Structural and functional motor-network disruptions predict selective action-concept deficits: Evidence from frontal lobe epilepsy.

Built on neurodegenerative lesions models, the disrupted motor grounding hypothesis (DMGH) posits that motor-system alterations selectively impair action comprehension. However, major doubts remain concerning the dissociability, neural signatures, and etiological generalizability of such deficits. Few studies have compared action-concept outcomes between disorders affecting and sparing motor circuitry, and none has examined their multimodal network predictors via data-driven approaches. Here, we first assessed action- and object-concept processing in patients with frontal lobe epilepsy (FLE), patients with posterior cortex epilepsy (PCE), and healthy controls. Then, we examined structural and functional network signatures via diffusion tensor imaging and resting-state connectivity measures. Finally, we used these measures to predict behavioral performance with an XGBoost machine learning regression algorithm. Relative to controls, FLE (but not PCE) patients exhibited selective action-concept deficits together with structural and functional abnormalities along motor networks. The XGBoost model reached a significantly large effect size only for action-concept outcomes in FLE, mainly predicted by structural (cortico-spinal tract, anterior thalamic radiation, uncinate fasciculus) and functional (M1-parietal/supramarginal connectivity) motor networks. These results extend the DMGH, suggesting that action-concept deficits are dissociable markers of frontal/motor (relative to posterior) disruptions, directly related to the structural and functional integrity of motor networks, and traceable beyond canonical movement disorders.

Multimodal neurocognitive markers of frontal lobe epilepsy: Insights from ecological text processing.

The pressing call to detect sensitive cognitive markers of frontal lobe epilepsy (FLE) remains poorly addressed. Standard frameworks prove nosologically unspecific (as they reveal deficits that also emerge across other epilepsy subtypes), possess low ecological validity, and are rarely supported by multimodal neuroimaging assessments. To bridge these gaps, we examined naturalistic action and non-action text comprehension, combined with structural and functional connectivity measures, in 19 FLE patients, 19 healthy controls, and 20 posterior cortex epilepsy (PCE) patients. Our analyses integrated inferential statistics and data-driven machine-learning classifiers. FLE patients were selectively and specifically impaired in action comprehension, irrespective of their neuropsychological profile. These deficits selectively and specifically correlated with (a) reduced integrity of the anterior thalamic radiation, a subcortical structure underlying motoric and action-language processing as well as epileptic seizure spread in this subtype; and (b) hypoconnectivity between the primary motor cortex and the left-parietal/supramarginal regions, two putative substrates of action-language comprehension. Moreover, machine-learning classifiers based on the above neurocognitive measures yielded 75% accuracy rates in discriminating individual FLE patients from both controls and PCE patients. Briefly, action-text assessments, combined with structural and functional connectivity measures, seem to capture ecological cognitive deficits that are specific to FLE, opening new avenues for discriminatory characterizations among epilepsy types.

Cavernomatosis múltiple y aneurisma cerebral trombosado: una asociación inusual / Cavernous haemangioma multiple and brain aneurysm thrombosed: an unusual association

Los cavernomas son malformaciones angiográficamente ocultas, pueden ser únicos o múltiples y esporádica o familiar.Suelen asociarse a otras malformaciones vasculares como las anomalías de drenaje venoso, sin embargo no es habitual su asociación con aneurismas cerebrales. Los aneurismas son malformaciones evidenciables en angiografía, sin embargo cuando se encuentran trombosados puede dificultarse su diagnostico, observándose en algunos casos como lesiones pseudotumorales. Nuestro objetivo es exponer una rara asociación entre cavernomatosis múltiple y aneurisma cerebral trombosado en un paciente pediátrico. Presentamos una paciente de 2 años de edad con diagnóstico de cavernomatosis múltiple y aneurisma cerebral trombosado. Se realiza una revisión de la literatura de ambas entidades y su rara asociación, medianteuna búsqueda exhaustiva en la base de datos de PUBMED Y COCHRANE utilizando las siguientes palabras claves: Cavernous angioma. Familial cavernomatosis. Hemorrhagic stroke. Multiple cavernomatosis. Cerebral aneurysm. Thrombosed aneurysm. Se discute la epidemiologia, diagnóstico y manejo quirúrgico de la cavernomatosis múltiple y sus asociaciones, preconizando fundamentalmente la evaluación pre quirúrgica de estos pacientes. No encontramos ningún caso de asociación entre cavernomatosis múltiple y aneurismas en nuestra revisión bibliográfica. Dado que se pueden presentar como lesiones pseudotumorales, la tomografía computada, resonancia magnética y la angiografía cerebral son métodos fundamentales para llegar a un diagnostico prequirúrgico certero. La indicación quirúrgica debe ser evaluada individualmente en cada paciente, y se debe realizar un seguimiento clínico-imagenologico.

Cavernomas are angiographically occult malformations may be single or multiple and sporadic or familial. Usually associated with other vascular malformations such as venous drainage anomalies, however it is not common its association with brain aneurysms. Aneurysms are into evidence malformations in angiography, however when they meet their diagnosis can be difficult thrombosed observed in some cases as pseudotumoral injuries. Our goal is to present a rare association between multiple cavernous haemangioma and thrombosed cerebral aneurysm in a pediatric patient. We present a patient 2 years old diagnosed with multiple cavernous haemangioma and thrombosed cerebral aneurysm. A review of the literature of both entities and its rare association is done through an exhaustive search in the database PUBMED and COCHRANE using the following keywords: Cavernous angioma. Familial cavernous haemangioma. Hemorrhagic stroke. Multiple cavernous haemangioma. Brain aneurysm. Thrombosed aneurysm. The epidemiology, diagnosis and surgical management of multiple cavernous haemangioma and their associations is discussedessentially advocating the presurgical evaluation of these patients. No case of association between multiple cavernous haemangioma and aneurysms in our literature review. Because can be presented as pseudotumoral lesions, computed tomography, magnetic resonance imaging and cerebral angiography are fundamental methods to reach an certain diagnosis preoperatively. The surgical indication should be evaluated individually for each patient, and should be performed a clinical-imaging follow-up.

Hidatidosis cerebral sobreinfectada en la infancia: a propósito de un caso / Overinfected cerebral hydatid disease in childhood: report of a case

La hidatidosis es una enfermedad parasitaria en la que el hombre es un huésped intermediario accidental, portador de la forma larvaria de Echinococcus granulosus. La forma más frecuente de hidatidosis es la hepática, seguida de la pulmonar. La localización en el sistema nervioso central es rara. La gran mayoría de los quistes hidatídicos cerebrales han sido diagnosticados en niños. Los quistes localizados en este sitio presentan diferentes e interesantes características en su evolución y diagnóstico. Las manifestaciones clínicas están en relación a su localización, y al síndrome de hipertensión endocraneana que las lesiones ocasionan por efecto de masa y/o por la hidrocefalia que puedan condicionar. Se presenta el caso de un paciente de 10 años de edad que presenta un cuadro de cefalea, vómitos y hemiparesia braquiocrural izquierda de 48 h de evolución. Fue evaluado con métodos diagnósticos imagenológicos, bioquímicos y serológicos, logrando el diagnostico de hidatidosis cerebral múltiple sobreinfectada. Es intervenido quirúrgicamente, resecando dos quistes hidatídicos de 5 cm en diferentes tiempos quirúrgicos. Se realiza una revisión bibliográfica sobre el tema y se discute sus principales características clínicas, diagnóstico, tratamiento y pronóstico.

Hydatid disease is a parasitic disease in which the man is an accidental intermediate host, carrying the larval form of Echinococcus granulosus. The most common form of liver hydatid disease is followed by the lung. Locating in the central nervous system is rare. The vast majority of cerebral hydatid cysts have been diagnosed in children. Cysts located on this site have different and interesting features in its evolution and diagnosis. The clinical manifestations are related to their location, and intracranial hypertension syndrome that injuries cause by mass effect and / or hydrocephalus that may condition. We report the case of a patient aged 10 years presented symptoms of headache, vomiting and left hemiparesis braquio 48 hours of evolution. It was evaluated with diagnostic imaging methods, biochemical and serological, making the diagnosis of multiple cerebral hydatid superinfected. The patient underwent surgery, resecting two hydatid cysts of 5 cm in different surgical times. We review the literature on the subject and discusses its main clinical features, diagnosis, treatment and prognosis.

An energy-based detection algorithm of epileptic seizures in EEG records.

A simple algorithm to automatically detect segments with epileptic seizures in long EEG records has been developed. The main advantages of the proposed method are: the simple algorithm used and the lower computational cost. The algorithm measures the energy of each EEG channel by a sliding window and calculates some features of each patient signal to detect the epileptic seizure. It is also able to distinguish between seizures and noise artifacts. Nine invasive EEG records acquired by Epilepsy Center of the University Hospital of Freiburg were analyzed in this work. In 90 segments studied (39 with epileptic seizures) the sensitivity obtained with the method is 87.18 %. The algorithm is appropriate to detect epileptic seizures, with high sensitivity, in long EEG records to decrease the time used by physicians and specialists in visual inspections.