Epilepsy & Behavior最新文献

{"title":"Differentiation with electroencephalography microstate in temporal lobe epilepsy with and without cognitive decline","authors":"Lingxuan Lv ,&nbsp;Nan Lin ,&nbsp;Weifang Gao ,&nbsp;Feifei Zhai ,&nbsp;Jing Wang ,&nbsp;Huanhuan Xiang ,&nbsp;Xinshan Liu ,&nbsp;Heyang Sun ,&nbsp;Qiang Lu ,&nbsp;Mengyang Wang ,&nbsp;Qing Liu ,&nbsp;Yicheng Zhu","doi":"10.1016/j.yebeh.2025.110365","DOIUrl":"10.1016/j.yebeh.2025.110365","url":null,"abstract":"<div><h3>Objective</h3><div>Electroencephalography (EEG) microstate analysis is widely used in the study of various neurological and psychiatric disorders. We aim to assess whether EEG microstates are altered in TLE patients with and without cognitive decline.</div></div><div><h3>Methods</h3><div>This study included a total of 47 temporal lobe epilepsy (TLE) patients with or without cognitive decline and 14 healthy controls (HCs). All participants underwent 64-channel EEG monitoring. Two-minute epochs of preprocessed eye closed awake EEG data were extracted for microstate analysis. Participants were divided into groups based on intelligence quotient (IQ) scores assessed by the Wechsler Intelligence Scale: normal cognition group (n = 23, IQ ≥ 90) and abnormal cognition group (n = 24, IQ &lt; 90). We conducted frequency spectral analysis on each frequency sub-bands (delta, 1–4 Hz; theta, 4–8 Hz; alpha, 8–12 Hz; beta, 12–30 Hz) of the three groups. Then the following microstate parameters were extracted for analysis over the full frequency band (1–30 Hz) and frequency sub-bands: duration, coverage, occurrence, and transition probability. Statistical analysis using multivariate analysis of variance (MANOVA) with Bonferroni correction (α = 0.0025).</div></div><div><h3>Result</h3><div>Microstate analysis in the beta sub-band revealed significant differences among groups. TLE patients with abnormal cognition showed increased occurrence of Map-D; significantly higher transition probabilities from Map-A, Map-B, and Map-C to Map-D; and distinct microstate characteristics compared to patients with normal cognition and HCs. In frequency spectral analysis, the power across all frequency sub-bands showed no significant differences among TLE patients with normal cognition, TLE patients with abnormal cognition, and HCs.</div></div><div><h3>Conclusion</h3><div>Beta sub-band EEG microstates, particularly Map-D characteristics, may serve as potential neurophysiological markers for cognitive decline in TLE patients.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110365"},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631922","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":"Providing integrated mental health care as a neurologist","authors":"Milena Gandy ,&nbsp;Gaston Baslet ,&nbsp;Sophie Bennett ,&nbsp;Heidi M. Munger Clary","doi":"10.1016/j.yebeh.2025.110368","DOIUrl":"10.1016/j.yebeh.2025.110368","url":null,"abstract":"<div><div>Mental health comorbidities are highly prevalent and problematic in epilepsy, making it important for neurologists to be equipped to manage their patients’ mental health concerns. This article explores the paradigm shift toward integrated mental health care approaches, aiming to educate early-career neurologists on their role within epilepsy care. We focus on depression and anxiety, how they present in epilepsy, and the role of integrated mental health care in managing these comorbidities. Key areas include the neurologist’s role in identifying mental health issues through patient discussions and screening tools, and the basics of neurologist-led management. This covers the selection and adjustment of antiseizure medications and the use of psychopharmacology. Additionally, we emphasize the importance of providing psychoeducation and promoting healthy lifestyle choices that support mental well-being. Finally, we discuss the neurologist’s role in facilitating referrals to mental health specialists, including information about the role of psychological interventions and psychiatry. This article aims to provide foundational knowledge to encourage early-career neurologists to actively engage in integrated mental health care approaches with their patients. This care can be flexible in how it incorporates different modalities and is tailored to local resources. It does not have to be extensive but should be meaningful enough to identify mental health concerns and facilitate patient access to appropriate resources and care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110368"},"PeriodicalIF":2.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621031","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":"Novel analogous tasks to assess material-specific memory impairments associated with temporal lobe epilepsy","authors":"Amélie Landry ,&nbsp;Isabelle Rouleau ,&nbsp;Véronique Desrochers ,&nbsp;Emma Colucci ,&nbsp;Victoria Gravel ,&nbsp;Dang Khoa Nguyen ,&nbsp;Olivier Boucher","doi":"10.1016/j.yebeh.2025.110366","DOIUrl":"10.1016/j.yebeh.2025.110366","url":null,"abstract":"<div><div>Episodic memory tasks employing verbal material are generally sensitive to material-specific memory impairments in individuals with left mesial temporal lobe epilepsy (LTLE), whereas visuospatial memory tasks are less consistently failed by individuals with right mesial temporal lobe epilepsy (RTLE). A limitation of these tasks is the possibility for the examinee to use verbalization strategies when tested with visuospatial stimuli, and visualization strategies with verbal material. In this study, we aimed to develop two new analogous computerized recognition tasks to identify material-specific memory impairments, adapted from those previously developed in our lab: one using verbal material (i.e., pseudowords), and the other visuospatial material (i.e., pictures depicting similar landscapes of mountains, trees, and lakes). Each task consists of a 3-trial learning phase and delayed recognition trials after 30 min. and two weeks. After having established normative data for adults (<em>N</em> = 124), we assessed the ability of each task to detect material-specific memory impairments in patients who have had surgery for LTLE (<em>n</em> = 16) or RTLE (<em>n</em> = 12). Both tasks have good psychometric properties. The RTLE group showed significantly poorer performance on the visuospatial than on the verbal memory test on all trials. The LTLE group showed significantly poorer performance on the verbal than on the visuospatial memory test on delayed (30-min. and 2-week) recognition trials. Memory profile on delayed recognition trials was concordant with the lateralization of epilepsy surgery in 87.5% of LTLE and in 83.3% of the RTLE group. This study provides preliminary clinical validation for our novel tasks to detect material-specific memory impairments in individuals with temporal lobe epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110366"},"PeriodicalIF":2.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621034","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":"Grapheme-color synesthesia in patients with epilepsy: A pilot study","authors":"Irene Chu ,&nbsp;Atef Kokash ,&nbsp;Snow P. Li ,&nbsp;Martina Vendrame","doi":"10.1016/j.yebeh.2025.110378","DOIUrl":"10.1016/j.yebeh.2025.110378","url":null,"abstract":"<div><h3>Background</h3><div>Synesthesia is a condition in which the stimulation of one sensory modality triggers unusual experiences in a second sensory modality such as colors or shapes. Synesthesia has been linked to specific conditions such as autism spectrum disorder, although the mechanisms underlying synesthesia remain largely unclear.</div></div><div><h3>Objective</h3><div>This pilot study aimed to investigate the prevalence of grapheme-color synesthesia (GCS) in patients with epilepsy and to characterize the epilepsy features associated with GCS experiences.</div></div><div><h3>Methods</h3><div>Participants were asked whether they reported experiences suggesting GCS. Those reporting GCS underwent a standard online consistency and congruency battery test (<span><span><u>http://www.synesthete.org</u></span><svg><path></path></svg></span>). Epilepsy features, electroencephalogram (EEG) findings, and magnetic resonance imaging (MRI) findings were collected and analyzed.</div></div><div><h3>Results</h3><div>Of the 40 study participants, 21 reported GCS experiences and 3 (7.5 %) resulted synesthetes from the battery test. Analysis of the test results showed that participants with focal seizures had lower median consistency scores (indicating they were less consistent in their color assignments) and higher congruency scores (indicating they were more accurate in quickly identifying matching color and letter/number combinations) compared to patients with generalized-onset seizures (2.9 and 51.4 respectively; p = 0.006, p = 0.001). Participants with non-motor seizures had lower median consistency scores (1.1) and higher congruency scores (79.2) compared to patients with motor seizures (2.8 and 52.8, respectively; p = 0.011, p = 0.036).</div></div><div><h3>Conclusion</h3><div>GCS may be more prevalent in patients with epilepsy than the general population. Focal and non-motor seizures may be associated with predisposition to GCS. Further larger scale studies are needed to confirm and expand these observations.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110378"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611128","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 Scoping Review of Responsive Neurostimulation in Focal Cortical Dysplasia-Related Epilepsy","authors":"Vincent Chang ,&nbsp;Puck C. Reeders ,&nbsp;Elizabeth R. Blackwood ,&nbsp;Elizabeth Palmi ,&nbsp;Brian N. Lundstrom ,&nbsp;Sandipan Pati ,&nbsp;Pariya Salami ,&nbsp;Vikram R. Rao ,&nbsp;Shruti Agashe","doi":"10.1016/j.yebeh.2025.110362","DOIUrl":"10.1016/j.yebeh.2025.110362","url":null,"abstract":"<div><h3>Objective</h3><div>Responsive Neurostimulation (RNS) is a closed-loop neuromodulation therapy approved for treating drug resistant epilepsy (DRE) with 1 or 2 seizure foci, but its potential utility for treating complex seizure networks, such as in focal cortical dysplasia (FCD), remains uncertain. This review and commentary discuss the current practice of RNS use in focal cortical dysplasia-related drug-resistant epilepsy(FCD-DRE), and the potential of individualized approaches.</div></div><div><h3>Methods</h3><div>Our scoping review followed a search to identify relevant studies on epilepsy and RNS across MEDLINE, Embase, and Web of Science, yielding 674, 1,255, and 579 results, respectively followed by abstract and full text review to include FCD-DRE. Data on history, imaging, intracranial EEG, RNS implantation and programming strategies were recorded.</div></div><div><h3>Results</h3><div>78 patients with FCD-DRE across 25 studies were included. The most common lead configuration was two depth electrodes in 53 % (19/36). The median seizure reduction was 85 % [IQR = 66, 96] with a median follow up of 17 months., including 6 patients (7.6 %) achieving seizure freedom for a median 15 months. In 17 patients with resections and RNS implantation, median seizure frequency reduction was 87 % (N = 15), not significantly different from the group with RNS only. 8 patients with cortical and thalamic leads had median seizure frequency reduction of 87 % [IQR = 51, 92]. RNS was effective when used in refractory status epilepticus associated with FCDs.</div></div><div><h3>Significance</h3><div>RNS is a flexible therapy that effectively reduces seizures in FCD-DRE. Electrographic and imaging signatures can potentially be leveraged. Hybrid resection with RNS approaches and the role in refractory status epilepticus associated with FCD is highlighted. Future studies are necessary to optimize RNS therapy in FCD-DRE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110362"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611129","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":"FMRI activation during paragraph reading in pediatric epilepsy","authors":"Gabrielle L. Sarlo ,&nbsp;Chloe A. Hooker ,&nbsp;Kelly T. Macdonald ,&nbsp;Leigh N. Sepeta ,&nbsp;William D. Gaillard ,&nbsp;Hua Xie ,&nbsp;Madison M. Berl","doi":"10.1016/j.yebeh.2025.110341","DOIUrl":"10.1016/j.yebeh.2025.110341","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined brain activation differences during paragraph reading between children with and without epilepsy and if findings were related to neuropsychological performance. Exploratory analyses assessed activation in a subset of struggling readers.</div></div><div><h3>Methods</h3><div>The study included 41 children with focal epilepsy (M = 10.5 years, 2.2) and 41 healthy controls with a similar mean age (M = 10 years, 1.7) who completed a neuropsychological battery and a functional magnetic resonance imaging (fMRI) paragraph reading task. Analyses included group comparisons of activation, including exploratory analyses with a subset of struggling readers with epilepsy. Correlational analyses examined relationships between activation and neuropsychological performance.</div></div><div><h3>Results</h3><div>Despite significant differences in neuropsychological performance, there were no group differences in activation on reading fMRI between children with and without epilepsy. Across the combined sample, better sight word reading, reading fluency, and reading comprehension were positively correlated with activation of the left superior temporal gyrus. A subset analysis comparing healthy controls and non-struggling epilepsy readers to struggling epilepsy readers (SS &lt; 85) showed more activation in the control groups compared to the struggling readers in focused areas including bilateral temporal gyrus, left cerebellum, and right inferior frontal gyrus. The subset of struggling readers was more likely than the non-struggling patient group to have frequent seizures and their seizure focus ipsilateral to their language dominance.</div></div><div><h3>Significance</h3><div>Despite worse neuropsychological performance, the reading network was similarly activated in children with and without epilepsy. Relative to the broader functional network for reading, small, focused areas—particularly in the superior temporal lobe—were associated with less activation for those who had worse reading performance. Use of an fMRI paragraph reading task matched to a child’s level show no to small differences related to epilepsy or reading performance which suggests its robustness as a task when the goal is to identify the language network such as for presurgical mapping.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110341"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611307","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 effect of an educative-supportive program based on the continuous care model on daily living activities and sleep quality in peoples with epilepsy","authors":"HamidReza Amirhosseni ,&nbsp;Shirmohammad Davoodvand ,&nbsp;Soleiman Kheiri ,&nbsp;Majid Jafari ,&nbsp;Reza Masoudi","doi":"10.1016/j.yebeh.2025.110382","DOIUrl":"10.1016/j.yebeh.2025.110382","url":null,"abstract":"<div><div>The impairment of sleep quality and the occurrence of frequent nocturnal awakenings significantly contribute to the reduction of effective sleep duration in individuals diagnosed with epilepsy. This deterioration not only compromises overall life satisfaction but also adversely affects cognitive functioning and concentration on daily living activities. Therefore, the imperative for enhanced management strategies for this disorder among individuals with epilepsy is critically important. This study is designed to systematically assess the impact of an educational-support program grounded in the Continuous Care Model on the daily living activities and sleep quality of individuals with epilepsy.</div></div><div><h3>Methods</h3><div>This clinical trial was conducted in 2023, involving 70 patients diagnosed with epilepsy, who were selected through purposive sampling and subsequently randomized into intervention and control groups. The intervention group participated in a 12-week program formulated according to the principles of the Continuous Care Model. Data collection was executed utilizing a demographic questionnaire, the Barthel Activities of Daily Living Scale, and the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses were performed using SPSS software version 22 to evaluate the data.</div></div><div><h3>Findings</h3><div>The study population consisted of 42.9 % females and 57.1 % males, with a mean age of 37.8 ± 16.6 years. The mean age for the intervention group was 34.9 ± 12.9 years, while the control group had a mean age of 40.7 ± 19.4 years. Prior to the intervention, no statistically significant differences were identified between the intervention and control groups concerning the mean scores for daily living activities (P = 0.24) and sleep quality (P = 0.377). However, immediately following the intervention and at the two-month follow-up, statistically significant differences were observed between the two groups in the mean scores for daily living activities (P &lt; 0.001) and sleep quality (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The implementation of a structured care program based on the Continuous Care Model has demonstrated beneficial effects on both daily living activities and sleep quality in individuals with epilepsy. Given its safety profile, cost-effectiveness, and proven efficacy, the integration of this model into standard care practices is strongly advocated to enhance the functional capabilities and sleep quality of individuals living with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110382"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621033","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":"Employment and seizure frequency as important predictors of health-related quality of life in people with functional/dissociative seizures","authors":"Carmen Uhlmann ,&nbsp;Susanne Jaeger ,&nbsp;Petra Schmid","doi":"10.1016/j.yebeh.2025.110357","DOIUrl":"10.1016/j.yebeh.2025.110357","url":null,"abstract":"<div><h3>Background</h3><div>There are inconsistent results on health-related quality of life (HRQoL) in patients with functional/dissociative seizures (FDS), particularly in relation to the predictors. The aim of the present study was to investigate variables predicting HRQoL in a sample of patients with FDS who had been hospitalized for an average of 5.6 years.</div></div><div><h3>Methods</h3><div>People with a confirmed diagnosis of FDS who had already received inpatient treatment years ago were contacted to participate to the survey by completing a self-report questionnaire. They were asked to rate their current HRQoL and provide information on seizure frequency at onset and current, employment and other clinical and sociodemographic variables.</div></div><div><h3>Results</h3><div>Of the n = 443 treated inpatients over a period of 14 years, n = 63 patients could still be reached and participated in the study. Seizure frequency decreased significantly over the course of the disease. At the time of the survey, half of the participants were limited in their HRQoL. The three significant predictors of HRQoL were current seizure frequency, current employment status and seizure frequency at the onset of the disease.</div></div><div><h3>Conclusions</h3><div>Even years after inpatient treatment, half of the people with FDS reported limited HRQoL. The frequency of seizures (current and at the onset) and current employment status were identified as predictors of better HRQoL. These variables can be targeted in psychotherapeutic treatment, for instance on the basis of the concept of experiential avoidance.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110357"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611126","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":"Artificial intelligence (ChatGPT 4.0) vs. Human expertise for epileptic seizure and epilepsy diagnosis and classification in Adults: An exploratory study","authors":"Francesco Brigo ,&nbsp;Serena Broggi ,&nbsp;Gionata Strigaro ,&nbsp;Sasha Olivo ,&nbsp;Valentina Tommasini ,&nbsp;Magdalena Massar ,&nbsp;Gianni Turcato ,&nbsp;Arian Zaboli","doi":"10.1016/j.yebeh.2025.110364","DOIUrl":"10.1016/j.yebeh.2025.110364","url":null,"abstract":"<div><h3>Aims</h3><div>Artificial intelligence (AI) tools like ChatGPT hold promise for enhancing diagnostic accuracy and efficiency in clinical practice. This exploratory study evaluates ChatGPT’s performance in diagnosing and classifying epileptic seizures, epilepsy, and underlying etiologies in adult patients compared to epileptologists and neurologists.</div></div><div><h3>Methods</h3><div>A prospective simulation study assessed 37 clinical vignettes based on real adult patient cases. ChatGPT was ’trained’ using official ILAE documents on epilepsy diagnosis and classification. Diagnoses and classifications by ChatGPT, two epileptologists, and two neurologists were compared against a reference standard set by a senior epileptologist. Diagnostic accuracy was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Cohen’s kappa (κ) was calculated to assess agreement.</div></div><div><h3>Results</h3><div>ChatGPT demonstrated high sensitivity (≥96.9 %) in identifying epileptic seizures and diagnosing epilepsy, ensuring no cases were missed. However, its specificity was lower, particularly for distinguishing acute symptomatic from unprovoked seizures (33.3 %) and diagnosing epilepsy (26.7 %), leading to frequent false positives. ChatGPT excelled in diagnosing epileptic syndromes (κ = 1.00) and structural etiologies (accuracy = 90.0 %) but struggled with ambiguous cases such as unknown seizure onset (accuracy = 12.5 %) and rare etiologies. Human experts consistently outperformed ChatGPT with near-perfect accuracy and higher κ values.</div></div><div><h3>Conclusion</h3><div>ChatGPT shows potential as a supplementary diagnostic tool but requires human oversight due to reduced specificity and limitations in nuanced clinical judgment. Further development with diverse datasets and targeted training is necessary to improve AI performance. Integrating AI with expert clinicians can optimize diagnostic workflows in epilepsy care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110364"},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611127","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":"Real-world experience of cannabidiol in conjunction with clobazam for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome: Results from a retrospective multicentre chart review in Germany","authors":"Adam Strzelczyk ,&nbsp;Susanne Schubert-Bast ,&nbsp;Felix von Podewils ,&nbsp;Susanne Knake ,&nbsp;Thomas Mayer ,&nbsp;Kerstin Alexandra Klotz ,&nbsp;Elisa Buhleier ,&nbsp;Luise Herold ,&nbsp;Ilka Immisch ,&nbsp;Gerhard Kurlemann ,&nbsp;Felix Rosenow","doi":"10.1016/j.yebeh.2025.110302","DOIUrl":"10.1016/j.yebeh.2025.110302","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) are rare and debilitating forms of epilepsy, characterised by recurrent, severe, drug-resistant seizures and neurodevelopmental impairments. A non-euphoric, plant-derived, highly purified formulation of cannabidiol (CBD; Epidyolex®, 100 mg/mL oral solution) is approved in the European Union and United Kingdom for use in patients aged ≥2 years for the adjunctive treatment of seizures associated with LGS or DS in conjunction with clobazam (CLB), and for the adjunctive treatment of seizures associated with tuberous sclerosis complex in patients aged ≥2 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a retrospective chart review of patients with treatment-resistant epilepsies who were treated with adjunctive CBD at six epilepsy centres in Germany. We analysed patient and treatment characteristics, seizure outcomes, treatment retention rates (i.e. the proportion of patients remaining on CBD treatment at time of assessment and retention as estimated by Kaplan-Meier [KM] analyses), physician-rated Clinical Global Impression of Change (CGI-C), and adverse events (AEs) for up to 12 months. Here, we report data from this chart review for those patients with LGS or DS receiving adjunctive treatment with concomitant CBD and CLB.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 126 patients (102 LGS; 24 DS) receiving CBD and CLB, with a mean (standard deviation [SD]) age of 23.2 (15.8) years and a mean (SD) age of epilepsy onset of 3 (3.7) years. Patients had received a median (range) number of prior antiseizure medications (ASMs) of 6 (1–24) and concomitant ASMs of 3 (1–7). The median target CBD dose was 11.1 mg/kg/day in the total population (17.8, 15.8, and 9.7 mg/kg/day in the &lt;6 years, 6–17 years, and ≥18 years subgroups, respectively). The median time to the target dose was 21–22 days across age groups. The median concomitant CLB dose was 0.14 mg/kg/day (0.38, 0.22, and 0.10 mg/kg/day in the respective age groups). A ≥50% reduction in total seizures was observed in 47.5% of patients at 3 months (35.7–52.6% across age groups) and 45.5% of patients at 12 months (44.4–46.2% across age groups). For generalised tonic-clonic seizures, a ≥50% reduction was observed in 63.0% of patients at 3 months (60.7–66.7% across age groups) and 56.9% of patients at 12 months (50.0–75.0% across age groups). Median seizure days per month significantly decreased from 30 (range: 0.5–30) at baseline to 15 (range: 0–30) at the last follow-up (p &lt;0.001). Overall, 89.7%, 80.7%, and 69.8% patients remained on CBD at 3, 6, and 12 months, respectively. KM estimated treatment retention was similar across paediatric and adult groups, according to earlier or later initiation (e.g. ≤4 vs ≥15 prior and concomitant ASMs) and according to the syndrome (LGS and DS). Physicians rated 66% of patients demonstrated a CGI-C improvement and 67% demonstrated a CGI-C behaviour improvement. The most c","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110302"},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591473","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}