Fluid suppression in amide proton transfer-weighted (APTw) CEST imaging: New theoretical insights and clinical benefits.

Purpose: Amide proton transfer-weighted (APTw) MRI at 3T provides a unique contrast for brain tumor imaging. However, APTw imaging suffers from hyperintensities in liquid compartments such as cystic or necrotic structures and provides a distorted APTw signal intensity. Recently, it has been shown that heuristically motivated fluid suppression can remove such artifacts and significantly improve the readability of APTw imaging.

The role of the electroencephalogram (EEG) in determining the aetiology of catatonia: a systematic review and meta-analysis of diagnostic test accuracy.

Background: Catatonia is a psychomotor syndrome that has a wide range of aetiologies. Determining whether catatonia is due to a medical or psychiatric cause is important for directing treatment but is clinically challenging. We aimed to ascertain the performance of the electroencephalogram (EEG) in determining whether catatonia has a medical or psychiatric cause, conventionally defined.

Development of a patient journey map for people living with cervical dystonia.

Background: Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment.

Methods: The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group.

Management of Secondary Poor Response to Botulinum Toxin in Cervical Dystonia: A Multicenter Audit.

Background: Botulinum toxin A (BoNT-A) is an effective treatment for cervical dystonia. Nevertheless, up to 30% to 40% patients discontinue treatment, often because of poor response. The British Neurotoxin Network (BNN) recently published guidelines on the management of poor response to BoNT-A in cervical dystonia, but adherence to these guidelines has not yet been assessed.

Manual and automated tissue segmentation confirm the impact of thalamus atrophy on cognition in multiple sclerosis: A multicenter study.

Background And Rationale: Thalamus atrophy has been linked to cognitive decline in multiple sclerosis (MS) using various segmentation methods. We investigated the consistency of the association between thalamus volume and cognition in MS for two common automated segmentation approaches, as well as fully manual outlining.

Methods: Standardized neuropsychological assessment and 3-Tesla 3D-T1-weighted brain MRI were collected (multi-center) from 57 MS patients and 17 healthy controls.

Sex differences in memory clinic patients with possible vascular cognitive impairment.

Introduction: We aimed to establish sex differences in vascular brain damage of memory clinic patients with possible vascular cognitive impairment (VCI).

Methods: A total of 860 memory clinic patients (aged 67.7 ± 8.

Prediction of poor clinical outcome in vascular cognitive impairment: TRACE-VCI study.

Introduction: Prognostication in memory clinic patients with vascular brain injury (eg possible vascular cognitive impairment [VCI]) is often uncertain. We created a risk score to predict poor clinical outcome.

Methods: Using data from two longitudinal cohorts of memory clinic patients with vascular brain injury without advanced dementia, we created (n = 707) and validated (n = 235) the risk score.

Amyloid β influences the relationship between cortical thickness and vascular load.

Introduction: Cortical thickness has been proposed as a biomarker of Alzheimer's disease (AD)- related neurodegeneration, but the nature of its relationship with amyloid beta (Aβ) deposition and white matter hyperintensity volume (WMHV) in cognitively normal adults is unclear.

Methods: We investigated the influences of Aβ status (negative/positive) and WMHV on cortical thickness in 408 cognitively normal adults aged 69.2 to 71.

Possible role of skeletal muscle mutation in apnea during seizure.

gene mutations cause a number of neuromuscular phenotypes including myotonia. A subset of infants with myotonia-causing mutations experience severe life-threatening episodic laryngospasm with apnea. We have recently identified similar mutations in association with sudden infant death syndrome.

Aging related cognitive changes associated with Alzheimer's disease in Down syndrome.

Objective: Individuals with Down syndrome (DS) have an extremely high genetic risk for Alzheimer's disease (AD), however, the course of cognitive decline associated with progression to dementia is ill-defined. Data-driven methods can estimate long-term trends from cross-sectional data while adjusting for variability in baseline ability, which complicates dementia assessment in those with DS.

Methods: We applied an event-based model to cognitive test data and informant-rated questionnaire data from 283 adults with DS (the largest study of cognitive functioning in DS to date) to estimate the sequence of cognitive decline and individuals' disease stage.

The Markov blankets of life: autonomy, active inference and the free energy principle.

This work addresses the autonomous organization of biological systems. It does so by considering the boundaries of biological systems, from individual cells to , in terms of the presence of Markov blankets under the active inference scheme-a corollary of the free energy principle. A Markov blanket defines the boundaries of a system in a statistical sense.

Predicting green: really radical (plant) predictive processing.

In this article we account for the way plants respond to salient features of their environment under the free-energy principle for biological systems. Biological self-organization amounts to the minimization of surprise over time. We posit that any self-organizing system must embody a generative model whose predictions ensure that (expected) free energy is minimized through action.

Right hippocampal pathology inhibits the Flynn effect in temporal lobe epilepsy.

If brain pathology impedes the mechanisms that drive the Flynn effect, the gap between the mean IQ of patient groups and the general population will increase over successive generations. We examined the IQs of a large series of patients aged between 18 and 35 years, with homogenous underlying brain pathology tested over two decades, for evidence of a Flynn effect; 381 patients with temporal lobe epilepsy and unilateral hippocampal sclerosis (n = 221 left hippocampal sclerosis, LHS; n = 160 right hippocampal sclerosis, RHS) completed the Wechsler Adult Intelligence Scales. Patients assessed between 1990 and 2000 were assessed on the Wechsler Adult Intelligence Scale-Revised (WAIS-R; n = 234).

The epileptic singers of belle époque Paris.

In late 19th century Paris, people with epilepsy were treated alongside those with hysteria in the now famous Salpêtrière Hospital, where both conditions were deemed to have a neurological basis. When Jean Martin Charcot became chief physician at the Salpêtrière Hospital in 1862, he described himself 'in possession of a kind of museum of living pathology whose holdings were virtually inexhaustible'. He opened the doors of his 'living museum' and exhibited his prize specimens to all of Paris.

Light therapy as a treatment for epilepsy.

From a neurobiological level to epidemiological studies, there are four strands of evidence in the scientific literature that indicate that light therapy could be an effective treatment for some people with epilepsy. (1) Sunlight is important in the endogenous production and regulation of melatonin and vitamin D, both of which influence seizure thresholds. Although melatonin influences seizure thresholds, the relationship is complex.

Beyond localization: the role of traditional neuropsychological tests in an age of imaging.

Rapid advances in structural and functional magnetic resonance imaging (MRI) present two significant challenges to the rationale and role of the traditional neuropsychological assessment in the presurgical evaluation of epilepsy surgery candidates today. The first is a direct challenge to the model of material-specific memory that has underpinned much clinical practice over the last 50 years. The second, more fundamental, challenge goes to the very heart of the lateralizing/localizing approach that has been the cornerstone of clinical neuropsychology practice in epilepsy surgery centers to date.

Socioeconomic status, cognition, and hippocampal sclerosis.

Objective: Poorer surgical outcomes in patients with low socioeconomic status have previously been reported, but the mechanisms underlying this pattern are unknown. Lower socioeconomic status may be a proxy marker for the limited economic opportunities associated with compromised cognitive function. The aim of this study was to examine the preoperative neuropsychological characteristics of patients with unilateral hippocampal sclerosis (HS) and their relationship to socioeconomic status.

The Flynn effect and memory function.

The Flynn effect refers to the steady increase in IQ that appears to date back at least to the inception of modern-day IQ tests. This study examined the possible Flynn effects on clinical memory tests involving the learning and recall of verbal and nonverbal material. Comparisons of the age-related norms on the list learning and design learning tasks from the Adult Memory and Information Processing Battery (AMIPB), published in 1985, and its successor, the BIRT (Brain Injury Rehabilitation Trust) Memory and Information Processing Battery (BMIPB) published in 2007, indicate that there is a significant Flynn effect on tests of memory function.

Seeing the light? Seizures and sunlight.

We examined 1715 seizures recorded on a dedicated epilepsy inpatient ward over 363 days in 2006-2007. Epileptic seizures, particularly complex partial seizures are less likely to occur on bright sunny days, than dull days. This correlation remains stable when seasonal patterns are controlled for.

Long term monitoring in refractory epilepsy: the Gowers Unit experience.

Introduction: Guidelines from the National Institute for Health and Clinical Excellence (NICE) and the International League Against Epilepsy recommend long term EEG monitoring (LTM) in patients for whom seizure or syndrome type is unclear, and in patients for whom it is proving difficult to differentiate between epilepsy and non-epileptic attack disorder (NEAD). The purpose of this study was to evaluate this recommended use of LTM in the setting of an epilepsy tertiary referral unit.

Methods: This study reviewed the case notes of all admissions to the Sir William Gowers Unit at the National Society for Epilepsy in the years 2004 and 2005.

Improvements in memory function following anterior temporal lobe resection for epilepsy.

Background: While up to a third of patients may experience a decline in memory following an anterior temporal lobe resection (ATL) for epilepsy, between 10 and 20% may experience a postoperative improvement in function. The aim of this study was to examine the preoperative characteristics of these patients.

Methods: Logistic regression analyses were used to determine which variables influenced postoperative memory improvement following ATL on standardized memory tests in 237 patients with unilateral hippocampal sclerosis (105 right; 132 left).

Preoperative amygdala fMRI in temporal lobe epilepsy.

Purpose: Anterior temporal lobe resections (ATLR) benefit 70% of patients with refractory mesial temporal lobe epilepsy (TLE), but may be complicated by emotional disturbances. We used functional magnetic resonance imaging (fMRI) to investigate the role of the amygdala in processing emotions in TLE and whether this may be a potential preoperative predictive marker for emotional disturbances following surgery.

Methods: We studied 54 patients with refractory mesial TLE due to hippocampal sclerosis (28 right, 26 left) and 21 healthy controls using a memory encoding fMRI paradigm, which included viewing fearful and neutral faces.

Moonstruck? The effect of the lunar cycle on seizures.

Recent reports on the effects of the lunar cycle on seizure occurrence have yielded mixed results. If the moon phase is influential, we hypothesized that this would be due to the moon's contribution to nocturnal illumination, rather than its waxing or waning state, and that significant correlations would not be apparent if local cloud cover were controlled for. We found a significant negative correlation between the mean number of seizures and the fraction of the moon illuminated by the sun (rho=-0.

Imaging the brain's highways-diffusion tensor imaging in epilepsy.

Diffusion tensor imaging evaluates the motion of water at the voxel level and can provide data on the structural integrity of brain tissue, with quantitative measures of diffusion and fractional anisotropy. Imaging of the orientation of preferential diffusion of water in the brain can visualize major white matter pathways and infer the structural basis of cerebral networks. Thus, how these pathways and networks may be altered in specific epilepsy syndromes and in consequence to therapies can be assessed with the aid of these images.