Loss of the ability to form pole cells in Drosophila embryos with artificially delayed nuclear arrival at the posterior pole.
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Animals↗
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Effects of walking poles on lower extremity gait mechanics.
PURPOSE: The purpose of this study was to determine whether walking with poles reduces loading to the lower extremity during level over ground walking. METHODS: Three-dimensional gait analysis was conducted on 13 healthy adults who completed 10 walking trials using three different poling conditions (selected poles, poles back, and poles front) and without the use of poles (no poles). The inverse dynamics approach was used to calculate kinetic data via anthropometric, kinematic, and kinetic data. RESULTS: All walking with poles conditions increased walking speed (P = 0.0001-0.0004), stride length (P < 0.0001), and stance time (P < 0.0001) compared with the no poles condition. There also was a decrease in anterior-posterior GRF braking impulse (P = 0.0001), a decrease in average vertical GRF walking with poles (P < 0.0001-0.0023), and a decrease in vertical (compressive) knee joint reaction force (P < 0.0001-0.0041) compared with the no poles condition. At the knee, extensor impulse decreased a 7.3% between the no poles and selected poles conditions (P = 0.0083-0.0287) and 10.4% between the no poles and poles back conditions (P < 0.0001). The support moment was reduced between the no poles and poles back (P = 0.0197) and poles front (P = 0.0002) conditions. Ankle plantarflexor work (A2) was reduced in the poles-front condition (P = 0.0334), but no differences were detected in all other ankle, knee or hip power and work variables (P > 0.05). CONCLUSION: There were differences in kinetic variables between walking with and without poles. The use of walking poles enabled subjects to walk at a faster speed with reduced vertical ground reaction forces, vertical knee joint reaction forces, and reduction in the knee extensor angular impulse and support moment, depending on the poling condition used.
Adult↗
The clinical landscape of POLE-mutant colorectal cancer: a retrospective analysis of real-world outcome.
BACKGROUND: Pathogenic mutations in the POLE gene disrupt its proofreading function during DNA replication, causing an accumulation of erroneous nucleotide incorporations. This defect leads to a significantly elevated tumor mutation burden (TMB) and increased generation of tumor neoantigens. These molecular characteristics suggest a potential association between POLE-mutant tumors and distinct prognostic outcomes in colorectal cancer (CRC); however, clinical evidence supporting this correlation remains limited. METHODS: We retrospectively collected a cohort of CRC patients harboring pathogenic POLE mutations. Comparative analyses were performed between POLE-mutant and POLE wild-type CRCs regarding their clinical characteristics, prognostic outcomes, and genomic profiles. Additionally, we evaluated the response to immunotherapy in metastatic POLE-mutant CRC cases. RESULTS: Among 35,108 CRC patients, pathogenic POLE mutations were identified in 261 individuals, accounting for 0.74% of the cohort. The median age at diagnosis for POLE-mutant patients was 48 years, with a male predominance (74.4%) and a substantial proportion (50.4%) of tumors localized in the right-sided colon. All patients with pathogenic POLE mutations exhibited hypermutated phenotypes, characterized by a median TMB of 235.26 mutations per megabase (range: 71.20-719.00 mutations/Mb). In stage II CRC, POLE mutations were significantly associated with a reduced risk of recurrence (hazard ratio [HR] 0.344, 95% confidence interval [CI] 0.157-0.754, p = 0.008) when compared to POLE wild-type, microsatellite stable CRC patients. However, this association was not evident in stage III patients (HR 1.004, 95% CI 0.490-2.057, p = 0.992). Importantly, the incorporation of immune checkpoint inhibitors in first-line treatment regimens significantly improved progression-free survival (HR = 0.247, 95% CI 0.117-0.552, p = 0.0002) and overall survival (HR = 0.317, 95% CI 0.103-1.143, p = 0.0832) in metastatic CRC patients with pathogenic POLE mutations. CONCLUSIONS: Pathogenic POLE-mutant CRC constitutes a relatively rare, yet clinically important, subtype. These cancers exhibit distinct clinicopathological and genomic features. Our results indicate that mutations in the POLE gene may serve as a valuable prognostic marker and a potential indicator of benefit to immunotherapy in CRC, offering promising avenues for personalized treatment strategies.
Humans↗
Reproducibility of energy parameters in the pole vault.
The purpose of this study was to analyze the reproducibility of kinematic, dynamometric and derived mechanical energy parameters in the pole vault as a main precondition for the practical applicability of the concept of energy exchange in the pole vault. A total of 46 vaults of six experienced vaulters were analyzed. On the basis of 3D kinematic data of the athlete and the pole and ground reaction forces measured at the end of the pole in the planting box the reproducibility of parameters that describe the energy transfer into the pole and the energy exchange between the athlete and the pole during the vault was proofed. Intraclass correlation, mean root mean square and the coefficient of variance were determined, additionally the Wilcoxon Test was applied. Parameters of the athlete's 3D total mechanical energy, e.g. initial energy and final energy, and the pole energy (maximum pole energy, energy of the pole due to compressive force and bending moment) were highly reproducible. The distribution of the energy transferred into the pole due to compressive force and bending moment, the same as the energy gain of the vaulter-pole system during the vault, which indicates the strategy of interacting with the pole, were also reproducible. With this the concept of energy exchange in the pole vault can be used to analyze the impact of training interventions, changes in movement pattern respectively, on the vaulters performance during different phases of the vault. The analysis of one trial of an athlete should be sufficient to identify changes in the athlete's interaction with the elastic pole.
Biomechanical Phenomena↗
Role of gamma-tubulin in mitosis-specific microtubule nucleation from the Schizosaccharomyces pombe spindle pole body.
The ability of the Schizosacchromyces pombe spindle pole body to nucleate microtubules is activated at the onset of mitosis for forming a mitotic spindle, but it is inactivated during interphase. We have previously developed an in vitro assay for studying the molecular mechanism of spindle pole body activation using permeabilized interphase S. pombe cells and Xenopus mitotic extracts. We have shown that the interphase spindle pole body is activated indirectly by p34cdc2 protein kinase in Xenopus mitotic extracts. In this study we examined the role of gamma-tubulin, a component of both interphase and mitotic spindle pole body, in formation of the microtubule nucleating complex at the mitotic spindle pole body. A polyclonal antibody specific to S. pombe gamma-tubulin inhibited both activation of the interphase spindle pole body and microtubule nucleation from the mitotic spindle pole body. Addition of bacterially expressed S. pombe gamma-tubulin or its amino-terminal fragments to Xenopus mitotic extracts inhibited spindle pole body activation. Affinity chromatography of partially fractionated Xenopus mitotic extracts with the amino-terminal fragment of S. pombe gamma-tubulin showed that fractions bound to the fragment supported the activation. The fractions did not contain Xenopus gamma-tubulin, showing that activation of the spindle pole body is not due to recruitment of Xenopus gamma-tubulin to the spindle pole body. The spindle pole body activation occurred in extracts depleted of p34cdc2 protein kinase or MAP kinase. The activity of the fractions bound to the fragment was inhibited by a protein kinase inhibitor, staurosporine. These results suggest that S. pombe gamma-tubulin is a component of the microtubule nucleating complex, and that the function of proteins that interact with gamma-tubulin is required for activation of the spindle pole body. We present possible models for the activation that convert the immature microtubule nucleating complex at interphase into the mature microtubule nucleating complex at mitosis.
Amino Acid Sequence↗
Investigation of the potential release of polychlorinated dioxins and furans from PCP-treated utility poles.
The United States (US) Environmental Protection Agency (EPA) estimated that the use of technical grade pentachlorophenol (PCP) between 1970 and 1995 to treat wood was approximately 400,000 metric tons in the US, and that between 4800 and 36,000 g of 2,3,7,8-tetrachlorodibenzo-p-dioxin toxic equivalents (TEQs) were incorporated annually in treated wood. The EPA has been unable, however, to estimate the rate of release of polychlorinated dibenzo-p-dioxins and dibenzofurans (CDD/Fs) from treated utility poles into the environment. There is some evidence that CDD/Fs leach from treated poles into the surrounding soils, but these studies do not allow for the calculation of a rate of release from this mechanism. Another possible release mechanism is the volatilization of dioxins into the atmosphere, but there are no data to demonstrate, much less quantify, this release. While not directly measuring the release of dioxins from treated utility poles into the environment, this study was designed to examine the potential for such release. The general approach taken was to collect PCP-treated poles of varying ages, to remove and analyze multiple samples from each pole cross-section, and to compare the spatial distribution of CDD/F congeners among poles of different ages. Evidence of concentration-depth profile changes over time may provide insight into the potential for dioxins to migrate through and then out of PCP-treated utility poles. It was found that the CDD/F concentrations were consistently higher in the outer portions of the poles than the center. This trend tends to be most marked in older poles and for the lower chlorinated congeners. The trend for dioxins to concentrate in the outer portions of the pole over time suggest migration within the poles, and this migration may result in some environmental release. Other possible explanations were also offered.
Benzofurans↗
Hypertension after surgical management of renal duplication associated with an upper pole ureterocele.
PURPOSE: Duplicated upper pole systems associated with a ureterocele frequently have areas of segmental renal dysplasia. Since dysplasia has been related to the development of renin mediated hypertension, we hypothesized that preservation of functional upper pole moieties may result in an increased incidence of high blood pressure. MATERIALS AND METHODS: We evaluated 115 patients with a history of renal duplication and an ipsilateral upper pole ureterocele. Patients were separated into group 1-nonfunctional upper pole managed by partial nephrectomy, group 2-functional upper pole moiety managed by partial nephrectomy and group 3-functional upper pole moiety managed by a nephron sparing procedure. All charts were reviewed for hypertension, febrile urinary tract infection, vesicoureteral reflux and renal scarring. RESULTS: At a median followup age of 15 years (range 1 to 33) hypertension developed in 13 of the 115 patients (11%), including 8 of the 87 (9%) with nonfunctional upper pole systems managed by partial nephrectomy, 1 of the 12 (8%) with a functional upper pole moiety managed by partial nephrectomy and 4 of the 16 (25%) with a functional upper pole system managed by an upper pole salvage procedure. Statistical evaluations failed to reveal any relationship between hypertension and preservation of the upper pole system or between hypertension and vesicoureteral reflux. Rather, elevation in blood pressure was found to be related to development of a renal scar after a febrile urinary tract infection. CONCLUSIONS: Hypertension in patients with a history of renal duplication associated with a ureterocele is directly related to renal scarring.
Child↗
Experimental analysis of the reproduction of spindle poles.
We have investigated the functional properties of the mechanisms that control the reproduction of spindle poles in fertilized sea-urchin eggs. By prolonging mitosis by three independent means, we show that a spindle pole can split during mitosis into two functional poles of normal appearance. However, these poles have only half the normal reproductive capacity; each daughter cell that receives a split pole, always forms a monopolar spindle at the next division. Each monopolar spindle appears to be exactly half of a spindle because two of them can come together to form a functional bipolar spindle of normal appearance. The poles of such spindles show normal reproduction in subsequent divisions. By following the development of individual cells with monopolar spindles, we show that such a cell can stay in mitosis longer than normal, and the single pole splits into two asters, which move apart to give a functional bipolar spindle. The poles of such a spindle have only half the normal reproductive capacity, because the two daughters of the cell always form monopolar spindles at the next mitosis. This novel cycle of development is often repeated. The occurrence of such phenomena does not depend upon the method used to induce monopolar spindles. These results show that each normal pole has two polar determinants. The results also demonstrate that the reproduction of spindle poles consists of three distinct events: splitting of the polar determinants, physical separation of the two determinants, and duplication of the determinants to return the pole to a duplex state. Splitting and duplication are distinct events because they can be experimentally put out of phase with each other for several cell cycles.
Animals↗
A simplified technique of upper pole heminephrectomy for duplex kidney.
PURPOSE: We describe a simplified technique of upper pole heminephrectomy in cases of duplex kidney. MATERIALS AND METHODS: The upper pole collecting system is entered and the upper pole is excised. The vascular supply to the upper pole is then easily identified and divided. The upper pole ureter is dissected below the lower pole vessels and distal ureteral dissection is completed. We performed the technique in 11 girls and 3 boys with a mean age of 1. 8 years who had poor or nonfunctioning upper moieties of duplicated kidneys. The diagnosis was ectopic ureter in 11 cases and ureterocele with duplication in 3. RESULTS: Mean surgical time was 95 minutes. Blood loss was not clinically significant in any patient and mean hospitalization was 2.7 days. The only postoperative complication was atelectasis, which resolved promptly with medical treatment. There was no injury to the lower pole ureter or vascular pedicle. CONCLUSIONS: Our technique enables reliable and safe excision of upper pole renal tissue with the maximal preservation of functioning lower pole parenchyma. The chance of inadvertent entry into the lower pole collecting system is significantly decreased since the demarcation of the upper and lower moieties is clearly identifiable. In addition, the avoidance of initial, potentially cumbersome hilar dissection minimizes the risk of injury to the lower pole ureter and vascular supply. This technique may be performed rapidly and requires only brief hospitalization postoperatively.
Female↗
A force balance model of early spindle pole separation in Drosophila embryos.
The formation and function of the mitotic spindle depends upon force generation by multiple molecular motors and by the dynamics of microtubules, but how these force-generating mechanisms relate to one another is unclear. To address this issue we have modeled the separation of spindle poles as a function of time during the early stages of spindle morphogenesis in Drosophila embryos. We propose that the outward forces that drive the separation of the spindle poles depend upon forces exerted by cortical dynein and by microtubule polymerization, and that these forces are antagonized by a C-terminal kinesin, Ncd, which generates an inward force on the poles. We computed the sum of the forces generated by dynein, microtubule polymerization, and Ncd, as a function of the extent of spindle pole separation and solved an equation relating the rate of pole separation to the net force. As a result, we obtained graphs of the time course of spindle pole separation during interphase and prophase that display a reasonable fit to the experimental data for wild-type and motor-inhibited embryos. Among the novel contributions of the model are an explanation of pole separation after simultaneous loss of Ncd and dynein function, and the prediction of a large value for the effective centrosomal drag that is needed to fit the experimental data. The results demonstrate the utility of force balance models for explaining certain mitotic movements because they explain semiquantitatively how the force generators drive a rapid initial burst of pole separation when the net force is great, how pole separation slows down as the force decreases, and how a stable separation of the spindle poles characteristic of the prophase steady state is achieved when the force reaches zero.
Animals↗
Influence of different approaches for calculating the athlete's mechanical energy on energetic parameters in the pole vault.
The purposes of this study were as follows: (1) To determine the differences between two- and three-dimensionally calculated energy of the athlete in the pole vault. (2) To determine the differences between CM energy and total body energy. (3) To examine the influence of these different approaches of calculating the athlete's energy on energetic parameter values during the pole vault. Kinematic data were gathered during the pole vault final of the track and field world championships in 1997. Two video cameras (50Hz) covered the last step of the approach including the pole plant and 2 cameras covered the pole phase up to bar clearance, respectively. Twenty successful jumps were analysed. The characteristics of the energy development is similar for the different approaches. Initial energy, energy at maximum pole bend and energy at pole release (primary parameters) show significant differences (p<0.05). The findings indicate that rotatory movements and movements relative to the CM have a larger influence on the primary parameters than movements apart from the main plane of movement. For analysing the energy exchange between the athlete and the elastic implement pole only the differences among the secondary parameters (initial energy minus energy at maximum pole bend, final energy minus energy at maximum pole bend) are needed (Arampatzis et al., 1997 Biomechanical Research Project at the Vth World Championships in Athletics, Athens 1997: Preliminary Report. New Studies in Athletics 13, 66-69). For those parameters the relative differences between the calculation approaches range only between 1.47 and 0.04%. This indicates that the influence of the different approaches for calculating the athlete's energy on the analysis of energy exchange is negligible.
Biomechanical Phenomena↗
The physiological responses to walking with and without Power Poles on treadmill exercise.
Power Poles are specially constructed, rubber-tipped ski poles designed for use during walking. Using Power Poles simulates the arm motion of cross-country skiing, thus increasing the muscle mass used during walking. This study investigated the potential increases in exercise intensity and energy cost associated with the use of walking poles. Thirty-two apparently healthy volunteers (16 men and 16 women) between the ages of 19 and 33 years participated. Each completed a treadmill maximal oxygen consumption (VO2max) test and two randomly assigned, submaximal walking trials (one with poles and one without poles) on separate days. Each walking trial was conducted on a level treadmill, for 20 minutes, at an identical self-selected pace. Expired gases, heart rate in beats per minute (bpm), and ratings of perceived exertion (RPE) were recorded each minute. Results between trials were compared using repeated measures analysis of variance and Tukey's post hoc tests. It was found that walking with poles resulted in an average of 23% (4.4 ml.kg-1.min-1) higher VO2, 22% higher caloric expenditure (1.5 kcal.min-1), and 16% (18 bpm) higher heart rate responses compared to walking without poles on a treadmill. RPE values averaged 1.5 units higher with the use of the poles, and the pattern of responses between conditions was similar for men and women. It is concluded that the use of Power Poles can increase the intensity of walking at a given speed and, thus, may provide additional training benefits to walkers.
Adult↗
Oscillatory movements of monooriented chromosomes and their position relative to the spindle pole result from the ejection properties of the aster and half-spindle.
During mitosis a monooriented chromosome oscillates toward and away from its associated spindle pole and may be positioned many micrometers from the pole at the time of anaphase. We tested the hypothesis of Pickett-Heaps et al. (Pickett-Heaps, J. D., D. H. Tippit, and K. R. Porter, 1982, Cell, 29:729-744) that this behavior is generated by the sister kinetochores of a chromosome interacting with, and moving in opposite direction along, the same set of polar microtubules. When the sister chromatids of a monooriented chromosome split at the onset of anaphase in newt lung cells, the proximal chromatid remains stationary or moves closer to the pole, with the kinetochore leading. During this time the distal chromatid moves a variable distance radially away from the pole, with one or both chromatid arms leading. Subsequent electron microscopy of these cells revealed that the kinetochore on the distal chromatid is free of microtubules. These results suggest that the distal kinetochore is not involved in the positioning of a monooriented chromosome relative to the spindle pole or in its oscillatory movements. To test this conclusion we used laser microsurgery to create monooriented chromosomes containing one kinetochore. Correlative light and electron microscopy revealed that chromosomes containing one kinetochore continue to undergo normal oscillations. Additional observations on normal and laser-irradiated monooriented chromosomes indicated that the chromosome does not change shape, and that the kinetochore region is not deformed, during movement away from the pole. Thus movement away from the pole during an oscillation does not appear to arise from a push generated by the single pole-facing kinetochore fiber, as postulated (Bajer, A. S., 1982, J. Cell Biol., 93:33-48). When the chromatid arms of a monooriented chromosome are cut free of the kinetochore, they are immediately ejected radially outward from the spindle pole at a constant velocity of 2 micron/min. This ejection velocity is similar to that of the outward movement of an oscillating chromosome. We conclude that the oscillations of a monooriented chromosome and its position relative to the spindle pole result from an imbalance between poleward pulling forces acting at the proximal kinetochore and an ejection force acting along the chromosome, which is generated within the aster and half-spindle.
Anaphase↗
Asymmetry of the spindle pole bodies and spg1p GAP segregation during mitosis in fission yeast.
In the fission yeast Schizosaccharomyces pombe, the onset of septum formation is induced by a signal transduction network involving several protein kinases and a GTPase switch. One of the roles of the spg1p GTPase is to localise the cdc7p protein kinase to the poles of the mitotic spindle, from where the onset of septation is thought to be signalled at the end of mitosis. Immunofluorescence studies have shown that cdc7p is located on both spindle pole bodies early in mitosis, but only on one during the later stages of anaphase. This is mediated by inactivation of spg1p on one pole before the other. The GAP for spg1p is a complex of two proteins, cdc16p and byr4p. Localisation of cdc16p and byr4p by indirect immunofluorescence during the mitotic cell cycle showed that both proteins are present on the spindle pole body in interphase cells. During mitosis, byr4p is seen first on both poles of the spindle, then on only one. This occurs prior to cdc7p becoming asymmetric. In contrast, the signal due to cdc16p decreases to a low level during early mitosis, before being seen strongly on the same pole as byr4p. Double staining indicates that this is the opposite pole to that which retains cdc7p in late anaphase. Examination of the effect of inactivating cdc16p at various stages of the cell cycle suggests that cdc16p, together with cdc2p plays a role in restraining septum formation during interphase. The asymmetric inactivation of spg1p is mediated by recruitment of the cdc16p-byr4p GAP to one of the poles of the spindle before the other, and the asymmetry of the spindle pole bodies may be established early during mitosis. Moreover, the spindle pole bodies appear to be non-equivalent even after division has been completed.
Base Sequence↗
Laparoscopic upper pole heminephrectomy for ectopic ureter: initial experience.
OBJECTIVES: To determine the feasibility, clinical outcomes, and complications of laparoscopic upper pole heminephrectomy for ectopic ureter. The standard treatment for a duplex kidney with a poorly functioning upper pole moiety is an upper pole heminephrectomy. We review our technique and experience with laparoscopic upper pole heminephrectomy. A brief review of the literature is provided. METHODS: A retrospective review of clinical records from three patients who underwent laparoscopic upper pole heminephrectomy was performed. Two of the three patients presented with lifelong urinary incontinence and were diagnosed with an ectopic ureter associated with a poorly functioning upper pole moiety. The third patient presented with recurrent episodes of pyelonephritis and was found to have a duplex kidney with a poorly functioning upper pole segment draining into a ureterocele. RESULTS: All three patients underwent laparoscopic upper pole heminephrectomy through the transperitoneal approach. Mean operative time, including ureteral stent insertion, was 198 minutes. Two of the three patients were discharged within 24 hours of surgery. The third patient had a urinary leak secondary to a small amount of residual upper pole parenchyma which resolved with superselective renal arterial embolization. All three patients are well at 5.3 months follow-up. CONCLUSIONS: Laparoscopic upper pole heminephrectomy for ectopic ureter is safe and reproducible and offers the patient the typical postoperative benefits of laparoscopic surgery.
Adolescent↗
Regulation of primary erythropoiesis in the ventral mesoderm of Xenopus gastrula embryo: evidence for the expression of a stimulatory factor(s) in animal pole tissue.
We have previously shown that the animal pole tissue from a st.10+ early gastrula Xenopus embryo stimulates the primary differentiation of erythrocytes in the ventral mesoderm in combination culture. To characterize the nature of this stimulation, various sizes and different portions of animal pole tissue were combined with the ventral mesoderm explants. The erythrocyte differentiation in terms of globin expression depended on the size of the animal pole tissue that was combined with the ventral mesoderm. No difference was observed in the potency of stimulation between the ventral and dorsal halves of animal pole tissue. We also found that animal pole tissue from as late as st.7 failed to stimulate both mRNA and protein levels of globin in the explant. Histological studies of the combination explant with st.7 animal pole tissue showed that epidermis, vesicle structure, and blood-cell-like cells developed in the explant, but very few blood cells expressed globin molecules. However, the stimulation of erythroid differentiation was restored if total (20 ng) or poly(A)+ (0.2 ng) RNA from st.10+ animal pole tissue was previously injected at the 2-cell stage and the resulting animal pole tissue at st.7 was combined with st.10+ ventral mesoderm. Erythroid differentiation was also restored by injection with 1 ng of Xenopus bone morphogenetic protein-4 (XBMP-4) RNA. The effect of an extremely small dose of poly(A)+ RNA on erythroid differentiation suggests that in addition to XBMP-4 there exist substances, expressed later than st.7 in the animal pole region, which can stimulate erythrocyte differentiation in the ventral mesoderm.
Animals↗
Fat facets interacts with vasa in the Drosophila pole plasm and protects it from degradation.
Anterior-posterior patterning and germ cell specification in Drosophila requires the establishment, during oogenesis, of a specialized cytoplasmic region termed the pole plasm. Numerous RNAs and proteins accumulate to the pole plasm and assemble in polar granules. Translation of some of these RNAs is generally repressed and active only in pole plasm. Vasa (VAS) protein, an RNA helicase and a component of polar granules, is essential maternally for posterior patterning and germ cell specification, and VAS is a candidate translational activator in the pole plasm. VAS is stabilized within the pole plasm in that it is initially present throughout the entire embryo but strictly limited to the pole cells by the cellular blastoderm stage. hsp83 mRNA, which accumulates in the pole plasm through a stabilization-degradation mechanism, is another example. Here, we used a biochemical approach to identify proteins that copurify with VAS in crosslinked extracts. Prominent among these proteins was the ubiquitin-specific protease Fat facets (FAF), a pole plasm component [7], but one whose roles in posterior patterning and germ line specification have remained unclear. We present evidence that FAF interacts with VAS physically and reverses VAS ubiquitination, thereby stabilizing VAS in the pole plasm.
Animals↗
Correlation between temporal pole MRI abnormalities and surface ictal EEG patterns in patients with unilateral mesial temporal lobe epilepsy.
OBJECTIVE: The objective of this retrospective study is to analyze ictal patterns observed during continuous Video-EEG monitoring in patients with temporal lobe epilepsy (TLE) due to unilateral hippocampal sclerosis (HS), and to correlate these EEG patterns to temporal pole abnormalities observed on magnetic resonance imaging exams. METHODS: We analyzed 147 seizures from 35 patients with TLE and unilateral HS. Ictal patterns were classified and correlated to signal abnormalities and volumetric measures of the temporal poles. Volume differences over 10% were considered abnormal. RESULTS: The most frequent type of ictal pattern was rhythmic theta activity (RTA), encountered in 65.5% of the seizures. Rhythmic beta activity (RBA) was observed in 11% of the seizures, localized attenuation in 8%, interruption of epileptiform discharges in 6%, repetitive discharges in 5.5%, and rhythmic delta activity (RDA) in 4%. Sixty-six percent of the patients presented signal abnormalities in the temporal pole that were always ipsilateral to the HS. Sixty percent presented significant asymmetry of the temporal poles consisting of reduced volume that was also always ipsilateral to HS. Although patients with RTA as the predominant ictal pattern tended to present asymmetry of temporal poles (p=0.305), the ictal EEG pattern did not correlate with temporal pole asymmetry or signal abnormalities. CONCLUSIONS: RTA is the most frequent initial ictal pattern in patients with TLE due to unilateral HS. Temporal pole signal changes and volumetric reduction were commonly found in this group of patients, both abnormalities appearing always ipsilateral to the HS. However, neither temporal pole volume reduction nor signal abnormalities correlated with the predominant ictal pattern, suggesting that the temporal poles are not crucially involved in the process of epileptogenesis.
Adult↗