PubMed Health⌕ Search

Biomedical subjects

Claude Adam

Publications and source records attributed to Claude Adam.

14 recordsLinked to original sources
PubMed2006

Complete change of seizure and spike lateralization in temporal lobe epilepsy at two separate monitorings.

OBJECTIVE: To report complete change of seizure and spike lateralization over time in bilateral temporal lobe epilepsies (TLE). METHODS: Repetition of video-EEG monitorings in 115 patients; 2 cases are reported in detail; 113 other severe partial epilepsies were included to estimate retrospectively the frequency of the reported phenomenon. RESULTS: In 2 cases, two video-EEG monitorings, separated by several months, revealed the first time one unilateral TL (temporal lobe) seizure and spike focus and the second time a distinct seizure and spike focus located in the opposite TL. The second monitoring was planned for these two patients because of the presence of a discordant lesion or, in the absence of a lesion, of some bilateral or discordant functional (EEG, SPECT and PET) abnormalities. No patient among the other 113 cases had this video-EEG pattern. CONCLUSIONS: In TLE, two video-EEG sessions may be necessary to disclose two opposite TL epileptogenic foci. SIGNIFICANCE: In rare bilateral TLE cases, the expression of seizure and spike foci can alternate between hemispheres.

Adult↗
PubMed2006

Direct intracranial, FMRI, and lesion evidence for the causal role of left inferotemporal cortex in reading.

Models of the "visual word form system" postulate that a left occipitotemporal region implements the automatic visual word recognition required for efficient reading. This theory was assessed in a patient in whom reading was explored with behavioral measures, fMRI, and intracranial local field potentials. Prior to surgery, when reading was normal, fMRI revealed a normal mosaic of ventral visual selectivity for words, faces, houses, and tools. Intracranial recordings demonstrated that the left occipitotemporal cortex responded with a short latency to conscious but also to subliminal words. Surgery removed a small portion of word-responsive occipitotemporal cortex overlapping with the word-specific fMRI activation. The patient developed a marked reading deficit, while recognition of other visual categories remained intact. Furthermore, in the post-surgery fMRI map of visual cortex, only word-specific activations disappeared. Altogether, these results provide direct evidence for the causal role of the left occipitotemporal cortex in the recognition of visual words.

Brain Mapping↗
PubMed2006

Frequency flows and the time-frequency dynamics of multivariate phase synchronization in brain signals.

The quantification of phase synchrony between brain signals is of crucial importance for the study of large-scale interactions in the brain. Current methods are based on the estimation of the stability of the phase difference between pairs of signals over a time window, within successive frequency bands. This paper introduces a new approach to study the dynamics of brain synchronies, Frequency Flows Analysis (FFA). It allows direct tracking and characterization of the nonstationary time-frequency dynamics of phase synchrony among groups of signals. It is based on the use of the one-to-one relationship between frequency locking and phase synchrony, which applies when the concept of phase synchrony is not taken in an extended 'statistical' sense of a bias in the distribution of phase differences, but in the sense of a continuous phase difference conservation during a short period of time. In such a case, phase synchrony implies identical instantaneous frequencies among synchronized signals, with possible time varying frequencies of synchronization. In this framework, synchronous groups of signals or neural assemblies can be identified as belonging to common frequency flows, and the problem of studying synchronization becomes the problem of tracking frequency flows. We use the ridges of the analytic wavelet transforms of the signals of interest in order to estimate maps of instantaneous frequencies and reveal sustained periods of common instantaneous frequency among groups of signal. FFA is shown to track complex dynamics of synchrony in coupled oscillator models, reveal the time-frequency and spatial dynamics of synchrony convergence and divergence in epileptic seizures, and in MEG data the large-scale ongoing dynamics of synchrony correlated with conscious perception during binocular rivalry.

Adult↗
PubMed2006

Ictal brain hyperperfusion contralateral to seizure onset: the SPECT mirror image.

PURPOSE: Ictal single-photon emission computed tomography (SPECT) may help localize the seizure-onset zone (SOZ) by detecting changes in regional cerebral blood flow induced by epileptic discharges. This imaging method also reveals hyperperfusions in areas of seizure propagation, including the hemisphere contralateral to the SOZ. We have studied the occurrence, the topography, and the clinical value of such contralateral ictal hyperperfusion areas (HPAs). METHODS: We examined data from presurgical evaluations of 36 consecutive patients with pharmacoresistant partial epilepsy of various localizations. Ictal and interictal SPECT examinations were made with 99mTc-ECD, and the scans were processed for coregistration, normalization, subtraction, and merging with MRI images. RESULTS: Contralateral HPAs were observed in 72% of the patients: 50% of mesiotemporal epilepsy cases with hippocampal sclerosis, 85.7% of the other mesiotemporal epilepsies, 85.7% of neocortical lateral temporal epilepsies, and 87.5% of extratemporal epilepsies. Contralateral HPAs were usually symmetrical to the SOZ, forming a mirror image, observed in 57.1% of the patients. They could be slightly asymmetrical in mesiotemporal epilepsies, perhaps because of the particular anatomic pathways linking temporal lobes. In neocortical epilepsies, they were located in the cortex homotopic to the SOZ. CONCLUSIONS: We show that the symmetrical nature of the mirror image usually does not disturb SPECT interpretation. It can confirm the location of the SOZ (11 patients) and even occasionally improve the precision of its definition (nine patients) by restraining several potential SOZ-related HPAs to a single one or by permitting a restricted localization of the SOZ in a large HPA.

Brain↗
PubMed2006

Toothbrush-thinking seizures.

Seizures associated with toothbrushing have been reported in patients with precentral or postcentral partial epilepsy. Seizures precipitated by thinking have been described in patients with idiopathic generalized epilepsy. We report a patient with intractable partial epilepsy in which seizures were induced both by toothbrushing, and by seeing or thinking about toothbrush and toothpaste. Video-EEG analysis revealed a left temporal lobe origin for these reflex seizures. We discuss how complex multimodal stimuli may trigger these reflex seizures.

Electroencephalography↗
PubMed2006

Long-term prognosis and psychosocial outcomes after surgery for MTLE.

PURPOSE: To assess the seizure-freedom rates and self-perceived psychosocial changes associated with the long-term outcome of epilepsy surgery in patients with refractory medial temporal lobe epilepsy associated with hippocampal sclerosis. METHODS: A standard questionnaire was given to 183 patients who underwent surgery between 1988 and 2004, and 110 were completed. RESULTS: The mean duration of follow-up after surgery was 7 years, with a maximum of 17 years. The probability that patients were seizure-free after surgery was dependent on the definition of the seizure freedom. For the patients who were seizure-free since surgery (Engel's class Ia), the probability was 97.6% at 1 year after surgery, 85.2% at 2 years after surgery, 59.5% at 5 years after surgery, and 42.6% at 10 years after surgery. For the patients who still experienced rare disabling seizures after surgery but were seizure-free at least 1 year before the time of assessment, the probability was of 97.6% at 1 year after surgery, 95% at 2 years after surgery, 82.8% at 5 years after surgery, and 71.1% at 10 years after surgery. The psychosocial long-term outcome, as measured by indices of driving, employment, familial and social relationships, and marital status, was similar to the psychosocial short-term outcome. It did not depend on seizure freedom or on follow-up time interval and was not influenced statistically by seizure frequency in cases of persisting seizures. Most but not all patients noticed a substantial overall improvement in their psychosocial condition; 48% drove (increased by 7%), 47% improved (14% worsened) in their employment status, and 68% improved (5% worsened) in their familial and social relationships. Overall, 91% of patients were satisfied with the surgery, and 92% did not regret their decision. CONCLUSIONS: The results of this study suggest that temporal lobe surgery has real long-term benefits. Two specific conclusions emerge: (a) the long-term rates of freedom from seizure depend on how seizure freedom is defined, and (b) the psychosocial long-term outcome does not change dramatically over years and does not depend on seizure freedom.

Adaptation, Psychological↗
PubMed2005

Interictal diffusion MRI in partial epilepsies explored with intracerebral electrodes.

Patients with refractory partial seizures may benefit from epilepsy surgery. However, invasive investigations are often needed to define the precise location and limits of the epileptogenic zone (EZ). In this study, we asked whether diffusion tensor imaging (DTI) might provide a non-invasive alternative to locate the EZ or at least provide insights to help place intracerebral electrodes for stereo-electroencephalography (SEEG). Whole brain DTI and voxel-based analysis (SPM99) was used to assess diffusion properties objectively in 16 epilepsy patients investigated with SEEG. Epilepsy was symptomatic in two patients and cryptogenic in the 14 remaining patients. The suspected onset of seizures was temporal in 10 patients, frontal in 2 and occipital in 4. Individual maps of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated and compared to a database of 40 healthy volunteers. Thirteen of 16 patients exhibited diffusion abnormalities. ADC abnormalities were better correlated with SEEG data than FA abnormalities which were usually located at a distance or in the white matter. A significant increase in ADC (P < 0.01) was found in 11 patients and was located in the regions explored with depth electrodes in 7 of them. Surgery outcome was available in 3 of these 7 patients (2 were seizure free and 1 not). DTI specificity was better in extratemporal lobe epilepsy (83%) than in temporal lobe epilepsy (20%). When abnormalities concurred with the SEEG data, the concordance was optimal between the localization of the diffusion abnormalities and the irritative zone defined by SEEG. These encouraging, preliminary results, suggest that DTI examinations may provide accurate spatial data on the location and extent of the epileptogenic network in extratemporal lobe epilepsies.

Adolescent↗
PubMed2005

Diffusion tensor imaging in medial temporal lobe epilepsy with hippocampal sclerosis.

Interictal diffusion imaging studies in patients with medial temporal lobe epilepsy (MTLE) accompanied by hippocampal sclerosis (HS) have shown an increased diffusivity in the epileptogenic hippocampus. In this study, we wanted to explore the whole brain in order to determine if MTLE could have an impact on the organization and the architecture of a large cerebral network and to identify clinical factors that could mediate diffusion abnormalities. Diffusion tensor imaging (DTI) and statistical parametric mapping of the entire brain were performed in 35 well-defined MTLE patients and in 36 healthy volunteers. SPM analyses identified three abnormal areas: an increased diffusivity was detected in the epileptic hippocampus and the ipsilateral temporal structures associated with a decreased anisotropy along the temporal lobe, a decreased diffusivity was found in the contralateral non-sclerotic hippocampus, the amygdala, and the temporal pole, and finally, a decreased anisotropy was noted ipsilaterally in posterior extratemporal regions. Duration of epilepsy, age at onset, and the frequency of generalized tonic-clonic seizures or partial complex seizures did not correlate with the presence of diffusion abnormalities. Region of interest analysis in the hippocampus/parahippocampus demonstrated a correlation between lower ipsilateral diffusivity values and occurrence of epigastric aura and between higher anisotropy values in both hemispheres and history of febrile seizures. In conclusion, this study showed that diffusion abnormalities are not restricted to the pathologic hippocampus and involve a larger network. This pattern may indirectly reflect the epileptogenic network and may be interpreted as a cause or a consequence of epilepsy.

Adult↗
PubMed2005

A direct intracranial record of emotions evoked by subliminal words.

A classical but still open issue in cognitive psychology concerns the depth of subliminal processing. Can the meaning of undetected words be accessed in the absence of consciousness? Subliminal priming experiments in normal subjects have revealed only small effects whose interpretation remains controversial. Here, we provide a direct demonstration of semantic access for unseen masked words. In three epileptic patients with intracranial electrodes, we recorded brain potentials from the amygdala, a neural structure that responds to fearful or threatening stimuli presented in various modalities, including written words. We show that the subliminal presentation of emotional words modulates the activity of the amygdala at a long latency (>800 ms). Our result indicates that subliminal words can trigger long-lasting cerebral processes, including semantic access to emotional valence.

Adult↗
PubMed2005

On the intrinsic time scales involved in synchronization: a data-driven approach.

We address the problem of detecting, from scalar observations, the time scales involved in synchronization of complex oscillators with several spectral components. Using a recent data-driven procedure for analyzing nonlinear and nonstationary signals [Huang, Proc. R. Soc. London A 454, 903 (1998)], we decompose a time series in distinct oscillation modes which may display a time varying spectrum. When applied to coupled oscillators with multiple time scales, we found that motions are captured in a finite number of phase-locked oscillations. Further, in the synchronized state distinct phenomena as phase slips, anti-phase or perfect phase locking can be simultaneously observed at specific time scales. This fully data-driven approach (without a priori choice of filters or basis functions) is tested on numerical examples and illustrated on electric intracranial signals recorded from an epileptic patient. Implications for the study of the build-up of synchronized states in nonstationary and noisy systems are pointed out.

Biophysics↗
PubMed2004

[Place of surgery in the treatment of adult temporal lobe epilepsy].

Surgery for temporal lobe epilepsy has made significant progress during the past twenty years: in addition to traditional factors (frequency of partial seizures and relative resistance to medical treatment), the possibilities offered by MRI in a large number of cases to detect the responsible lesion (hippocampal sclerosis in the majority of cases) has led to an increase in the use of surgical methods. Furthermore, other examinations (EEG-video, SPECT Depth-electrode recording) now permit precise localization of the epileptic focus. Surgical techniques have likewise been considerably modified: in parallel to classical temporal lobectomy, new surgical methods offer more restricted resection of the lateral cortex. The results are, on the whole, quite satisfactory, as three-quarters of patients can be considered cured or greatly improved. The length of post-operative follow-up does not seem to influence the quality of the results, as observed by the end of the second year.

Electroencephalography↗
PubMed2002

Seizure anticipation in human neocortical partial epilepsy.

The transition of brain activity towards an epileptic seizure is still a poorly understood phenomenon. Dynamic changes in brain activity have been detected several minutes before seizure emergence in populations of patients with mesial temporal lobe epilepsy (MTLE), using non-linear analysis of intracranial EEG recordings. Similar detection of a pre-ictal state has been obtained with standard scalp EEG recordings using a modified non-linear method. Here we applied this strategy to the seizures of patients with neocortical partial epilepsy. Results obtained by non-linear similarity analysis of 41 seizures from 11 patients with refractory partial epilepsy originating from various sites of the neocortex showed that (i) a pre-ictal state was detected in 90% of the patients and in 83% of the seizures whatever their location, with a mean anticipation time of 7.5 min; (ii) similar pre-ictal dynamic changes were detected when non-linear analysis methods were applied to either intracranial or scalp EEG recordings; (iii) the recording sites exhibiting these pre-ictal changes were distributed both within the epileptogenic focus and at remote locations; (iv) most pre-ictal dynamic changes were not correlated with linear changes in the frequency spectrum or with changes in the visually inspected EEG and the patients' behaviour. Hypotheses on the neuronal mechanisms underlying the pre-ictal period are discussed. The present results, together with those recently obtained in an MTLE population, suggest that changes in pre-ictal dynamics are a general phenomenon associated with seizure emergence in a wide population of patients with partial epilepsy, wherever the epileptogenic focus is located. The possibility of anticipating the onset of seizures has considerable therapeutic implications.

Adolescent↗