{"title":"Sexual dysfunction in men with epilepsy – An observational case-control study","authors":"Sumant Jayadev Balagandi , Lakshminarayanapuram Gopal Viswanathan , Ezhumalai Sinu , Nandakumar Dalavaikodihalli Nanjaiah , Ajay Asranna , Mundlamuri Ravindranadh Chowdary , Raghavendra Kenchaiah , Thennarasu Kandavel , 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 < 0.0001). The cut-off score for sexual dysfunction (>18) was present in 20 individuals in the polytherapy group, 8 in the monotherapy group and none in the control group (p < 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}
Sofya Popova , Mikhail Zinchuk , Georgii Kustov , Flora Rider , Alla Guekht
{"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 , Mikhail Zinchuk , Georgii Kustov , Flora Rider , 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 > 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 > 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}
Cemal Karakas , Megan C. Alam , Liam D. Ferreira , Sidharth Nair , Dmitri Kovalev , Zulfi Haneef
{"title":"Sociodemographic barriers in epilepsy surgery in the United States: A systematic review and meta-analysis","authors":"Cemal Karakas , Megan C. Alam , Liam D. Ferreira , Sidharth Nair , Dmitri Kovalev , 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 , Gülcan Bahçecioğlu Turan , Nurgul Karakurt , 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 < 0.01) and illness-related fear (b = −0.449, 95 % CI [−0.544 to −0.344], p < 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 < 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 < 0.01) was found to be negative and significant and the total effect (b = -0.693, 95 % CI [−0.789 to −0.597], p < 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}
Katelyn G. Joyal , Nicole A. Boodhoo , Gordon F. Buchanan
{"title":"MK-212 precipitates seizure-induced death in amygdala-kindled mice via a non-5-HT2C receptor-mediated mechanism","authors":"Katelyn G. Joyal , Nicole A. Boodhoo , 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<sub>2C</sub> 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<sub>2C</sub> receptor in seizure expression and morphology. However, limbic kindling models have been underutilized in this endeavor. We used the selective 5-HT<sub>2C</sub> receptor agonist MK-212 to examine the effect of 5-HT<sub>2C</sub> 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<sub>2C</sub> receptor. This suggests that a non-5-HT<sub>2C</sub> 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}
Pilar Robles-Lomelín , Salvador Martínez-Medina , Jimena Gonzalez-Salido , Jimena Colado-Martinez , Irving Fuentes-Calvo , Iván Díaz-Meneses , Nora Kerik-Rotenberg , Juan Salvador Rosales-García , Guillermo Axayacalt Gutiérrez-Aceves , Alfonso Arellano-Reynoso , Sergio Moreno-Jiménez , Betsy C. Vázquez-Cruz , Fernando Vasquez-Lopez , Antonio Camiro-Zúñiga , Rodolfo Solís-Vivanco , Mario A. Sebastián-Díaz , Iris E. Martínez-Juárez
{"title":"Association between metabolic patterns in 18-FDG PET-CT scan and postsurgical seizure outcomes in patients with temporal lobe epilepsy","authors":"Pilar Robles-Lomelín , Salvador Martínez-Medina , Jimena Gonzalez-Salido , Jimena Colado-Martinez , Irving Fuentes-Calvo , Iván Díaz-Meneses , Nora Kerik-Rotenberg , Juan Salvador Rosales-García , Guillermo Axayacalt Gutiérrez-Aceves , Alfonso Arellano-Reynoso , Sergio Moreno-Jiménez , Betsy C. Vázquez-Cruz , Fernando Vasquez-Lopez , Antonio Camiro-Zúñiga , Rodolfo Solís-Vivanco , Mario A. Sebastián-Díaz , Iris E. Martínez-Juárez","doi":"10.1016/j.yebeh.2025.110387","DOIUrl":"10.1016/j.yebeh.2025.110387","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults, and surgery is a standard treatment, offering seizure freedom in 60–70 % of patients. Despite advanced imaging, many TLE patients show inconsistent MRI findings, making functional imaging such as 18-FDG PET-CT scans essential in identifying epileptogenic zones. This study aims to assess the association between concordant or non-concordant metabolic patterns in presurgical 18-FDG PET-CT scans and postoperative outcomes in TLE patients.</div></div><div><h3>Methods</h3><div>This retrospective, observational study included people with epilepsy (PWE) who underwent TLE surgery at a clinic in Mexico City and had a presurgical 18-FDG PET-CT scan. Seizure outcomes were measured using Engel and ILAE classifications at a two-year follow-up. The concordant group had only temporal hypometabolism ipsilateral to the epileptogenic zone, while the non-concordant group had normal, extratemporal, or bitemporal hypometabolism.</div></div><div><h3>Results</h3><div>The study included 49 PWE: 28 with concordant PET-CT scans and 21 with non-concordant scans. Comparisons of seizure outcomes using the Engel and ILAE classifications at two years post-surgery revealed no significant differences between the groups (p = 0.972 and p = 0.279, respectively). The use of anti-seizure medications (ASM) after surgery did not differ significantly between groups (p = 0.649).</div></div><div><h3>Conclusion</h3><div>At our center, preoperative evaluation emphasizes the alignment of clinical findings, video-EEG, and MRI. At the two-year follow-up, no significant difference in seizure freedom was observed between patients with temporal lobe hypometabolism alone and those with other patterns.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110387"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681723","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}
Leonid S. Godlevsky , Mykhailo P. Pervak , Olha S. Yehorenko , Serhii V. Marchenko
{"title":"Effects of electrical stimulation of the lateral cerebellar nucleus on PTZ-kindled seizures","authors":"Leonid S. Godlevsky , Mykhailo P. Pervak , Olha S. Yehorenko , Serhii V. Marchenko","doi":"10.1016/j.yebeh.2025.110377","DOIUrl":"10.1016/j.yebeh.2025.110377","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, the cerebellum and its nuclei have become an essential target for understanding and suppressing the mechanisms of seizures. This study aimed to investigate the effects of electrical stimulation (ES) applied to the Lateral Cerebellar Nucleus (LCN) in rats at the early and fully developed pentylenetetrazol (PTZ) kindled seizures.</div></div><div><h3>Methods</h3><div>The experimental groups were represented by the male Wistar rats kindled with PTZ (35.0 mg/kg, i.p.) to myoclonus (9–11 PTZ injections) and generalized tonic-clonic seizures (21 PTZ injections). Unilateral ES (100 Hz) was delivered daily for five days after the last kindled PTZ administration, with PTZ seizure testing after ES. Seizures were videotaped, and the severity score was determined in a blinded manner.</div></div><div><h3>Results</h3><div>ES of LCN performed at the early stage of kindling facilitated the appearance of myoclonus, and increased seizure severity by 30.2 % points compared to the control group (H = 6.94; df = 2; p = 0.037) with the spikes frequency generation increased during the poststimulation period (H = 27.34; df = 5; p < 0.001). In fully developed kindling, ES prevented generalized seizure and reduced seizure severity by 27.5 % (H = 9.385; df = 2; p = 0.009), while myoclonuses were present with spikes generation in brain structures.</div></div><div><h3>Conclusion</h3><div>The data obtained showed that repeated ES of LCN at the early stage promoted myoclonic seizures, while in fully PTZ-kindled rats, it suppressed generalized seizure fits, which were substituted with myoclonus.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110377"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682165","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":"Translation and validation of the Thai version of health-related quality of life measure for children with epilepsy (CHEQOL-25)","authors":"Natcha Lueangapapong , Lunliya Thampratankul , Anannit Visudtibhan , Chaiyos Khongkhatithum","doi":"10.1016/j.yebeh.2025.110337","DOIUrl":"10.1016/j.yebeh.2025.110337","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to translate and validate the Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Thai version (TH-CHEQOL-25), and to evaluate factors affecting quality of life (QOL).</div></div><div><h3>Methods</h3><div>After approval by the original developer, cross cultural adaptation process of CHEQOL-25 was performed including forward translation by two translators, reconciliation, backward translation, and final approval by the original creator. TH-CHEQOL-25 was completed by 161 children with epilepsy aged 6–15 years and their parents twice in 10–14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). The face validity and construct validity were assessed.</div></div><div><h3>Results</h3><div>Internal consistency reliability, evaluated by Cronbach’s α coefficient showed the acceptable reliability in three subscales of child self-report and four subscales of parent-proxy response scale. Both versions had good test–retest reliability as ICC for all items ranged between 0.68–0.85. The correlations between child-report and parent-proxy were acceptable. Higher number of anticonvulsants was significantly negatively correlated with poor QOL.</div></div><div><h3>Conclusions</h3><div>TH-CHEQOL-25 is a reliable and valid tool to assess health-related QOL in Thai children with epilepsy. The parent-proxy version can be used if children cannot report it themselves.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110337"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681659","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}
Yu Sun , Dongming Wang , Hao Yu , Chang Liu , Yao Wang , Yi Wang , Bocheng Zhou , Ruofan Wang , Taoyun Ji , Shuang Wang , Ye Wu , Xiaoyan Liu , Yuwu Jiang , Huili Wang , Qingzhu Liu , Lixin Cai
{"title":"Computer-Assisted planning for SEEG-Guided RF-TC in Pediatric Epilepsy: Improved surgical outcomes","authors":"Yu Sun , Dongming Wang , Hao Yu , Chang Liu , Yao Wang , Yi Wang , Bocheng Zhou , Ruofan Wang , Taoyun Ji , Shuang Wang , Ye Wu , Xiaoyan Liu , Yuwu Jiang , Huili Wang , Qingzhu Liu , Lixin Cai","doi":"10.1016/j.yebeh.2025.110386","DOIUrl":"10.1016/j.yebeh.2025.110386","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the efficiency of an RF-TC Target Planning Software in enhancing outcomes of SEEG-guided RF-TC for pediatric drug-resistant epilepsy.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 68 cases at Peking University First Hospital from May 2018 and November 2023 was conducted. Of these, software-assisted planning and manual planning were utilized in 27 and 41 patients, respectively. Surgical parameters, primarily the number of contact pairs, planning time, and postoperative results were analyzed. Statistical analysis compared seizure-free rates and other key metrics across the two planning groups.</div></div><div><h3>Results</h3><div>A larger group with software-assisted planning was associated with a significantly higher number of contact pairs for RF-TC and lower planning time. The software-assisted group’s seizure-free rate was 77.78 % after 23 months, compared to 29.41 % over 57.97 months for the manual planning group. Transient contralateral limb weakness was observed in 11.11 % of software-assisted cases, but full recovery was eventually noted for all patients.</div></div><div><h3>Interpretation</h3><div>The RF-TC Target Planning Software enhances the effectiveness and efficiency of SEEG-guided RF-TC by improving electrode contact pair choice, reducing planning time, and increasing postoperative seizure-free rates. In complex situations, such as hypothalamic hamartomas, the software displays its value by reducing the risk of missed electrode pairings. Notwithstanding its advantages, the software-assisted approach may raise transient postoperative neurological deficits slightly. Additional studies with expanded cohorts and extended follow-ups are necessary for a comprehensive assessment of this technique’s long-term effectiveness.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"167 ","pages":"Article 110386"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682166","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":"Digital communication and social cognition in adults with frontal lobe epilepsy: A scoping review","authors":"Panayiotis Patrikelis , Theodoros Fasilis , Lambros Messinis , Vasileios Kimiskidis","doi":"10.1016/j.yebeh.2025.110363","DOIUrl":"10.1016/j.yebeh.2025.110363","url":null,"abstract":"<div><h3>Background</h3><div>Patients with Frontal Lobe Epilepsy (FLE) face problems with social cognition (SC) since their difficulties in humor appreciation, facial and eye gaze emotional recognition. The effects of frontal (and temporal) seizures on SC may be understood in terms of emotion recognition (ER), Theory of Mind (ΤοΜ), empathy, and social behavior deficits in relation to their relevant pathophysiology. The impact of FLE on SC as expressed in digital environments still represents a <em>terra incognita,</em> as well as the objective of this exploratory work.</div></div><div><h3>Objective</h3><div>We aimed at exploring, elaborate and critically examine a) the ways deficits in SC impact digital communication (DC) in FLE; b) the way specific neuropsychological abnormalities that may disrupt DC in FLE; c) how to integrate neuropsychological assessment and rehabilitation to provide FLE patients strategies and enhance social outcomes in DC. We anticipate that a) since FLE as other types of frontal syndromes present with deficits in SC, frontal seizures will adversely affect DC; b) executive dysfunction, besides deficits in working memory (WM) and ToM, vigilance and attention, memory and thought in FLE may interfere with SC during online interactions; c) considering FLE’s neurobehavioral and emotional breakdowns in DC, compensatory neurorehabilitation approaches along with psychological and stigma-related ones may be planned, respectively.</div></div><div><h3>Method</h3><div>A scoping review approach was opted as the most approp<em>ri</em>ate one due to the exploratory nature of our research questions, which aim to map the existing literature, identify gaps, and understand the breadth of evidence available on this topic.</div></div><div><h3>Results</h3><div>The effects of FLE (and TLE) on SC may be translated into deficits of ER, ToM, empathy, and social behavior in either physical or DC environments. Particularly in FLE, response maintenance/inhibition deficits link to aberrant emotional control and impulsivity, while during on-line interactions inferential reasoning may be secondarily affected. Executive dysfunction in FLE may impair encoding and retrieval, plus the ability to coherently organize thinking and clearly communicate on social media. Deficits in WM systems may further disrupt DC in FLE, since the prefrontal involvement in the temporal organization of conscious behavior. Such neurocognitive abnormalities can help to understand problems in interpreting emotional behavior and exerting emotional control, making social judgments and appropriate decisions in digital environments encountered in FLE. Excessive use of digital devices seems to impact both brain anatomy and physiology with cognitive impairments resembling dementia. Neurobehavioral abnormalities linked to the use of digital tools in psychiatric patients should be given careful consideration, since their cognitive deficits parallel those of FLE and may likewise interact and ","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110363"},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644050","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}