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Tidsskrift For Den Norske Laegeforening... Jan 2023The temporal lobes are the part of the brain most likely to give rise to epileptic seizures. Seizures originating in the temporal lobes vary greatly in character; some...
The temporal lobes are the part of the brain most likely to give rise to epileptic seizures. Seizures originating in the temporal lobes vary greatly in character; some may be so unusual that they are not even recognised as epileptic. For patients who have been diagnosed with hippocampal sclerosis and whose seizures cannot be controlled with drugs, epilepsy surgery may be a good treatment option. In this brief clinical review, we summarise the key features of epilepsy and highlight the importance of accurate and early diagnosis for achieving good clinical outcomes.
Topics: Humans; Epilepsy, Temporal Lobe; Seizures; Epilepsy; Temporal Lobe; Brain; Hippocampus; Electroencephalography
PubMed: 36718887
DOI: 10.4045/tidsskr.22.0369 -
Annals of Clinical and Translational... Nov 2020Previous studies suggest that daily music listening can aid stroke recovery, but little is known about the stimulus-dependent and neural mechanisms driving this effect.... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Previous studies suggest that daily music listening can aid stroke recovery, but little is known about the stimulus-dependent and neural mechanisms driving this effect. Building on neuroimaging evidence that vocal music engages extensive and bilateral networks in the brain, we sought to determine if it would be more effective for enhancing cognitive and language recovery and neuroplasticity than instrumental music or speech after stroke.
METHODS
Using data pooled from two single-blind randomized controlled trials in stroke patients (N = 83), we compared the effects of daily listening to self-selected vocal music, instrumental music, and audiobooks during the first 3 poststroke months. Outcome measures comprised neuropsychological tests of verbal memory (primary outcome), language, and attention and a mood questionnaire performed at acute, 3-month, and 6-month stages and structural and functional MRI at acute and 6-month stages.
RESULTS
Listening to vocal music enhanced verbal memory recovery more than instrumental music or audiobooks and language recovery more than audiobooks, especially in aphasic patients. Voxel-based morphometry and resting-state and task-based fMRI results showed that vocal music listening selectively increased gray matter volume in left temporal areas and functional connectivity in the default mode network.
INTERPRETATION
Vocal music listening is an effective and easily applicable tool to support cognitive recovery after stroke as well as to enhance early language recovery in aphasia. The rehabilitative effects of vocal music are driven by both structural and functional plasticity changes in temporoparietal networks crucial for emotional processing, language, and memory.
Topics: Aged; Cerebral Cortex; Cognitive Dysfunction; Connectome; Default Mode Network; Female; Humans; Language; Magnetic Resonance Imaging; Male; Middle Aged; Music; Music Therapy; Neuropsychological Tests; Outcome Assessment, Health Care; Singing; Stroke; Stroke Rehabilitation; Temporal Lobe; Verbal Learning
PubMed: 33022148
DOI: 10.1002/acn3.51217 -
Nature Communications Oct 2020Epilepsy is one of the most common neurological disorders, yet its pathophysiology is poorly understood due to the high complexity of affected neuronal circuits. To...
Epilepsy is one of the most common neurological disorders, yet its pathophysiology is poorly understood due to the high complexity of affected neuronal circuits. To identify dysfunctional neuronal subtypes underlying seizure activity in the human brain, we have performed single-nucleus transcriptomics analysis of >110,000 neuronal transcriptomes derived from temporal cortex samples of multiple temporal lobe epilepsy and non-epileptic subjects. We found that the largest transcriptomic changes occur in distinct neuronal subtypes from several families of principal neurons (L5-6_Fezf2 and L2-3_Cux2) and GABAergic interneurons (Sst and Pvalb), whereas other subtypes in the same families were less affected. Furthermore, the subtypes with the largest epilepsy-related transcriptomic changes may belong to the same circuit, since we observed coordinated transcriptomic shifts across these subtypes. Glutamate signaling exhibited one of the strongest dysregulations in epilepsy, highlighted by layer-wise transcriptional changes in multiple glutamate receptor genes and strong upregulation of genes coding for AMPA receptor auxiliary subunits. Overall, our data reveal a neuronal subtype-specific molecular phenotype of epilepsy.
Topics: Adolescent; Adult; Biopsy; Case-Control Studies; Cell Nucleus; Datasets as Topic; Drug Resistant Epilepsy; Epilepsy, Temporal Lobe; Female; Glutamic Acid; Humans; Magnetic Resonance Imaging; Male; Microdissection; Middle Aged; Models, Genetic; Nerve Net; Neurons; RNA-Seq; Receptors, AMPA; Receptors, Glutamate; Signal Transduction; Single-Cell Analysis; Temporal Lobe; Transcription, Genetic; Transcriptome; Up-Regulation; Young Adult
PubMed: 33028830
DOI: 10.1038/s41467-020-18752-7 -
PLoS Biology Aug 2023Music is core to human experience, yet the precise neural dynamics underlying music perception remain unknown. We analyzed a unique intracranial electroencephalography...
Music is core to human experience, yet the precise neural dynamics underlying music perception remain unknown. We analyzed a unique intracranial electroencephalography (iEEG) dataset of 29 patients who listened to a Pink Floyd song and applied a stimulus reconstruction approach previously used in the speech domain. We successfully reconstructed a recognizable song from direct neural recordings and quantified the impact of different factors on decoding accuracy. Combining encoding and decoding analyses, we found a right-hemisphere dominance for music perception with a primary role of the superior temporal gyrus (STG), evidenced a new STG subregion tuned to musical rhythm, and defined an anterior-posterior STG organization exhibiting sustained and onset responses to musical elements. Our findings show the feasibility of applying predictive modeling on short datasets acquired in single patients, paving the way for adding musical elements to brain-computer interface (BCI) applications.
Topics: Humans; Auditory Cortex; Music; Brain Mapping; Auditory Perception; Temporal Lobe; Acoustic Stimulation
PubMed: 37582062
DOI: 10.1371/journal.pbio.3002176 -
Brain Structure & Function Mar 2022Visual mental imagery is the faculty whereby we can "visualize" objects that are not in our line of sight. Longstanding evidence dating back over thirty years has shown... (Review)
Review
Visual mental imagery is the faculty whereby we can "visualize" objects that are not in our line of sight. Longstanding evidence dating back over thirty years has shown that unilateral brain lesions, especially in the left temporal lobe, can impair aspects of this ability. Yet, there is currently no attempt to identify analogies between these neuropsychological findings of hemispheric asymmetry and those from other neuroscientific approaches. Here, we present a critical review of the available literature on the hemispheric laterality of visual mental imagery, by looking at cross-method patterns of evidence in the domains of lesion neuropsychology, neuroimaging, and direct cortical stimulation. Results can be summarized under three main axes. First, frontoparietal networks in both hemispheres appear to be associated with visual mental imagery. Second, lateralization patterns emerge in the temporal lobes, with the left inferior temporal lobe being the most common finding in the literature for endogenously generated images, especially, but not exclusively, when orthographic material is used to ignite imagery. Third, an opposite pattern of hemispheric laterality emerges when visual mental images are induced by exogenous stimulation; direct cortical electrical stimulation tends to produce visual imagery experiences predominantly when applied to the right temporal lobe. These patterns of hemispheric asymmetry are difficult to reconcile with the dominant model of visual mental imagery, which emphasizes the implication of early sensory cortices. They suggest instead that visual mental imagery relies on large-scale brain networks, with a crucial participation of high-level visual regions in the temporal lobes.
Topics: Brain; Brain Mapping; Functional Laterality; Imagination; Neuroimaging; Temporal Lobe
PubMed: 33885966
DOI: 10.1007/s00429-021-02277-w -
Epileptic Disorders : International... Oct 2022The ventral precuneal and posterior cingulate area (VP-PC) represents a distinct but topographically variable mesial parietal site of epileptogenicity that may manifest... (Review)
Review
The ventral precuneal and posterior cingulate area (VP-PC) represents a distinct but topographically variable mesial parietal site of epileptogenicity that may manifest as a common temporal lobe-mediated ictal expression. In a review of records of 62 presumptive epilepsy surgery cases, two cases of primary epileptogenicity expressed within the VP-PC were identified and are detailed to bring attention to this electroencephalographically-hidden area of ictal expression. Details of their investigation and surgical treatment illustrate distinctly different approaches addressing the problem and bringing about a seizure-free outcome.
Topics: Electroencephalography; Epilepsy; Epilepsy, Temporal Lobe; Gyrus Cinguli; Humans; Magnetic Resonance Imaging; Parietal Lobe; Temporal Lobe
PubMed: 35816098
DOI: 10.1684/epd.2022.1457 -
Epilepsia Open Feb 2024Biallelic CNTNAP2 variants have been associated with Pitt-Hopkins-like syndrome. We describe six novel and one previously reported patients from six independent families...
Biallelic CNTNAP2 variants have been associated with Pitt-Hopkins-like syndrome. We describe six novel and one previously reported patients from six independent families and review the literature including 64 patients carrying biallelic CNTNAP2 variants. Initial reports highlighted intractable focal seizures and the failure of epilepsy surgery in children, but subsequent reports did not expand on this aspect. In all our patients (n = 7), brain MRI showed bilateral temporal gray/white matter blurring with white matter high signal intensity, more obvious on the T2-FLAIR sequences, consistent with bilateral temporal lobe dysplasia. All patients had focal seizures with temporal lobe onset and semiology, which were recorded on EEG in five, showing bilateral independent temporal onset in four. Epilepsy was responsive to anti-seizure medications in two patients (2/7, 28.5%), and pharmaco-resistant in five (5/7, 71.5%). Splice-site variants identified in five patients (5/7, 71.5%) were the most common mutational finding. Our observation expands the phenotypic and genetic spectrum of biallelic CNTNAP2 alterations focusing on the neuroimaging features and provides evidence for an elective bilateral anatomoelectroclinical involvement of the temporal lobes in the associated epilepsy, with relevant implications on clinical management.
Topics: Child; Humans; Epilepsy, Temporal Lobe; Electroencephalography; Epilepsy; Temporal Lobe; Seizures; Membrane Proteins; Nerve Tissue Proteins
PubMed: 37805811
DOI: 10.1002/epi4.12843 -
Journal of Chemical Neuroanatomy Apr 2021Historically, the anterior part of the temporal lobe was labelled as a unique structure named Brain Area 38 by Brodmann or Temporopolar Area TG by Von Economo, but its... (Review)
Review
Historically, the anterior part of the temporal lobe was labelled as a unique structure named Brain Area 38 by Brodmann or Temporopolar Area TG by Von Economo, but its functions were unknown at that time. Later on, a few studies proposed to divide the temporal pole in several different subparts, based on distinct cytoarchitectural structure or connectivity patterns, while a still growing number of studies have associated the temporal pole with many cognitive functions. In this review, we provide an overview of the temporal pole anatomical and histological structure and its various functions. We performed a literature review of articles published prior to September 30, 2020 that included 112 articles. The temporal pole has thereby been associated with several high-level cognitive processes: visual processing for complex objects and face recognition, autobiographic memory, naming and word-object labelling, semantic processing in all modalities, and socio-emotional processing, as demonstrated in healthy subjects and in patients with neurological or psychiatric diseases, especially in the field of neurodegenerative disorders. A good knowledge of those functions and the symptoms associated with temporal pole lesions or dysfunctions is helpful to identify these diseases, whose diagnosis may otherwise be difficult.
Topics: Animals; Brain Mapping; Humans; Memory; Neural Pathways; Social Cognition; Temporal Lobe
PubMed: 33582250
DOI: 10.1016/j.jchemneu.2021.101925 -
Brain : a Journal of Neurology Apr 2020Human episodic memory critically depends on subregions of the medial temporal lobe, which are part of functional brain systems such as the anterior-temporal and the...
Human episodic memory critically depends on subregions of the medial temporal lobe, which are part of functional brain systems such as the anterior-temporal and the posterior-medial system. Here we analysed how Alzheimer's pathology affects functional connectivity within these systems. Data from 256 amyloid-β-negative cognitively unimpaired, 103 amyloid-β-positive cognitively unimpaired, and 83 amyloid-β-positive individuals with mild cognitive impairment were analysed. Amyloid-β and tau pathology were measured using the CSF amyloid-β42/40 ratio and phosphorylated tau, respectively. We found that amyloid-β-positive cognitively unimpaired individuals were mainly characterized by decreased functional connectivity between the medial temporal lobe and regions in the anterior-temporal system, most prominently between left perirhinal/entorhinal cortices and medial prefrontal cortex. Furthermore, correlation analysis in this group revealed decreasing functional connectivity between bilateral perirhinal/entorhinal cortices, anterior hippocampus and posterior-medial regions with increasing levels of phosphorylated tau. The amyloid-β-positive individuals with mild cognitive impairment mostly exhibited reduced connectivity between the medial temporal lobe and posterior-medial regions, predominantly between the anterior hippocampus and posterior cingulate cortex. In addition, they showed hyperconnectivity within the medial temporal lobe and its immediate proximity. Lower medial temporal-cortical functional connectivity networks resulting from the group comparisons of cognitively unimpaired individuals were associated with reduced memory performance and more rapid longitudinal memory decline as shown by linear mixed-effects regression analysis. Finally, we found that reduced medial temporal-cortical connectivity in mildly cognitively impaired individuals was related to reduced entorhinal thickness and white matter integrity of the parahippocampal cingulum and the fornix. No such relationships were found in cognitively unimpaired individuals. In conclusion, our findings show that the earliest changes in preclinical Alzheimer's disease might involve decreased connectivity within the anterior-temporal system, and early changes in connectivity might be related to memory impairment, but not to structural changes. With disease progression and increased tau pathology, medial temporal functional connectivity with posterior-medial regions seems to be increasingly impaired. In individuals with mild cognitive impairment, reduced functional connectivity is associated with structural brain changes as well as the emergence of locally increased connectivity patterns. Thus, functional connectivity between the medial temporal lobe and the anterior-temporal and posterior-medial system could serve as stage-specific functional markers in early Alzheimer's disease.
Topics: Aged; Aged, 80 and over; Alzheimer Disease; Cognition; Disease Progression; Female; Humans; Magnetic Resonance Imaging; Male; Memory, Episodic; Middle Aged; Neural Pathways; Temporal Lobe
PubMed: 32252068
DOI: 10.1093/brain/awaa068 -
The Journal of Neuroscience : the... Feb 2021Deciphering the mechanisms of human memory is a central goal of neuroscience, both from the point of view of the fundamental biology of memory and for its translational... (Review)
Review
Deciphering the mechanisms of human memory is a central goal of neuroscience, both from the point of view of the fundamental biology of memory and for its translational relevance. Here, we review some contributions that recordings from neurons in humans implanted with electrodes for clinical purposes have made toward this goal. Recordings from the medial temporal lobe, including the hippocampus, reveal the existence of two classes of cells: those encoding highly selective and invariant representations of abstract concepts, and memory-selective cells whose activity is related to familiarity and episodic retrieval. Insights derived from observing these cells in behaving humans include that semantic representations are activated before episodic representations, that memory content and memory strength are segregated, and that the activity of both types of cells is related to subjective awareness as expected from a substrate for declarative memory. Visually selective cells can remain persistently active for several seconds, thereby revealing a cellular substrate for working memory in humans. An overarching insight is that the neural code of human memory is interpretable at the single-neuron level. Jointly, intracranial recording studies are starting to reveal aspects of the building blocks of human memory at the single-cell level. This work establishes a bridge to cellular-level work in animals on the one hand, and the extensive literature on noninvasive imaging in humans on the other hand. More broadly, this work is a step toward a detailed mechanistic understanding of human memory that is needed to develop therapies for human memory disorders.
Topics: Electrodes, Implanted; Hippocampus; Humans; Memory Disorders; Memory, Episodic; Memory, Short-Term; Mental Recall; Neurons; Temporal Lobe
PubMed: 33257323
DOI: 10.1523/JNEUROSCI.1648-20.2020