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OBJECTIVE - Currently, approximately 60-70% of patients with unilateral temporal lobe epilepsy (TLE) remain seizure-free 3 years after surgery. The goal of this work was to develop a presurgical connectivity-based biomarker to identify those patients who will have an unfavorable seizure outcome 1-year postsurgery.
METHODS - Resting-state functional and diffusion-weighted 3T magnetic resonance imaging (MRI) was acquired from 22 unilateral (15 right, 7 left) patients with TLE and 35 healthy controls. A seizure propagation network was identified including ipsilateral (to seizure focus) and contralateral hippocampus, thalamus, and insula, with bilateral midcingulate and precuneus. Between each pair of regions, functional connectivity based on correlations of low frequency functional MRI signals, and structural connectivity based on streamline density of diffusion MRI data were computed and transformed to metrics related to healthy controls of the same age.
RESULTS - A consistent connectivity pattern representing the network expected in patients with seizure-free outcome was identified using eight patients who were seizure-free at 1-year postsurgery. The hypothesis that increased similarity to the model would be associated with better seizure outcome was tested in 14 other patients (Engel class IA, seizure-free: n = 5; Engel class IB-II, favorable: n = 4; Engel class III-IV, unfavorable: n = 5) using two similarity metrics: Pearson correlation and Euclidean distance. The seizure-free connectivity model successfully separated all the patients with unfavorable outcome from the seizure-free and favorable outcome patients (p = 0.0005, two-tailed Fisher's exact test) through the combination of the two similarity metrics with 100% accuracy. No other clinical and demographic predictors were successful in this regard.
SIGNIFICANCE - This work introduces a methodologic framework to assess individual patients, and demonstrates the ability to use network connectivity as a potential clinical tool for epilepsy surgery outcome prediction after more comprehensive validation.
Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

C. S. Carver and E. Harmon-Jones have made an important contribution to the understanding of anger, its linkage to higher order dimensions of emotion, and potential neurobiological substrates. The authors believe, however, that their model and future research conducted to test it would be improved by a more precise explication and parsing of the primary constructs, a clearer articulation of the relation between anger and approach, and the use of methods for assessing brain activation that are more precise than the electroencephalogram. Neuroimaging studies reviewed generally fail to corroborate several features of their model.
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Existing biological models of posttraumatic stress disorder (PTSD) posit that the amygdala plays a critical role in the development and expression of this disorder. However, increasing data indicate that the amygdalae are not functionally identical, raising the possibility that the 2 amygdalae may make differential contributions to the expression of PTSD. The authors present a unique patient who developed PTSD following a traffic accident that occurred 2 years after she had undergone removal of her left amygdala to treat pharmacologically intractable epilepsy. The authors propose that the right amygdala is preferentially involved in several processes related to the expression of PTSD symptoms, such that the disorder can occur even in the absence of the left amygdala.

A challenge for theories of episodic memory is to determine how we focus memory search on a set of recently learned items. Cognitive theories suggest that the recall of an item representation is driven by an internally maintained context representation that integrates incoming information with a long time-scale. Neural investigations have shown that recalling an item revives the pattern of brain activity present during its study. To link these neural and cognitive approaches, we propose a framework in which context is maintained and updated in prefrontal cortex, and is associated with item information through hippocampal projections. The proposed framework is broadly consistent with neurobiological studies of temporal integration and with studies of memory deficits in individuals with prefrontal damage.

The vertebrate brain is anatomically and functionally asymmetric; however, the molecular mechanisms that establish left-right brain patterning are largely unknown. In zebrafish, asymmetric left-sided Nodal signaling within the developing dorsal diencephalon is required for determining the direction of epithalamic asymmetries. Here, we show that Six3, a transcription factor essential for forebrain formation and associated with holoprosencephaly in humans, regulates diencephalic Nodal activity during initial establishment of brain asymmetry. Reduction of Six3 function causes brain-specific deregulation of Nodal pathway activity, resulting in epithalamic laterality defects. Based on misexpression and genetic epistasis experiments, we propose that Six3 acts in the neuroectoderm to establish a prepattern of bilateral repression of Nodal activity. Subsequently, Nodal signaling from the left lateral plate mesoderm alleviates this repression ipsilaterally. Our data reveal a Six3-dependent mechanism for establishment of correct brain laterality and provide an entry point to understanding the genetic regulation of Nodal signaling in the brain.

Sex differences on language and visuospatial tasks are of great interest, with differences in hemispheric laterality hypothesized to exist between males and females. Some functional imaging studies examining sex differences have shown that males are more left lateralized on language tasks and females are more right lateralized on visuospatial tasks; however, findings are inconsistent. Here we used functional magnetic resonance imaging to study thirty participants, matched on task performance, during phonological and visuospatial tasks. For each task, region-of-interest analyses were used to test differences in cerebral laterality. Results indicate that lateralization differences exist, with males more left lateralized during the phonological task and showing greater bilateral activity during the visuospatial task, whereas females showed greater bilateral activity during the phonological task and were more right lateralized during the visuospatial task. Our data provide clear evidence for differences in laterality between males and females when processing language versus visuospatial information.

People with color-graphemic synesthesia experience vivid, reliable color upon viewing achromatic alphanumeric characters. Recent evidence indicates that synesthetic color experiences are as perceptually real as actual colors are for non-synesthetic observers. To investigate possible interactions between real and synesthetic colors, we tested two adult color-graphemic synesthetes on a pair of perceptual grouping tasks. In Experiment 1, we employed a well-known phenomenon of motion perception, bistable apparent motion, to explore whether synesthetic colors interact with real colors in grouping over time. Two-frame apparent motion sequences were presented with both path lengths and colors systematically manipulated. Results showed that synesthetic colors of motion tokens interacted with matching real colors of the corresponding motion tokens, which could subsequently bias perceived direction of motion. In Experiment 2, we exploited binocular rivalry, a condition under which two dissimilar monocular images compete with each other and result in perceptual switches, to explore whether synesthetic colors interact with real colors in grouping over space. Pairs of rival images with two different characters were presented dichoptically with colors of characters manipulated. Results showed that synesthetic and real colors of characters tended to group together, which, in turn, promoted the perceived global dominance during binocular rivalry. Therefore, the present results identify substantial interaction between synesthetic colors and real colors in perceptual grouping.

Studies of perceptual expertise typically ask whether the mechanisms underlying face recognition are domain specific or domain general. This debate has so dominated the literature that it has masked the more general usefulness of the expertise framework for studying the phenomenon of category specialization. Here we argue that the value of an expertise framework is not solely dependent on its relevance to face recognition. Beyond offering an alternative to domain-specific accounts of face specialization in terms of interactions between experience, task demands, and neural biases, expertise studies reveal principles of perceptual learning that apply to many different domains and forms of expertise. As such the expertise framework provides a unique window onto the functional plasticity of the mind and brain.

Expertise with print is likely to optimize visual processes for recognizing characters of a familiar writing system. Although brain activations have been identified for words and letter strings in contrast with other stimuli, relatively little work has focused on the neural basis of single-letter perception. English readers and Chinese-English bilinguals participated in an ERP study and performed a 1-back identity judgment on Roman letters, Chinese characters, pseudofonts, and their string versions. The Chinese-English bilinguals showed an enhanced N170 for both Roman letters and Chinese characters relative to pseudofonts. For the non-Chinese readers, the N170 amplitude was larger for Roman letters relative to Chinese characters and pseudofonts. Our results suggest that changes in relatively early visual processes underlie expert letter perception.