High-density electric source imaging (esi) in focal epilepsy: a prospective study of 150 operated patients

Purpose: EEG is mandatory in the diagnosis of the epilepsy syndrome. However, its potential as imaging tool is still under estimated. In the present study, we aim to determine the prerequisites of maximal benefit of electric source imaging (ESI) to localize the irritative zone in patients with focal epilepsy. Methods: One hundred fifty patients suffering from focal epilepsy and with minimum 1 year postoperative follow-up were studied prospectively and blinded to the underlying diagnosis. We evaluated the influence of two important factors on sensitivity and specificity of ESI: the number of electrodes (low resolution, LR-ESI: <30 versus high resolution, HR-ESI: 128-256 electrodes), and the use of individual MRI (i-MRI) versus template MRI (t-MRI) as the head model. Findings: ESI had a sensitivity of 85% and a specificity of 87% when HR-ESI with i-MRI was used. Using LR-ESI, sensitivity decreased to 68%, or even 57% when only t-MRI was available. The sensitivity of HR-ESI/i-MRI compared favorably with those of MRI (76%), PET (69%) and ictal/interictal SPECT (64%). Interpretation: This study on a large patient group shows excellent sensitivity and specificity of ESI if 128 EEG channels or more are used for ESI and if the results are coregistered to the patient's individual MRI. Localization precision is as high as or even higher than established brain imagery techniques. HR-ESI appears to be a valuable additional imaging tool, given that larger electrode arrays are easily and rapidly applied with modern EEG equipment and that structural MRI is nearly always available for these patients.

Description of Culicoides (Mataemyia) felippebauerae sp. n., Forcipomyia musae immatures, and occurrence of F. genualis, breeding in banana stems in Brazilian Amazonia (Diptera: Ceratopogonidae)

The following three species of Ceratopogonidae were collected breeding in the rhizomatous herb Phenakospermum guyannense Endl., 1833 in the vicinity of Manaus, Brazil, a new species, Culicoides (Mataemyia) felippebauerae Spinelli, Forcipomyia (Forcipomyia) genualis (Loew), and F. (Phytohelea) musae Clastrier & Dellécole. C. (M.) felippebauerae is described and illustrated as adult, pupa, and fourth instar larva, the adult compared with the adult of C. barthi Taveres and Souza and larva and pupa with those of C. dicrourus Wirth & Blanton and C. macieli Tavares & Ruiz, the only species with known immatures in the subgenus. The pupa and fourth instar larva of F. (P.) musae are described and illustrated and compared with immatures of F. (P.) edwardsi Saunders.

Phlebotominae (Diptera: Psycodidae) fauna in the Chaco region and Cutaneous Leishmaniasis transmission patterns in Argentina

In Argentina, the incidence of American Cutaneous Leishmaniasis (ACL) has shown a steady increase over the last few decades. In the Chaco biogeographical region, specifically, several outbreaks of ACL were recently reported in addition to the usual time-space scattering of ACL cases. However, little is known about the sandfly composition in the eastern, humid Chaco (HC) region or the western, dry Chaco (DC) region. Therefore, phlebotomine captures were performed throughout this region and an analysis of the distribution of reported ACL cases was conducted in order to assess the vector diversity in ACL endemic and epidemic scenarios in the Chaco region. The results support the hypothesis of two distinct patterns: (1) the DC, where Lutzomyia migonei was the most prevalent species, had isolated ACL cases and a zoonotic cycle; (2) the HC, where Lutzomyia neivai was the most prevalent species, had an increase in ACL incidence and outbreaks and an anthropozoonotic cycle. The epidemic risk in the Chaco region may be associated with the current climate trends, landscape modification, connection with other ACL foci, and Lu. neivai predominance and abundance. Therefore, changes in sandfly population diversity and density in the Chaco region are an indicator of emergent epidemic risk in sentinel capture sites.

Five new species of Culicoides Latreille described from Colombia, yielding a new species list and country records (Diptera: Ceratopogonidae)

The following five new species of Culicoides from Colombia are described, illustrated and placed to subgenus or species group: Culicoides antioquiensis, Culicoides gabrieli, Culicoides inermis, Culicoides micayensis and Culicoides nigrifemur. C. gabrieli is also known from Peru. When possible, their position in previously published keys is indicated and their features discussed in light of the most recent revisions. A list of 180 Culicoides species known (114) or suspected of being in Colombia (66) is given in a Table. Of these, 12 including the new species are recorded from Colombia for the first time.

Culicoides baniwa sp.nov. from the Brazilian Amazon Region with a synopsis of the hylas species group (Diptera: Ceratopogonidae)

A new species of the Culicoides (Hoffmania) hylas species group, Culicoides baniwa Felippe-Bauer is described and illustrated based on a female specimen from the state of Amazonas, Brazil. A systematic key, wing photographs, diagramme of the legs pattern, table with numerical characters of females and a synopsis of the 11 species of the C. hylas group are presented. This paper further presents a new record of Culicoides pseudoheliconiae Felippe-Bauer out of the previously defined geographic distribution of the hylas species group, in the province of Misiones, Argentina.

Description of Culicoides lisicarruni (Diptera: Ceratopogonidae), a new species from Cundinamarca, Colombia

A new species of Culicoides of the subgenus Diphaomyia Vargas from high altitudes of the Andes in Colombia is described and photographied. The species is compared with its similar congener Culicoides marinkellei Wirth & Lee. Data on the collecting site and notes on the species daily activity are also provided.

Two new species and new records of biting midges of the genus Culicoides from northwestern Argentina (Diptera: Ceratopogonidae)

The following two new species of Culicoides from the Argentinean Yungas are described, illustrated and placed to subgenus or species group and compared with related congeners: Culicoides calchaqui Spinelli & Veggiani Aybar and Culicoides willinki Spinelli & Veggiani Aybar. Culicoides daedaloides Wirth & Blanton is recorded for the first time for Argentina and Culicoides pseudoheliconiae Felippe-Bauer is firstly mentioned from the northwestern region of the country.

Successful surgical resection in non-lesional operculo-insular epilepsy without intracranial monitoring.

Pre-operative assessment and surgical management of patients with non-lesional extratemporal epilepsy remain challenging due to a lack of precise localisation of the epileptic zone. In most cases, invasive recording with depth or subdural electrodes is required. Here, we describe the case of 6.5-year-old girl who underwent comprehensive non-invasive phase I video-EEG investigation for drug-resistant epilepsy, including electric source and nuclear imaging. Left operculo-insular epilepsy was diagnosed. Post-operatively, she developed aphasia which resolved within one year, corroborating the notion of enhanced language plasticity in children. The patient remained seizure-free for more than three years.

Effects of amygdala-hippocampal stimulation on interictal epileptic discharges.

Deep brain stimulation (DBS) of different nuclei is being evaluated as a treatment for epilepsy. While encouraging results have been reported, the effects of changes in stimulation parameters have been poorly studied. Here the effects of changes of pulse waveform in high frequency DBS (130Hz) of the amygdala-hippocampal complex (AH) are presented. These effects were studied on interictal epileptic discharge rates (IEDRs). AH-DBS was implemented with biphasic versus pseudo monophasic charge balanced pulses, in two groups of patients: six with temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) and six with non lesional (NLES) temporal epilepsy. In patients with HS, IEDRs were significantly reduced with AH-DBS applied with biphasic pulses in comparison with monophasic pulse. IEDRs were significantly reduced in only two patients with NLES independently to stimulus waveform. Comparison to long-term seizure outcome suggests that IEDRs could be used as a neurophysiological marker of chronic AH-DBS and they suggest that the waveform of the electrical stimuli can play a major role in DBS. We concluded that biphasic stimuli are more efficient than pseudo monophasic pulses in AH-DBS in patients with HS. In patients with NLES epilepsy, other parameters relevant for efficacy of DBS remain to be determined.

Chronic deep brain stimulation in mesial temporal lobe epilepsy.

The objective of this study was to evaluate the efficiency and the effects of changes in parameters of chronic amygdala-hippocampal deep brain stimulation (AH-DBS) in mesial temporal lobe epilepsy (TLE). Eight pharmacoresistant patients, not candidates for ablative surgery, received chronic AH-DBS (130 Hz, follow-up 12-24 months): two patients with hippocampal sclerosis (HS) and six patients with non-lesional mesial TLE (NLES). The effects of stepwise increases in intensity (0-Off to 2 V) and stimulation configuration (quadripolar and bipolar), on seizure frequency and neuropsychological performance were studied. The two HS patients obtained a significant decrease (65-75%) in seizure frequency with high voltage bipolar DBS (≥1 V) or with quadripolar stimulation. Two out of six NLES patients became seizure-free, one of them without stimulation, suggesting a microlesional effect. Two NLES patients experienced reductions of seizure frequency (65-70%), whereas the remaining two showed no significant seizure reduction. Neuropsychological evaluations showed reversible memory impairments in two patients under strong stimulation only. AH-DBS showed long-term efficiency in most of the TLE patients. It is a valuable treatment option for patients who suffer from drug resistant epilepsy and who are not candidates for resective surgery. The effects of changes in the stimulation parameters suggest that a large zone of stimulation would be required in HS patients, while a limited zone of stimulation or even a microlesional effect could be sufficient in NLES patients, for whom the importance of the proximity of the electrode to the epileptogenic zone remains to be studied. Further studies are required to ascertain these latter observations.

The previously unknown pupa and adult male of Neobezzia fittkaui Wirth & Ratanaworabhan (Diptera, Ceratopogonidae)

The previously unknown pupa and adult male of Neobezzia fittkaui Wirth & Ratanaworabhan (Diptera, Ceratopogonidae). The pupa of Neobezzia fittkaui Wirth & Ratanaworabhan, 1972, collected from a mat of floating fern (Salvinia auriculata Aubl., Salviniaceae) in Ilha da Marchantaria near Manaus, Brazil and the reared adult male are described, photographed and illustrated for the first time. This is the first detailed pupal description for the genus Neobezzia Wirth & Ratanaworabhan.

A new species of Stilobezzia Kieffer from the neotropical region (Diptera, Ceratopogonidae)

A new species from the Neotropical Region, Stilobezzia (Stilobezzia) pseudopunctulata Cazorla & Ronderos, is described and illustrated based on male and female adults and pupal exuviae. Adults were collected in the Argentinian provinces of Chaco, Formosa, Corrientes and Buenos Aires, and in Santa Cruz, Bolivia. The pupa was collected from mats of floating aquatic macrophytes in a lagoon in Ilha da Marchantería, in the vicinities of Manaus, Brazil. This new species is compared with its similar congener Stilobezzia punctulata Lane, from which it can be mainly distinguished by the wing with only two dark spots, the parameres longer and hook-shaped, the pupal respiratory organ with 11-12 pores and the very short apicolateral processes of the anal segment.

The yield of high-density electric source imaging in focal epilepsy

Background: EEG is the cornerstone of epilepsy diagnostics and mandatory to determine the underlying epilepsy syndrome (e.g. focal vs idiopathic generalized). However, its potential as imaging tool is still underrecognized. In the present study, we aim to determine the prerequisites of maximal benefit of electric source imaging (ESI) to localize the irritative zone in patients with focal epilepsy. Methods: 150 patients suffering from focal epilepsy and with minimum 1 year post-operative follow-up were studied prospectively by reviewers blinded to the underlying diagnosis and outcome. We evaluated the influence of two important factors on sensitivity and specificity of ESI: the number of electrodes (low resolution, LR-ESI: \30 vs. high resolution, HR-ESI: 128-256 electrodes), and the use of individual MRI (i-MRI) vs. template MRI (t-MRI) as head model.Results: ESI had a sensitivity of 85% and a specificity of 87% when HR-ESI with i-MRI was used. Using LR-ESI, sensitivity decreased to 68%, or even 57% when only t-MRI was available. The sensitivity of HR-ESI/i-MRI compared favorably with those of MRI (76%), PET (69%) and ictal/interictal SPECT (64%).Interpretation: This study on a large patient group shows excellent sensitivity and specificity of ESI if 128 EEG channels or more are used for ESI and if the results are co-registered to the patient's individual MRI. Localization precision is as high as or even higher than established brain imaging techniques, providing excellent costeffectiveness in epilepsy evaluation. HR-ESI appears to be a valuable additional imaging tool, given that larger electrode arrays are easily and rapidly applied with modern EEG equipment and that structural MRI is nearly always available for these patients.

Efeito de substâncias húmicas na cinética de absorção de potássio, crescimento de plantas e concentração de nutrientes em Phaseolus vulgaris L.

As substâncias húmicas podem influenciar direta ou indiretamente o metabolismo das plantas, alterando assim o seu crescimento. O objetivo deste trabalho foi avaliar o efeito de substâncias húmicas (SH) no crescimento e na concentração de nutrientes em plantas de feijão (Phaseolus vulgaris, L.) e nos parâmetros cinéticos de absorção de K. O experimento foi realizado em bancada de laboratório, com luz artificial. As plantas cresceram em vasos contendo solução nutritiva completa acrescida de cinco doses (0; 2,5; 5; 10; e 20 mg L-1 de C) de SH solúveis em meio alcalino (ácido húmico + ácido fúlvico), extraídos de amostra de carvão mineral da mina de Candiota, RS, da Companhia Riograndense de Mineração, num delineamento completamente ao acaso, com três repetições. Aos 28 dias de cultivo, foram avaliados parâmetros cinéticos de absorção de K, massa da parte aérea e da raiz seca, teores de N, P, K, Ca e Mg no tecido da parte área e as características morfológicas de raízes (comprimento, área e raio). Os resultados evidenciaram que a adição de SH extraída de carvão mineral estimulou o crescimento do feijão e afetou a cinética de absorção de K. A produção de massa da parte aérea seca das plantas mostrou resposta quadrática à adição de substâncias húmicas, atingindo valor máximo na dose equivalente a 11 mg L-1 de C, enquanto a massa das raízes secas aumentou linearmente em até 41 %, com as doses testadas. As características morfológicas de raiz e o estado nutricional das plantas não foram significativamente afetados pelas SH. Os parâmetros cinéticos de absorção de K, Imáx, Cmín e Km, decresceram linearmente com o aumento das doses de SH, causando redução na taxa de absorção de K nas concentrações deste nutriente na solução superiores a 10 μmol L-1.

Densidade de um planossolo sob sistemas de cultivo avaliada por meio da tomografia computadorizada de raios gama

A sustentabilidade do arroz (Oryza sativa L.) irrigado em solos de várzea está alicerçada na utilização da rotação e sucessão de culturas, fundamentais para o controle do arroz-vermelho e preto. Os reflexos sobre os atributos dos solos de várzea merecem estudos em especial sobre a compactação do solo. O objetivo deste trabalho foi identificar camadas compactadas em Planossolo submetido a diferentes sistemas de cultivo e preparo, avaliando-se a densidade do solo (Ds) pela Tomografia Computadorizada de Raios Gama (TC). A análise foi realizada em um experimento de longa duração, conduzido de 1985 a 2004, na Estação Experimental da Embrapa Clima Temperado, Capão do Leão, RS, num delineamento experimental em blocos ao acaso, com sete tratamentos, cada um com quatro repetições (T1 - um ano de arroz com preparo convencional do solo seguido de dois anos de pousio; T2 - cultivo contínuo de arroz com preparo convencional do solo; T4 - rotação de arroz e soja (Glycine max L.) com preparo convencional do solo; T5 - rotação de arroz, soja e milho (Zea maiz L.) em preparo convencional do solo; T6 - plantio direto de arroz no verão em sucessão do azevém (Lolium multiflorum L.) no inverno; T7 - rotação de arroz sob plantio direto e soja sob preparo convencional do solo; T8 - testemunha: solo sem cultivo). A Tomografia Computadorizada de Raios Gama permitiu detectar que o plantio direto de arroz no verão em sucessão do azevém no inverno não resultou na formação de camadas compactadas; a utilização de dois anos de pousio, no sistema de produção de arroz irrigado, não foi suficiente para evitar a formação de uma camada superficial compactada; e a rotação de arroz, soja e milho com preparo convencional do solo apresentou duas camadas compactadas (0,0 a 1,5 cm e 11 a 14 cm), indicando que essas podem limitar a produção agrícola nesse sistema de produção em Planossolos.