Epilepsy Research最新文献

{"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":"2025-12-01","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":"CREB3L4 upregulates SIRT4 expression to increase GABA/glutamate ratio and mitochondrial homeostasis for epilepsy suppression","authors":"Haoyu Liu ,&nbsp;Qiannan Song ,&nbsp;Jiayi Jin ,&nbsp;Hong Chen","doi":"10.1016/j.eplepsyres.2025.107668","DOIUrl":"10.1016/j.eplepsyres.2025.107668","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;cAMP response element-binding protein 3-like transcription factor 4 (CREB3L4) serves as an important transcriptional regulatory factor and plays a crucial role in neurological diseases, however, its specific mechanism in epilepsy pathogenesis remains unclear. This study aims to investigate the role of the CREB3L4-Sirtuin 4 (SIRT4) regulatory axis in epilepsy pathogenesis and its effects on γ-aminobutyric acid GABA/glutamate balance and mitochondrial function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A classical epilepsy animal model was established, and quantitative real-time PCR, Western blot, and immunofluorescence staining techniques were employed to detect the expression changes of CREB3L4 and SIRT4 in the epilepsy model. CREB3L4 expression levels were modulated through lentivirus-mediated gene overexpression and RNA interference techniques to observe their effects on epileptic behavioral manifestations. ELISA was used to detect GABA and glutamate contents in brain tissues, and the GABA/glutamate ratio was calculated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;CREB3L4 expression was downregulated 3.2-fold in the epilepsy model (1.026 ± 0.051–0.325 ± 0.028, p &lt; 0.001), with 1.8-fold decreased GABA/glutamate ratio (1.065 ± 0.063–0.581 ± 0.046, p &lt; 0.001). CREB3L4 overexpression upregulated SIRT4 mRNA 3.5-fold (0.185 ± 0.051–0.643 ± 0.039, p &lt; 0.01) and reduced seizure frequency 2.0-fold (67.6 ± 3.1–34.4 ± 2.4 seizures, p &lt; 0.001) and severity 2.2-fold (4.3 ± 0.3–2.0 ± 0.3 grade, p &lt; 0.001). Conversely, CREB3L4 silencing exacerbated epilepsy progression, increasing seizure frequency 1.4-fold (58.7 ± 2.7–79.3 ± 4.2 seizures, p &lt; 0.001) and severity 1.3-fold (3.7 ± 0.3–4.7 ± 0.2 grade, p &lt; 0.001), with 2.2-fold decreased GABA/glutamate ratio (0.639 ± 0.051–0.288 ± 0.041, p &lt; 0.001). Mechanistic studies demonstrated that CREB3L4 overexpression improved mitochondrial function through SIRT4 upregulation, thereby maintaining mitochondrial homeostasis. Meanwhile, activation of the CREB3L4-SIRT4 axis effectively increased brain tissue GABA content, improved the GABA/glutamate ratio, and restored neurotransmitter balance. Rescue experiments demonstrated that SIRT4 silencing (3.1-fold knockdown) significantly attenuated CREB3L4's neuroprotective effects, increasing seizure severity 1.6-fold (3.0 ± 0.5–4.8 ± 0.2 grade, p &lt; 0.01), frequency 1.7-fold (43.2 ± 3.1–74.7 ± 4.2 seizures, p &lt; 0.001), and reducing GABA/glutamate ratio 1.6-fold (1.81 ± 0.05–1.12 ± 0.05, p &lt; 0.001), confirming SIRT4 as the key downstream mediator.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study elucidates the important role of the CREB3L4-SIRT4 regulatory axis in epilepsy pathogenesis, revealing the molecular mechanism by which CREB3L4 transcriptionally activates SIRT4, subsequently regulates GABA/glutamate balance and maintains mitochondrial homeostasis, ultimately suppressing seizures and associated pathophysiological damage.&lt;/","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107668"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154691","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":"2025-12-01","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":"Author response: Seizure outcome and anti-seizure medication use in post-stroke epilepsy: A retrospective cohort study","authors":"Ahmed Khadija,&nbsp;Jacques Theitler,&nbsp;Revital Gandelman-Marton","doi":"10.1016/j.eplepsyres.2025.107673","DOIUrl":"10.1016/j.eplepsyres.2025.107673","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107673"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265973","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":"Health care burden of access barriers to epilepsy care in the United States: A claims-based analysis of payer channels","authors":"Herbert Peeples ,&nbsp;Emily Achter ,&nbsp;Christopher Dieyi ,&nbsp;Keshia Maughn","doi":"10.1016/j.eplepsyres.2025.107639","DOIUrl":"10.1016/j.eplepsyres.2025.107639","url":null,"abstract":"<div><h3>Objective</h3><div>To describe access challenges, barriers to antiseizure medications (ASMs), and impact of ASM formulary policies for patients with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>Observational study of de-identified claims from an all-payer claims database (2014–2021) and a formulary/payer policy database. Adults prescribed ≥ 1 ASM following initial epilepsy diagnosis, with continuous medical/pharmacy benefits, were included. Demographic characteristics, proximity to/use of a neurology health care professional (HCP), health care resource utilization (HCRU), and costs were assessed.</div></div><div><h3>Results</h3><div>In total, 35,351, 33,339, and 24,722 PWE with commercial, Medicare, and Medicaid insurance, respectively, were included. The Medicare group was older, had a higher comorbidity index score, more males, and fewer non-White and Hispanic individuals versus other groups. Most (&gt; 58 %) commercially-insured PWE had coverage to all six first-generation ASMs examined, six to 12 second-generation ASMs, and all four third-generation ASMs; coverage rates were higher for Medicaid while data for Medicare were incomplete. Most commercial and Medicaid PWE had no access requirements to first-generation ASMs; approximately two-thirds and half of patients had access requirements for second- and third-generation ASMs, respectively. Although &gt; 90 % of PWE used a neurology HCP during follow-up, only about one-third lived within proximity. Of PWE with formulary data (N = 77,787), &gt; 80 % and &lt; 8.0 % were prescribed second- and third-generation ASMs, respectively. There were no clear patterns in epilepsy-related HCRU/cost.</div></div><div><h3>Conclusions</h3><div>Data revealed difficulties in neurologist access and predominant use of second-generation ASMs, despite access restrictions for many PWE, suggesting obstacles in accessing treatment and specialist care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107639"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890018","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 in children and adolescents with B-cell acute lymphoblastic leukemia","authors":"Sun Ah Choi ,&nbsp;Aditi Trivedi ,&nbsp;Daanish Unwalla ,&nbsp;Anuja Jindal ,&nbsp;Maria A. Montenegro ,&nbsp;Shifteh Sattar","doi":"10.1016/j.eplepsyres.2025.107671","DOIUrl":"10.1016/j.eplepsyres.2025.107671","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate seizure outcomes and identify predisposing factors for epilepsy in patients diagnosed with B-cell acute lymphoblastic leukemia (B-ALL).</div></div><div><h3>Methods</h3><div>This was a retrospective study conducted at a tertiary care hospital. Inclusion criteria were: age younger than 18 years at the time of B-ALL diagnosis, and occurrence of seizures at any point after B-ALL diagnosis.</div></div><div><h3>Results</h3><div>A total of 23 patients met the inclusion criteria. The mean age at B-ALL diagnosis was 6.1 years, and 21.7 % received prophylactic brain irradiation. The mean age at first seizure was 8.5 years, with a mean latency of 28 months from B-ALL diagnosis. Of the 23 patients, 17 (73.9 %) experienced provoked seizures, most commonly related to acute or subacute methotrexate (MTX) neurotoxicity. Overall, seven patients (30.4 %) developed epilepsy, and five (21.7 %) had drug-resistant epilepsy (two with focal intractable epilepsy and three with Lennox-Gastaut syndrome). Patients who developed epilepsy had a significantly older age of seizure onset compared to those with only provoked seizures (p = 0.012), suggesting that older age at seizure onset may be a predisposing factor for epilepsy.</div></div><div><h3>Conclusions</h3><div>Most seizures in patients with B-ALL were provoked and resolved without the need for long-term antiseizure medication treatment. Acute or subacute MTX neurotoxicity accounted for the majority of provoked seizures. However, these rarely progressed to epilepsy. Long-term neurological surveillance is important in B-ALL survivors, especially those with delayed seizure onset or magnetic resonance imaging evidence of leukoencephalopathy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107671"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323835","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":"Fenfluramine for developmental and epileptic encephalopathy with spike-wave activation in sleep (DEE-SWAS): An exploratory study","authors":"Paloma Parra-Díaz ,&nbsp;Antonio Gil-Nagel ,&nbsp;Irene Sánchez-Miranda Román ,&nbsp;Irene Pascual-Zapatero ,&nbsp;Adrián Valls-Carbó ,&nbsp;Ángel Aledo-Serrano ,&nbsp;Álvaro Beltrán-Corbellini","doi":"10.1016/j.eplepsyres.2025.107687","DOIUrl":"10.1016/j.eplepsyres.2025.107687","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and potential efficacy of fenfluramine (FFA) in patients with developmental and epileptic encephalopathy with spike-and-wave activation in sleep (DEE-SWAS).</div></div><div><h3>Methods</h3><div>We conducted an open-label, interventional, exploratory study of FFA in pediatric patients with DEE-SWAS. We assessed changes in seizure frequency, intensity, and spike-wave index (SWI), as well as non-seizure outcomes including a neuropsychological evaluation with BRIEF®-2 and Vineland-3 questionnaires, assessment of sleep habits, and caregiver-reported changes in cognitive, behavioral and motor symptoms. Adverse effects and changes in concomitant antiseizure medications (ASMs) were recorded.</div></div><div><h3>Results</h3><div>Six patients were included (2 females, median age 10 years, range 4–11 years), with a median follow-up of 12 months (9–13 months). FFA was well tolerated; only two patients experienced mild, transient adverse events, and all participants continued treatment throughout the study. SWI improved in 4/6 patients (66.7 %), with ≥ 50 % reduction in two (near-resolution in one). Seizures were reported as less severe, although their frequency remained unchanged. The total dose of concomitant corticosteroids and ASMs was reduced in 66.7 % of patients. Executive functioning showed a tendency to improvement in 4/6 patients (66.7 %) based on BRIEF®-2 scores, although Vineland-3 scores remained stable. Caregivers also reported perceived improvements in behavior, cognition, and sleep.</div></div><div><h3>Conclusion</h3><div>FFA was a safe and potentially effective treatment in our cohort of patients with DEE-SWAS. We observed a reduction of SWI in most patients, along with modest improvements in executive function. These preliminary findings support the need for larger studies to confirm efficacy and explore long-term outcomes.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107687"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412783","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":"Antiseizure medication effects on the autonomic nervous system in pediatric patients with epilepsy","authors":"Fatemeh Mohammad Alizadeh Chafjiri ,&nbsp;Stephanie Dailey ,&nbsp;Saeid Sadeghian ,&nbsp;Adriana Ulate-Campos ,&nbsp;Tobias Loddenkemper","doi":"10.1016/j.eplepsyres.2025.107688","DOIUrl":"10.1016/j.eplepsyres.2025.107688","url":null,"abstract":"<div><div>Patients with epilepsy (PWE) taking antiseizure medications (ASMs) exhibit altered autonomic nervous system (ANS) parameters. ANS signals may monitor ASM applications and effectiveness non-invasively. Due to limited research, we reviewed the effects of ASMs on the pediatric ANS. We followed PRISMA guidelines and searched PubMed, Web of Science, and Embase for publications until 12/2024. These studies investigated the impact of ASMs on ANS, including heart rate (HR), heart rate variability (HRV), temperature, and sweat. We used Covidence software for screening processes and data extraction. After screening 9837 studies, 23 were included. Zonisamide and topiramate showed reduced sweating and increased temperature. In polytherapy patients, HRV decreased, with reductions in high-frequency (HF) values on valproic acid and low-frequency values on phenobarbital. Higher ASM doses reduced HRV but did not affect HR or sweat glands. One study reported altered cardiac ventricle functioning in PWE on ASMs. Two studies reviewing the effect of levetiracetam found minimal short-term ANS effects within the ECG but improved parasympathetic control and restored balance in HRV parameters over time. Sympathetic and parasympathetic dysfunctions were prominent in some patients, with polytherapy increasing HR and reducing HF values of HRV. In one study, higher ASM concentrations lowered HRV. Overall, ASMs may influence HR, sweat, and temperature, though many studies lacked analysis of specific ASM types. A better understanding of how ASMs affect ANS is essential for assessing medication efficacy, side effects, and their role as confounders in seizure prediction. These biosignal data can support device-based neuromodulation, seizure detection, and prediction algorithms.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107688"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358493","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":"2025-12-01","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":"Attention-deficit/hyperactivity disorder in adults with epilepsy: Preliminary prevalence and associated factors in a Czech sample","authors":"Karin Daniele ,&nbsp;Jaroslava Raudenská ,&nbsp;Alena Javůrková","doi":"10.1016/j.eplepsyres.2025.107645","DOIUrl":"10.1016/j.eplepsyres.2025.107645","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in Czech adult people with epilepsy (PWE) and examined factors potentially contributing to the co-occurrence of these two conditions. Although previous research has consistently reported elevated rates of ADHD in epilepsy populations, data from adult samples in Czech Republic remain limited.</div></div><div><h3>Methods</h3><div>Fifty-six adults with epilepsy completed validated self-report questionnaires assessing ADHD symptoms (ASRS), anxiety (GAD-2), and depression (NDDIE-2). Epilepsy-related clinical factors, such as seizure frequency, anti-seizure medication (ASM), type of epilepsy and epilepsy duration, were also analyzed in relation to ADHD symptoms.</div></div><div><h3>Results</h3><div>A high prevalence of ADHD symptoms n = 25 (44.6 %) was found in the sample. No significant associations were observed between ADHD symptoms and epilepsy-related variables or depressive symptoms, but a regression model of clinical and sociodemographic variables can explain 34.2 % of the variance in ASRS scores (Adj. R² = 0.342), with only anxiety emerging as a significant predictor (β = 0.517, SE = 0.50, t = 3.23, p = .003).</div></div><div><h3>Conclusion</h3><div>These preliminary findings suggest a possible link between epilepsy and ADHD, which may be further explored in future research through shared emotional or neurobiological mechanisms. The results underscore the need for integrated screening approaches and further research into the co-occurrence of epilepsy and ADHD in adult populations.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107645"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018503","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}