Epilepsy & Behavior最新文献

{"title":"The attitude of medical students, resident doctors, and nurses toward people with epilepsy: A multi-centre study.","authors":"Fitri Octaviana, Aprida Situngkir, Nova Dian Lestari, Herlyani Khosama, Adrian Ridski Harsono, Luh Ari Indrawati, Winnugroho Wiratman, Astri Budikayanti","doi":"10.1016/j.yebeh.2025.110276","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110276","url":null,"abstract":"<p><strong>Introduction: </strong>The rising incidence of epilepsy has not been accompanied by sufficient public education, contributing to persistent social stigma towards people with epilepsy. This stigma leads to their exclusion and discrimination in key areas such as employment, education, and social interactions, ultimately diminishing their quality of life. This study aimed to assess the attitudes of medical students, resident doctors, and nurses toward people with epilepsy in three large cities in Indonesia.</p><p><strong>Methods: </strong>A cross-sectional multi-centre study was conducted in Jakarta, Manado, and Banda Aceh between June 2020 to January 2021 in three tertiary hospitals. Subjects were medical students, resident doctors, and nurses, aged over 18 years, with no known history of epilepsy. Sociodemographic characteristics were recorded, and attitude was assessed using the validated Indonesian version of the Public Attitudes Toward Epilepsy questionnaire. Data were analyzed using Kruskal-Wallis with post-hoc pairwise Mann-Whitney U comparison.</p><p><strong>Results: </strong>The findings revealed that most respondents held positive attitudes in both the general and personal domains. However, negative perceptions persisted on more personal topics, particularly regarding dating and marriage with people who have epilepsy. Sociodemographic characteristics that correlated with attitudes toward individuals with epilepsy included centre, sex, educational level, occupation, and ethnicity.</p><p><strong>Conclusion: </strong>Despite overall positive attitudes, certain stigmatizing beliefs remain, particularly in personal areas such as marriage and relationships. These findings highlight the need for targeted educational interventions to address persistent misconceptions and reduce stigma, ultimately improving the social inclusion and quality of life for people with epilepsy in Indonesia.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110276"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037621","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":"Cognitive and behavioral impact of antiseizure medications, neuromodulation, ketogenic diet, and surgery in lennox-gastaut syndrome: A comprehensive review.","authors":"Debopam Samanta","doi":"10.1016/j.yebeh.2025.110272","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110272","url":null,"abstract":"<p><p>Lennox-Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy marked by drug-resistant seizures and profound cognitive and behavioral impairments, with nearly 95% of individuals affected by moderate to severe intellectual disability. This review comprehensively explores the cognitive and behavioral impacts of current treatment options for LGS, including antiseizure medications (ASMs), neuromodulation strategies, the ketogenic diet, and surgical interventions. Given the limited availability of LGS-specific data for several ASMs, the evidence base is supplemented with findings from general epilepsy populations and individuals with epilepsy and intellectual disabilities. The evidence reveals that ASMs exert varied cognitive and behavioral effects in LGS. Medications such as valproate, lamotrigine, cannabidiol, fenfluramine, levetiracetam, brivaracetam, felbamate, and rufinamide generally support cognitive stability, while topiramate and zonisamide are associated with cognitive challenges. Behavioral outcomes also vary: stability is observed with valproate, lamotrigine, rufinamide, cannabidiol, and fenfluramine, whereas medications like levetiracetam, perampanel, brivaracetam, clobazam, and zonisamide can increase aggression or irritability. Nonpharmacological therapies, particularly when they reduce seizure frequency, typically provide greater cognitive and behavioral stability, with some offering improvement. Early intervention-especially through surgical options-appears most beneficial for preserving cognitive function. Additionally, therapies such as the ketogenic diet and neuromodulation may provide independent cognitive benefits beyond seizure control. This review emphasizes the importance of personalized treatment strategies, integrating cognitive and behavioral evaluations in therapy selection. Key components include baseline cognitive and behavioral assessments, followed by regular follow-up evaluations, particularly after therapy changes. Consideration of minimizing ASM polytherapy, careful evaluation of drug-drug interactions, pharmacogenomic implications, and the need for therapeutic drug monitoring in cases of cognitive adverse effects is essential. Future research should focus on developing assessment tools tailored to the unique needs of individuals with LGS, utilizing connectivity measures to assess intervention impacts, and advancing precision therapeutics to improve cognitive and behavioral outcomes.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110272"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037619","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":"Therapeutic yield of comprehensive inpatient treatment for patients with intellectual disability and epilepsy - A prospective observational study.","authors":"David Steinbart, Anja Grimmer, Rebekka Geelhaar, Martin Holtkamp","doi":"10.1016/j.yebeh.2025.110278","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110278","url":null,"abstract":"<p><strong>Introduction: </strong>In people with intellectual disability (ID), prevalence of epilepsy can be over 40-times higher than in normally intelligent people, impacting quality of life (QoL) of those affected. Patients with ID are often excluded from clinical trials, resulting in limited evidence regarding treatment. This study aimed to evaluate effects of a comprehensive inpatient treatment program on seizure outcome and QoL and to identify predictive factors for improvement in these measures.</p><p><strong>Methods: </strong>This prospective observational study included people with epilepsy (PWE) and ID (IQ < 70) who underwent comprehensive inpatient treatment in a tertiary epilepsy center. The program consisted of adjustments of anti-seizure medication (ASM) and various interventions such as occupational therapy, ergotherapy, logopedics, physiotherapy and counseling services, requiring a minimum hospital stay of 14 days. Outcome was measured by the Liverpool Seizure Severity Scale (LSSS), Glasgow Epilepsy Outcome Scale (GEOS), Aberrant Behavior Checklist (ABC), and Liverpool Adverse Events Profile (LAEP), alongside global QoL (numerical rating scale; 10 best, 0 worst) by caregivers. Seizure outcome was classified as \"favorable\" for patients experiencing not more than one seizure per month without any seizure-related injuries in the last 2 months. Data were collected within 2 weeks prior to admission and 8 weeks post-discharge. Wilcoxon signed rank tests and regression analysis were used to assess the effects of inpatient treatment and to identify predictive factors.</p><p><strong>Results: </strong>A total of 65 patients (30 female, median age 32 years) were included. During their hospital stays, number of ASM was reduced significantly, but not the total ASM dosage. Inpatient treatment led to a significant improvement in favorable seizure outcome (25 % before admission vs. 46 % after discharge; p = 0.004) and ASM adverse effects (LAEP median 34.0 vs. 31.0; p = 0.006). QoL ratings improved significantly post-treatment (rating scale median 4.0 vs. 6.0; p = 0.0015). A significant improvement of global QoL after discharge compared to the time point before admission was independently associated with a reduction of ASM number during hospital stay (p = 0.011). In general, higher global QoL after discharge was independently associated with a favorable seizure outcome (p < 0.001) and lower scores for ASM adverse effects (p = 0.03).</p><p><strong>Conclusion: </strong>In PWE and ID, a comprehensive inpatient treatment program may be helpful to reduce burden of seizures and of ASM adverse effects as well as to improve global QoL. A reduction of the number of ASM may facilitate improvement of global QoL.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110278"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037622","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":"Caregiving burden for adults with epilepsy and coping strategies, a systematic review.","authors":"Xuen Yu, Kheng-Seang Lim, Li-Yoong Tang, Pamela David, Zhi-Qian Ong, Kian-Yong Wong, Mingli Ji","doi":"10.1016/j.yebeh.2025.110262","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110262","url":null,"abstract":"<p><strong>Objectives: </strong>Caregiving for adults with epilepsy (AWE) imposes a different degree and scope of challenges than for children and teenagers with epilepsy, and it remains understudied. This study aimed to identify the types of caregiver burdens, needs, and coping strategies in caregiving for AWE.</p><p><strong>Methods: </strong>Previous studies relevant to this topic were identified from 7 databases. Searches were performed in PubMed, CINAHL, Web of Science (WOS), Scopus, Psychology and Behavioral Science Collection (PBSC), Embase, PsychINFO from 1 Jan 1980 to 31 December 2023. The findings were reported according to caregiver burden, caregiver needs, and coping strategies.</p><p><strong>Results: </strong>22 studies were included in this review, including 14 quantitative and 8 qualitative studies. Six types of burdens were identified: psychological, physical, medical, economic, social, and family. The predominantly reported burden was the psychological burden in developed and developing countries. However, caregivers in developing countries reported additional physical, social, and economic burdens due to cultural and socioeconomic factors. Furthermore, inaccessible and unaffordable health care with a lack of medical knowledge exacerbated the challenges. Stigma and misconceptions led to more psychological distress and social restriction. There is a need for psychological, social, and family support as well as medical information to promote self-efficacy among caregivers. Most caregivers develop their own coping strategies for dealing with caregiving stress.</p><p><strong>Conclusion: </strong>The caregiving burden for AWE is an understudied area that needs to be addressed by healthcare professionals. The caregivers are experiencing unaddressed psychological and other types of burdens, together with a lack of appropriate interventions and healthcare information.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110262"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037618","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":"Incidence of RINCH in pediatric EMU patients.","authors":"Natasha Varughese, Amber Cooke, Bassel Abou-Khalil","doi":"10.1016/j.yebeh.2025.110270","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110270","url":null,"abstract":"<p><p>RINCH (Rhythmic Ictal Non-Clonic Hand movements), a lateralizing sign in frontotemporal epilepsy, has been well described in the adult epilepsy population but not in the pediatric setting. We looked for evidence of RINCH as an ictal sign in pediatric epilepsy monitoring unit reports in a large academic pediatric hospital. We found nine patients with RINCH ictal phenomenon over a five-year period. We compared the characteristics of their epilepsy to the known data in adult patients. The patient age range was 6-15 years. Five patients had a lesion in the temporal lobe; the remaining four were non-lesional. The ictal EEG onset was in one temporal lobe in five patients. The remaining patients had frontal or non-localizable onset. However, ictal activity was present in the frontal lobe(s) in six patients at the time of RINCH. Seven occurrences of RINCH were contralateral to the epileptogenic lesion and/or ictal scalp EEG activity. The remaining patients were non-lesional with bilateral frontotemporal ictal activity. Dystonia was ipsilateral to the RINCH in two patients. This study reinforces the lateralizing significance of RINCH as an ictal phenomenon when it is present. RINCH may be rare in the pediatric epilepsy population, but it may also be under-reported.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110270"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037620","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":"Antiseizure medications for Lennox-Gastaut Syndrome: Comprehensive review and proposed consensus treatment algorithm.","authors":"Debopam Samanta, Sonam Bhalla, Sonal Bhatia, Anthony L Fine, Babitha Haridas, Cemal Karakas, Cynthia Guadalupe Keator, Hyun Yong Koh, M Scott Perry, Carl E Stafstrom, Jorge Vidaurre, Aaron E L Warren","doi":"10.1016/j.yebeh.2024.110261","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110261","url":null,"abstract":"<p><p>Lennox-Gastaut syndrome (LGS) is a severe, childhood-onset developmental and epileptic encephalopathy characterized by multiple drug-resistant seizure types, specific electroencephalogram (EEG) patterns, and significant cognitive and behavioral impairments. To date, eight anti-seizure medications (ASMs) have been specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of LGS: clonazepam, felbamate, lamotrigine, topiramate, rufinamide, clobazam, cannabidiol, and fenfluramine. Additionally, several other ASMs, including valproate, are frequently used off-label for LGS management. As the therapeutic landscape for LGS expands, clinicians are increasingly faced with complex decisions regarding optimal ASM selection. This narrative review explores evolving treatment strategies, offering a consensus-based treatment algorithm designed by a panel of U.S.- based experts. We analyze both FDA-approved and off-label ASMs, drawing on data from randomized controlled trials, open-label extensions, and real-world studies to assess each drug's efficacy and safety profile. A key challenge in comparing ASMs lies in the heterogeneity of study designs and outcome measures. This review addresses these limitations and considers crucial factors influencing ASM selection, such as seizure outcomes, safety profiles, cognitive and behavioral outcomes, drug-drug interactions, and rational polypharmacy. Barriers to access, including economic and regulatory hurdles, are also discussed. The proposed treatment algorithm emphasizes a personalized approach to LGS management, recommending valproate or clobazam as first-line treatments, followed by individualized combinations based on the specific patient profile and associated comorbidities.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110261"},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037617","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":"Knowledge, attitude and perception of epilepsy patients toward epilepsy surgery at Jordan University hospital.","authors":"Mahmoud Abdallat, Yacoub Bahou, Sareen Sufan, Reem Abushqeer, Waseem Sufan, Dania Al-Halhouli, Mohammad Abuarqob, Majed Hbahbih","doi":"10.1016/j.yebeh.2024.110255","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110255","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Epilepsy is a condition associated with stigma and considerable morbidity, placing a significant burden on patients and their families. It is fundamental to be mindful of the fact that a substantial number of patients remain unaware of the effective surgical procedures that have shown great success in many cases, drawing upon the global underutilization of epilepsy surgery (ES). In this study, we explore the knowledge and attitudes of epilepsy patients towards ES at Jordan University Hospital (JUH).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aims to evaluate epilepsy patients' attitudes and knowledge regarding ES at JUH, identify the variables affecting their attitudes, and compare the results with other Middle Eastern and Western reports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this cross-sectional study, conducted between the 1st of March and the 1st of September 2023, we gathered and analyzed data from epilepsy patients in the neurology clinic at JUH. A self-administered questionnaire was utilized, with questions emphasizing patients' demographics, disease status, and their knowledge and attitude toward ES. In order to determine the predictors of attitude, logistic regression was performed on the univariate analysis using the SPSS software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study included 145 participants, most of them within the 17 and 29 age group, and a mean age at first seizure of 21.6 years. Our sample included more generalized than focal epilepsy patients, with an additional 30 % of patients being unaware of their specific seizure type. 46 % of patients were on at least 2 antiepileptic drugs (AEDs), especially among the focal epilepsy group and 61 % were non-adherent to their medications. Eighty-two participants (57 %) were aware of ES, yet only twenty-five have shown a high level of understanding. The majority of patients (77 %) have expressed a positive attitude towards ES. Although patients' attitude was significantly associated with their first impression towards ES, age, age at first seizure and not possessing a driving license, the regression model did not reveal significant predictors. Despite the perception of 94 % of the patients that ES has a moderate to high risk, this did not have any significant influence on their final attitude. Furthermore, our results concluded that income, insurance type, educational level, frequency of seizures, and poor academic outcome played no significant role in patients' final attitude towards ES.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;ES is no longer considered an \"experimental\" or \"last resort\" treatment option. The results emphasize the importance of adapting educational interventions to improve knowledge and understanding of ES and implement measures to surgically pre-evaluate potential candidates. Further research should be done to overcome and address this gap in underutilization. In our study, we conclude that this gap is still present especially in people who are in","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110255"},"PeriodicalIF":2.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002107","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":"Butylphthalide may inhibit blood-brain barrier disruption through complement-related pathways to alleviate cognitive impairment in epileptic mice.","authors":"Linqian Zhao, Shihao Chen, Xing Jin, Weihao Zhuang, Qichang Liu, Yuqing Xiao, Huiqin Xu","doi":"10.1016/j.yebeh.2024.110251","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110251","url":null,"abstract":"<p><strong>Background: </strong>Temporal lobe epilepsy is often accompanied by comorbid symptoms such as anxiety, depression, and cognitive dysfunction. Research indicates a close relationship between blood-brain barrier (BBB) impairment and these symptoms. DL-3n-butylphthalide (NBP) has been reported to protect the BBB, but the molecular mechanisms by which NBP protects the BBB in epilepsy models remain unclear. This study investigated the protective effects of NBP on the BBB in epileptic mice to alleviate the comorbid symptoms associated with epilepsy.</p><p><strong>Methods: </strong>We utilized Mendelian randomization to explore the association between VEGFA and epilepsy. In the animal experiments, adult male C57BL/6 mice were used to establish a KA-induced epilepsy model, receiving daily intraperitoneal injections of NBP for 30 days. After this period, behavioral experiments and Western blot analyses were conducted to assess whether the comorbid symptoms of epilepsy and BBB disruption were alleviated. Subsequently, RNA sequencing was performed to analyze potential signaling pathways involved in the pharmacological effects of NBP.</p><p><strong>Results: </strong>Elevated circulating levels of VEGFA may be a risk factor for the onset of epilepsy. Animal experiments demonstrated that NBP treatment improved BBB disruption in KA-induced epileptic mice and alleviated depressive and anxious behaviors, as well as cognitive impairments. RNA sequencing results suggest that the pharmacological effects of NBP may be mediated through the inhibition of complement and coagulation cascades.</p><p><strong>Conclusion: </strong>NBP can protect the integrity of the BBB in KA-induced epileptic mice, inhibiting depression, anxiety behaviors, and cognitive dysfunction. This pharmacological effect may be associated with pathways involving complement and coagulation cascades.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110251"},"PeriodicalIF":2.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002407","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":"Developmental outcome in infancy after epilepsy surgery and its associated factors: A systematic review and meta-analysis.","authors":"Fandi Hendrawan, Ofadhani Afwan, Patricia Alika Kurniawan, Mirna Theresia Eka Wardana, Prasista Ariadna Kusumadewi, Dian Prasetyo Wibisono, Dian Kesumapramudya Nurputra","doi":"10.1016/j.yebeh.2024.110247","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110247","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of epilepsy surgery on the developmental outcome in infancy with pharmacoresistant epilepsy and its associated factors.</p><p><strong>Method: </strong>This systematic review and meta-analysis was conducted in adherence with PRISMA 2020. Literature searching was done using PubMed, CENTRAL, and Scopus database. The risk of bias within included studies was evaluated using ROBINS-I. The developmental outcome was explored by comparing the developmental quotient (DQ) between before and after the epilepsy surgery. The subgroup analysis was planned for sex, etiology, affected side, affected lobe, surgical method and intention, and seizure-free state after the surgery. Age at onset of epilepsy, age at surgery, duration of disease, and follow-up time were explored as well in meta-regression.</p><p><strong>Result: </strong>Ten articles were included in this review yielded 361 participants. The overall meta-analysis did not show a significant change of DQ after the surgery (MD -2.38; 95%CI -5.53 - 0.78). The comparison of delta DQ between seizure-free and not seizure-free population was not significantly different (seizure-free group; MD -4.33; 95%CI -20.37 - 11.70 vs. non-seizure-free group; MD -4.34; 95%CI -16.22 - 7.54). No independent significant moderator was identified.</p><p><strong>Conclusion: </strong>Epilepsy surgery may offer some benefits in infants with PRE despite most participants having stable developmental progress. Seizure-free state following epilepsy surgery is crucial for infants' development; however, not all epileptogenic lesions are located in the favourable and resectable area. Hence, seizure control with palliative surgery shall be offered.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110247"},"PeriodicalIF":2.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002540","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, compulsion and oxytocin: Insights from behavioral sequences, using neuroethology and complexity systems approaches.","authors":"Simone S Marroni, Victor R Santos, Olagide W Castro, Julian Tejada, Jessica Santos, Jose Antonio Cortes de Oliveira, Norberto Garcia-Cairasco","doi":"10.1016/j.yebeh.2025.110273","DOIUrl":"https://doi.org/10.1016/j.yebeh.2025.110273","url":null,"abstract":"<p><p>Epilepsies are complex neurological entities usually co-existing with neuropsychiatric comorbidities. We already demonstrated that microinjection of oxytocin (OT) into the central nucleus of amygdala (CeA) induces hypergrooming in Wistar rats, a model of compulsion. Furthermore, the Wistar Audiogenic Rat (WAR) strain is a genetic model of generalized tonic-clonic seizures. Here we quantified grooming behavior in WAR, with grooming scores, flowcharts and directed graphs of syntactic and non-syntactic grooming chains, after bilateral administration of OT or saline (SAL) into the CeA. Our current pioneer behavioral description considers that hypergrooming (compulsion) in WARs is a comorbidity because: (1) WARs have the highest grooming scores, when exposed only to novelty (2), WARs have better grooming scores than Wistars after CeA-SAL, (3) Epileptic WARs perform much better than Wistars in OT-CeA-dependent stereotyped behavioral sequences (flowcharts of syntactic/non-syntactic grooming chains). One additional observation is that the behavioral sequences here demonstrated can be modeled as reliable Markov chains. In conclusion we can drive hypergrooming in WARs, defined previously as a model of ritualistic motor behavior in Wistar rats, with OT from CeA, one of the principal amygdala complex outputs. As perspectives, ongoing cellular studies are on their way, to demonstrate the neural network, certainly incorporating cortico-striatal-thalamic-basal ganglia-cortical circuits, driven from CeA OT-dependent grooming pattern, a stereotyped, sequential and complex array of behaviors, and its association with seizure susceptibility.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"164 ","pages":"110273"},"PeriodicalIF":2.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001729","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}