Epilepsia Open最新文献

{"title":"Epilepsia Open – April 2025 Announcements","authors":"","doi":"10.1002/epi4.70025","DOIUrl":"https://doi.org/10.1002/epi4.70025","url":null,"abstract":"<p>\u0000 7th ILAE School on EEG in the First Year of Life\u0000 </p><p>26 - 27 April 2025</p><p>Sanya City, Hainan, China</p><p>\u0000 ILAE School on Neuroimaging 2025\u0000 </p><p>15 - 17 May 2025</p><p>Potsdam, Germany</p><p>\u0000 5th African Epilepsy Congress\u0000 </p><p>16 - 18 May 2025</p><p>Lusaka, Zambia</p><p>\u0000 Curso-taller internacional de electroencefalografia básica y avanzada\u0000 </p><p>23 - 24 May 2025</p><p>En línea</p><p>\u0000 15th ILAE School for Neuropathology and Neuroimaging in Epilepsy\u0000 </p><p>31 July - 3 August 2025</p><p>Campinas, São Paulo, Brazil</p><p>\u0000 XVIII Workshop on Neurobiology of Epilepsy (WONOEP 2025)\u0000 </p><p>25 - 29 August 2025</p><p>Portugal</p><p>\u0000 36th International Epilepsy Congress\u0000 </p><p>30 August - 3 September 2025</p><p>Lisbon, Portugal</p><p>\u0000 15th ILAE School on Pre-Surgical Evaluation for Epilepsy and Epilepsy Surgery\u0000 </p><p>19 - 23 January 2026</p><p>Brno, Czech Republic</p><p>\u0000 16th European Epilepsy Congress\u0000 </p><p>5 - 9 September 2026</p><p>Athens, Greece</p><p>\u0000 Epilepsy and Stroke\u0000 </p><p>1 April 2025</p><p>\u0000 Crises occipitales et pariétales\u0000 </p><p>8 April 2025</p><p>\u0000 Focal Ictogenesis: When and why does interictal activity transition into ictal activity?\u0000 </p><p>10 April 2025</p><p>\u0000 ILAE e-Forum: Diagnosis and classification of Developmental and Epileptic Encephalopathies (DEE)\u0000 </p><p>22 April 2025</p><p>\u0000 Thalamo-cortical Network: How does coupling between focus and thalamus change before seizures?\u0000 </p><p>24 April 2025</p><p>\u0000 ILAE Eastern Mediterranean Webinar\u0000 </p><p>24 April 2025</p><p>\u0000 Neurodevelopment\u0000 </p><p>1 May 2025</p><p>\u0000 SUDEP: What are the mechanisms and risk factors?\u0000 </p><p>13 May 2025</p><p>\u0000 Neurodegeneration: When and how do neurodegenerative diseases lead to seizures?\u0000 </p><p>20 May 2025</p><p>\u0000 Understanding Functional Seizures in Children\u0000 </p><p>17 June 2025</p><p>\u0000 AD/PD™ 2025 International Conference on Alzheimer's and Parkinson's Diseases and related neurological disorders\u0000 </p><p>1 - 5 April 2025</p><p>Vienna, Austria & Online</p><p>\u0000 International Congress on Structural Epilepsy & Symptomatic Seizures 2025\u0000 </p><p>2 - 4 April 2025</p><p>Gothenburg, Sweden</p><p>\u0000 EPIPED Course: Treatment Strategies in Pediatric Epilepsies\u0000 </p><p>23 - 26 April 2025</p><p>Girona, Spain</p><p>\u0000 12th International Residential Course on Drug Resistant Epilepsies\u0000 </p><p>11 - 27 May 2025</p><p>Tagliacozzo, Italy</p><p>\u0000 International Conference for Technology and Analysis of Seizures (ICTALS 2025)\u0000 ","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":"10 2","pages":"658-660"},"PeriodicalIF":2.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/epi4.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perampanel monotherapy in pediatric epilepsy: Emphasizing the need for comprehensive safety evaluation.","authors":"Gabriel Christian de Farias Morais, Guilherme Bastos Alves, Shahina Akter, Shopnil Akash, Md Aktaruzzaman, Md Sakib Al Hasan, Umberto Laino Fulco, Edilson Dantas da Silva Junior, Jonas Ivan Nobre Oliveira","doi":"10.1002/epi4.70031","DOIUrl":"https://doi.org/10.1002/epi4.70031","url":null,"abstract":"","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy with tiagabine, levetiracetam, and perampanel in status epilepticus: Insights from EEG, biochemical, and histopathological studies in rats.","authors":"Sana Javaid, Faleh Alqahtani, Abida Parveen, Waseem Ashraf, Zohabia Rehman, Syed Muhammad Muneeb Anjum, Tanveer Ahmad, Imran Imran","doi":"10.1002/epi4.13141","DOIUrl":"https://doi.org/10.1002/epi4.13141","url":null,"abstract":"<p><strong>Objective: </strong>Status epilepticus (SE) is a condition of neurological emergency, which precipitates various functional and morphological changes in the brain. Due to the risk of drug resistance associated with SE, this study aimed to evaluate a multitargeted approach to treat SE by combining clinically used antiseizure drugs.</p><p><strong>Methods: </strong>In this study, we intraperitoneally administered tiagabine (TGB), levetiracetam (LEV), and perampanel (PER) alone and in combination as a duo and trio therapy after 30 min of SE in electrode-implanted male Sprague-Dawley rats subjected to lithium-pilocarpine-induced convulsive SE. The rats were monitored for SE-associated behavioral and electroencephalographic (EEG) changes. Moreover, at the end of the experiment, rats were sacrificed and brains were excised for biochemical and histopathological evaluation.</p><p><strong>Results: </strong>The control rats showed behavioral progression to the seizure of Stages 4-5 with 30-40 min of pilocarpine administration along with the appearance of uninterrupted fully blown epileptic spikes on EEG noted up to 2 h. The rats treated with TGB, LEV, and PER alone failed to provide behavioral and ictal attenuation. However, when combinations were tested, there was an improvement in seizure presentation while TGB + PER and LEV + PER also reversed SE-associated electrographic changes. However, the most prominent seizure attenuation was noted in rats receiving trio therapy with TGB, LEV, and PER. Moreover, the trio-treated rats demonstrated marked protection from SE-induced oxidative stress and morphological alterations in different regions of the brains.</p><p><strong>Significance: </strong>We observed that intraperitoneal administration of TGB, LEV, and PER alone did not significantly alter the ictal activity recorded by EEG but pharmacological manipulation of acutely coadministered drugs caused a reduction of electrographic, biochemical, and histopathological eruptions providing preclinical evidence of a novel multitargeted combination treatment to ameliorate the acute SE.</p><p><strong>Plain language summary: </strong>This study investigates and compares the efficacy of mono- and polytherapy approach to counter the behavioral, electrographic, and histopathlogical manifestations of status epilepticus. The tiagabine as monotherapy was administered after 30 min of uninterrupted SE, and the outcomes were compared with levetiracetam and perampanel alone as well as their duo and trio combinations. We noted that combining the low doses of tiagabine, levetiracetam, and perampanel notably interrupted the seizure progression through distinct mechanism in rat model of status epilepticus. Thus, we conclude that this novel combination may be a promising multitargeted approach for management of status epilepticus.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of perampanel on bone health in adult patients with epilepsy.","authors":"Mingxing Yu, Nana Zhang, Chunyan Chen, Yuxuan He, Jing Meng, Wen Luo, Yi Liang, Yi Guo, Liang Yu","doi":"10.1002/epi4.70038","DOIUrl":"https://doi.org/10.1002/epi4.70038","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to assess the effects of perampanel (PER) on bone metabolism and bone mineral density (BMD) in adult patients with epilepsy.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients admitted to the Epilepsy Center of Sichuan Provincial People's Hospital from January 2023 to June 2024. A total of 39 patients who completed bone metabolism and BMD evaluations after 1 year of PER treatment were included in the PER group. The control group comprised 44 patients with newly diagnosed epilepsy. A cross-sectional analysis was conducted between the two groups. We conducted a subgroup analysis of patients stratified by seizure frequency and type. Patients in the PER group were further stratified according to their seizure frequency and seizure type. Finally, we performed a cohort study involving 10 PER-treated patients whose baseline data were available prior to initiating PER therapy.</p><p><strong>Results: </strong>No significant differences in bone mineral density were observed between the experimental groups and the control group. With respect to bone metabolism, minor alterations were observed only in thyroid hormone levels and serum magnesium concentrations relative to those of the controls. No significant differences in bone metabolism or BMD were observed before or after PER treatment.</p><p><strong>Significance: </strong>Short-term PER treatment did not significantly affect bone mineral density in adult patients with epilepsy.</p><p><strong>Plain language summary: </strong>This study investigated how PER, a drug used to treat epilepsy, affects bone health in adult patients. Researchers compared 39 patients who were treated with PER for 1 year with 44 patients with newly diagnosed epilepsy. They did not observe significant differences in BMD between the two groups. Some minor changes were observed in thyroid hormone and magnesium levels in the blood, but overall, PER treatment did not have a major effect on bone metabolism or BMD. This study suggested that the short-term use of PER does not significantly affect bone health in people with epilepsy.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of phenobarbital is maintained after exposure to mild-to-moderate seizures in neonates.","authors":"Cynthia Sharpe, Charlotte-Rose Rennie-Younger, Dug Yeo Han, Suzanne L Davis, Mark Nespeca, Francesco Pisani, Jeffrey J Gold, Gail E Reiner, Sonya Wang, Richard H Haas","doi":"10.1002/epi4.70020","DOIUrl":"https://doi.org/10.1002/epi4.70020","url":null,"abstract":"<p><p>To study the relationship between the delay in treatment and the efficacy of phenobarbital in neonates, we re-analyzed data from the NEOLEV2 study. Continuous video EEG (cEEG) from patients treated with phenobarbital was reviewed by neurophysiologists who marked each seizure. The time from seizure onset to phenobarbital, total seizure burden pre-phenobarbital, and maximum seizure density (summed seizure burden per hour) pre-phenobarbital were calculated and correlated with phenobarbital efficacy at 20 mg/kg and at 40 mg/kg. The time between seizure onset and phenobarbital treatment did not predict refractoriness to phenobarbital. However, the maximum seizure density per hour and total seizure burden before phenobarbital treatment were strongly correlated with efficacy. ROC curve analysis showed cut-offs of maximum seizure density pre-phenobarbital of 10 ½ min/h and total seizure burden pre-phenobarbital of 36 ¼ min had excellent discriminatory ability in separating patients in whom phenobarbital would be effective from patients in whom it would not be effective (AUC 0.84, p = 0.0002 and AUC 0.85, p = 0.0051). These data suggest that whereas neonates with high seizure density must be treated as an emergency, mild-to-moderate seizures remain responsive to phenobarbital if treated within a time frame of several hours. PLAIN LANGUAGE SUMMARY: Phenobarbital is very effective at stopping seizures in newborns. But if phenobarbital is given after many hours of seizures, it becomes less effective. We do not know how quickly this happens. Our study found that it does not happen over the short term (<4 h). It is more difficult to stop seizures that cumulatively last more than 10 min/h.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased homovanillic acid and 5-hydroxyindoleacetic acid levels in the cerebrospinal fluid of patients with Dravet syndrome with parkinsonism.","authors":"Ryo Sugiyama, Takashi Saito, Atsuko Katsumoto, Shota Yoneno, Tomoyuki Akiyama, Hirofumi Komaki","doi":"10.1002/epi4.70034","DOIUrl":"https://doi.org/10.1002/epi4.70034","url":null,"abstract":"<p><p>Dravet syndrome (DS) is an early onset, developmental, and epileptic encephalopathy characterized by drug-resistant seizures and multiple comorbidities. It has been reported that in adulthood, it may be accompanied by parkinsonism, but the pathogenesis of this condition remains unclear. We performed dopamine transporter single-photon emission computed tomography (DAT SPECT) and measured monoamine metabolite levels in the cerebrospinal fluid (CSF) in two adult patients with DS who developed parkinsonism around the age of 30 years. DAT SPECT showed no abnormalities in either patient, whereas CSF tests revealed significant decreases in the levels of homovanillic and 5-hydroxyindoleacetic acids. One patient with severe symptoms was treated with levodopa-carbidopa, which improved parkinsonism manifestations. The other patient initiated treatment with a low dose and has been continuing the treatment without any reported side effects. In conclusion, CSF testing can detect a decrease in dopamine synthesis and may be useful in monitoring the efficacy of levodopa treatment in patients with DS and parkinsonism. PLAIN LANGUAGE SUMMARY: Dravet syndrome (DS) is an early onset, developmental, and epileptic encephalopathy. DS can lead to the development of parkinsonism in adulthood, a clinical syndrome characterized by tremor, slowed movements, and rigidity. Although parkinsonism is a significant issue for patients, its underlying pathology has not yet been elucidated. In this study, we confirmed that the levels of monoamine metabolites in the CSF were low in two patients, potentially shedding light on the pathology involved.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial stimulation for pediatric refractory epilepsy: A single institutional experience using evolving therapies.","authors":"Rohin Singh, Megan M J Bauman, Karimul Islam, Panagiotis Kerezoudis, Sanjeet S Grewal, Jonathon J Parker, Jamie J Van Gompel, Kai J Miller, Brian N Lundstrom, Keith Starnes","doi":"10.1002/epi4.70006","DOIUrl":"https://doi.org/10.1002/epi4.70006","url":null,"abstract":"<p><strong>Objective: </strong>Neuromodulation for pediatric refractory epilepsy (PRE) is preferred when the seizure onset zone is not amenable to surgical resection, due to multifocal onset or involvement of eloquent cortex. Given its rapidly evolving landscape, we describe our institutional experience with neurostimulation therapies including deep brain stimulation (DBS) of the anterior nucleus (DBS-ANT), the centromedian nucleus (DBS-CM), responsive neurostimulation (RNS), and chronic subthreshold stimulation (CSS) to treat PRE.</p><p><strong>Methods: </strong>A retrospective chart review was conducted to identify pediatric patients (≤18 years of age) who presented to our institution with PRE. Patients were included who had at least 1 year of follow-up after neurostimulation was started. Patients with ≥50% seizure frequency reduction at last follow-up compared to baseline were classified as responders.</p><p><strong>Results: </strong>A total of 35 patients (21 females) were included in the series. Nine patients underwent DBS-ANT, 9 underwent DBS-CM (+ ANT in 7 patients), 5 underwent RNS, and 12 underwent CSS. The median age at seizure onset and surgery was 8 and 16 years, respectively. Structural lesions were the most common etiology of epilepsy (54%). Eighteen patients had prior interventions and 13 received invasive EEG. Post-operative complications following neurostimulation implantation were noted in three patients (9%). However, no permanent deficits were noted. Median follow-up time was 46 months (range 13-162 months). Twenty-three patients (59%) were responders (3/9 DBS-ANT; 7/9 DBS-CM; 4/5 RNS; 9/12 CSS). Further, median seizure reduction was 25% (DBS-ANT), 89% (DBS-CM), 87% (RNS), and 88% (CSS) across the cohort. Six patients (17%) had improved subjective neurocognitive outcomes while the other 29 had stable neurocognitive outcomes.</p><p><strong>Significance: </strong>DBS, RNS, and CSS are safe and effective options for PRE. An understanding of treatment approaches can optimize results by tailoring therapy to individual patients.</p><p><strong>Plain language summary: </strong>This study investigates the use of various neurostimulation therapies for treating pediatric refractory epilepsy (PRE) including deep brain stimulation (DBS), responsive neurostimulation (RNS), and chronic subthreshold stimulation (CSS). Overall, neuromodulation was found to be effective in reducing seizures in most patients, with 59% of patients showing at least a 50% reduction in seizure frequency. Additionally, the treatments were generally safe, with few complications and no instances of permanent deficits.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of artificial intelligence chatbots' performance in responding to healthcare professionals' and caregivers' questions about Dravet syndrome.","authors":"Joana Jesus-Ribeiro, Eugenia Roza, Bárbara Oliveiros, Joana Barbosa Melo, Mar Carreño","doi":"10.1002/epi4.70022","DOIUrl":"https://doi.org/10.1002/epi4.70022","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Artificial intelligence chatbots have been a game changer in healthcare, providing immediate, round-the-clock assistance. However, their accuracy across specific medical domains remains under-evaluated. Dravet syndrome remains one of the most challenging epileptic encephalopathies, with new data continuously emerging in the literature. This study aims to evaluate and compare the performance of ChatGPT 3.5 and Perplexity in responding to questions about Dravet Syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We curated 96 questions about Dravet syndrome, 43 from healthcare professionals and 53 from caregivers. Two epileptologists independently graded the chatbots' responses, with a third senior epileptologist resolving any disagreements to reach a final consensus. Accuracy and completeness of correct answers were rated on predefined 3-point scales. Incorrect responses were prompted for self-correction and re-evaluated. Readability was assessed using Flesch reading ease and Flesch-Kincaid grade level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both chatbots had the majority of their responses rated as \"correct\" (ChatGPT 3.5: 66.7%, Perplexity: 81.3%), with no significant difference in performance between the two (χ&lt;sup&gt;2&lt;/sup&gt; = 5.30, p = 0.071). ChatGPT 3.5 performed significantly better for caregivers than for healthcare professionals (χ&lt;sup&gt;2&lt;/sup&gt; = 7.27, p = 0.026). The topic with the poorest performance was Dravet syndrome's treatment, particularly for healthcare professional questions. Both models exhibited exemplary completeness, with most responses rated as \"complete\" to \"comprehensive\" (ChatGPT 3.5: 73.4%, Perplexity: 75.7%). Substantial self-correction capabilities were observed: ChatGPT 3.5 improved 55.6% of responses and Perplexity 80%. The texts were generally very difficult to read, requiring an advanced reading level. However, Perplexity's responses were significantly more readable than ChatGPT 3.5's [Flesch reading ease: 29.0 (SD 13.9) vs. 24.1 (SD 15.0), p = 0.018].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Significance: &lt;/strong&gt;Our findings underscore the potential of AI chatbots in delivering accurate and complete responses to Dravet syndrome queries. However, they have limitations, particularly in complex areas like treatment. Continuous efforts to update information and improve readability are essential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Artificial intelligence chatbots have the potential to improve access to medical information, including on conditions like Dravet syndrome, but the quality of this information is still unclear. In this study, ChatGPT 3.5 and Perplexity correctly answered most questions from healthcare professionals and caregivers, with ChatGPT 3.5 performing better for caregivers. Treatment-related questions had the most incorrect answers, particularly those from healthcare professionals. Both chatbots demonstrated the ability to correct previous incorrect responses, particularly Perplexity. Both chatbots produ","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A public benchmark for human performance in the detection of focal cortical dysplasia.","authors":"Lennart Walger, Matthias H Schmitz, Tobias Bauer, David Kügler, Fabiane Schuch, Christophe Arendt, Tobias Baumgartner, Johannes Birkenheier, Valeri Borger, Christoph Endler, Franziska Grau, Christian Immanuel, Markus Kölle, Patrick Kupczyk, Asadeh Lakghomi, Sarah Mackert, Elisabeth Neuhaus, Julia Nordsiek, Anna-Maria Odenthal, Karmele Olaciregui Dague, Laura Ostermann, Jan Pukropski, Attila Racz, Klaus von der Ropp, Frederic Carsten Schmeel, Felix Schrader, Aileen Sitter, Alexander Unruh-Pinheiro, Marilia Voigt, Martin Vychopen, Philip von Wedel, Randi von Wrede, Ulrike Attenberger, Hartmut Vatter, Alexandra Philipsen, Albert Becker, Martin Reuter, Elke Hattingen, Alexander Radbruch, Rainer Surges, Theodor Rüber","doi":"10.1002/epi4.70028","DOIUrl":"https://doi.org/10.1002/epi4.70028","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to report human performance in the detection of Focal Cortical Dysplasias (FCDs) using an openly available dataset. Additionally, it defines a subset of this data as a \"difficult\" test set to establish a public baseline benchmark against which new methods for automated FCD detection can be evaluated.</p><p><strong>Methods: </strong>The performance of 28 human readers with varying levels of expertise in detecting FCDs was originally analyzed using 146 subjects (not all of which are openly available), we analyzed the openly available subset of 85 cases. Performance was measured based on the overlap between predicted regions of interest (ROIs) and ground-truth lesion masks, using the Dice-Soerensen coefficient (DSC). The benchmark test set was chosen to consist of 15 subjects most predictive for human performance and 13 subjects identified by at most 3 of the 28 readers.</p><p><strong>Results: </strong>Expert readers achieved an average detection rate of 68%, compared to 45% for non-experts and 27% for laypersons. Neuroradiologists detected the highest percentage of lesions (64%), while psychiatrists detected the least (34%). Neurosurgeons had the highest ROI sensitivity (0.70), and psychiatrists had the highest ROI precision (0.78). The benchmark test set revealed an expert detection rate of 49%.</p><p><strong>Significance: </strong>Reporting human performance in FCD detection provides a critical baseline for assessing the effectiveness of automated detection methods in a clinically relevant context. The defined benchmark test set serves as a useful indicator for evaluating advancements in computer-aided FCD detection approaches.</p><p><strong>Plain language summary: </strong>Focal cortical dysplasias (FCDs) are malformations of cortical development and one of the most common causes of drug-resistant focal epilepsy. Once found, FCDs can be neurosurgically resected, which leads to seizure freedom in many cases. However, FCDs are difficult to detect in the visual assessment of magnetic resonance imaging. A myriad of algorithms for automated FCD detection have been developed, but their true clinical value remains unclear since there is no benchmark dataset for evaluation and comparison to human performance. Here, we use human FCD detection performance to define a benchmark dataset with which new methods for automated detection can be evaluated.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial direct current stimulation treatment reduces, while repetitive transcranial magnetic stimulation treatment increases electroencephalography spike rates with refractory occipital lobe epilepsy: A case study.","authors":"Tine Tronrud, Marco Hirnstein, Tom Eichele, Eivind Kolstad, Lynn Marquardt","doi":"10.1002/epi4.70024","DOIUrl":"https://doi.org/10.1002/epi4.70024","url":null,"abstract":"<p><strong>Objective: </strong>Non-invasive brain stimulation has been suggested as an alternative/supplementary treatment for focal, refractory epilepsy. However, there are only a few studies and even fewer that directly compared transcranial direct current stimulation (tDCS) to repetitive transcranial magnetic stimulation (rTMS).</p><p><strong>Methods: </strong>We report the case of a 20-year-old female patient with persistent epileptiform discharges in the left occipital region consistent with focal status epilepticus. The patient received 20 min sessions of tDCS (2 mA) for five consecutive days, with the cathode over the left occipital region and the anode over the contralateral prefrontal lobe. After initial improvement, the patient's condition worsened again, and thus it was decided to treat her with rTMS (1 Hz, 1800 pulses), also for five consecutive days. Before and after each treatment, spike frequency was recorded with electroencephalography (EEG).</p><p><strong>Results: </strong>There was a significant decrease in spike frequency from pre- to post-tDCS treatment. Depending on the type of data analysis, there was either a near significant (p = 0.058, d = 0.51) or a significant (p < 0.001, d = 1.13) increase from pre- to post-rTMS treatment, and the patient reported a worsening of symptoms.</p><p><strong>Significance: </strong>The study adds to a growing body of evidence on non-invasive brain stimulation treatments in focal refractory epilepsy. On the one hand, we corroborate its usefulness. On the other hand, we highlight that non-invasive brain stimulation might inadvertently worsen symptoms. Future research needs to determine which method, with which parameters, for which patient is beneficial (and detrimental).</p><p><strong>Plain language summary: </strong>The study details the case of a patient suffering from epilepsy, located in the occipital region of the brain, who did not respond to several antiseizure medications. We treated with both transcranial direct current stimulation and repetitive transcranial magnetic stimulation. The transcranial direct current stimulation treatment resulted in a significant decrease in EEG spikes, yet the patient's condition worsened again after 2 weeks. We therefore used repetitive transcranial magnetic stimulation treatment, which, in fact, resulted in an increase in spike frequency. The results demonstrate both the potential benefits and risks of non-invasive brain stimulation as treatment in drug-resistant epilepsy.</p>","PeriodicalId":12038,"journal":{"name":"Epilepsia Open","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}