Kenezy Hospital LTD

Debrecen, Hungary

Kenezy Hospital LTD

Debrecen, Hungary
SEARCH FILTERS
Time filter
Source Type

Clemens B.,Kenezy Hospital Ltd. | Puskas S.,Debrecen University | Besenyei M.,Kenezy Hospital Ltd. | Emri M.,Debrecen University | And 8 more authors.
Epilepsy Research | Year: 2012

Objective: We tested the hypothesis that the cortical areas with abnormal local EEG synchronization are dissimilar in the three common idiopathic generalized epilepsy (IGE) phenotypes: IGE patients with absence seizures (ABS), juvenile myoclonic epilepsy (JME) and epilepsy with generalized tonic-clonic seizures exclusively (EGTCS). Patients and methods: Groups of unmedicated ABS, JME and EGTCS patients were investigated. Waking EEG background activity (without any epileptiform potentials) was analyzed by a source localization method, LORETA (Low Resolution Electromagnetic Tomography). Each patient group was compared to a separate, age-matched group of healthy control persons. Voxel-based, normalized broad-band (delta, theta, alpha, and beta) and very narrow band (VNB, 1Hz bandwidth, from 1 to 25Hz) LORETA activity (=current source density, A/m2) were computed for each person. Group comparison included subtraction (average patient data minus average control data) and group statistics (multiple t-tests, where Bonferroni-corrected p<0.05 values were accepted as statistically significant). Results: Statistically not significant main findings were: overall increased delta and theta broad band activity in the ABS and JME groups; decrease of alpha and beta activity in the EGTCS group. Statistically significant main findings were as follows. JME group: bilaterally increased theta activity in posterior (temporal, parietal, and occipital) cortical areas; bilaterally increased activity in the medial and basal prefrontal area in the 8. Hz VNB; bilaterally decreased activity in the precuneus, posterior cingulate and superior parietal lobule in the 11. Hz and 21-22. Hz VNBs. ABS group: bilaterally increased theta activity emerged in the basal prefrontal and medial temporal limbic areas. Decreased activity was found at 19-21. Hz in the right postcentral gyrus and parts of the right superior and medial temporal gyri. EGTCS group: decreased activity was found in the frontal cortex and the postcentral gyrus at 10-11. Hz, increased activity in the right parahippocampal gyrus at 16-18. Hz. Discussion: Increased theta activity in the posterior parts of the cortex is the endophenotype for JME. Increased theta activity in the fronto-temporal limbic areas is the endophenotype for ABS. Statistically not significant findings might indicate diffuse biochemical abnormality of the cortex in JME and ABS. Significance: EEG-LORETA endophenotypes may correspond to the selective propensity to generate absence and myoclonic seizures in the ABS and JME syndromes. © 2011 Elsevier B.V.


Clemens B.,Kenezy Hospital Ltd. | Puskas S.,Debrecen University | Bessenyei M.,Kenezy Hospital Ltd. | Emri M.,Debrecen University | And 8 more authors.
Epilepsy Research | Year: 2011

Aims: Intrahemispheric, cortico-cortical EEG functional connectivity (fC) was investigated in untreated patients with idiopathic generalized epilepsy (IGE) in this explorative study. Patients and methods: Group comparison was carried out between 19, drug-naive IGE patients and 19, matched healthy persons. 90 × 2. s of 19 channels waking, interictal background EEG signal (without epileptiform potentials) were processed to the LORETA (low resolution electromagnetic tomography) software to compute current source density for 2394 voxels representing parcels of the cerebral cortex for 25 very narrow bands of 1. Hz bandwidth (VNBs) from 1 to 25. Hz. EEG fC was investigated among the already localized sources. Pearson correlation coefficients (R) were computed among the 33 regions of interest (ROI) within the left and within the right hemisphere, separately. Group differences were computed by means of t-statistics. Corrected p< 0.05 differences were accepted as statistically significant. Main results: (1) The anatomical patterns of the fC differences showed great frequency-dependency. (2) Hemispheric asymmetry was prominent within most VNBs. (3) Decreased fC in the IGE group was found across all VNBs in the 1-6. Hz frequency range as compared to mixed patterns comprising both increased and decreased fC at >6. Hz frequencies. (4) In the 5-25. Hz range, decreased fC dominated in the anterior, increased fC in the posterior parts of the cortex. (5) The results delineated an anterior and a posterior network. Discussion: (1) Decreased fC in the 1-6. Hz band might indicate some relationship to yet hidden structure network abnormalities. (2) The anatomical patterns of fC indicate frequency-dependent, pathological coupling and decoupling processes in the interictal state. (3) The two networks might help to understand seizure liability and seizure precipitation in IGE. Significance: This is the first study to explore EEG fC in the interictal condition of IGE patients. The importance of EEG frequencies in evaluating fC in IGE was demonstrated and starting points for further research were given. © 2011 Elsevier B.V.


Besenyei M.,Kenezy Hospital Ltd. | Varga E.,Kenezy Hospital Ltd. | Fekete I.,Debrecen University | Puskas S.,Debrecen University | And 6 more authors.
Epilepsy Research | Year: 2012

Introduction: Benign rolandic epilepsy of childhood (BERS) is an epilepsy syndrome with presumably genetic-developmental etiology. The pathological basis of this syndrome is completely unknown. We postulated that a developmental abnormality presumably results in abnormal EEG background activity findings. Patients and methods: 20 children with typical BERS and an age- and sex-matched group of healthy control children underwent EEG recording and analysis. 60 × 2. s epochs of waking EEG background activity (without epileptiform potentials and artifacts) were analyzed in the 1-25. Hz frequency range, in very narrow bands (VNB, 1. Hz bandwidth). LORETA (Low Resolution Electromagnetic Tomography) localized multiple distributed sources of EEG background activity in the Talairach space. LORETA activity (current source density) was computed for 2394 voxels and 25 VNBs. Normalized LORETA data were processed to voxel-wise comparison between the BERS and control groups. Bonferroni-corrected p< 0.05 Student's t-values were accepted as statistically significant. Results: Increased LORETA activity was found in the BERS group (as compared to the controls) in the left and right temporal lobes (fusiform gyri, posterior parts of the superior, middle and inferior temporal gyri) and in the angular gyri in the parietal lobes, in the 4-6. Hz VNBs, mainly at 5. Hz. Discussion: (1) Areas of abnormal LORETA activity exactly correspond to the temporal and parietal cortical areas that are major components of the Mirsky attention model and also the perisylvian speech network. Thus the LORETA findings may correspond to impaired attention and speech in BERS patients. (2) The LORETA findings may contribute to delineating the epileptic network in BERS. Significance: The novel findings may contribute to investigating neuropsychological disturbances and organization of the epileptic network in BERS. © 2011 Elsevier B.V.


Clemens B.,Kenezy Hospital Ltd. | Puskas S.,Debrecen University | Besenyei M.,Debrecen University | Spisak T.,Debrecen University | And 5 more authors.
Epilepsy Research | Year: 2013

Introduction: The neuronal mechanisms of enduring seizure propensity and seizure precipitation in juvenile myoclonic epilepsy (JME) are not known. We investigated these issues, within the framework of the "network concept" of epilepsy. Methods: Design1: 19, unmedicated JME patients were compared with nineteen, age-, and sex-matched normal control persons (NC). A total of 120. s, artifact-free, paroxysm-free, eyes-closed, resting state EEG background activity was analyzed for each person. Design2: interictal and immediate preictal periods of the JME patients were compared in order to explore interictal-preictal network differences. For both comparison designs, statistically significant differences of EEG functional connectivity (EEGfC), nodal and global graph parameters were evaluated. Main results: Design1: maximum abnormalities were: increased delta, theta, alpha1 EEGfC and decreased alpha2 and beta EEGfC in the JME group as compared to the NC group, mainly among cortical areas that are involved in sensory-motor integration. Nodal degree and efficiency of three, medial, basal frontal nodes were greater in JME than in NC, in the alpha1 band. Design2: preictal delta EEGfC showed further increase in the above-mentioned areas, as compared to the interictal state. Discussion: Increased EEGfC indicates a hypercoupled state among the specified cortical areas. This interictal abnormality further increases in the preictal state. Nodal graph statistics indicates abnormal neuronal dynamics in the cortical area that is the ictal onset zone in JME. Significance: Interictal and preictal neuronal dysfunction has been described in terms of network dynamics and topography in JME patients. Forthcoming investigations of seizure precipitation and therapeutic drug effects are encouraged on this basis. © 2013 Elsevier B.V.


Cserni G.,Bacs Kiskun County Teaching Hospital | Francz M.,Josa Andras Teaching Hospital | Kalman E.,University of Pécs | Kelemen G.,University of Szeged | And 7 more authors.
Pathology and Oncology Research | Year: 2011

Estrogen receptor (ER) testing has become an important part of breast cancer reporting as the ER status is a predictor of hormonal treatment efficacy. Progesteron receptors (PR) are often tested in parallel, and the best response to hormonal manipulations can be expected in tumors positive for both receptors. The existence of breast cancers with an ER negative and PR positive phenotype is controversial. A series of cases with this phenotype were reevaluated to clarify the existence and the frequency of this entity. A total of 205/6587 (3.1%; range of the rate per department: 0.3-7.1%.) cases reported to have the ER-negative and PR-positive status by immunohistochemistry were collected from 9 Hungarian departments. After careful reevaluation of the tumor slides and control tissues with a 1% cut-off for positivity and restaining of the questionable cases, all but 1 of the reevaluable 182 cases changed their original phenotype. Most cases converted to dual positives (n = 124) or dual negatives (n = 31) or unassessable / questionable. ER-negative and PR-positive breast cancers are very rare if existing. Such a phenotype should prompt reassessment. © 2011 Arányi Lajos Foundation.


Fuzi M.,Debrecen University | Palicz Z.,Debrecen University | Vincze J.,Debrecen University | Cseri J.,Debrecen University | And 7 more authors.
Journal of Muscle Research and Cell Motility | Year: 2012

Although statins, the most widely used drugs in the treatment of hyperlipidaemia, are generally accepted as efficient and safe drugs their side-effects on skeletal muscle have been reported with increasing frequency. The lack of an animal model in which these side effects would consistently be observed is one of the important drawbacks in studying statin associated myopathy. To overcome this and enable the studying of the effects of fluvastatin on skeletal muscles an animal model with high blood cholesterol levels was developed. In these animals cholesterol levels rose more than seven fold (from 1.5 ± 0.1 to 10.7 ± 2.0 mmol/l; n = 15 and 16) with a dramatic increase in low density lipoprotein/high density lipoprotein ratio (from 0.29 ± 0.02 to 1.56 ± 0.17). While the latter was reversed by statin treatment, an elevation in blood creatine kinase (CK) level indicated the presence of muscle wasting. Fibers from m. extensor digitorum longus (EDL) showed significant reduction in cross sectional area in the statin treated groups. Statin treatment also decreased the proliferation and fusion of skeletal myotubes in culture. In line with this, resting intracellular calcium concentration ([Ca2+]i) was reduced in statin treated satellite cells and myotubes. On the other hand, in adult skeletal muscle fibers statin treatment increased resting [Ca2+]i (116 ± 4 nM vs. 151 ± 5 nM; n = 33 and 34) and decreased both twitch and tetanic force both in EDL and m. soleus. In addition, in m. soleus the duration of twitch and tetanic force was shortened. These results clearly indicate that statin administration in these animals results in a myopathy characterized by decreased muscle force and elevated plasma CK level. © 2011 Springer Science+Business Media B.V.


Clemens B.,Kenezy Hospital Ltd. | Puskas S.,Debrecen University | Besenyei M.,Debrecen University | Spisak T.,Debrecen University | And 2 more authors.
Epilepsy Research | Year: 2013

Purpose: The neuronal mechanisms of remission of epilepsy are not known. Based on the principles of the "network theory of epilepsy" we postulated the existence of abnormal cortico-cortical interactions at the onset of epilepsy (Hypothesis-1), and postulated that remission is associated with the decrease or disappearance of the abnormal quantitative EEG findings (Hypothesis-2). Methods: Four children with benign epilepsy with rolandic sharp waves (BERS) were investigated. 21-channel EEG was recorded at the onset of the disease (Setting No. 1) and in remission (Setting No. 2). Local EEG synchronization was estimated by LORETA (low resolution electromagnetic tomography). Remote EEG synchronization (intra-hemispheric, cortico-cortical EEG functional connectivity, EEGfC) was computed by the LSC (LORETA Source Correlation) method, among 23 regions of interest (ROI) in both hemispheres. Both local and remote EEG synchronization were evaluated in very narrow frequency bands of 1. Hz bandwidth (VNB), from 1 to 25. Hz. Results: Individual results were presented. Abnormal but topographically very dissimilar LORETA and LSC findings were found at the onset of the disease. The disappearance of the initial abnormalities was found in Setting No. 2. An unforeseen finding was the presence of abnormal EEGfC results in Setting No. 2. Discussion: The authors confirmed both hypotheses. The dissimilarity of the initial abnormalities is in accord with the network concept of epilepsy and the etiology of BERS. The disappearance of the initial abnormalities reflects "normalization" of network dynamics while the emergence of new EEGfC abnormalities is interpreted as "compensation". Conclusion: EEG-based local and remote connectivity (EEGfC) are appropriate tools to describe network dynamics in the active state of BERS and in remission. © 2013 Elsevier B.V.


Puskas S.,Debrecen University | Bessenyei M.,Kenezy Hospital Ltd. | Fekete I.,Debrecen University | Hollody K.,University of Pécs | Clemens B.,Kenezy Hospital Ltd.
Epilepsy Research | Year: 2010

Objective: Epileptic predisposition means genetically determined, increased seizure susceptibility. Neurophysiological evaluation of this condition is still lacking. In order to investigate " pure epileptic predisposition" (without epilepsy) in this pilot study the authors prospectively recruited ten persons who displayed generalized tonic-clonic seizures precipitated by 24 or more hours of sleep deprivation but were healthy in any other respects. Methods: 21-channel EEGs were recorded in the morning, in the waking state, after a night of sufficient sleep in the interictal period. For each person, a total of 120. s artifact-free EEG was processed to low resolution electromagnetic tomography (LORETA) analysis. LORETA activity (Ampers/meters squared) was computed for 2394 voxels, 19 active electrodes and 1. Hz very narrow bands from 1 to 25. Hz. The data were compressed into four frequency bands (δ: 0.5-4.0. Hz, θ: 4.5-8.0. Hz, α: 8.5-12.0. Hz, β: 12.5-25.0. Hz) and projected onto the MRI figures of a digitized standard brain atlas. The band-related LORETA results were compared to those of ten, age- and sex-matched healthy persons using independent t-tests. p<0.01 differences were accepted as statistically significant. Results: Statistically significant decrease of α activity was found in widespread, medial and lateral parts of the cortex above the level of the basal ganglia. Maximum α decrease and statistically significant β decrease were found in the left precuneus. Statistically not significant differences were δ increase in the medial-basal frontal area and θ increase in the same area and in the basal temporal area. Discussion: The significance of α decrease in the patient group remains enigmatic β decrease presumably reflects non-specific dysfunction of the cortex. Prefrontal δ and θ increase might have biological meaning despite the lack of statistical significance: these findings are topographically similar to those reported in idiopathic generalized epilepsy in previous investigations. Significance: Quantitative EEG characteristics of the genetically determined epilepsy predisposition were given in terms of frequency bands and anatomical distribution. © 2010 Elsevier B.V.


Clemens B.,Kenezy Hospital Ltd. | Bessenyei M.,Kenezy Hospital Ltd. | Fekete I.,Debrecen University | Puskas S.,Debrecen University | And 3 more authors.
Clinical Neurophysiology | Year: 2010

Objective: To investigate and localize the sources of spontaneous, scalp-recorded theta activity in patients with partial epilepsy (PE). Methods: Nine patients with beginning, untreated PE (Group 1), 31 patients with already treated PE (Group 2), and 14 healthy persons were investigated by means of spectral analysis and LORETA, low resolution electromagnetic tomography (1 Hz very narrow band analysis, age-adjusted, Z-scored values). The frequency of main interest was 4-8 Hz. Results: Group analysis: Group 1 displayed bilateral theta maxima in the temporal theta area (TTA), parietal theta area (PTA), and frontal theta area (FTA). In Group 2, theta activity increased all over the scalp as compared to the normative mean (Z = 0) and also to Group 1. Maximum activity was found in the TTA, PTA, and FTA. However, in the PTA and FTA the centers of the abnormality shifted towards the medial cortex. Individual analysis: all the patients showed preferential activation (maximum Z-values) within one of the three theta areas. Conclusions: EEG activity in the theta band is increased in anatomically meaningful patterns in PE patients, which differs from the anatomical distribution of theta in healthy persons. Significance: The findings contribute to our understanding of the sources of theta rhythms and the pathophysiology of PE. © 2010 International Federation of Clinical Neurophysiology.


PubMed | Kenezy Hospital Ltd.
Type: Journal Article | Journal: Epilepsy research | Year: 2012

We tested the hypothesis that the cortical areas with abnormal local EEG synchronization are dissimilar in the three common idiopathic generalized epilepsy (IGE) phenotypes: IGE patients with absence seizures (ABS), juvenile myoclonic epilepsy (JME) and epilepsy with generalized tonic-clonic seizures exclusively (EGTCS).Groups of unmedicated ABS, JME and EGTCS patients were investigated. Waking EEG background activity (without any epileptiform potentials) was analyzed by a source localization method, LORETA (Low Resolution Electromagnetic Tomography). Each patient group was compared to a separate, age-matched group of healthy control persons. Voxel-based, normalized broad-band (delta, theta, alpha, and beta) and very narrow band (VNB, 1Hz bandwidth, from 1 to 25Hz) LORETA activity (=current source density, A/m(2)) were computed for each person. Group comparison included subtraction (average patient data minus average control data) and group statistics (multiple t-tests, where Bonferroni-corrected p<0.05 values were accepted as statistically significant).Statistically not significant main findings were: overall increased delta and theta broad band activity in the ABS and JME groups; decrease of alpha and beta activity in the EGTCS group. Statistically significant main findings were as follows. JME group: bilaterally increased theta activity in posterior (temporal, parietal, and occipital) cortical areas; bilaterally increased activity in the medial and basal prefrontal area in the 8Hz VNB; bilaterally decreased activity in the precuneus, posterior cingulate and superior parietal lobule in the 11Hz and 21-22Hz VNBs. ABS group: bilaterally increased theta activity emerged in the basal prefrontal and medial temporal limbic areas. Decreased activity was found at 19-21Hz in the right postcentral gyrus and parts of the right superior and medial temporal gyri. EGTCS group: decreased activity was found in the frontal cortex and the postcentral gyrus at 10-11Hz, increased activity in the right parahippocampal gyrus at 16-18Hz.Increased theta activity in the posterior parts of the cortex is the endophenotype for JME. Increased theta activity in the fronto-temporal limbic areas is the endophenotype for ABS. Statistically not significant findings might indicate diffuse biochemical abnormality of the cortex in JME and ABS.EEG-LORETA endophenotypes may correspond to the selective propensity to generate absence and myoclonic seizures in the ABS and JME syndromes.

Loading Kenezy Hospital LTD collaborators
Loading Kenezy Hospital LTD collaborators