Visual assessment of magnetic resonance imaging (MRI) from the Human Epilepsy Project 1 (HEP1) found 18% of participants had atrophic brain changes relative to age without known etiology. Here, we ...identify the underlying factors related to brain volume differences in people with focal epilepsy enrolled in HEP1.
Enrollment data for participants with complete records and brain MRIs were analyzed, including 391 participants aged 12-60 years. HEP1 excluded developmental or cognitive delay with intelligence quotient <70, and participants reported any formal learning disability diagnoses, repeated grades, and remediation. Prediagnostic seizures were quantified by semiology, frequency, and duration. T1-weighted brain MRIs were analyzed using Sequence Adaptive Multimodal Segmentation (FreeSurfer v7.2), from which a brain tissue volume to intracranial volume ratio was derived and compared to clinically relevant participant characteristics.
Brain tissue volume changes observable on visual analyses were quantified, and a brain tissue volume to intracranial volume ratio was derived to compare with clinically relevant variables. Learning difficulties were associated with decreased brain tissue volume to intracranial volume, with a ratio reduction of .005 for each learning difficulty reported (95% confidence interval CI = -.007 to -.002, p = .0003). Each 10-year increase in age at MRI was associated with a ratio reduction of .006 (95% CI = -.007 to -.005, p < .0001). For male participants, the ratio was .011 less than for female participants (95% CI = -.014 to -.007, p < .0001). There were no effects from seizures, employment, education, seizure semiology, or temporal lobe electroencephalographic abnormalities.
This study shows lower brain tissue volume to intracranial volume in people with newly treated focal epilepsy and learning difficulties, suggesting developmental factors are an important marker of brain pathology related to neuroanatomical changes in focal epilepsy. Like the general population, there were also independent associations between brain volume, age, and sex in the study population.
Jane Secker and Chris Morrison have completely revised and updated this highly successful text to take into account recent developments in the field and changes to the law in the UK and elsewhere in ...the world. Through its practically based overview of current and emerging copyright issues facing those working in e-learning, this book will help equip professionals with the tools, skills and understanding they need to work confidently and effectively in the virtual learning environment with the knowledge that they are doing so legally. New and developing services, software and other technologies are being adapted for online learning environments to engage students and academic staff. These technologies present increasing challenges to IPR and legal issues and this book will help librarians and educators to meet them.
Podcasting by practitioners in higher education to support the development of peers is becoming more popular and yet, unlike its use in learning and assessment, remains little researched. This paper ...identifies some of the reasons that bring HE practitioners to podcasting for professional development, some techniques and suggestions for making successful podcasts, and what the characteristics are of the medium that leads to podcasting being an effective tool for professional development. An emergent theme this process uncovered is the key role that playfulness has in podcasting. The discussion cites extensive quotes from interviews with creators of four podcasts aimed at HE practitioners, in order to give a rich account of the experiences of podcasting.
In a major public health milestone, European regulators have for the first time delivered a positive scientific opinion of a vaccine against malaria. The European Medicines Agency (EMA)s decision ...paves the way for a policy recommendation by the World Health Organization (WHO) for vaccinating children in sub-Saharan Africa. The vaccine, Mosquirix (also known as RTS,S/AS01), from London-based GlaxoSmithKline, is the result of three decades of development. Although the vaccines efficacy is limited, its public health value could be particularly great for children in high-transmission areas where mortality is very high.
Neuropsychology Within a Tertiary Care Epilepsy Center Morrison, Chris E; MacAllister, William S; Barr, William B
Archives of clinical neuropsychology,
2018-May-01, 2018-05-01, 20180501, Volume:
33, Issue:
3
Journal Article
Peer reviewed
Open access
Epilepsy is a prevalent condition characterized by variations in its clinical presentation, etiology, and amenability to treatment. Through history, neuropsychologists have played a significant role ...in performing research studies on changes in language, memory, and executive functioning in patients with epilepsy, including those undergoing surgical treatment for medically refractory seizures. These studies provided a foundation for establishing neuropsychologists as critical members of interdisciplinary clinical teams specializing in evaluation and treatment of epilepsy. This article describes a number of elements of specialized neuropsychological practice that have evolved over the years within a tertiary care epilepsy center. Through diagnostic interview and objective testing, the neuropsychologist is able to provide a more complete and objective understanding of a patient's cognitive and behavioral functioning than what is obtained by other clinicians through brief office visits. While assessment of cognition, mood, and behavior is the most commonly provided service to patients with epilepsy from all age groups, there are many instances when neuropsychologists in surgical settings are called to perform more specialized procedures, including the intracarotid amytal (Wada) procedure, electrocortical stimulation mapping of language eloquent brain regions, and functional brain imaging procedures. While working as a neuropsychologist on an interdisciplinary epilepsy care team requires specialized knowledge and clinical training, it is extremely satisfying due to the diversity of the patient population and the particular challenges resulting from the often unique manner that cognition and behavior can be affected in patients with epilepsy across the lifespan.
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