Epilepsy & Behavior最新文献

{"title":"Nonsuicidal self-injurious behavior in people with epilepsy and non-psychotic mental disorders","authors":"Mikhail Zinchuk ,&nbsp;Georgii Kustov ,&nbsp;Sofya Popova ,&nbsp;Flora Rider ,&nbsp;Alexander Yakovlev ,&nbsp;Alla Guekht","doi":"10.1016/j.yebeh.2025.110634","DOIUrl":"10.1016/j.yebeh.2025.110634","url":null,"abstract":"<div><h3>Purpose</h3><div>Persons with epilepsy (PWE) are at an increased risk for self-injurious behaviors. While suicidal behavior in PWE has been the subject of considerable research, data on nonsuicidal self-injury (NSSI) in PWE remains limited. The aim of this study was to describe the basic characteristics of NSSI in PWE and to identify associated sociodemographic, biographical, psychological, and clinical factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study assessed 209 consecutive adult PWE with non-psychotic mental disorders using the Self-Injurious Thoughts and Behaviors Interview, Beck Depression Inventory, State-Trait Anxiety Inventory, Brief Reasons for Living Inventory, Modified 36-Item Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified, World Health Organization Quality of Life – 100, as well as a case-report form, to collect relevant for the study data.</div></div><div><h3>Results</h3><div>Lifetime NSSI was reported by 27.7% of PWE, with cutting, carving hitting, picking a wound, biting, and skin scraping being the most common methods. NSSI in PWE was associated with significant features in sociodemographic (born after 1980), biographical (school bullying), clinical (higher levels of depression, anxiety, suicidal ideation and suicide attempts), and psychological profiles (deficits in suicide resilience factors, more pronounced traits of negative affectivity, detachment, antagonism, and psychoticism), and a poorer quality of life.</div></div><div><h3>Conclusion</h3><div>This is the first study to report methods and other NSSI-related parameters in PWE. NSSI is associated with numerous negative parameters, some of which are potentially modifiable, and may therefore become a target for therapeutic interventions with potential benefit in terms of reducing suicide risk, which is high in this subpopulation of PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110634"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy and safety of perampanel versus levetiracetam monotherapy for focal epilepsy: A single-center retrospective study","authors":"Yingfang She ,&nbsp;Yide Li ,&nbsp;Shuda Chen ,&nbsp;Xiaowei Xu ,&nbsp;Liemin Zhou","doi":"10.1016/j.yebeh.2025.110630","DOIUrl":"10.1016/j.yebeh.2025.110630","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110630"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationship between white matter structural connectivity and epilepsy","authors":"Nan Zhang ,&nbsp;Rui Huang ,&nbsp;Xiaoyu Dong","doi":"10.1016/j.yebeh.2025.110642","DOIUrl":"10.1016/j.yebeh.2025.110642","url":null,"abstract":"<div><div>White matter structural connectivity has recently been linked to epilepsy pathogenesis, yet its causal role remains unclear. This study used Mendelian randomization (MR) to investigate the causal relationship between white matter structural connectivity and epilepsy. GWAS summary statistics for white matter structural connectivity were sourced from the UK Biobank, while epilepsy data were obtained from FinnGen R10 and the International League Against Epilepsy (ILAE). Our MR analysis revealed significant causal links between white matter structural connectivity and epilepsy risk. Increased connectivity between the right hemisphere visual and salience/ventral attention networks (<em>RH Vis to RH Sal/VentAttn WMSC</em>) was associated with higher epilepsy risk in FinnGen_R10_FE_STRICT (OR = 2.25, 95 % CI = 1.43–3.56, p &lt; 0.01, FDR P = 0.019). Conversely, increased connectivity between left and right hemisphere salience/ventral attention networks (<em>LH Sal/VentAttn to RH Sal/VentAttn WMSC</em>) was linked to reduced epilepsy risk in FinnGen_R10_GE_STRICT (OR = 0.17, 95 % CI = 0.07–0.46, p &lt; 0.01, FDR P = 0.033). A total of 15 nominally significant associations were identified across datasets. These findings suggest a causal relationship between white matter structural connectivity and epilepsy, offering insights into disease mechanisms and potential therapeutic targets.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110642"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a community-based online incentivized survey to describe the healthcare and school-based care of adolescents with functional seizures","authors":"Andrea L. Tanner ,&nbsp;Ukamaka M. Oruche ,&nbsp;Claire Burke Draucker","doi":"10.1016/j.yebeh.2025.110636","DOIUrl":"10.1016/j.yebeh.2025.110636","url":null,"abstract":"<div><h3>Introduction</h3><div>Functional seizures have profound effects on adolescents and their families. These adolescents report negative experiences with healthcare and school-based providers that are likely exacerbated by racial/ethnic and socioeconomic disparities. Research with this population has been conducted mainly in clinic settings. This study aimed to (1) Determine if a racially/ethnically and socioeconomically diverse group of adolescents with functional seizures can be recruited via a community-based online incentivized survey, (2) Describe adolescents’ mental health care utilization and parents’ perceptions of encountering disparities in the adolescents’ healthcare, (3) Describe adolescents’ school-based outcomes, and (4) Describe adolescents’ and their parents’ perspectives on school-based care.</div></div><div><h3>Methods</h3><div>A cross-sectional community-based online incentivized survey with adolescents with functional seizures and their parents.</div></div><div><h3>Results</h3><div>A racially/ethnically and socioeconomically diverse sample of 22 adolescents with functional seizures and their parents completed the survey, although recruitment was challenged by a high rate of fraudulent and careless responders. Most adolescent responders were chronically absent from school, and most were receiving mental health treatment. Half of the parents reported health disparities due to race/ethnicity, cost, or both. Parents and adolescents provided valuable insights regarding their perspectives on school-based care for adolescents with functional seizures.</div></div><div><h3>Conclusion</h3><div>School nurses and other healthcare providers should develop strategies to address chronic absenteeism due to functional seizures, assess health disparities experienced by adolescents and their families, combat lack of understanding of functional seizures, and provide informed and compassionate care for this population. Survey researchers should develop a systematic plan using multiple strategies to combat fraudulent responses in survey research.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110636"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Hughlings Jackson’s dreamy state: dissociative symptoms in temporal lobe epilepsy","authors":"Fiore D’Aprano ,&nbsp;Alice Matson ,&nbsp;Jessamae Pieters ,&nbsp;Jacquie Eyres ,&nbsp;Toby Winton-Brown ,&nbsp;Terence J. O’Brien ,&nbsp;Graeme Jackson ,&nbsp;Sarah J. Wilson ,&nbsp;Charles B. Malpas ,&nbsp;Genevieve Rayner","doi":"10.1016/j.yebeh.2025.110623","DOIUrl":"10.1016/j.yebeh.2025.110623","url":null,"abstract":"<div><h3>Background</h3><div>Transient, dissociative experiences have been attributed to temporal lobe epilepsy (TLE) since at least the time of John Hughlings Jackson in the 1870s, who described how different dissociative symptoms might have distinct clinical potential. While dissociative symptoms are well-understood as a semiological feature of mesial TLE, they can also occur interictally yet remain poorly understood. We systematically examined the frequency, nature, and clinical correlates of dissociative experiences in TLE in an initial effort to better understand their phenotypic features.</div></div><div><h3>Methods</h3><div>157 adults with TLE and 57 healthy controls participated (<em>N</em> = 214). A data-driven statistical approach determined the underlying factor structure of the Wessex Dissociation Scale in this cohort and delineated phenotypic symptom clusters. We then examined group differences in rates of dissociation symptoms, as well as the influence of epilepsy-related and mood factors.</div></div><div><h3>Results</h3><div>People with TLE reported more frequent dissociative experiences (<em>M</em> = 0.96, SD = 0.61) than controls (<em>M</em> = 0.69, <em>SD</em> = 0.38; <em>p &lt;</em> 0.001). A novel five-factor solution of dissociative symptoms emerged, namely intrusive, affective, memory, somatic, and numbing. Memory blanks and somatic distortions were uniquely elevated in TLE. Memory blanks and numbing dissociative symptoms were associated with increased seizure frequency, epilepsy duration, and number of anti-seizure medications. Higher depression and anxiety symptoms were linked to elevated overall dissociative symptoms and scores on each subfactor (<em>r</em> = 0.26–.64; <em>p</em> &lt; 0.01–&lt;.001).</div></div><div><h3>Conclusions</h3><div>People with TLE experience elevated rates of dissociative symptoms in their daily lives. Rather than a general dissociative phenotype, memory- and sensory-related symptoms predominate. The data-driven five-factor model refines earlier understandings and aligns well with contemporary neurocognitive models of epilepsy as a disorder of large-scale network dysfunction, with psychological and epilepsy-specific mechanisms underpinning dissociative experiences in TLE. While the aetiology of these symptoms is complex and multidetermined, TLE nevertheless remains an insightful model for understanding the neurological basis of dissociation more broadly.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110623"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalized and focal epilepsy and pregnancy, delivery and neonatal outcomes: a retrospective cohort study","authors":"Noah Margolese ,&nbsp;Ahmad Badeghiesh ,&nbsp;Haitham Baghlaf ,&nbsp;Aaron Samuels ,&nbsp;Michael H. Dahan","doi":"10.1016/j.yebeh.2025.110640","DOIUrl":"10.1016/j.yebeh.2025.110640","url":null,"abstract":"<div><div>We previously demonstrated associations between maternal epilepsy and pregnancy outcomes. Now, we seek to determine whether these outcomes differ between generalized and focal epilepsy.</div><div>A retrospective cohort study was completed using the HCUP-NIS database. Pregnancy outcomes were compared across generalized and focal epilepsy types, as determined via ICD-9 codes.</div><div>Of 2,596 pregnancies, 1978 women had focal epilepsy and 618 had generalized epilepsy. Focal epilepsy was associated with increased rates of cesarean sections as compared to generalized epilepsy (aOR = 1.27;95 %CI = 1.02–1.57;p = 0.030). Other pregnancy outcomes did not differ significantly, including pregnancy induced hypertension, gestational hypertension, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on pre-existing hypertension, gestational diabetes mellitus, placenta previa, preterm premature rupture of membranes, preterm delivery, abruptio placenta, chorioamnionitis, operative vaginal delivery, hysterectomy, postpartum hemorrhage, wound complications, maternal death, transfusion, maternal infection, deep venous thrombosis, pulmonary embolism, venous thromboembolism, disseminated intravascular coagulation, small for gestational age, intrauterine fetal demise and congenital anomalies (P &gt; 0.05, all). As compared to generalized epilepsy, focal epilepsy was associated with younger age (p &lt; 0.001), lower income quartile (p = 0.013), tobacco smoking during pregnancy (p = 0.037) and illicit drug use (p &lt; 0.001). Women with focal epilepsy were more likely than those with generalized epilepsy to be covered by Medicaid and less likely to be covered through Medicare or private insurance (p &lt; 0.001). No significant differences were observed regarding other maternal characteristics.</div><div>Women with focal epilepsy are at a higher risk of delivery through cesarean section than those with generalized epilepsy. The reason why remains unclear. Reassuringly, other pregnancy complications are not increased by generalized as opposed to focal epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110640"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating microRNAs as potential biomarkers in pediatric epilepsy: a pilot study","authors":"Beata Rzepka-Migut ,&nbsp;Celina Kruszniewska-Rajs ,&nbsp;Magdalena Bugowska ,&nbsp;Marcela Krzempek ,&nbsp;Joanna Gola ,&nbsp;Pasquale Striano ,&nbsp;Justyna Paprocka","doi":"10.1016/j.yebeh.2025.110631","DOIUrl":"10.1016/j.yebeh.2025.110631","url":null,"abstract":"<div><h3>Objective</h3><div>Epilepsy is among the most prevalent neurological disorders in children, yet its diagnosis remains largely subjective and reliant on clinician expertise. This highlights the need for objective, minimally invasive biomarkers to support early diagnosis and predict drug resistance. Circulating microRNAs (miRNAs) in whole blood present a promising avenue as potential diagnostic and prognostic biomarkers for pediatric epilepsy. This study explores the relationship between selected miRNA expression levels and clinical characteristics in children with epilepsy.</div></div><div><h3>Methods</h3><div>A literature review identified five miRNAs with high potential as biomarkers for drug-resistant epilepsy based on studies of the adult population. Quantitative RT-PCR (RT-qPCR) assays were employed to measure miRNA levels in whole blood and assess correlations with clinical characteristics. This pilot study, conducted from June to December 2023, analyzed 109 of the 115 collected blood samples.</div></div><div><h3>Results</h3><div>Correlation analysis revealed significant relationships between miR-142-3p, miR-194-5p, and miR-342-5p expression levels with sex, miR-142-3p and miR-342-5p expression levels with the age of seizure onset, and miR-342-5p with family history. Additionally, miR-233-3p expression showed a statistically significant correlation with EEG abnormalities. The analysis did not demonstrate the potential of the selected miRNAs as valuable biomarkers.</div></div><div><h3>Significance</h3><div>Differences in epilepsy etiology between pediatric and adult populations, along with age and disease duration-dependent miRNA expression, suggest that adult-based findings may not be directly applicable to children. Further research in pediatric cohorts is essential to establish miRNAs as reliable biomarkers for pediatric epilepsy diagnosis and prognosis.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110631"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring barriers and facilitators regarding medication adherence to anti-seizure medication in epilepsy patients with a low socio-economic status: a qualitative study","authors":"Semure H. Kaya Günes ,&nbsp;Milou van Heuckelum ,&nbsp;Sijgje M. Droger ,&nbsp;Anneke J.J. Rampen ,&nbsp;Thomas A. Smits ,&nbsp;Barbara Kuijper","doi":"10.1016/j.yebeh.2025.110635","DOIUrl":"10.1016/j.yebeh.2025.110635","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110635"},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to use social media in medical education: A focus on epilepsy","authors":"Francesco Brigo ,&nbsp;Michael Kinney ,&nbsp;Nathan A. Shlobin","doi":"10.1016/j.yebeh.2025.110643","DOIUrl":"10.1016/j.yebeh.2025.110643","url":null,"abstract":"<div><div>Social media has transformed global communication and information sharing, significantly impacting medical education. It offers dynamic opportunities for enhancing learning experiences, engaging learners, and fostering professional development among healthcare professionals. Benefits include quick information dissemination, collaborative learning, professional networking, and continuous medical education, which help improve patient care outcomes. However, challenges such as maintaining patient confidentiality and adhering to ethical guidelines are critical. The article explores these complexities, with a focus on epilepsy education, highlighting how each platform presents unique risks and opportunities that shape content delivery and user engagement in the field of epilepsy. To support targeted, evidence-based strategies ensuring that educational content is accurate, empathetic, and accessible, we propose a multidimensional framework for evaluating educational impact, encompassing reach, content accuracy, behavioral outcomes, and community-level effects. Social media, despite its challenges, can significantly enhance medical education through interactive learning, virtual conferences, and self-directed modules tailored to diverse learning needs. It fosters a culture of lifelong learning among healthcare providers, improving epilepsy management and patient outcomes. Future innovations in social media, including artificial intelligence, virtual reality, and telemedicine, hold promise for advancing epilepsy education, patient care, and research. By addressing challenges and leveraging these digital tools, stakeholders can improve healthcare outcomes, empower patients, and advance scientific knowledge in epilepsy management.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110643"},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy and violence: historical misconceptions, scientific evidence, and legal realities","authors":"Sergio Nojiri ,&nbsp;Kette Valente","doi":"10.1016/j.yebeh.2025.110633","DOIUrl":"10.1016/j.yebeh.2025.110633","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy has historically been mischaracterized as a disorder associated with aggression and criminal behavior. Misconceptions dating back to the 19th century, particularly those propagated by Cesare Lombroso, have contributed to persistent stigma and misinformed legal interpretations.</div></div><div><h3>Methods</h3><div>This narrative review examines the historical, clinical, neuroscientific, and legal literature on the purported link between epilepsy and violent behavior. Key seizure phases—ictal, postictal, and interictal—are analyzed alongside recent findings from psychiatric comorbidity studies and forensic neurology.</div></div><div><h3>Results</h3><div>There is no consistent evidence that epilepsy per se leads to violent or criminal acts. Aggressive behavior in people with epilepsy (PWE) is rare and typically arises from confusional states during the postictal phase or from psychiatric comorbidities. Modern classification schemes and video-EEG telemetry have clarified the behavioral distinctions across seizure phases. Legal defenses based on mental insanity often fail to accurately reflect the neurobiological underpinnings of seizure-related behaviors.</div></div><div><h3>Conclusions</h3><div>Violence in epilepsy must be understood as a context-dependent and biologically nuanced phenomenon. Relying on outdated legal constructs, such as blanket insanity defenses, perpetuates stigma and undermines clinical reality. Integration of neuroscientific evidence and seizure-phase classification improves forensic clarity and supports more equitable judicial outcomes for PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110633"},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}