bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional MRI Predicts Memory Performance after Right Mesiotemporal Epilepsy Surgery
Authors: Janszky Jozsef , Jokeit Hennric , Kontopoulou Konstantina , Mertens Markus , Ebner Alois , Pohlmann‐Eden Bernd , Woermann Friedrich G. 
Published: January 2005

Summary:  Purpose: Anterior temporal lobe resection (ATR) is a treatment option in drug‐resistant epilepsy. An important risk of ATR is loss of memory because mesiotemporal structures contribute substantially to memory function. We investigated whether memory‐activated functional MRI (fMRI) can predict postoperative memory loss after anterior temporal lobectomy in right‐sided medial temporal lobe epilepsy (MTLE). Methods: We included 16 patients (10 women) aged 16–54 years. The mean age at epilepsy onset was 12.5 years (range, 1–26 years). The patients' mean Wechsler IQ score was 95.2 (range, 62–125). The activation condition of fMRI consisted of retrieval from long‐term memory induced by self‐paced performance of an imaginative walk. All but one patient had left‐sided speech dominance according to speech‐activated fMRI. Outside the scanner, we evaluated the pre‐ and postoperative visual memory retention by using Rey Visual Design Learning Test. Results: We found a correlation between the preoperative asymmetry index of memory‐fMRI and the change between pre‐ and postsurgical measures of memory retention. Reduced activation of the mesiotemporal region ipsilateral to the epileptogenic region correlated with a favorable memory outcome after right‐sided ATR. Conclusions: In light of the postoperative results, the theoretical implication of our study is that fMRI based on a simple introspective retrieval task measures memory functions. The main clinical implication of our study is that memory‐fMRI might replace the invasive Wada test in MTLE by using a simple fMRI paradigm. Predictive power, however, will be studied in larger patient samples. Other studies are required for left‐sided MTLE and neocortical epilepsies to assess the clinical usefulness of memory‐fMRI.
The Role of bcl‐2 Family of Genes During Kindling
Authors: Akcali Kamil Can , Sahiner Melike , Sahiner Turker 
Published: January 2005

Summary:  Purpose: Several experimental models of human temporal lobe epilepsy have shown that apoptotic death of neurons is an important part of this degenerative disease. However, the role of apoptotic regulators is not clear during the epileptogenesis. Therefore we investigated the expression pattern of bcl‐2 family of genes during the formation of kindling model of epilepsy in rats. Methods: We examined the expression pattern of bax, bcl‐2, bcl‐xL, mtd, and bcl‐w both at messenger RNA (mRNA) and protein level in the brain tissues during the formation of epilepsy with kindling model in adult rats, which has been the most acceptable form of experimental model of human epilepsy. We also assessed the onset of DNA fragmentation by using the terminal deoxynucleotidyl transferase–mediated dUTP nick‐end labeling (TUNEL) assay. Results: Animals have started to have epileptic discharges after day 10 of kindling model. Recurrent subthreshold electrical stimuli induced not only epileptic foci but also the expression of bax, an inducer of apoptosis, in this time period. Conversely, bcl‐xL, which is an inhibitor of apoptosis, had an opposite pattern of expression both at mRNA and protein level during the formation of epilepsy. We did not observe DNA fragmentation by TUNEL staining. Conclusions: Our study shows differential expression of Bax and Bcl‐xL at the CA1 region during the formation of hippocampal kindling model. The absence of DNA fragmentation during this period suggests that epileptic changes in neurons have the potential to induce DNA fragmentation by altering the expression levels of Bax and Bcl‐xL.
Incidence of Fractures among Epilepsy Patients: A Population‐based Retrospective Cohort Study in the General Practice Research Database
Authors: Souverein Patrick C. , Webb David J. , Petri Hans , Weil John , Van Staa Tjeerd P. , Egberts Toine 
Published: January 2005

Summary:  Purpose: To compare the incidence of various fractures in a cohort of patients with epilepsy with a reference cohort of patients not having epilepsy. Methods: Patients were included in the epilepsy cohort if they had at least one diagnosis of epilepsy in their medical history and had sufficient evidence of “active” epilepsy (use of antiepileptic drugs, diagnoses) after the practice was included in the General Practice Research Database (GPRD). Two reference patients were sampled for each patient with epilepsy from the same practice. Primary outcome was the occurrence of any fracture during follow‐up. Poisson regression analysis was used to estimate incidence density ratios (IDRs). Results: The study population comprised 40,485 and 80,970 patients in the epilepsy and reference cohorts, respectively. The median duration of follow‐up was ∼3 years. The overall incidence rate in the epilepsy cohort was 241.9 per 10,000 person‐years. This rate was about twice as high as that in reference cohort: age‐ and sex‐adjusted IDR, 1.89 (95% CI, 1.81–1.98). When comparing IDRs among the different groups of fractures, the highest relative‐risk estimate was found for hip and femur fractures (adjusted IDR, 2.79; 95% CI, 2.41–3.24). IDRs were consistently elevated across age and sex groups and across fracture subtypes. Conclusions: The overall risk of fractures was nearly twice as high among patients with epilepsy compared with the general population. The relative fracture risk was highest for hip and femur. Further study is necessary to elucidate whether this elevated risk is due to the disease, the use of antiepileptic drugs, or both.
Reduced Anesthetization during the Intracarotid Amobarbital (Wada) Test in Patients Taking Carbonic Anhydrase–Inhibiting Medications
Authors: Bookheimer Susan , Schrader Lara M. , Rausch Rebecca , Sankar Raman , Engel Jerome 
Published: January 2005

Summary:  Purpose: Failure to show adequate anesthetization during the intracarotid amobarbital procedure (IAP or “Wada test”) is a rare complication. After an unusually high rate of recent anesthetization failures, we sought to determine the frequency of reduced anesthetization and any common factors underlying these failures. Methods: We reviewed the records of all patients who underwent IAP tests through the UCLA Seizure Disorder Center between September 1999 and May 2002. Age, date, epileptogenic focus, radiologist, and current medications were all considered. Results: Of a total of 56 patients who underwent our intracarotid amobarbital examination, 11 (19.6%) showed either very rapid recovery (≤1 min) or anesthetization failure. Of these, 10 (91%) of 11 were taking a medication with some carbonic anhydrase–inhibiting (CAI) properties (topiramate (TPM), n = 7; zonisamide (ZNS), n = 2; hydrochlorothiazide and furosemide, n = 1 each). The only patient of 40 (2.5%) who was not taking any CAI drugs and showed an early IAP recovery (55 s) had recently discontinued TPM. IAPs performed on patients after weaning from TPM showed a correlation between length of drug discontinuation and duration of anesthesia effect. Conclusions: Our data strongly suggest that recent failures of anesthetization during the IAP are associated with a possible interaction between amobarbital and medications possessing CAI properties. We suggest that the IAP be performed only after ≥8 weeks after discontinuation of such medications.
Characterization of the Tetanus Toxin Model of Refractory Focal Neocortical Epilepsy in the Rat
Authors: Nilsen Karen E. , Walker Matthew C. , Cock Hannah R. 
Published: January 2005

Summary:  Purpose: To characterize in detail a model of focal neocortical epilepsy. Methods: Chronic focal epilepsy was induced by injecting 25–50 ng of tetanus toxin or vehicle alone (controls) into the motor neocortex of rats. EEG activity was recorded from electrodes implanted at the injection site, along with facial muscle electromyographic (EMG) activity and behavioral monitoring intermittently for up to 5 months in some animals. Drug responsiveness was assessed by using the antiepileptic drugs (AEDs) diazepam (DZP) and phenytoin (PHT) delivered systemically, while 1,2,3,4‐tetrahydro‐6‐nitro‐2,3‐dioxo‐benzo[f]quinoxaline‐7‐sulfonamide (NBQX), a competitive antagonist at AMPA receptors, was administered directly to the brain to investigate the potential benefits of focal drug delivery. Results: Tetanus toxin induced mild behavioral seizures that persisted indefinitely in all animals. EEG spiking activity, occurring up to 80% of the time, correlated with clinical seizures consisting of interrupted behavioral activity, rhythmic bilateral facial twitching, and periods of abrupt motor arrest. Seizures were refractory to systemic administration of DZP and PHT. However, focal delivery of NBQX to the seizure site reversibly reduced EEG and behavioral seizure activity without detectable side effects. Conclusions: This study provides a long‐term detailed characterisation of the tetanus toxin model. Spontaneous, almost continuous, well‐tolerated seizures occur and persist, resembling those seen in neocortical epilepsy, including cortical myoclonus and epilepsia partialis continua. The seizures appear to be similarly resistant to conventional AEDs. The consistency, frequency, and clinical similarity of the seizures to refractory epilepsy in humans make this an ideal model for investigation of both mechanisms of seizure activity and new therapeutic approaches.
Health‐related Quality of Life and Self‐perceived Competence of Children Assessed before and up to Two Years after Epilepsy Surgery
Authors: Van Empelen Ron , Jennekens‐Schinkel Aag , Van Rijen Peter C. , Helders Paul J. M. , Van Nieuwenhuizen Onno 
Published: January 2005

Summary:  Purpose: To measure outcome of epilepsy surgery in terms of health‐related quality of life (HrQoL) and self‐perceived competence of children and adolescents. Methods: Prospective longitudinal follow‐up study of 21 patients (aged 6.2 to 16.8 years). Frequency and severity of seizures and epilepsy‐related restrictions, HrQoL, and self‐perceived competence were rated before and 6, 12, and 24 months after epilepsy surgery. Data were analysed nonparametrically and using analysis of variance for repeated measures. Results: Group‐wise, seizure parameters had almost normalized 6 months after surgery (p < 0.001) and remained so. Two years after surgery, 15 (72%) patients were free of seizures. At the first postsurgical assessment, parents and children evaluated the frequency of activities as improved and that of seizures as diminished (p < 0.05). Parents evaluated their children as having positive emotions more frequently (p < 0.05). Children started to feel better about seizure variables in the second year after surgery. Two years after surgery, children perceived themselves as being socially more competent and having greater self‐worth (p = 0.05). In the adolescent group, several aspects of self‐perceived competence improved shortly after surgery (p < 0.05), whereas 2 years after surgery, athletic competence and romance had improved (p < 0.05). Conclusions: In children and adolescents, epilepsy surgery sets the stage for improvement in HrQoL and in competence to participate in social and societal domains. Most improvement occurs in the first 6 months after surgery.
Glutamate Receptor Antagonists and Benzodiazepine Inhibit the Progression of Granule Cell Dispersion in a Mouse Model of Mesial Temporal Lobe Epilepsy
Authors: Suzuki Fumio , Heinrich Christophe , Boehrer Any , Mitsuya Koichi , Kurokawa Kiyoshi , Matsuda Masayuki , Depaulis Antoine 
Published: January 2005

Summary:  Purpose: Unilateral intrahippocampal injection of kainic acid (KA) in adult mice induces the progressive dispersion of dentate granule cells, one of the characteristic pathologic changes of mesial temporal lobe epilepsy. However, little is known about the mechanisms that trigger this dispersion. In this study, the possible involvement of glutamatergic and γ‐aminobutyric acid (GABA)ergic neurotransmissions in the development of granule cell dispersion (GCD) was examined in this model. Methods: Antagonists of N‐methyl‐d‐aspartate (NMDA) receptor (MK‐801) and non‐NMDA receptor (GYKI52466), and an agonist of benzodiazepine‐GABAA receptor (midazolam) were injected before and after KA in various ways, and the morphologic changes of the hippocampus, especially GCD, were examined. Results: MK‐801 (5 mg/kg, i.p.) did not reduce GCD when injected 2 h before KA injection but inhibited GCD almost completely for ≤14 days, when injected 4 h after KA. However, mild to moderate dispersion was observed at 28 days, indicating that MK‐801 may delay the progression of GCD. Similarly, daily treatment with MK‐801 (2 × 1 mg/kg i.p./day) for the first 26 days after KA significantly reduced GCD. In contrast, GYKI52466 (30 mg/kg, s.c.) was effective only when it was injected before KA. A significant reduction of GCD was also observed after continuous administration of midazolam (10 mg/kg/h) after KA. Conclusions: These data show that GCD in this mouse model is triggered by either the stimulation of the NMDA receptor or reduction of GABAA‐mediated inhibition after intrahippocampal injection of KA. It is suggested that the increased excitation or the reduced inhibition or both could be one of the factors triggering or maintaining or both the process of GCD.
Hippocampal Afterdischarges after GABAB‐Receptor Blockade in the Freely Moving Rat
Authors: Leung L. Stan , Canning Kevin J. , Shen Bixia 
Published: January 2005

Summary:  Purpose: To determine whether hippocampal afterdischarges (ADs) and excitability changes were induced by γ‐aminobutyric acid (GABA)B‐receptor blockade in adult, freely moving rats. Methods: A specific GABAB‐receptor antagonist CGP35348, CGP55845A, or CGP55699A was injected intracerebroventricularly (i.c.v.), and EEGs and behaviors of rats were analyzed. Results: CGP35348 (56–110 μg, i.c.v.) induced afterdischarges (ADs) ∼60% of the time, starting at the hippocampus or neocortex. Neocortical‐onset ADs began with sporadic discharges and were <3 mV. Hippocampal‐onset ADs were bilateral, >5 mV, and spread to the entorhinal cortex and amygdala, often ending in a rebound AD and accompanied with stereotypic jumping, forelimb clonus, and wet‐dog shakes. The CGP35348‐induced hippocampal AD had an onset frequency (5–9 Hz) that was higher than the electrically evoked AD (2–4 Hz). CGP35348 i.c.v. also increased the mean starting frequency of an electrically evoked hippocampal AD from 3.6 Hz to 5.3 Hz. Hippocampal gamma activity (25–80 Hz) increased up to twofold for 30 min after a hippocampal but not a neocortical AD. A single dose of CGP35348 induced repeated ADs of increasing duration. Paired‐pulse inhibition of the evoked potentials in CA1, at interpulse interval of <100 ms, was decreased after but not before a hippocampal AD. CGP56999A (i.c.v.) gave results similar to those with CGP35348, whereas CGP55845A (i.c.v.) rarely induced ADs. Conclusions: GABAB‐receptor blockade increases seizure susceptibility by reducing AD threshold and increasing the frequency and spread of a hippocampal AD. Hippocampal excitability (based on paired‐pulse test) and gamma activity increased after but not before a hippocampal AD.
Worldwide Use of the Ketogenic Diet
Authors: Kossoff Eric H. , McGrogan Jane R. 
Published: January 2005

Summary:  Purpose: Over the past decade, the use of the ketogenic diet internationally has increased dramatically. The purpose of this survey was to evaluate the use of the diet worldwide. Methods: With the use of the Internet, e‐mail requests for information about international ketogenic diet centers (outside the United States) were made over a 9‐month period. Assistance also was obtained from the Child Neurology Society and International League Against Epilepsy. Questions included patient enrollment (total and annually), year the diet was first offered, unique cultural and religious issues in the country, community opinion, and research interests. Results: Successful communication was made with 73 academic centers in 41 countries outside the United States. Sixteen (39%) countries provided information from multiple centers. The median duration offering the diet was 8 years (range, 1–45 years). The average number of patients enrolled to date was 71.6 per country, with 5.4 new patients annually. Common difficulties included avoiding rice intake, tolerating higher fat‐to‐protein and carbohydrate ratios (e.g., 4:1), finding specific nutritional labels on foods, and handling the growing interest from large populations with limited resources. Nevertheless, cultural and religious issues were generally not limiting; physician and patient acceptance of the diet as an option is high; and most meals were similar among countries. Centers often had great pride in their programs, and international collaborative groups are forming rapidly. A website is now available with updated center information at http://www.neuro.jhmi.edu/Epilepsy/Peds/ketoworldwide.htm Conclusions: Despite occasional difficulties, the ketogenic diet is being used worldwide.
Limbic Self‐sustaining Status Epilepticus in Rats Is Not Associated with Hyperthermia
Authors: Schmitt Friedhelm C. , Matzen Julia , Buchheim Katharina , Meierkord Hartmut , Holtkamp Martin 
Published: January 2005

Summary:  Purpose: To evaluate the impact of limbic status epilepticus on temperature. Methods: The perforant path in freely moving rats was stimulated electrically for 120 min to induce self‐sustaining status epilepticus (SSSE). For 150 min after the end of stimulation, epidural temperature and electrographic and clinical seizure activity were assessed in animals with limbic and motor SSSE, as well as in animals without development of SE. Results: Temperature in all animals with SSSE was elevated by 1.5 ± 0.8°C after the end of stimulation compared with baseline values (p < 0.01). In animals with pure limbic SE, temperature decreased continuously to baseline values over the 150‐min period of observation. In contrast, in animals with motor SSSE, temperature remained elevated during continuing epileptic activity and was still significantly higher 150 min after the end of stimulation compared with baseline (p < 0.01). In animals that did not develop SSSE, temperature was not changed after the end of electrical stimulation and in the 150 min thereafter compared with baseline values. Conclusions: The results indicate that hyperthermia as seen in SE is the consequence of motor convulsions and not of epileptic activity itself, as seen in limbic SSSE.
Kindling Limits the Interictal Neuronal Temporal Response Properties in Cat Primary Auditory Cortex
Authors: Valentine Pamela A. , Teskey G. Campbell , Eggermont Jos J. 
Published: January 2005

Summary:  Purpose: The present study examined the effect of electrical kindling on the interictal temporal response properties of single units recorded from primary auditory cortex (AI) of the adult cat. Methods: Cats were permanently implanted with electrodes in AI, kindled twice daily for 40 sessions, and the contralateral AI was subsequently mapped. Kindling stimulation consisted of 1‐s trains of biphasic square‐wave pulses applied at a frequency of 60 Hz, 100 μA above the afterdischarge (AD) threshold. The EEG activity was recorded during each kindling session, and the behavioral manifestation was scored. Subsequent to kindling, multiple single‐unit responses were recorded under ketamine anesthesia in response to 1‐s‐long periodic click trains, with click rates between 2 and 64 Hz. Neuronal responses were characterized according to their ability to respond in time‐locked fashion to the clicks. Results: Kindling stimulation resulted in progression of the AD characteristics and seizure behavior, with six of 10 kindled cats reaching a fully generalized state. In the fully kindled cats, the best modulation frequencies and limiting following rates for the single‐unit responses were significantly lower compared with those of naive and sham controls. Conclusions: Repeated epileptiform activity interferes with temporal processing in cat auditory cortex in the interictal state. This may have implications for people with epileptic foci in auditory‐related areas.
Efficacy and Safety of the Ketogenic Diet for Intractable Childhood Epilepsy: Korean Multicentric Experience
Authors: Chul Kang Hoon , Joo Kim Yong , Wook Kim Dong , Dong Kim Heung 
Published: January 2005

Summary:  Purpose: We wished to evaluate the efficacy and safety of the ketogenic diet (KD), and we also evaluated the prognosis of the patients after successful discontinuation of the diet in infants, children, and adolescents with refractory epilepsy. Methods: This was a retrospective study of epilepsy patients treated with the KD during 1995 through 2003 at the Korean multicenters. Outcome measures included seizure frequency, electroencephalography (EEG), adverse reactions, and antiepileptic drug (AED) number. The variables related to the efficacy and prognosis also were analyzed. Results: The outcomes of the 199 patients enrolled in this study at 6 and 12 months after the diet were revealed; 68% and 46% of patients remained on the diet, 58% and 41% showed a reduction of seizure frequency of >50%, including 33% and 25% who became seizure free, respectively. Finally, 66 (34%) of 199 patients successfully completed or maintained the diet. EEGs showed an improvement in background in 40 (72.7%) of 55 patients and a reduction in generalized and focal discharges in 41 (57.7%) of 71 and 15 (33.3%) of 45 patients. Most complications were mild, but five patients died during the KD. No significant variables were related to the efficacy, but those with symptomatic (p = 0.047) and partial epilepsies (p = 0.073) showed more frequent relapse after completion of the diet. Conclusions: The KD is a safe and effective alternative therapy for intractable childhood epilepsy in Korea, although the customary diet contains substantially less fat than traditional Western diets, but life‐threatening complications should be monitored closely during follow‐up.
Introgression of chukar genes into a reintroduced red‐legged partridge (Alectoris rufa) population in central Italy
Authors: Baratti M. , Ammannati M. , Magnelli C. , Dessì‐Fulgheri F. 
Published: January 2005

SummaryInsight regarding the genetic origin and composition of the studied population of the red‐legged partridge (Alectoris rufa) is likely to provide general and critical information for the appropriate management and possible conservation of the species. The reintroduced population of red‐legged partridges living in Pianosa Island (National Park Tuscany Archipelago) has proven to be sustainable: captive‐bred individuals, morphologically assigned to the taxon A. rufa, were released to the island approximately 20 years ago, establishing an apparently well‐adapted population. We have investigated this population by means of 10 microsatellite loci in order to shed light on its genetic structure. Considering that A. rufa is known to crossbreed with A. chukar, the Pianosa Island population was compared at the molecular level with a red‐legged partridge breeding stock (Aulla, MS) as well as with a population of pure A. chukar. Our results indicate that the red‐legged partridge population from Pianosa, morphologically identified as A. rufa, is actually partly introgressed with A. chukar, questioning its genetic purity and the possible use of this population as a starting stock for future reintroductions elsewhere.