Epilepsy & Behavior最新文献

{"title":"Drug-Related epileptic seizures and Age-Specific Differences: A Real-World study based on the FAERS database","authors":"Zian Wang,&nbsp;Hao Mei,&nbsp;Bangguo Song,&nbsp;Zhenggang Shi","doi":"10.1016/j.yebeh.2025.110638","DOIUrl":"10.1016/j.yebeh.2025.110638","url":null,"abstract":"<div><h3>Background</h3><div>Epileptic seizures are a serious neurological event that can be triggered by various medications, posing significant threats to patient safety and treatment compliance. With the increasing use of neurotoxic drugs such as antidepressants, antipsychotics, anti-infectives, and anticancer agents, drug-related epileptic seizures (DRES) have become an emerging concern in clinical pharmacovigilance. Despite growing awareness, limited real-world data exists on the age-specific risk patterns and onset timing of DRES.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the incidence trends, high-risk drugs, age-specific differences, and time-to-onset profiles of drug-related epileptic seizures using the FDA Adverse Event Reporting System (FAERS) from 2004 to 2024.</div></div><div><h3>Methods</h3><div>A retrospective pharmacovigilance analysis was conducted using standardized MedDRA terms and RxNorm drug names. Disproportionality analysis via Reporting Odds Ratio (ROR) was applied to detect significant seizure-related safety signals. Subgroup analyses by age and time-to-onset distributions were performed, including Weibull survival modeling.</div></div><div><h3>Results</h3><div>A total of 29,389 seizure-related adverse events were identified, with a marked increase in reports after 2011. The 15–44 age group accounted for the highest proportion (34.2 %). Bupropion (ROR: 5.62; 95 % CI: 5.21–6.07), Tramadol (ROR: 4.48; 95 % CI: 4.12–4.88), and Interferon beta-1a (ROR: 4.16; 95 % CI: 3.81–4.54) demonstrated consistently elevated seizure risk across all age groups. Age-specific signals included Methotrexate in children (0–14 years; ROR: 12.45; 95 % CI: 8.97–17.28) and Tranexamic Acid in the elderly (&gt;60 years; ROR: 9.32; 95 % CI: 6.81–12.75). Eleven drugs not labeled for seizure risk in FDA documents, such as Meropenem and Indapamide, emerged as novel safety signals. Time-to-onset analysis showed that most drug-related seizure events occurred within 30 days of initiation, and Weibull modeling confirmed an early-failure time pattern across all age groups.</div></div><div><h3>Conclusion</h3><div>This study provides real-world evidence on the epidemiological characteristics, age-related drug risk heterogeneity, and early-onset patterns of DRES. It highlights the need for individualized pharmacovigilance and regulatory updates to address under-recognized neurotoxic risks, particularly in vulnerable age groups. These findings contribute critical insights into safer prescribing practices and improved post-marketing surveillance.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110638"},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748955","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":"Behavioral health resources among US pediatric epilepsy centers","authors":"Janelle L. Wagner ,&nbsp;Rachel Hirschberger ,&nbsp;Julie DesMarteau ,&nbsp;Cortney Wolfe-Christensen ,&nbsp;Grace Gaston ,&nbsp;Sucheta Joshi ,&nbsp;Anup D. Patel ,&nbsp;Matthew Sweeney ,&nbsp;Amani Jridi ,&nbsp;Zhining Ou ,&nbsp;Nilika Singhal ,&nbsp;Jason Coryell","doi":"10.1016/j.yebeh.2025.110632","DOIUrl":"10.1016/j.yebeh.2025.110632","url":null,"abstract":"<div><div>Current guidelines, quality indicators, and recommendations broadly recognize the importance of behavioral health care integrated into routine epilepsy visits; however, no specific guidance currently exists for how to implement this care. To address this gap, the Value-based special interest group (SIG) of the Pediatric Epilepsy Research Consortium (PERC) developed and disseminated a survey to inquire about availability and access to behavioral health care and roles of behavioral health care providers (e.g., neuropsychologists, psychologists, and social workers) within epilepsy centers across the US. This 52-item survey was emailed to directors of the National Association of Epilepsy Centers (NAEC) level 3 and 4 pediatric centers (n = 130). The response rate was 38 % (N = 50 centers). The 14 questions pertaining to behavioral health care and several additional items regarding epilepsy center size (i.e., number of neurologists) and comprehensive care resource availability are presented here. Survey results identified that most sites (80 %) have access to neuropsychologist(s), who uniformly perform presurgical evaluations. In contrast, only a quarter of centers have psychologists dedicated to epilepsy patients, with 40 % of them indicating a greater than 3-month wait to see a psychologist. Approximately half of centers have social workers dedicated to epilepsy patients. Common practice for all three of these behavioral health professionals is discussed. Findings underscore the need for greater access to psychologists and more defined roles for behavioral health providers within specific settings to increase the availability of and decrease wait times for behavioral health care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110632"},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748972","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":"A feasibility and pilot study of a family-focused intervention program for parents of children and adolescents with epilepsy","authors":"Christopher McCusker,&nbsp;Sinead Hartley,&nbsp;Emma Hennessy,&nbsp;Eadaoin Whelan","doi":"10.1016/j.yebeh.2025.110627","DOIUrl":"10.1016/j.yebeh.2025.110627","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and evaluate the acceptability of a pilot feasibility study of a family-focused intervention program (Improving Outcomes for Children with Epilepsy – IOCE) for families affected by pediatric epilepsy.</div></div><div><h3>Methods</h3><div>The IOCE program was adapted from a previously published family intervention program for children with congenital heart disease. The intervention included a one-day family workshop, one individual follow-up session for each family, and a psychoeducational manual. It was delivered to 9 families of children and teenagers with epilepsy. Feasibility, acceptability and changes in self-reported parent, family and child outcomes were assessed from baseline to 1-month post-intervention.</div></div><div><h3>Results</h3><div>Parents reported a high level of intervention acceptability. Recruitment and retention data suggested that we engaged families of children at risk (indexed by seizure frequency and profile on an epilepsy related quality of life scale). 48% of those offered the intervention engaged with the program and there was 100% retention rate. Exploratory analyses indicated preliminary positive effects on measures of child and family functioning.</div></div><div><h3>Conclusions</h3><div>Findings suggested good feasibility and acceptability of the IOCE program. Pilot outcomes were positive; however, results should be interpreted with caution given the small sample size (<em>n</em> = 9) and absence of control group. Given the relevance of parent and family functioning for child adjustment in pediatric epilepsy, further development and trialling of this program is warranted.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110627"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724773","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":"Clinical characteristics and surgical outcomes of gross total resection in pediatric low-grade epilepsy-associated brain tumors: A retrospective study","authors":"Xinyu Dong,&nbsp;Yuxin Wu,&nbsp;Difei Wang,&nbsp;Han Xiao,&nbsp;Bin Zou,&nbsp;Yudong Zhou,&nbsp;Xuan Zhai","doi":"10.1016/j.yebeh.2025.110639","DOIUrl":"10.1016/j.yebeh.2025.110639","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the clinical characteristics and identify risk factors associated with postoperative seizure outcomes in pediatric patients with low-grade epilepsy-associated brain tumors (LEATs) who underwent gross total resection (GTR).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the clinical data of pediatric patients who underwent GTR of LEATs. Descriptive statistics were used to summarize the clinical features, and patients were categorized into two groups based on postoperative seizure outcomes: seizure-free and non-seizure-free. Binary logistic regression analysis was performed to identify independent risk factors for failure to achieve seizure freedom.</div></div><div><h3>Results</h3><div>A total of 75 pediatric patients with LEATs who underwent GTR were included in the study. Among them, 58 (77.3 %) achieved seizure freedom, while 17 (22.7 %) remained non-seizure-free postoperatively. Binary logistic regression analysis identified longer epilepsy duration (OR = 1.03, p = 0.034), the number of antiepileptic drugs (AEDs) (OR = 10.90, p = 0.005), and non-temporal lobe tumor location (OR = 6.02, p = 0.028) as significant independent risk factors for persistent postoperative seizures.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that even after gross total resection, a prolonged history of epilepsy, extratemporal tumor location, and polytherapy with AEDs are associated with a lower likelihood of achieving seizure freedom. Early surgical intervention and comprehensive preoperative assessment may help optimize postoperative seizure outcomes in pediatric patients with LEATs.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110639"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724776","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":"First seizure care in Australia and Aotearoa/New Zealand: health service needs for addressing the intersectoral global action plan in epilepsy","authors":"Justin Jiang ,&nbsp;Emma Foster ,&nbsp;Peter Bergin ,&nbsp;Wendyl J. D’Souza ,&nbsp;David Vaughan ,&nbsp;Patrick W. Carney","doi":"10.1016/j.yebeh.2025.110625","DOIUrl":"10.1016/j.yebeh.2025.110625","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the current state of first seizure clinics (FSCs) in Australia and Aotearoa/New Zealand (NZ) and identify modifiable risk factors impacting patient access to these services in line with the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders (IGAP).</div></div><div><h3>Methods</h3><div>An online survey was distributed to neurologists, epileptologists and heads-of-unit affiliated with the Epilepsy Society of Australia (ESA). Additional clinics not captured by the survey were identified through professional networks and personal communication. Survey responses were recorded using Research Electronic Data Capture (REDCap) software.</div></div><div><h3>Results</h3><div>Survey responses identified 24 first seizure clinics across Australia and Aotearoa/NZ, including 21 adult and 3 paediatric services. These comprised 23 metropolitan services and 1 regional service; 15 were dedicated FSCs. Regional patients comprised more than 20 % of the patient base in 17 services. Telehealth was utilized by 21 (88 %) services, with 8 (33 %) services seeing over half their patients via telehealth. Median estimated wait time for initial FSC appointment was 6 weeks (IQR 3–15, range 2–56). Only 20 % of services were supported by a clinical nurse/care coordinator. This was the most commonly reported service need (58 % of services). Need for additional senior medical staff (54 % of services) and junior medical staff (45 %) was also noted. The most frequently reported barriers to access included limited clinic capacity, insufficient staffing, inappropriate referrals, patients’ failure to attend and delays to investigations.</div></div><div><h3>Significance</h3><div>First seizure services for adults are well established across Australia and Aotearoa/NZ. Despite broad metropolitan coverage in services, there remains a lack of first seizure clinics in regional areas of Australia and Aotearoa/NZ, and a need for additional nursing and medical staff in established services. This study demonstrates areas where improvements could potentially lead to better access to first seizure care across Australia and Aotearoa/NZ and achieve the goals of the IGAP.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110625"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724774","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":"Depressive symptoms in youth with refractory epilepsy: Exploration of seizure, sociodemographic and cognitive factors","authors":"S.B. Brothers ,&nbsp;C. Wolfe-Christensen ,&nbsp;H.J. Loblein ,&nbsp;H. Kimbley ,&nbsp;K.E. Patrick ,&nbsp;LN. Sepeta ,&nbsp;K.A. McNally ,&nbsp;J.I. Koop ,&nbsp;R.L. Stilp ,&nbsp;A. Ailion ,&nbsp;K. Boyer ,&nbsp;A.M. DeCrow ,&nbsp;P. Espe-Pfeifer ,&nbsp;C.M. Cooper ,&nbsp;M. Gabriel ,&nbsp;G.M. Berrios-Siervo ,&nbsp;P.H. Duong ,&nbsp;E. Hodges ,&nbsp;D.F. Marshall ,&nbsp;G. Gaston ,&nbsp;J.L. Wagner","doi":"10.1016/j.yebeh.2025.110608","DOIUrl":"10.1016/j.yebeh.2025.110608","url":null,"abstract":"<div><h3>Introduction</h3><div>Rates of depressive symptoms in children and youth with epilepsy (CYE) vary among studies, ranging from 12 to 41%. The current study examined depressive symptoms in a large, multi-site sample of CYE who completed measures of emotional and behavioral functioning as part of a pre-surgical neuropsychological evaluation.</div></div><div><h3>Methods</h3><div>CYE ranged in age from 5 to 18 years old, had refractory epilepsy (n = 416), and underwent neuropsychological assessment, including standardized assessment of intellectual (IQ), emotional, and behavioral functioning using caregiver-proxy. Sociodemographic (e.g., age, biological sex, race/ethnicity, insurance status, distance from hospital) and epilepsy-specific characteristics e.g., seizure type, epilepsy duration, frequency, foci, number of anti-seizure medications [ASM], and MRI findings) were also examined.</div></div><div><h3>Results</h3><div>Elevated levels (i.e., at-risk or clinically significant threshold) of depressive symptoms were reported in 28.9 % of CYE. Youth with temporal lobe epilepsy (TLE; 18.9 %) had significantly higher rates of depressive symptoms compared to youth with extratemporal epilepsy (11.7 %; OR = 1.73, 95 % CI [1.10, 2.73]; χ² (2) = 7.08, p = 0.029). All other sociodemographic and epilepsy-specific variables were unrelated to levels of depressive symptoms. There was no difference in level of depressive symptoms for CYE with IQ below 70 despite being more likely to be in a minority racial/ethnic group, having public insurance, and experiencing more frequent seizures.</div></div><div><h3>Conclusions</h3><div>CYE are at risk of comorbid depressive symptoms, especially if they have TLE. However, other seizure and sociodemographic variables did not increase risk or resilience. Depression screening during routine epilepsy care is indicated, including for those CYE with low IQ.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110608"},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724775","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":"Long-term tolerability and efficacy of adjunctive brivaracetam in pediatric patients with generalized-onset seizures: Subgroup analysis of an open-label, follow-up trial","authors":"Dimitrios Bourikas ,&nbsp;Sami Elmoufti ,&nbsp;Jan-Peer Elshoff ,&nbsp;Allison Little ,&nbsp;Kristy Pucylowski ,&nbsp;Brian Moseley ,&nbsp;Lieven Lagae","doi":"10.1016/j.yebeh.2025.110569","DOIUrl":"10.1016/j.yebeh.2025.110569","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess long-term safety, tolerability, and efficacy of adjunctive brivaracetam in children with generalized-onset seizures.</div></div><div><h3>Methods</h3><div>Subgroup analysis of a Phase 3, open-label trial (N01266/NCT01364597; ≤5 mg/kg/day brivaracetam [maximum 200 mg/day]) in patients aged ≥ 1 month to &lt; 17 years with generalized-onset seizures at core trial entry. Seizure-related outcomes were assessed for patients aged &lt; 2/≥2 years using daily record-card data. Kaplan-Meier–estimated retention and change in Achenbach Child Behavior Checklist (CBCL) scores were assessed post hoc.</div></div><div><h3>Results</h3><div>Of 257 patients receiving brivaracetam, 68 had generalized-onset seizures (50.0 % male; mean age: 6.65 years; median modal brivaracetam dose 3.6 mg/kg/day). Twenty-eight (41.2 %) patients completed the trial; most common reasons for discontinuation (≥10 % patients) were adverse event (22.1 %), lack of efficacy (17.6 %), and withdrawn consent (11.8 %). Kaplan-Meier–estimated retention at 1, 3, and 5 years was 61.8 %, 47.7 %, and 43.3 %, respectively. Sixty-one (89.7 %) patients had treatment-emergent adverse events (serious 25 [36.8 %]). In patients aged &lt; 2/≥2 years (n = 12/n = 33), median percent reduction in 28-day-adjusted total seizure frequency from baseline to end of evaluation was 66.7 %/56.9 %; 50.0 %/60.6 % had ≥ 50 % reduction in all seizures. Mean changes from baseline to last evaluation in Achenbach CBCL 1.5–5 raw syndrome scores (n = 18) were all around 0 (minimal/small amplitude). Mean changes in CBCL 6–18 raw syndrome scores (n = 20) showed small numerical improvements for most syndromes. At last evaluation, most patients (range: 61.1 %–100 %) remained in baseline T-score categories.</div></div><div><h3>Conclusions</h3><div>Long-term adjunctive brivaracetam was well tolerated and efficacious in children with generalized-onset seizures. Behavior/emotional function were generally stable or slightly improved.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110569"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722473","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":"Adaptive mental health screening in veterans admitted to an epilepsy monitoring unit","authors":"David Engel ,&nbsp;Corey Meyer ,&nbsp;Sarah Senderling ,&nbsp;Esther Fiore ,&nbsp;Lina Lee ,&nbsp;Jeremiah Lum ,&nbsp;Andrea Hildebrand ,&nbsp;Marissa Kellogg ,&nbsp;Megan Callahan","doi":"10.1016/j.yebeh.2025.110628","DOIUrl":"10.1016/j.yebeh.2025.110628","url":null,"abstract":"<div><div><strong><em>Objective:</em></strong> To describe and characterize results from Computer Adaptive Testing (CAT) and Computer Adaptive Diagnosis (CAD) mental health instruments administered to a sample of Veterans admitted to an Epilepsy Monitoring Unit (EMU). <strong><em>Method</em></strong>: Forty-two Veterans admitted to a large urban VA Medical Center in the Pacific Northwest for overnight epilepsy monitoring completed tablet-administered CAT measures for depression, anxiety, posttraumatic stress, mania/hypomania, psychosis, substance use disorder risk, and suicide risk, along with CAD screenings for Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD). The Minnesota Multiphasic Personality Inventory-2-Restructuered Form (MMPI-2-RF) was also administered to assess symptom validity. Patients were diagnosed with epileptic seizures (ES), psychogenic nonepileptic seizures (PNES), mixed ES/PNES, other seizure-related disorder, or had a non-diagnostic evaluation. <strong><em>Results</em></strong>: Most patients reported at least mild symptoms of depression (73.8 %), anxiety (61.9 %), and/or posttraumatic stress (64.1 %). More than half (57.1 %) screened positive for MDD, and 23 % screened positive for PTSD. Approximately 41 % endorsed mild or greater psychotic symptoms. About 36 % of patients were at intermediate or high risk for substance use disorder, and 56.3 % were at intermediate or high risk for suicide. Analysis of symptom validity suggested 7–24 % of patients demonstrated likely noncredible responding on the MMPI-2-RF. <strong><em>Conclusions</em></strong>: Veterans undergoing EMU evaluation demonstrate a high prevalence of mental health symptoms. Tablet-administered CAT and CAD instruments provide an efficient screening method for psychiatric distress. Findings highlight the importance of routine mental health assessment, appropriate treatment planning, and safety monitoring for patients in the EMU.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110628"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722476","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 functional and structural language-associated brain network in patients with temporal lobe epilepsy and atypical language organization","authors":"Mehmet Salih Yildirim ,&nbsp;Karl-Heinz Nenning ,&nbsp;Victor Ulrich Schmidbauer ,&nbsp;Radheshyam Stepponat ,&nbsp;Marc Berger ,&nbsp;Johannes Koren ,&nbsp;Christoph Baumgartner ,&nbsp;Ekaterina Pataraia ,&nbsp;Christian Dorfer ,&nbsp;Karl Rössler ,&nbsp;Silvia Bonelli ,&nbsp;Gregor Kasprian","doi":"10.1016/j.yebeh.2025.110629","DOIUrl":"10.1016/j.yebeh.2025.110629","url":null,"abstract":"<div><h3>Background</h3><div>Evidence suggests that epilepsy may contribute to both functional and structural brain alterations, with atypical language organization (ALO) being more frequently observed in epilepsy patients compared to healthy controls. This study aimed to investigate structural connectivity differences between left-hemispheric language dominance (LLD) and ALO in patients with temporal lobe epilepsy (TLE) using probabilistic tractography.</div></div><div><h3>Methods</h3><div>Twenty-two TLE patients with ALO and 27 age- and sex-matched patients with LLD who underwent pre-surgical language assessment using 3 Tesla functional magnetic resonance imaging (fMRI) were included in this study. Both groups were subdivided further based on the seizure onset hemisphere. SPM12 was used to determine the functional task-based language pattern. Individual structural connectivity network was investigated based on tractography and whole brain segmentation.</div></div><div><h3>Results</h3><div>In patients with ALO, the structural connectivity of the inferior frontal gyrus (IFG) exhibited stronger lateralization to the right hemisphere compared to LLD patients (ANOVA, p_FDR = 0.030). FMRI activations in the IFG and superior temporal gyrus (STG) ipsilateral to seizure onset were negatively associated with epilepsy duration (p_uncorrected &lt; 0.001) in ALO with right-hemispheric TLE. Furthermore, lateralization index of the STG- (Pearson’s correlation: ρ = 0.714, p_uncorrected = 0.020) and IFG-connectivity (ρ = −0.608, p_uncorrected = 0.036) correlated with epilepsy duration in ALO.</div></div><div><h3>Conclusion</h3><div>Several similarities regarding structural connectivity were detected across all groups. However, increased right-hemispheric connectivity of the IFG was detected in ALO, showing a correlation with epilepsy duration. Network analysis may enhance the understanding reorganization patterns underlying epilepsy and help to improve neurosurgical outcome.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110629"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722475","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":"Radiomics, machine learning, and deep learning for hippocampal sclerosis identification: a systematic review and diagnostic meta-analysis","authors":"João Marcelo Baptista ,&nbsp;Leonardo O. Brenner ,&nbsp;João Victtor Koga ,&nbsp;Victor A. Ohannesian ,&nbsp;Leonardo A. Ito ,&nbsp;Paulo H. Nabarro ,&nbsp;Lucas P. Santos ,&nbsp;Arthur Henrique ,&nbsp;Gustavo de Oliveira Almeida ,&nbsp;Lorran U. Berbet ,&nbsp;Thiago Paranhos ,&nbsp;Vitor Nespoli ,&nbsp;Raphael Bertani","doi":"10.1016/j.yebeh.2025.110624","DOIUrl":"10.1016/j.yebeh.2025.110624","url":null,"abstract":"<div><h3>Purpose</h3><div>Hippocampal sclerosis (HS) is the primary pathological finding in temporal lobe epilepsy (TLE) and a common cause of refractory seizures. Conventional diagnostic methods, such as EEG and MRI, have limitations. Artificial intelligence (AI) and radiomics, utilizing machine learning and deep learning, offer a non-invasive approach to enhance diagnostic accuracy. This study synthesized recent AI and radiomics research to improve HS detection in TLE.</div></div><div><h3>Methods</h3><div>PubMed/Medline, Embase, and Web of Science were systematically searched following PRISMA-DTA guidelines until May 2024. Statistical analysis was conducted using STATA 14. A bivariate model was used to pool sensitivity (SEN) and specificity (SPE) for HS detection, with I2 assessing heterogeneity.</div></div><div><h3>Results</h3><div>Six studies were included. The pooled sensitivity and specificity of AI-based models for HS detection in medial temporal lobe epilepsy (MTLE) were 0.91 (95 % CI: 0.83–0.96; I2 = 71.48 %) and 0.9 (95 % CI: 0.83–0.94; I2 = 69.62 %), with an AUC of 0.96. AI alone showed higher sensitivity (0.92) and specificity (0.93) than AI combined with radiomics (sensitivity: 0.88; specificity: 0.9). Among algorithms, support vector machine (SVM) had the highest performance (SEN: 0.92; SPE: 0.95), followed by convolutional neural networks (CNN) and logistic regression (LR).</div></div><div><h3>Conclusion</h3><div>AI models, particularly SVM, demonstrate high accuracy in detecting HS, with AI alone outperforming its combination with radiomics. These findings support the integration of AI into non-invasive diagnostic workflows, potentially enabling earlier detection and more personalized clinical decision-making in epilepsy care—ultimately contributing to improved patient outcomes and behavioral management.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"171 ","pages":"Article 110624"},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722441","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}