Left-sided epileptiform activity influences language lateralization in right mesial temporal sclerosis.

OBJECTIVE: To investigate the association between left epileptiform activity and language laterality indices (LI) in patients with right mesial temporal sclerosis (MTS). METHODS: Twenty-two patients with right MTS and 22 healthy subjects underwent fMRI scanning while performing a language task. LI was calculated in multiple regions of interest (ROI). Data on the presence of left epileptiform abnormalities were obtained during prolonged video-EEG monitoring. RESULTS: After correction for multiple comparisons, LI was reduced in the middle temporal gyrus in the left interictal epileptiform discharges (IED+) group, compared with the left IED- group (p < 0.05). SIGNIFICANCE: Using a responsive reading naming fMRI paradigm, right MTS patients who presented left temporal interictal epileptiform abnormalities on video-EEG showed decreased LI in the middle temporal gyrus, indicating decreased left middle temporal gyrus activation, increased right middle temporal gyrus activation or a combination of both, demonstrative of language network reorganization, specially in the MTG, in this patient population. PLAIN LANGUAGE SUMMARY: This research studied 22 patients with right mesial temporal sclerosis (a specific type of epilepsy) comparing them to 22 healthy individuals. Participants were asked to perform a language task while undergoing a special brain imaging technique (fMRI). The findings showed that patients with epilepsy displayed a change in the area of the brain typically responsible for language processing. This suggests that their brains may have adapted due to their condition, altering the way language is processed.

Orientações ao paciente epiléptico submetido ao vídeo-eletrencefalograma: comparação dos níveis de ansiedade com o uso de diferentes estratégias / Orientations to epileptic patient undergoing a video-EEG monitoring: comparison of anxiety levels using different strategies

Trata-se de um estudo experimental, correlacional, com abordagem quantitativa que compara os níveis de ansiedade de dois grupos de pacientes epilépticos submetidos ao vídeo-eletrencefalograma (vídeo-EEG) que tiveram diferentes estratégias de orientação para o exame; o controle teve apenas orientações verbais e o experimental, além das orientações verbais, também, recebeu um manual de orientações, variável independente do estudo. A amostra foi, aleatoriamente, composta por dois grupos de 30 pacientes. Para avaliar o uso de diferentes estratégias de orientação, foi comparada a ansiedade dos grupos, por meio da aplicação do Inventário de Ansiedade Traço-Estado (IDATE), sendo o estado de ansiedade, avaliado pré e pós-exame. Os resultados mostraram que o grupo experimental apresentou perfil de ansiedade superior, porém, estado de ansiedade inferior, antes do exame, em relação ao controle. A ansiedade do grupo experimental foi mais baixa, antes do exame do que seu perfil, entretanto, o mesmo não ocorreu com o grupo controle. Após o exame, a grande maioria de ambos os grupos apresentou ansiedade baixa e menor que seu perfil. A estratégia de orientação com o manual parece ter beneficiado os pacientes que o receberam, promovendo a redução da ansiedade antes do exame ser realizado.

This exploratory, correlated and quantitative study had the objective to identify and compare the anxiety level between two groups of epileptic patients undergoing a video-EEG monitoring using different patients guidelines strategies. The random sample was composed by two groups of 30 patients each one. The control group only had verbal orientations and the experimental group, beyond the same orientations received a written guide (a booklet) with all the procedures too. The anxiety was assessed using State-Trait Anxiety Inventory (STAI-T and STAI-S) with the STAI-S being applied for both groups before and after examination as described above. The results demonstrated that, before video-EEG, the anxiety-trait score of the experimental group was higher and the anxiety-state was lower than the control group. After video-EEG, the majority of both groups demonstrated low anxiety-state score and lower than their anxiety-trait score. The strategy used with the written guide associated to verbal orientations seems to help to reduce the anxiety level before the video-EEG.