional communication, the majority of them using methods that tap the frequency domain, like spectral coherence. Considering brain interareal communication as binary interactions, we describe a novel method devised to predict dynamics and thus highlight abrupt changes marked by unpredictability. Based on a variable-order Markov model algorithm developed in-house for data compression, the prediction error connectivity (PEC) estimates network transitions by calculating error matrices (EMs).

Degenerate time-dependent network dynamics anticipate seizures in human epileptic brain.

Epileptic seizures are known to follow specific changes in brain dynamics. While some algorithms can nowadays robustly detect these changes, a clear understanding of the mechanism by which these alterations occur and generate seizures is still lacking. Here, we provide crossvalidated evidence that such changes are initiated by an alteration of physiological network state dynamics.

Ictal spitting in non-dominant temporal lobe epilepsy: an anatomo-electrophysiological correlation.

We report a patient presenting drug-resistant, non-dominant temporal lobe epilepsy with ictal spitting and prosopometamorphopsia, both extremely rare semiologies. Second-phase pre-surgical monitoring was performed using SEEG due to lesion-negative imaging and the rare semiology. The seizure onset zone was delimited to the right anterior hippocampus and the temporobasal cortex, with the propagation zone within the entorhinal cortex.

Effect of lacosamide on depression and anxiety symptoms in patients with focal refractory epilepsy: A prospective multicenter study.

Introduction: Depression is the main psychiatric comorbidity in epilepsy with an estimated prevalence between 20% and 55% and one of the main determinants of quality of life. The aim of this study was to investigate the effect of lacosamide (LCM) on mood and anxiety symptoms in patients with focal onset seizures (FOS). The secondary objective was to evaluate if the potential modifications in variables were related to seizure control or to the intrinsic effect of LCM.

Detection of recurrent activation patterns across focal seizures: Application to seizure onset zone identification.

Objective: We introduce a method that quantifies the consistent involvement of intracranially monitored regions in recurrent focal seizures.

Methods: We evaluated the consistency of two ictal spectral activation patterns (mean power change and power change onset time) in intracranial recordings across focal seizures from seven patients with clinically marked seizure onset zone (SOZ). We examined SOZ discrimination using both patterns in different frequency bands and periods of interest.

Relevance of stroke subtype in vascular risk prediction.

Objective: To ascertain the risk of a new vascular event (NVE) occurring after ischemic stroke and evaluate differences in risk based on stroke subtype.

Methods: This was a prospective observational study of consecutive patients with nonfatal stroke recruited at a single tertiary stroke center with follow-up ranging from 2 to 5 years (average, 31 ± 15.9 months).