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[Imaging the functions of central neurons].

The dynamic behavior of biomolecules underlies various life functions including brain functions. Imaging techniques enable direct visualization of such behavior and afford us the opportunity to understand the mechanisms of the functions in spatiotemporal contexts. We have developed imaging techniques for visualization of IP3 and NO. A fluorescent IP3 probe GFP-PHD, which consists of GFP and the PH domain, translocates from plasma membrane to cytoplasm upon IP3 elevation. We can thus evaluate the changes in IP3 concentrations by imaging the translocation. Analysis with GFP-PHD revealed spatiotemporal IP3 dynamics underlying calcium oscillations and waves. We also discovered a novel mechanism for IP3 production which is mediated by AMPA receptor activation in cerebellar Purkinje neurons. A fluorescent NO probe HBR-GFP, consisting of GFP and the heme binding region of soluble guanylyl cyclase, reports NO by its fluorescence intensity. NO imaging in Purkinje neurons showed that a firing of parallel fibers elicits the localized NO signals which ensure synapse independence in LTP induction. The amount of NO production depended on the temporal firing patterns of parallel fibres: 1 Hz is the optimal frequency. In addition, 1 Hz firing effectively induced LTP. The above results indicate that imaging is useful to study the functions of central neurons.

Animals↗

Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP). DESIGN: Randomized controlled trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with CP (age range, 6-16 y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references. INTERVENTION: A 9-month strength-training program. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well. RESULTS: At E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2. CONCLUSIONS: The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients' motivations, ages, and postoperative statuses.

Adolescent↗

A novel organotypic long-term culture of the rat hippocampus on substrate-integrated multielectrode arrays.

Spatiotemporally coordinated activity of neural networks is crucial for brain functioning. To understand the basis of physiological information processing and pathological states, simultaneous multisite long-term recording is a prerequisite. In a multidisciplinary approach we developed a novel system of organotypically cultured rat hippocampal slices on a planar 60-microelectrode array (MEA). This biohybrid system allowed cultivation for 4 weeks. Methods known from semiconductor production were employed to fabricate and characterize the MEA. Simultaneous extracellular recording of local field potentials (LFPs) and spike activity at 60 sites under sterile conditions allowed the analysis of network activity with high spatiotemporal resolution. To our knowledge this is the first realization of hippocampus cultured organotypically on multi-microelectrode arrays for simultaneous recording and electrical stimulation. This biohybrid system promises to become a powerful tool for drug discovery and for the analysis of neural networks, of synaptic plasticity, and of pathophysiological conditions such as ischemia and epilepsy.

Action Potentials↗

The landscape of structural variation in pediatric cancer.

Structural variants (SVs) account for over 60% of the driver variants in pediatric cancer, and in many cases act as the cancer initiating event. To study SVs from a pan-cancer perspective, we analyzed 1,616 pediatric cancer genomes in 16 major cancer types of hematological malignancies (n = 908), brain tumors (n = 183), and solid tumors (n = 525) and compared their profiles to those of 2,203 adult cancers. The SV burden varied ~100-fold across pediatric cancer types and demonstrated an 8- to 16-fold reduction compared to adult brain and solid tumors but was comparable in pediatric versus adult hematological malignancies. Recurrent SV hotspots occurred uniquely in pediatric acute lymphoblastic leukemias (ALLs) in proximity to RAG-mediated recombination signal sequences (RSS) and disrupted multiple immune-related loci as well as 69 genes, which often involved cryptic RSS sites. By contrast, such hotspots affected only immune-related loci but not driver genes in adult lymphoid cancers. Eight SV signatures extracted from the cohort had varying distributions across cancer types, with clustered translocations reflecting templated insertions in osteosarcoma, and medium-sized deletions (10 kb to 1 Mb) enriched in cancers with RAG-mediated deletions. Intra-patient evolutionary analysis in 13 patients with multiple spatiotemporally distinct samples revealed that RAG-mediated recombination in leukemia and complex rearrangements in solid tumors occurred both early in disease initiation and continuously during later diversification, contributing to clonal heterogeneity. Finally, we found that both driver genes and fragile sites were the two genomic regions most frequently disrupted by SVs. The unique and diverse SV landscapes that emerged from this comprehensive analysis expand the scope of RSS-mediated mutagenesis in pediatric ALL and will be a valuable resource for guiding future functional studies and the design of clinical genomic testing in pediatric cancer.

Journal Article↗

Semi-automated analysis of color M-mode echocardiographic images for determining transmitral pressure gradients using a simplified Euler equation.

UNLABELLED: We hypothesize that a simplified version of the Euler equation (SEE) utilizing differences in velocity over a distance and time as obtained by Color Doppler M-mode (CMM) echocardiography can approximate actual peak transmitral pressure gradients deltaP(TM). METHODS: In 14 patients undergoing open-heart surgery, deltaP(TM) was measured under various hemodynamic conditions using 2 high fidelity transducers, 5 cm apart. Transesophageal CMM images were simultaneously acquired and a customized image analysis application was used to abstract spatiotemporal velocity characteristics. Using both the SEE and a simplified Bernoulli equations, deltaP(TM) were determined and compared to the actual deltaP(TM). RESULTS: While the simplified Bernoulli equation resulted in a poor estimate (y=0.075x+0.71, r=0.45), the deltaP(TM) obtained using the SEE correlated strongly (y=0.79x+0.48, r=0.91) with the actual measurements. CONCLUSIONS: Semi-automated analysis of CMM images using a SEE can accurately estimate actual deltaP(TM).

Algorithms↗

Cerebellar and premotor function in bimanual coordination: parametric neural responses to spatiotemporal complexity and cycling frequency.

In the present functional magnetic resonance imaging (fMRI) study, we assessed the neural network governing bimanual coordination during manipulations of spatiotemporal complexity and cycling frequency. A parametric analysis was applied to determine the effects of each of both factors as well as their interaction. Subjects performed four different cyclical movement tasks of increasing spatiotemporal complexity (i.e., unimanual left-right hand movements, bimanual in-phase movements, bimanual anti-phase movements, and bimanual 90 degrees out-of-phase movements) across four frequency levels (0.9, 1.2, 1.5, and 1.8 Hz). Results showed that, within the network involved in bimanual coordination, functional subcircuits could be distinguished: Activation in the supplementary motor area, superior parietal cortex (SPS), and thalamic VPL Nc was mainly correlated with increasing spatiotemporal complexity of the limb movements, suggesting that these areas are involved in higher-order movement control. By contrast, activation within the primary motor cortex, cingulate motor cortex (CMC), globus pallidus, and thalamic VLo Nc correlated mainly with movement frequency, indicating that these areas play an important role during movement execution. Interestingly, the cerebellum and the dorsal premotor cortex were identified as the principal regions responding to manipulation of both parameters and exhibiting clear interaction effects. Therefore, it is concluded that both areas represent critical sites for the control of bimanual coordination.

Adult↗

Comparison of atrial signal extraction algorithms in 12-lead ECGs with atrial fibrillation.

Analysis of atrial rhythm is important in the treatment and management of patients with atrial fibrillation. Several algorithms exist for extracting the atrial signal from the electrocardiogram (ECG) in atrial fibrillation, but there are few reports on how well these techniques are able to recover the atrial signal. We assessed and compared three algorithms for extracting the atrial signal from the 12-lead ECG. The 12-lead ECGs of 30 patients in atrial fibrillation were analyzed. Atrial activity was extracted by three algorithms, Spatiotemporal QRST cancellation (STC), principal component analysis (PCA), and independent component analysis (ICA). The amplitude and frequency characteristics of the extracted atrial signals were compared between algorithms and against reference data. Mean (standard deviation) amplitude of QRST segments of V1 was 0.99 (0.54) mV, compared to 0.18 (0.11) mV (STC), 0.19 (0.13) mV (PCA), and 0.29 (0.22) mV (ICA). Hence, for all algorithms there were significant reductions in the amplitude of the ventricular activity compared with that in V1. Reference atrial signal amplitude in V1 was 0.18 (0.11) mV, compared to 0.17 (0.10) mV (STC), 0.12 (0.09) mV (PCA), and 0.18 (0.13) mV (ICA) in the extracted atrial signals. PCA tended to attenuate the atrial signal in these segments. There were no significant differences for any of the algorithms when comparing the amplitude of the reference atrial signal with that of the extracted atrial signals in segments in which ventricular activity had been removed. There were no significant differences between algorithms in the frequency characteristics of the extracted atrial signals. There were discrepancies in amplitude and frequency characteristics of the atrial signal in only a few cases resulting from notable residual ventricular activity for PCA and ICA algorithms. In conclusion, the extracted atrial signals from these algorithms exhibit very similar amplitude and frequency characteristics. Users of these algorithms should be observant of residual ventricular activities which can affect the analysis of the fibrillatory waveform in clinical practice.

Algorithms↗

Synaptic organization and neurotransmitters in the rat accessory olfactory bulb.

The accessory olfactory bulb (AOB) is the first relay station in the vomeronasal system and may play a critical role in processing pheromone signals. The AOB shows similar but less distinct lamination compared with the main olfactory bulb (MOB). In this study, synaptic organization of the AOB was analyzed in slice preparations from adult rats by using both field potential and patch-clamp recordings. Stimulation of the vomeronasal nerve (VN) evoked field potentials that showed characteristic patterns in different layers of the AOB. Current source density (CSD) analysis of the field potentials revealed spatiotemporally separated loci of inward current (sinks) that represented sequential activation of different neuronal components: VN activity (period I), synaptic excitation of mitral cell apical dendrites (period II), and activation of granule cells by mitral cell basal dendrites (period III). Stimulation of the lateral olfactory tract also evoked field potentials in the AOB, which indicated antidromic activation of the mitral cells (period I and II) followed by activation of granule cells (period III). Whole cell patch recordings from mitral and granule cells of the AOB supported that mitral cells are excited by VN terminals and subsequently activate granule cells through dendrodendritic synapses. Both CSD analysis and patch recordings provided evidence that glutamate is the neurotransmitter at the vomeronasal receptor neuron; mitral cell synapses and both NMDA and non-NMDA receptors are involved. We also demonstrated electrophysiologically that reciprocal interaction between mitral and granule cells in the AOB is through the dendrodendritic reciprocal synapses. The neurotransmitter at the mitral-to-granule synapses is glutamate and at the granule-to-mitral synapse is gamma-aminobutyric acid. The synaptic interactions among receptor cell terminals, mitral cells, and granule cells in the AOB are therefore similar to those in the MOB, suggesting that processing of chemosensory information in the AOB shares similarities with that in the MOB.

Animals↗

Spatiotemporal regulation of morphogenetic molecules during in vitro branching of the isolated ureteric bud: toward a model of branching through budding in the developing kidney.

In search of guiding principles involved in the branching of epithelial tubes in the developing kidney, we analyzed branching of the ureteric bud (UB) in whole kidney culture as well as in isolated UB culture independent of mesenchyme but in the presence of mesenchymally derived soluble factors. Microinjection of the UB lumen (both in the isolated UB and in the whole kidney) with fluorescently labeled dextran sulfate demonstrated that branching occurred via smooth tubular epithelial outpouches with a lumen continuous with that of the original structure. Epithelial cells within these outpouches cells were wedge-shaped with actin, myosin-2 and ezrin localized to the luminal side, raising the possibility of a "purse-string" mechanism. Electron microscopy and decoration of heparan sulfates with biotinylated FGF2 revealed that the basolateral surface of the cells remained intact, without the type of cytoplasmic extensions (invadopodia) that are seen in three-dimensional MDCK, mIMCD, and UB cell culture models of branching tubulogenesis. Several growth factor receptors (i.e., FGFR1, FGFR2, c-Ret) and metalloproteases (i.e., MT1-MMP) were localized toward branching UB tips. A large survey of markers revealed the ER chaperone BiP to be highly expressed at UB tips, which, by electron microscopy, are enriched in rough endoplasmic reticulum and Golgi, supporting high activity in the synthesis of transmembrane and secretory proteins at UB tips. After early diffuse proliferation, proliferating and mitotic cells were mostly found within the branching ampullae, whereas apoptotic cells were mostly found in stalks. Gene array experiments, together with protein expression analysis by immunoblotting, revealed a differential spatiotemporal distribution of several proteins associated with epithelial maturation and polarization, including intercellular junctional proteins (e.g., ZO-1, claudin-3, E-cadherin) and the subapical cytoskeletal/microvillar protein ezrin. In addition, Ksp-cadherin was found at UB ampullary cells next to developing outpouches, suggesting a role in epithelial-mesenchymal interactions. These data from the isolated UB culture system support a model where UB branching occurs through outpouching possibly mediated by wedge-shaped cells created through an apical cytoskeletal purse-string mechanism. Additional potential mechanisms include (1) differential localization of growth factor receptors and metalloproteases at tips relative to stalks; (2) creation of a secretory epithelium, in part manifested by increased expression of the ER chaperone BiP, at tips relative to stalks; (3) after initial diffuse proliferation, coexistence of a balance of proliferation vs. apoptosis favoring tip growth with a very different balance in elongating stalks; and (4) differential maturation of the tight and adherens junctions as the structures develop. Because, without mesenchyme, both lateral and bifid branching occurs (including the ureter), the mesenchyme probably restricts lateral branching and provides guidance cues in vivo for directional branching and elongation as well as functioning to modulate tubular caliber and induce differentiation. Selective cadherin, claudin, and microvillar protein expression as the UB matures likely enables the formation of a tight, polarized differentiated epithelium. Although, in vivo, metanephric mesenchyme development occurs simultaneously with UB branching, these studies shed light on how (mesenchymally derived) soluble factors alone regulate spatial and temporal expression of morphogenetic molecules and processes (proliferation, apoptosis, etc.) postulated to be essential to the UB branching program as it forms an arborized structure with a continuous lumen.

Animals↗

Electroatriography - time-frequency analysis of atrial fibrillation from modified 12-lead ECG configurations for improved diagnosis and therapy.

Current atrial fibrillation (AF) management guidelines suggest that initially a decision must be made to apply either a rate control or rhythm control strategy in the individual patient. However, patients' selection remains substantially empirical and the strategy initially chosen often proves unsuccessful and alternative therapies must be adopted. Thus, it seems desirable to develop and apply tests that quantify AF disease state and guide AF management. The overall hypothesis of this paper is that time-frequency analysis of AF from modified 12-lead ECG configurations will improve AF management beyond current diagnostic and therapeutic standards. In particular, we present a novel concept in which 12-lead ECG configurations are modified for time-frequency analysis of AF (electroatriography). While five electrodes (VR, VL, VF, V1, V2) are placed in the conventional position, the other four electrodes (V3, V4, V5, V6) are empirically repositioned anterior or posterior over the atria. By applying spatiotemporal QRST cancellation and time-frequency analysis to these recordings in 19 patients with persistent AF, fibrillatory rate dispersion among individual anterior (25+/-14 fibrillations per minute, fpm) and posterior leads (16+/-11fpm) as well as individual anterior/posterior rate gradients ranging between -24 and +116fpm could be identified. Consequently, the portrayed techniques may form the conceptual basis for individualized noninvasive characterization of AF. Initiation of further studies using the described techniques in different AF subsets, for comparisons with intracardiac recordings and outcome of different therapies, e.g. cardioversion, antiarrhythmic drug and ablation therapy may be stimulated.

Aged↗

Expression of bone morphogenetic protein-10 mRNA during chicken heart development.

In this communication we describe the expression pattern of BMP10 mRNA during cardiac development in chickens. BMP10 is considered an important factor in the regulation of cardiac growth and trabeculation in the murine embryo. We identified chicken Ests, which are similar to mouse and human BMP10 in the UMIST database. The cDNA clone that contained most sequences was obtained, verified by sequence analysis, and used to determine the spatiotemporal pattern of gene expression. BMP10 mRNA is initially expressed at HH10 in the myocardium of the arterial pole of the heart tube, anterior to the interventricular groove. Between HH14 and HH22, BMP10 mRNA becomes broadly expressed in the outflow tract, the distal part of the inflow tract, and the trabeculated part of the developing ventricles and atria. From HH31 onward, BMP10 mRNA expression decreases in the ventricular myocardium by first disappearing from the compact myocardium and then from the tips of the trabecules. At HH44, BMP10 mRNA is expressed only in the trabeculated myocardium of the atria and the endocardium of the ventricles. The observed expression pattern of BMP10 mRNA suggests that it may play a role in regulating the formation of the ventricular wall and trabecules.

Animals↗

Differentiation of granule cell dendrites in the dentate gyrus of the rhesus monkey: a quantitative Golgi study.

The differentiation of granule cell dendrites in the dentate gyrus of the hippocampal region was studied in a series of developing fetal and postnatal rhesus monkeys whose brains were processed by the rapid Golgi method. The total combined lengths of dendrites, the total number of dendritic spines, and their density on the proximal, middle, and distal thirds of the dendritic shafts were determined at embryonic days 58, 95, 120, 153, term (165), postnatal days 3, 20, 60, 150, 365, and adults. At all ages examined, granule cells exhibited various levels of maturation with the more differentiated cells being situated in the superficial strata of the granular layer and the less mature cells lying in progressively deeper positions, thus conforming to the outside-to-inside spatiotemporal gradient of their genesis. Quantitative analysis shows that, in this primate, hippocampal granule cells differentiate mainly in the second half of gestation with all measured parameters attaining mature values by the time of birth. However, the analysis also reveals a transient phase of exuberant postnatal development which involves excessive dendritic branching, regional changes in dendritic length, overproduction of dendritic spines, and redistribution of spines within the molecular layer. After reaching peak values around the middle of the first year of life, these parameters decrease and in adult monkeys fall back to the neonatal level.

Animals↗

Spatiotemporal stability and patterning of speech movement sequences.

In order to examine the stability and patterning of speech movement sequences, movements of the lip were recorded as subjects produced a phrase at normal, fast, and slow rates. Three methods of analysis were employed. First, a new index of spatiotemporal stability was derived by summing the standard deviations computed across amplitude- and time-normalized displacement records. This index indicated that normal and fast rates of speech production result in more stable movement execution compared to slow rates. In the second analysis, the relative time of occurrence of the peak velocity of the three middle opening movements of the utterance was measured. For each of the three peaks, the preservation of relative timing was assessed by applying Genter's (1987) slope test. The results clearly indicate that the relative timing of these events does not remain constant across changes in speech rate. The relative timing of the middle opening gestures shifted, becoming later as utterance duration increased. In a third analysis, pattern recognition techniques were applied to the normalized displacement waveforms. A classification algorithm was highly successful in sorting waveforms into normal, fast, and slow rate conditions. These findings were interpreted to suggest that, within a subject, three distinct patterns or movement templates exist, one for each rate of production. Speech rate appears to be a global parameter, one that affects the entire command sequence for the utterance.

Adult↗

Parameter estimation in a model for multidimensional recording of neuronal data: a Gibbsian approximation approach.

This article proposes improved numerical procedures for estimating parameters in a spatiotemporal lattice model introduced for the analysis of cortical activities monitored from arrays of diodes. The numerical algorithms are based on approximations inspired by statistical physics. Both Gibbsian and mean-field approximations are used; they allow for computing local conditional probabilities inside the lattice. The statistical procedures rely on the computation of pseudomaximum-likelihood estimators. The estimators are evaluated on the basis of Monte Carlo simulations. These simulations show that mean-field approximations are useful for reducing the variance of estimators when the data are recorded from arrays of 144 diodes (which are in accordance with standard practice). In light of these improved methods, we give new interpretations for a data set obtained from optical recording of a Guinea pig's auditory cortex in response to pure tone stimulations.

Algorithms↗

Manganese and other trace elements in urban snow near an expressway.

The Mn contamination arising from the combustion of MMT (methylcyclopentadienyl manganese tricarbonyl) in unleaded gasoline was assessed using snow collected at different distances 15, 25, 125 and 150 m from an expressway (Montreal, Canada) in February 1993. The snow samples were analyzed by atomic absorption and by neutron activation for total Mn, Mg, Cu, V, Al, Zn, Fe, Na, and Ca concentrations in the soluble (<0.4 microm) and particulate fractions. ANOVA with ranked values was performed to compare element concentrations and soluble/particulate ratios among receptor sites and depths. Principal component analysis was used to describe the spatiotemporal variations of the deposition rates and the influence of meteorological factors. The average concentration of all trace elements, except Mg, Cu, and V, decreased significantly (p<0.05) from receptor sites near the road (15-25 m) to those farther away (125-150 m). The deposition rates of all metals and ions, except Cu, were highly positively correlated (tau = 0.5-0.9) with each other and inversely correlated with snowfalls. Wind frequency showed no correlation with deposition rate. The spatial trend was similar for all these elements making it difficult to distinguish Mn arising from the combustion of MMT from that due to other sources, such as road dust. Only the soluble/particulate ratio calculated for Mn seemed higher than that for the other metals, which might be explained by the particle size of Mn from MMT (0.2-0.4 microm). The present study only indicates a direct contamination of the snow by road activities and substantial deposition of trace elements near the roadway; no clear link can be established between motor vehicle emissions and the concentration of Mn in snow.

Journal Article↗

Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait.

The GAITRite is a portable gait analysis tool for automated measurement of spatiotemporal gait parameters. Although frequently used for clinical and research purposes, the concurrent validity of GAITRite has not been validated against a criterion measure. The aim of this experiment was to investigate the concurrent validity and test retest reliability of the GAITRite carpet walkway system for quantification of spatial and temporal parameters of the footstep pattern. Twenty-five healthy adults aged 21-71 years (mean 40.5 years, S.D. 17.2) performed three walk trials at self-selected pace, three at fast pace and three at slow pace. For each trial, data were simultaneously collected from the GAITRite and a Clinical Stride Analyzer, which has established reliability and validity. At preferred, slow and fast walking pace there were very high correlations between the two measurement systems for gait speed (ICC (2,1)=0.99), stride length (ICC (2,1)=0.99) and cadence (ICC (2,1)=0.99). Correlations between the electronic carpet and the stride analyser were moderate to high for single limb support (SLS) time (ICC (2,1)=0.69-0.91) and weak for the proportion of the gait cycle spent in double limb support (ICC (2,1)=0.44-0.57). The reliability of repeated measures for the GAITRite was good at preferred and fast speed for speed (ICC (3,1)=0.93-0.94), cadence (ICC (3,1)=0.92-0.94), stride length (ICC (3,1)=0.97), single support (ICC (3,1)=0.85-0.93) and the proportion of the gait cycle spent in double limb support (ICC (3,1)=0.89-0.92). The repeatability of the GAITRite measures were more variable at slow speed (ICC (3,1)=0.76-0.91). These results indicate that the GAITRite system has strong concurrent validity and test retest reliability, in addition to being a portable, simple clinical tool for the objective assessment of gait.

Adult↗

Effects of muscle strengthening and physical conditioning training on temporal, kinematic and kinetic variables during gait in chronic stroke survivors.

The purpose of this study was to evaluate the impact of a combined program of muscle strengthening and physical conditioning on gait performance in subjects with chronic stroke, using a single group pre- and post-test design. Thirteen subjects were recruited for the 10-week program (3 days/week), which consisted of warm-up, aerobic exercises, lower extremity muscle strengthening and cool-down. Data from cinematographic film and a force plate obtained during multiple walking trials were used in a four-segment kinetic model to yield spatiotemporal, kinematic and kinetic variables. Gait analysis revealed that the 10 week training resulted in significant increases in gait speed associated with improvements in walking patterns as determined by increases in selected kinematic and kinetic measures. After training, subjects were able to generate higher levels of powers and demonstrated increases in positive work performed by the ankle plantar flexor and hip flexor/extensor muscles.

Aged↗

Neuronal complexity loss in interictal EEG recorded with foramen ovale electrodes predicts side of primary epileptogenic area in temporal lobe epilepsy: a replication study.

PURPOSE: To investigate whether a correct lateralization of the primary epileptogenic area by means of neuronal complexity loss analysis can be obtained from interictal EEG recordings using semi-invasive foramen ovale electrodes. In a previous study with recordings from intrahippocampal depth and subdural strip electrodes it was shown that the dynamics of the primary epileptogenic area can be characterized by an increased loss of neuronal complexity in patients with unilateral temporal lobe epilepsy (TLE). METHODS: Neuronal complexity loss analysis was applied. This analysis method is derived from the theory of nonlinear dynamics and provides a topological diagnosis even in cases where no actual seizure activity can be recorded. We examined interictal EEG recorded intracranially from multipolar foramen ovale electrodes in 19 patients with unilateral TLE undergoing presurgical evaluation. RESULTS: The primary epileptogenic area was correctly lateralized in 16 of the 19 investigated patients. The misclassification of the side of seizure onset in three patients might be attributed to the larger distance between the foramen ovale electrodes and the mesial temporal structures as compared to intrahippocampal depth electrodes. CONCLUSIONS: Our results confirm the previous findings and provide further evidence for the usefulness of nonlinear time-series analysis for the characterization of the spatiotemporal dynamics of the primary epileptogenic area in mesial temporal lobe epilepsy.

Adult↗