Epilepsy Research最新文献

{"title":"Long-term efficacy and tolerability of brivaracetam in pediatric patients with focal-onset seizures and cognitive or learning comorbidities: Post hoc analysis of an open-label trial.","authors":"Dimitrios Bourikas, Juliane Koch, Christine de la Loge, Svetlana Dimova, Sami Elmoufti, Brian Moseley, Lieven Lagae","doi":"10.1016/j.eplepsyres.2024.107482","DOIUrl":"10.1016/j.eplepsyres.2024.107482","url":null,"abstract":"<p><strong>Objective: </strong>Efficacy, tolerability, and behavioral/executive functioning during long-term adjunctive brivaracetam treatment were assessed in pediatric patients with focal-onset seizures (FOS) with/without cognitive/learning comorbidities (CLC).</p><p><strong>Methods: </strong>Post hoc analysis of a phase 3 open-label follow-up trial (N01266/NCT01364597). Patients with FOS (<16 years at core trial entry; direct enrollers ≥4-<17 years) received ≤5 mg/kg/day brivaracetam (≤200 mg/day). Subgroup analyses were performed for patients with and without ongoing CLC at baseline.</p><p><strong>Results: </strong>Patients with CLC (84/185 [45.4 %]) had longer epilepsy duration and higher number of prior antiseizure medications. Kaplan-Meier-estimated brivaracetam retention at 1, 3, and 5 years was 75.0 %/78.2 %, 61.9 %/61.9 %, and 52.2 %/53.3 % in patients with/without CLC. Efficacy assessments (patients >2 years of age) showed numerically lower median percent reduction in FOS frequency/28 days (43.8 %/74.1 % [n = 63/60]), 50 % responder rates for FOS (46.0 %/61.7 % [n = 63/60]), and ≥12-month continuous freedom from all seizures (31.7 %/55.9 % [n = 60/68 patients with ≥12 months treatment]) in patients with/without CLC. Treatment-emergent adverse events were reported in 94.0 %/95.0 % of patients with/without CLC (serious: 33.3 %/27.7 %; drug-related: 31.0 %/33.7 %). From baseline to last evaluation, most patients with/without CLC had no shift in T-score category for each Achenbach Child Behavior Checklist (CBCL) 1.5-5 syndrome (≥50.0 %/≥72.2 %), CBCL 6-18 syndrome (≥66.0 %/≥69.1 %), and Behavior Rating Inventory of Executive Function scale (≥66.7 %/≥69.0 %).</p><p><strong>Conclusions: </strong>These data indicate that brivaracetam could be an efficacious and well-tolerated treatment option for pediatric patients with FOS with and without CLC. Behavior and executive functioning were generally stable or slightly improved in patients with and without CLC.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107482"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784564","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":"Late onset epilepsy findings in a developmental country, a report of first results.","authors":"Hasan Saad Hosny, Mahmoud Salah Adly, Sarah Sherif Abdo, Sarah Khalil, Amr Mohamed Fouad","doi":"10.1016/j.eplepsyres.2024.107496","DOIUrl":"10.1016/j.eplepsyres.2024.107496","url":null,"abstract":"<p><strong>Introduction: </strong>Older patients with Late onset epilepsy (LOE) provide a special set of difficulties for both the treating doctors and the patients.</p><p><strong>Objectives: </strong>To address the characteristics and treatment outcomes of LOE in a cohort of Egyptian population at a tertiary center and to assess factors affecting seizure freedom in this age group.</p><p><strong>Methods: </strong>From December 1, 1995, to November 30, 2020, we analysed all patients with newly diagnosed epilepsy above the age of 50 at Cairo University's neurology department. The term \"seizure freedom\" was used to refer to the absence of seizures or auras for at least 12 months. Patients were classified as either having achieved seizure freedom or not.</p><p><strong>Results: </strong>One hundred and twenty-one patients were included. The median follow-up time was 24 months. 69.4 % attain seizure freedom. 52.1 % of our patients had symptomatic epilepsy. Among this group, 31.4 % (n = 38) had epilepsy caused by cerebrovascular disease (ischemic or hemorrhagic). Patients with epileptogenic lesions in neuroimaging, and those who are receiving ≥ 2 ASMs had significantly higher probability of not achieving seizure freedom for 12 months compared to those with normal or non-epileptogenic lesions in neuroimaging and receiving ≤ 1 ASMs with significant trends a trend toward lower seizure freedom in both.</p><p><strong>Conclusion: </strong>Patients with Late- onset epilepsy have an excellent chance of achieving seizure freedom, especially those controlled on 1 ASM and those with normal neuroimaging.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107496"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893172","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 characterization of psychosis and response to antipsychotic therapy in monogenic forms of familial focal epilepsy: A systematic review.","authors":"Mark Ainsley Colijn","doi":"10.1016/j.eplepsyres.2024.107493","DOIUrl":"10.1016/j.eplepsyres.2024.107493","url":null,"abstract":"<p><p>While the genetic architecture of epilepsy is complex and presumably polygenic in many cases, pathogenic variants have increasingly been identified, and this is perhaps best exemplified by the monogenic familial focal epilepsies. Although individuals with epilepsy (particularly focal epilepsy) are at increased risk of developing psychosis, little has been written on this topic in relation to monogenic familial focal epilepsy, specifically. As such, this systematic review aimed to characterize the phenomenology of psychosis (and response to antipsychotic therapy) in affected individuals. Only eight articles were identified and minimal information with respect to psychiatric phenotyping was provided in most cases. As such, although no firm conclusions can be drawn, it is notable that none of the reports described a temporal relationship between seizure and psychosis onset; the typical convention used in epilepsy. As most reports also did not include primary psychotic disorder diagnoses, it remains unclear if the individuals' presentations were understood to represent epileptic psychoses or schizophrenia, and to what degree (if at all) their genetic variants were thought to have contributed directly to psychosis risk. More robust case descriptions are needed to better characterize the nature of psychotic symptoms (and their response to treatment) in monogenic familial focal epilepsy.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107493"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846314","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":"Plasma proteomics in epilepsy: Network-based identification of proteins associated with seizures.","authors":"Saman Hosseini Ashtiani, Sarah Akel, Evelin Berger, Johan Zelano","doi":"10.1016/j.eplepsyres.2024.107480","DOIUrl":"10.1016/j.eplepsyres.2024.107480","url":null,"abstract":"<p><strong>Purpose: </strong>Identification of potential biomarkers of seizures.</p><p><strong>Methods: </strong>In this exploratory study, we quantified plasma protein intensities in 15 patients with recent seizures compared to 15 patients with long-standing seizure freedom. Using TMT-based proteomics we found fifty-one differentially expressed proteins.</p><p><strong>Results: </strong>Network analyses including co-expression networks and protein-protein interaction networks, using the STRING database, followed by network centrality and modularity analyses revealed 22 protein modules, with one module showing a significant association with seizures. The protein-protein interaction network centered around this module identified a subnetwork of 125 proteins, grouped into four clusters. Notably, one cluster (mainly enriching inflammatory pathways and Gene Ontology terms) demonstrated the highest enrichment of known epilepsy-related genes.</p><p><strong>Conclusion: </strong>Overall, our network-based approach identified a protein module linked with seizures. The module contained known markers of epilepsy and inflammation. The results also demonstrate the potential of network analysis in discovering new biomarkers for improved epilepsy management.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107480"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767166","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":"Epilepsy core outcome set for effectiveness trials (EPSET): A systematic review of outcomes measured in registered phase III and IV clinical trials for adults with epilepsy.","authors":"James W Mitchell, Rachel Batchelor, Guleed Adan, Adam Noble, Paula R Williamson, Tony Marson","doi":"10.1016/j.eplepsyres.2024.107481","DOIUrl":"10.1016/j.eplepsyres.2024.107481","url":null,"abstract":"<p><p>At present, little is known about the outcomes measured in studies assessing the effectiveness of treatments for adults with epilepsy. As part of a wider project developing a Core Outcome Set for clinical trials for adults with epilepsy, we summarised the current outcomes and measurement instruments used in completed phase III and IV clinical trials registered in the clinicaltrials.gov and International Standard Randomised Controlled Trial Number (ISRCTN) databases. Of the reviewed studies 104 were deemed eligible. The outcomes that were measured were recorded, and trial registry entries cross referenced against associated peer review publications. In total, 374 unique granular outcome terms were identified, which grouped into 45 outcome concepts across the following domains: seizures, cognitive/behavioural/psychiatric, sleep, general symptom, functional status / disability, emotional functioning, social functioning, delivery of care, life impact, trial processes, side effects / adverse events, pregnancy / offspring, and death. We identified evidence of outcome measurement heterogeneity, with just 10/45 outcome concepts measured in more than half of the identified studies. This association remained when assessing studies grouped by epilepsy chronicity (newly diagnosed vs. chronic/treatment refractory) and epilepsy classification (focal vs. other). These findings highlight the need for a Core Outcome Set for interventional studies for adults with epilepsy to improve consistency of outcome measurement and reporting.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107481"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767163","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":"Effectiveness and tolerability of cenobamate: A single center experience.","authors":"Christopher Saouda, Omar Nofal, Yamane Makke, Alexandra Eid, Victoria Vinarsky, Helen Edelberg, Sean M Lee, Mohamad Koubeissi","doi":"10.1016/j.eplepsyres.2024.107498","DOIUrl":"10.1016/j.eplepsyres.2024.107498","url":null,"abstract":"<p><strong>Introduction: </strong>Medication-resistant epilepsy (MRE) is characterized by the failure of adequate trials of two antiseizure medications (ASMs). Numerous studies have shown that once two ASMs fail to control seizures, the likelihood of subsequent ASM regimens providing seizure control diminishes significantly. Recent clinical data on cenobamate (CNB) suggest it may offer higher rates of seizure freedom in MRE patients. This study aims to report real-world, single-center findings on the effectiveness and tolerability of CNB in treating MRE.</p><p><strong>Methods: </strong>This retrospective study includes adult patients diagnosed with MRE and treated with CNB between 2020 and 2023 at The George Washington University (GWU). Data were collected from electronic medical records. Statistical analyses were conducted to evaluate CNB's impact on seizure control and patient outcomes.</p><p><strong>Results: </strong>121 patients with medication-resistant epilepsy (MRE) were prescribed cenobamate (CNB). After exclusions, 104 patients were included in the effectiveness analysis and 111 in the tolerability analysis. Results showed that 34.6 % of patients achieved seizure freedom for at least three months, with a mean duration of seizure freedom of 11 ( ± 7.9) months.</p><p><strong>Significance: </strong>CNB use in a large population of more than 100 patients demonstrated impressive anti-seizure activity with a good proportion of patients with MRE achieving seizure freedom despite having failed multiple prior ASMs.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"107498"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871695","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":"Long-term efficacy and safety of perampanel monotherapy in patients with newly diagnosed or currently untreated recurrent focal-onset seizures: Results from the open-label extension phase of FREEDOM (Study 342).","authors":"Takamichi Yamamoto, Sung Chul Lim, Hirotomo Ninomiya, Yuichi Kubota, Won Chul Shin, Dong Wook Kim, Dong Jin Shin, Koji Iida, Taku Ochiai, Risa Matsunaga, Hidetaka Hiramatsu, Ji Hyun Kim","doi":"10.1016/j.eplepsyres.2024.107494","DOIUrl":"https://doi.org/10.1016/j.eplepsyres.2024.107494","url":null,"abstract":"<p><strong>Objective: </strong>FREEDOM (Study 342; NCT03201900) assessed the long-term treatment effect of perampanel monotherapy in adolescent and adult patients (12-74 years of age) with untreated focal-onset seizures (FOS), with or without focal to bilateral tonic-clonic seizures (FBTCS).</p><p><strong>Methods: </strong>In the Core Study, after a 4-week Pretreatment Phase, perampanel was up-titrated to 4 mg/day during a 6-week Titration Period followed by a 26-week Maintenance Period. Patients experiencing seizure(s) during the 4-mg/day Maintenance Period could have perampanel up-titrated to 8 mg/day over 4 weeks then could enter the 26-week 8-mg/day Maintenance Period. Patients could enter Extension to continue treatment upon the completion of the Core Study. Seizure-freedom rates, time to seizure recurrence or withdrawal since the initiation of maintenance treatment, and safety outcomes were assessed.</p><p><strong>Results: </strong>In FREEDOM, 89 patients who received ≥ 1 perampanel dose were included for safety assessments (Safety Analysis Set), and 73 of them entered the 4-‍‍‍mg/day Maintenance Period (the modified Intent-to-Treat Analysis set) with 21 patients having perampanel up-titrated to 8 mg/day; 46 patients entered Extension with 38 patients completing. Overall, 42/89 (47.2 %) patients had cumulative exposure to perampanel for > 52 weeks. Among patients who entered Extension, 52.2 % (n = 24/46; 95 % confidence interval [CI] 36.9, 67.1) remained seizure free for 52 weeks at perampanel 4 mg/day and 67.4 % (n = 31/46; 95 % CI 52.0, 80.5) at 4-8 mg/day. The cumulative probabilities of seizure recurrence and withdrawal at 4-8 mg/day over 52 weeks were 28.9 % (95 % CI 19.0, 42.4) and 43.8 % (95 % CI 33.4, 55.9), respectively. Treatment-emergent adverse events (TEAEs) occurred in 74/89 (83.1 %) patients, with 9/89 (10.1 %) discontinuing because of TEAEs. Dizziness occurred in 34/89 (38.2 %) patients and was the most common event.</p><p><strong>Conclusions: </strong>Patients with untreated FOS (with or without FBTCS) are able to maintain seizure freedom for up to 52 weeks with perampanel monotherapy at a dose of 4-8 mg/day. The tolerability profile was manageable, and the safety profile was consistent with previous findings.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"107494"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946965","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":"Epilepsy Arabic renaming to cerebroelectric disorder could minimize the stigma.","authors":"Doaa A Mekkawy, Nirmeen Kishk, Noha T Abokrysha, Gihan M Ramzy, Reham Mohamed Shamloul, Rehab Magdy, Alshimaa S Othman, Amr Mohamed Fouad, Osama Yacoub, Maged Abdel-Naseer, Hatem S Shehata, Nevin M Shalaby, Amr Hassan, Amal S Ashour, Ahmed Dahshan, Mona Hussein, Mohamed Khodery, Hazem Kamal Alhewag, Dalia Abdelfatah, Nesma Mounir","doi":"10.1016/j.eplepsyres.2024.107495","DOIUrl":"https://doi.org/10.1016/j.eplepsyres.2024.107495","url":null,"abstract":"<p><strong>Background: </strong>Naming is an important part of human communication. The precision of medical terms greatly influences the patients and their caregivers. \"Alsara'الصرع \" is the Arabic term defining epilepsy. However, it has a highly negative impact on patients, as reported by many caring physicians.</p><p><strong>Methods: </strong>A multiple-choice face-to-face questionnaire was designed to assess stigma among patients with epilepsy (PwE), causes, impact on quality of life, impression of PwE about the Arabic terminology of epilepsy Alsara', and their opinion regarding changing it to precise term \"itrab fi kahrabeit el mokh\" اضطراب في كهربية المخ\" which means disturbance of the electrical brain activity. Stigma was assessed using a three-item stigma scale.The interviewed subjects were recruited from Cairo, Beni Suef, and Sohag University hospitals consecutively during a period from 15 August 2023 to 30 December 2023.</p><p><strong>Results: </strong>Three hundred seventy-two PwE responded to the survey. Three hundred fifty-one (94.4 %) PwE felt a disease stigma. About 50 % of them attributed this stigma to the Arabic name of the disease. Eighty-four percent accepted changing the name Alsara' into \"itrab fi kahrabeit el mokh\" and 77.2 % suspected a positive impact of this amendment on society. The occurrence of generalized tonic-clonic seizures was found to be an independent risk factor for epilepsy-associated stigma.</p><p><strong>Conclusion: </strong>The Arabic nomenclature of epilepsy \"Alsara'\" is not an accurate term for epilepsy. In addition to being associated with many poor misconceptions and stigma. We hope this study will pave the way to replace it with a more appropriate and less defaming term.</p>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"210 ","pages":"107495"},"PeriodicalIF":2.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964275","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":"Surgical outcome and contributing presurgical evaluations in children with magnetic resonance imaging-negative epilepsy and periodic seizure cycles","authors":"Yoshihiko Saito ,&nbsp;Kenji Sugai ,&nbsp;Masaki Iwasaki ,&nbsp;Noriko Sato ,&nbsp;Akiyoshi Kakita ,&nbsp;Yuko Saito ,&nbsp;Taisuke Ohtsuki ,&nbsp;Masayuki Sasaki","doi":"10.1016/j.eplepsyres.2024.107492","DOIUrl":"10.1016/j.eplepsyres.2024.107492","url":null,"abstract":"<div><h3>Background</h3><div>The identification of surgical candidates is a critical issue in patients with magnetic resonance imaging (MRI)-negative drug-resistant focal epilepsy and latent accompanying resectable lesions, such as focal cortical dysplasia (FCD). Recently, periodic seizure cycles have been associated with FCD in both patients with MRI-positive and MRI-negative epilepsy. We investigated the presurgical evaluation and postsurgical outcome of patients with MRI-negative epilepsy with FCD and a history of periodic seizure cycles.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the characteristics of presurgical evaluation and postsurgical seizure outcome in 14 children with MRI-negative drug-resistant focal epilepsy and a history of periodic seizure cycles. All the patients had FCD histopathologically.</div></div><div><h3>Results</h3><div>The mean age at epilepsy surgery was 7.7 ± 4.7 years (0.7–16.1 years). Favorable postsurgical seizure outcome (ILAE classes 1–3) was obtained in 10 (71 %) patients five years after surgery. The relative risk of the complete concordance between imaging findings and resected area for five-year seizure freedom was 2.25 in positron emission tomography (PET) and 2.22 in subtraction ictal single-photon emission computed tomography co-registered to MRI (SISCOM), and 1.86 in magnetoencephalography (MEG).</div></div><div><h3>Conclusion</h3><div>All the children with MRI-negative focal epilepsy and a history of periodic seizure cycles were turned out to have FCD pathologically, and are good surgical candidates. Favorable seizure outcome can be expected in such patients when resective epilepsy surgery is planned based on presurgical evaluation with PET or SISCOM.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"Article 107492"},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757686","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":"Cannabis use, sleep and mood disturbances among persons with epilepsy – A clinical and polysomnography study from a Canadian tertiary care epilepsy center","authors":"Garima Shukla ,&nbsp;Rishabh Sablok ,&nbsp;Zaitoon Shivji ,&nbsp;Stuart Fogel ,&nbsp;Gavin P. Winston ,&nbsp;Lysa Boissé Lomax ,&nbsp;Ana Johnson ,&nbsp;Helen Driver","doi":"10.1016/j.eplepsyres.2024.107479","DOIUrl":"10.1016/j.eplepsyres.2024.107479","url":null,"abstract":"<div><h3>Objective</h3><div>Interest in anti-seizure properties of cannabinoids is increasing, with the rise in prevalence of recreational and medical cannabis use, especially across Canada. In a recent study on people with epilepsy (PWE), cannabis use showed a strong association with poor psychosocial health. Sleep and mood comorbidities are highly prevalent in epilepsy, and are common motivations for cannabis use. The primary objective of this study was to assess demographic, subjective and objectively assessed sleep quality and mood related differences among PWE who regularly use cannabis compared to those who do not.</div></div><div><h3>Methods</h3><div>Consecutive consenting patients with a confirmed epilepsy diagnosis, admitted to our Epilepsy Monitoring Unit, over a 3-year period (2019–2022) were enrolled. Detailed epilepsy-related data and self-reported sleep [Pittsburgh Sleep quality index (PSQI)], Epworth Sleepiness Scale (ESS)], mood [(Beck’s Depression Inventory (BDI) and Beck’s Anxiety inventory (BAI)] and cannabis use related data were collected. Overnight polysomnography (PSG) was conducted on the first night of admission, with simultaneous 18-channel video-EEG. Sleep (PSG) scoring followed American Academy of Sleep Medicine guidelines by a scorer blinded to clinical details.</div></div><div><h3>Results</h3><div>Among 51 patients with similar seizure control, 25 (13 F) reported cannabis use (mean age 36.3<u>+</u>14.8 years) and were significantly younger than 26 (18 F) non-users (mean age 48.3<u>+</u>15 years). Cannabis users had significantly better subjective sleep quality (mean PSQI scores 7.2<u>+</u>2.9 vs 10.2<u>+</u>5.2 respectively). Most patients endorsed sleepiness (Cannabis users with ESS scores greater than 10; 91.3 %, 77.3 % in non-users) and moderate to extreme depression (BDI) scores. No significant differences were observed in objective sleep parameters. BDI score significantly predicted PSQI and ESS scores on multiple logistic regression analysis.</div></div><div><h3><strong>Significance</strong></h3><div>Despite a significant age difference, self-reported sleep quality is better among PWE who report regular cannabis use compared to non-users. However, there is no significant difference in objective sleep quantity and quality from PSG between the two groups. Additionally, severity of depressive symptoms is a significant predictor of sleep quality and of excessive daytime sleepiness among PWE.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"209 ","pages":"Article 107479"},"PeriodicalIF":2.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}