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Determinants of depression and anxiety in patients with refractory epilepsy and cognitive problems 难治性癫痫和认知问题患者抑郁和焦虑的决定因素
Pub Date : 2014-05-07 DOI: 10.14800/MCE.137
V. Ekaterina
800x600 Background and Purpose: Few studies of psychopathology in patients with cognitive problems and refractory epilepsy (RE) have been performed . We aimed to assess depression, anxiety, and their determining factors in Bulgarian patients with RE and cognitive problems. Method s: We conduct ed a study based on questionnaires designed for people with intellectual disability (stigma scale, Glasgow Depression Scale, Glasgow Anxiety Scale) and a purposeful interview on clinical and social factors of 6 4 patients with RE and cognitive problems . Results : We found depression in 40.63% and anxiety in 71.43% of study participants. Depression correlated with female gender P < 0.01 ( c 2 = 6.48), seizure type P < 0.05 ( c 2 = 7.68), seizure severity P < 0.05 ( c 2 = 9.04), educational level P < 0.05 ( c 2 = 3.86), and stigma P < 0.01 ( c 2 = 12.57). Seizure severity, gender, stigma, and educational level proved to be predictors of depression on multivariate regression analysis P < 0.001 (F = 12.08). Anxiety correlated with seizure severity P < 0.05 ( c 2 = 8.65), focal neurological deficit P < 0.05 ( c 2 = 5.91), stigma P < 0.05 ( c 2 = 7.01), and depression P < 0.05 ( c 2 = 5.31). Seizure severity and focal neurological deficit were the only predictors of anxiety on multivariate regression analysis P < 0.001 (F = 6.35). Conclusions : W e have affirmed frequent anxiety and depression in patients with RE and cognitive problems and their clinical, social, and demographic determinants. The results from our study prove the necessity of a multidisciplinary approach to these patients. Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";}
背景与目的:认知障碍和难治性癫痫(RE)患者的精神病理学研究很少。我们的目的是评估保加利亚患有RE和认知问题的患者的抑郁、焦虑及其决定因素。方法:采用智障人士调查问卷(耻感量表、格拉斯哥抑郁量表、格拉斯哥焦虑量表)和目的访谈法,对64例有认知障碍的智障患者进行临床及社会因素调查。结果:抑郁和焦虑分别占40.63%和71.43%。抑郁症与女性性别P < 0.01 (c 2 = 6.48)、发作类型P < 0.05 (c 2 = 7.68)、发作严重程度P < 0.05 (c 2 = 9.04)、文化程度P < 0.05 (c 2 = 3.86)、病耻感P < 0.01 (c 2 = 12.57)相关。多因素回归分析显示,癫痫发作严重程度、性别、病耻感和受教育程度是抑郁症的预测因素,P < 0.001 (F = 12.08)。焦虑与癫痫发作严重程度P < 0.05 (c 2 = 8.65)、局灶性神经功能缺损P < 0.05 (c 2 = 5.91)、病耻感P < 0.05 (c 2 = 7.01)、抑郁P < 0.05 (c 2 = 5.31)相关。多变量回归分析显示,癫痫发作严重程度和局灶性神经功能缺损是焦虑的唯一预测因子,P < 0.001 (F = 6.35)。结论:我们已经确认了RE患者和认知问题及其临床、社会和人口统计学决定因素中频繁出现的焦虑和抑郁。我们的研究结果证明了对这些患者采取多学科方法的必要性。正常0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table。mso-style-name:"Table Normal";mso-tstyle-rowband-size: 0;mso-tstyle-colband-size: 0;mso-style-noshow:是的;mso-style-priority: 99;mso-style-parent:“”;Mso-padding-alt:0cm 5.4pt;mso-para-margin: 0厘米;mso-para-margin-bottom: .0001pt;mso-pagination: widow-orphan;字体大小:10.0分;font-family:"Times New Roman","serif";}
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引用次数: 2
BRIEF REPORT ON REFLEX EPILEPSY 反射性癫痫的简要报道
Pub Date : 2014-05-07 DOI: 10.14800/MCE.150
A. Deshpande, Vikram Khardenavis
Reflex epilepsies are a rare, unusual, complex & bizarre group of epilepsies seen most commonly in adolescent females ,most probably due to the hyper synchronization & propagation of epileptic cortex which are connected to each other through functional network occurring in innocuous ways such as an olfactory stimuli or as common as a sensory, visual, somato-sensory or a proprioceptive stimuli either isolated or in combination. However, there could be other set of unusual, however more complex & well known precipitants such as praxis, listening to music or reading a book. These can be diagnosed through a combination of good clinical history, Video EEG monitoring & Imaging of the brain especially functional MRI, ictal SPECT. Avoiding exposure to inciting stimulus and adequate anti-epileptic medication, forms the corner stone of treatment of this condition.
反射性癫痫是一种罕见的、不寻常的、复杂的和奇怪的癫痫,最常见于青春期女性,最可能是由于癫痫皮质的高度同步和传播,它们通过功能网络相互连接,以无害的方式发生,如嗅觉刺激,或常见的感觉、视觉、躯体感觉或本体感觉刺激,无论是孤立的还是组合的。然而,可能还有其他不寻常的,但更复杂和众所周知的促发因素,如练习,听音乐或读书。这些可以通过良好的临床病史,视频脑电图监测和脑成像,特别是功能性MRI, SPECT相结合来诊断。避免暴露于刺激性刺激和适当的抗癫痫药物,形成治疗这种情况的基石。
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引用次数: 0
The role of levetiracetam following aneurysmal subarachnoid hemorrhage: current practice and future directions 左乙拉西坦在动脉瘤性蛛网膜下腔出血中的作用:目前的实践和未来的方向
Pub Date : 2014-05-07 DOI: 10.14800/MCE.139
M. Dewan, P. Kelly, S. Zuckerman, P. Morone, J. Mocco
Seizures complicate the hospital course of up to a quarter of patients suffering from aneurysmal subarachnoid hemorrhage.  Despite limited evidence supporting the role of antiepileptic medications, many practitioners prescribe AEDs with the notion that any clinical benefit likely outweighs the minimal and rare deleterious effects.   Herein we underscore recently published results of a survey of expert clinicians on this topic.  While there was disagreement regarding the necessity to offer pharmacologic prophylaxis, those practitioners that did endorse prophylaxis utilized levetiracetam with far greater frequency than any other AED.  The authors indicate the importance and timeliness of a randomized trial investigating on the topic.
癫痫发作使多达四分之一的动脉瘤性蛛网膜下腔出血患者的住院过程复杂化。尽管支持抗癫痫药物作用的证据有限,但许多医生在开aed时都认为,任何临床益处都可能超过最小和罕见的有害影响。在此,我们强调最近发表的一项关于该主题的专家临床医生调查结果。虽然对于提供药物预防的必要性存在分歧,但那些确实支持预防的从业人员使用左乙拉西坦的频率远远高于任何其他AED。作者指出了调查该主题的随机试验的重要性和及时性。
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引用次数: 0
Periventricular Nodular Heterotopia: Pathogenesis, Epileptogenesis and Implications in Higher Cerebral Functions. 脑室周围结节性异位:发病机制、癫痫发生及其对高级脑功能的影响。
Pub Date : 2014-04-15 DOI: 10.14800/MCE.20
Valmir Passarelli, Camila Hobi Moreira
Periventricular nodular heterotopias (PNH) is a neuronal migration disorder characterized by nodules of gray matter located along the lateral ventricles, which can range from isolated single nodules to bilateral confluent nodules. This malformation of cortical development can be related genetic or extrinsic factors. Reading dysfluency, epilepsy and normal intelligence are main hallmark. PNH and overlying cortex integrate a (dis)functional network. In this review, we discuss the recent progress about pathogenes and epileptogenesis on PNH, and their participation in the processing of higher cortical functions.
脑室周围结节性异位(PNH)是一种以沿侧脑室分布的灰质结节为特征的神经元迁移障碍,其范围可以是孤立的单个结节,也可以是双侧融合结节。这种皮质发育畸形可能与遗传或外在因素有关。阅读障碍、癫痫和智力正常是主要标志。PNH和上覆皮层整合了一个功能失调的网络。本文就PNH的发病机制、癫痫发生机制及其参与高级皮质功能加工等方面的研究进展作一综述。
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引用次数: 3
Electrophysiological properties and carbamazepine sensitivity of epileptic human cortical neurons 癫痫人皮质神经元电生理特性及卡马西平敏感性
Pub Date : 2014-04-10 DOI: 10.14800/MCE.132
C. Gavrilovici, R. McLachlan, M. Poulter
There are between 20 and 30 drugs available for the treatment of seizures but despite this ~30% of the epilepsy population remains unresponsive to treatment. The underlying mechanisms behind drug resistance in temporal lobe epilepsy (TLE) have not been completely identified. The purpose of this study was to determine if distinct types of neuronal firing patterns occurring in human epileptic cortex are altered by carbamazepine (CBZ). We used whole-cell patch-clamp techniques combined with intracellular labeling to electrophysiologically and morphologically characterize neuronal populations in resected cortical tissue from patients with drug resistant epilepsy. We then determined if cells were uniformly resistant to carbamazepine or whether only a subset did not respond. Cortical spiking patterns were segregated in six main clusters: adapting high frequency cluster 1 and 2 (AHF1 and AHF2), adapting low frequency cluster 1 and 2 (ALF1 and ALF2), strongly adapting low frequency group (sALF) and one spike cluster (OS). A morphological analysis showed that some spiking patterns tend to be associated with specific neuronal morphology. OS group included only pyramidal cells while adapting high frequency groups (AHF1 &AHF2) displayed typical interneuron phenotype. Finally, we found that CBZ does not uniformly suppress neuronal activity as only ~27% of interneurons and ~40% of pyramidal cells were carbamazepine insensitive. These data indicate that in humans with DRE there is a heterogeneous CBZ insensitivity in all sub-populations of neurons.
有20至30种药物可用于治疗癫痫发作,但尽管如此,仍有30%的癫痫患者对治疗无反应。颞叶癫痫(TLE)耐药的潜在机制尚未完全确定。本研究的目的是确定卡马西平(CBZ)是否改变了人类癫痫皮质中发生的不同类型的神经元放电模式。我们使用全细胞膜片钳技术结合细胞内标记技术,从电生理学和形态学上表征了从耐药癫痫患者切除的皮质组织中的神经元群。然后我们确定细胞是否对卡马西平一致耐药,还是只有一部分细胞没有反应。皮层峰值模式被划分为6个主要簇:适应高频簇1和2 (AHF1和AHF2)、适应低频簇1和2 (ALF1和ALF2)、强适应低频组(sALF)和单峰簇(OS)。形态学分析表明,一些尖峰模式往往与特定的神经元形态有关。OS组仅包括锥体细胞,而适应高频组(AHF1和ahf2)表现出典型的神经元间表型。最后,我们发现CBZ并不能均匀地抑制神经元活动,因为只有27%的中间神经元和40%的锥体细胞对卡马西平不敏感。这些数据表明,在DRE患者中,所有神经元亚群中都存在不同种类的CBZ不敏感。
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引用次数: 1
The rearrangement of synaptic actin networks after pilocarpine-induced status epilepticus and pentylenetetrazol-induced kindling 匹罗卡平诱导的癫痫持续状态和戊四唑诱导的点火后突触肌动蛋白网络的重排
Pub Date : 2014-04-10 DOI: 10.14800/MCE.128
Yan-Feng Zhang, Shu-lei Li, Tianqing Xiong, Yan-Chao Li
Post status epilepticus (SE) and chemical kindling are two widely used animal models for epileptic studies The pilocarpine-treated C57BL/6 mice exhibited stereotypical alterations of F-actin networks, including a severe reduction of F-actin in area CA1-CA3 and in the hilum. By contrast, F-actin networks seemed less affected by pentylenetetrazol kindling, and almost no remarkable alterations were noted in area CA1 or in the hilum. The overall labeling of F-actin in the hippocampus was generally consistent with the pathological observations on dendritic spines reported in both the epileptic models. Because the reorganized F-actin network can lead to long-term stabilization of synaptic changes and to consolidation of the enhanced neuronal activity, the alterations of F-actin networks may be related to the aberrant hyperexcitability in the epileptic animals.
经匹罗卡品处理的C57BL/6小鼠表现出典型的f -肌动蛋白网络改变,包括CA1-CA3区和脑门区f -肌动蛋白的严重减少。相比之下,f -肌动蛋白网络似乎受戊四氮点燃的影响较小,CA1区和脐区几乎没有明显的改变。海马中f -肌动蛋白的总体标记与两种癫痫模型中报道的树突棘病理观察大体一致。由于重组的f -肌动蛋白网络可以导致突触变化的长期稳定和增强的神经元活动的巩固,f -肌动蛋白网络的改变可能与癫痫动物的异常高兴奋性有关。
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引用次数: 3
Ophthalmoplegic Migraine and Juvenile Myoclonic Epilepsy: Two side of the same coin? 眼麻痹性偏头痛和青少年肌阵挛性癫痫:同一枚硬币的两面?
Pub Date : 2014-03-05 DOI: 10.14800/MCE.70
A. Deshpande, Supriya Khardenavis, Aakash Shetty
Excessive neocortical cellular excitability secondary to complex molecular mechanisms involving Sodium Pottasium ATPase & elevated glutamate ,potassium levels in extracellular fluid form the possible common underlying mechanism for causation of ophthalmoplegic migraine & juvenile myoclonic epilepsy both alike and further research is needed to establish these hypothesis in the future.
过度的新皮质细胞兴奋性继发于复杂的分子机制,包括atp酶钠钾和谷氨酸升高,细胞外液中钾水平的升高,这可能是导致眼麻痹性偏头痛和青少年肌挛性癫痫的共同潜在机制,未来需要进一步的研究来证实这些假设。
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引用次数: 0
How Can Network-Pharmacology Contribute to Antiepileptic Drug Development? 网络药理学如何促进抗癫痫药物的开发?
Pub Date : 2014-02-28 DOI: 10.14800/MCE.30
M. D. Ianni, A. Talevi
Fil: Di Ianni, Mauricio Emiliano. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Departamento de Ciencias Biologicas. Catedra de Quimica Medicinal; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - La Plata; Argentina
迪·雅尼,毛里西奥·埃米利亚诺。拉普拉塔国立大学。精确科学学院。生物科学系。药用化学目录;阿根廷。国家科学技术研究委员会。科学技术中心Conicet -拉普拉塔;阿根廷
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引用次数: 3
Otx genes and seizure susceptibility Otx基因与癫痫易感性
Pub Date : 2014-02-19 DOI: 10.14800/MCE.74
Y. Bozzi, A. Simeone
Homeobox-containing transcription factors crucially regulate the patterning and regionalization of the developing nervous system, as well as the proliferation, survival and differentiation of distinct neuronal populations. Altered expression of these factors markedly impacts the structure and function of the embryonic and adult central nervous system (CNS). In both humans and mice, mutations of homeobox genes have been associated to severe syndromes characterized by developmental CNS defects, which often lead to the occurrence of seizures in the adult life. Among homeobox genes, Otx genes ( Otx1 and Otx2) are crucially involved in brain regionalization. Our previous work showed that mice lacking Otx1 present cerebral cortex defects and develop epilepsy, whereas mice with conditional deletion or overexpression of Otx2 show profound alterations in midbrain-to-forebrain circuits, which are accompanied by an abnormal response to experimentally-induced seizures. In this brief review, we highlight and discuss the major findings suppporting the role of Otx genes in sculpting midbrain and forebrain circuits involved in epileptogenesis.
含有同源盒的转录因子对发育中的神经系统的模式和区域化以及不同神经元群体的增殖、存活和分化起着至关重要的调节作用。这些因子表达的改变显著影响胚胎和成人中枢神经系统(CNS)的结构和功能。在人类和小鼠中,同型盒基因的突变与以发育性中枢神经系统缺陷为特征的严重综合征有关,这通常会导致成年期癫痫发作。在同型盒基因中,Otx基因(Otx1和Otx2)在大脑区域化中起着至关重要的作用。我们之前的研究表明,缺乏Otx1的小鼠出现大脑皮质缺陷并发展为癫痫,而条件缺失或过度表达Otx2的小鼠在中脑到前脑回路中表现出深刻的改变,并伴有对实验诱导的癫痫发作的异常反应。在这篇简短的综述中,我们强调并讨论了支持Otx基因在塑造参与癫痫发生的中脑和前脑回路中的作用的主要发现。
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引用次数: 2
Is non-P450 enzyme inducing antiepileptic drugs the best ADEs choice for glioblastoma patients? 非p450酶诱导抗癫痫药物是胶质母细胞瘤患者ADEs的最佳选择吗?
Pub Date : 2014-02-15 DOI: 10.14800/MCE.32
Mao Qing
The seizure prognosis of using P450 enzyme inducing and non-enzyme inducing antiepileptic drugs for seizure prophylaxis after glioma resection surgery has been investigated in several clinical studies. However, the results of these studies are inconsistent.  Additional multicenter RCTs are necessary to provide class I evidence on the role of AEDs in the treatment of glioma associated seizure.
一些临床研究对胶质瘤切除术后使用P450酶诱导和非酶诱导抗癫痫药物预防癫痫发作的预后进行了研究。然而,这些研究的结果并不一致。需要更多的多中心随机对照试验来提供aed在治疗胶质瘤相关癫痫发作中的作用的一级证据。
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引用次数: 0
期刊
Molecular & Cellular Epilepsy
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