Epilepsy & Behavior最新文献

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Social neuropsychology of epilepsy in the digital age: A narrative review on challenges and opportunities
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-10 DOI: 10.1016/j.yebeh.2025.110336
Marcel Eicher , Rebecca Johannessen , Hennric Jokeit
{"title":"Social neuropsychology of epilepsy in the digital age: A narrative review on challenges and opportunities","authors":"Marcel Eicher ,&nbsp;Rebecca Johannessen ,&nbsp;Hennric Jokeit","doi":"10.1016/j.yebeh.2025.110336","DOIUrl":"10.1016/j.yebeh.2025.110336","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Social cognition (e.g., theory of mind and emotion recognition) is frequently impaired in people with epilepsy (PWE) and plays a critical role in social functioning. The impact of the digital revolution on the social neuropsychology of PWE remains underexplored, while clinical neuropsychology has been slow to incorporate technological advancements. This study aims to (a) evaluate the impact of digital communication on social cognition and functioning in PWE, and (b) explore the potential of digital tools to enhance their assessment.</div></div><div><h3>Methods</h3><div>Given the limited and fragmented nature of the available research, a non-systematic, exploratory, narrative approach was adopted. Literature relevant to the interplay of digital communication, social cognition, and social functioning in PWE was synthesized to identify key areas for future research.</div></div><div><h3>Results</h3><div>Digital communication differs from face-to-face interaction at phenomenological and neural levels; however, research on its effects in PWE remains scarce. Traditional social cognition assessments suffer from low ecological validity. Technological innovations, involving second-person paradigms and dynamic multimodal assessments, address these limitations. Digital biomarkers enable high-frequency, longitudinal data collection of intra-individual variability.</div></div><div><h3>Conclusion</h3><div>Digital tools offer the opportunity to improve the assessment of social cognition and functioning in PWE, especially regarding ecological validity, by enabling real-world, interactive, dynamic, and multimodal paradigms. Digital social cognitive proxies (e.g., markers of interactional synchrony) may help capture social cognition and functioning in highly dynamic disease trajectories in PWE more accurately. The interplay between social cognition, social functioning, and digital communication in PWE offers research opportunities into their complex and dynamic relationships.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110336"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577884","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}
引用次数: 0
Genotype-phenotype correlation of ODLURO syndrome comorbid epilepsy associated with KMT2E variations: Report on a novel case and systematic literature review
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-05 DOI: 10.1016/j.yebeh.2025.110338
Shuyao Zhu , Hui Zhu , Xingyu Liu , Jinglin Liu , Guanghuan Pi , Li Yang , Zemin Luo , Jun Fan , Fu Xiong , Wenwen Zhang , Jiaji Zhou , Lan Zeng , Ai Chen
{"title":"Genotype-phenotype correlation of ODLURO syndrome comorbid epilepsy associated with KMT2E variations: Report on a novel case and systematic literature review","authors":"Shuyao Zhu ,&nbsp;Hui Zhu ,&nbsp;Xingyu Liu ,&nbsp;Jinglin Liu ,&nbsp;Guanghuan Pi ,&nbsp;Li Yang ,&nbsp;Zemin Luo ,&nbsp;Jun Fan ,&nbsp;Fu Xiong ,&nbsp;Wenwen Zhang ,&nbsp;Jiaji Zhou ,&nbsp;Lan Zeng ,&nbsp;Ai Chen","doi":"10.1016/j.yebeh.2025.110338","DOIUrl":"10.1016/j.yebeh.2025.110338","url":null,"abstract":"<div><h3>Background</h3><div>O’Donnell-Luria-Rodan (ODLURO) syndrome is a newly described neurodevelopmental disorder caused by a pathogenic <em>KMT2E</em> variant. The primary clinical phenotypes include developmental delay, intellectual disability (ID), and epilepsy. Epilepsy, observed in 29% of affected individuals, has not been thoroughly investigated. In this study, we describe the phenotypes and genetic profiles of patients with ODLURO syndrome and epilepsy.</div></div><div><h3>Methods</h3><div>We summarized and analyzed data from 30 patients with ODLURO syndrome and epilepsy from the systematic literature and DECIPHER database. Information regarding seizure classification, brain MRI findings, antiseizure medications, and genetics variations was collected and analyzed retrospectively.</div></div><div><h3>Results</h3><div>The risk factors associated with epilepsy in ODLURO syndrome remain unclear, and clinical heterogeneity exists. While focal seizures are most prevalent, various epilepsy classifications are observed. Brain MRI findings indicated that cerebral atrophy and cystic changes were common, though no correlation with epilepsy was established. Among ten individuals with a record of antiseizure medication, approximately 70% required two or more antiseizure medications.</div></div><div><h3>Conclusions</h3><div>A clear genotype-phenotype correlation remains elusive even among individuals with the same <em>KMT2E</em> variation. The pathogenesis of epilepsy associated with <em>KMT2E</em> variation is complex and necessitates further molecular genetic studies to elucidate the mechanisms underlying these genetic disorders. This research provides essential evidence for specific and individualized treatment approaches.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110338"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550906","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}
引用次数: 0
Metacognitive beliefs in epilepsy: What is their contribution to quality of life in the context of anxiety, depression and cognitive functioning?
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-05 DOI: 10.1016/j.yebeh.2025.110356
Kristijonas Puteikis, Arminas Jasionis, Rūta Mameniškienė
{"title":"Metacognitive beliefs in epilepsy: What is their contribution to quality of life in the context of anxiety, depression and cognitive functioning?","authors":"Kristijonas Puteikis,&nbsp;Arminas Jasionis,&nbsp;Rūta Mameniškienė","doi":"10.1016/j.yebeh.2025.110356","DOIUrl":"10.1016/j.yebeh.2025.110356","url":null,"abstract":"<div><h3>Background</h3><div>Beliefs about one’s own thinking process – metacognition – are thought to influence a person’s susceptibility to anxiety and depression. We aimed to explore the association between metacognitive beliefs, psychological symptomatology, objective cognitive functioning and quality of life (QoL) among people with epilepsy.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study including adults with epilepsy who attended an outpatient clinic. Participants provided sociodemographic data, information about their seizures and were then asked to complete the metacognitions questionnaire-30 (MCQ-30), the patient-weighted inventory on quality of life in epilepsy (QOLIE-31-P), the Neurological Disorders Depression Inventory in Epilepsy (NDDI-E), the Generalized Anxiety Disorder Scale-7 (GAD-7), and provide a self-rated assessment of cognitive functioning by rating their memory, attention and reaction speed on single-item scales from 0 to 10. They then underwent neuropsychological assessment targeting executive functioning, attention and reaction speed. The associations between metacognitive beliefs, psychological symptoms and QoL as well as self-rated and objective cognitive assessment were explored through correlation calculations. Statistically significant relationships were then used for analysis of path models with QoL as the dependent variable.</div></div><div><h3>Results</h3><div>The PWE sample consisted of 54 PWE (32, 59.3 % female), most having focal epilepsy (38, 70.4 %) and receiving ASM polytherapy (36, 66.7 %). There were no substantial differences in metacognitive beliefs based on demographic or epilepsy-related variables (p &gt; 0.05). Symptoms of anxiety and depression were found to mediate the association between negative metacognitive beliefs about the uncontrollability and danger of perseverative thinking and QoL. Cognitive confidence and self-rated assessment of memory, attention and reaction speed contributed to overlapping psychometric constructs with the cognitive subscale of QOLIE-31-P. Correlations between objective cognitive measures and self-rated attention, but not metacognitive domains were seen.</div></div><div><h3>Conclusion</h3><div>Metacognitive beliefs may be associated with QoL in epilepsy by exerting effect through psychological symptomatology. Based on our findings, negative metacognitive beliefs may be investigated as relevant targets for future therapies aiming to improve QoL among PWE. Self-rated cognitive ability assessment and cognitive confidence are largely independent of objective cognitive performance and overlap with the cognitive domain of QOLIE-31-P.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110356"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551010","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}
引用次数: 0
The temporal-insula type of temporal plus epilepsy patients with different postoperative seizure outcomes have different cerebral blood flow patterns
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-05 DOI: 10.1016/j.yebeh.2025.110342
Yuanfang Jiang , Guixian Tang , Shixin Liu , Yongjin Tang , Qijun Cai , Chunyuan Zeng , Guowei Li , Biao Wu , Huanhua Wu , Zhiqiang Tan , Jingjie Shang , Qiang Guo , Xueying Ling , Hao Xu
{"title":"The temporal-insula type of temporal plus epilepsy patients with different postoperative seizure outcomes have different cerebral blood flow patterns","authors":"Yuanfang Jiang ,&nbsp;Guixian Tang ,&nbsp;Shixin Liu ,&nbsp;Yongjin Tang ,&nbsp;Qijun Cai ,&nbsp;Chunyuan Zeng ,&nbsp;Guowei Li ,&nbsp;Biao Wu ,&nbsp;Huanhua Wu ,&nbsp;Zhiqiang Tan ,&nbsp;Jingjie Shang ,&nbsp;Qiang Guo ,&nbsp;Xueying Ling ,&nbsp;Hao Xu","doi":"10.1016/j.yebeh.2025.110342","DOIUrl":"10.1016/j.yebeh.2025.110342","url":null,"abstract":"<div><h3>Purpose</h3><div>This study retrospectively analyzed preoperative arterial spin labeling (ASL) perfusion MRI data of patients with the temporal-insula type of temporal plus epilepsy (TI-TPE). We aimed to investigate the differences in presurgical cerebral blood flow (CBF) changes in TI-TPE patients with different surgical outcomes.</div></div><div><h3>Method</h3><div>A total of 48 TI-TPE patients confirmed by SEEG were meticulously reviewed for this study. Patients were divided into the seizure-free (SF) group (Engel IA) and the non-seizure-free (NSF) group (Engel IB to IV) according to the Engel seizure classification. The 3D-ASL data of all patients before surgery were analyzed using statistical parametric mapping (SPM) and graph theory analysis. These findings were then compared to healthy controls (HC) based on whole-brain voxel-level analysis and covariance network analysis.</div></div><div><h3>Result</h3><div>At the voxel-level, both SF and NSF groups showed significantly decreased CBF in the ipsilateral transverse temporal gyrus and insula (TTG/insula), contralateral middle cingulate gyrus, precuneus (MCG/precuneus), and increased CBF in the ipsilateral superior temporal gyrus and the superior temporal pole (STG/STP). Wherein the SF group showed more lower CBF in the contralateral MCG/precuneus, with unique increased CBF in the contralateral STG/insula and decreased CBF in the contralateral calcarine as well. In terms of network attributes, the NSF group showed a significantly higher clustering coefficient (Cp), global efficiency (Eglob), local efficiency (Eloc), shorter shortest path length (Lp), and more extensive abnormal nodes compared to the SF and HC groups. While the SF group has higher synchronicity than the HC group.</div></div><div><h3>Conclusion</h3><div>Both SF and NSF groups had abnormal CBF changes at the voxel and network levels with different patterns. The SF group showed more obvious regional CBF changes, while the NSF group showed more extended network disruption, which might underlie different seizure outcomes after local surgical resection.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110342"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551011","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}
引用次数: 0
Comparison of the three scoring models (STEPSS, mSTEPSS, and END-IT) for outcome characteristics in a pediatric status epilepticus cohort
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-04 DOI: 10.1016/j.yebeh.2025.110346
Seda Kanmaz , Gürsel Şen , Erdem Simsek , Yavuz Ataş , Özlem Yılmaz , Kübra Cebeci , Pınar Yazıcı Özkaya , Benay Turan , Benan Dernek , Caner Turan , Ali Yurtseven , Eylem Ulaş Saz , Bülent Karapınar , Sanem Yılmaz , Hasan Tekgül
{"title":"Comparison of the three scoring models (STEPSS, mSTEPSS, and END-IT) for outcome characteristics in a pediatric status epilepticus cohort","authors":"Seda Kanmaz ,&nbsp;Gürsel Şen ,&nbsp;Erdem Simsek ,&nbsp;Yavuz Ataş ,&nbsp;Özlem Yılmaz ,&nbsp;Kübra Cebeci ,&nbsp;Pınar Yazıcı Özkaya ,&nbsp;Benay Turan ,&nbsp;Benan Dernek ,&nbsp;Caner Turan ,&nbsp;Ali Yurtseven ,&nbsp;Eylem Ulaş Saz ,&nbsp;Bülent Karapınar ,&nbsp;Sanem Yılmaz ,&nbsp;Hasan Tekgül","doi":"10.1016/j.yebeh.2025.110346","DOIUrl":"10.1016/j.yebeh.2025.110346","url":null,"abstract":"<div><h3>Background</h3><div>Various scoring models have been developed to predict outcomes in pediatric status epilepticus (SE)</div></div><div><h3>Objectives</h3><div>To compare a set of scoring models for predictivity of outcome characteristics in a single-center pediatric SE cohort.</div></div><div><h3>Patients and Methods</h3><div>Three SE scoring models (STEPSS, mSTEPSS, and END-IT) were retrospectively evaluated for outcome characteristics in a cohort including 240 children. The areas under curves (AUC) were calculated for the models: short-term outcome with in-hospital mortality, progression to refractory / super-refractory SE, poor outcome at hospital discharge with modified Rankin scale (mRS), and long-term functional outcome with the scores of pediatric overall performance category (POPC) scale at 2-years of follow-up.</div></div><div><h3>Results</h3><div>The mean age was 64.8 <strong>±</strong> 53.9 (1–216) months and 59.2 % of the patients were male. The refractory or super-refractory SE was observed in 100 patients of 240 (41.7 %) patients. A non-convulsive status epilepticus developed in 2.1 % (n = 5) of the patients during follow-up. Fifty-seven patients (23.7 %) received a new diagnosis of epilepsy. In-hospital mortality was 2.5 % in the whole cohort. A poor primary outcome was defined in 64 (26.7 %) with a POPC score ≥ 3. Among three scoring models, the END-IT provided a moderate predictivity for in-hospital mortality, progression to refractory/super-refractory SE, poor outcome at hospital discharge with mRS, and POPC score ≥ 3, <em>AUCs</em> were <em>0.815, 0.715, 0.742</em> and <em>0.720</em>, respectively.</div></div><div><h3>Conclusion</h3><div>The END-IT scoring model is a practical and reliable tool for outcome prediction in the intensive care unit as well as the poor outcome at hospital discharge and functional outcome at 2 years of follow-up.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110346"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535237","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}
引用次数: 0
Health priorities and treatment preferences of adults with epilepsy: A narrative literature review with a systematic search
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-04 DOI: 10.1016/j.yebeh.2025.110359
Chloé E. Hill , Kathryn Vanderboll , Jack M. Parent , Lesli E. Skolarus , Darin B. Zahuranec
{"title":"Health priorities and treatment preferences of adults with epilepsy: A narrative literature review with a systematic search","authors":"Chloé E. Hill ,&nbsp;Kathryn Vanderboll ,&nbsp;Jack M. Parent ,&nbsp;Lesli E. Skolarus ,&nbsp;Darin B. Zahuranec","doi":"10.1016/j.yebeh.2025.110359","DOIUrl":"10.1016/j.yebeh.2025.110359","url":null,"abstract":"<div><div>The care of people with epilepsy can be complex. Seizure control is a top priority, however there are other important health-related factors that can impact the well-being of a person with epilepsy. Understanding the range of health priorities and treatment preferences is a critical step in facilitating patient-centered care. In this narrative review, we queried four electronic databases with search terms including patient preferences, needs, priorities, and goals. In total, 20 articles met criteria to be included in the review; these included both quantitative and qualitative analyses of patient responses. Key issues identified were a variety of seizure-specific priorities (such as frequency, duration, severity, warning) and non-seizure medical priorities (such as cognition, mood, physical side effects). Support needs (such as psychological support, improved access to health care) and life goals (such as driving, relationships, work) were also prevalent and emphasized. The range of these findings support the importance of querying individual priorities to promote patient-centered care. Additionally, our results demonstrate that non-medical considerations are an important piece of the illness of epilepsy and should be considered in health care encounters as possible to improve patient outcomes and overall well-being.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110359"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551008","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}
引用次数: 0
Information on epilepsy genetics available online for people with epilepsy and their families
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-04 DOI: 10.1016/j.yebeh.2025.110361
Natalie J. Strohmayer , Itzel A. Camarillo , Hyunmi Choi , Ruth Ottman
{"title":"Information on epilepsy genetics available online for people with epilepsy and their families","authors":"Natalie J. Strohmayer ,&nbsp;Itzel A. Camarillo ,&nbsp;Hyunmi Choi ,&nbsp;Ruth Ottman","doi":"10.1016/j.yebeh.2025.110361","DOIUrl":"10.1016/j.yebeh.2025.110361","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and compare the types of information available online about epilepsy genetics to people with epilepsy and their family members on websites and social media platforms.</div></div><div><h3>Methods</h3><div>To identify websites, we used the search terms “epilepsy,” “genetic epilepsy,” and “epilepsy genetics” in Google, using Incognito mode. We selected the first ten English, non-sponsored websites for analysis. Websites were then classified according to their target audience (healthcare professionals vs. lay persons), and as epilepsy-specific or not and genetic-focused or not. On YouTube, X, Facebook, and TikTok, we searched using the terms “epilepsy” and “genetic epilepsy.” Posts were assessed for genetic-related themes, and the frequency of discussion was recorded.</div></div><div><h3>Results</h3><div>Among 31 websites assessed, only one did not discuss genetics in any capacity. However, many sources did not expand upon the potential role of genetics in epilepsy, and genetic testing was not frequently discussed. On social media, epilepsy genetics was more frequently discussed using a more specific search term, “genetic epilepsy” than using “epilepsy.” In posts that addressed genetics, the importance of genetic testing was the most frequent topic discussed. Other complexities, including offspring epilepsy risk, mode of inheritance, genetic heterogeneity, and variable expressivity, were very seldom discussed. Genetics was more frequently addressed in posts on YouTube and X than in those on Facebook or TikTok.</div></div><div><h3>Significance</h3><div>Online information about epilepsy genetics is difficult to encounter by chance; users must actively seek out this information. While information is available, accessibility and depth of the discussion is limited.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110361"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551012","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}
引用次数: 0
Unlocking new frontiers in epilepsy through AI: From seizure prediction to personalized medicine
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-03-04 DOI: 10.1016/j.yebeh.2025.110327
Majd A. AbuAlrob , Adham Itbaisha , Boulenouar Mesraoua
{"title":"Unlocking new frontiers in epilepsy through AI: From seizure prediction to personalized medicine","authors":"Majd A. AbuAlrob ,&nbsp;Adham Itbaisha ,&nbsp;Boulenouar Mesraoua","doi":"10.1016/j.yebeh.2025.110327","DOIUrl":"10.1016/j.yebeh.2025.110327","url":null,"abstract":"<div><div>Artificial intelligence (AI) is revolutionizing epilepsy care by advancing seizure detection, enhancing diagnostic precision, and enabling personalized treatment. Machine learning and deep learning technologies improve seizure monitoring, automate EEG analysis, and facilitate tailored therapeutic strategies, addressing the complexities of epilepsy management. However, challenges remain, including issues of model accuracy, interpretability, and applicability across diverse patient populations. Ethical considerations, such as safeguarding patient privacy, ensuring data security, and mitigating algorithmic bias, underscore the importance of responsible AI integration. Collaborative efforts among neurologists, data scientists, and regulatory authorities are critical to refining models, establishing ethical guidelines, and ensuring safe clinical adoption. This review examines AI’s transformative potential, its current limitations, and the multidisciplinary initiatives driving its effective implementation in epilepsy care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110327"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535168","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}
引用次数: 0
Predictors of status epilepticus among older adults – a prospective real-world study
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-02-28 DOI: 10.1016/j.yebeh.2025.110329
Telma Assis , Luan Côrtes , Silas Santana , Aroldo Bacellar
{"title":"Predictors of status epilepticus among older adults – a prospective real-world study","authors":"Telma Assis ,&nbsp;Luan Côrtes ,&nbsp;Silas Santana ,&nbsp;Aroldo Bacellar","doi":"10.1016/j.yebeh.2025.110329","DOIUrl":"10.1016/j.yebeh.2025.110329","url":null,"abstract":"<div><div>Data on status epilepticus (SE) in older inpatients is limited.</div></div><div><h3>Aim</h3><div>To assess SE characteristics and etiologies, and <del>i</del>dentify risk factors for SE in a cohort of hospitalized patients.</div></div><div><h3>Methods</h3><div>We selected patients aged <span><math><mrow><mo>≥</mo></mrow></math></span> 60 years with late-onset seizures from a tertiary center. We analyzed demographics, clinical characteristics, etiology of seizures, neurological diseases, and comorbidities. We performed the Kaplan-Meier analysis to examine acute symptomatic and unprovoked seizures and multivariate logistic regression to identify risk factors for SE.</div></div><div><h3>Results</h3><div>We enrolled 236 patients (mean age: 77.1 ± 9.7 years [SD]) with acute symptomatic seizures, unprovoked seizures and both. SE occurred in 61 (25.8 %) patients. The mean age at the first-ever seizure was 76.5 ± 9.8 years. Females comprised 62.3 % of the patients in the SE group. Convulsive SE was the most common presentation (80.3 %). Cerebrovascular disorders were the most common etiology (27.9 %) among patients with SE. The likelihood of SE occurring was similar between patients with acute symptomatic seizures alone or in combination with unprovoked seizures (118/50 %), and those with unprovoked seizures (118/50 %). Dyslipidemia negatively correlated with SE (OR 0.45 [95 % CI, 0.24–0.85]; p = 0.014), perhaps due to statin use. Psychiatric disorders (OR 2.76 [95 % CI, 1.45–5.24]; <em>p</em> = 0.002;), sepsis (OR 2.33 [95 % CI, 1.13–4.79]; <em>p</em> = 0.021), and congestive heart failure (OR 2.95 [95 % CI,1.07–8.12]; <em>p</em> = 0.036) were risk factors for SE.</div></div><div><h3>Conclusion</h3><div>We identified older inpatients who developed SE, their characteristics, and the risk factors for developing SE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110329"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511529","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}
引用次数: 0
Chronic outcomes after mild-moderate traumatic brain injury in adult seizure-prone (FAST) and seizure-resistant (SLOW) rats: A model for understanding genetic contributions to acquired epileptogenesis?
IF 2.3 3区 医学
Epilepsy & Behavior Pub Date : 2025-02-28 DOI: 10.1016/j.yebeh.2025.110347
Wai Lam Leung , Ali Shad , Piero Perucca , Terence J. O’Brien , Bridgette D. Semple , Pablo M. Casillas-Espinosa
{"title":"Chronic outcomes after mild-moderate traumatic brain injury in adult seizure-prone (FAST) and seizure-resistant (SLOW) rats: A model for understanding genetic contributions to acquired epileptogenesis?","authors":"Wai Lam Leung ,&nbsp;Ali Shad ,&nbsp;Piero Perucca ,&nbsp;Terence J. O’Brien ,&nbsp;Bridgette D. Semple ,&nbsp;Pablo M. Casillas-Espinosa","doi":"10.1016/j.yebeh.2025.110347","DOIUrl":"10.1016/j.yebeh.2025.110347","url":null,"abstract":"<div><div>Post-traumatic epilepsy (PTE) is a common, serious, long-term complication of traumatic brain injury (TBI). However, only a minority of individuals will develop epilepsy after a TBI, and the contribution of genetic predisposition to the risk of acquired epilepsy warrants further exploration. In this study, we examined whether innate, genetically determined differences in seizure susceptibility between seizure-prone FAST and seizure-resistant SLOW rat strains would influence chronic behavioral and PTE outcomes after experimental TBI. We hypothesized that FAST rats would show increased vulnerability to PTE and poorer neurobehavioral outcomes. Using the lateral fluid percussion injury model, we first determined the optimal injury parameters to generate a mild-moderate TBI in young adult FAST rats, which had previously shown high mortality to severe TBI. Then, FAST and SLOW rats underwent TBI or sham surgery, and a series of behavioral tests were performed either acutely (within 4 weeks) or chronically (more than 22 weeks) post-injury. Acutely, FAST rats showed an increased physiological response to TBI with a longer apnea duration, delayed pain response, and delayed self-righting, as well as increased acute seizure-like behavior compared to SLOW rats. Conversely, SLOW rats showed greater neuromotor deficits and weight loss sub-acutely compared to FAST rats. Chronically, while strain-specific phenotypes were observed (e.g., FAST rats showing increased anxiety-like behavior, altered nociceptive responses, and polydipsia), no TBI effects were detected. Analysis of continuous video-electroencephalographic recordings over a 1-month period starting at 6 months post-TBI did not reveal any spontaneous seizures. However, periodic epileptiform discharges were only found in FAST rats that had a TBI. Together, these findings reflect fundamental differences in chronic behavior and epileptiform discharges as a result of innate distinctions in epileptogenic susceptibility in FAST versus SLOW rats. However, a lack of spontaneous seizure activity or chronic neurobehavioral deficits in TBI animals confounded our ability to address the initial hypothesis, such that alternative injury models may be more suitable to study genetic contributions to the development of PTE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"166 ","pages":"Article 110347"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519765","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}
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