No abstract

the skill of absolute pitch (ap) has been proposed as an ideal paradigm for investigating the complex relationships that exist between the genome and its expression at a cognitive and behavioral level (the phenotype). Yet despite this, we still have limited understanding of the early conditions that might be necessary or sufficient for development of this skill, and the influence of the current music environment has not been explored. To investigate these issues we undertook a detailed characterization of the early and current music environment of 160 musicians, and then identified factors predictive of varying extent of AP ability. The results demonstrate a similar contribution of past and present environmental influences, with a combination of factors (rather than any given factor) most salient in AP musicians. The novel finding for the role of the current environment suggests that auditory processing models emphasizing plasticity effects are relevant to AP ability.

SUMMARYPurpose: Both neurobiologic and psychosocial factors have been proposed to account for the high prevalence of depression surrounding epilepsy surgery. Using a prospective longitudinal approach, this study aimed to profile the evolution of depression after epilepsy surgery at multiple time points, including early and longer-term follow-up. We also sought to identify neurobiologic and psychosocial predictors of depression before and after surgery, including whether patients undergoing mesial temporal lobe resection (MTR) were at greater risk of depression than patients undergoing nonmesial temporal lobe resection (NMTR). Methods: Sixty patients undergoing epilepsy surgery (38 MTR, 22 NMTR) for the treatment of medically intractable seizures were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively in the Comprehensive Epilepsy Program of Austin Health. The diagnosis of depression was based on DSM-IV criteria for major depressive disorder, as assessed from a mental state examination. The Austin CEP Interview was used to obtain a detailed psychosocial assessment of each patient and family members. Key Findings: Before surgery, 43% of patients had a lifetime prevalence of depression, with no difference between the proportion of patients in the MTR (40%) and NMTR groups (50%). Predictive factors included a family history of psychiatric illness (p = 0.015) and financial dependence of either family members or government income benefits (p = 0.024). Discriminant function analysis indicated that these factors classified 69% of cases correctly (p = 0.006, partial g 2 = 0.06). In the 12 months following surgery, 37% of MTR and 27% of NMTR patients experienced major depression, with no significant difference between the two groups. The majority of depressed patients (70%) were diagnosed in the first 3 months and in 65% of diagnosed cases, the depression persisted for at least 6 months within the follow-up period. The pattern of recurrent and de novo depression differed significantly between the groups, with 13% of MTR patients developing de novo major depression in comparison to no NMTR patients (p = 0.05). A preoperative history of depression (p = 0.003) and poor postoperative family dynamics (1 month, p < 0.001; 3 months, p = 0.007; 6 months, p = 0.021; 12 months, p = 0.097) were predictive of depression after surgery. These factors correctly classified 78% of cases (p = 0.000, partial g 2 = 0.19). Significance: The findings of this study confirm high rates of major depression before and after epilepsy surgery, the etiology of which is multifactorial. They highlight the need for thorough assessment and diagnosis before surgery, as well as the provision of routine follow-up and psychological support, particularly early after surgery. When estimating level of risk for depression, patients should be counseled about the role of both neurobiologic and psychosocial factors. Before surgery, these include a family history of psychiatric illness and financial dependence, whereas poor family adjustment to lif...

Survivors of traumatic brain injury (TBI) often develop chronic neurological, neurocognitive, psychological, and psychosocial deficits that can have a profound impact on an individual's wellbeing and quality of life. TBI is also a common cause of acquired epilepsy, which is itself associated with significant behavioral morbidity. This review considers the clinical and preclinical evidence that post-traumatic epilepsy (PTE) acts as a 'second-hit' insult to worsen chronic behavioral outcomes for brain-injured patients, across the domains of emotional, cognitive, and psychosocial functioning. Surprisingly, few well-designed studies have specifically examined the relationship between seizures and behavioral outcomes after TBI. The complex mechanisms underlying these comorbidities remain incompletely understood, although many of the biological processes that precipitate seizure occurrence and epileptogenesis may also contribute to the development of chronic behavioral deficits. Further, the relationship between PTE and behavioral dysfunction is increasingly recognized to be a bidirectional one, whereby premorbid conditions are a risk factor for PTE. Clinical studies in this arena are often challenged by the confounding effects of anti-seizure medications, while preclinical studies have rarely examined an adequately extended time course to fully capture the time course of epilepsy development after a TBI. To drive the field forward towards improved treatment strategies, it is imperative that both seizures and neurobehavioral outcomes are assessed in parallel after TBI, both in patient populations and preclinical models.