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Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders
Rosa, Vivianne Pellegrino;Araújo Filho, Gerardo Maria de;Rahal, Márcio Andriani;Caboclo, Luís Otávio Sales Ferreira;Sakamoto, Américo Ceiki;Yacubian, Elza Márcia T.;
Journal of Epilepsy and Clinical Neurophysiology , 2006, DOI: 10.1590/S1676-26492006000300008
Abstract: introduction: ictal fear (if) is one of the most frequent emotional auras. it is the sole or predominant manifestation of simple partial seizures or initial expression of a complex partial seizure. it is more often experienced in patients with mesial temporal lobe epilepsy (tle), probably associated with mesial temporal structures, like the amygdala. anxiety disorders are very common psychiatric disorders associated with epilepsy, with a prevalence of 15 to 25%. objectives: to describe three patients with if with refractory mesial tle, also presenting the results of eeg, imaging exams, neuropsychological, quality of life and psychiatric evaluations. methods and results: three case reports of patients with refractory mesial tle and if followed up in the outpatient's clinic at the epilepsy section, universidade federal de s?o paulo, brazil, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. two patients presented ictal scalp-sphenoidal eeg onset on left side. two patients had major depressive disorder in psychiatric evaluation. conclusion: although if is the most frequent ictal psychological symptom, anxiety and mood disorders are very common psychiatric comorbidity in patients with epilepsy. it was concluded that differential diagnosis of interictal anxiety disorders, panic attacks and if can be difficult, and requires careful management.
H. Pourmahmoodian,M. Kahani,M. Ghaffarpour,M. H. Harrirchian
Acta Medica Iranica , 2007,
Abstract: There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ± 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively. Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62). Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%). Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68), though slow discharges were detected more in adult group. The most common abnormality was slow high voltage waves, which was observed in 33/47 (70%) of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed) discharges in 14/47 (29%), epileptiform (alone or associated with slow waves) in 4/47 (8.5%), diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1%) of abnormal recordings.
Colloquium on the 2013 Nobel Prize in Physics Awarded to Francois Englert and Peter Higgs  [PDF]
Philip D. Mannheim
Physics , 2015,
Abstract: In 2013 the Nobel Prize in Physics was awarded to Francois Englert and Peter Higgs for their development in 1964 of the mass generation mechanism (the Higgs mechanism) in local gauge theories. This mechanism requires the existence of a massive scalar particle, the Higgs boson, and in 2012 the Higgs boson was finally observed at the Large Hadron Collider after an almost half a century search. In this talk we review the work of these Nobel recipients and discuss its implications.
Ictal but Not Interictal Epileptic Discharges Activate Astrocyte Endfeet and Elicit Cerebral Arteriole Responses  [PDF]
Marco de Curtis,Giorgio Carmignoto
Frontiers in Cellular Neuroscience , 2011, DOI: 10.3389/fncel.2011.00008
Abstract: Activation of astrocytes by neuronal signals plays a central role in the control of neuronal activity-dependent blood flow changes in the normal brain. The cellular pathways that mediate neurovascular coupling in the epileptic brain remain, however, poorly defined. In a cortical slice model of epilepsy, we found that the ictal, seizure-like discharge, and only to a minor extent the interictal discharge, evokes both a Ca2+ increase in astrocyte endfeet and a vasomotor response. We also observed that rapid ictal discharge-induced arteriole responses were regularly preceded by Ca2+ elevations in endfeet and were abolished by pharmacological inhibition of Ca2+ signals in these astrocyte processes. Under these latter conditions, arterioles exhibited after the ictal discharge only slowly developing vasodilations. The poor efficacy of interictal discharges, compared with ictal discharges, to activate endfeet was confirmed also in the intact in vitro isolated guinea pig brain. Although the possibility of a direct contribution of neurons, in particular in the late response of cerebral blood vessels to epileptic discharges, should be taken into account, our study supports the view that astrocytes are central for neurovascular coupling also in the epileptic brain. The massive endfeet Ca2+ elevations evoked by ictal discharges and the poor response to interictal events represent new information potentially relevant to interpret data from diagnostic brain imaging techniques, such as functional magnetic resonance, utilized in the clinic to localize neural activity and to optimize neurosurgery of untreatable epilepsies.
Influence of Sleep and Sleep Deprivation on Ictal and Interictal Epileptiform Activity  [PDF]
Antonio Díaz-Negrillo
Epilepsy Research and Treatment , 2013, DOI: 10.1155/2013/492524
Abstract: Sleep is probably one of the most important physiological factors implicated both in epileptic seizures and interictal epileptiform discharges. The neurophysiology concerning the relationship between sleep and epilepsy is well described in the literature; however, the pathological events that culminate in the seizures are poorly explored. The present paper intends to make a rigorous approach to the main mechanisms involved in this reciprocal relation. Knowledge of sleep and sleep deprivation effects in epilepsy stands as crucial in the understanding of how seizures are produced, their possible lines of treatment, and future research. 1. Introduction There is a very important interaction between epilepsy and sleep. This connection is not new; since antiquity, it has been recognized that some seizures only appear during sleep, as a result of which they acquired magical significance. Hippocrates stated that a person affected with epilepsy should “spend the day awake and the night asleep. If this habit be disturbed, it is not so good … worse of all when he sleeps neither night nor day” [1]. Sleep and sleep deprivation have an influence in the onset, frequency, and semiology of seizures, as well as in EEG findings. Some seizure types have different circadian distributions, and understanding these patterns may provide useful diagnostic clues [2]. In 1885, Gowers observed in 850 institutionalized patients that 21% of seizures occurred exclusively at night, 42% only during day, and 37% interchangeably during day or night. In those terms, he classified seizures occurrence as diurnal, nocturnal and diffuse [3]. In 1890 Féré studied the times when the seizures occurred over 3 months in epileptic hospitalized patients, finding that two thirds all of seizures occurred between 8?p.m. and 8?p.m. [4]. Some years later, Langdon-Down and Russell Brain in 1929 analysed 2524 seizures in 66 patients over 6 months: 24% of seizures were nocturnal, 43% daily and 33% occurred randomly [5]. Janz was the first to describe what he called “awakening epilepsy.” In 1969, he published five articles about the chronobiology of tonic-clonic generalized seizures in 2825 patients: 44% had seizures during sleep and 33% during waking [6]. Gibberd and Bateson studied 645 patients with epilepsy, founding that sleep-related epilepsy has an ultradian pattern differentiated at the beginning and end of sleep, while seizures in epilepsy daytime waking occur preferentially in the midafternoon [7]. The interaction between sleep and epilepsy is reciprocal; sleep affects the presentation mode of
Sensitivity and Specificity of Interictal EEG-fMRI for Detecting the Ictal Onset Zone at Different Statistical Thresholds  [PDF]
Simon Tousseyn,Patrick Dupont,Karolien Goffin
Frontiers in Neurology , 2014, DOI: 10.3389/fneur.2014.00131
Abstract: There is currently a lack of knowledge about electroencephalography (EEG)-functional magnetic resonance imaging (fMRI) specificity. Our aim was to define sensitivity and specificity of blood oxygen level dependent (BOLD) responses to interictal epileptic spikes during EEG-fMRI for detecting the ictal onset zone (IOZ). We studied 21 refractory focal epilepsy patients who had a well-defined IOZ after a full presurgical evaluation and interictal spikes during EEG-fMRI. Areas of spike-related BOLD changes overlapping the IOZ in patients were considered as true positives; if no overlap was found, they were treated as false-negatives. Matched healthy case-controls had undergone similar EEG-fMRI in order to determine true-negative and false-positive fractions. The spike-related regressor of the patient was used in the design matrix of the healthy case-control. Suprathreshold BOLD changes in the brain of controls were considered as false positives, absence of these changes as true negatives. Sensitivity and specificity were calculated for different statistical thresholds at the voxel level combined with different cluster size thresholds and represented in receiver operating characteristic (ROC)-curves. Additionally, we calculated the ROC-curves based on the cluster containing the maximal significant activation. We achieved a combination of 100% specificity and 62% sensitivity, using a Z-threshold in the interval 3.4–3.5 and cluster size threshold of 350 voxels. We could obtain higher sensitivity at the expense of specificity. Similar performance was found when using the cluster containing the maximal significant activation. Our data provide a guideline for different EEG-fMRI settings with their respective sensitivity and specificity for detecting the IOZ. The unique cluster containing the maximal significant BOLD activation was a sensitive and specific marker of the IOZ.
Role of Cytokines During Epileptogenesis and in the Transition from the Interictal to the Ictal State in the Epileptic Mutant EL Mouse
Yoshiya L. Murashima,Jiro Suzuki,Mitsunobu Yoshii
Gene Regulation and Systems Biology , 2008,
Abstract: Purpose: Epileptic mutant EL mice show secondary generalized seizures. Seizure discharges initiate in the parietal cortex and generalize through the hippocampus. We have previously demonstrated an increase in the activity of inducible nitric oxide synthetase (iNOS) as well as a decrease in the activity of superoxide dismutase (SOD) in the hippocampus of EL mice, suggesting that cell toxic free radicals are increased in the brain of EL mice. In parallel with this, neurotrophic factors were significantly increased in the hippocampus of EL mice in earlier developmental stages before exhibiting frequent seizures. These findings were no longer present after frequent seizures, suggesting that these events may trigger ictogenesis. On the other hand, it is reported that limbic seizures rapidly induce cytokines and related inflammatory mediators. It remains to be seen, however, whether cytokines contribute to the transition from interictal to ictal state. The present study was designed to address this issue using EL mice.Methods: EL mice at the age from 4 to 23 weeks and their control animal, DDY mice at the age of 10 and 20 weeks were used. Seizures were induced in EL mice once every week since 5 weeks. Cytokines, such as interleukin-1 alpha (IL-1a), interleukin 1-beta (IL-1b), IL-6, IL-1 receptor (IL-1r), IL-1 receptor antagonist (IL-ra) and tumor necrosis factor alpha (TNF-a) were examined by Western blotting in the ‘focus complex’ of brain (namely, in the parietal cortex and hippocampus) of EL mice in the interictal period at different developmental stages. In 15 week old EL mice, which show seizures once a week, these cytokines were similarly determined 5 min, 2 hr, 4 hr, 11 hr, 24 hr, 3 days and 6 days after the last seizure induced.Results: A significant increase in the level of cytokines was observed in the brain of EL mice at any stages during development, compared with the level of cytokines in the brain of control DDY. Cytokines were increased predominantly before experiencing frequent seizures. In EL mice at the age of 15 weeks, the level of cytokines in the hippocampus was highest 6 days after seizures. In the parietal cortex, cytokines were most highly expressed 2 hr after seizures. The results indicate that cytokines were kept up-regulated until next seizures in the hippocampus, whereas they were transiently up-regulated immediately after seizures in the parietal cortex.Conclusion: It is concluded that in the brain of EL mice, pro-inflammatory cytokines are increased progressively and periodically in association with the development and the seizur
Bioinformatics awarded  [cached]
Ned Stafford
Genome Biology , 2004, DOI: 10.1186/gb-spotlight-20040629-01
Abstract: Martin Vingron, 42, director at the Max Planck Institute for Molecular Genetics in Berlin, and Eugene W. Myers, 50, professor of computer science and molecular biology at the University of California, Berkeley, were honored Thursday (June 24) at a ceremony in Stuttgart.In past years, the annual prize was awarded to as many as 12 researchers with cash payments of €150,000 (USD $183,200), but was modified this year to make the prize more internationally attractive. The prize, awarded by the Alexander von Humboldt Foundation and the Max Planck Society with additional funding support from the Germany Ministry of Education and Research, now will go to only two researchers, one based inside Germany and one outside of Germany.The goal of the prize is to promote collaboration on cutting-edge research between scientists from Germany and elsewhere.Myers was described by the Max Planck Research Prize committee as one of the pioneers of computational molecular biology, which now is commonly called bioinformatics. As head of the bioinformatics department at Celera Genomics, he developed methods for stringing together the small segments of DNA that are generated during the sequencing process.Vingron's main research interests center around the regulation of gene activity and gene expression. In an interview with us, he said that the awarding of such a prestigious prize to bioinformatics scientists is a signal that the field has come of age."I have been doing it almost 20 years," Vingron said. "For me, it came of age almost 20 years ago. But in society, [this year's prize] does mean that bioinformatics has now found widespread acceptance."Vingron said he would use his award to help turn Berlin into what a "center of intellectual creativity" in bioinformatics, with a focus on regulatory genomics and network analysis. Seminars for up to 6 weeks in summer would be held at the Max Planck Institute for Molecular Genetics, with overseas researchers taking part. He also will use award mon
Discovery of a cellular pathway on energy-consuming protein degradation --Introducing the work that was awarded the Nobel Prize in Chemistry for 2004.

CHANG Zeng-yi,JIAO Wang-wang,

生物物理学报 , 2004,
Abstract: The Nobel Prize in Chemistry for 2004 was awarded to Aaron Ciechanover, Avram Hershko and Irwin Rose, for their discovery of the ubiquitin-mediated protein degradation (proteolysis). Their discoveries are reviewed here in a historical perspective. Lessons that might be learned from their experiences are discussed.
Interictal SPECT in the presurgical evaluation in epileptic patients with normal MRI or bilateral mesial temporal sclerosis
Marques, Lucia H.N.;Ferraz-Filho, José R.L.;Lins-Filho, Mário L.M.;Maciel, Marina G.;Yoshitake, Rafael;Filetti, Sarah V.;
Arquivos de Neuro-Psiquiatria , 2009, DOI: 10.1590/S0004-282X2009000400012
Abstract: the aim of this study was to evaluate the sensitivity of interictal compared to ictal spect in the lateralization of the epileptogenic focus in refractory temporal lobe epilepsy (tle) patients that present with normal magnetic resonance imaging (mri) or bilateral mesial temporal sclerosis (mts). thirty patients with tle, for whom mri examinations were normal or who presented with bilateral mts, were retrospectively studied. using a confidence interval of 95% and a level of significance for p-value <0.05, an estimated agreement rate of 73% with a minimum agreement rate of 57% was calculated comparing interictal and ictal spects. in conclusion the interictal spect is only useful when associated with the ictal spect and does not substitute it in the localization of epileptogenic areas in patients with normal mri or bilateral mts.
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