Acta Epileptologica最新文献

{"title":"A comparative study on the efficacy of different combinational anti-seizure medication therapies following valproate monotherapy failure.","authors":"Raowei Yan, Hesheng Zhang, Jia He, Wenyu Liu, Nanya Hao, Enhui Zhang, Yujie Chen, Zhujing Ou, Xintong Wu, Dong Zhou","doi":"10.1186/s42494-025-00233-3","DOIUrl":"https://doi.org/10.1186/s42494-025-00233-3","url":null,"abstract":"<p><strong>Background: </strong>Sodium valproate (VPA) is widely recognized as the first-line treatment for patients with epilepsy (PWE). However, current studies lack evidence to determine the best add-on medication following VPA monotherapy failure. Lamotrigine (LTG), levetiracetam (LEV), oxcarbazepine (OXC), topiramate (TPM), and carbamazepine (CBZ) also exhibit broad-spectrum activity for seizures. This study aims to compare the therapeutic efficacy of different anti-seizure medication combinations in PWE following valproate monotherapy failure.</p><p><strong>Methods: </strong>Individuals were categorized into five groups: VPA + LTG, VPA + LEV, VPA + TPM, VPA + OXC and VPA + CBZ. Each group was further subdivided based on seizure type: generalized onset, focal onset, or unknown onset. The effectiveness of these five groups was compared using variance, χ² test and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>A total of 2656 PWEs were included in this study. The ≥ 50% response rates for subjects with generalized epilepsy when combining VPA with LTG, OXC, LEV, TPM, and CBZ were 89.6%, 81.0%, 77.9%, 77.7%, and 75.9%, respectively. The LTG group demonstrated significantly higher efficacy than the LEV, TPM, and CBZ groups (P < 0.05). The ≥ 50% response rate of LTG, OXC, LEV, TPM and CBZ for subjects with focal epilepsy were 86.3%, 88.9%, 79.3%, 75.9% and 74.8%, respectively; with the OXC group being significantly more effective than the LEV, TPM, and CBZ groups (P < 0.05).</p><p><strong>Conclusions: </strong>In this real-world study, we assessed the effectiveness of five anti-seizure medications as add-on therapy for PWE who failed sodium valproate monotherapy. Our findings suggest that combining LTG may be more effective for subjects with generalized epilepsy, while combining OXC may be more effective for subjects with focal epilepsy.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"48"},"PeriodicalIF":1.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of brivaracetam in comparison with levetiracetam in seizures.","authors":"Shalini Sivadasan, Flencinecia Basil Raj, Kevin John, Sowmya Murugan, Stephy Susan Sam, Senthil Kumar Elumalai","doi":"10.1186/s42494-025-00229-z","DOIUrl":"10.1186/s42494-025-00229-z","url":null,"abstract":"<p><strong>Background: </strong>There are increasing incidence of psychiatric side effects associated with the use of anti-epileptics. Prospective observational studies on the effectiveness and safety of levetiracetam (LEV) and brivaracetam (BRV), along with the haematological abnormalities of both treatments, in seizure patients in an Indian population are lacking. Therefore, we aimed to compare the effectiveness and safety of LEV and BRV in seizure patients and evaluated behavioural and non-behavioural side effects, as well as outcomes when switching between LEV and BRV.</p><p><strong>Methods: </strong>A prospective observational study was conducted in newly diagnosed as well as previously diagnosed patients (n = 115) with epilepsy aged ≥ 5 years of age receiving LEV (n = 66) or BRV (n = 49). Baseline data were collected during the initiation of the study and were compared to the data obtained at the end of the study. A seizure severity questionnaire was used to assess the severity of seizures, and a brief psychiatric rating scale, Hamilton anxiety rating scale, and pediatric epilepsy side effects questionnaire were used to assess the behavioural and non-behavioural side effects.</p><p><strong>Results: </strong>At baseline, adults taking LEV showed higher rates of behavioral adverse events (BAEs) compared to those on BRV. During follow-up, the most common behavioural adverse event reported in both treatment groups (LEV and BRV) was depression. The most frequently reported non-behavioural side effect in patients taking BRV was drowsiness. Patients who switched from LEV to BRV due to psychiatric side effects showed positive results with BRV (n = 5).</p><p><strong>Conclusions: </strong>In summary, the study found that BRV is a safe alternative, with fewer and less severe side effects compared to LEV. While LEV showed slightly higher efficacy and a lower probability of drowsiness, BRV proved more tolerable for patients experiencing LEV-induced side effects. Switching from LEV to BRV decreased the psychiatric side effects.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"47"},"PeriodicalIF":1.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision gene diagnosis and treatment of epilepsy: a new frontier in medical care.","authors":"Jie Mu, Weijia Jiang, Ying Tang, Dong Zhou, Weiping Liao","doi":"10.1186/s42494-025-00241-3","DOIUrl":"10.1186/s42494-025-00241-3","url":null,"abstract":"","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"46"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: SPOUT1 variants associated with autosomal-recessive developmental and epileptic encephalopathy.","authors":"Wenwei Liu, Kai Gao, Xilong Du, Sijia Wen, Huifang Yan, Jingmin Wang, Yong Wang, Conglei Song, Li Lin, Taoyun Ji, Weiyue Gu, Yuwu Jiang","doi":"10.1186/s42494-025-00240-4","DOIUrl":"10.1186/s42494-025-00240-4","url":null,"abstract":"","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"44"},"PeriodicalIF":1.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term efficacy and predictors of vagus nerve stimulation in drug-resistant epilepsy: a multicenter cohort study.","authors":"Bojing Tan, Yuye Liu, Mingkun Gong, Fangang Meng, Anchao Yang, Kai Zhang, Lin Sang, Jianguo Zhang","doi":"10.1186/s42494-025-00220-8","DOIUrl":"10.1186/s42494-025-00220-8","url":null,"abstract":"<p><strong>Background: </strong>At present, a number of indicators have been analyzed for the relationship with the efficacy of vagus nerve stimulation (VNS) in drug-resistant epilepsy (DRE) patients, but there is still no definite predictor of efficacy. This study is to assess the long-term effectiveness and predictors of VNS in DRE patients.</p><p><strong>Methods: </strong>We analyzed DRE patients monitored for over a year post-surgery (2016-2019) to evaluate VNS outcomes. Logistic regression was used to identify efficacy predictors.</p><p><strong>Results: </strong>Out of 162 DRE patients with VNS, 99 were followed for over 12 months, 80 for over 24 months, and 70 for over 36 months. At 12 months, 33 (33.4%) showed effectiveness, including 7 (7.1%) who were seizure-free. At 24 months, 32 (40.0%) were effective, including 12 (15.0%) who were seizure-free. At 36 months, 36 (51.4%) were effective, including 11 (15.7%) who were seizure-free. After 5 years, 27 (55.1%) were effective, including 8 (16.3%) who were seizure-free. Multivariate regression analysis identified structural etiology as a predictive factor for the effective VNS treatment (P = 0.039, OR = 0.35 [0.13-0.95]).</p><p><strong>Conclusions: </strong>VNS effectively controls seizures, with effectiveness and seizure-free rates improving over time. Patients with structural factors are at higher risk of ineffective VNS, suggesting epilepsy etiology may predict VNS outcomes.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"40"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hybrid metaheuristic framework for epileptic seizure detection in healthcare decision support systems.","authors":"Indu Dokare, Sudha Gupta","doi":"10.1186/s42494-025-00238-y","DOIUrl":"10.1186/s42494-025-00238-y","url":null,"abstract":"<p><strong>Background: </strong>The detection of epileptic seizures is a crucial aspect of epilepsy care, requiring precision and reliability for effective diagnosis and treatment. Seizure detection plays a critical role in healthcare informatics, aiding in the timely diagnosis and management of epilepsy. The use of computational intelligence and optimization techniques has shown significant promise in improving the performance of automated seizure detection systems.</p><p><strong>Methods: </strong>This research work proposes a novel hybrid approach that combines Ant Colony Optimization (ACO) for feature selection with Gray Wolf Optimization (GWO) to optimize the hyperparameters of a Random Forest (RF) classifier. In this patient-specific seizure detection, ACO effectively reduces the feature set, improving computational efficiency, while GWO ensures optimal RF performance. The method is evaluated on the Children's Hospital Boston-Massachusetts Institute of Technology (CHB-MIT) and Seina datasets, which include multichannel EEG data from epileptic patients. Performance metrics such as accuracy, sensitivity, and specificity are employed to evaluate the effectiveness of the seizure detection system.</p><p><strong>Results: </strong>The proposed ACO-GWO-RF pipeline demonstrated excellent performance on the CHB-MIT dataset, with a mean accuracy of 96.70%, mean sensitivity of 92.66%, and mean specificity of 99.24%, outperforming existing approaches. The mean values of accuracy, sensitivity, and specificity obtained using the Seina dataset are 93.01%, 89.82%, and 96.26%, respectively. These improvements highlight the robustness of the hybrid metaheuristic method in handling complex EEG data.</p><p><strong>Conclusions: </strong>The hybrid metaheuristic approach effectively optimizes the processing and classification of EEG data for seizure detection. Its strong performance across datasets suggests potential for integration into interactive health applications. Furthermore, its patient-specific adaptability makes it a promising tool for personalized epilepsy diagnosis, treatment, and long-term management.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"42"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining seizure foci localization: the potential of TSPO-PET.","authors":"Yiqiao Wang, Yuncan Chen, Shimin Xu, Xunyi Wu","doi":"10.1186/s42494-025-00234-2","DOIUrl":"10.1186/s42494-025-00234-2","url":null,"abstract":"<p><p>Translocator protein positron emission tomography (TSPO-PET) is a novel imaging modality that leverages the high expression of TSPO in activated microglia and other cells within seizure foci. It has been increasingly applied in the preoperative evaluation of drug-resistant epilepsy (DRE) to aid in the localization of these foci. With advances in tracer development, TSPO-PET has achieved higher signal-to-noise ratios and broader clinical utility. Clinical studies indicate that TSPO-PET yields significantly higher positive detection rates for seizure foci compared to magnetic resonance imaging and fluorodeoxyglucose positron emission tomography. This review summarizes recent progress in TSPO-PET radiotracer technology, its mechanism of action, and its clinical applications for managing DRE.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"41"},"PeriodicalIF":1.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identify the origin of de novo variants in TSC patients by ddPCR.","authors":"Kun Ni, Xiaolong Yu, Jiehui Ma, Dan Sun","doi":"10.1186/s42494-025-00227-1","DOIUrl":"10.1186/s42494-025-00227-1","url":null,"abstract":"<p><strong>Background: </strong>Tuberous sclerosis complex (TSC), an inherited neurocutaneous disorder, is caused by variants in the TSC1 or TSC2 genes. The mosaic variants of TSC1 and TSC2 are scarcely detectable using the conventional next-generation sequencing (NGS). Therefore, this study aims to explore the detection and distribution of mosaic variants within affected families.</p><p><strong>Methods: </strong>Through whole-exome sequencing (WES) or the TSC1/TSC2 panel to detect the variants of the TSC1 and TSC2 genes, the reaction system of droplet digital PCR (ddPCR) was designed to detect the mosaicism of these variants in affected families.</p><p><strong>Results: </strong>Genetic testing was carried out on 29 TSC patients via WES or the TSC1/TSC2 panel. The results showed that 27 patients had positive results in the TSC gene variant tests. Fourteen cases were confirmed as de novo variants, and the asymptomatic fathers or mothers of 4 patients were identified as somatic mosaics by ddPCR, with mosaic proportions of 0.8%, 24.18%, 8.02%, and 0.33% respectively.</p><p><strong>Conclusions: </strong>The ddPCR holds the potential to improve diagnostic accuracy, genetic risk assessment, and clinical diagnosis rates. Consequently, it could potentially be adopted as one of the modalities for prompt clinical diagnosis.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"37"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the efficacy of deep brain stimulation in pediatric neurological disorders: a comprehensive review.","authors":"Tianshuang Wang, Xinhua Wang, Yi Wang, Yuanfeng Zhou","doi":"10.1186/s42494-025-00230-6","DOIUrl":"10.1186/s42494-025-00230-6","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) has emerged as an important therapeutic intervention, effectively addressing a spectrum of drug-resistant neurological and psychiatric disorders. Although its efficacy has been validated in adult populations, the current literature reveals a significant gap concerning its application in pediatric patients. Specifically, pediatric populations afflicted with severe conditions such as dystonia, drug-resistant epilepsy, Tourette syndrome, and some other neuropsychiatric conditions demonstrate an urgent need for alternative therapeutic options. This review systematically examined the existing literature on the application of DBS in pediatric neurological disorders, focusing on the aforementioned conditions. Preliminary findings indicate that while DBS shows potential for a specific subset of pediatric patients, the current data is limited and lacks statistical power. Reported cases exhibit varying degrees of therapeutic success. Although adverse effects associated with DBS in pediatric populations are rare, further investigation is essential to define safety profiles accurately. Future research should focus on conducting large-scale, randomized controlled trials to validate outcomes and determine optimal patient selection criteria, thereby broadening its clinical application within the pediatric population.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"39"},"PeriodicalIF":1.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the different pathogenesis of epileptogenesis: vitamins as an adjunctive treatment for epilepsy.","authors":"Weiyi Sun, Yiming Wang, Bo Xiao, Zhaohui Luo","doi":"10.1186/s42494-025-00228-0","DOIUrl":"10.1186/s42494-025-00228-0","url":null,"abstract":"<p><p>Vitamins play an essential role in the maintenance of normal physiological functions of the human body. In recent years, the use of vitamins as an adjunctive treatment for epilepsy has attracted increasing interest academically. There is a substantial body of evidence indicating that vitamin supplementation could contribute to the treatment and prevention of epilepsy. This review  discusses the pathogenesis of epilepsy associated with ten vitamins from five perspectives, namely,  inflammatory signaling pathways, excitotoxicity, oxidative stress, neuroprotection, and the blood-brain barrier, and explores the relationships between the gut microbiota and vitamins in epileptic disorders with a focus on summarizing the antiepileptic effects of vitamin D and vitamin E. In addition, we discuss the effects of antiseizure medications on vitamins. This review aims to provide a more comprehensive view of the use of vitamins as an adjunctive therapy in epilepsy.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"7 1","pages":"38"},"PeriodicalIF":1.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}