Network alterations in temporal lobe epilepsy during non-rapid eye movement sleep and wakefulness.

OBJECTIVE: Investigate sleep and temporal lobe epilepsy (TLE) effects on brain networks derived from electroencephalography (EEG). METHODS: High-density EEG was recorded during non-rapid eye movement (NREM) sleep stage 2 (N2) and wakefulness in 23 patients and healthy controls (HC). Epochs without epileptic discharges were source-reconstructed in 72 brain regions and connectivity was estimated. We calculated network integration and segregation at global (global efficiency, GE; average clustering coefficient, avgCC) and hemispheric level. These were compared between groups across frequency bands and correlated with the individual proportion of wakefulness- or sleep-related seizures. RESULTS: At the global level, patients had higher delta GE, delta avgCC and theta avgCC than controls, irrespective of the vigilance state. During wakefulness, theta GE of patients was higher than controls and, for patients, theta GE during wakefulness was higher than during N2. Wake-to-sleep differences in TLE were notable only in the ipsilateral hemisphere. Only measures from wakefulness recordings correlated with the proportion of wakefulness- or sleep-related seizures. CONCLUSIONS: TLE network alterations are more prominent during wakefulness and at lower frequencies. Increased integration and segregation suggest a pathological 'small world' configuration with a possible inhibitory role. SIGNIFICANCE: Network alterations in TLE occur and are easier to detect during wakefulness.

Structure-function coupling increases during interictal spikes in temporal lobe epilepsy: A graph signal processing study.

OBJECTIVE: Structure-function coupling remains largely unknown in brain disorders. We studied this coupling during interictal epileptic discharges (IEDs), using graph signal processing in temporal lobe epilepsy (TLE). METHODS: We decomposed IEDs of 17 patients on spatial maps, i.e. network harmonics, extracted from a structural connectome. Harmonics were split in smooth maps (long-range interactions reflecting integration) and coarse maps (short-range interactions reflecting segregation) and were used to reconstruct the part of the signal coupled (Xc) and decoupled (Xd) from the structure, respectively. We analysed how Xc and Xd embed the IED energy over time, at global and regional level. RESULTS: For Xc, the energy was smaller than for Xd before the IED onset (p < .001), but became larger around the first IED peak (p < .05, cluster 2, C2). Locally, the ipsilateral mesial regions were significantly coupled to the structure over the whole epoch. The ipsilateral hippocampus increased its coupling during C2 (p < .01). CONCLUSIONS: At whole-brain level, segregation gives way to integrative processes during the IED. Locally, brain regions commonly involved in the TLE epileptogenic network increase their reliance on long-range couplings during IED (C2). SIGNIFICANCE: In TLE, integration mechanisms prevail during the IED and are localized in the ipsilateral mesial temporal regions.

[Human fibroblast interferon therapy alone and human fibroblast interferon combined with thymostimulin in genital papillomavirus infection associated with cervical intraepithelial neoplasia]. / La terapia con interferone umano da fibroblasti e con interferone umano da fibroblasti più timostimolina nelle infezioni genitali da HPV associate a CIN.

Eighteen patients suffering for HPV infections associated with CIN were treated using human fibroblast interferon, via an intramuscular route, with positive results. Five cases of recurrent HPV within nine months of treatment received thymostimulin therapy, via an intramuscular route, with positive results.