Epilepsy Research最新文献

{"title":"Dynamic functional connectivity variability in the thalamocortical circuit: Insights from Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTs)","authors":"Ahmed Ameen Fateh ,&nbsp;Abla Smahi ,&nbsp;Muhammad Hassan ,&nbsp;Cristina Cañete-Massé ,&nbsp;Adam A.Q. Mohammed ,&nbsp;Feng Yue ,&nbsp;Zhanqi Hu ,&nbsp;Hongwu Zeng","doi":"10.1016/j.eplepsyres.2025.107665","DOIUrl":"10.1016/j.eplepsyres.2025.107665","url":null,"abstract":"<div><h3>Background</h3><div>Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTs) is a dominant childhood epilepsy form characterized by seizures originating from the brain’s centrotemporal region. Crucially, unlocking the neural dynamics and mechanisms underlying SeLECTs paves the way for potent diagnostic and therapeutic strategies. Our work investigates dynamic functional connectivity (dFC) variability in the thalamocortical circuit in SeLECTs individuals, thereby shedding light on the temporal dynamics and anomaly in connectivity patterns tied to seizure occurrence and propagation.</div></div><div><h3>Methods</h3><div>Utilizing resting-state functional magnetic resonance imaging (rs-fMRI) data from 45 SeLECTs patients and 55 healthy controls (HCs), dynamic changes in functional connectivity (FC) across various brain regions were examined over time. We selected 16 thalamic seeds to delve into dFC variability using a sliding window approach. We also evaluated clinical data from both groups to discern its correlation with dFC variability. As a final step, a Support Vector Machine (SVM) was employed for classification analysis to demonstrate the potential use of dFC variability as a distinguishing feature between SeLECTs patients and HCs.</div></div><div><h3>Results</h3><div>t-test analysis manifested significant variances in dFC variability between SeLECTs and HCs groups related to thalamus seeds, also showing a correlation between VCI and certain areas. Out of 16 thalamus seeds, significant variances emerged in 9 seeds. Specifically, an increase in dFC variability was observed between the right occipital thalamus seed and the right precentral gyrus in SeLECTs patients, implying a positive connectivity alteration. On the other hand, a lowered dFC was observed between the right inferior prefrontal thalamus seed and the left cuneus, reflecting a reduction in their connectivity strength.</div></div><div><h3>Conclusion</h3><div>Our study underscores the significance of dFC variability within the thalamocortical circuit in SeLECTs individuals. The noticeable aberrant connectivity patterns enrich our understanding of temporal dynamics linked to SeLECTs seizure occurrence and propagation, thereby contributing to understanding SeLECTs pathophysiology. These insights may steer the development of precise diagnostic and therapeutic strategies for this widespread childhood epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107665"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of preclinical methodologies for discovery and validation of circulating microRNA biomarkers for post-traumatic epileptogenesis – Lessons learned from the EpiBioS4Rx Project 1","authors":"Noora Puhakka ,&nbsp;Mette Heiskanen ,&nbsp;Xavier Ekolle Ndode-Ekane ,&nbsp;Idrish Ali ,&nbsp;Cesar Santana-Gomez ,&nbsp;Shalini Das Gupta ,&nbsp;Meheli Banerjee ,&nbsp;Pedro Andrade ,&nbsp;Riikka Immonen ,&nbsp;Pablo Casillas-Espinosa ,&nbsp;Gregory Smith ,&nbsp;Rhys D. Brady ,&nbsp;Juliana Silva ,&nbsp;Emma Braine ,&nbsp;Matthew R. Hudson ,&nbsp;Glen R. Yamakawa ,&nbsp;Nigel C. Jones ,&nbsp;Sandy R. Shultz ,&nbsp;Neil G. Harris ,&nbsp;David K. Wright ,&nbsp;Asla Pitkänen","doi":"10.1016/j.eplepsyres.2025.107667","DOIUrl":"10.1016/j.eplepsyres.2025.107667","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the success of harmonization and standardization of plasma miRNA biomarker discovery and validation for post-traumatic epilepsy (PTE) in the EpiBioS4Rx international multicenter project.</div></div><div><h3>Methods</h3><div>Adult male Sprague-Dawley rats were randomized to lateral fluid-percussion-induced traumatic brain injury (TBI) or sham operation at three study sites (Finland, Australia, USA). Video-electroencephalogram (vEEG) was performed in the 7th post-injury month to detect spontaneous seizures. Tail vein plasma was collected at baseline and 48 h after TBI for microRNA (miRNA) analysis. Common data elements were generated to document and monitor pre-analytic activities, including housing conditions, post-injury care, blood sampling, plasma preparation, plasma quality, storage, and shipping. miRNA analysis was performed using droplet digital PCR (ddPCR) at one study site (Finland) with on-site standardized procedures.</div></div><div><h3>Results</h3><div>The 2-day miRNA levels were successfully measured in 85 % (209/245) of the rats included in the final analysis cohort. Exclusions were related to small sample volume, hemolysis, and failed RNA extraction for ddPCR. Most of the pre-analytical factors leading to sample exclusions were related to non-optimal plasma pipetting. We also recognized gaps in data entry and monitoring of personnel training.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that conducting a successful plasma miRNA biomarker analysis requires procedural harmonization between laboratories, protocol standardization, inclusion and analysis of quality controls, training of researchers, and continuous monitoring of adherence to pre-agreed protocols.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107667"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging surface and depth: A systematic review of seizure patterns in simultaneous scalp and stereo-EEG","authors":"Cristiana Santos ,&nbsp;Daniel Filipe Borges ,&nbsp;Joana Isabel Soares","doi":"10.1016/j.eplepsyres.2025.107666","DOIUrl":"10.1016/j.eplepsyres.2025.107666","url":null,"abstract":"<div><h3>Background</h3><div>Drug-resistant epilepsy often requires invasive monitoring. Although simultaneous scalp EEG and stereo EEG are increasingly used together, their added value for preoperative evaluation and surgical planning remains uncertain and warrants systematic investigation.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus and Web of Science for English- or Portuguese-language studies in which patients with drug-resistant epilepsy were simultaneously monitored with scEEG and SEEG. Reports lacking primary data, systematic reviews, conference abstracts, case reports and studies limited to scEEG with electrocorticography were excluded. Two reviewers independently screened all records, extracted data and assessed methodological quality. The protocol was registered in PROSPERO (CRD42024590432) and conducted in accordance with PRISMA-P guidelines.</div></div><div><h3>Results</h3><div>From 9750 records, 16 articles underwent full-text analysis, and eight retrospective observational studies met the inclusion criteria. These eight studies - evenly split between the United States and Europe - included 250 patients. Data on diagnostic yield and postoperative outcomes were inconsistent. Key findings included (i) detailed mapping of seizure onset and propagation across cortical and subcortical regions, (ii) typical latency intervals between scEEG and SEEG detection, and (iii) concordance rates in localizing the epileptogenic zone.</div></div><div><h3>Conclusions</h3><div>Simultaneous scEEG-SEEG provides complementary cortical and mesial findings that sharpen the delineation of the epileptogenic zone and allow for targeted surgery. SEEG captures the deep generators, while scEEG provides the broader context for electrode placement. Current evidence is limited to small, methodologically heterogeneous series. Standardized protocols, larger multicenter cohorts and multimodal co-registration are needed to confirm the diagnostic gain and anchor this two-layered approach in routine clinical care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107666"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and EEG characteristics of sleep-related hypermotor epilepsy in children","authors":"Xinru Tan ,&nbsp;Hailang Liu ,&nbsp;Yan Li ,&nbsp;Qiaoling Hu ,&nbsp;Lisi Yan ,&nbsp;Jin Chen ,&nbsp;Siqi Hong ,&nbsp;Li Jiang","doi":"10.1016/j.eplepsyres.2025.107664","DOIUrl":"10.1016/j.eplepsyres.2025.107664","url":null,"abstract":"<div><h3>Background</h3><div>Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy with nocturnal hypermotor seizures. Although SHE was redefined in 2014, comprehensive pediatric studies are still lacking for this disorder. To address this need, here we describe the clinical and electroencephalography (EEG) characteristics of children with SHE.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled pediatric patients with SHE diagnosis who were hospitalized at our institution from August 1, 2021, to August 31, 2023.</div></div><div><h3>Results</h3><div>Among the 47 patients, 31.9 % and 42.6 % manifested as SP2 and SP3, respectively. A total of 57.4 % of the patients showed a focal discharge as diagnosed by interictal EEG, 36.2 % showed multifocal discharges, and 6.4 % did not have discharge. Ictal EEG revealed that 66.0 % of patients presented with frontal lobe onset, 10.6 % with temporal lobe onset, and 23.4 % with unknown onset. Further, 36.2 % of patients had a structural etiology, approximately 80 % of those patients had focal cortical dysplasia. Finally, 23 patients were diagnosed with refractory epilepsy, and 15 of them underwent surgery.</div></div><div><h3>Conclusions</h3><div>Patients mainly presented as SP3 and SP2. The focal discharges detected by interictal EEG accounted for approximately 57.4 % and the frontal lobe onset detected by ictal EEG accounted for approximately 66 %. Structural etiology (mainly focal cortical dysplasia) accounted for approximately 33 %, and surgery was an effective treatment for these patients.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107664"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astrocytic and microglial phenotypes in focal cortical dysplasia","authors":"Aditi Goyal ,&nbsp;Shilpa Rao ,&nbsp;Mariamma Philip ,&nbsp;A. Arivazhagan ,&nbsp;Jitender Saini ,&nbsp;LG Vishwanathan ,&nbsp;Ajay Asranna ,&nbsp;Raghavendra K ,&nbsp;RC Mundlamuri ,&nbsp;Nishanth Sadashiva ,&nbsp;RD Bharath ,&nbsp;Karthik K ,&nbsp;Sandhya M ,&nbsp;Malla Bhaskara Rao ,&nbsp;Sanjib Sinha ,&nbsp;Anita Mahadevan","doi":"10.1016/j.eplepsyres.2025.107663","DOIUrl":"10.1016/j.eplepsyres.2025.107663","url":null,"abstract":"<div><h3>Background</h3><div>Focal cortical dysplasia (FCD) is a common cause of focal epilepsy, however pathophysiology of epileptogenesis in FCD remains unresolved. Emerging evidence suggests that dysfunctional astrocytes are key players in epilepsy. Recently two phenotypes of astrocytes (A1/A2) and microglia (M1/M2) have been described in neurological diseases with neuroinflammatory and neuroprotective roles. We investigated astrocytic (A1/A2) and microglial (M1/M2) phenotypes in FCD and their role in epileptogenesis.</div></div><div><h3>Material and Methods</h3><div>Histologically confirmed cases of surgically resected FCD IIa (n = 10) and FCD IIb (n = 10) and age and region-matched post-mortem controls (n = 4) were evaluated by immunohistochemistry using C3d and GBP2 (A1-astrocytic markers), pSTAT3 (A2-astrocytes), CD14 (M1-microglia) and CD163 (M2-microglia), caspase 3 (for apoptosis) and phosphorylated-Tau and phosphorylated-neurofilament (for neuronal degeneration). Semi-quantitative assessment for glial phenotypes were correlated with clinical parameters.</div></div><div><h3>Results</h3><div>Compared to the control group, in FCDIIa, pSTAT3 + A2-astrocytes (mean-44.1 cells/mm²) predominated in absence of C3d/GBP2 + A1-astrocytes. In FCDIIb, A2-astrocytes were significantly higher than A1 (p-value=0.04) [A1 (C3d-15.79 cells/mm²; GBP2–13.67 cells/mm²); A2 (pSTAT3–78.24 cells/mm²)]. Balloon cells in FCDIIb strongly labelled with C3d and GBP2 (A1-phenotype). In both FCDIIa and IIb, pSTAT3 + A2 astrocytes were localised to subpial zone. Increase in both inflammatory CD14 + M1 and reparative CD163 + M2 microglia in perivascular region, was seen in the dysplastic cortex in both FCD IIa (M1- 11.9/mm², M2- 12.4 cells/mm²) and FCD IIb (M1–27.9/mm², M2–18.7/mm²) with M1 &gt;M2 in FCD IIb, though not statistically significant (p-value&gt;0.05). Mean densities of astrocytes (A1, A2) and microglia (M1, M2) did not correlate with any of the clinical parameters. Caspase 3 labelled reactive astrocytes and oligodendrocytes and occasional dysmorphic neurons in both, and BC in FCDIIb.</div></div><div><h3>Conclusions</h3><div>This is the first study examining astrocytic and microglial phenotypes in FCD IIa and IIb. Identification of specific astrocytic and microglial phenotypes offers novel therapeutic targets for modulation of epileptogenesis, especially in drug resistant epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107663"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The health care costs of epilepsy: Evidence from all-payer claims data","authors":"Ioannis Karakis ,&nbsp;Lidia MVR Moura ,&nbsp;Nada Boualam ,&nbsp;Martha Wetzel ,&nbsp;David Howard","doi":"10.1016/j.eplepsyres.2025.107661","DOIUrl":"10.1016/j.eplepsyres.2025.107661","url":null,"abstract":"<div><h3>Objective</h3><div>To provide updated estimates of the healthcare costs associated with epilepsy using large, state-based all-payer claims databases.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using all-payer claims data from Colorado, Massachusetts, and Virginia for 2016–2019, including individuals enrolled in Medicare, Medicaid, and individual and small-group commercial plans. Individuals with epilepsy were identified using a validated claims-based algorithm and matched with non-epilepsy controls based on age and sex. The two groups' healthcare use and costs were compared using generalized linear regressions and adjusting for age, sex, insurance status, and comorbidities.</div></div><div><h3>Results</h3><div>The study included 150,808 adults with epilepsy in Colorado, 122,222 in Virginia, and 118,707 in Massachusetts. State-level estimates of annual costs for adults with epilepsy were between $28,000 and $34,000 (2021 U.S. dollars), whereas costs for matched controls were between $2900 and $6300. Adults with epilepsy incurred higher costs than matched controls across all types of care. Adjusted analyses revealed that costs attributable to epilepsy ranged from $12,000 to $31,000, depending on the covariates included.</div></div><div><h3>Conclusion</h3><div>Our study provides updated and comprehensive cost estimates for epilepsy from diverse U.S. states, demonstrating the utility of all-payer claims data to generate state-specific and aggregate estimates of epilepsy burden to guide interventions. This study confirms that epilepsy imposes a substantial economic burden on the healthcare system, with costs higher than previous estimates.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107661"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodic limb movements among persons with epilepsy: A retrospective polysomnographic study","authors":"Manav Jain ,&nbsp;Laurel Charlesworth ,&nbsp;Helen Driver ,&nbsp;Gavin P. Winston ,&nbsp;Lysa Boissé Lomax ,&nbsp;Garima Shukla","doi":"10.1016/j.eplepsyres.2025.107662","DOIUrl":"10.1016/j.eplepsyres.2025.107662","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Persons with epilepsy (PWE) frequently contend with disrupted sleep related to multiple seizure related as well as other factors like medications and comorbidities. Such disturbances often lead to fragmented sleep, which can adversely affect quality of life and compromise seizure management. Previous&lt;/div&gt;&lt;div&gt;Although previous research has addressed conditions like sleep apnea and insomnia among PWE, less attention has been paid to periodic limb movements (PLMs), a requirement for diagnosis of the periodic limb movement disorder and also commonly observed in restless legs syndrome (RLS) as well as other conditions. This study aims to determine the prevalence and specific features of PLMs in PWE and to explore how these movements correlate with objective sleep measurements.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This investigation employed a retrospective chart review of consecutive adult patients diagnosed with epilepsy who underwent polysomnography at a tertiary-care sleep laboratory over a ten-year span. The control group consisted of individuals evaluated for possible obstructive sleep apnea, who were matched to cases based on age, sex, and the severity of sleep apnea. Patient records were initially identified using keywords related to “epilepsy” or “seizures.” Epilepsy diagnosis was confirmed through detailed chart review, which also yielded clinical details likety duration of epilepsy, seizure classification, and antiseizure medication usage. Sleep parameters such as sleep efficiency, spontaneous arousal index, periodic limb movement index, periodic limb movement with arousal index, and apnea-hypopnea index were extracted from archived polysomnography reports. The subsequent analysis was carried out using descriptive statistical methods using RStudio version 4.4.1.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 152 relevant patient records were found in the database. Of these, 61 patients with epilepsy (mean age 41.4 ± 17.2 years, including 31 females) met the inclusion criteria and were matched with 61 patients suspected for OSA. Within the epilepsy cohort, 43 patients experienced focal-onset epilepsy while 16 had generalized epilepsy. 25 patients were prescribed two or more antiseizure medications, and 12 were categorized as medically refractory. PLMs were detected in 23 % of patients with epilepsy compared to 26 % in the control group, with mean PLMI values of 6.1 ± 16.8 and 8.8 ± 20.7, respectively. The PLMAI was also similar between the two groups (0.5 ± 1.0 vs. 1.1 ± 2.4). Other sleep parameters, including the mean AHI (16.0 ± 20.0 in the epilepsy group vs. 19.7 ± 19.4 in the control group), did not exhibit significant differences between groups. Within the epilepsy cohort, the only factor linked to the presence of periodic limb movements was older age, with no observed association with seizure type, number of antiseizure medications, or seizure control.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;PLMs are a","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107662"},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison between magnetic resonance-guided laser interstitial thermal therapy and resective surgery for drug-resistant epilepsy in patients with MRI-positive focal cortical dysplasia: A systematic review and meta-analysis","authors":"Patricio S. Haro-Perez ,&nbsp;Fausto A. Saltos-Ponce ,&nbsp;Christopher D. Del Valle-Lascano ,&nbsp;Ruthiar S. Cortes-Chiluiza ,&nbsp;Jose E. Naranjo-Carrillo ,&nbsp;Andrea Ortiz-Ordonez","doi":"10.1016/j.eplepsyres.2025.107660","DOIUrl":"10.1016/j.eplepsyres.2025.107660","url":null,"abstract":"<div><h3>Objective</h3><div>To compare seizure outcomes and complication rates between magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) and resective surgery (RS) in patients with MRI-positive focal cortical dysplasia (FCD).</div></div><div><h3>Methods</h3><div>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting seizure outcomes and complications in patients with MRI-positive FCD were included. Meta-analysis of the data was conducted using random effects models. Meta-regression explored associations between mean age at surgery and mean duration of epilepsy with seizure outcomes.</div></div><div><h3>Results</h3><div>Thirty-four studies were included, totaling 1162 patients for analysis. Engel I rates were 71.3 % for MRgLITT and 65.6 % for RS, with no difference between both arms (OR 1.11, 95 % CI 0.49–2.52; p = 0.79). Overall complication rates were similar (12 % vs. 11 %; RD: +1 %, 95 % CI, −7 % to +12 %; p = 0.84). MRgLITT had a significant higher rate of transient neurologic deficits (15 % vs. 6.4 %; RD: +8.6 %, 95 % CI, −0.6 % to +17.8 %; p = 0.012), while permanent deficits did not differ significantly (1.7 % vs. 4.4 %; RD: −3 %, 95 % CI, −6 % to +1 %; p = 0.30). In RS studies, mean age at surgery was not associated with seizure freedom (OR per 10 years 1.18, 95 % CI 0.77–1.79; p = 0.43), nor was mean epilepsy duration (OR per 5 years 1.05, 95 % CI 0.94–1.18; p = 0.343). Risk of bias was serious across studies. Across FCD type II RS studies, the pooled proportion of Engel I was 74.0 % (95 % CI 64.0–82.1; I² = 0.7 %).</div></div><div><h3>Conclusion</h3><div>In MRI-positive FCD, MRgLITT and RS yielded comparable seizure freedom and rates of permanent complications, but MRgLITT showed a higher risk of transient neurologic deficits. Study-level meta-regressions found no association between seizure freedom and mean age at surgery or epilepsy duration. Interpretation is limited by the indirect comparison, observational designs with serious risk of bias, and substantial heterogeneity in some analyses. Prospective, adequately powered head-to-head studies with standardized outcomes are needed to confirm these findings and guide surgical decision-making.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107660"},"PeriodicalIF":2.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of executive functions on quality of life in Pediatric Epilepsy: A cross-sectional study","authors":"Lena Mühe ,&nbsp;Elisabeth Kaufmann ,&nbsp;Mirjam N. Landgraf ,&nbsp;Moritz Tacke ,&nbsp;Christine Makowski ,&nbsp;Malin Zaddach ,&nbsp;Leonie Grosse ,&nbsp;Miriam Gerstner ,&nbsp;Robert Optiz ,&nbsp;Ingo Borggraefe","doi":"10.1016/j.eplepsyres.2025.107646","DOIUrl":"10.1016/j.eplepsyres.2025.107646","url":null,"abstract":"<div><h3>Background</h3><div>The EpiTrack Junior is a screening tool assessing executive function in children with epilepsy. This study aimed to investigate whether children and adolescents with epilepsy are at a higher risk of experiencing a reduced quality of life if they also reveal abnormal results reflecting executive dysfunction.</div></div><div><h3>Methods</h3><div>We screened patients for executive dysfunction using the clinical test tool EpiTrack Junior. To assess health-related quality of life (HRQoL), the German children’s and parents’ version of KINDL questionnaire was used. The KINDL scores (total score and dimensions scores) of patients with and without clinically conspicuous values were compared (≤ 28 and &gt; 29, respectively). In addition, the exact EpiTrack Junior point scores were correlated with the KINDL total score and the scores of all KINDL dimensions.</div></div><div><h3>Results</h3><div>In this study 112 (mean age = 11.72, SD = 3.6) patients with epilepsy and their parents were included. Patients with executive dysfunctions (EpiTrack Junior values ≤ 28) scored significantly poorer in the QoL categories ‘family’ and ‘social environment’ than patients without. In the ‘family’ dimension, the child-report revealed the following data: z = -2.759; adjusted <em>p-</em>value: 0.042, and in the ‘friends’ dimension, parent-reports yielded the following data: z = -3.645; adjusted <em>p</em>-value: 0.007. In contrast, the 'self-esteem' dimension in the children's version showed significantly higher values in patients with executive dysfunctions than for those without: z = -2.524; adjusted <em>p-</em>value: 0.042. No significant differences between patients with and without executive dysfunctions were found for the overall quality of life (as assessed by the KINDL 'total score') as well as for the other dimensions (school, physical and emotional well-being).</div></div><div><h3>Conclusions</h3><div>No differences were found in the overall quality of life between patients with and without executive dysfunction. Nevertheless, executive dysfunction appeared to have a negative impact on some areas of life, such as family and friends, and was a predictor of increased self-esteem.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107646"},"PeriodicalIF":2.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring metabolic biomarkers and pathways in pharmacoresistant epilepsy: A systematic review","authors":"Zheng-Dong Lim ,&nbsp;Nur Asyiqin Syafiqa Abdullah ,&nbsp;Kheng-Seang Lim ,&nbsp;Paul Chi-Lui Ho ,&nbsp;Alina Arulsamy ,&nbsp;Si-Lei Fong ,&nbsp;Hui-Yin Yow","doi":"10.1016/j.eplepsyres.2025.107656","DOIUrl":"10.1016/j.eplepsyres.2025.107656","url":null,"abstract":"<div><div>Drug-resistant epilepsy (DRE) is characterized by the failure to attain sustained seizure freedom despite adequate trials of two antiseizure medication (ASM) regimens that are well tolerated and appropriately chosen and administered, either as monotherapies or in combination. Despite being a cornerstone of epilepsy treatment, ASMs are ineffective in achieving seizure remission in nearly one-third of patients, who are consequently classified as having DRE. This systematic review aims to determine potential metabolic biomarkers and pathways linked to DRE, which could inform personalized treatment and optimize therapeutic outcomes. A comprehensive search of databases, namely Medline, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) based on predefined inclusion and exclusion criteria yielded 29 eligible studies after full-text screening. The risk of bias from these studies was reviewed using the Office of Health Assessment and Translation (OHAT) risk of bias rating tool. Key information, including study groups, sample size, model types, and main findings were tabulated. Several metabolites were identified, including amino acids (glycine, glutamate, isoleucine), organic acids (lactate), and glucose, which may serve as potential biomarkers for DRE. MetaboAnalyst 6.0 pathway analysis identified the alanine, aspartate and glutamate metabolism, as well as phenylalanine, tyrosine and tryptophan biosynthesis pathways, emerged with significant impact score (≥0.5, p &lt; 0.05). The findings highlight the promising role of these metabolites and pathways as predictive biomarkers for DRE and potential therapeutic targets for novel drug development.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107656"},"PeriodicalIF":2.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}