Superficial and deep white matter abnormalities in temporal lobe epilepsy.

Non-invasive neuroimaging is important in epilepsy to help identify cerebral abnormalities. Abnormally reduced fractional anisotropy (FA) in deep white matter (WM) from diffusion-weighted imaging (DWI) is widely reported in large multi-cohort studies across all types of epilepsies. However, abnormalities in FA for superficial WM are rarely investigated in epilepsy.

Novel Approach for Assessing Outcomes of Type 1 Diabetes Prevention Trials Over a Fixed Time Interval.

Challenges in time to event type 1 diabetes (T1D) prevention trial design can yield negative results even for treatments that may actually improve disease pathology. We evaluated whether a binary metabolic end point for 12-month change from baseline to 1 year postrandomization could be useful in T1D prevention trials. This approach detected treatment effects at least as well as standard primary end points with shorter follow-up.

Multi-centre normative brain mapping of intracranial EEG lifespan patterns in the human brain.

Understanding healthy human brain function is crucial to identify and map pathological tissue within it. Whilst previous studies have mapped intracranial EEG (icEEG) from non-epileptogenic brain regions, they often neglect age and sex effects. Further, they are limited by small sample sizes due to the modality's invasive nature.

Changes in Gray Matter Morphology and White Matter Microstructure Across the Adult Lifespan in People With Temporal Lobe Epilepsy.

Background And Objectives: Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of gray and white matter structures. Evidence supports a progressive condition, although the temporal evolution of TLE is poorly defined. In this ENIGMA-Epilepsy study, we aim to investigate structural alterations in gray and white matter across the adult lifespan in patients with TLE by charting both gray and white matter changes and explore the covariance of age-related alterations in both compartments.

Risk of death and adverse effects in patients on Liothyronine: a multi-source systematic review and meta-analysis.

Context: Although some patients with hypothyroidism prefer combination therapy with Liothyronine (LT3) and Levothyroxine (LT4), the safety of LT3 remains unresolved.

Objective: We undertook a multi-source systematic-review and meta-analysis of LT3 safety.

Data Sources: We searched PubMed for articles relating to death, adverse events (AEs), and cardiovascular outcomes in LT3 users.

Multiscale cortical morphometry reveals pronounced regional and scale-dependent variations across the lifespan.

Characterizing changes in cortical morphology across the lifespan is fundamental for both research and clinical applications. Most studies report a monotonic decrease in commonly used morphometrics, such as cortical thickness and volume, with only subtle regional variations in the rate of decline. However, these findings are limited to a single length scale.

Combined impact of gray and superficial white matter abnormalities: Implications for epilepsy surgery.

Objective: Drug-resistant focal epilepsy is associated with abnormalities in the brain in both gray matter (GM) and superficial white matter (SWM). However, it is unknown if both types of abnormalities are important in supporting seizures. Here, we test if surgical removal of GM and/or SWM abnormalities relates to post-surgical seizure outcome in people with temporal lobe epilepsy (TLE).

Seizure freedom after surgical resection of diffusion-weighted magnetic resonance imaging abnormalities.

Objective: Successful epilepsy surgery requires accurate localization and removal of the epileptogenic zone. Neuroimaging helps detect structural brain abnormalities to guide surgery, but current clinical practice does not use diffusion-weighted magnetic resonance imaging (dwMRI). However, previous work has shown that diffusion abnormalities are present in epilepsy and may relate to the epileptogenic zone.

From Bedside to Desktop: A Data Protocol for Normative Intracranial EEG and Abnormality Mapping.

Normative mapping is a framework used to map population-level features of health-related variables. It is widely used in neuroscience research, but the literature lacks established protocols in modalities that do not support healthy control measurements, such as intracranial electroencephalograms (icEEG). An icEEG normative map would allow researchers to learn about population-level brain activity and enable the comparison of individual data against these norms to identify abnormalities.

Controlled Antenatal Thyroid Screening Study III: Effects of gestational thyroid status on brain microstructure.

Context: Children born to mothers with gestational thyroid dysfunction may have an increased risk of adverse neurodevelopmental outcomes but the effects of maternal thyroid function on brain microstructure are unknown.

Objective: To establish whether adolescent white matter microstructure is affected by suboptimal gestational thyroid function (SGTF).

Design And Setting: The Controlled Antenatal Thyroid Screening (CATS) study randomized mothers with SGTF to levothyroxine or no supplementation from 12 weeks' gestation.

Seizure duration is associated with multiple timescales in interictal iEEG band power.

Background Seizure severity can change from one seizure to the next within individual people with epilepsy. It is unclear if and how seizure severity is modulated over longer timescales. Characterising seizure severity variability over time could lead to tailored treatments.

More variable circadian rhythms in epilepsy captured by long-term heart rate recordings from wearable sensors.

Objective: The circadian rhythm synchronizes physiological and behavioral patterns with the 24-h light-dark cycle. Disruption to the circadian rhythm is linked to various health conditions, although optimal methods to describe these disruptions remain unclear. An emerging approach is to examine the intraindividual variability in measurable properties of the circadian rhythm over extended periods.

Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex.

Anti-seizure medications are the primary treatment for epilepsy; yet medication tapering effects have not been investigated in a dose, region and time-dependent manner, despite their potential impact on research and clinical practice. We examined over 3000 h of intracranial EEG recordings in 32 subjects during long-term monitoring, of which 22 underwent concurrent anti-seizure medication tapering. We estimated anti-seizure medication plasma levels based on known pharmaco-kinetics of all the major anti-seizure medication types.

Insights into epileptic aphasia: Intracranial recordings in a child with a left insular ganglioglioma.

Intracranial EEG was recorded during a dialog-based task in a 16-year-old boy with a left insular ganglioglioma, medically intractable epilepsy, epileptic foci in auditory cortex on the lateral superior temporal gyrus (STG) and language deficiencies. Performance of the task was highly erratic, characterized by rapid cycling between providing correct answers, incorrect answers and failure to respond. There was no relationship between performance and the degree of concurrent epileptic activity in auditory cortex.

How Does Thyroid Hormone Profile Differ on and Off Replacement Treatment?

Introduction: There continues to be much discussion around optimisation of thyroid hormone status in hypothyroid individuals. We here looked the way that free T4(FT4) and thyroid-stimulating hormone (TSH) related to each other in a large laboratory sample of people who underwent a thyroid function test (TFT), split between those on levothyroxine replacement (monitoring test) and those who underwent a test to check for thyroid hormone imbalance (diagnostic test; not on levothyroxine).

Methods: TFT test (FT4/TSH) results were extracted from the Salford Royal Hospital Laboratory Information Management System during 2009-2012.

Alpha rhythm slowing in temporal lobe epilepsy across scalp EEG and MEG.

EEG slowing is reported in various neurological disorders including Alzheimer's, Parkinson's and Epilepsy. Here, we investigate alpha rhythm slowing in individuals with refractory temporal lobe epilepsy compared with healthy controls, using scalp EEG and magnetoencephalography. We retrospectively analysed data from 17 (46) healthy controls and 22 (24) individuals with temporal lobe epilepsy who underwent scalp EEG and magnetoencephalography recordings as part of presurgical evaluation.

The Imaging Database for Epilepsy And Surgery (IDEAS).

Objective: Magnetic resonance imaging (MRI) is a crucial tool for identifying brain abnormalities in a wide range of neurological disorders. In focal epilepsy, MRI is used to identify structural cerebral abnormalities. For covert lesions, machine learning and artificial intelligence (AI) algorithms may improve lesion detection if abnormalities are not evident on visual inspection.

Vagus nerve stimulation for epilepsy: A narrative review of factors predictive of response.

Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy. However, there is a lack of reliable predictors of VNS response in clinical use. The identification of factors predictive of VNS response is important for patient selection and stratification as well as tailored stimulation programming.

Diminished circadian and ultradian rhythms of human brain activity in pathological tissue in vivo.

Chronobiological rhythms, such as the circadian rhythm, have long been linked to neurological disorders, but it is currently unknown how pathological processes affect the expression of biological rhythms in the brain. Here, we use the unique opportunity of long-term, continuous intracranially recorded EEG from 38 patients (totalling 6338 hours) to delineate circadian (daily) and ultradian (minute to hourly) rhythms in different brain regions. We show that functional circadian and ultradian rhythms are diminished in pathological tissue, independent of regional variations.

Neuro-evolutionary evidence for a universal fractal primate brain shape.

The cerebral cortex displays a bewildering diversity of shapes and sizes across and within species. Despite this diversity, we present a universal multi-scale description of primate cortices. We show that all cortical shapes can be described as a set of nested folds of different sizes.

Status epilepticus and thinning of the entorhinal cortex.

Status epilepticus (SE) carries risks of morbidity and mortality. Experimental studies have implicated the entorhinal cortex in prolonged seizures; however, studies in large human cohorts are limited. We hypothesised that individuals with temporal lobe epilepsy (TLE) and a history of SE would have more severe entorhinal atrophy compared to others with TLE and no history of SE.

Defining Gestational Thyroid Dysfunction Through Modified Nonpregnancy Reference Intervals: An Individual Participant Meta-analysis.

Background: Establishing local trimester-specific reference intervals for gestational TSH and free T4 (FT4) is often not feasible, necessitating alternative strategies. We aimed to systematically quantify the diagnostic performance of standardized modifications of center-specific nonpregnancy reference intervals as compared to trimester-specific reference intervals.

Methods: We included prospective cohorts participating in the Consortium on Thyroid and Pregnancy.