We present an update of the literature concerning long-term neuropsychological outcomes following surgery for refractory temporal lobe epilepsy (TLE). A thorough search was conducted through the PubMed and Medline electronic databases for studies investigating neuropsychological function in adult patients undergoing resective TLE surgery and followed for a mean/median > five years period. Two independent reviewers screened citations for eligibility and assessed relevant studies for the risk of bias. We found eleven studies fulfilling the above requirements. Cognitive function remained stable through long-term follow up despite immediate post-surgery decline; a negative relation between seizure control and memory impairment has emerged and a possible role of more selective surgery procedures is highlighted.

Background: Frontal lobe circuit dysfunction, including the mesolimbic network, plays an important role in learning reward behaviors and is involved in the development of impulsive compulsive disorders (ICDs) in Parkinson’s disease (PD). ICDs in PD are characterized by disinhibited, reward-driven behaviors performed with poor impulse control, often linked to dopaminergic treatment. The purpose of the present study was to assess the presence of these behaviors in relation to frontal dysfunction and overall cognitive status in a cohort of patients with sporadic PD. Methods: The study consisted of 55 patients (n = 55), 36 males (65.5%), diagnosed with Parkinson’s disease, assessed at the First Neurological Clinic of Eginition University Hospital in Athens. The participants had a mean age of 62.6 (±13.54) years, with an average of 11.94 (±3.00) years of education and a mean disease duration of 7.17 (±5.90) years. The evaluation tools used to assess the participants were the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Geriatric Depression Scale (GDS). Results: The mean score on the QUIP was 0.64 (±1.05), with a threshold of 1. Of the total number of patients (n = 55), 18 (32.72%) showed behaviors related to ICDs. The most commonly reported impulsive compulsive behavior was an excessive preoccupation with hobbies (n = 7, 38.9%), followed by a tendency toward gambling (n = 6, 33.3%). The mean score on the MoCA scale was 24.69/30 (±4.25), while the mean score on the FAB scale was 14.70/18 (±2.45). Pearson’s correlation analysis revealed a moderate positive correlation between total MoCA score and FAB (r = 0.588, p < 0.000) and a weak to moderate negative correlation between MoCA score and QUIP (r = −0.291, p = 0.038). Additionally, there was a statistically significant negative correlation between QUIP scores and performance on the MoCA attention subtests (Forward Digit Span, Backward Digit Span, and Vigilance tasks), (r = −0.389, p = 0.009). Conclusions: Lower global cognitive function, as measured by the MoCA, was strongly associated with reduced frontal lobe function, as measured by the FAB, in Parkinson’s patients. Additionally, lower scores on the MoCA, particularly in the attention subtests, showed a weak to moderate correlation with increased impulsive compulsive behaviors, as measured by the QUIP.

Background: Dance for Parkinson’s Disease (DfPD) is a dance program for individuals with Parkinson disease (PD). There is a lack of knowledge about the effect of this program on frailty and sarcopenia experienced by patients with PD. In addition, no randomized controlled trial to date has investigated either the possible differential effects of in-person versus online DfPD or the possible effects of DfPD on clinical parameters in Greek patients with PD. Objective: We aimed to assess the efficacy, safety, and feasibility of a culturally tailored and patient-centered DfPD program offered both in-person and online to Greek patients with early- to midstage PD. Methods: This is a 3-arm crossover randomized controlled trial (in-person DfPD vs online DfPD vs control) of UPGRADE-PD (Upbeating Greek Application of Dance in Parkinson’s Disease). The experimental period will be 10 months, including three 2-month interventional periods of two 60-minute dance classes per week for each group (in-person DfPD vs online DfPD) versus a control group (nonintervention group), and two 2-month washout periods between each group for 40 Greek patients with early- to midstage PD. Assessments will be performed face-to-face at baseline and at the end of each study period and will include quality of life, fatigue, depressive symptoms, stress, anxiety, sarcopenia, frailty, balance, cognitive functions, movement and nonmovement PD symptoms, and BMI. Safety, feasibility, and patient satisfaction for each dance intervention (in-person DfPD vs online DfPD) will be assessed as well. Results: The study protocol was approved by the Medical Ethics Committee of the Eginition University Hospital in September 2022 and the Research and Ethics Committee of the University of West Attica in October 2023 and funded in September 2023. The first participant was enrolled in April 2023, and the trial is currently ongoing and will conclude in September 2024. Conclusions: The results of this study are expected to show the possible differential effect of a patient-centered and culturally tailored in-person vs online DfPD intervention on several movement and nonmovement symptoms, as well as on quality of life, sarcopenia, and frailty in people living with PD in Greece. Trial Registration: ClinicalTrials.gov NCT06220084; https://clinicaltrials.gov/study/NCT06220084 International Registered Report Identifier (IRRID): DERR1-10.2196/65490

BACKGROUND Dance for Parkinson’s Disease (DfPD) is a dance program for individuals with Parkinson disease (PD). There is a lack of knowledge about the effect of this program on frailty and sarcopenia experienced by patients with PD. In addition, no randomized controlled trial to date has investigated either the possible differential effects of in-person versus online DfPD or the possible effects of DfPD on clinical parameters in Greek patients with PD. OBJECTIVE We aimed to assess the efficacy, safety, and feasibility of a culturally tailored and patient-centered DfPD program offered both in-person and online to Greek patients with early- to midstage PD. METHODS This is a 3-arm crossover randomized controlled trial (in-person DfPD vs online DfPD vs control) of UPGRADE-PD (Upbeating Greek Application of Dance in Parkinson’s Disease). The experimental period will be 10 months, including three 2-month interventional periods of two 60-minute dance classes per week for each group (in-person DfPD vs online DfPD) versus a control group (nonintervention group), and two 2-month washout periods between each group for 40 Greek patients with early- to midstage PD. Assessments will be performed face-to-face at baseline and at the end of each study period and will include quality of life, fatigue, depressive symptoms, stress, anxiety, sarcopenia, frailty, balance, cognitive functions, movement and nonmovement PD symptoms, and BMI. Safety, feasibility, and patient satisfaction for each dance intervention (in-person DfPD vs online DfPD) will be assessed as well. RESULTS The study protocol was approved by the Medical Ethics Committee of the Eginition University Hospital in September 2022 and the Research and Ethics Committee of the University of West Attica in October 2023 and funded in September 2023. The first participant was enrolled in April 2023, and the trial is currently ongoing and will conclude in September 2024. CONCLUSIONS The results of this study are expected to show the possible differential effect of a patient-centered and culturally tailored in-person vs online DfPD intervention on several movement and nonmovement symptoms, as well as on quality of life, sarcopenia, and frailty in people living with PD in Greece. CLINICALTRIAL ClinicalTrials.gov NCT06220084; https://clinicaltrials.gov/study/NCT06220084 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/65490