Epilepsy & Behavior最新文献

{"title":"Neuropsychological outcome after surgery of frontal lobe epilepsy in children with good seizure outcome","authors":"S. Blanchet ,&nbsp;C. Bulteau ,&nbsp;S. Perguilhem ,&nbsp;A. Salaun ,&nbsp;S. Ferrand-Sorbets ,&nbsp;J. Laschet ,&nbsp;P. Piolino ,&nbsp;I. Jambaqué","doi":"10.1016/j.yebeh.2025.110405","DOIUrl":"10.1016/j.yebeh.2025.110405","url":null,"abstract":"<div><div>One third of children with drug-resistant epilepsy included in surgical programmes have frontal lobe epilepsy. Frontal lobe epilepsy in itself constitutes a high risk of impacting neurocognitive and behavioral development. In this study, we characterized the long-term neuropsychological and behavioral outcomes of children with pharmacoresistant structural focal epilepsy who underwent frontal neurosurgery. The clinical variables that may influence these outcomes were also investigated. A comprehensive neuropsychological evaluation – including a behavioral questionnaire − was administered to 37 children on long-term postoperative follow-up (5.1 years ± 2.9) using the Wechsler Intelligence Scale for Children, Fluency task, Rey-Osterrieth Complex Figure, Trail Making Test, Tower of London, Wisconsin Sorting Card Test and Achenbach Child Behaviour Inventory. To assess executive functions in the youngest children, we administered the junior version of EpiTrack. The clinical characteristics were as follows (mean in years ± standard deviation): Engel I (78 % with among them 96 % without anti-seizure medication), age of onset of seizures (3.5 ± 2.9), preoperative delay (3.9 ± 2.5), neurosurgical age (7.5 ± 3.6), FCD (n = 25) versus LEAT (n = 12) aetiologies. In our series, the children had an average FSIQ (92 ± 17) with a significant difference between VCI which was higher than WMI and PSI. About a third of the children experienced weakness of the executive functions with some difficulties in phonemic verbal fluency and slowness in attentional tasks, and a long execution time in planning, as well as impaired conceptualization and organization capacities. Mild to severe alteration on the Epitrack Junior was found in the majority of the youngest patients although they had a mean FSIQ of 96. At the behavioral level, around a quarter of children reached a pathological score in the attentional, social and anxiety/depression domains. Regarding the effects of clinical variables, we demonstrated that early age at surgery, shorter disease duration and LEAT etiology, were good prognosis factors for neuropsychological outcomes. Early frontal lobe resection followed by good seizure outcome efficiently determines intellectual and neuropsychological trajectory in selected patients. Our results help to better understand the cognitive and behavioral outcomes of this pediatric population, who may benefit from cognitive follow-up and adapted intervention when weaknesses are identified.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110405"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759564","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 associated with chromosomal disorders","authors":"Maria A. Montenegro ,&nbsp;Silvia Vincentiis ,&nbsp;Kette D. Valente","doi":"10.1016/j.yebeh.2025.110360","DOIUrl":"10.1016/j.yebeh.2025.110360","url":null,"abstract":"<div><div>Chromosomal disorders are multisystemic conditions frequently presenting developmental delay and epilepsy as primary neurological symptoms. Epilepsy in these syndromes significantly impacts morbidity, quality of life, and neurodevelopment. Angelman syndrome, ring chromosome 20, Down syndrome, Dup15q syndrome, and others display suggestive electroclinical profiles that may help diagnose and treatment. Understanding the associated electroencephalographic (EEG) findings is critical for clinicians to tailor interventions and optimize outcomes. This review highlights the prevalence, onset, seizure types, EEG characteristics, and treatment approaches for epilepsy in major chromosomal disorders. Angelman syndrome features epilepsy with atypical absences and myoclonic seizures, often associated with specific EEG patterns such as rhythmic delta activity. Ring chromosome 20 syndrome presents with focal frontal seizures, including non-convulsive <em>status epilepticus</em>. Down syndrome has a biphasic epilepsy distribution, from infantile spasms to late-onset myoclonic epilepsy. Similarly, Dup15q syndrome is marked by drug-resistant epilepsy, with EEG showing beta rhythms and hypsarrhythmia. Knowing the electroclinical patterns associated with chromosomal disorders may improve diagnosis and epilepsy management, which enhances patient care and prognosis accuracy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110360"},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760288","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":"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}