Jonathan Horsley , Yujiang Wang , Callum Simpson , Vytene Janiukstyte , Karoline Leiberg , Bethany Little , Jane de Tisi , John Duncan , Peter N. Taylor
{"title":"Status epilepticus and thinning of the entorhinal cortex","authors":"Jonathan Horsley , Yujiang Wang , Callum Simpson , Vytene Janiukstyte , Karoline Leiberg , Bethany Little , Jane de Tisi , John Duncan , Peter N. Taylor","doi":"10.1016/j.yebeh.2024.110016","DOIUrl":"10.1016/j.yebeh.2024.110016","url":null,"abstract":"<div><p>Status epilepticus (SE) carries risks of morbidity and mortality. Experimental studies have implicated the entorhinal cortex in prolonged seizures; however, studies in large human cohorts are limited. We hypothesised that individuals with temporal lobe epilepsy (TLE) and a history of SE would have more severe entorhinal atrophy compared to others with TLE and no history of SE.</p><p>357 individuals with drug resistant temporal lobe epilepsy (TLE) and 100 healthy controls were scanned on a 3T MRI. For all subjects, the cortex was segmented, parcellated, and the thickness calculated from the T1-weighted anatomical scan. Subcortical volumes were derived similarly. Cohen’s d and Wilcoxon rank-sum tests respectively were used to capture effect sizes and significance.</p><p>Individuals with TLE and SE had reduced entorhinal thickness compared to those with TLE and no history of SE. The entorhinal cortex was more atrophic ipsilaterally (d = 0.51, p <span><math><mrow><mo><</mo></mrow></math></span> 0.001) than contralaterally (d = 0.37, p <span><math><mrow><mo>=</mo></mrow></math></span> 0.01). Reductions in ipsilateral entorhinal thickness were present in both left TLE (n = 22:176, d = 0.78, p <span><math><mrow><mo><</mo></mrow></math></span> 0.001), and right TLE (n = 19:140, d = 0.31, p = 0.04), albeit with a smaller effect size in right TLE. Several other regions exhibited atrophy in individuals with TLE, but these did not relate to a history of SE.</p><p>These findings suggest potential involvement or susceptibility of the entorhinal cortex in prolonged seizures.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525505024003986/pdfft?md5=3e393e0f2aac23ad1b16b2ef34f8382b&pid=1-s2.0-S1525505024003986-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145411","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}
Karnig Kazazian , Nicolas Gaspard , Lawrence J. Hirsch , Marissa Kellogg , Sara E. Hocker , Nora Wong , Raquel Farias-Moeller , Krista Eschbach , Teneille E. Gofton
{"title":"Communication trends over time in new-onset refractory status epilepticus (NORSE): Interim analysis from the NORSE/FIRES Family Registry","authors":"Karnig Kazazian , Nicolas Gaspard , Lawrence J. Hirsch , Marissa Kellogg , Sara E. Hocker , Nora Wong , Raquel Farias-Moeller , Krista Eschbach , Teneille E. Gofton","doi":"10.1016/j.yebeh.2024.110023","DOIUrl":"10.1016/j.yebeh.2024.110023","url":null,"abstract":"<div><p>The new-onset refractory status epilepticus (NORSE)/febrile infection-related epilepsy syndrome (FIRES) Family Registry contributes to a systematic effort to collect clinical and epidemiological information on individuals affected by NORSE/FIRES. We explore diagnostic and prognostic information provided to patients and their families, their satisfaction with the communication, and utilisation of palliative care services during acute hospitalization. Communication about the diagnosis of NORSE/FIRES to families has improved since the publication of consensus definitions in 2018, with families being more likely to be told about NORSE/FIRES after 2018. Families rate the quality of prognostic information as being moderate. Palliative care services were involved in a minority of patients. Understanding and characterizing the prevalence and satisfaction of diagnostic and prognostic conversations is important for improving overall care, the quality of physician-patient-family relationships, and the recovery process for those affected by NORSE/FIRES.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145408","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 seizure self-efficacy and quality of life in children with epilepsy","authors":"Fatma Tekçiftci , Semra Köse","doi":"10.1016/j.yebeh.2024.110015","DOIUrl":"10.1016/j.yebeh.2024.110015","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to examine seizure self-efficacy and quality of life of children with epilepsy and to evaluate the relationship between these parameters.</p></div><div><h3>Method</h3><p>The study was conducted between November 2022 and November 2023 in the Pediatric Neurology Outpatient Clinic of a university hospital with 200 children aged 9–14 who met the inclusion criteria and accepted the study. The data were collected using the “Child Descriptive Form,” “Seizure Self-Efficacy Scale in Children with Epilepsy,” and “KIDSCREEN-27 Health-Related Quality of Life Scale”. The data were evaluated using the IBM SPSS Statistics Standard Concurrent User V 26 statistical package program. Number, percentage, mean-standard deviation, median, minimum and maximum values, Cronbach’s Alpha coefficient, Shapiro Wilk normality test, Independent Sample <em>t</em>-test, Analysis of Variance (ANOVA), Bonferroni test, Pearson correlation coefficient, linear regression analysis, Durbin-Watson value and normality of residuals Q-Q graphs were used in the evaluation of the data. A value of p < 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>It was determined that 53 % of the children participating in the study were male, and the median age was 12 years. The mean total score of the seizure self-efficacy scale was 3.13 ± 1.03, and the mean total score of the health-related quality of life scale was 89.83 ± 15.63. There was a statistically significant positive correlation between the dimension of individual seizure control and total score of health-related quality of life and physical well-being, emotional well-being and social support, and peer dimensions (p < 0.05). A statistically significant positive correlation was determined between the effect of environment on seizure control and health-related quality of life total score, physical well-being, social support, and peer and school environment dimensions (p < 0.05). A statistically significant positive correlation was determined between seizure self-efficacy total score and health-related quality of life total score and physical well-being, emotional well-being, social support, and peer dimensions (p < 0.05).</p></div><div><h3>Conclusion</h3><p>The study results reveal that high self-efficacy levels of children with epilepsy improve the quality of life of children with epilepsy.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145412","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":"Preclinical toxicity studies supporting 2DG for treatment of status epilepticus","authors":"Thomas P. Sutula , Nathan B. Fountain","doi":"10.1016/j.yebeh.2024.110004","DOIUrl":"10.1016/j.yebeh.2024.110004","url":null,"abstract":"<div><p>2-deoxy-D-glucose (2DG) has been proposed as a potential antiseizure treatment based on seizure suppressive actions in multiple acute and chronic seizure models, including models of status epilepticus (SE). Here we summarize recently completed preclinical toxicological studies of single doses of an intravenous formulation of 2DG supporting potential safety of 2DG for acute treatment of SE and acute repetitive seizures (ARS).</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145409","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}
Jeong-Won Jeong , Min-Hee Lee , Michael Behen , Hiroshi Uda , Nore Gjolaj , Aimee Luat , Eishi Asano , Csaba Juhász
{"title":"Quantitative phenotyping of verbal and non-verbal cognitive impairment using diffusion-weighted MRI connectome: Preliminary study of the crowding effect in children with left hemispheric epilepsy","authors":"Jeong-Won Jeong , Min-Hee Lee , Michael Behen , Hiroshi Uda , Nore Gjolaj , Aimee Luat , Eishi Asano , Csaba Juhász","doi":"10.1016/j.yebeh.2024.110009","DOIUrl":"10.1016/j.yebeh.2024.110009","url":null,"abstract":"<div><p>The “crowding” effect (CE), wherein verbal functions are preserved presumably at the expense of nonverbal functions, which diminish following inter-hemispheric transfer of language functions, is recognized as a specific aspect of functional reorganization, offering an insight about neural plasticity in children with neural insult to the dominant hemisphere. CE is hypothesized as a marker for language preservation or improvement after left-hemispheric injury, yet it remains challenging to fully discern it in preoperative evaluation. We present a novel DWI connectome (DWIC) approach to predict the presence of CE in 24 drug-resistant epilepsy (DRE) patients with a left-hemispheric focus and 29 young healthy controls. Psychometry-driven DWIC analysis was applied to create verbal and non-verbal modular networks. Local efficiency (LE) was assessed at individual regions of the two networks and its Z-score was compared to predict the presence of CE. Compared with a traditional organization (TO) group, wherein verbal functions are adversely affected, while non-verbal functions are preserved, the CE group showed significantly higher Z-scores in verbal network and significantly lower Z-scores in non-verbal network, corresponding to network reorganization in CE. A larger number of antiseizure drugs was significantly associated with more decreased Z-score in the right non-verbal network of the CE group and left verbal network of the TO group. These findings hold great potential to identify DRE patients whose verbal/language skills may over time be preserved due to effective inter-hemispheric reorganization and identify those whose verbal/language impairments may persist due to lack of inter-hemispheric reorganization.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145410","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}
Shripathi H. Adiga , Ramya S. Adiga , Kumar M.R. Bhat , Dinesh Upadhya
{"title":"Ayurveda therapy in the management of epilepsy","authors":"Shripathi H. Adiga , Ramya S. Adiga , Kumar M.R. Bhat , Dinesh Upadhya","doi":"10.1016/j.yebeh.2024.110026","DOIUrl":"10.1016/j.yebeh.2024.110026","url":null,"abstract":"<div><p>Epilepsy, a chronic non-communicable disease of the brain, is one of the most common neurological diseases globally that affects people of all ages. The existence of medical, neurological, psychiatric, and cognitive comorbidities has always undermined the available advanced treatment strategies for epilepsy. New-generation antiepileptic drugs being less successful in completely controlling the seizures and observance of complex diseases, including drug-resistant cases, have provided scope for integrating and incorporating the therapeutic modalities of Ayurveda, the ancient Indian art of holistic medicine, in the effective management of epilepsy. Epilepsy can be correlated to <em>Apasmara,</em> described in the classics of Ayurveda as the transient appearance of unconsciousness with loathsome expression due to derangement of memory, intelligence, and mind. The multifaceted therapeutic approach of Ayurveda, which involves pharmacologic and nonpharmacologic measures, purificatory and pacifying procedures, herbal and herbo-mineral formulations, disease, and host-specific approaches, have enhanced the potential of not only relieving symptoms but also modifying the pathophysiology of the disease. Newer paradigms of research in Ayurveda, along with holistic and integrative approaches with contemporary medicine, can not only benefit the existing healthcare system but also impact future healthcare management in epileptology research. This cursory literature review is an earnest attempt to identify, evaluate, and summarize various studies and provide a comprehensive insight into the potential of Ayurveda in understanding and treating epilepsy.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525505024004086/pdfft?md5=11f628abc9138a0230d4ab3074efa12c&pid=1-s2.0-S1525505024004086-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137127","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}
Rong Chen , Mengyun Li , Bofei Tan , Sihui Li , Xiaodan Jia , Qing Zhang , Xianrui Xu , Qiang Liu , Zeli Ma , Xuan Li , Ying Wang , Nan Tian , Yanzi Jin , Qing Zhang
{"title":"SPECT/CT imaging of poor sleep quality in people with epilepsy","authors":"Rong Chen , Mengyun Li , Bofei Tan , Sihui Li , Xiaodan Jia , Qing Zhang , Xianrui Xu , Qiang Liu , Zeli Ma , Xuan Li , Ying Wang , Nan Tian , Yanzi Jin , Qing Zhang","doi":"10.1016/j.yebeh.2024.110014","DOIUrl":"10.1016/j.yebeh.2024.110014","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the characteristics of cerebral blood flow changes of poor sleep quality in people with epilepsy(PWE).</p></div><div><h3>Methods</h3><p>90 PWE treated in The General Hospital of Ningxia Medical University from December 2021 to September 2023 were divided into poor sleep quality group (PSQG) and good sleep quality group (GSQG) according to the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), to compare the differences in cerebral perfusion between the two groups of patients, so as to summarize the characteristics of cerebral blood flow changes of poor sleep quality in PWE.</p></div><div><h3>Results</h3><p>The positive rate of interictal single-photon emission computed tomography/computed tomography (SPECT/CT) was 76.7 %(69/90), which showed localized cerebral hypoperfusion. There was no statistical difference between the two groups of PSQG (N=29) and GSQG (N=61) in terms of the positive rate of SPECT/CT, the number of hypoperfusion foci, and the range of hypoperfusion foci. In PSQG and GSQG, 9 patients(31.0 %) and 6 patients(9.8 %) showed hypoperfusion in the right parietal lobe, respectively, and the difference between the two groups was statistically significant (<em>P</em>=0.017). There was no statistical difference the rate of the interictal epileptiform discharges (IEDs) and the brain area of IEDs in electroencephalography(EEG) between the two groups.</p></div><div><h3>Conclusion</h3><p>SPECT/CT of poor sleep quality in PWE demonstrated hypoperfusion in the right parietal lobe.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137126","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}
Cameron P. Beaudreault , Sharon Chiang , Ariel Sacknovitz , Robert Moss , Paige Brabant , David Zuckerman , Jessica R. Dorilio , Eris Spirollari , Alexandria F. Naftchi , Patricia E. McGoldrick , Carrie R. Muh , Richard Wang , Bridget Nolan , Kevin Clare , Vishad V. Sukul , Steven M. Wolf
{"title":"Association of reductions in rescue medication requirements with vagus nerve stimulation: Results of long-term community collected data from a seizure diary app","authors":"Cameron P. Beaudreault , Sharon Chiang , Ariel Sacknovitz , Robert Moss , Paige Brabant , David Zuckerman , Jessica R. Dorilio , Eris Spirollari , Alexandria F. Naftchi , Patricia E. McGoldrick , Carrie R. Muh , Richard Wang , Bridget Nolan , Kevin Clare , Vishad V. Sukul , Steven M. Wolf","doi":"10.1016/j.yebeh.2024.110008","DOIUrl":"10.1016/j.yebeh.2024.110008","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the impact of vagus nerve stimulation (VNS) on quality of life contributors such as rescue medications.</p></div><div><h3>Methods</h3><p>Using the seizure diary application SeizureTracker™ database, we examined trends in rescue administration frequency before and after the first recorded VNS magnet swipe in patients with drug-resistant epilepsy who had 1) At least one VNS magnet swipe recorded in the diary, and 2) Recorded usage of a benzodiazepine rescue medication (RM) within 90 days prior to the first swipe. A paired Wilcoxon rank-sum test was used to assess changes in RM usage frequency between 30-, 60-, 90-, 180- and 360-day intervals beginning 30 days after first magnet swipe. Longitudinal changes in RM usage frequency were assessed with a generalized estimating equation model.</p></div><div><h3>Results</h3><p>We analyzed data of 95 patients who met the inclusion criteria. Median baseline seizure frequency was 8.3 seizures per month, with median baseline rescue medication usage frequency of 2.1 administrations per month (SD 3.3). Significant reductions in rescue medication usage were observed in the 91 to 180 day interval after first VNS magnet swipe, and at 181 to 360 days and at 361 to 720 days, with the magnitude of reduction increasing over time. Decreases in rescue medication usage were sustained when controlling for patients who did not record rescue medication use after the first VNS magnet swipe (N=91). Significant predictors of reductions in rescue medication included baseline frequency of rescue medication usage and time after first VNS magnet swipe.</p></div><div><h3>Significance</h3><p>This retrospective analysis suggests that usage of rescue medications is reduced following the start of VNS treatment in patients with epilepsy, and that the magnitude of reduction may progressively increase over time.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1525505024003895/pdfft?md5=ed5225fc3098241e651eb5e80d4a62c3&pid=1-s2.0-S1525505024003895-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095886","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":"Why have status epilepticus trials failed: Wrong drugs or wrong trials?","authors":"Hannah Cock","doi":"10.1016/j.yebeh.2024.110030","DOIUrl":"10.1016/j.yebeh.2024.110030","url":null,"abstract":"<div><p>Despite burgeoning interest in trials in status epilepticus over the last 20 years, outcomes have yet to improve and a number of high profile studies have failed to deliver for a range of reasons. The range of reasons a trial may fail to meet the intended outcomes are discussed. Recent well designed, adequately powered studies in established status epilepticus failed to meet primary endpoints, but are nonetheless influencing practice, reflecting the importance of interpreting results in the context of broader literature, safety and practical considerations. Studies in refractory and super-refractory status epilepticus have yet to do so, frequently failing to deliver as hoped despite huge financial and human cost. The importance of reviewing regulatory frameworks, and our approach to trial design to address important clinical questions is reviewed, reflecting on lessons from the COVID-19 RECOVERY trials, and other disease areas, together with the potential associated with the use artificial intelligence tools. This paper is based on a presentation made at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures in April 2024.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095889","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":"Aprepitant’s roles in abating seizures, behavioral, and cognitive deficits in mice model of epilepsy","authors":"Heba A. Hassan , Yousef Al-Saraireh","doi":"10.1016/j.yebeh.2024.110028","DOIUrl":"10.1016/j.yebeh.2024.110028","url":null,"abstract":"<div><h3>Background</h3><p>Aprepitant (APR), a neurokinin 1 receptor antagonist, is an approved drug for treating chemotherapy-induced nausea and vomiting.</p></div><div><h3>Objectives</h3><p>Investigate the beneficial roles of APR alone or in combination with sodium valproate (VPA) against lithium pilocarpine [li-pilo]-induced seizures, behavioral changes, and cognitive deficits.</p></div><div><h3>Methods</h3><p>Thirty male mice were divided into five groups, each containing 6. “Vehicle Group I,” “Control Group II ”li-pilo, “ Valproate (VPA) group III (400 mg/kg/i.p.), ”APR group IV, “ and ”Combination Group V.“ Videos of mice were recorded, and they were watched for episodes of spontaneous recurring seizures (SRS). Behavioral Tests were performed. At the end of the study, animal brains were taken for biochemical assays and gene expression studies.</p></div><div><h3>Results</h3><p>APR partially protected against SRS with partial restoration of average behavioral and standard cognitive skills associated with a significant increase in brain SOD activity and a significant decrease in MDA, IL-1β, NF-КB, and SP-3 levels in relation to the control group. Interestingly, a combination of APR with VPA in epileptic mice showed complete protection against li-pilo-induced behavioral changes and cognitive deficits, a significant increase in brain SOD activity, and a considerable decrease in MDA, IL-1β, NF-ΚB, and SP levels to normal.</p></div><div><h3>Conclusion</h3><p>Using APR as an adjuvant to VPA is more effective in protecting against li-pilo-induced seizures, behavioral changes, and cognitive deficits due to its antioxidant, anti-inflammatory, and NK1 antagonist effects than using APR alone as drug therapy.</p></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095887","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}