Epilepsy & Behavior最新文献

{"title":"Tuberous Sclerosis Complex: An updated in the treatment of epilepsy for early careers","authors":"Kette D. Valente ,&nbsp;Leticia Brito Sampaio ,&nbsp;Silvia Vincentiis ,&nbsp;Anna Lecticia R. Pinto ,&nbsp;Maria Augusta Montenegro","doi":"10.1016/j.yebeh.2025.110396","DOIUrl":"10.1016/j.yebeh.2025.110396","url":null,"abstract":"<div><div>Tuberous Sclerosis Complex (TSC) is a rare autosomal dominant disorder that is characterized by multisystem involvement and significant neurological manifestations. <em>TSC1</em> and <em>TSC2</em> pathogenic variants lead to hyperactivation of the mammalian target of rapamycin (mTOR) pathway, which disrupts cellular growth and differentiation. Epilepsy, affecting 85–90% of individuals with TSC, often presents within the first year of life and is commonly resistant to conventional therapies. This paper provides a comprehensive overview of the diagnostic criteria, pathophysiology, and current treatment strategies for TSC-associated epilepsy, including pharmacological approaches such as vigabatrin, cannabidiol, and mTOR inhibitors, as well as non-pharmacological interventions such as ketogenic diet and epilepsy surgery. Preventive strategies, highlighted by robust trials, delay seizure onset and reduce its severity but have a limited impact on neurodevelopmental outcomes. Challenges include the heterogeneity of cortical tubers, suboptimal seizure control with existing therapies, and underutilization of neuropsychiatric care for TSC-associated neuropsychiatric disorders. Advances in biomarkers, precision medicine, and surgical techniques have paved the way for personalized treatment approaches. Future research providing earlier detection strategies and integrating therapies targeting both the neurological and behavioral dimensions of TSC is ongoing. By addressing these needs, clinicians and researchers can enhance the quality of life and developmental outcomes of individuals with TSC.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110396"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739304","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":"Gaze behavior in infancy associates with developmental outcome at the age of two years in early-onset epilepsies","authors":"Henna Jonsson ,&nbsp;Sofie de Sena ,&nbsp;Tarja Linnankivi ,&nbsp;Eija Gaily ,&nbsp;Susanna Stjerna","doi":"10.1016/j.yebeh.2025.110397","DOIUrl":"10.1016/j.yebeh.2025.110397","url":null,"abstract":"<div><h3>Purpose</h3><div>The neurodevelopmental outcome of infants with early-onset epilepsies varies widely, ranging from typical development to global developmental delay. Visual skills, which emerge during infancy, are crucial for the development of cognitive functions. The aim of this observational cohort study was to explore gaze behavior in infants with early-onset epilepsy and evaluate if eye tracking could support prognostication of their neurodevelopment.</div></div><div><h3>Methods</h3><div>Fifty-one infants (22 females, mean seizure onset-age 5, SD ± 2, months) from a prospective epilepsy cohort underwent repeated eye tracking and Hammersmith Infantile/Neonatal Neurological examination (HINE/HNNE). Neurodevelopment at age two was categorized as typical development (mean Bayley [BSID-III] cognitive and language or Griffiths [GMDS-III] scales score ≥ 85) and developmental delay. At initial (age 3–10 months) and 12-month visit, we compared reliability of fixation, probability of gaze shifts and saccadic reaction times (SRTs) in a non-competitive SRT-task between developmental groups. Gaze behavior was also compared across etiologies, syndrome groups and between those with optimal versus suboptimal first HINE/HNNE.</div></div><div><h3>Results</h3><div>Infants with typical developmental outcome (n = 23) had higher reliability of fixation (<em>p</em> = 0.007) and higher probability of gaze shifts (<em>p</em> = 0.012) at initial eye tracking than those with delay (n = 28). SRTs became faster during the follow-up but did not differ significantly between the developmental groups. Gaze behavior associated with epilepsy syndrome, etiology, and initial HINE/HNNE result.</div></div><div><h3>Conclusions</h3><div>Ability to fixate reliably and shift gaze soon after the epilepsy diagnosis is associated with developmental outcome in infants with early-onset epilepsy, suggesting that eye tracking could be useful as an additional prognostic tool.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110397"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal cortical dysplasia detection by artificial intelligence using MRI: A systematic review and meta-analysis","authors":"Mohammad Dashtkoohi ,&nbsp;Delaram J. Ghadimi ,&nbsp;Farzan Moodi ,&nbsp;Nima Behrang ,&nbsp;Ehsan Khormali ,&nbsp;Hanieh Mobarak Salari ,&nbsp;Nathan T. Cohen ,&nbsp;Taha Gholipour ,&nbsp;Hamidreza Saligheh Rad","doi":"10.1016/j.yebeh.2025.110403","DOIUrl":"10.1016/j.yebeh.2025.110403","url":null,"abstract":"<div><h3>Purpose</h3><div>Focal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy. However, it can be challenging to detect FCD using MRI alone. This study aimed to review and analyze studies that used machine learning and artificial neural networks (ANN) methods as an additional tool to enhance MRI findings in FCD patients.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in four databases (Embase, PubMed, Scopus, and Web of Science). The quality of the studies was assessed using QUADAS-AI, and a bivariate random-effects model was used for analysis. The main outcome analyzed was the sensitivity and specificity of patient-wise outcomes. Heterogeneity among studies was assessed using I².</div></div><div><h3>Results</h3><div>A total of 41 studies met the inclusion criteria, including 24 ANN-based studies and 17 machine learning studies. Meta-analysis of internal validation datasets showed a pooled sensitivity of 0.81 and specificity of 0.92 for AI-based models in detecting FCD lesions. Meta-analysis of external validation datasets yielded a pooled sensitivity of 0.73 and specificity of 0.66. There was moderate heterogeneity among studies in the external validation dataset, but no significant publication bias was found.</div></div><div><h3>Conclusion</h3><div>Although there is an increasing number of machine learning and ANN-based models for FCD detection, their clinical applicability remains limited. Further refinement and optimization, along with longitudinal studies, are needed to ensure their integration into clinical practice. Addressing the identified limitations and intensifying research efforts will improve their relevance and reliability in real medical scenarios.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110403"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725198","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":"Can transcutaneous auricular vagus nerve stimulation be considered a viable adjuntive therapy in drug-resistant epilepsy? A systematic review and meta-analysis of randomized controlled trials","authors":"Pierludovico Moro ,&nbsp;Marco Antonnio Rocha dos Santos ,&nbsp;Abner Lucas Balduino de Souza ,&nbsp;Thaís Pereira Mendes ,&nbsp;Laura de Lima Xavier ,&nbsp;Carlo Di Bonaventura ,&nbsp;Emanuele Cerulli Irelli","doi":"10.1016/j.yebeh.2025.110394","DOIUrl":"10.1016/j.yebeh.2025.110394","url":null,"abstract":"<div><h3>Objective</h3><div>Transcutaneous auricular vagal nerve stimulation (tVNS) has been investigated as a potential non-invasive therapy in addition to standard medical care in patients with drug-resistant epilepsy (DRE). This <em>meta</em>-analysis evaluates the efficacy and safety of tVNS compared to sham stimulation in patients with DRE.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in three electronic databases (PubMed, Scopus, Cochrane) to identify randomized controlled trials (RCTs) comparing tVNS versus sham stimulation for the treatment of DRE. The Cochrane risk of bias tool for randomized trials was utilized for quality assessment.</div></div><div><h3>Results</h3><div>Four RCTs, comprising 368 patients, with 232 patients in the tVNS group, were included. The <em>meta</em>-analysis revealed that tVNS significantly reduces seizure frequency, as expressed by mean monthly seizure number (mean difference [MD] −3.01, 95 % confidence interval [CI] [−5.37 to −0.65], p &lt; 0.01, I² = 0 %) and percentage seizure reduction (MD 17.57 %, 95 % CI [1.90 to 33.25], p = 0.03, I² = 0 %) at the end of treatment. The analysis also indicated a potential effect on responder rate (odds ratio 2.00, 95 % CI [0.98 to 4.05], p = 0.06, I² = 42 %), although not statistically significant. No significant differences between groups were found regarding seizure freedom, depression, and QOL. Adverse events reported were mostly mild and transient, with no significant differences between groups and comparable discontinuation rates.</div></div><div><h3>Conclusions</h3><div>This <em>meta</em>-analysis supports the efficacy and safety of tVNS as an adjunctive therapy for the treatment of DRE. Due to significant methodological concerns in some of the included studies, well-designed RCTs are needed to investigate the efficacy of tVNS on seizure and non-seizure outcomes in patients with DRE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110394"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725285","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":"Delphi consensus on referral criteria for pediatric patients with suspected Dravet syndrome","authors":"Angel Aledo-Serrano ,&nbsp;Susana Boronat ,&nbsp;Juan José García-Peñas ,&nbsp;Adrián García-Ron ,&nbsp;Antonio Gil-Nagel ,&nbsp;Juan Jesús Rodríguez Uranga ,&nbsp;Rocio Sánchez-Carpintero ,&nbsp;Patricia Smeyers ,&nbsp;Vicente Villanueva","doi":"10.1016/j.yebeh.2025.110401","DOIUrl":"10.1016/j.yebeh.2025.110401","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to establish referral criteria, based on the Hattori precedent, to assist in the easy identification and referral of pediatric patients with suspected Dravet syndrome (DS) at first-line care facilities to support early diagnosis and appropriate management.</div></div><div><h3>Methods</h3><div>DS referral criteria were developed by a Scientific Committee (SC) of 9 epilepsy specialists by consensus review. These criteria were evaluated for suitability by an Expert Panel (EP) comprising 10 frontline healthcare professionals not specialized in epilepsy using a conventional two-phase Delphi methodology. Results were evaluated using the Interpercentile Range Adjusted for Symmetry method.</div></div><div><h3>Results</h3><div>Four DS referral criteria were proposed by the SC, including: (1) history of prolonged febrile/non-febrile seizures before one year of age; (2) history of different types of non-febrile seizures before one year of age; (3) history of seizures sensitive to temperature changes before one year of age; and (4) neurodevelopmental disorders without previous signs or regression. Genetic criteria were excluded due to lack of availability of tests for frontline professionals. The EP rated all four criteria as appropriate for use by frontline professionals (A), with a high degree of consensus (median score 6–9) across four dimensions (“ease of identification”, “relevance”, “feasibility of referral if one criterion met”, and “feasibility of referral if &gt; 1 criterion met”).</div></div><div><h3>Conclusions</h3><div>A set of DS referral criteria has been identified and validated for use by non-epilepsy-specialized professionals within the framework of current clinical practice. The adapted criteria could be effective and beneficial for incorporation into existing care protocols.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110401"},"PeriodicalIF":2.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725197","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":"Sexual dysfunction in men with epilepsy – An observational case-control study","authors":"Sumant Jayadev Balagandi ,&nbsp;Lakshminarayanapuram Gopal Viswanathan ,&nbsp;Ezhumalai Sinu ,&nbsp;Nandakumar Dalavaikodihalli Nanjaiah ,&nbsp;Ajay Asranna ,&nbsp;Mundlamuri Ravindranadh Chowdary ,&nbsp;Raghavendra Kenchaiah ,&nbsp;Thennarasu Kandavel ,&nbsp;Sanjib Sinha","doi":"10.1016/j.yebeh.2025.110388","DOIUrl":"10.1016/j.yebeh.2025.110388","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy presents multifaceted challenges, including sexual dysfunction and psychiatric comorbidities in men. Understanding the interplay between epilepsy, antiseizure medications, hormonal alterations, and sexual dysfunction is crucial for tailored interventions and improved quality of life.</div></div><div><h3>Methods</h3><div>This case-control study enrolled 226 married men (150 MWE, 76 controls) from a tertiary care neurology hospital in Southern India. Demographic, clinical, and hormonal data were collected. Sexual dysfunction was assessed using the Arizona Sexual Experience Scale (ASEX) and the Premature Ejaculation Diagnostic Tool (PEDT). Psychiatric symptoms were evaluated using the DASS-21 questionnaire.</div></div><div><h3>Results</h3><div>Nineteen percent of MWE exhibited significant sexual dysfunction. Median ASEX scores were significantly higher in polytherapy (15) compared with monotherapy (13) and controls (10), (p &lt; 0.0001). The cut-off score for sexual dysfunction (&gt;18) was present in 20 individuals in the polytherapy group, 8 in the monotherapy group and none in the control group (p &lt; 0.0001). PEDT scores showed a similar pattern, with statistically significant differences between subgroups. Hormonal analysis revealed dysregulated LH and testosterone levels in MWE and were significantly more on pairwise comparisons in the polytherapy subgroup. Epilepsy duration, valproate usage, and presence of anxiety/depression were associated with sexual dysfunction on a multivariable regression model using the Akaike information criterion.</div></div><div><h3>Conclusion</h3><div>This study elucidates the complex relationship between epilepsy, medications, hormonal alterations, and sexual dysfunction in men. Valproate was found to be strongly associated with sexual dysfunction and hormonal imbalance. Further research is warranted to address study limitations and advance our understanding of sexual dysfunction in MWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110388"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714480","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":"Validation of Item 4 of the Neurological disorders depression Inventory for epilepsy as a rapid screening tool for suicidality in Russian persons with epilepsy","authors":"Sofya Popova ,&nbsp;Mikhail Zinchuk ,&nbsp;Georgii Kustov ,&nbsp;Flora Rider ,&nbsp;Alla Guekht","doi":"10.1016/j.yebeh.2025.110392","DOIUrl":"10.1016/j.yebeh.2025.110392","url":null,"abstract":"<div><h3>Background</h3><div>Suicide rates among persons with epilepsy (PWE) are high and a reliable and valid tool to screen for suicidality in this population is needed. The aim of this study is to validate the Russian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) Item 4 as a screening tool for suicidality in PWE.</div></div><div><h3>Methods</h3><div>A consecutive sample of the Russian PWE has completed the NDDI-E. The Columbia Suicide Severity Rating Scale (C-SSRS) was used as the gold standard for assessing suicide risk. Statistical methods used were Fisher’s exact test, Mann-Whitney test and Benjamini-Hochberg procedure. Item 4 characteristics for suicide screening were evaluated using receiver operating characteristics (ROC) analysis, and the maximum value of Youden’s index (J) was used to select the optimal cut-off point.</div></div><div><h3>Results</h3><div>A total of 372 PWE were enrolled (mean age 42.9 years, 64.8 % female), of whom 42 (11.3 %) were at risk for suicide. The area under the curve (AUC) for Item 4 in identifying suicide risk was 0.86 and the optimal cut-off for Item 4 was &gt; 1 (J = 0.661). At this cut-off, Item 4 had a sensitivity of 80.9 %, a specificity of 85.1 %, a positive predictive value (PPV) of 41.0 % and a negative predictive value (NPV) of 97.2 %.</div></div><div><h3>Conclusion</h3><div>Item 4 of the Russian version of the NDDI-E (with a cut-off of &gt; 1) is a reliable and valid tool for screening suicidality in PWE. It has good psychometric properties, is not time-consuming, and could therefore be recommended for routine use in settings providing medical care to Russian-speaking PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110392"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705000","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":"Sociodemographic barriers in epilepsy surgery in the United States: A systematic review and meta-analysis","authors":"Cemal Karakas ,&nbsp;Megan C. Alam ,&nbsp;Liam D. Ferreira ,&nbsp;Sidharth Nair ,&nbsp;Dmitri Kovalev ,&nbsp;Zulfi Haneef","doi":"10.1016/j.yebeh.2025.110391","DOIUrl":"10.1016/j.yebeh.2025.110391","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to perform a systematic review and <em>meta</em>-analysis to identify sociodemographic barriers that could contribute to the underutilization of epilepsy surgery.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, and Web of Science databases were systematically reviewed from January 2002 until August 2024. The studies examining the impact of sociodemographic barriers on epilepsy surgery were included. The primary outcomes were the odds ratio (OR) and 95 % confidence intervals (CI) for receiving surgery compared to not-receiving surgery in persons with epilepsy. Race/ethnicity, sex, and insurance had sufficient data to perform a <em>meta</em>-analysis of OR and 95 % CI.</div></div><div><h3>Results</h3><div>Overall, 1,520,813 patients from 12 studies were evaluated, among which relevant studies were selected for comparing sex (338,170 males and 341,821 females), race (1,056,571 White, 224,693 Hispanic, and 239,549 Black/African-American [Black/AA]), and insurance (232,908 private, 190,849 Medicaid, and 204,478 Medicare). Black/AA patients were significantly less likely to have surgery compared to Whites (OR 0.46, CI 0.35–0.61) or Hispanics (OR: 0.54, CI 0.43–0.67). White patients were more likely to have surgery than other groups examined (OR 1.61, CI 1.28–2.02). There were no significant differences in surgical odds when comparing males to females (OR 1.00, CI 0.97–1.03). Compared to the private insurance, patients with Medicaid (OR 0.61, CI 0.49–0.75) or Medicare (OR: 0.49, CI 0.32–0.77) were less likely to obtain surgery.</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis highlights the impact of race/ethnicity, sex, and insurance status in the likelihood of receiving epilepsy surgery and can inform targeted interventions and policies aimed at ensuring equity for disadvantaged groups.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110391"},"PeriodicalIF":2.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704294","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":"The relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy in eastern Türkiye: A path analysis","authors":"Yasemin Erden ,&nbsp;Gülcan Bahçecioğlu Turan ,&nbsp;Nurgul Karakurt ,&nbsp;Ercan Bakır","doi":"10.1016/j.yebeh.2025.110367","DOIUrl":"10.1016/j.yebeh.2025.110367","url":null,"abstract":"<div><h3>Background</h3><div>The effects of psychological factors such as self-efficacy, illness-related fear, and intolerance of uncertainty on illness management and quality of life of patients who have epilepsy have important roles in understanding the health behaviors of individuals.</div></div><div><h3>Aim</h3><div>The present study was conducted to examine the relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy and to investigate the mediating role of illness-related fear in the relationship between self-efficacy and intolerance of uncertainty.</div></div><div><h3>Method</h3><div>This cross-sectional and correlational study had a descriptive design and was conducted with 150 epilepsy patients who met the inclusion criteria and applied to the neurology clinic of a university hospital. The study population comprised epilepsy patients who applied to the Neurology Clinic of a university hospital in eastern Türkiye between May 2024 and August 2024. The data were collected by using the Personal Information Form, Epilepsy Self-Efficacy Scale, Illness-Related Fear Scale, and Mishel Uncertainty in Illness Scale − Community Form. The Structural Equation Modeling and Bootstrapping Methods were used to analyze the study data. The study was reported following the STROBE Recommendations.</div></div><div><h3>Results</h3><div>Based on the findings, self-efficacy was found to negatively affect intolerance of uncertainty about the illness (b = −0.384, 95 % CI [−0.462 to −0.306], p &lt; 0.01) and illness-related fear (b = −0.449, 95 % CI [−0.544 to −0.344], p &lt; 0.01). Also, illness-related fear was found to positively affect intolerance of uncertainty (b = 0.688, 95 % CI [0.586 to 0.789], p &lt; 0.01). The indirect effect of self-efficacy on intolerance of uncertainty through illness-related fear (b = -0.309, 95 % CI [-0.444 to −0.210], p &lt; 0.01) was found to be negative and significant and the total effect (b = -0.693, 95 % CI [−0.789 to −0.597], p &lt; 0.01) was also negative and significant. Self-efficacy explained 34 % of the illness-related fear and 59 % of the total intolerance of uncertainty in the model. The estimated effects were calculated with 5000 repeated operations and were evaluated to be significant because the indirect effects did not include zero in the 95 % Confidence Interval.</div></div><div><h3>Conclusion</h3><div>The results of the present study showed that self-efficacy has a direct negative impact on intolerance of uncertainty in patients who have epilepsy and that fear related to the illness plays mediating roles in this effect.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110367"},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681724","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":"MK-212 precipitates seizure-induced death in amygdala-kindled mice via a non-5-HT2C receptor-mediated mechanism","authors":"Katelyn G. Joyal ,&nbsp;Nicole A. Boodhoo ,&nbsp;Gordon F. Buchanan","doi":"10.1016/j.yebeh.2025.110385","DOIUrl":"10.1016/j.yebeh.2025.110385","url":null,"abstract":"<div><div>Epilepsy is a common neurological condition that affects over 65 million people worldwide. Despite an increasing number of anti-seizure medications being made available, many patients do not find seizure freedom with medication. The leading cause of death in this refractory population is sudden unexpected death in epilepsy (SUDEP). Both human and animal research has implicated serotonin (5-HT) in modulating seizure proclivity, severity, and mortality. More recently, evidence has pointed to the 5-HT_2C receptor as a salient target for investigating the mechanisms of seizure facilitation and mortality. Various seizures models have been used previously to assess the role of the 5-HT_2C receptor in seizure expression and morphology. However, limbic kindling models have been underutilized in this endeavor. We used the selective 5-HT_2C receptor agonist MK-212 to examine the effect of 5-HT_2C receptor activation in amygdala kindled mice. C57BL/6J mice were instrumented with an EEG/EMG headmount and a bipolar electrode in the basolateral amygdala (BLA). The animals then received vehicle or MK-212 (10, 30 mg/kg) prior to seizure induction. 12.5% of WT animals that received 10 mg/kg MK-212 experienced seizure-induced respiratory arrest and died following seizure induction. When the dose was raised to 30 mg/kg, 100% of the animals succumbed following a seizure. These fatal seizures persisted when the same doses of MK-212 were administered to mice lacking the 5-HT_2C receptor. This suggests that a non-5-HT_2C mediated effect of MK-212 facilitates seizure-induced death in a dose-dependent manner. While amygdala kindling is not a model that is traditionally associated with seizure-induced death, these results suggest that there are circuits that, when recruited, will cause death following kindled seizures. Uncovering these circuits will both deepen our understanding of the amygdala kindling model and provide a new technique for researchers to test novel therapeutic interventions to lessen SUDEP risk.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110385"},"PeriodicalIF":2.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681722","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}