BACKGROUND: Improved conversational fluency is sometimes identified postoperatively in patients with epilepsy, but improvements can be difficult to assess using tests such as the intelligence quotient (IQ) test. Evaluation of pre- and postoperative differences might be considered subjective at present because of the lack of objective criteria. Artificial intelligence (AI) could possibly be used to make the evaluations more objective. The aim of this case report is thus to analyze the speech of a young female patient with epilepsy before and after surgery.
METHODS: The speech of a nine-year-old girl with epilepsy secondary to tuberous sclerosis complex is recorded during interviews one month before and two months after surgery. The recorded speech is then manually transcribed and annotated, and subsequently automatically analyzed using AI software. IQ testing is also conducted on both occasions. The patient remains seizure-free for at least 13 months postoperatively.
RESULTS: There are decreases in total interview time and subjective case markers per second, whereas there are increases in morphemes and objective case markers per second. Postoperatively, IQ scores improve, except for the Perceptual Reasoning Index.
CONCLUSIONS: AI analysis is able to identify differences in speech before and after epilepsy surgery upon an epilepsy patient with tuberous sclerosis complex.

Intelligence quotient (IQ) outcomes after pediatric epilepsy surgery show significant individual variation. Clinical factors such as seizure cessation or antiepileptic medication discontinuation have been implicated, but do not fully account for the heterogeneity seen. Less is known about the impact of neurobiological factors, such as brain development and resection location. This study examines clinical and neuroimaging factors associated with cognitive outcome after epilepsy surgery in childhood.
Fifty-two children (28 boys, 24 girls) were evaluated for epilepsy surgery and reassessed on average 7.7 years later. In the intervening time, 13 were treated pharmacologically and 39 underwent focal surgery (17 temporal, 16 extratemporal, six multilobar; mean age at surgery = 14.0 years). Pre- and postsurgical assessments included IQ tests and T1-weighted brain images. Predictors of IQ change were investigated, including voxel-based analyses of resection location, and gray and white matter volume change.
Overall modest IQ improvement was seen in children treated surgically, but not in those treated pharmacologically only. Applying a ≥10-point change threshold, 39% of the surgically treated children improved, whereas 10% declined. Clinical factors associated with IQ increases were lower preoperative IQ and longer follow-up duration, whereas seizure and antiepileptic medication cessation were not predictive. Among neuroimaging factors, we observed that left anterior temporal resections impacted negatively on verbal reasoning, linked to full-scale IQ decline. In contrast, gray matter volume change in ipsi- and contralesional hemispheres was positively correlated with IQ change. Voxel-based morphometry identified the gray matter volume change in the contralesional dorsolateral frontal cortex as most strongly associated with IQ improvement.
We show that a variety of factors are likely to contribute to patterns of postsurgical change in IQ. Neuroimaging results indicate that left anterior temporal resections constrain development of verbal cognition, whereas simultaneously cortical growth after surgical treatment can support improvements in IQ.

BACKGROUND: Food insecurity (FI) refers to the lack of sufficient and safe availability of the food. Accumulating studies have suggested associations between dietary intake and Intelligence quotient (IQ). Accordingly, we aimed to examine the association between FI and IQ.
METHODS: Case-control study.
METHODS: In this case-control study, 222 girl students aged 9 to 11 years old were randomly chosen from Bandar-Anzali, Iran in 2013. Students with low and moderate IQ were considered as case (n=111) and control (n=111) group, respectively. General and demographic characteristics were collected using interview. United States Department of Agriculture (USDA) household FI questionnaires were also completed. To determine IQ, Wechsler\'s revised intelligence test was used.
RESULTS: FI was observed in 51% of study participants. The prevalence of FI in case and control group was 58.6% and 22.5%, respectively. The mean IQ was 77.97 ±5.56 in case and 94.6 ±5.47 for control group. It was found that there was an inverse association between FI and low IQ. The results of the multiple variable logistic regression analysis (odds ratio and its 95% confidence interval) showed that, FI 3.46 (1.85, 6.50; P>0.001), natural type of delivery 2.45 (1.30, 4.62; P=0.006), and father\'s low education level 2.97 (1.43, 6.19; P=0.004) were the risky factors leading to low IQ.
CONCLUSIONS: There was an inverse link between FI and IQ. Therefore, it is necessary to pay more attention to FI and its consequences, particularly in mental health of children.

BACKGROUND: In Ireland, pregnant women are not routinely screened for subclinical hypothyroidism (SCH).
OBJECTIVE: Our objective was to compare the intelligence quotient (IQ) of children whose mothers had been diagnosed with SCH prenatally with matched controls using a case-control retrospective study.
METHODS: In a previous study from our group, 1000 healthy nulliparous women were screened anonymously for SCH. This was a laboratory diagnosis involving elevated TSH with normal fT4 or normal TSH with hypothyroxinaemia. We identified 23 cases who agreed to participate. These were matched with 47 controls. All children underwent neurodevelopmental assessment at age 7-8. Wechsler Intelligence Scale for Children IV assessment scores were used to compare the groups. Our main outcome measure was to identify whether there was a difference in IQ between the groups.
RESULTS: From the cohort of cases, 23 mothers agreed to the assessment of their children as well as 47 controls. The children in the control group had higher mean scores than those in the case group across Verbal Comprehension Intelligence, Perceptual Reasoning Intelligence, Working Memory Intelligence, Processing Speed Intelligence and Full Scale IQ. Mann-Whitney U-test confirmed a significant difference in IQ between the cases (composite score 103.87) and the controls (composite score 109.11) with a 95% confidence interval (0.144, 10.330).
CONCLUSIONS: Our results highlight significant differences in IQ of children of mothers who had unrecognised SCH during pregnancy. While our study size and design prevents us from making statements on causation, our data suggest significant potential public health implications for routine prenatal screening.

BACKGROUND: Hippocampal sclerosis is the most common lesion in patients with mesial temporal lobe epilepsy. Recently, there has been growing evidence on the involvement of mitochondria also in sporadic forms of epilepsy. In addition, it has been increasingly argued that mitochondrial dysfunction has an important role in epileptogenesis and seizure generation in temporal lobe epilepsy. Although mtDNA polymorphisms have been identified as potential risk factors for neurological diseases, the link between homoplasmy and heteroplasmy within tissues is not clear. We investigated whether mitochondrial DNA (mtDNA) polymorphisms are involved in a case report of a patient with mesial temporal lobe epilepsy-hippocampal sclerosis (MTLE-HS).
METHODS: We report the whole genome mtDNA deep sequencing results and clinical features of a 36-year-old woman with MTLE-HS. We used pyrosequencing technology to sequence a whole mitochondrial genome isolated from six different regions of her brain and blood. To assess the possible role of mitochondrial DNA variations in affected tissues, we compared all specimens from different regions of the hippocampus and blood.
RESULTS: In total, 35 homoplasmic and 18 heteroplasmic variations have been detected in 6 different regions of the hippocampus and in blood samples. While the samples did not display any difference in homoplasmic variations, it has been shown that hippocampus regions contain more heteroplasmic variations than blood. The number of heteroplasmic variations was highest in the CA2 region of the brain and accumulated in ND2, ND4 and ND5 genes. Also, dentate and subiculum regions of the hippocampus had similar heteroplasmic variation profiles.
CONCLUSIONS: We present a new rare example of parallel mutation at 16223 position. Our case suggests that defects in mitochondrial function might be underlying the pathogenesis of seizures in temporal lobe epilepsy.