Zhaoyang Huang

Elevated plasma S100B concentration is associated with mesial temporal lobe epilepsy in Han Chinese: A case–control study

Mesial temporal lobe epilepsy (MTLE) is a common type of intractable epilepsy characterized by astroglial gliosis. The S100B was viewed as an astrocyte marker and experimental studies indicated that S100B might be involved in the pathophysiology of temporal lobe epilepsy. In this study, we measured plasma S100B levels by ELISA in 28 patients with MTLE and 28 healthy controls and found that patients showed significantly elevated S100B levels compared with healthy controls (P=0.018). Moreover, S100B levels were significantly higher in female patients than those in male patients (P=0.027). These results suggest that S100B may be a biomarker of MTLE.

Mapping intrinsic functional brain changes and repetitive transcranial magnetic stimulation neuromodulation in idiopathic restless legs syndrome: a resting-state functional magnetic resonance imaging study.

OBJECTIVE The objectives of this study were, first, to explore differences in brain activity between normal people and idiopathic restless legs syndrome (RLS) patients during asymptomatic periods; and, second, to determine whether administering repetitive transcranial magnetic stimulation (rTMS) to specific cortical regions would reverse any observed differences in brain activity and alleviate patient symptoms. METHODS Fifteen idiopathic RLS patients (nine drug-naive patients) and 14 gender- and age-matched healthy controls were enrolled. Resting-state functional magnetic resonance imaging was used to measure the amplitude of low-frequency fluctuations (ALFF) in spontaneous brain activity during asymptomatic periods. Seven patients received high-frequency (5 Hz) rTMS directed toward the leg area of the primary motor cortex. Scores on the International Restless Legs Syndrome Study Group (IRLSSG) Rating Scale and ALFF values were measured before and after treatment. RESULTS Compared with healthy controls, RLS patients showed lower ALFF in the sensorimotor and visual processing regions, and higher ALFF in the insula, parahippocampal and hippocampal gyri, left posterior parietal areas, and brainstem. These results were largely conserved when only drug-naive patients were considered. After rTMS treatment, ALFF in several sensorimotor and visual regions were significantly elevated and IRLSSG Rating Scale scores decreased, indicating improved RLS symptoms. CONCLUSIONS High-frequency rTMS delivered to the leg area of the primary motor cortex may raise functional activity in the sensorimotor and occipital regions, leading to improve symptoms in RLS patients. These results provide novel insight into RLS pathophysiology and suggest a potential mechanism for rTMS therapy in idiopathic RLS patients.

Repetitive Transcranial Magnetic Stimulation for the Treatment of Restless Legs Syndrome

Background: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique used to alter cortex excitability that has been proposed as an efficient method for treating brain hyperexcitability or hypoexcitability disorders. The aim of this study was to investigate whether high-frequency rTMS could have any beneficial effects in restless legs syndrome (RLS). Methods: Fourteen patients with RLS were given high-frequency rTMS (15 Hz, 100% motor threshold) to the leg representation motor cortex area of the frontal lobe for 14 sessions over 18 days. Patients were diagnosed according to the international criteria proposed by the International Restless Legs Syndrome Study Group in 2003. The International RLS Rating Scale (IRLS-RS), Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale were used to evaluate the severity of RLS, sleep quality, anxiety and depression, respectively. The scale scores were evaluated at four-time points (baseline, end of the 14th session, and at 1- and 2-month posttreatment). One-way analysis of variance was used to compare scale scores at different time points. Results: There was significant improvement in the IRLS-RS (from 23.86 ± 5.88 to 11.21 ± 7.23, P < 0.05), PSQI (from 15.00 ± 4.88 to 9.29 ± 3.91, P < 0.05), and HAMA (from 17.93 ± 7.11 to 10.36 ± 7.13, P < 0.05) scale scores at the end of 14th session, with ongoing effects lasting for at least 2 months. Conclusions: High-frequency rTMS can markedly alleviate the motor system symptoms, sleep disturbances, and anxiety in RLS patients. These results suggest that rTMS might be an option for treating RLS.

Event-related potentials in adolescents with different cognitive styles: field dependence and field independence

Field dependence/independence (FD/FI) is an important dimension of personality and cognitive styles. Different ability in mobilizing and/or allocating mental-attentional capacity was considered to be the most possible explanation for the FDI cognitive style. Many studies on characterizing the functional neuroanatomy of attentional control indicated the existence of a dissociable sub-process of conflict-monitoring and “cognitive control” system. However, little was known about it. We might dissociate “cognitive control” system from conflict processing by taking advantage of the variable of the FDI cognitive style. In addition, essentially cognitive styles (FDI) are often widely studied in psychological and educational fields, but hardly in neuroscience. We speculated that ERP components could help to explain the difference between how FD and FI individuals process information. The purpose of the reported study was to explore the possible relation between the “cognitive control” system and the conflict processing system during stimulus-matching task. We first characterized the standard FD/FI of senior-high-school Han students in grade two in Beijing, China, based on 160 students with similar age, education, living and cultural background. Twenty-six adolescents were selected and divided into two groups (extreme FD group and extreme FI group) according to their Group Embedded Figures Test (GEFT) results (FD: 5–8; FI: 17–19). They were tested on both Wechsler Adult Intelligence Scale (WAIS) and stimulus-matching task. ERP was measured while the subjects performed the stimulus-matching tasks by categorizing two figures that were presented sequentially either as a match (same shape) or as a conflict (different shape) conditions. The results showed that the mean amplitude of N270 in FI group was higher relative to that in FD group at nearly all centrofrontal areas in the conflict condition. We conclude that the FDI cognitive styles could influence the conflict processing by the “cognitive control” system due to the different abilities of FD and FI subjects in mobilizing and/or allocating attentional resources, which can be indexed by N270.

High-frequency Oscillations and the Seizure Onset Zones in Neocortical Epilepsy.

Background: To study the characters of high-frequency oscillations (HFOs) in the seizure onset zones (SOZ) and the nonseizure onset zones (NSOZ) in the electrocorticography (ECoG) of patients with neocortical epilepsy. Methods: Only patients with neocortical epilepsy who were seizure-free after surgery as determined with ECoG were included. We selected patients with normal magnetic resonance imaging before surgery in order to avoid the influence of HFOs by other lesions. Three minutes preictal and 10 min interictal ECoG as recorded in 39 channels in the SOZ and 256 channels in the NSOZ were analyzed. Ripples and fast ripples (FRs) were analyzed by Advanced Source Analysis software (ASA, The Netherlands). Average duration of HFOs was analyzed in SOZ and NSOZ separately. Results: For ripples, the permillage time occupied by HFOs was 0.83 in NSOZ and 1.17 in SOZ during the interictal period. During preictal period, they were 2.02 in NSOZ and 7.93 in SOZ. For FRs, the permillage time occupied by HFOs was 0.02 in NSOZ and 0.42 in SOZ during the interictal period. During preictal period, they were 0.03 in NSOZ and 2 in SOZ. Conclusions: High-frequency oscillations are linked to SOZ in neocortical epilepsy. Our study demonstrates the prevalent occurrence of HFOs in SOZ. More and more burst of HFOs, especially FRs, means the onset of seizures.

Sleep induced abnormal motor behaviors caused by medium-chain acyl-CoA dehydrogenase deficiency: a case report.

1389-9457/

Seizure-free after surgery in a patient with non-lesional startle epilepsy: A case report

see front matter 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.sleep.2011.04.017 q The patient and her family have agreed with this report. ⇑ Corresponding author. Tel.: +86 10 83198273; fax: +86 10 83157841. E-mail addresses: wangyp0109@gmail.com, mdwangyp@yahoo.com.cn (Y. Wang). 1 Co-first author. to offer stimulating opportunities for discussion and new insights into the field of sleep.

Lateralization Value of Low Frequency Band Beamformer Magnetoencephalography Source Imaging in Temporal Lobe Epilepsy

We present the case of a patient with startle epilepsy provoked by auditory, somatosensory and visual stimuli during video-electrocorticography (ECoG) recording. Ictal ECoG of all types of seizures triggered by the three kinds of stimuli showed that seizure onset originated from the left supplementary sensorimotor area (SSMA). The patient has been seizure-free after the cortex around the left SSMA only had been resected. Therefore, we speculate that left SSMA is the epileptogenic zone of startle epilepsy in this patient and perhaps the primary cortex to modulate the startle reflex in healthy persons.

Expert Consensus on Clinical Diagnostic Criteria for Fatal Familial Insomnia

Objective: In presurgical evaluation of temporal lobe epilepsy (TLE), selection of the resection side is challenging when bilateral temporal epileptiform discharges or structural abnormalities are present. We aim to evaluate the lateralization value of beamformer analysis of magnetoencephalography (MEG) in TLE. Methods: MEG data from 14 TLE patients were analyzed through beamformer analysis. We measured the hemispherical power distribution of beamformer sources and calculated the lateralization index (LI). We calculated the LI at multiple frequencies to explore the frequency dependency and at the delta frequency to define laterality. LI values ranging from −1 to −0.05 indicated right hemispheric dominance. LI values ranging from 0.05 to 1 indicated left hemispheric dominance. LI values ranging from −0.05 to 0.05 defined bilaterality. We measured the power of beamformer sources with a 9-s duration to explore time dependency. Results: The beamformer analysis showed that 10/14 patients had power dominance ipsilateral to resection. The delta frequency band had a higher lateralization value than other frequency bands. A time-dependent power fluctuation was found in the delta frequency band. Conclusions: MEG beamformer analysis, especially in the delta band, might efficiently provide additional information regarding lateralization in TLE.

Comorbidity of narcolepsy and schizophrenia: one case report

IntroductIon Fatal familial insomnia (FFI) is a serious and rare prion disease, which was first reported by Lugaresi et al. in 1986.[1] Early diagnosis of FFI might be important for early and sufficient counseling of patients and their relatives, also concerning the risk of inheritance, and potentially also for treatment studies. However, the diagnosis of FFI might be difficult because of the heterogeneity of clinical features, low sensitivity of diagnostic tests, and absence of family history. The aim of the present study was to develop a clinical scheme and diagnostic criteria for FFI based on our research and expert consensus.