Publications by authors named "William Gaillard"

In literate adults, an area along the left posterior fusiform gyrus that is often referred to as the "visual word form area" (VWFA) responds particularly strongly to written characters compared to other visually similar stimuli. Theoretical accounts differ in whether they attribute the strong left-lateralization of the VWFA to a left-hemisphere bias towards visual features used in script, to competition of visual word form processing with that of other visual stimuli processed in the same general cortical territory (especially faces), or to the well-established left-lateralization of the language system.Here we used functional magnetic resonance imaging to test the last hypothesis by investigating lateralization of the VWFA in participants (male and female) who have right-hemisphere language due to a large left-hemisphere perinatal stroke.

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Introduction: Hereditary bleeding disorders stem from the absence or insufficient levels of particular clotting proteins, essential for facilitating coagulation in the clotting cascade. Among the most prevalent are hemophilia A (deficiency of Factor VIII), hemophilia B (deficiency of Factor IX), and von Willebrand disease. Management of pharmacoresistant epilepsy is more difficult in a patient with bleeding disorder due to increased risk of bleeding during surgery.

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Background And Objectives: There is a paucity of data directly comparing the outcome of surgical techniques available for the treatment of hypothalamic hamartomas (HHs). This study aims to evaluate the safety and efficacy of commonly used surgical approaches in the treatment of HH-related epilepsy.

Methods: A systematic review and individual participant data (IPD) meta-analysis was conducted.

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The interaction between basic science epilepsy researchers and clinical epileptologists is a longstanding issue. Efforts to provide opportunities for a dialogue between preclinical and clinical epilepsy professionals are crucial to reduce the knowledge gap between them and improve the translational success of neurobiology-based research. The International League Against Epilepsy (ILAE) Research and Innovation Task Force circulated a survey to investigate the need for an update on new clinical epilepsy concepts within the basic science community.

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Article Synopsis
  • Right and bilateral language representation in focal epilepsy may be influenced by seizure activity and lesions in the left hemisphere, with research suggesting that earlier seizure onset could lead to atypical language lateralization due to childhood brain plasticity.
  • A meta-analysis examined the link between age at seizure onset and language lateralization using fMRI, finding a small but significant correlation (r=0.1, p=.005) between earlier onset and rightward lateralization across various samples.
  • The study concluded that while there is a slight association consistent with theories of declining language plasticity, this relationship is subtle and not a reliable indicator of atypical language lateralization for individual patients.
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In healthy adults different language abilities-sentence processing versus emotional prosody-are supported by the left (LH) versus the right hemisphere (RH), respectively. However, after LH stroke in infancy, RH regions often support both abilities with normal outcomes. This finding raises an important question: How does the functional map of RH regions change to support both emotional prosody and also typically left-lateralized language functions after an early LH stroke? Does sentence processing simply become reflected into RH frontotemporal regions and overlap with emotional prosody processing? Or do these functions overlap less than would be expected with simple mirroring? In the current work we used task fMRI to examine precisely how sentence processing and emotional prosody processing are both organized in the intact RH of individuals who suffered a large LH perinatal arterial ischemic stroke (LHPS participants).

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Purpose: Evaluate the relationship between first and second-line medication dosing and progression to refractory status epilepticus (RSE) in children.

Methods: This is a retrospective analysis of prospectively collected data from September 2014 to February 2020 of children with status epilepticus (SE) who received at least two antiseizure medications (ASMs). We evaluated the risk of developing RSE after receiving a low total benzodiazepine dose (lower than 100 % of the minimum recommended dose for each benzodiazepine dose administered within 10 min) and a low first non-benzodiazepine ASM dose (lower than 100 % of the minimum recommended dose of non-benzodiazepine ASM given as the first single-dose) using a logistic regression model, adjusting for confounders such as time to ASMs.

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Article Synopsis
  • * Researchers used advanced imaging techniques to analyze how different parts of the hippocampus connect with specific cortical pathways during brain development, with the front part linked to the anterior temporal pathway and the back part to the posterior medial pathway.
  • * The study found that as brains develop, there is a shift in connectivity from the back to the front of the hippocampus, emphasizing its role in episodic memory and identifying key regions that influence how the hippocampus integrates into broader brain functions.
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Objective: The purpose of this study was to evaluate the performance and generalizability of an automated, interpretable surface-based MRI classifier for the detection of focal cortical dysplasia.

Methods: This was a retrospective cohort incorporating MRIs from the epilepsy surgery (FCD and MRI-negative) and neuroimaging (healthy controls) databases at Children's National Hospital (CNH), and a publicly-available FCD Type II dataset from Bonn, Germany. Clinical characteristics and outcomes were abstracted from patient records and/or existing databases.

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Objective: To determine common network alterations in focal cortical dysplasia pharmacoresistant epilepsy (FCD-PRE) using functional connectivity analysis of resting-state functional magnetic resonance imaging (rsfMRI).

Methods: This is a retrospective imaging cohort from Children's National Hospital (Washington, DC, USA) from January, 2011 to January, 2022. Patients with 3-T MRI-confirmed FCD-PRE underwent rsfMRI as part of routine clinical care.

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Introduction: Stereoelectroencephalography (SEEG) is valuable for delineating the seizure onset zone (SOZ) in pharmacoresistant epilepsy when non-invasive presurgical techniques are inconclusive. Secondary epilepsy surgery after initial failure is challenging and there is limited research on SEEG following failed epilepsy surgery in children.

Objective: The objective of this manuscript is to present the outcomes of children who underwent SEEG after failed epilepsy surgery.

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In healthy adults different language abilities-sentence processing versus emotional prosody-are supported by the left (LH) versus the right hemisphere (RH), respectively. However, after LH stroke in infancy, RH regions support both abilities with normal outcomes. We investigated how these abilities co-exist in RH regions after LH perinatal stroke by evaluating the overlap in the activation between two fMRI tasks that probed auditory sentence processing and emotional prosody processing.

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The ILAE Neuroimaging Task Force publishes educational case reports that highlight basic aspects of neuroimaging in epilepsy consistent with the ILAE's educational mission. Subcortical laminar heterotopia, also known as subcortical band heterotopia (SBH) or "double cortex," is an intriguing and rare congenital malformation of cortical development. SBH lesions are part of a continuum best designated as agyria-pachygyria-band-spectrum.

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There is insufficient evidence regarding the efficacy of epilepsy surgery in patients with pharmacoresistant focal epilepsy and coexistent DEPDC5 (dishevelled EGL-10 and pleckstrin domain-containing protein 5) pathogenic (P), likely pathogenic (LP), or variance of unknown significance (VUS) variants. To conduct a systematic review on the literature regarding the use and efficacy of epilepsy surgery as an intervention for patients with DEPDC5 variants who have pharmacoresistant epilepsy. A systematic review of the current literature published regarding the outcomes of epilepsy surgery for patients with DEPDC5 variants was conducted.

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Emerging neuromodulatory treatments, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), have shown promise in reducing drug-resistant seizures. While centromedian thalamic nucleus and anterior thalamic nucleus stimulation have been effective in certain types of seizures, limited research has explored pulvinar nucleus stimulation for epilepsy. To address this gap, we conducted a systematic review and individual patient data analysis.

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Article Synopsis
  • Scientists wanted to see how people's brains can adapt when part of the brain is damaged at birth, especially in language.
  • They looked at brain scans of 14 people who had strokes on one side of their brain and compared them to healthy siblings.
  • They found that the healthy side of the brain (the right side) took over some language tasks, using parts that worked similarly to how the left side usually does in people without brain damage.
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  • Lennox-Gastaut syndrome (LGS) is a severe epilepsy disorder in children that is hard to treat; when medications fail, surgeries like vagus nerve stimulation (VNS) and corpus callosotomy (CC) may be options, with CC often being more effective.
  • This study reviewed the outcomes of 127 children with LGS who had undergone CC after unsuccessful VNS, focusing on their seizure types and surgery results.
  • The findings showed that about 83% of patients experienced at least a 50% reduction in drop attacks after CC, demonstrating that CC is an important option for improving seizure control with low surgical risks.
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Article Synopsis
  • - Screenings for ADHD and emotional issues are important for children with epilepsy, but there’s not enough research on which screening tools to use in clinics.
  • - In a study involving 50 parents of children aged 5-17 with epilepsy, various screening tools were compared, including the Strengths and Difficulties Questionnaire and the Pediatric Quality of Life Inventory.
  • - The study found positive screening rates for ADHD (40%-72%) and emotional concerns (38%-46%), with varying levels of agreement between the measures, suggesting that while all are effective, they may differ in specificity and usability.
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Focal cortical dysplasia (FCD) is the most frequent etiology of operable pharmacoresistant epilepsy in children. There is burgeoning evidence that FCD-related epilepsy is a disorder that involves distributed brain networks. Functional magnetic resonance imaging (fMRI) is a tool that allows one to infer neuronal activity and to noninvasively map whole-brain functional networks.

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To evaluate the role of focal cortical dysplasia co-localization to cortical functional networks in the development of pharmacoresistance. One hundred thirty-six focal cortical dysplasia patients with 3.0 T or 1.

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Purpose: Delayed treatment in status epilepticus (SE) is independently associated with increased treatment resistance, morbidity, and mortality. We describe the prehospital management pathway and Emergency Medical Services (EMS) timeliness in children who developed refractory convulsive status epilepticus (RCSE).

Methods: Retrospective multicenter study in the United States using prospectively collected observational data from June 2011 to March 2020.

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Central venous catheter placement continues to be an extremely common procedure throughout hospital systems. Although ultrasound guidance can mitigate some placement risks, misplacement of lines into neighboring structures, such as arteries, remains an unfortunate complication. In this report, we will discuss an 83-year-old female with aberrant left subclavian artery and right sided arch, which provided for successful stent graft coverage of arterial injury secondary to accidental subclavian artery cannulation with a central venous catheter with preservation of the right common carotid artery and avoidance of a potentially morbid sternotomy.

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Objective: Focal cortical dysplasia (FCD) is the most common etiology of surgically-remediable epilepsy in children. Eighty-seven percent of patients with FCD develop epilepsy (75% is pharmacoresistant epilepsy [PRE]). Focal to bilateral tonic-clonic (FTBTC) seizures are associated with worse surgical outcomes.

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