Epilepsy Research最新文献

{"title":"Attenuation of mitochondrial refractory epilepsy in rotenone corneal kindling model of drug resistance by idebenone: An approach to bypass mitochondrial complex I","authors":"Arshbir Kaur,&nbsp;Arvinder Kaur,&nbsp;Samriti,&nbsp;Rajesh Kumar Goel","doi":"10.1016/j.eplepsyres.2024.107458","DOIUrl":"10.1016/j.eplepsyres.2024.107458","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the potential of bypassing mitochondrial complex I with idebenone to overcome drug resistance in a Rotenone corneal kindling (RCK) mouse model of mitochondrial refractory epilepsy.</div></div><div><h3>Material and method</h3><div>Resistance was developed by administering rotenone 2.5 mg/kg intraperitoneally once and corneal kindling twice daily. The kindling development took 15 days, and pre-treatment resistance validation was carried out with five different antiseizure drugs: pregabalin, levetiracetam, valproate, lamotrigine, and phenytoin. The treatment drug, Idebenone (IDB) was given at doses of 10, 20, and 40 mg/kg intraperitoneally for 10 days. The post-treatment resistance validation was evaluated with same standard drugs in same order along with other parameters assessment, such as NAD(P)H: quinone oxidoreductase 1 (NQO1), ATP, GSH, and TBARS.</div></div><div><h3>Results</h3><div>The pre-treatment resistance validation shows an inability of standard drugs to attenuate seizure scores by rotenone kindling, justifying the development of drug resistance. IDB successfully abolished the resistance developed in RCK model. IDB elevated the levels of ATP and NQO1 and showed antioxidant activity by elevating GSH and attenuating TBARS.</div></div><div><h3>Conclusion &amp; future direction</h3><div>IDB have successfully elevated the level of ATP, NQO1 in RCK model, hence proving the complex I bypass hypothesis. Thus, IDB can be the drug of choice for mitochondrial epilepsies involving drug refractoriness as adjuvant with anticonvulsant drugs.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107458"},"PeriodicalIF":2.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432988","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":"Epidemiology and real-world management of childhood epilepsy in Japan: A descriptive study using a health claim database","authors":"Takashi Saito ,&nbsp;Nozomi Miyagawa ,&nbsp;Kyoko Kanazawa ,&nbsp;Masaki Iwasaki ,&nbsp;Eiji Nakagawa","doi":"10.1016/j.eplepsyres.2024.107455","DOIUrl":"10.1016/j.eplepsyres.2024.107455","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this epidemiological study was to assess the prevalence, comorbidities, and real-world management of childhood epilepsy to provide insights for enhancing epilepsy management and medical resource planning.</div></div><div><h3>Materials and methods</h3><div>The study encompassed insured individuals aged 0–17 years as of December 2018 who were registered at any point in 2018, for at least part of the year, in a Japanese health claims database spanning January—December 2018. Epilepsy was defined as a diagnosis of epilepsy based on the International Classification of Diseases, 10th Revision codes, and a claimed management fee for epilepsy or an anti-seizure medication (ASM) prescription for longer than 4 weeks. The prevalence of epilepsy, patient characteristics, including comorbidities, and management status, such as prescription of ASMs, were evaluated.</div></div><div><h3>Results</h3><div>Among 1528,905 registered children, 9279 were identified as having epilepsy. The prevalence of epilepsy was the lowest at 1.97 per 1000 population (95 % confidence interval [CI] 1.80–2.15) in the 0–2-year age group and increased with age to 9.34 per 1000 population (95 % CI 8.98–9.72) in the 15–17-year age group, with a significantly higher prevalence in boys than in girls in the ≥12-year age group. ASMs were prescribed to 88.3 %–91.9 % of the patients. Moreover, 27 (0.29 %) patients underwent epilepsy surgery. The frequency of claiming intravenous ASMs and long-term electroencephalogram fees increased with a decrease in age.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that young children receive more medical resources than adolescents and that epilepsy surgery is underutilized. Further investigations will help improve the management of and develop measures against epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107455"},"PeriodicalIF":2.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399754","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":"Serum matrix metallopeptidase-9 levels in infantile epileptic spasms syndrome of unknown etiology","authors":"Ryuki Matsuura ,&nbsp;Shin-ichiro Hamano ,&nbsp;Reiko Koichihara ,&nbsp;Rikako Takeda ,&nbsp;Hirokazu Takeuchi ,&nbsp;Yuko Hirata ,&nbsp;Kenjiro Kikuchi ,&nbsp;Akira Oka","doi":"10.1016/j.eplepsyres.2024.107454","DOIUrl":"10.1016/j.eplepsyres.2024.107454","url":null,"abstract":"<div><h3>Purpose</h3><div>Epileptic spasms are the primary symptom of infantile epileptic spasms syndrome (IESS); however, their direct impact on blood–brain barrier (BBB) function is unknown. Matrix metallopeptidase-9 (MMP-9), degrades type IV collagen, a key component of the blood-brain barrier, while tissue inhibitor of metalloproteinase-1 (TIMP-1) suppresses its activity, protecting BBB integrity. This study aimed to assess serum MMP-9 and TIMP-1 levels in patients with IESS of unknown etiology.</div></div><div><h3>Methods</h3><div>We prospectively assessed serum MMP-9 and TIMP-1 levels prior to administering vigabatrin or adrenocorticotropic hormone therapy in patients with IESS of unknown etiology at Saitama Children’s Medical Center between February 2012 and December 2023. We compared these biomarkers between patients with epileptic spasms and age-matched controls and performed a curve regression analysis between the biomarkers and the frequency of epileptic spasms. Additionally, we assessed whether MMP-9 and TIMP-1 levels were diagnostic predictors of IESS.</div></div><div><h3>Results</h3><div>This study included 22 patients with IESS (11 males) and 12 controls. Serum MMP-9 and MMP-9/TIMP-1 ratios were higher in patients with IESS than in controls (<em>p</em> &lt; 0.001 and <em>p</em> = 0.002, respectively). A high frequency of epileptic spasms also led to higher serum MMP-9 levels (y = 0.0871x² + 0.195x + 195.15, <em>R</em>² = 0.77, <em>p</em> &lt; 0.001). Using MMP &gt;188 ng/mL as the cutoff level, the sensitivity for diagnosing IESS was 95.5 %, the specificity was 75.0 %, the positive likelihood ratio was 3.82 (95 % confidence interval (CI) 1.43–10.22), and the relative risk was 8.75 (95 % CI 1.36–56.5).</div></div><div><h3>Conclusion</h3><div>Patients with IESS had elevated serum MMP-9 levels, suggesting an association between epileptic spasms and blood–brain barrier dysfunction. MMP-9 level measurement may be useful for diagnosing suspected patients.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107454"},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344064","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":"Face swapping in seizure videos for patient deidentification","authors":"Chin-Jou Li ,&nbsp;Jen-Cheng Hou ,&nbsp;Chien-Chen Chou ,&nbsp;Yen-Cheng Shih ,&nbsp;Stephane Dufau ,&nbsp;Po-Tso Lin ,&nbsp;Aileen McGonigal ,&nbsp;Hsiang-Yu Yu","doi":"10.1016/j.eplepsyres.2024.107453","DOIUrl":"10.1016/j.eplepsyres.2024.107453","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to test different AI-based face-swapping models applied to videos of epileptic seizures, with the goal of protecting patient privacy while retaining clinically useful seizure semiology. We hypothesized that specific models would show differences in semiologic fidelity compared to the original clinical videos.</div></div><div><h3>Methods</h3><div>Three open-source models, SimSwap, MobileFaceSwap and GHOST were adopted for face-swapping. For every model, an AI generated male and female image were used to replace the original faces. One representative seizure per patient from three patients with epilepsy was chosen (3 seizure videos x 3 AI models x 2 M/F swap) and remade to 18 transformed video clips. To evaluate the performance of the three models, we used both objective (AI-based) and subjective (expert clinician) evaluation. The objective assessment included four metrics for facial appearance and four metrics for facial expression changes. Four experienced epileptologists reviewed the clips and scoring according to deidentification and preservation of semiology. Kruskal-Wallis H test was used for statistical analysis among the models.</div></div><div><h3>Results</h3><div>In the reproduced videos, the swapped face cannot be recognized as the original face, with no significant difference in scores of deidentification either by objective or subjective assessment. Regarding semiology preservation, no significant differences between models were observed in the objective evaluations. The subjective evaluations revealed that the GHOST model outperformed the other two models (<em>p</em>=0.028).</div></div><div><h3>Conclusion</h3><div>This is the first study evaluating AI face swapping models in epileptic seizure video clips. Optimization of AI face-swapping models could enhance the accessibility of seizure videos for education and research while protecting patient privacy and maintaining semiology.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107453"},"PeriodicalIF":2.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0920121124001682/pdfft?md5=fdbd2e70e749c1faff0aabb208404bb7&pid=1-s2.0-S0920121124001682-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315547","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}

{"title":"Psychosis and schizophrenia among patients with epilepsy: A systematic review and meta-analysis","authors":"Sangharsha Thapa ,&nbsp;Mohammad Yazdan Panah ,&nbsp;Saeed Vaheb ,&nbsp;Krishna Dahal ,&nbsp;Prashanna Man Maharjan ,&nbsp;Sangam Shah ,&nbsp;Omid Mirmosayyeb","doi":"10.1016/j.eplepsyres.2024.107452","DOIUrl":"10.1016/j.eplepsyres.2024.107452","url":null,"abstract":"<div><h3>Background</h3><div>Prior research has indicated an association between epilepsy and psychosis. This review aimed to estimate the global prevalence rate of psychosis and schizophrenia in epilepsy and assess the odds of psychosis and schizophrenia among patients with epilepsy (PWE).</div></div><div><h3>Method</h3><div>A comprehensive literature search was carried out utilizing relevant keywords in PubMed/MEDLINE and Scopus, covering from January 1, 1990, to November 18, 2023. The meta-analysis was performed using R software employing a random-effect model to establish the overall prevalence and odds ratio (OR), with 95 % confidence intervals (95 % CI), of psychosis and schizophrenia in epilepsy.</div></div><div><h3>Result</h3><div>Eighty-one studies encompassing 970,497 PWE met the inclusion criteria. The meta-analysis revealed that the overall prevalence of psychosis and schizophrenia among PWE was 7.8 % (95 % CI: 6.3–9.2 %, I² = 100 %) and 3 % (95 % CI: 1.7–4.3 %, I² = 95 %), respectively. Moreover, epilepsy was associated with a threefold rise in the odds of psychosis (OR = 3.41, 95 % CI: 2.3–5.08, <em>p</em>-value &lt; 0.01, I² = 99 %, <em>p</em>-heterogeneity &lt; 0.01). Furthermore, epilepsy was found to be significantly correlated with a fivefold increased odds of schizophrenia (OR = 5.22, 95 % CI: 2.99–9.11, <em>p</em>-value &lt; 0.01, I² = 94 %, <em>p</em>-heterogeneity &lt; 0.01)</div></div><div><h3>Conclusion</h3><div>Epilepsy can increase the risk of developing psychosis and schizophrenia. Additional longitudinal research is warranted to elucidate the influence of epilepsy and its treatments on the risk of psychosis and schizophrenia, and also a comprehensive suite of confounding adjustments will be requisite.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107452"},"PeriodicalIF":2.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282352","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":"Extracting seizure control metrics from clinic notes of patients with epilepsy: A natural language processing approach","authors":"Marta Fernandes ,&nbsp;Aidan Cardall ,&nbsp;Lidia MVR Moura ,&nbsp;Christopher McGraw ,&nbsp;Sahar F. Zafar ,&nbsp;M.Brandon Westover","doi":"10.1016/j.eplepsyres.2024.107451","DOIUrl":"10.1016/j.eplepsyres.2024.107451","url":null,"abstract":"<div><h3>Objectives</h3><p>Monitoring seizure control metrics is key to clinical care of patients with epilepsy. Manually abstracting these metrics from unstructured text in electronic health records (EHR) is laborious. We aimed to abstract the date of last seizure and seizure frequency from clinical notes of patients with epilepsy using natural language processing (NLP).</p></div><div><h3>Methods</h3><p>We extracted seizure control metrics from notes of patients seen in epilepsy clinics from two hospitals in Boston. Extraction was performed with the pretrained model RoBERTa_for_seizureFrequency_QA, for both date of last seizure and seizure frequency, combined with regular expressions. We designed the algorithm to categorize the timing of last seizure (“today”, “1–6 days ago”, “1–4 weeks ago”, “more than 1–3 months ago”, “more than 3–6 months ago”, “more than 6–12 months ago”, “more than 1–2 years ago”, “more than 2 years ago”) and seizure frequency (“innumerable”, “multiple”, “daily”, “weekly”, “monthly”, “once per year”, “less than once per year”). Our ground truth consisted of structured questionnaires filled out by physicians. Model performance was measured using the areas under the receiving operating characteristic curve (AUROC) and precision recall curve (AUPRC) for categorical labels, and median absolute error (MAE) for ordinal labels, with 95 % confidence intervals (CI) estimated via bootstrapping.</p></div><div><h3>Results</h3><p>Our cohort included 1773 adult patients with a total of 5658 visits with reported seizure control metrics, seen in epilepsy clinics between December 2018 and May 2022. The cohort average age was 42 years old, the majority were female (57 %), White (81 %) and non-Hispanic (85 %). The models achieved an MAE (95 % CI) for date of last seizure of 4 (4.00–4.86) weeks, and for seizure frequency of 0.02 (0.02–0.02) seizures per day.</p></div><div><h3>Conclusions</h3><p>Our NLP approach demonstrates that the extraction of seizure control metrics from EHR is feasible allowing for large-scale EHR research.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107451"},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172742","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 relationship between perceived stress, spiritual well-being and alexithymia in people with epilepsy: A path analysis","authors":"Yanmış Safiye ,&nbsp;Bahçecioğlu Turan Gülcan ,&nbsp;Özer Zülfünaz ,&nbsp;Alevtina Ersoy","doi":"10.1016/j.eplepsyres.2024.107450","DOIUrl":"10.1016/j.eplepsyres.2024.107450","url":null,"abstract":"<div><h3>Aim</h3><p>The present study was performed to investigate the associations among perceived stress, spiritual well-being, and alexithymia in people with epilepsy.</p></div><div><h3>Method</h3><p>The study was performed with 140 patients diagnosed with epilepsy in the neurology clinic of a training and research hospital between May and December 2022. Personal Information Form, Perceived Stress Scale (PSS-14), Spiritual Well-Being Scale (FACIT Sp-12), and Toronto Alexithymia Scale (TAS-20) were used to collect the data. Descriptive statistical methods, simple and multiple regression analyses, and path analysis were used to analyze the data.</p></div><div><h3>Results</h3><p>The mean scores of the patients were 25.51±9.42 for PSS-14, 29.77±8.33 for FACIT Sp-12, and 56.55±16.87 for TAS-20. Concerning direct effects, a negative association was found between perceived stress and spiritual well-being, a positive association between perceived stress and alexithymia, and a negative association between spiritual well-being and alexithymia. The confirmed mediating effect was the role of spiritual well-being in the association between perceived stress and alexithymia. Perceived stress explained 28 % of spiritual well-being. In addition, the model explained 34 % of alexithymia in total.</p></div><div><h3>Conclusion</h3><p>Perceived stress levels of people with epilepsy were low, while alexithymia and spiritual well-being levels were found to be moderate. It was found that as the stress levels perceived by people with epilepsy increased, alexithymia levels also increased. It was also found that the negative impact of perceived stress on alexithymia was reduced through spiritual well-being. The study shows how important spiritual well-being is in decreasing the negative impacts of perceived stress on alexithymia in people with epilepsy.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"207 ","pages":"Article 107450"},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230001","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 seizure characteristics in individuals with autoimmune encephalitis: A comprehensive retrospective study in a low-middle-income country setting","authors":"S.S. Sánchez-Boluarte ,&nbsp;W. Aguirre-Quispe ,&nbsp;W. De La Cruz Ramirez ,&nbsp;J. Tacunan-Cuellar ,&nbsp;A. Vergaray-Loayza ,&nbsp;L. Quintana-Garcia ,&nbsp;M. Alfaro-Olivera ,&nbsp;L. Nuñez Del Prado Murillo ,&nbsp;C. Caparó-Zamalloa","doi":"10.1016/j.eplepsyres.2024.107439","DOIUrl":"10.1016/j.eplepsyres.2024.107439","url":null,"abstract":"<div><h3>Introduction</h3><p>Seizures and epilepsy are well-documented in association with autoimmune encephalitis. Despite this, a notable gap exists in understanding the persistence of seizures beyond the acute phase, particularly within the context of low- and low-middle-income settings.</p></div><div><h3>Objective</h3><p>To evaluate the frequency, clinical characteristics, diagnosis, and potential factors associated with the occurrence and persistence of seizures in autoimmune encephalitis patients.</p></div><div><h3>Methods</h3><p>This was a retrospective, cross-sectional study. Patients diagnosed with possible, probable or confirmed autoimmune encephalitis according to the Graus criteria at the “Instituto Nacional de Ciencias Neurológicas” in Lima, Peru, were included between January 2018 and April 2023. Demographic, clinical, diagnosis, and management information was recorded. A bivariate analysis was performed considering the persistence of seizures at one-year follow-up and a second analysis was performed to compare the groups according to the anti N-methyl-D-aspartate receptor (NMDAR) antibody results.</p></div><div><h3>Results</h3><p>Sixty patients predominantly male (40; 66.7 %) were included. Only 36 (60 %) patients were tested for antibodies, 16 (44.4 %) were NMDAR positive. 46 (76.7 %) patients had at least one seizure and 13 (37.1 %) had seizures after 1 year of follow-up. Patients with seizure relapse were younger, 20 (IQR: 18–28) versus 29.5 years (IQR: 21–48), p=0.049. Four (44.4 %) patients with persistent seizures had positive NMDAR results. Similar sex distributions, no differences in seizure characteristics, and higher CSF cell count in the NMDAR-positive group were observed. Neuroimaging, EEG findings, and follow-up times were comparable between the groups.</p></div><div><h3>Conclusions</h3><p>We found a 37.1 % seizures rate after one year of follow-up, predominantly in younger patients.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"206 ","pages":"Article 107439"},"PeriodicalIF":2.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083581","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":"New onset status epilepticus and its long-term outcome: A cohort study","authors":"Sharath Adiga ,&nbsp;Ravindranadh Chowdary Mundlamuri ,&nbsp;Ajay Asranna ,&nbsp;Lakshminarayanapuram Gopal Vishwanathan ,&nbsp;Kenchaiah Raghavendra ,&nbsp;Nandakumar Dalavaikodihalli Nanjaiah ,&nbsp;PV Prathyusah ,&nbsp;Karthik Kulanthaivelu ,&nbsp;Sanjib Sinha","doi":"10.1016/j.eplepsyres.2024.107442","DOIUrl":"10.1016/j.eplepsyres.2024.107442","url":null,"abstract":"<div><h3>Purpose</h3><p>New onset status epilepticus (NOSE), a subtype of status epilepticus, is a neurological emergency associated with significant morbidity and mortality. This study aimed to analyze the phenotypic spectrum and outcomes of patients presenting with NOSE.</p></div><div><h3>Methods</h3><p>This prospective and retrospective descriptive study included patients presenting with NOSE over a 10-year period. Data collected included patient demographics, phenotypic characteristics of SE and its etiology, Status Epilepticus Severity Score (STESS), SE classification Axis-II, and Modified Rankin Scale (mRS) scores at admission and discharge. Functional outcomes and seizure status were assessed at least 6 months post-discharge. Prognostic factors for mortality and the development of epilepsy were also analyzed.</p></div><div><h3>Results</h3><p>A total of 208 patients were included, with a mean age of 41.97 ± 21.66 years, and a male predominance (57.1 %). Focal to bilateral tonic-clonic seizures were observed in 47.5 % of patients. The etiology was acute symptomatic in 35.57 % and remote symptomatic in 24 %. The median hospital stay was 4 days (range: 2.25–10.75 days). The mortality rate was 26.5 %, and 23 % of patients developed epilepsy with a median follow-up of 9 months. Higher age (≥ 50 years), elevated STESS, ICU admission, use of anesthetic agents, refractory status epilepticus (RSE), and new-onset refractory status epilepticus (NORSE) were significant risk factors for mortality (p&lt;0.05). The development of epilepsy was associated with a higher number of antiseizure medications (ASM) at discharge, ICU admission, use of anesthetic agents, RSE, and NORSE (p&lt;0.05).</p></div><div><h3>Conclusion</h3><p>NOSE is a neurological emergency with a variable etiology and significant long-term consequences. Approximately one-fourth of patients presenting with NOSE died, and another quarter developed epilepsy during a median follow-up of 9 months. Identifying and addressing the predictors of mortality and epilepsy development following NOSE may improve long-term outcomes.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"206 ","pages":"Article 107442"},"PeriodicalIF":2.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087299","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":"NS-Pten knockout mice exhibit sex and hippocampal subregion-specific increases in microglia/macrophage density","authors":"David A. Narvaiz ,&nbsp;Katherine J. Blandin ,&nbsp;D. Gregory Sullens ,&nbsp;Paige D. Womble ,&nbsp;Jacob B. Pilcher ,&nbsp;Grace O’Neill ,&nbsp;Taylor A. Wiley ,&nbsp;Eliesse M. Kwok ,&nbsp;Srikhar V. Chilukuri ,&nbsp;Joaquin N. Lugo","doi":"10.1016/j.eplepsyres.2024.107440","DOIUrl":"10.1016/j.eplepsyres.2024.107440","url":null,"abstract":"<div><p>Seizures induce hippocampal subregion dependent enhancements in microglia/macrophage phagocytosis and cytokine release that may contribute to the development of epilepsy. As a model of hyperactive mTOR induced epilepsy, neuronal subset specific phosphatase and tensin homolog (NS-<em>Pten</em>) knockout (KO) mice exhibit hyperactive mTOR signaling in the hippocampus, seizures that progress with age, and enhanced hippocampal microglia/macrophage activation. However, it is unknown where microglia/macrophages are most active within the hippocampus of NS-<em>Pten</em> KO mice. We quantified the density of IBA1 positive microglia/macrophages in the CA1, CA2/3, and dentate gyrus of NS-<em>Pten</em> KO and wildtype (WT) male and female mice at 4, 10, and 15 weeks of age. NS-<em>Pten</em> KO mice exhibited an overall increase in the number of IBA1 positive microglia/macrophages in each subregion and in the entire hippocampus. After accounting for differences in size, the whole hippocampus of NS-<em>Pten</em> KO mice still exhibited an increased density of IBA1 positive microglia/macrophages. Subregion analyses showed that this increase was restricted to the dentate gyrus of both male and female NS-<em>Pten</em> KO mice and to the CA1 of male NS-<em>Pten</em> KO mice. These data suggest enhanced microglia/macrophage activity may occur in the NS-<em>Pten</em> KO mice in a hippocampal subregion and sex-dependent manner. Future work should seek to determine whether these region-specific increases in microgliosis play a role in the progression of epilepsy in this model.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"206 ","pages":"Article 107440"},"PeriodicalIF":2.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094897","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}