Epilepsy Research最新文献

{"title":"White matter integrity and its correlation to seizures in diffuse glioma","authors":"Ludwig Klein ,&nbsp;Gordian Prasse ,&nbsp;Alim E. Basaran ,&nbsp;Jost-Julian Rumpf ,&nbsp;Martin Vychopen ,&nbsp;Johannes Wach ,&nbsp;Erdem Güresir ,&nbsp;Tim Wende","doi":"10.1016/j.eplepsyres.2025.107627","DOIUrl":"10.1016/j.eplepsyres.2025.107627","url":null,"abstract":"<div><h3>Introduction</h3><div>Seizures are one of the most common symptoms in patients with diffuse glioma, occurring in 30–80 % of cases. Although seizure control can be achieved in up to 90 %, seizures remain a significant burden and are hardly predictable. The aim of this analysis was, therefore, to investigate the association between white matter integrity and seizure occurrence in patients with diffuse glioma using diffusion tensor imaging (DTI).</div></div><div><h3>Methods</h3><div>Patients with first diagnosis of diffuse glioma (WHO-grade 2, 3, 4) who received preoperative DTI sequences for surgical planning were analyzed. Tractography of corpus callosum and cingulum was carried out, extracting mean FA values of the resulting volumes.</div></div><div><h3>Results</h3><div>50 patients (17 female) were included with a mean age of 59.5 ± 2.2 years. Glioma WHO grade 4 was most common (82 %), followed by grade 3 (10 %) and grade 2 (8 %). Most gliomas were located left temporal (32 %) and bilateral frontal (each hemisphere 16 %). 16 % presented with multifocal glioma. 48 % had suffered seizures prior to surgery, and were thus diagnosed with structural epilepsy. 22 % of all patients presented recurring seizures despite surgery and anti-seizure medication, and 6 % developed new seizures after surgery. After correction for multiple comparisons, increased FA in the left parahippocampal cingulum was significantly associated with preoperative seizures (0.30 ± 0.01 versus 0.27 ± 0.01, p_corr = 0.007), while increased FA in the forceps minor of the corpus callosum correlated with postoperative seizures (0.49 ± 0.01 versus 0.43 ± 0.01, p_corr = 0.014).</div></div><div><h3>Conclusion</h3><div>Higher preoperative white matter integrity was associated with increased risk for occurrence of seizures in diffuse glioma. Further research is warranted to investigate the relation with tumor pathology.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107627"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632069","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":"Childhood-onset epilepsy: Longitudinal seizure outcomes in a large single-center cohort","authors":"Hyun-Jin Kim,&nbsp;Min-Jee Kim,&nbsp;Eon Ah Kim,&nbsp;Ohcheol Kwon,&nbsp;Yun Sung Nam,&nbsp;Mi-Sun Yum ,&nbsp;Tae-Sung Ko","doi":"10.1016/j.eplepsyres.2025.107622","DOIUrl":"10.1016/j.eplepsyres.2025.107622","url":null,"abstract":"<div><h3>Objectives</h3><div>Epilepsy is the most common serious neurological disorder in children; however, previous long-term studies are often limited by small sample sizes or methodological variability. This study aimed to assess the epidemiology, seizure outcomes, and prognostic factors of childhood-onset epilepsy over &gt; 10 years of follow-up at a single tertiary center.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the medical records of 4248 patients diagnosed with epilepsy before age 19 between 1995 and 2017 at Asan Medical Center Children’s Hospital. All patients underwent at least one electroencephalogram (EEG) and received anti-seizure medications (ASMs) for &gt; 2 years.</div></div><div><h3>Results</h3><div>During a mean follow-up of 11.0 years, 43 patients (1.0 %) died. The median age at seizure onset was 7.2 years. Etiologies included unknown (52.5 %), structural (29.3 %), genetic/metabolic (23.4 %), and infectious/autoimmune (4.5 %). Focal epilepsy was the most common (63.4 %). Neurocognitive and psychological comorbidities were observed in 32.7 % and 20.6 % of patients, respectively. Seizure freedom for ≥ 2 years was achieved in 81.2 %, and terminal remission in 63.1 %. However, relapse occurred in 38.0 %, and 28.6 % developed intractable epilepsy. Prognostic factors included status epilepticus, intellectual disability, pretreatment seizure frequency, etiology, epilepsy syndromes, and EEG abnormalities.</div></div><div><h3>Conclusions</h3><div>This study reaffirms known risk factors while providing comprehensive insights into seizure trajectories, relapse patterns, and treatment responses in a large cohort. It highlights the clinical relevance of the 2-year seizure-free definition and underscores the need for early interventions in high-risk subgroups. Despite diagnostic advances, several cases remain etiologically unresolved, reinforcing the importance of expanding access to molecular and imaging tools in pediatric epilepsy care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107622"},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604321","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":"Machine learning models for predicting therapeutic response in drug-resistant epilepsy: A bivariate diagnostic meta-analysis","authors":"Anderson Matheus Pereira da Silva ,&nbsp;Victor Arthur Ohannesian ,&nbsp;Luciano Falcão ,&nbsp;Filipe Virgilio Ribeiro ,&nbsp;Isabelle Rodrigues Menezes ,&nbsp;Mariana Leticia de Bastos Maximiano ,&nbsp;Mariana Lee Han ,&nbsp;Lucas Silva Cabeça ,&nbsp;Pedro Lucas Machado Magalhães ,&nbsp;Gustavo Sousa Noleto ,&nbsp;Maria Bernadete de Sousa Maia ,&nbsp;Eryvelton de Souza Franco","doi":"10.1016/j.eplepsyres.2025.107623","DOIUrl":"10.1016/j.eplepsyres.2025.107623","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy affects approximately 6.4 per 1000 individuals worldwide. Despite advances in antiseizure medications (ASMs), nearly one-third of patients remain refractory to treatment, meeting criteria for drug-resistant epilepsy (DRE). This meta-analysis evaluated the performance of machine learning (ML) models in predicting therapeutic response in DRE based on ILAE-defined outcomes.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted in accordance with PRISMA-DTA guidelines. Studies applying ML algorithms to predict treatment response in DRE were included. Eligible designs comprised retrospective or prospective observational studies. Outcomes included seizure remission (ILAE Class 1), ≥ 50 % reduction in seizure frequency, treatment failure, and diagnostic accuracy metrics. A bivariate random-effects model was used to pool sensitivity, specificity, and diagnostic odds ratio (DOR). Heterogeneity was assessed (I², χ²), and subgroup and meta-regression analyses were performed. Likelihood ratios, area under the curve (AUC), and Bayesian post-test probabilities were estimated. Publication bias was evaluated with Deeks’ test.</div></div><div><h3>Results</h3><div>Eight studies (n = 1887) met inclusion criteria (Kappa=0.98). Pooled sensitivity and specificity were both 0.84 (95 % CI: 0.76–0.89 and 0.77–0.89, respectively), with an AUC of 0.91. DOR was 27; LR+ , 5.2; LR−, 0.19. Heterogeneity was high (χ²=22.7; p &lt; 0.001). Sensitivity was lower in prospective studies, prognostic models, and ASMs users, and higher with long-term follow-up. Meta-regression identified model type, study design, ASM exposure, and sample adequacy as key moderators.</div></div><div><h3>Conclusion</h3><div>ML models demonstrate high diagnostic accuracy in predicting therapeutic response in DRE. Findings support their potential clinical utility, provided external validation and methodological standardisation.</div></div><div><h3>Registration PROSPERO protocol number</h3><div>CRD 42024628323</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107623"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595496","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":"Corrigendum to “Oxidative stress, metalloproteinase and LDH in children with intractable and non-intractable epilepsy as reflected in salivary analysis” [Epilepsy Res. 108 (1) (2014) 117–124]","authors":"Eli Shahar ,&nbsp;Uri Attias ,&nbsp;Dana Savulescu ,&nbsp;Jacob Genizin ,&nbsp;Moshe Gavish ,&nbsp;Rafael Nagler","doi":"10.1016/j.eplepsyres.2025.107612","DOIUrl":"10.1016/j.eplepsyres.2025.107612","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"215 ","pages":"Article 107612"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552704","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":"Theta functional connectivity alterations related to executive control in refractory temporal lobe epilepsy","authors":"Changqing Zhan ,&nbsp;Qiao Wang ,&nbsp;Wenyu Wang ,&nbsp;Xueping Lu ,&nbsp;Shizao Fei ,&nbsp;Zongsheng Chen ,&nbsp;Yingnian Chen","doi":"10.1016/j.eplepsyres.2025.107620","DOIUrl":"10.1016/j.eplepsyres.2025.107620","url":null,"abstract":"<div><h3>Aims</h3><div>Using the attention network test (ANT) with simultaneous electroencephalography (EEG) recordings, this study investigated the neural mechanisms underlying executive control (EC) dysfunction in patients with temporal lobe refractory epilepsy.</div></div><div><h3>Methods</h3><div>Participants comprised three demographically matched groups (n = 20 each): refractory temporal lobe epilepsy (RE), drug-sensitive temporal lobe epilepsy (DSE), and healthy controls (Ctrl). Participants were instructed to perform the ANT while scalp EEG signals were simultaneously recorded. Theta-band functional connectivity was computed from EEG data acquired during ANT task execution.</div></div><div><h3>Results</h3><div>The RE group exhibited significant impairment in EC performance. Theta-band functional connectivity strength in the whole-brain and frontal regions of the EC network was significantly reduced in both patient groups (RE/DSE) versus healthy controls. Notably, the RE group demonstrated reduced whole-brain and frontal theta connectivity within the EC network relative to the DSE group. Furthermore, frontal theta connectivity strength positively correlated with EC_effect in both Ctrl and DSE groups (r = -0.658, p = 0.002; r = -0.540, p = 0.014). In contrast, no significant association was observed between EC network theta connectivity and behavioral performance in the RE group (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Patients with refractory epilepsy exhibited impaired EC behavioral performance, concomitant with reduced theta-band functional connectivity strength in frontal regions. This diminished frontal theta connectivity may underlie EC dysfunction in this patient population.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107620"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534978","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":"Phenylbutyrate for monogenetic epilepsy: Literature review","authors":"Amelia Stone ,&nbsp;Jacqueline Burré ,&nbsp;Natalie Wayland ,&nbsp;Zachary M. Grinspan","doi":"10.1016/j.eplepsyres.2025.107621","DOIUrl":"10.1016/j.eplepsyres.2025.107621","url":null,"abstract":"<div><div>Monogenetic epilepsies are seizure disorders with a single-gene etiology. More than 500 genes are linked to epilepsy. As many as 40 % of epilepsies are caused by variants in one of these genes. Single gene-linked epilepsies have a wide phenotypic spectrum and may be accompanied by comorbidities such as developmental and motor delays. Epilepsy is often pharmacoresistant and does not respond to existing drug therapies. Preclinical data suggests that 4-phenylbutyrate (PBA) may produce an anti-seizure effect in individuals with genetic epilepsies, including STXBP1, SLC6A1, SLC6A8, GABA(A) disorders, Dravet Syndrome (SCN1A), and LGI1 variants. Clinical data also suggests that PBA may have a therapeutic effect for SYNGAP1. This literature review describes the clinical profiles of several monogenetic epilepsies and the pathogenesis of seizure activity in these disorders. We focus on gene-linked epilepsy syndromes that may benefit from treatment with PBA according to several proposed theories of the drug’s mechanism and functional impact.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107621"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579869","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":"Reaffirming construct validity: A response to methodological concerns","authors":"Elif Sarac ,&nbsp;Esra Yildiz","doi":"10.1016/j.eplepsyres.2025.107619","DOIUrl":"10.1016/j.eplepsyres.2025.107619","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107619"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517334","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 closer look at construct validity: Methodological pitfalls in the Turkish adaptation of the perceived disability scale","authors":"Prateek Kumar Panda,&nbsp;Indar Kumar Sharawat","doi":"10.1016/j.eplepsyres.2025.107618","DOIUrl":"10.1016/j.eplepsyres.2025.107618","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107618"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517335","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":"Blood-brain barrier impairment as an early marker of neurodegeneration in late-onset epilepsy of unknown origin","authors":"Silvia Maio ,&nbsp;Mariana Fernandes ,&nbsp;Fabio Placidi ,&nbsp;Francesca Izzi ,&nbsp;Alessandro Castelli ,&nbsp;Andrea Pagano ,&nbsp;Nicola Biagio Mercuri ,&nbsp;Claudio Liguori","doi":"10.1016/j.eplepsyres.2025.107614","DOIUrl":"10.1016/j.eplepsyres.2025.107614","url":null,"abstract":"<div><h3>Purpose</h3><div>Blood-brain barrier (BBB) plays a crucial role in maintaining brain health, and its dysfunction during the early stages of neurodegeneration may contribute to neuropathological processes. Patients with late-onset epilepsy with unknown etiology (LOEU) can present early signs of neurodegeneration and convert to an overt neurodegenerative disease longitudinally. This study analyzed cerebrospinal-fluid (CSF)/serum albumin ratio (Qalb), as a marker of BBB integrity, and assessed biomarkers of neurodegeneration in patients with LOEU compared to age- and sex-matched controls.</div></div><div><h3>Methods</h3><div>Patients diagnosed with LOEU were compared to a sex- and age-matched control group. All participants underwent a neurological visit, cognitive evaluation to exclude cognitive impairment, and a lumbar puncture for CSF biomarker analysis [β-Amyloid₄₂ (Aβ₄₂); total-Tau (t-Tau); phosphorylated-Tau at threonine 181 (p-Tau181); Qalb]. Lumbar puncture was performed within 2 months after epilepsy diagnosis, and at least 3 weeks after the last seizure.</div></div><div><h3>Results</h3><div>Twenty-eight LOEU patients (53.6 % female, mean age 68.79 ± 7.83 y) and twenty-five controls (52.0 % female, mean age 65.64 ± 8.10 y) were included. LOEU patients showed significantly higher Qalb values (<em>p</em> = 0.003), lower Aβ₄₂ CSF levels (<em>p</em> = 0.030), and higher t-Tau/Aβ₄₂ (<em>p</em> = 0.030) and p-Tau181/Aβ₄₂ ratios (<em>p</em> = 0.030) than controls. Qalb values did not significantly differ between patients with and without pathological AD biomarker profile.</div></div><div><h3>Conclusions</h3><div>LOEU patients show BBB dysfunction and early changes in CSF biomarker ratios pointing to AD pathology. Qalb increase seems to be unrelated to the pathological changes in CSF AD biomarkers. Future studies should be performed to better understand the neuropathological basis of LOEU and the risk for patients to develop a neurodegenerative disorder.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107614"},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489930","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":"Turning data analytics into an organisational asset: A landscape population analysis of 5720 people with epilepsy attending outpatient care in Ireland","authors":"Derek Corrigan ,&nbsp;Colin P. Doherty ,&nbsp;Tim Jacquemard ,&nbsp;Norman Delanty ,&nbsp;Máire White ,&nbsp;Mary Fitzsimons","doi":"10.1016/j.eplepsyres.2025.107613","DOIUrl":"10.1016/j.eplepsyres.2025.107613","url":null,"abstract":"<div><h3>Introduction</h3><div>The National Clinical Programme for Epilepsy (NCPE) in Ireland identified analytics applied to Electronic Patient Record (EPR) data as an organisational asset for driving continuous service improvement. This study describes the diagnostic, therapeutic and prognostic characteristics of a population of people with epilepsy (PwE) currently taking anti-epileptic drugs. This is an epidemiological question of interest to clinicians, PwE and their families, along with those involved in heath policy, and health service planning, implementation, monitoring and evaluation.</div></div><div><h3>Material and methods</h3><div>A de-identified data extract of 5720 PwE was taken from the Irish epilepsy EPR. Phenotypical characteristics were aggregated and visualised using data analytics. A set of landscape analyses fully describe this subpopulation in terms of epilepsy types, seizure types, seizure frequencies, aetiologies, comorbidities and numbers of anti-epileptic-drugs taken.</div></div><div><h3>Results</h3><div>A multi-disciplinary team of epilepsy healthcare providers and stakeholders reviewed the analytics results from which they identified a number of policy issues that required improvement relating to current epilepsy service delivery including:<ul><li><span>•</span><span><div>Equity of care relating to less refractory and older people with epilepsy.</div></span></li></ul></div><div><ul><li><span>•</span><span><div>Further review of patient cohorts taking greater than 4 AEDs with a view to describing underlying aetiologies of patients with complex epilepsy that may be poorly controlled.</div></span></li></ul><ul><li><span>•</span><span><div>Closer integration of other clinical disciplines that reflects diverse needs of PwE e.g. mental health and geriatric services.</div></span></li></ul></div><div><ul><li><span>•</span><span><div>Development of national capacity for genetic testing and preventative strategies for epilepsy.</div></span></li></ul></div></div><div><h3>Significance</h3><div>This study demonstrates how interrogation and analysis of large volumes of patient data can be applied to a real-world epilepsy EPR that is used in frontline epilepsy clinical care. This analytics approach was supported by a multi-disciplinary review of outputs to support a data-driven approach that interprets analytics with a view to improving actual clinical care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107613"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489919","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}