Neurology最新文献

{"title":"Noncontrast Head CT Alone vs CT Perfusion in Basilar Artery Occlusion Thrombectomy: Sometimes Less Is Just as Good.","authors":"Thomas R Ford,Brian Silver","doi":"10.1212/wnl.0000000000213973","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213973","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"15 1","pages":"e213973"},"PeriodicalIF":9.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Prognosis of Pediatric Stroke in Denmark: A Nationwide Population-Based Study.","authors":"Julie Brix Bindslev,Jan Brink Valentin,Søren P Johnsen,John Hauerberg,Klaus Hansen,Christina Engel Hoei-Hansen,Thomas Truelsen","doi":"10.1212/wnl.0000000000213901","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213901","url":null,"abstract":"BACKGROUND AND OBJECTIVESThe aim of this study was to estimate incidence rates, changes in incidence rates, and prognosis of pediatric stroke in Denmark from 2013 to 2020.METHODSThrough a nationwide register, we identified all children (age 29 days-17 years) registered with a first-ever stroke or stroke-related diagnosis between 2013 and 2020. Possible stroke events were validated by medical record review. Age-adjusted incidence rates and absolute changes in incidence rates were estimated by Poisson regression analysis. Kaplan-Meier analysis was used to estimate 30-day, 1-year, and 5-year cumulative mortality risks.RESULTSBetween 2013 and 2020, the age-adjusted stroke incidence rate increased in male individuals while no change was noted in female individuals. The trend observed in male individuals was driven by the increased incidence rate of arterial ischemic stroke (AIS) (yearly absolute change per 100,000 person-years: 0.14, 95% CI 0.018-0.26). The 30-day, 1-year, and 5-year cumulative mortality risks were 7.7% (95% CI 4.2-11.2), 10.0% (95% CI 6.0-13.9), and 11.0% (95% CI 6.8-15.2), respectively. Mortality risk remained stable over time (p value = 0.77). Among children alive at follow-up, moderate-severe neurologic impairment was present in 20.2% with AIS and 23.1% with intracerebral hemorrhage.DISCUSSIONFrom 2013 through 2020, the age-adjusted incidence rate of pediatric stroke increased in male individuals while remaining stable in female individuals. Morbidity and mortality after stroke were substantial, highlighting the need for further improvements in pediatric stroke management.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"109 1","pages":"e213901"},"PeriodicalIF":9.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Randomized Controlled Trials on IV Thrombolysis in Patients With Minor Acute Ischemic Stroke.","authors":"Mohamed F Doheim,Thanh N Nguyen,Yunyun Xiong,Hui-Sheng Chen,Nirav R Bhatt,Yongjun Wang,Raul G Nogueira","doi":"10.1212/wnl.0000000000213863","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213863","url":null,"abstract":"BACKGROUND AND OBJECTIVESThe therapeutic efficacy and safety of IV thrombolysis (IVT) for patients with minor strokes remain a subject of significant debate and uncertainty. This meta-analysis aimed to assess the comparative effectiveness and safety of IVT vs nonthrombolytic standard of care (NT-SC) in minor strokes, focusing exclusively on data from randomized controlled trials (RCTs).METHODSA comprehensive literature search was conducted to identify RCTs evaluating IVT in minor stroke, defined as a NIH Stroke Scale (NIHSS) score ≤5. The primary outcome was excellent functional recovery, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 days. Secondary outcomes included functional independence (mRS 0-2 at 90 days) and safety end points, including 90-day mortality, recurrent stroke, symptomatic intracranial hemorrhage (sICH), and any ICH. The study was registered with PROSPERO (CRD42024621714).RESULTSThe primary analysis included data from 4 RCTs that exclusively enrolled patients with minor stroke (N = 3,364; age range: 56-80 years). Secondary analyses incorporated post hoc and subgroup data on patients with minor stroke from earlier RCTs. In the primary analysis, IVT was not significantly associated with higher odds of excellent functional recovery at 90 days compared with NT-SC (mRS 0-1; odds ratio [OR] 0.85, 95% CI 0.70-1.03). IVT was significantly associated with lower odds of achieving 90-day functional independence (mRS 0-2; OR 0.71, 95% CI 0.55-0.91) and higher odds of both sICH (OR 5.22, 95% CI 1.76-15.48) and 90-day mortality (OR 2.40, 95% CI 1.23-4.67) compared with NT-SC. Subgroup analysis showed a nonsignificant association of IVT with odds of excellent functional recovery across both groups with disabling symptoms (OR 0.84, 95% CI 0.38-1.88) and nondisabling symptoms (OR 0.82, 95% CI 0.66-1.03). The pooled analysis, which incorporated nonoverlapping subgroups and post hoc data, yielded consistent findings.DISCUSSIONThe findings suggest that IVT does not confer improved functional outcomes among patients with minor strokes and can be associated with higher odds of sICH and mortality at 90 days compared with NT-SC. Since most of the included patients presented with nondisabling minor strokes, additional studies on patients with mildly disabling symptoms are warranted.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"24 1","pages":"e213863"},"PeriodicalIF":9.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Alpha-Linolenic Acid and Long-Term Multiple Sclerosis Activity and Progression.","authors":"Marianna Cortese,Xiaojing Peng,Gilles Edan,Mark S Freedman,Hans-Peter Hartung,Xavier Montalban,Rupert Sandbrink,Ernst-Wilhelm Radü,Frederik Barkhof,Eva-Maria Wicklein,Ludwig Kappos,Alberto Ascherio,Kjetil Bjornevik, ","doi":"10.1212/wnl.0000000000213905","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213905","url":null,"abstract":"BACKGROUND AND OBJECTIVESHigher dietary intake of alpha-linolenic acid (ALA), a plant-derived omega-3 polyunsaturated fatty acid (PUFA), was associated with a lower risk of multiple sclerosis (MS) in a prospective cohort study and lower risk of new lesions, relapses, and disability progression in a patient cohort. We examined whether serum levels of ALA and other PUFAs predicted MS outcomes up to 11 years after clinical onset.METHODSThis prospective study was conducted among participants in the BENEFIT clinical trial, who had serum samples collected starting at randomization. Serum fatty acids were measured using gas chromatography. We evaluated the association of individual fatty acids with time to clinically definite MS (CDMS) and other measures of disease activity and progression using Cox, negative binomial, and linear regression.RESULTSWe followed 468 participants for 5 years, including 278 followed to year 11. At baseline, the median age was 30 years and 71% were women. Higher baseline serum ALA levels were associated with a lower risk of CDMS and relapses during follow-up. The multivariable-adjusted hazard ratios for CDMS comparing top to bottom quartile were 0.60 (95% CI 0.39-0.95) and 0.60 (95% CI 0.37-0.98) after 5 and 11 years, respectively. The multivariable adjusted risk ratios for relapses comparing top to bottom quartile were 0.60 (95% CI 0.38-0.94) and 0.65 (95% CI 0.43-0.99) after 5 and 11 years, respectively. None of the other 35 fatty acids were associated with CDMS risk. Three fatty acids were associated with relapse rate after 5 years, but not 11 years. Higher ALA levels were associated with a slower decline in MS Functional Composite, an assessment of disability, at 5 years. The association was similar at 11 years, but the results did not retain statistical significance. Baseline ALA levels were not associated with subsequent changes in cognitive function, time to confirmed Expanded Disability Status Scale progression, new active lesions, or brain volume loss.DISCUSSSIONHigher serum ALA levels were associated with a lower risk of CDMS, relapses, and disability progression in a large prospective cohort. The results were null or inconsistent for other fatty acids.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"677 1","pages":"e213905"},"PeriodicalIF":9.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Neuropathy: Expanding the Horizon of Risk Factors.","authors":"Georgette Dib,Nicholas E Johnson","doi":"10.1212/wnl.0000000000213968","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213968","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"12 1","pages":"e213968"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Differences in Peripheral Neuropathy Risk Factors Among United States Adults.","authors":"Evan L Reynolds,David Russman,Melissa A Elafros,Eva L Feldman,Brian C Callaghan","doi":"10.1212/wnl.0000000000213851","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213851","url":null,"abstract":"BACKGROUND AND OBJECTIVESPeripheral neuropathy (PN) is a morbid condition. In the United States, there is higher prevalence of PN in non-Hispanic Black and Hispanic individuals vs non-Hispanic White individuals. Underlying mechanisms driving this increased prevalence are unknown. We aimed to determine associations between PN and race/ethnicity; other demographic information; and metabolic, lifestyle, and social determinants of health (SDOH) risk factors in a large and diverse sample of adults from the United States.METHODSWe performed a cross-sectional secondary analysis of the National Health and Nutrition Examination Survey from 1999 to 2004. PN was assessed using a monofilament test of reduced sensation. Risk factors included demographic (age, sex, race/ethnicity), metabolic (height, weight, waist circumference, systolic blood pressure, high-density lipoproteins, HbA1c), lifestyle (physical activity, diet), and SDOH (food security, household income, health insurance) information.RESULTSThe study included 8,014 individuals (55% non-Hispanic White, 18% non-Hispanic Black, 24% Hispanic, 3% other). The mean (SD) age was 60.8 (13.3) years, and 50% were female. Logistic regression revealed that non-Hispanic Black (odds ratio: 1.39, 95% CI 1.16-1.66) and Hispanic (1.31, 1.11-1.54) individuals had higher age-adjusted and sex-adjusted odds of PN than White individuals. Male individuals had higher age-adjusted and race-adjusted odds of PN than female individuals (0.55, 0.48-0.63). After adjusting for metabolic, lifestyle, and SDOH factors, we found that non-Hispanic Black individuals had similar odds of PN to White individuals (1.17, 0.93-1.46, p = 0.17) and male individuals (0.83, 0.66-1.05, p = 0.12) had similar odds of PN to female individuals. However, Hispanic individuals maintained a higher likelihood of PN (1.32, 1.07-1.63, p = 0.001) after adjusting for these comprehensive risk factors. Among individual risk factors, we found that age (1.05, 1.04-1.06), height (1.03, 1.02-1.05), HbA1c (1.13, 1.06-1.21), waist circumference (1.011, 1.005-1.017), and lack of health insurance (1.49, 1.16-1.92) were associated with PN. In stratified analyses, among Hispanic individuals, we found that the percentage of caloric intake from saturated fatty acids (1.06, 1.01-1.10) and food insecurity (1.48, 1.06-2.05) were associated with PN.DISCUSSIONWe found that PN risk factors likely explain higher PN prevalence in non-Hispanic Black individuals but not among Hispanic individuals. We also determined SDOH risk factors-including being uninsured, and, in Hispanic individuals, experiencing food insecurity-increased the odds of PN, indicating the need for screening, prevention, and treatment of PN in persons with SDOH risk factors.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"22 1","pages":"e213851"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Disease-Modifying Therapies in Patients With Late-Onset Multiple Sclerosis.","authors":"Camille Robin,Fabien Rollot,Mathilde Lefort,Romain Casey,Sandra Vukusic,Guillaume Mathey,Jonathan Ciron,Jerome De Seze,Bruno Stankoff,Elisabeth Maillart,Aurélie Ruet,Pierre M Labauge,Arnaud Kwiatkowski,Helene Zephir,Caroline Papeix,Gilles Defer,Christine Lebrun-Frenay,Thibault Moreau,David Axel Laplaud,Eric Berger,Pierre Clavelou,Eric Thouvenot,Olivier Heinzlef,Jean Pelletier,Olivier Casez,Bertrand Bourre,Abir Wahab,Laurent Magy,Solène Moulin,Jean-Philippe Camdessanche,Ines Doghri,Mariana Sarov,Karolina Hankiewicz,Corinne Pottier,Amélie Dos Santos,Eric Manchon,Maya Tchikviladze,Chantal Nifle,Anne Kerbrat,Gilles Edan,Emmanuelle Le Page,Laure Michel, ","doi":"10.1212/wnl.0000000000213744","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213744","url":null,"abstract":"BACKGROUND AND OBJECTIVESThe therapeutic strategy in patients with late-onset MS (LOMS) remains poorly defined. In this study, we aimed to evaluate both clinical and MRI outcomes between 2 cohorts of patients with relapsing-remitting LOMS treated or not yet treated.METHODSPatients with relapsing-remitting MS were included for the analysis if disease onset occurred after 55 years and if they had at least one follow-up visit. The primary outcome was time to first relapse between 2 matched groups of patients with LOMS (treated and not yet treated). Secondary outcomes were as follows: (1) time to first confirmed disability progression (CDP), (2) time to first progression independent of relapse activity (PIRA) event, (3) time to secondary progression (SPMS), (4) time to first MRI activity, and (5) serious infection incidence rates (IIRs). For the comparative analyses, we adopted a time-dependent propensity score matching approach.RESULTSA total of 881 patients fulfilled the inclusion criteria. The mean (SD) age at onset was 59.9 (4.43) years. After applying propensity score matching, 436 patients were matched. The mean (SD) follow-up duration was 5.2 (4.27) years in the treated group and 5.0 (3.86) years in the not-yet-treated group. Mean (SD) time to first relapse was significantly longer in the treated group compared with the not-yet-treated group (7.0 years [0.33] vs 5.4 years [0.33]; p = 0.001). Mean (SD) time to first MRI activity was significantly longer in the treated group (5.9 years [0.33] vs 5.0 years [0.33]; p = 0.049). However, the mean time to CDP, PIRA, or SPMS was not different between the 2 groups (difference = 0.32 years; p = 0.585 for CDP; difference = 0.40 years; p = 0.442 for PIRA; difference = -0.02 years; p = 0.952 for SPMS). No increase in serious IIRs was observed with an incidence rate ratio of 0.38 (95% CI 0.07-2.10, p = 0.265) in the never-treated group compared with the treated one.DISCUSSIONThis study demonstrates a beneficial effect of disease-modifying therapy (DMT) on disease activity in patients with LOMS but without significant impact on disability progression. Main limitations are linked to the challenge of data collection and to the baseline imbalances between the 2 groups.CLASSIFICATION OF EVIDENCEThis study provides Class III evidence that in patients with LOMS, treatment with DMTs is associated with a longer time to first relapse compared with those not treated with DMTs.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"2 1","pages":"e213744"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Antiseizure Medications Early in Pregnancy and the Risk of Major Malformations in the Newborn.","authors":"Sonia Hernandez-Diaz,Moira Quinn,Susan Conant,Amy Lyons,Hyun Paik,Jason Ward,Esther Bui,W Allen Hauser,Mark Yerby,Paula Emanuela Voinescu,Deborah G Hirtz,Frances A High,Lewis Ball Holmes","doi":"10.1212/wnl.0000000000213786","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213786","url":null,"abstract":"BACKGROUND AND OBJECTIVESMaternal use of first-generation antiseizure medications (ASMs), such as valproate and phenobarbital, increases the risk of congenital malformations in offspring. Second-generation ASMs, such as lamotrigine and levetiracetam, pose less risk to fetal development, although topiramate seems to increase the risk of oral clefts. Less is known about the safety of newer second-generation ASMs during pregnancy including oxcarbazepine, zonisamide, and lacosamide. The aim of this study was to quantify the relative risk of major malformations in offspring after maternal use of specific ASMs early in pregnancy, with special interest in second-generation ASMs.METHODSThe study population included pregnant women who enrolled in the North American Antiepileptic Drug Pregnancy Registry between 1997 and 2023. Data on ASM use and maternal characteristics were collected through phone interviews at enrollment, at 7 months of gestation, and within 3 months after delivery. Malformations were confirmed by medical records and adjudicated by a dysmorphologist. The risk of major malformations was estimated among infants exposed to specific ASMs in monotherapy during the first trimester of pregnancy. Risk ratios (RRs) and 95% CIs were estimated with logistic regression models.RESULTSA total of 7,311 participants taking an ASM as monotherapy during the first trimester were eligible for analysis. The mean age was 30 years. The risk of major malformations was 2.1% (52/2,461) for lamotrigine, 2.0% (26/1,283) for levetiracetam, 2.8% (32/1,132) for carbamazepine, 5.1% (26/510) for topiramate, 2.8% (12/423) for phenytoin, 9.2% (31/337) for valproate, 1.5% (5/327) for oxcarbazepine, 1.5% (4/270) for gabapentin, 1.3% (3/228) for zonisamide, 6.0% (12/200) for phenobarbital, 3.2% (2/62) for pregabalin, and 0% (0/88) for lacosamide. Compared with lamotrigine, the RR was 5.1 (95% CI 3.0-8.5) for valproate, 2.9 (1.4-5.8) for phenobarbital, and 2.2 (1.2-4.0) for topiramate. Topiramate was specifically associated with a higher risk of cleft lip.DISCUSSIONResults confirm the association between maternal use of valproate, phenobarbital, and topiramate early in pregnancy and a higher risk of major malformations in the infant compared with lamotrigine. However, they do not support meaningful risk elevation for levetiracetam, oxcarbazepine, gabapentin, or zonisamide. Relative risk estimates for lacosamide and pregabalin are still imprecise.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"43 1","pages":"e213786"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Multiple Sclerosis: Is Disease-Modifying Therapy Indicated?","authors":"Dennis Bourdette,Lindsey Wooliscroft","doi":"10.1212/wnl.0000000000213971","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213971","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"13 1","pages":"e213971"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Seizure-Related Impact Assessment Scale: A Novel Patient-Reported Outcome Measure for Epilepsy.","authors":"Emma Foster,Alison Conquest,Chris Ewart,John-Paul Nicolo,Genevieve Rayner,Toby T Winton-Brown,Terence J O'Brien,Patrick Kwan,Charles Malpas,Jacqueline French","doi":"10.1212/wnl.0000000000213900","DOIUrl":"https://doi.org/10.1212/wnl.0000000000213900","url":null,"abstract":"BACKGROUND AND OBJECTIVESThere is a clear need in epilepsy clinical trials and practice for a measure that captures the trade-off between seizure and treatment-related adverse effects, which is reliable over time and across different treatment regimens. We aimed to create and validate the Seizure-Related Impact Assessment Scale (SERIAS) to fill this need.METHODSThis was a prospective longitudinal study of adults with epilepsy recruited from an Australian comprehensive epilepsy center. Participants completed SERIAS at baseline and 3 and 6 months later. SERIAS has 6 self-report items. Five items record the number of days per month that seizures or treatment-related adverse effects partially or fully affect work/home/school and family/social/nonwork activities. The final item is an epilepsy disability visual analog scale. SERIAS is scored by adding the days per month of disability, with scores ranging from 0 to 150 (higher scores indicate more disability). SERIAS was completed alongside 7 validated instruments measuring seizure-related and treatment-related adverse effects (Work and Social Adjustment Scale [WSAS], Liverpool Adverse Events Profile [LAEP]), mood disorders (Neurological Disorders Depression Inventory for Epilepsy [NDDI-E], Generalized Anxiety Disorder [GAD-7]), somatic symptoms (Somatic Symptom Scale [SSS-8]), and quality of life (Quality of Life in Epilepsy Inventory [QOLIE]-31, EuroQol 5 Dimensions [EQ-5D]). General linear mixed models were used to investigate the relationship between the SERIAS and other relevant clinical and psychometric data. Standardized model coefficients β are presented with 95% confidence intervals.RESULTSA total of 90 patients (64.4% female, mean age 43.1 years) completed baseline SERIAS. Most patients reported at least 1 day of disability (62%, median SERIAS score = 3, interquartile range = 18.3). Greater disability was negatively correlated with QOLIE-31 total score (β = -0.17, 95% CI -0.27 to -0.07) and positively correlated with scores on 5-level EQ-5D (β = 0.15, 95% CI 0.04-0.25), NDDI-E (β = 0.22, 95% CI 0.13-0.31), GAD-7 (β = 0.21, 95% CI 0.09-0.32), SSS8 (β = 0.29, 95% CI 0.17-0.41), LAEP (β = 0.29, 95% CI 0.20-0.39), WSAS seizure-related adverse events (β = 0.23, 95% CI 0.14-0.33), and WSAS treatment-related adverse events (β = 0.36, 95% CI 0.26-0.46). Higher seizure frequency was associated with higher SERIAS score (β = 0.07, 95% CI 0.03-0.11). Psychometric reliability for the SERIAS was acceptable (all coefficients >0.70) as was test-retest reliability (n = 35 patients, intraclass correlation coefficient = 0.72, 95% CI 0.51-0.85).DISCUSSIONSERIAS shows good psychometric reliability and strong test-retest stability. These findings suggest that SERIAS is a valid scale to measure epilepsy-related disability.","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"7 1","pages":"e213900"},"PeriodicalIF":9.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}