Title: Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy
AbstractObjective
This study was undertaken to evaluate the influence that subject‐specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy.
Methods
One hundred fifty subjects with intracranial electrodes performed multiple sessions of a free recall memory task; this standardized task controlled for subject attention levels. We utilized a dominance analysis to rank the importance of subject‐specific factors based on their relative influence on IED rates. Linear mixed‐effects models were employed to comprehensively examine factors with highly ranked importance.
Results
Antiseizure medication (ASM) status, time of testing, and seizure onset zone (SOZ) location were the highest‐ranking factors in terms of their impact on IED rates. The average IED rate of electrodes in SOZs was 34% higher than the average IED rate of electrodes outside of SOZs (non‐SOZ;p < .001). However, non‐SOZ electrodes had similar IED rates regardless of the subject's SOZ location (p = .99). Subjects on older generation (p < .001) and combined generation (p < .001) ASM regimens had significantly lower IED rates relative to the group taking no ASMs; newer generation ASM regimens demonstrated a nonsignificant association with IED rates (p = .13). Of the ASMs included in this study, the following ASMs were associated with significant reductions in IED rates: levetiracetam (p < .001), carbamazepine (p < .001), lacosamide (p = .03), zonisamide (p = .01), lamotrigine (p = .03), phenytoin (p = .03), and topiramate (p = .01). We observed a nonsignificant association between time of testing and IED rates (morning–afternoonp = .15, morning–eveningp = .85, afternoon–eveningp = .26).
Significance
The current study ranks the relative influence that subject‐specific factors have on IED rates and highlights the importance of considering certain factors, such as SOZ location and ASM status, when analyzing IEDs for clinical or research purposes.
Quon, Robert J.; Camp, Edward J.; Meisenhelter, Stephen; Song, Yinchen; Steimel, Sarah A.; Testorf, Markus E.; Andrew, Angeline S.; Gross, Robert E.; Lega, Bradley C.; Sperling, Michael R.; et al(
, Epilepsia)
AbstractObjective
Interictal epileptiform discharges (IEDs) were shown to be associated with cognitive impairment in persons with epilepsy. Previous studies indicated that IED rate, location, timing, and spatial relation to the seizure onset zone could predict an IED's impact on memory encoding and retrieval if they occurred in lateral temporal, mesial temporal, or parietal regions. In this study, we explore the influence that other IED properties (e.g., amplitude, duration, white matter classification) have on memory performance. We were specifically interested in investigating the influence that lateral temporal IEDs have on memory encoding.
Methods
Two hundred sixty‐one subjects with medication‐refractory epilepsy undergoing intracranial electroencephalographic monitoring performed multiple sessions of a delayed free‐recall task (n = 671). Generalized linear mixed models were utilized to examine the relationship between IED properties and memory performance.
Results
We found that increased IED rate, IEDs propagating in white matter, and IEDs localized to the left middle temporal region were associated with poorer memory performance. For lateral temporal IEDs, we observed a significant interaction between IED white matter categorization and amplitude, where IEDs with an increased amplitude and white matter propagation were associated with reduced memory performance. Additionally, changes in alpha power after an IED showed a significant positive correlation with memory performance.
Significance
Our results suggest that IED properties may be useful for predicting the impact an IED has on memory encoding. We provide an essential step toward understanding pathological versus potentially beneficial interictal epileptiform activity.
Quon, Robert J.; Casey, Michael A.; Camp, Edward J.; Meisenhelter, Stephen; Steimel, Sarah A.; Song, Yinchen; Testorf, Markus E.; Leslie, Grace A.; Bujarski, Krzysztof A.; Ettinger, Alan B.; et al(
, Scientific Reports)
Abstract
There is growing evidence for the efficacy of music, specifically Mozart’s Sonata for Two Pianos in D Major (K448), at reducing ictal and interictal epileptiform activity. Nonetheless, little is known about the mechanism underlying this beneficial “Mozart K448 effect” for persons with epilepsy. Here, we measured the influence that K448 had on intracranial interictal epileptiform discharges (IEDs) in sixteen subjects undergoing intracranial monitoring for refractory focal epilepsy. We found reduced IEDs during the original version of K448 after at least 30-s of exposure. Nonsignificant IED rate reductions were witnessed in all brain regions apart from the bilateral frontal cortices, where we observed increased frontal theta power during transitions from prolonged musical segments. All other presented musical stimuli were associated with nonsignificant IED alterations. These results suggest that the “Mozart K448 effect” is dependent on the duration of exposure and may preferentially modulate activity in frontal emotional networks, providing insight into the mechanism underlying this response. Our findings encourage the continued evaluation of Mozart’s K448 as a noninvasive, non-pharmacological intervention for refractory epilepsy.
Roots and rhizospheres host diverse microbial communities that can influence the fitness, phenotypes, and environmental tolerances of plants. Documenting the biogeography of these microbiomes can detect the potential for a changing environment to disrupt host‐microbe interactions, particularly in cases where microbes buffer hosts against abiotic stressors. We evaluated whether root‐associated fungi had poleward declines in diversity, tested whether fungal communities in roots shifted near host plant range edges, and determined the relative importance of environmental and host predictors of root fungal community structure.
Location
North American plains grasslands.
Taxon
Foundation grasses –Andropogon gerardii, Bouteloua dactyloides, B. eriopoda, B. gracilis,andSchizachyrium scopariumand root fungi.
Methods
At each of 24 sites representing three replicate 17°–latitudinal gradients, we collected roots from 12 individuals per species along five transects spaced 10 m apart (40 m × 40 m grid). We used next‐generation sequencing of ITS2, direct fungal culturing from roots, and microscopy to survey fungi associated with grass roots.
Results
Root‐associated fungi did not follow the poleward declines in diversity documented for many animals and plants. Instead, host plant identity had the largest influence on fungal community structure. Edaphic factors outranked climate or host plant traits as correlates of fungal community structure; however, the relative importance of environmental predictors differed among plant species. As sampling approached host species range edges, fungal composition converged in similarity among individual plants of each grass species.
Main conclusions
Environmental predictors of root‐associated fungi depended strongly on host plant species identity. Biogeographic patterns in fungal composition suggested a homogenizing influence of stressors at host plant range limits. Results predict that communities of non‐mycorrhizal, root‐associated fungi in the North American plains will be more sensitive to future changes in host plant ranges and edaphic factors than to the direct effects of climate.
Callaghan, Melissa N.; Reich, Stephanie M.(
, British Journal of Educational Technology)
Abstract
Guiding hints and challenge can help scaffold learners to progress beyond what they would achieve independently. The interactive and adaptive capabilities of mobile devices allow educational applications (apps) to support learning through scaffolding designs. However, little research has tested the effects of scaffolding features in apps on young children’s learning. Using a 3 × 2 between‐subjects design, this study experimentally tests how three types of app feedback (nonverbal sounds, verbal encouragement, or scaffolded verbal hints) and two types of leveling (gradual vs. random‐ordered challenge) influence 4–5‐year‐old children’s learning of novel words (N = 240). Results showed that scaffolded feedback was especially useful when provided at the beginning of app play (p < .01), and scaffolded leveling through gradual increases in difficulty supported faster and more accurate responses than random order challenge (p < .001).
Practitioner Notes
What is already known about this topic
Researchers have worked to apply what we know about traditional in‐person teaching with young learners and how that might translate to digital platforms.
Parent and teacher scaffolding has been shown to successfully help young children learn. Guidance through increased difficulty and explanatory feedback can help learners gradually build their skills and reflect more deeply on the content they are learning.
What this paper adds
This study adds to the newly growing collection of experiments testing the design features of educational pre‐school apps.
Findings show that scaffolding through educational app feedback and leveling can support young children learning.
Results also show that the impact of scaffolding can depend on when the guidance is presented during app play – at the very beginning of play versus later on.
Implications for practice and/or policy
Findings can help educators and other consumers identify which types of apps are better for scaffolding young children’s learning.
Suggestions are provided to support educational app developers in designing products that are truly effective.
Findings suggest that combinations of app designs may differently impact young children’s learning, providing next step testing conditions for educational app designs.
McCowan, K.(
, Annual Conference of the American Psychology-Law Society.)
Abstract
Expert testimony varies in scientific quality and jurors have a difficult time evaluating evidence quality (McAuliff et al., 2009). In the current study, we apply Fuzzy Trace Theory principles, examining whether visual and gist aids help jurors calibrate to the strength of scientific evidence. Additionally we were interested in the role of jurors’ individual differences in scientific reasoning skills in their understanding of case evidence. Contrary to our preregistered hypotheses, there was no effect of evidence condition or gist aid on evidence understanding. However, individual differences between jurors’ numeracy skills predicted evidence understanding.
Summary
Poor-quality expert evidence is sometimes admitted into court (Smithburn, 2004). Jurors’ calibration to evidence strength varies widely and is not robustly understood. For instance, previous research has established jurors lack understanding of the role of control groups, confounds, and sample sizes in scientific research (McAuliff, Kovera, & Nunez, 2009; Mill, Gray, & Mandel, 1994). Still others have found that jurors can distinguish weak from strong evidence when the evidence is presented alone, yet not when simultaneously presented with case details (Smith, Bull, & Holliday, 2011). This research highlights the need to present evidence to jurors in a way they can understand. Fuzzy Trace Theory purports that people encode information in exact, verbatim representations and through “gist” representations, which represent summary of meaning (Reyna & Brainerd, 1995). It is possible that the presenting complex scientific evidence to people with verbatim content or appealing to the gist, or bottom-line meaning of the information may influence juror understanding of that evidence. Application of Fuzzy Trace Theory in the medical field has shown that gist representations are beneficial for helping laypeople better understand risk and benefits of medical treatment (Brust-Renck, Reyna, Wilhelms, & Lazar, 2016). Yet, little research has applied Fuzzy Trace Theory to information comprehension and application within the context of a jury (c.f. Reyna et. al., 2015). Additionally, it is likely that jurors’ individual characteristics, such as scientific reasoning abilities and cognitive tendencies, influence their ability to understand and apply complex scientific information (Coutinho, 2006).
Methods
The purpose of this study was to examine how jurors calibrate to the strength of scientific information, and whether individual difference variables and gist aids inspired by Fuzzy Trace Theory help jurors better understand complicated science of differing quality. We used a 2 (quality of scientific evidence: high vs. low) x 2 (decision aid to improve calibration - gist information vs. no gist information), between-subjects design. All hypotheses were preregistered on the Open Science Framework.
Jury-eligible community participants (430 jurors across 90 juries; Mage = 37.58, SD = 16.17, 58% female, 56.93% White). Each jury was randomly assigned to one of the four possible conditions. Participants were asked to individually fill out measures related to their scientific reasoning skills prior to watching a mock jury trial. The trial was about an armed bank robbery and consisted of various pieces of testimony and evidence (e.g. an eyewitness testimony, police lineup identification, and a sweatshirt found with the stolen bank money). The key piece of evidence was mitochondrial DNA (mtDNA) evidence collected from hair on a sweatshirt (materials from Hans et al., 2011). Two experts presented opposing opinions about the scientific evidence related to the mtDNA match estimate for the defendant’s identification. The quality and content of this mtDNA evidence differed based on the two conditions. The high quality evidence condition used a larger database than the low quality evidence to compare to the mtDNA sample and could exclude a larger percentage of people. In the decision aid condition, experts in the gist information group presented gist aid inspired visuals and examples to help explain the proportion of people that could not be excluded as a match. Those in the no gist information group were not given any aid to help them understand the mtDNA evidence presented. After viewing the trial, participants filled out a questionnaire on how well they understood the mtDNA evidence and their overall judgments of the case (e.g. verdict, witness credibility, scientific evidence strength). They filled this questionnaire out again after a 45-minute deliberation.
Measures
We measured Attitudes Toward Science (ATS) with indices of scientific promise and scientific reservations (Hans et al., 2011; originally developed by National Science Board, 2004; 2006). We used Drummond and Fischhoff’s (2015) Scientific Reasoning Scale (SRS) to measure scientific reasoning skills. Weller et al.’s (2012) Numeracy Scale (WNS) measured proficiency in reasoning with quantitative information. The NFC-Short Form (Cacioppo et al., 1984) measured need for cognition. We developed a 20-item multiple-choice comprehension test for the mtDNA scientific information in the cases (modeled on Hans et al., 2011, and McAuliff et al., 2009). Participants were shown 20 statements related to DNA evidence and asked whether these statements were True or False. The test was then scored out of 20 points.
Results
For this project, we measured calibration to the scientific evidence in a few different ways. We are building a full model with these various operationalizations to be presented at APLS, but focus only on one of the calibration DVs (i.e., objective understanding of the mtDNA evidence) in the current proposal. We conducted a general linear model with total score on the mtDNA understanding measure as the DV and quality of scientific evidence condition, decision aid condition, and the four individual difference measures (i.e., NFC, ATS, WNS, and SRS) as predictors. Contrary to our main hypotheses, neither evidence quality nor decision aid condition affected juror understanding. However, the individual difference variables did: we found significant main effects for Scientific Reasoning Skills, F(1, 427) = 16.03, p <.001, np2 = .04, Weller Numeracy Scale, F(1, 427) = 15.19, p <.001, np2 = .03, and Need for Cognition, F(1, 427) = 16.80, p <.001, np2 = .04, such that those who scored higher on these measures displayed better understanding of the scientific evidence. In addition there was a significant interaction of evidence quality condition and scores on the Weller’s Numeracy Scale, F(1, 427) = 4.10, p = .04, np2 = .01. Further results will be discussed.
Discussion
These data suggest jurors are not sensitive to differences in the quality of scientific mtDNA evidence, and also that our attempt at helping sensitize them with Fuzzy Trace Theory-inspired aids did not improve calibration. Individual scientific reasoning abilities and general cognition styles were better predictors of understanding this scientific information. These results suggest a need for further exploration of approaches to help jurors differentiate between high and low quality evidence.
Note: The 3rd author was supported by an AP-LS AP Award for her role in this research.
Learning Objective:
Participants will be able to describe how individual differences in scientific reasoning skills help jurors understand complex scientific evidence.
Quon, Robert J., Meisenhelter, Stephen, Adamovich‐Zeitlin, Richard H., Song, Yinchen, Steimel, Sarah A., Camp, Edward J., Testorf, Markus E., MacKenzie, Todd A., Gross, Robert E., Lega, Bradley C., Sperling, Michael R., Kahana, Michael J., and Jobst, Barbara C. Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy. Epilepsia 62.2 Web. doi:10.1111/epi.16792.
Quon, Robert J., Meisenhelter, Stephen, Adamovich‐Zeitlin, Richard H., Song, Yinchen, Steimel, Sarah A., Camp, Edward J., Testorf, Markus E., MacKenzie, Todd A., Gross, Robert E., Lega, Bradley C., Sperling, Michael R., Kahana, Michael J., & Jobst, Barbara C. Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy. Epilepsia, 62 (2). https://doi.org/10.1111/epi.16792
Quon, Robert J., Meisenhelter, Stephen, Adamovich‐Zeitlin, Richard H., Song, Yinchen, Steimel, Sarah A., Camp, Edward J., Testorf, Markus E., MacKenzie, Todd A., Gross, Robert E., Lega, Bradley C., Sperling, Michael R., Kahana, Michael J., and Jobst, Barbara C.
"Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy". Epilepsia 62 (2). Country unknown/Code not available: Wiley-Blackwell. https://doi.org/10.1111/epi.16792.https://par.nsf.gov/biblio/10449784.
@article{osti_10449784,
place = {Country unknown/Code not available},
title = {Factors correlated with intracranial interictal epileptiform discharges in refractory epilepsy},
url = {https://par.nsf.gov/biblio/10449784},
DOI = {10.1111/epi.16792},
abstractNote = {Abstract ObjectiveThis study was undertaken to evaluate the influence that subject‐specific factors have on intracranial interictal epileptiform discharge (IED) rates in persons with refractory epilepsy. MethodsOne hundred fifty subjects with intracranial electrodes performed multiple sessions of a free recall memory task; this standardized task controlled for subject attention levels. We utilized a dominance analysis to rank the importance of subject‐specific factors based on their relative influence on IED rates. Linear mixed‐effects models were employed to comprehensively examine factors with highly ranked importance. ResultsAntiseizure medication (ASM) status, time of testing, and seizure onset zone (SOZ) location were the highest‐ranking factors in terms of their impact on IED rates. The average IED rate of electrodes in SOZs was 34% higher than the average IED rate of electrodes outside of SOZs (non‐SOZ;p < .001). However, non‐SOZ electrodes had similar IED rates regardless of the subject's SOZ location (p = .99). Subjects on older generation (p < .001) and combined generation (p < .001) ASM regimens had significantly lower IED rates relative to the group taking no ASMs; newer generation ASM regimens demonstrated a nonsignificant association with IED rates (p = .13). Of the ASMs included in this study, the following ASMs were associated with significant reductions in IED rates: levetiracetam (p < .001), carbamazepine (p < .001), lacosamide (p = .03), zonisamide (p = .01), lamotrigine (p = .03), phenytoin (p = .03), and topiramate (p = .01). We observed a nonsignificant association between time of testing and IED rates (morning–afternoonp = .15, morning–eveningp = .85, afternoon–eveningp = .26). SignificanceThe current study ranks the relative influence that subject‐specific factors have on IED rates and highlights the importance of considering certain factors, such as SOZ location and ASM status, when analyzing IEDs for clinical or research purposes.},
journal = {Epilepsia},
volume = {62},
number = {2},
publisher = {Wiley-Blackwell},
author = {Quon, Robert J. and Meisenhelter, Stephen and Adamovich‐Zeitlin, Richard H. and Song, Yinchen and Steimel, Sarah A. and Camp, Edward J. and Testorf, Markus E. and MacKenzie, Todd A. and Gross, Robert E. and Lega, Bradley C. and Sperling, Michael R. and Kahana, Michael J. and Jobst, Barbara C.},
}
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