Epilepsy & Behavior最新文献

{"title":"Connectivity-based localization and mapping of central epilepsy semiology","authors":"Min Zhu ,&nbsp;Jianping Song ,&nbsp;Xianjun Shi ,&nbsp;Kaifeng Shen ,&nbsp;Lukang Wang ,&nbsp;Zhiji Wang ,&nbsp;Lihong Liu ,&nbsp;Yahua Wu ,&nbsp;Yao Guo ,&nbsp;Xiaolin Yang ,&nbsp;Shiyong Liu ,&nbsp;Hui Yang ,&nbsp;Xiju He ,&nbsp;Chunqing Zhang","doi":"10.1016/j.yebeh.2025.110662","DOIUrl":"10.1016/j.yebeh.2025.110662","url":null,"abstract":"<div><h3>Objective</h3><div>Semiology-based preoperative anatomical hypotheses are necessary, yet comprehensive reports on the semiology and its correlation with central subregions in central epilepsy has still lacked. We wished to identify semiologic subgroups and their correlations with central subregions.</div></div><div><h3>Methods</h3><div>We retrospectively included 21 patients with central epilepsy identified by stereoelectroencephalography (sEEG). The central region was segmented into 12 subregions using the Human Brainnetome Atlas, and both sEEG data and semiology underwent quantitative analysis.</div></div><div><h3>Results</h3><div>We defined three patient groups based on semiologic pattern similarities. Several intriguing anatomical-electroclinical correlations were initially observed, including the involvement of paracentral lobule (PCL) subregion 2 in upper-limb sensations, PCL1 in autonomic signs, and notably, postcentral gyrus (PoG) 2 in orofacial motor signs and precentral gyrus (PrG) 1 in hand sensations, which may be explained by the overlap among motor and sensory cortices, suggesting a reexamination of traditional localizations of somatosensory or motor signs to the PoG or PrG. Furthermore, anatomic structures initiating ictal signs constructed specific early spread networks. While all patient groups exhibited propagation to the parietal (P) and cingulate cortices (CG), ictal discharges originating from the superior, the posterior-inferior (near the lateral sulcus), and the middle-inferior aspects tended to propagate anteriorly toward the frontal lobe, in a superior direction and to the adjacent insula, and in a bidirectional manner—that is, towards the middle-front and the posterior regions, respectively.</div></div><div><h3>Conclusion</h3><div>Localizing semiology to central subregions and mapping clinical patterns to early spread networks allowed central epilepsy dynamics to be realized and helped define the range of epileptogenic anomalies preoperatively.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110662"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996122","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":"Ovarian reserve markers in women of reproductive ages with epilepsy","authors":"Clara Colombo ,&nbsp;Janne G. Bentzen ,&nbsp;Michael Oettinger ,&nbsp;Henriette Ewers ,&nbsp;Lars H. Pinborg ,&nbsp;Anja Pinborg ,&nbsp;Anne Sabers","doi":"10.1016/j.yebeh.2025.110661","DOIUrl":"10.1016/j.yebeh.2025.110661","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to examine ovarian reserve parameters in women with epilepsy compared to women without epilepsy.</div></div><div><h3>Methods</h3><div>A total of 80 women with epilepsy (WWE) from the epilepsy clinic at Rigshospitalet, Denmark, participated and completed the study between 2018–2022. A historical cohort collected from 2008 to 2010 of 418 women without epilepsy and no prior diagnosis of infertility was used as control.</div><div>Ovarian reserve markers, including serum anti-Müllerian hormone (AMH) and antral follicle count (AFC) measured via transvaginal ultrasound, were assessed during the early follicular phase (cycle days 2–5). Age-adjusted ovarian reserve parameters were compared between WWE and controls, as well as among subgroups of WWE.</div></div><div><h3>Results</h3><div>There was no difference in AMH between the groups with mean AMH of 21.9 (15.0) pmol/L and 21.7 (18.0) pmol/L, respectively (p = 0.93). AFC was higher in WWE with a mean of 28.3 (16.4) compared to 22.7 (12.0) in the control group (p = 0.01). The difference in AFC remained significant after adjusting for age (p = 0.035). No differences were found when comparing subgroups of WWE based on the dominating seizure type.</div></div><div><h3>Conclusion</h3><div>Overall, women with epilepsy did not have diminished ovarian reserve as age-adjusted markers of ovarian reserve (AMH and AFC levels) were comparable to a control group of women without epilepsy. In daily clinical practice, this provides reassuring and important information to communicate to women with epilepsy of reproductive age, who are often concerned about their reproductive health.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110661"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996123","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":"Naturalistic driving behavior among older adults with and without epilepsy: A pilot study","authors":"Jonathan P. Williams ,&nbsp;Yiqi Zhu ,&nbsp;Ganesh M. Babulal","doi":"10.1016/j.yebeh.2025.110674","DOIUrl":"10.1016/j.yebeh.2025.110674","url":null,"abstract":"<div><h3>Objectives</h3><div>Insufficient data exist for driving risk for people with epilepsy (PWE). This longitudinal, retrospective case-control study examines the differences in driving behaviors among older adults with/without epilepsy history using a novel naturalistic driving datalogger.</div></div><div><h3>Methodology</h3><div>Eligible participants were cognitively normal ([CDR] = 0) or had mild cognitive impairment (MCI) ([CDR] = 0.5), age ≥ 65, self-reported epilepsy history, and had a global positioning system datalogger installed in their vehicle, which collected data every 30 s during driving trips. Driving data captured between January 2023 and January 2025, aggregated monthly, were included. Linear mixed-effects (LME) models assessed longitudinal driving behavior data as a function of epilepsy status using a matched (age, sex, and education) case-control design.</div></div><div><h3>Results</h3><div>In this pilot study, epilepsy history had a significant effect on the y-intercept/baseline in models for driving parameters related to driving distance and speed. Longitudinal differences in LME models were shown for driving parameters associated with in-vehicle time, driving distance, and speed. PWE drove slower, less frequently (e.g., fewer trips), and spent more non-driving time in vehicles.</div></div><div><h3>Conclusion</h3><div>Important differences in driving behaviors may exist between drivers with and without epilepsy. New, effective methods to unobtrusively measure longitudinal driving behavior of PWE are feasible and can improve clinical management at the patient level. More studies are needed to elucidate the relationship between specific driving behaviors and driving risk in PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110674"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996794","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":"Pyridoxine supplementation for levetiracetam-related neuropsychiatric adverse events in pediatric and adolescent epilepsy: a prospective, double-blind, randomized, placebo-controlled trial","authors":"Pavida Thananowan ,&nbsp;Thitiwan Simasathien ,&nbsp;Naruemol Kitvorametha ,&nbsp;Benyapa Kangwantanawat ,&nbsp;Piradee Suwanpakdee","doi":"10.1016/j.yebeh.2025.110691","DOIUrl":"10.1016/j.yebeh.2025.110691","url":null,"abstract":"<div><h3>Background</h3><div>Levetiracetam commonly causes neuropsychiatric adverse events (NPAEs) in pediatric patients, including irritability and aggression. This study evaluated pyridoxine supplementation for reducing levetiracetam-related NPAEs in children and adolescents with epilepsy.</div></div><div><h3>Methods</h3><div>We conducted a prospective, double-blind, randomized, placebo-controlled trial at Phramongkutklao Hospital, Thailand (January-June 2024). Participants aged 1–18 years with levetiracetam-related NPAEs were randomly assigned in a 1:1 ratio to receive either pyridoxine (10 mg/kg/day, maximum 200 mg) or placebo for 8 weeks. The primary outcome was change in behavioral symptoms using a validated 30-item questionnaire (score range 30–90). Secondary outcomes included treatment adherence, time to behavioral improvement, and adverse events. Sample size (n = 102) was calculated to detect a 20 % difference in behavioral improvement with 80 % power.</div></div><div><h3>Results</h3><div>102 patients were randomized (pyridoxine n = 51, placebo n = 51). Baseline characteristics—including age, sex, seizure type, and number of concomitant ASMs—were comparable between groups. The mean age was 9.2 vs 8.3 years (p = 0.363), and 52.9 % vs 51.0 % were female in the pyridoxine and placebo groups, respectively. Most participants (56.9 %) were on dual therapy, with a median of two ASMs in both groups (p = 0.94). Both groups showed significant behavioral improvement over 8 weeks: the pyridoxine group from 14.79 ± 6.87 to 11.54 ± 6.22 (p &lt; 0.001); placebo group from 15.65 ± 8.26 to 10.47 ± 8.22 (p &lt; 0.001). No significant between-group difference existed at week 8 (p = 0.468). However, multivariate analysis of behavioral change scores from baseline to week 8 revealed significantly greater improvement in the pyridoxine group (adjusted OR = 2.31, 95 % CI: 1.15–4.63, p = 0.020). No serious adverse events occurred in either group.</div></div><div><h3>Conclusion</h3><div>While pyridoxine did not significantly reduce behavioral scores compared to placebo at the study endpoint, the greater improvement in change scores over time suggests potential benefit in mitigating levetiracetam-associated NPAEs. Pyridoxine may serve as safe adjunctive therapy for patients who have behavioral side effects while maintaining seizure control. Further investigation in larger multicenter trials with extended follow-up is required before recommending pyridoxine for routine clinical use.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110691"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996856","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, it’s just not sexy, is it?”: A qualitative exploration into health and social care professionals’ perspectives of people with intellectual disabilities and epilepsy, in social care","authors":"Jay Price ,&nbsp;Paraskevi Triantafyllopoulou ,&nbsp;Ceridwen Evans ,&nbsp;Rohit Shankar","doi":"10.1016/j.yebeh.2025.110697","DOIUrl":"10.1016/j.yebeh.2025.110697","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is prevalent in 22.2% of the intellectual disability (ID) population, with complexities spanning across health and social care sectors. Minimal research has been conducted to explore the experiences of epilepsy care within social care, despite its significance.</div></div><div><h3>Methodology</h3><div>Qualitative methodologies, using semi-structured interviews, were used to explore the experiences of health and social care professionals within the United Kingdom and analysed using Braun and Clarke’s reflexive thematic analysis framework.</div></div><div><h3>Results</h3><div>Four overarching themes were constructed from 11 interviews a) “It’s just not sexy, is it?”: Barriers to good epilepsy care, b) “My mission is to make their life better”: Facilitators of good epilepsy care, c) “Sometimes they appear frightened”: Impact of epilepsy, d) “Epilepsy training as a mandatory”: Future of epilepsy care. Fear was the most prevalent emotion described by participants throughout, which was perpetuated by the lack of resources and understanding/awareness, such as training. However, facilitating better epilepsy care for people with ID, can help reduce fear, and promote better wellbeing in all. Participants made recommendations such as mandating epilepsy training, and involving all key stakeholders, including families of people with ID, to improve epilepsy care in the future.</div></div><div><h3>Conclusion</h3><div>Mandating epilepsy training in health and social care settings is beneficial for care delivery and reducing the impact of epilepsy upon families and caregivers. Involving key stakeholders, such as families and caregivers, in all aspects of epilepsy care for people with ID, improves communication, service delivery and quality.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110697"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003824","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":"Reactive astrogliosis and microgliosis in animal models of focally induced seizures: A systematic review and multivariate multilevel meta-analysis","authors":"Asya Egilmez ,&nbsp;Shao-Fang Yen ,&nbsp;Alberto Pauletti ,&nbsp;Sonja Bröer","doi":"10.1016/j.yebeh.2025.110694","DOIUrl":"10.1016/j.yebeh.2025.110694","url":null,"abstract":"<div><div>Reactive astrogliosis and microgliosis are hallmarks of various central nervous system (CNS) diseases, including epilepsy. Both are observed following seizures in various models of epilepsy. We conducted a systematic <em>meta</em>-analysis to synthesize current knowledge on reactive astrogliosis and microgliosis in animal models involving experimentally induced seizures using a multilevel approach to analyze 260 comparisons from 52 studies. Results revealed significant elevations in both astrogliosis (Standardized Mean Difference (SMD) = 1.90, 95 % Confidence Interval (CI): 1.39–2.40) and microgliosis (SMD = 2.02, 95 % CI: 1.39–2.66) with distinct model-specific temporal profiles. Models using chemoconvulsants demonstrated progressive astrocytic activation and pronounced microglial surge during the chronic phase, while electrical stimulation models showed temporally distinct glial activation patterns. Infection models induced acute microglial responses and progressive astrogliosis. Significant methodological heterogeneity was observed, with evidence of publication bias (including inconsistent definitions of seizure phases and limited use of EEG or blinding) and notable effects of <em>a priori</em> power analyses on reported outcomes. These findings provide a framework for understanding model-specific seizures induced glial responses and identify critical methodological considerations for enhancing translational value, including optimal windows for targeted interventions.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110694"},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003955","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":"Understanding lived experiences with KCNQ2 developmental and epileptic encephalopathy","authors":"Michele H. Potashman ,&nbsp;Katja Rudell ,&nbsp;Linda Abetz-Webb ,&nbsp;Naomi Suminski ,&nbsp;Audra Gold ,&nbsp;Rinchen Doma ,&nbsp;Kavita Jarodia ,&nbsp;Chris Buckley ,&nbsp;Matthew Ridley ,&nbsp;Jason Lerner ,&nbsp;Jim Mather ,&nbsp;Vlad Coric ,&nbsp;Adam L. Numis ,&nbsp;Tristan T. Sands ,&nbsp;John Millichap ,&nbsp;Anne T. Berg ,&nbsp;Gil L’Italien","doi":"10.1016/j.yebeh.2025.110670","DOIUrl":"10.1016/j.yebeh.2025.110670","url":null,"abstract":"<div><h3>Background</h3><div><em>KCNQ2</em> developmental and epileptic encephalopathy (<em>KCNQ2</em>-DEE) is a rare pediatric disorder characterized by seizures and neurodevelopmental impairments. Parent- and healthcare professional (HCP)-reported outcomes regarding the impacts of seizures and neurodevelopmental impairments may guide the design of clinically meaningful <em>KCNQ2</em>-DEE outcome measures.</div></div><div><h3>Methods</h3><div>Parents of children with <em>KCNQ2</em>-DEE (N = 53) and HCPs with <em>KCNQ2</em>-DEE expertise (N = 2) participated in qualitative interviews exploring signs, symptoms, and impacts of <em>KCNQ2</em>-DEE, and how varying <em>KCNQ2</em>-DEE phenotypes affect child development. Interviews were recorded, transcribed, coded, and analyzed by ATLAS.Ti v23 software.</div></div><div><h3>Results</h3><div>The most common <em>KCNQ2</em>-DEE concepts parents reported were difficulties with communication (88.9 %), and gross (81.5 %) and fine (63.0 %) motor problems. Difficulty with communication (74.1 %), behavioral disorders (37.0 %), and gross motor problems (24.1 %) were the most impactful and bothersome issues for parents. When asked to rate how impacted they were by each concept (0 = “not impacted” to 10 = “extremely impacted”), the most bothersome symptoms were difficulty with communication (mean score [SD] = 8.6 [1.7]; 87.0 % of parents), cognitive delays (8.1 [2.0]; 37.0 % parents), and personal care and hygiene issues (7.4 [2.2]; 29.6 % parents). Seizures were the least bothersome symptom post-infancy (mean score [SD] = 5.3 [3.6]; 87.0 % parents). Children’s developmental abilities varied substantially within and between <em>KCNQ2</em>-DEE phenotypes and across age groups. Overall, HCPs reported largely similar concepts to parents of children with <em>KCNQ2</em>-DEE.</div></div><div><h3>Conclusions</h3><div>These findings identify outcome domains important to those with <em>KCNQ2</em>-DEE and may inform the development of measurement tools and endpoint selection for therapeutic trials.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110670"},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988440","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":"Characterization of a real-world population with pediatric epilepsy point-of-care standardized data collection as a tool for healthcare quality improvement and disparities research in Canada","authors":"Morris H. Scantlebury ,&nbsp;Sabrina D’Alfonso ,&nbsp;Fejiro Erome ,&nbsp;Juan Pablo Appendino ,&nbsp;Alice Ho ,&nbsp;Julia Jacobs ,&nbsp;Adrian L. Rabinowicz ,&nbsp;Enrique Carrazana ,&nbsp;Jeffrey Buchhalter","doi":"10.1016/j.yebeh.2025.110684","DOIUrl":"10.1016/j.yebeh.2025.110684","url":null,"abstract":"<div><h3>Objective</h3><div>Electronic health records offer the opportunity for quality-improvement (QI) initiatives addressing health disparities in epilepsy care. The Pediatric Epilepsy Outcome-Informatics Project (PEOIP) at Alberta Children’s Hospital implemented point-of-care data entry into a standardized pediatric epilepsy electronic note as part of routine clinical care to support QI initiatives. Our study validated collected data by assessing the prevalence of patient characteristics, ethno-racial background, and 4 of the most common severe epilepsy syndromes: infantile epileptic spasms, Dravet, Lennox-Gastaut, and developmental epileptic encephalopathy with spike-wave action in sleep.</div></div><div><h3>Methods</h3><div>Demographic and clinical characteristics were drawn from the entire population of pediatric patients (≤18 y) with ≥ 1 standardized electronic note from January 1, 2016, to March 23, 2022. Descriptive statistics were compared with published sources.</div></div><div><h3>Results</h3><div>The dataset contained 18,889 notes from 3588 patients and was in general agreement with published literature, with a slight male predominance and focal onset more common than generalized onset diagnosis. Data for the 4 severe epilepsy syndromes were also similar. Using open-ended questions, self-reported parental ethno-racial data were available for 49.6 % of patients; this increased to 95.5 % (n = 1861) in those patients whose first note was a standardized electronic note. Results generally reflect Canadian census findings and published literature.</div></div><div><h3>Significance</h3><div>The PEOIP is a comprehensive pediatric clinical dataset in a tertiary epilepsy center and reflects published literature for pediatric patients with epilepsy and data for the 4 severe epilepsy syndromes were also similar. for similar populations. Ethno-racial background data were reliably collected at point of care and provide a representative sample of pediatric epilepsy in Alberta. The PEOIP dataset represents a valuable baseline for QI initiatives and disparities research.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110684"},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988444","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 qualitative study exploring physician perspectives on a cardiac-based seizure prediction digital service for epilepsy management","authors":"Eryse Amira Seth ,&nbsp;Jue Xie ,&nbsp;Jessica Watterson ,&nbsp;Ching Soong Khoo ,&nbsp;Mohd Farooq Shaikh ,&nbsp;Alina Arulsamy","doi":"10.1016/j.yebeh.2025.110689","DOIUrl":"10.1016/j.yebeh.2025.110689","url":null,"abstract":"<div><h3>Objective</h3><div>The unpredictability of epileptic seizures represents a significant challenge to people with epilepsy. To address this, research on seizure prediction has been evolving rapidly. However, insights from end-users that guide the development of this technology have been limited. This study aimed to explore physicians’ perspectives on the management of epilepsy and their perception of a proposed cardiac-based seizure prediction digital service.</div></div><div><h3>Method</h3><div>One-hour semi-structured interviews were conducted individually with physicians who treat epilepsy in Malaysia. The interviews explored challenges in managing epilepsy, information priorities, and feedback on the proposed digital service. Thematic analysis was used to identify relevant themes and subthemes.</div></div><div><h3>Results</h3><div>The study identified significant challenges related to clinical and treatment, patient management, and the workplace. Knowledge about patients’ well-being outside of the clinic was considered as most important among physicians, while having data on patients’ daily lives was cited as least important. Overall, physicians expressed interest in the digital service, describing its usefulness in clinical decision-making, enhancing patient outcomes, and providing objective seizure documentation. However, barriers related to increased workload, lack of trust in technology, and poor usability among patients also emerged. Requirements identified for the web-based portal that is linked to the digital service were categorized into seizure data and monitoring, patient management, and usability.</div></div><div><h3>Significance</h3><div>This study revealed significant challenges, clinical information needs, and requirements for the accompanying web-based portal. Design guidelines were generated in following aspects: [<span><span>1</span></span>] support clinical decision-making and comprehensive care, [<span><span>2</span></span>] interoperability and integration with clinical workflows, [<span><span>3</span></span>] building trust in technology, and [<span><span>4</span></span>] increase usability and accessibility. Overall, insights gained from this study will serve as a guide for the design and development of a seizure prediction digital service. Future research can consider exploring the perspectives of physicians in private settings and evaluating the effectiveness of the technology in a real-world setting.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110689"},"PeriodicalIF":2.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988448","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 impact of socioeconomic status on the management of epilepsy: a qualitative study","authors":"Jessica Spooner ,&nbsp;Soham Bandyopadhyay ,&nbsp;Mohammad Baraka ,&nbsp;Josemir W. Sander","doi":"10.1016/j.yebeh.2025.110685","DOIUrl":"10.1016/j.yebeh.2025.110685","url":null,"abstract":"<div><h3>Introduction</h3><div>Socioeconomic status (SES) is a recognised determinant of epilepsy outcome, yet it remains unclear whether epilepsy management is effectively contextualised to meet the needs of individuals across different SES backgrounds. This study explored how adults with epilepsy perceive the influence of SES on their care and self-management.</div></div><div><h3>Methods</h3><div>In-depth, semi-structured videoconference or telephone interviews were conducted until data saturation with fifteen adults (11 women, 18–75 <!--> <!-->years) recruited through national epilepsy charities. SES was classified with the “MacArthur Subjective Social Status ladder” and “Social Determinants of Health” indicators, yielding eight low/lower‑middle (“lower‑SES”) and seven upper‑middle/high (“higher‑SES”) participants. Two researchers analysed transcripts inductively using reflexive thematic analysis. Member checking confirmed analytic credibility.</div></div><div><h3>Results</h3><div>Eight interrelated themes emerged: support networks and relationships; financial implications and access to care; employment and economic stability; transportation and independence; treatment and medication adherence; interactions with the healthcare system; perceived power imbalance and stigma; and trust and future care decisions. In every theme, lower–SES participants reported a more significant number of – and more disruptive – barriers than higher–SES participants. They described issues regarding obtaining transport and medicines, navigating opaque benefit systems, lacking dependable social support, limited access to specialist care, and feeling dismissed or stigmatised by clinicians, which eroded trust and prompted disengagement from care. Higher–SES participants, while not immune to challenges, more often mobilised resources to buffer their impact.</div></div><div><h3>Conclusion</h3><div>Lower socioeconomic status intensifies financial, informational, and relational barriers to managing epilepsy effectively, undermining adherence and care consistency. Routine SES assessment, tailored education, and integrated social–support interventions are crucial to reduce these inequities and improve outcomes for socioeconomically disadvantaged people with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110685"},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931759","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}