Epilepsia最新文献

{"title":"Distinct gray matter and metabolic characteristics in hypothalamic hamartoma network with different semiology.","authors":"Yihe Wang, Tao Feng, Fenglai Xiao, Yanfeng Yang, Marine N Fleury, Lawrence P Binding, Davide Giampiccolo, Peter Taylor, Matthias J Koepp, John S Duncan, Penghu Wei, Yongzhi Shan, Guoguang Zhao","doi":"10.1111/epi.18438","DOIUrl":"https://doi.org/10.1111/epi.18438","url":null,"abstract":"<p><strong>Objective: </strong>Hypothalamic hamartomas (HHs) are developmental malformations associated with focal epilepsy. We investigated the patterns of gray matter morphology and cerebral metabolism in individuals with HHs, with and without focal to bilateral tonic-clonic seizures (FBTCSs), aiming to clarify the accompanying network abnormalities.</p><p><strong>Methods: </strong>We analyzed magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (PET) data from 59 patients with HHs (28 with FBTCSs, 31 without), as well as MRI data from 30 healthy controls (HCs) and PET data from 45 HCs. We assessed gray matter voxel-based morphometry and quantitative analysis of cerebral glucose uptake in HH patients and controls, with age, sex, and total intracranial volume as covariates, and drew correlations with duration of epilepsy and seizure semiology and frequency.</p><p><strong>Results: </strong>Compared to HCs, HH patients had significantly increased gray matter volume (GMV) in the ipsilateral amygdala, piriform cortex, hypothalamus, and bilateral temporal cortices; patients with FBTCSs primarily showed increased GMV in the HH stalk, whereas those without FBTCSs showed increased GMV prominently in the amygdala. GMVs of amygdala and piriform cortex were greater and the ipsilateral midtemporal cortex was more hypometabolic the longer the duration of epilepsy and the greater the seizure frequency. No significant GMV or cerebral glucose uptake differences were found between HH patients with and without FBTCSs.</p><p><strong>Significance: </strong>HH-related epilepsy is a network disorder characterized by widespread abnormalities beyond the lesion. This highlights the importance of considering the whole network when formulating diagnosis and treatment plans.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of effectiveness and seizure worsening with cenobamate in pediatric patients with Dravet syndrome.","authors":"Rita Cagigal, Celia Romero-Del-Rincon, Ana Fernandez-Perrone, Raquel Cruz, Rikke S Møller, Angel Aledo-Serrano","doi":"10.1111/epi.18426","DOIUrl":"https://doi.org/10.1111/epi.18426","url":null,"abstract":"<p><p>Dravet syndrome (DS) is a severe developmental and epileptic encephalopathy primarily caused by loss-of-function (LoF) variants in the SCN1A gene. Despite advancements in precision medicine, seizure control remains challenging. Cenobamate, a novel antiseizure medication, has shown positive results in a small case series of adults with DS, but its efficacy in children is unclear. This retrospective and single-center study analyzed the therapeutic response to cenobamate in six pediatric patients (median age = 8.5 years) with DS and SCN1A LoF variants. Patients were treated with cenobamate for a median follow-up of 7 months. Baseline seizure frequency was assessed over 3 months prior to treatment initiation. Response was defined as a ≥50% reduction in seizure frequency and worsening as a ≥25% increase compared to baseline. No patient met the responder criteria. Three patients experienced seizure worsening, including one patient who started presenting status epilepticus after a long status epilepticus-free period, and the remaining three showed no improvement. Adverse effects included sleepiness, restlessness, and loss of appetite, and cenobamate was discontinued in all patients due to lack of effectiveness or seizure worsening. Our findings suggest that cenobamate lacks effectiveness in pediatric DS and may exacerbate seizures in some cases. These results highlight the need for age-specific approaches in treatment decisions for genetic epilepsies.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell type mapping of mild malformations of cortical development with oligodendroglial hyperplasia in epilepsy using single-nucleus multiomics.","authors":"Isabella C Galvão, Manuela Lemoine, Ludmyla Kandratavicius, Clarissa L Yasuda, Marina K M Alvim, Enrico Ghizoni, Ingmar Blümcke, Fernando Cendes, Fabio Rogerio, Iscia Lopes-Cendes, Diogo F T Veiga","doi":"10.1111/epi.18413","DOIUrl":"https://doi.org/10.1111/epi.18413","url":null,"abstract":"<p><strong>Objective: </strong>Mild malformations of cortical development with oligodendroglial hyperplasia in epilepsy (MOGHE) are brain lesions associated with focal epilepsy and characterized by increased oligodendroglial density, heterotopic neurons, and hypomyelination in the white matter. Although previous studies have implicated somatic mutations in the SLC35A2 gene, the cellular and molecular mechanisms underlying MOGHE pathogenesis remain elusive. To address this gap, this study aimed to systematically characterize the cell type composition and molecular alterations of MOGHE lesions at cellular resolution using single-nucleus multiomic profiling.</p><p><strong>Methods: </strong>We performed single-nucleus multiomic sequencing to obtain paired gene expression and chromatin accessibility profiles of >31 000 nuclei from gray matter and white matter regions of MOGHE lesions and compared the results with publicly available neurotypical control datasets.</p><p><strong>Results: </strong>The analysis of gray and white matter regions from two MOGHE patients revealed significant cellular composition alterations, including the presence of heterotopic neurons and disease-specific oligodendrocyte populations within the subcortical white matter. MOGHE-specific oligodendrocytes were characterized by the upregulation of synaptic functions and enhanced neuron communication, denoting a possible role in synaptic support and the mediation of glia-neuron interactions in the disease. On the other hand, MOGHE heterotopic neurons were characterized by the upregulation of genes associated with neuronal migration and the Wnt signaling pathway, suggesting a mechanism underlying their atypical localization.</p><p><strong>Significance: </strong>This high-resolution cell type mapping of MOGHE lesions in clinical samples unveils neuronal and glial populations affected by the disease and provides novel insights into the pathophysiological mechanisms of MOGHE.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do cognitive activities during neuropsychological testing trigger seizures?","authors":"Sophia Wismeth, Mostafa Badr, Christoph Helmstaedter, Juri-Alexander Witt, Rainer Surges","doi":"10.1111/epi.18429","DOIUrl":"https://doi.org/10.1111/epi.18429","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have suggested that stress precipitates seizures and that cognitive exertion may increase brain excitability, thereby possibly contributing to seizure occurrence during neuropsychological examinations. The present study investigates whether specific, standardized cognitive activities are linked to seizure occurrence.</p><p><strong>Methods: </strong>Two thousand neuropsychological examinations including the Verbal Learning and Memory Test (VLMT) and Diagnosticum für Cerebralschädigung-Revised (DCS-R) were retrospectively evaluated, and occurrence of seizures during neuropsychological testing was assessed. In addition, patient characteristics and epilepsy features were collected from electronic patient charts. Statistical analysis was performed using chi-squared test and linear mixed regression models.</p><p><strong>Results: </strong>Data of 1444 patients (age = 46 ± 17 years, 48% female) were included in the study, of whom 95% displayed focal epilepsy. Seizures occurred in 36 (1.8%) of 2000 neuropsychological examinations in 34 (2.4%) of the 1444 patients. Test-related seizures were observed only in patients with focal epilepsy, predominantly during memory tests (58%) and most frequently during VLMT (33.3%) and DCS-R (19.4%). A significant association was found between seizure occurrence during VLMT and a seizure onset zone in the right and left temporal lobe, whereas no such association was identified with seizures occurring during DCS-R. No other features were linked with seizure occurrence during testing.</p><p><strong>Significance: </strong>The occurrence of seizures during neuropsychological examinations is very rare. Our data do not support the notion that specific cognitive activities favor acute onset of seizures but rather suggest a coincidental relationship.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potassium current inactivation as a novel pathomechanism for KCNQ2 developmental and epileptic encephalopathy.","authors":"Ingride Luzio Gaspar, Gaetano Terrone, Giusy Carleo, Lidia Carotenuto, Francesco Miceli, Gabriella De Vita, Maurizio Taglialatela","doi":"10.1111/epi.18427","DOIUrl":"https://doi.org/10.1111/epi.18427","url":null,"abstract":"<p><p>De novo variants in KCNQ2 cause neonatal onset developmental and epileptic encephalopathy (KCNQ2-DEE; Online Mendelian Inheritance in Man #613720), most often by loss-of-function in vitro effects. In this study, we describe a neonatal onset DEE proband carrying a recurrent de novo KCNQ2 variant (c.794C>T; p.A265V) affecting the pore domain of KCNQ2-encoded Kv7.2 subunits. Whole-cell patch-clamp measurement in a mammalian heterologous expression system revealed that, when compared to wild-type Kv7.2 channels, channels containing Kv7.2 A265V subunits displayed (1) reduced maximal current density; (2) decreased voltage-dependence of activation; and (3) an unusual inactivation process, with a 50% current reduction during 1-2-s depolarizing pulses at voltages > 0 mV. These effects were proportional to the number of mutant subunits incorporated in heteromeric channels, being overall less dramatic upon coexpression with Kv7.2 or Kv7.2 + Kv7.3 subunits. These results reveal current inactivation as a novel pathogenetic mechanism for KCNQ2-DEE caused by a recurrent variant affecting a critical pore residue, further highlighting the importance of in vitro functional assessment for a better understanding of disease molecular pathophysiology.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed diagnosis in adolescent onset focal epilepsy: Impact on morbidity and mental health.","authors":"Monica Ferrer, Nora Jandhyala, Jacob Pellinen, Hadley Greenwood, Liu Lin Thio, Dennis Dlugos, Kristen L Park, Andres M Kanner, Jacqueline French","doi":"10.1111/epi.18434","DOIUrl":"https://doi.org/10.1111/epi.18434","url":null,"abstract":"<p><strong>Objective: </strong>This study was undertaken to investigate diagnostic delay in adolescent onset focal epilepsy, including reasons for longer delays and associated morbidities.</p><p><strong>Methods: </strong>Secondary analysis was done using enrollment data from the Human Epilepsy Project, a multi-institutional cohort including 34 sites in the USA, Canada, Finland, Austria, and Australia (2012-2017). Participants were aged 11-64 years at enrollment and within 4 months of treatment initiation for newly diagnosed focal epilepsy. Participants with seizure onset at age ≤ 21 years were evaluated. Data included seizure diaries documenting onset, frequency, and characteristics of seizures, reasons for diagnostic delays, and prediagnosis morbidities, including injuries, suicidal ideation, and self-injurious behaviors.</p><p><strong>Results: </strong>Of 152 participants with adolescent onset seizures, those with a diagnosis delay > 1 year experienced a median delay to diagnosis of 4.4 years and reported higher rates of initial nonmotor seizures compared to those diagnosed within 1 year (n = 55, 78.6% vs. n = 33, 40.2%; χ² ₁ = 22.76, p < .001). Lack of recognition by patients and health care providers accounted for diagnostic delay in more than half (68.2%) of participants with initial nonmotor seizures. Notably, 70% of participants with initial nonmotor seizures went undiagnosed until development of motor seizures. This group reported more injuries compared to those who did not develop motor seizures (56.5% vs. 7.7%; χ² ₂ = 19.82, p < .001). Those with time to diagnosis > 1 year had more prediagnostic seizures (67 vs. 5.5 seizures, 95% confidence interval = 16.0-94.0; p < .001) and higher rates of suicidal ideation (33.3% vs. 14.9%; χ² ₁ = 6.27, p = .01), suicidal behaviors (13.8% vs. 1.5%; χ² ₁ = 7.19, p = .007), and nonsuicidal self-injurious behaviors (13.4% vs. 1.5%; χ² ₁ = 7.04, p = .008).</p><p><strong>Significance: </strong>This study highlights significant delays in diagnosing adolescent onset focal epilepsy, especially in cases with nonmotor seizures. These delays, often due to lack of recognition by patients and health care providers, are linked to more frequent seizures, higher injury rates, and increased suicidal ideation and self-injury. Early recognition and diagnosis may mitigate adverse outcomes and improve quality of life for adolescents with epilepsy.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive screening informs referrals for neuropsychological evaluation in children with epilepsy.","authors":"Kristina E Patrick, Allison N Shields, Holly A Dustin, Anup D Patel, Kelly McNally","doi":"10.1111/epi.18421","DOIUrl":"https://doi.org/10.1111/epi.18421","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to evaluate the effectiveness of current neuropsychology referral methods for children with epilepsy and develop data-informed recommendations for use of performance-based cognitive screening measures to improve these processes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Children with epilepsy who had been referred to neuropsychology (n = 51) or had never been referred (n = 34) completed four brief tablet-based screening tests from the National Institutes of Health Toolbox Cognition Battery along with a comprehensive neuropsychological test battery. Demographics, medical information, and parent questionnaires were gathered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean performance on the neuropsychological test battery was worse in the referral group (p = .008, d = .52), but percentage of patients who presented with cognitive impairment (at least two scores 1.5 SD below the mean) did not differ. Demographics did not predict performance on the comprehensive neurocognitive battery (p = .46, &lt;math&gt; &lt;semantics&gt; &lt;mrow&gt;&lt;msubsup&gt;&lt;mi&gt;R&lt;/mi&gt; &lt;mtext&gt;change&lt;/mtext&gt; &lt;mn&gt;2&lt;/mn&gt;&lt;/msubsup&gt; &lt;/mrow&gt; &lt;annotation&gt;$$ {R}_{mathrm{change}}^2 $$&lt;/annotation&gt;&lt;/semantics&gt; &lt;/math&gt;  = .06). Medical variables added some predictive value (p = .004, &lt;math&gt; &lt;semantics&gt; &lt;mrow&gt;&lt;msubsup&gt;&lt;mi&gt;R&lt;/mi&gt; &lt;mtext&gt;change&lt;/mtext&gt; &lt;mn&gt;2&lt;/mn&gt;&lt;/msubsup&gt; &lt;/mrow&gt; &lt;annotation&gt;$$ {R}_{mathrm{change}}^2 $$&lt;/annotation&gt;&lt;/semantics&gt; &lt;/math&gt;  = .25). Parent questionnaires added minimal value (p = .066, &lt;math&gt; &lt;semantics&gt; &lt;mrow&gt;&lt;msubsup&gt;&lt;mi&gt;R&lt;/mi&gt; &lt;mtext&gt;change&lt;/mtext&gt; &lt;mn&gt;2&lt;/mn&gt;&lt;/msubsup&gt; &lt;/mrow&gt; &lt;annotation&gt;$$ {R}_{mathrm{change}}^2 $$&lt;/annotation&gt;&lt;/semantics&gt; &lt;/math&gt;  = .05) beyond the previous variables. Performance on the cognitive screening battery added significant predictive value (p &lt; .001, &lt;math&gt; &lt;semantics&gt; &lt;mrow&gt;&lt;msubsup&gt;&lt;mi&gt;R&lt;/mi&gt; &lt;mtext&gt;change&lt;/mtext&gt; &lt;mn&gt;2&lt;/mn&gt;&lt;/msubsup&gt; &lt;/mrow&gt; &lt;annotation&gt;$$ {R}_{mathrm{change}}^2 $$&lt;/annotation&gt;&lt;/semantics&gt; &lt;/math&gt;  = .31) above demographics, medical variables, and parent questionnaires, explaining 31% additional variance in performance on the comprehensive neuropsychological battery. Stepwise analysis suggested that only three screening tests, totaling 15 min of administration time, were necessary. A cutoff score of .70 SD below the mean on any of those screening tests had high sensitivity (.90) while maintaining specificity &gt; .50. A cutoff score of 1 SD below the mean provided better balance of sensitivity (.74) and specificity (.70).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Significance: &lt;/strong&gt;Brief and easy to administer performance-based cognitive screening may add value and reduce bias when making decisions about neuropsychology referrals for children with epilepsy. An ideal clinical model could include neuropsychology consultation with chart review, clinical interview, questionnaires, and brief cognitive screening to inform referrals for more comprehensive evaluation. In settings where this is not possible, cognitive screening may be a usef","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More variable circadian rhythms in epilepsy captured by long-term heart rate recordings from wearable sensors.","authors":"Billy C Smith, Christopher Thornton, Rachel E Stirling, Guillermo M Besné, Sarah J Gascoigne, Nathan Evans, Peter N Taylor, Karoline Leiberg, Philippa J Karoly, Yujiang Wang","doi":"10.1111/epi.18424","DOIUrl":"https://doi.org/10.1111/epi.18424","url":null,"abstract":"<p><strong>Objective: </strong>The circadian rhythm synchronizes physiological and behavioral patterns with the 24-h light-dark cycle. Disruption to the circadian rhythm is linked to various health conditions, although optimal methods to describe these disruptions remain unclear. An emerging approach is to examine the intraindividual variability in measurable properties of the circadian rhythm over extended periods. Epileptic seizures are modulated by circadian rhythms, but the relevance of circadian rhythm disruption in epilepsy remains unexplored. Our study investigates intraindividual circadian variability in epilepsy and its relationship with seizures.</p><p><strong>Methods: </strong>We retrospectively analyzed >70 000 h of wearable smartwatch data (Fitbit) from 143 people with epilepsy (PWE) and 31 healthy controls. Circadian oscillations in heart rate time series were extracted, daily estimates of circadian period, acrophase, and amplitude properties were produced, and estimates of the intraindividual variability of these properties over an entire recording were calculated.</p><p><strong>Results: </strong>PWE exhibited greater intraindividual variability in period (76 vs. 57 min, d = .66, p < .001) and acrophase (64 vs. 48 min, d = .49, p = .004) compared to controls, but not in amplitude (2 beats per minute, d = -.15, p = .49). Variability in circadian properties showed no correlation with seizure frequency nor any differences between weeks with and without seizures.</p><p><strong>Significance: </strong>For the first time, we show that heart rate circadian rhythms are more variable in PWE, detectable via consumer wearable devices. However, no association with seizure frequency or occurrence was found, suggesting that this variability might be underpinned by the epilepsy etiology rather than being a seizure-driven effect.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in cortical delta power during chronic invasive epilepsy monitoring.","authors":"Emily R Dappen, Bryan M Krause, Rashmi N Mueller, Matthew I Banks, Kirill V Nourski","doi":"10.1111/epi.18419","DOIUrl":"https://doi.org/10.1111/epi.18419","url":null,"abstract":"<p><strong>Objective: </strong>Cortical delta band (1-4 Hz) activity is considered a biomarker for states of altered consciousness, with increased delta power observed during anesthesia, sleep, coma, and delirium. The current study sought to characterize delta power following electrode implantation with respect to patient demographics and clinical characteristics as well as type and duration of surgery.</p><p><strong>Methods: </strong>Participants were 25 adult neurosurgical patients implanted with intracranial electrodes for clinical monitoring of their epilepsy. Resting state cortical activity was recorded at multiple occasions over the course of the monitoring period. The initial time point was defined as the first recording within 72 h following surgery. Analyses of cortical activity were conducted using a linear mixed effects modeling approach to account for within-participant correlations and between-participant heterogeneity.</p><p><strong>Results: </strong>Throughout the monitoring period, delta power decreased in frontal, occipital, parietal, and temporal regions, indicating a global phenomenon. By contrast, beta (14-30 Hz) power remained stable. Delta power was higher following surgical cases that required craniotomy compared to stereoelectroencephalography cases. Surgery duration and anesthesia emergence duration were associated with higher delta power. Recordings from depth electrodes showed higher delta power compared to subdural electrodes. No significant effects of patients' age, sex, white blood cell count, antiseizure medication, and opioid medication dosage on postoperative delta power were found.</p><p><strong>Significance: </strong>The results are consistent with a postoperative elevation in delta power that resolves over the course of the monitoring period and indicate an association between increased delta power and craniotomy surgery, as well as longer surgery and emergence durations. The current work provides a comprehensive analysis of surgical, clinical, and physiological factors, suggests risk factors, and lays fundamental groundwork for future studies.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence, digital technology, and mobile health in epilepsy.","authors":"Sándor Beniczky, Samden Lhatoo, Michael R Sperling, Philippe Ryvlin","doi":"10.1111/epi.18435","DOIUrl":"https://doi.org/10.1111/epi.18435","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}