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Postictal clinical and EEG activity following intracranially recorded bilateral tonic-clonic seizures [Letter]

Bateman, Lisa M; Schevon, Catherine A
PMCID:6697043
PMID: 31313278
ISSN: 1528-1167
CID: 4041112

Minimax-optimal decoding of movement goals from local field potentials using complex spectral features

Angjelichinoski, Marko; Banerjee, Taposh; Choi, John; Pesaran, Bijan; Tarokh, Vahid
OBJECTIVE:We consider the problem of predicting eye movement goals from local field potentials (LFP) recorded through a multielectrode array in the macaque prefrontal cortex. The monkey is tasked with performing memory-guided saccades to one of eight targets during which LFP activity is recorded and used to train a decoder. APPROACH/METHODS:Previous reports have mainly relied on the spectral amplitude of the LFPs as decoding feature, while neglecting the phase without proper theoretical justification. This paper formulates the problem of decoding eye movement intentions in a statistically optimal framework and uses Gaussian sequence modeling and Pinsker's theorem to generate minimax-optimal estimates of the LFP signals which are used as decoding features. The approach is shown to act as a low-pass filter and each LFP in the feature space is represented via its complex Fourier coefficients after appropriate shrinking such that higher frequency components are attenuated; this way, the phase information inherently present in the LFP signal is naturally embedded into the feature space. MAIN RESULTS/RESULTS:We show that the proposed complex spectrum-based decoder achieves prediction accuracy of up to [Formula: see text] at superficial cortical depths near the surface of the prefrontal cortex; this marks a significant performance improvement over conventional power spectrum-based decoders. SIGNIFICANCE/CONCLUSIONS:The presented analyses showcase the promising potential of low-pass filtered LFP signals for highly reliable neural decoding of intended motor actions.
PMID: 30991369
ISSN: 1741-2552
CID: 4240922

Anatomical hemispherectomy revisited-outcome, blood loss, hydrocephalus, and absence of chronic hemosiderosis

Sood, Sandeep; Ilyas, Mohammed; Marupudi, Neena I; Asano, Eishi; Kumar, Ajay; Luat, Aimee; Saleem, Sheena; Chugani, Harry T
PURPOSE/OBJECTIVE:To evaluate microsurgical trans-sylvian trans-ventricular anatomical hemispherectomy with regard to seizure outcome, risk of hydrocephalus, blood loss, and risk of chronic hemosiderosis in patients with intractable seizures selected for surgery using current preoperative assessment techniques. METHODS:Out of 86 patients who underwent hemispherectomy between February 2000 and April 2019, by a single surgeon, at a tertiary care referral center, 77 patients (ages 0.2-20 years; 40 females) who had an anatomical hemispherectomy were analyzed. Five of these were 'palliative' surgeries. One-stage anatomical hemispherectomy was performed in 55 children, two-stage anatomical hemispherectomy after extraoperative intracranial monitoring in 16, and six hemispherectomies were done following failed previous resection. Mean follow-up duration was 5.7 years (range 1-16.84 years). Forty-six patients had postoperative MRI scans. RESULTS:Ninety percent of children with non-palliative hemispherectomy achieved ILAE Class-1 outcome. Twenty-seven patients were no longer taking anticonvulsant medications. Surgical failures (n = 4) included one patient with previous meningoencephalitis, one with anti-GAD antibody encephalitis, one with idiopathic neonatal thalamic hemorrhage, and one with extensive tuberous sclerosis. There were no failures among patients with malformations of cortical development. Estimated average blood loss during surgery was 387 ml. Ten (21%) children developed hydrocephalus and required a shunt following one-stage hemispherectomy, whereas 10 (50%) patients developed hydrocephalus among those who had extraoperative intracranial monitoring. Only 20% of the shunts malfunctioned in the first year. Early malfunctions were related to the valve and later to fracture disconnection of the shunt. One patent had a traumatic subdural hematoma. None of the patients developed clinical signs of chronic 'superficial cerebral hemosiderosis' nor was there evidence of radiologically persistent chronic hemosiderosis in patients who had postoperative MRI imaging. CONCLUSION/CONCLUSIONS:Surgical results of anatomical hemispherectomy are excellent in carefully selected cases. Post-operative complications of hydrocephalus and intraoperative blood loss are comparable to those reported for hemispheric disconnective surgery (hemispherotomy). The rate of shunt malfunction was less than that reported for patients with hydrocephalus of other etiologies Absence of chronic 'superficial hemosiderosis', even on long-term follow-up, suggests that anatomical hemispherectomy should be revisited as a viable option in patients with intractable seizures and altered anatomy such as in malformations of cortical development, a group that has a reported high rate of seizure recurrence related to incomplete disconnection following hemispheric disconnective surgery.
PMID: 31243582
ISSN: 1433-0350
CID: 3954232

Head-to-head comparison of 11C-PBR28 and 11C-ER176 for quantification of the translocator protein in the human brain

Zanotti-Fregonara, Paolo; Pascual, Belen; Veronese, Mattia; Yu, Meixiang; Beers, David; Appel, Stanley H; Masdeu, Joseph C
INTRODUCTION/BACKGROUND:C-PBR28. METHODS:for both tracers. RESULTS:C-PBR28 for high-affinity binders, and more than 9 times larger for mixed-affinity binders. CONCLUSION/CONCLUSIONS:C-ER176 are expected to have higher statistical power and thus require fewer subjects.
PMID: 31152207
ISSN: 1619-7089
CID: 3922102

Motor phenotype classification in moderate to advanced PD in BioFIND study

Luo, Lan; Andrews, Howard; Alcalay, Roy N; Poyraz, Fernanda Carvalho; Boehme, Amelia K; Goldman, Jennifer G; Xie, Tao; Tuite, Paul; Henchcliffe, Claire; Hogarth, Penelope; Amara, Amy W; Frank, Samuel; Sutherland, Margaret; Kopil, Catherine; Naito, Anna; Kang, Un Jung
BACKGROUND:Three motor phenotypes have been described in PD: postural instability and gait difficulty (PIGD) dominant, tremor-dominant (TD), and indeterminate (IND) subtype. These phenotypes have been associated with different cognitive trajectories, motor outcomes, and biomarkers profiles. However, whether motor subtype classifications change with treatment and disease progression is not well established. METHODS:To evaluate motor subtype ratio changes, we used the chi-square test for the off and on state motor subtypes for 115 PD participants in the BioFIND study and used repeated-measures analyses to evaluate longitudinal changes in 162 PD participants with five-year follow-up in the PPMI study. RESULTS:PIGD and TD subtypes in moderate to advanced PD participants change with dopaminergic agents. For those who shifted subtypes, improvement in tremor accounted for the transition of 15 (25.4%) TD participants, while the lack of tremor improvement along with minimal changes in PIGD score resulted in changes for eight (19.0%) PIGD individuals. Analyses of PPMI data revealed that all three subgroups had a significant decrease in subtype ratio with disease progression and a significant decline in subtype ratio occurred only in the TD subgroup with dopaminergic agents. The impact of dopaminergic medication effect on subtype shift for each visit was also more notable with disease advancement. CONCLUSIONS:Motor subtypes are not fixed but change with progression of the disease and with treatment. Improvement in tremor was the main contributor to motor phenotype transitions in the BioFIND cohort. A more stable classification system for subtypes based on underlying biological differences is desirable.
PMID: 31255537
ISSN: 1873-5126
CID: 3967712

Characterization of the First Conotoxin from Conus ateralbus, a Vermivorous Cone Snail from the Cabo Verde Archipelago

Neves, Jorge L B; Imperial, Julita S; Morgenstern, David; Ueberheide, Beatrix; Gajewiak, Joanna; Antunes, Agostinho; Robinson, Samuel D; Espino, Samuel; Watkins, Maren; Vasconcelos, Vitor; Olivera, Baldomero M
Conus ateralbus is a cone snail endemic to the west side of the island of Sal, in the Cabo Verde Archipelago off West Africa. We describe the isolation and characterization of the first bioactive peptide from the venom of this species. This 30AA venom peptide is named conotoxin AtVIA (δ-conotoxin-like). An excitatory activity was manifested by the peptide on a majority of mouse lumbar dorsal root ganglion neurons. An analog of AtVIA with conservative changes on three amino acid residues at the C-terminal region was synthesized and this analog produced an identical effect on the mouse neurons. AtVIA has homology with δ-conotoxins from other worm-hunters, which include conserved sequence elements that are shared with δ-conotoxins from fish-hunting Conus. In contrast, there is no comparable sequence similarity with δ-conotoxins from the venoms of molluscivorous Conus species. A rationale for the potential presence of δ-conotoxins, that are potent in vertebrate systems in two different lineages of worm-hunting cone snails, is discussed.
PMID: 31344776
ISSN: 1660-3397
CID: 3988182

SUDEP in the North American SUDEP Registry: The full spectrum of epilepsies

Verducci, Chloe; Hussain, Fizza; Donner, Elizabeth; Moseley, Brian D; Buchhalter, Jeffrey; Hesdorffer, Dale; Friedman, Daniel; Devinsky, Orrin
OBJECTIVE:To obtain medical records, family interviews, and death-related reports of sudden unexpected death in epilepsy (SUDEP) cases to better understand SUDEP. METHODS:All cases referred to the North American SUDEP Registry (NASR) between October 2011 and June 2018 were reviewed; cause of death was determined by consensus review. Available medical records, death scene investigation reports, autopsy reports, and next-of-kin interviews were reviewed for all cases of SUDEP. Seizure type, EEG, MRI, and SUDEP classification were adjudicated by 2 epileptologists. RESULTS:There were 237 definite and probable cases of SUDEP among 530 NASR participants. SUDEP decedents had a median age of 26 (range 1-70) years at death, and 38% were female. In 143 with sufficient information, 40% had generalized and 60% had focal epilepsy. SUDEP affected the full spectrum of epilepsies, from benign epilepsy with centrotemporal spikes (n = 3, 1%) to intractable epileptic encephalopathies (n = 27, 11%). Most (93%) SUDEPs were unwitnessed; 70% occurred during apparent sleep; and 69% of patients were prone. Only 37% of cases of SUDEP took their last dose of antiseizure medications (ASMs). Reported lifetime generalized tonic-clonic seizures (GTCS) were <10 in 33% and 0 in 4%. CONCLUSIONS:NASR participants commonly have clinical features that have been previously been associated with SUDEP risk such as young adult age, ASM nonadherence, and frequent GTCS. However, a sizeable minority of SUDEP occurred in patients thought to be treatment responsive or to have benign epilepsies. These results emphasize the importance of SUDEP education across the spectrum of epilepsy severities. We aim to make NASR data and biospecimens available for researchers to advance SUDEP understanding and prevention.
PMID: 31217259
ISSN: 1526-632x
CID: 3939212

Telerehabilitation benefits patients with multiple sclerosis in an urban setting

Shaw, Michael T; Best, Pamela; Frontario, Ariana; Charvet, Leigh E
PMID: 31307269
ISSN: 1758-1109
CID: 3977702

Steroids: A Wake-Up Call in TBI Induced Hypersomnolence

Oks, Margarita; Kothare, Sanjeev V
ABSTRACT/UNASSIGNED:Hypersomnolence is one of the more common symptoms reported after mild traumatic brain injury (TBI) and often one of the most difficult to treat. This case series presents a cohort of patients with TBI related hypersomnolence associated with a de novo autoimmune process that successfully resolved with pulse dose corticosteroid treatment. When associated with an autoimmune inflammatory process, corticosteroids may serve to stabilize the blood brain barrier leading to the successful and sustained resolution of TBI induced sleepiness.
PMCID:6622505
PMID: 31383244
ISSN: 1550-9397
CID: 4032942

Characterization of guided entry of tail-anchored proteins 3 homologues in Mycobacterium tuberculosis

Hu, Kuan; Jordan, Ashley T; Zhang, Susan; Dhabaria, Avantika; Kovach, Amanda; Rangel, Margarita; Ueberheide, Beatrix; Li, Huilin; Darwin, K Heran
We characterized an operon in Mycobacterium tuberculosis (M. tuberculosis), Rv3679-Rv3680, in which each open reading frame is annotated to encode "anion transporter ATPase" homologues. Using structure prediction modeling, we found Rv3679 and Rv3680 more closely resemble the guided-entry of tail-anchored proteins 3 (Get3) chaperone in eukaryotes. Get3 delivers proteins into the membranes of the endoplasmic reticulum and is essential for the normal growth and physiology of some eukaryotes. We sought to characterize the structures of Rv3679 and Rv3680 and test if they have a role in M. tuberculosis pathogenesis. We solved crystal structures of nucleotide-bound Rv3679-Rv3680 complex at 2.5-3.2 Ã… and show while it has some similarities to Get3 and ArsA, the complex has notable differences, including that these proteins are unlikely to be involved in anion transport. Deletion of both genes did not reveal any conspicuous defects in growth in vitro or in mice. Collectively, we identified a new class of proteins in bacteria with similarity to Get3 complexes, the functions of which remain to be determined.ImportanceNumerous bacterial species encode proteins predicted to have similarity with Get3 and ArsA-type anion transporters. Our studies provide evidence that these proteins, which we named BagA and BagB, are unlikely to be involved in anion transport. In addition, BagA and BagB are conserved in all mycobacterial species, including the causative agent of leprosy, which has a highly decayed genome. This conservation suggests BagAB constitutes a part of the core mycobacterial genome and is needed for some yet-to-be-determined part of the life cycle of these organisms.
PMID: 31036728
ISSN: 1098-5530
CID: 3854522