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Behavioral and brain-related changes in word production have been claimed to predominantly occur after 70 years of age. Most studies investigating age-related changes in adulthood only compared young to older adults, failing to determine whether neural processes underlying word production change at an earlier age than observed in behavior. This study aims to fill this gap by investigating whether changes in neurophysiological processes underlying word production are aligned with behavioral changes. Behavior and the electrophysiological event-related potential patterns of word production were assessed during a picture naming task in 95 participants across five adult lifespan age groups (ranging from 16 to 80 years old). While behavioral performance decreased starting from 70 years of age, significant neurophysiological changes were present at the age of 40 years old, in a time window (between 150 and 220 ms) likely associated with lexical-semantic processes underlying referential word production. These results show that neurophysiological modifications precede the behavioral changes in language production; they can be interpreted in line with the suggestion that the lexical-semantic reorganization in mid-adulthood influences the maintenance of language skills longer than for other cognitive functions., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: Several studies found that patients with new-onset epilepsy (NOE) have higher seizure recurrence rates if they presented already prior seizures. These observations suggest that timing of antiseizure medication (ASM) is crucial and should be offered immediately after the first seizure. Here, we wanted to assess whether immediate ASM is associated with improved outcome., Methods: Single-center study of 1010 patients (≥16 years) who presented with a possible first seizure in the emergency department between 1 March 2010 and 1 March 2017. A comprehensive workup was launched upon arrival, including routine electroencephalography (EEG), brain computed tomography/magnetic resonance imaging, long-term overnight EEG and specialized consultations. We followed patients for 5 years comparing the relapse rate in patients treated within 48 h to those with treatment >48 h., Results: A total of 487 patients were diagnosed with NOE. Of the 416 patients (162 female, age: 54.6 ± 21.1 years) for whom the treatment start could be retrieved, 80% (333/416) were treated within 48 h. The recurrence rate after immediate treatment (32%; 107/333) was significantly lower than in patients treated later (56.6%; 47/83; p < 0.001). For patients for whom a complete 5-year-follow-up was available (N = 297, 123 female), those treated ≤48 h (N = 228; 76.8%) had a significantly higher chance of remaining seizure-free compared with patients treated later (N = 69; 23.2%; p < 0.001)., Conclusions: In this retrospective study, immediate ASM therapy (i.e., within 48 h) was associated with better prognosis up to 5 years after the index event. Prospective studies are required to determine the value of immediate workup and drug therapy in NOE patients., (© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Objective: This study was undertaken to establish whether advanced workup including long-term electroencephalography (LT-EEG) and brain magnetic resonance imaging (MRI) provides an additional yield for the diagnosis of new onset epilepsy (NOE) in patients presenting with a first seizure event (FSE)., Methods: In this population-based study, all adult (≥16 years) patients presenting with FSE in the emergency department (ED) between March 1, 2010 and March 1, 2017 were assessed. Patients with obvious nonepileptic or acute symptomatic seizures were excluded. Routine EEG, LT-EEG, brain computed tomography (CT), and brain MRI were performed as part of the initial workup. These examinations' sensitivity and specificity were calculated on the basis of the final diagnosis after 2 years, along with the added value of advanced workup (MRI and LT-EEG) over routine workup (routine EEG and CT)., Results: Of the 1010 patients presenting with FSE in the ED, a definite diagnosis of NOE was obtained for 501 patients (49.6%). Sensitivity of LT-EEG was higher than that of routine EEG (54.39% vs. 25.5%, p < .001). Similarly, sensitivity of MRI was higher than that of CT (67.98% vs. 54.72%, p = .009). Brain MRI showed epileptogenic lesions in an additional 32% compared to brain CT. If only MRI and LT-EEG were considered, five would have been incorrectly diagnosed as nonepileptic (5/100, 5%) compared to patients with routine EEG and MRI (25/100, 25%, p = .0001). In patients with all four examinations, advanced workup provided an overall additional yield of 50% compared to routine workup., Significance: Our results demonstrate the remarkable added value of the advanced workup launched already in the ED for the diagnosis of NOE versus nonepileptic causes of seizure mimickers. Our findings suggest the benefit of first-seizure tracks or even units with overnight EEG, similar to stroke units, activated upon admission in the ED., (© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

The processes involved in the Stroop task/effect are thought to involve conflict detection and resolution stages. Little is known about the evolution of these two components over the lifespan. It is well admitted that children and older adults tend to show longer response latencies than young adults. The present study aims at clarifying the rational of such changes from childhood to adulthood and in aging by comparing the impacted cognitive processes across age groups. More precisely, the aim was to clarify if all processes take more time to be executed, hence implying that longer latencies rely mainly on processing speed or if an additional process lengthens the resolution of the conflict in children and/or older adults. To this aim we recorded brain electrical activity using EEG in school-age children, young and older adults while they performed a classic verbal Stroop task. The signal was decomposed in microstate brain networks, and age groups and conditions were compared. Behavioral results evolved following an inverted U-shaped curve. In children, different brain states from the ones observed in adults were highlighted, both in the conflict detection and resolution time-windows. Longer latencies in the incongruent condition were mainly attributed to an overly increased duration of the microstates involved in the conflict resolution time window. In aging, the same microstate maps were reported for both young and older adult groups. The differences in performances between groups could be explained by a disproportionally long conflict detection phase, even compressing the latest stage of response articulation. These results tend to favor a specific immaturity of the brain networks involved coupled with a slowing of the processes in children, while cognitive decline could be mostly explained by a general slowing., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ménétré, Laganaro. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To determine the influence of antiseizure medication (ASM) withdrawal on interictal epileptogenic discharges (IEDs) in scalp-EEG and seizure propensity., Methods: We included 35 adult unifocal epilepsy patients admitted for presurgical evaluation in the EEG and Epilepsy Unit of Geneva between 2016 and 2020, monitored for at least 5 days. ASM was individually tapered down, and automated IED detection was performed using Epilog PreOp (Epilog NV, Belgium, Ghent). We compared spike rate per hour (SR) at day 1 when patients were on full medication (baseline) with SR at the day with the lowest dose of medication. To determine possible peri-ictal changes of SR, we compared SR 8 h before and after a seizure with the SR at the same time of the baseline day., Results: Our results showed a significant increase in spiking activity in the day of lowest drug load if compared to spike rate at day on full medication (p < 0.001). The total amount of spikes during 24 h correlated significantly with seizure occurrence (p < 0.0001). We also revealed significant increase in peri-ictal SR, in particular 2-4 h preceding a seizure (p = 0.05) extending up to 3 h after the seizure (p = 0.03) with a short decrease just before seizure occurrence., Conclusions: Our results suggest that SR increases with medication withdrawal and particularly before and after seizures. There is a complex pattern of increase and decrease around seizure onset which explains divergent results in previous studies., Significance: Precise spike counting at similar circadian periods for a patient could help to determine the risk of seizure occurrence in a personalized fashion., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: PDS and EM have any conflict of interest to disclose. MS, SV and PVM report that they are shareholders of Epilog NV (Ghent, Belgium)., (© 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.)

Several parameters influence the interference effect elicited in a Stroop task, especially contextual information. Contextual effects in the Stroop paradigms are known as the Gratton or Sequential congruency effect (SCE). This research aims at isolating two processes contributing to the SCE in a Stroop paradigm, namely attentional reorientation from the color to the word and vice-versa, as well as inhibition (engagement/disengagement from one trial to the next one). To this end, in Study 1 subprocesses of the SCE were isolated. Specifically, attentional reorientation and inhibition were segregated by submitting young adults to a discrete verbal Stroop task including neutral trials. In Study 2, the same procedure was applied to 124 participants aged from 10 to 80 years old to analyze how interference, SCE, and the aforementioned decomposition of attention and inhibition change across the lifespan. In both studies, the Gratton effect was only partially replicated, while both attentional reorientation and inhibition effects were observed, supporting the idea that these two processes contribute to SCE on top of conflict monitoring and of other processes highlighted in different theories (contingency learning, feature integration, and repetition expectancy). Finally, the classical age-related evolution was replicated in Study 2 on raw interference scores, but no age effect was observed when processing speed was taken into account, nor on the isolated attentional reorientation and inhibition processes, which is in line with the hypothesis of stability of the inhibition processes over age.