Acta Epileptologica最新文献

{"title":"Efficacy and safety of Brivaracetam as an adjunctive therapy in patients with focal-onset seizures: a phase III, multi-center, randomized, double-blind, placebo-controlled trial.","authors":"Peimin Yu, Ting Zhao, Weihong Lin, Xiong Han, Feng Li, Zhen Hong","doi":"10.1186/s42494-026-00253-7","DOIUrl":"10.1186/s42494-026-00253-7","url":null,"abstract":"<p><strong>Background: </strong>Preclinical experiments have revealed that Brivaracetam (BRV) exhibited a significant anti-seizure function in animal models and was more effective and safer than other synaptic vesicle protein 2A (SV2A) ligands, including levetiracetam (LEV), this study aims to evaluate the efficacy and safety of generic BRV tablets in Chinese patients with focal-onset seizure.</p><p><strong>Methods: </strong>This phase III, randomized, double-blind, placebo-controlled clinical trial conducted in 21 medical centers evaluated BRV (200 mg/day) as an adjunctive therapy in Chinese adult patients with focal-onset seizures, with or without secondary generalization, despite treatment with one or two permitted concomitant anti-seizure medications (ASMs). After an 8-week screening baseline, patients were 1:1 randomized to BRV 200 mg/day or placebo for a 12-week treatment period. The primary efficacy endpoint was the percent reduction in seizure frequency per 28 days from baseline. Safety evaluations included the adverse events (AEs), side effects, and the regular monitoring of clinical symptoms, vital signs, physical examinations, laboratory tests, electrocardiograms, and mood.</p><p><strong>Results: </strong>Of 179 randomized patients, 178 were included in the final analysis (90 in BRV; 88 in placebo), while one patient in placebo group was excluded for not receiving the study drug. The percent reduction in seizure frequency per 28 days from baseline was 40.67% in the BRV group compared to the placebo group. The 12-week responder rate was significantly higher with BRV than placebo [48.89% vs. 23.86%, Odds Ratio (OR) = 3.12, 95% Confidence Interval (CI): 1.63-5.99, P = 0.0006]. There's no statistical significance of reported AEs in the BRV and placebo groups. Seizure freedom was achieved by 10 (11.11%) and 2 (2.27%) patients in the BRV and placebo groups, respectively (P = 0.0325). Discontinuations due to AEs (6.67% vs. 0, P = 0.0287) and special concern AEs (32.22% vs. 9.09%, P = 0.0002) were higher with BRV than placebo. Dizziness, somnolence, and nausea were reported more frequently with BRV than placebo.</p><p><strong>Conclusions: </strong>Generic BRV demonstrated a better efficacy and comparable safety in treating focal-onset seizure in Chinese patients.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843729","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":"Knockdown of Gasdermin D protects hippocampal neurons by regulating both pyroptosis and ferroptosis in a rat model of status epilepticus.","authors":"Fan Feng, Haijiao Wang, Yanmei Tian, Rong Luo, Qianyun Cai","doi":"10.1186/s42494-026-00255-5","DOIUrl":"10.1186/s42494-026-00255-5","url":null,"abstract":"<p><strong>Background: </strong>Pyroptosis and ferroptosis may be implicated in status epilepticus (SE)-induced neuronal damage. This study aimed to elucidate the effects of Gasdermin D (GSDMD) on pyroptosis and ferroptosis after SE, and to determine whether GSDMD inhibition ameliorates SE-induced neuronal damage and cognitive dysfunction.</p><p><strong>Methods: </strong>In the lithium-pilocarpine-induced SE rat model, we measured GSDMD and glutathione peroxidase 4 (GPX4) expression in the hippocampus via western blotting to evaluate the involvement of pyroptosis and ferroptosis after SE. After GSDMD knockdown by RNA interference, we performed Nissl staining to detect neuronal loss; quantitative reverse transcription polymerase chain reaction (qRT-PCR) to detect the hippocampal expressions of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α); Prussian blue staining to detect iron deposition; and western blotting and enzyme-linked immunosorbent assay to detect the expressions of the ferroptosis-related molecules GPX4, malonaldehyde (MDA), and glutathione (GSH). Finally, cognitive and behavioral functions were evaluated using the spontaneous-activity test and novel object-recognition test.</p><p><strong>Results: </strong>Western blotting showed a marked increase in GSDMD expression (P < 0.050) and a notable decrease in GPX4 levels in (P < 0.050) the hippocampus of rats, providing evidence that both pyroptosis and ferroptosis are activated following SE. In addition, GSDMD knockdown significantly improved hippocampal neuronal survival and improved cognitive and behavioral functions of SE rats. Meanwhile, knockdown of GSDMD led to a significant reduction in the mRNA expression of IL-1β, IL-6, and TNF-α (pyroptosis products) (P = 0.021, 0.010, and 0.015, respectively), a decrease in iron deposition (P = 0.000) and MDA levels (ferroptosis product) (P = 0.000), and increased GSH and GPX4 expression (negative ferroptosis regulators) (P = 0.000 and 0.004, respectively).</p><p><strong>Conclusions: </strong>Pyroptosis and ferroptosis may jointly contribute to SE-induced neuronal damage. GSDMD may regulate both pyroptosis and ferroptosis, and inhibiting GSDMD could improve cognitive and behavioral function in SE rats.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821590","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":"Case report: precise mapping and epilepsy surgery of the Broca's area after a comprehensive OPM-MEG investigation of Broca's area localization.","authors":"Yuanfeng Zhou, Yanjiong Zhang, Luo Tian, Tianshuang Wang, Min Wang, Renqing Zhu, Hao Li, Zhongwei Qiao, Zhigang Cao, Yuming Peng, Ming Ding, Yi Wang","doi":"10.1186/s42494-026-00245-7","DOIUrl":"10.1186/s42494-026-00245-7","url":null,"abstract":"<p><strong>Background: </strong>Optically pumped magnetometers magnetoencephalography (OPM-MEG) have demonstrated their value in the diagnosis and mapping of epilepsy, as well as their advantages in pediatric applications.</p><p><strong>Case presentation: </strong>We present a case of 8-year-old boy with drug-resistant epilepsy, whose epileptogenic lesion is in left Broca's region. The boy underwent language function evaluation and localization by on-scalp OPM-MEG before surgery. Dipole clusters and Dipole Density of epileptogenic signals by OPM-MEG were located in the left inferior frontal gyrus, though language verbal generation mapping of OPM-MEG signals were mainly located in left frontal orbital gyrus, indicating a localization of the language function area. Seizure freedom and no loss of language function were achieved after MRI-guided laser interstitial thermal therapy.</p><p><strong>Conclusions: </strong>This article underscores the feasibility of using OPM-MEG to record abnormal discharges of seizure and assess language function area in children, especially in drug-resistant epilepsy surgery involving brain functional areas.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821564","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":"Gene variants in periventricular nodular heterotopia.","authors":"Jianping Song, Xiaoqin Sun, Chunqing Zhang","doi":"10.1186/s42494-026-00243-9","DOIUrl":"https://doi.org/10.1186/s42494-026-00243-9","url":null,"abstract":"<p><p>Periventricular nodular heterotopia (PVNH) is a malformation of cortical development (MCD) mainly caused by aberrant neuronal migration, and a group of diseases sharing similar pathological manifestations, including the presence of nodular clusters of abnormal neurons in the subependymal region. PVNH is one of major causes that result in genetic epilepsy. Seizures can strike as early as a few days after birth but are more common at 10-20 years old, and among them, generalized tonic-clonic seizures are commonly observed. PVNH is a highly genetically heterogeneous disease associated with various rare single gene variants. However, despite the fact that the FLNA gene is identified to be closely correlated with the presence of PVNH, mutations in other genes were understudied and have not attracted as much attention due to the relatively low morbidity of PVNH. In consequence, an updated spectrum of PVNH-associated risk genes with potentially pathogenic changes that lead to PVNH in human patients is urgently needed. The risk genes that have already been clinically reported for PVNH are summarized here chronologically according to when the first patient was reported, and clinical manifestations of patients with each of these genes are described. Human cerebral organoids as well as animal models are subsequently discussed in this review to reveal alterations in risk gene products and the pathogenesis of PVNH.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821604","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":"The kynurenine pathway storm in epilepsy: mechanisms and therapeutic implications.","authors":"Yuxuan He, Jing Meng, Wen Luo, Mingxing Yu, Nana Zhang, Chunyan Chen, Liang Yu","doi":"10.1186/s42494-026-00250-w","DOIUrl":"https://doi.org/10.1186/s42494-026-00250-w","url":null,"abstract":"<p><p>The kynurenine pathway (KP) is the main route for tryptophan (TRP) degradation and plays a crucial role in neuroinflammation, oxidative stress and neurotransmission, which holds significant clinical significance. The dysregulation of this pathway is closely related to neurological disorders such as epilepsy, and its metabolic products can promote the occurrence of epileptic seizures and comorbid depression. This review aims to clarify the complex mechanisms of the KP in the occurrence and development of epilepsy and to explore its potential as a therapeutic target for epilepsy and comorbid depression. This is a narrative review and synthesis of the current literature. We reviewed animal experiments and clinical studies, elaborating in detail on how metabolites of the KP and their key enzymes function in the context of epilepsy by regulating neuroinflammation, oxidative stress, glutamatergic signaling, and the gut-brain axis. We also explored the interaction between antiseizure medications (ASMs) and the KP, and evaluated the potential value of targeting key enzymes (such as indoleamine 2,3-dioxygenase, IDO) as a new therapeutic strategy for epilepsy. This review particularly focuses on the promoting effect of KP imbalance on comorbid depression, clarifying how IDO-mediated TRP metabolism changes constitute a common mechanism basis, jointly leading to the occurrence of epilepsy and depression-like behaviors. The occurrence and development of epilepsy are closely related to the imbalance of the KP, specifically manifested as a decrease in kynurenic acid (KYNA) level and an increase in quinolinic acid (QA) level. The IDO-mediated shift of TRP metabolism towards the KP is established as a critical mechanism underlying depression comorbidity in epilepsy. Therapeutic modulation of this pathway, through targeting key enzymes like IDO and restoring the KYNA/QA balance, presents a viable strategy for improving the cerebral microenvironment. This approach holds promise for enhancing seizure control, counteracting drug resistance, and concurrently alleviating comorbid depressive symptoms.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821539","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":"Clinical and electroencephalogram characteristics of pilomotor seizures.","authors":"Zhijun Le, Bingqian Li, Hesheng Zhang, Yujie Chen, Raowei Yan, Dong Zhou, Jiani Chen, Xintong Wu","doi":"10.1186/s42494-026-00260-8","DOIUrl":"https://doi.org/10.1186/s42494-026-00260-8","url":null,"abstract":"<p><strong>Background: </strong>Piloerection, a physiological response to cold or emotional stimuli, is a rare autonomic manifestation of epileptic seizures. The anatomical correlates and electrophysiological mechanisms of pilomotor seizures remain poorly understood.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 13 patients with pilomotor seizures identified from 8482 individuals monitored at the Epilepsy Center of West China Hospital. Demographics, seizure characteristics, neuroimaging, and neurophysiological findings were analyzed to determine the epileptogenic zones and associated etiologies.</p><p><strong>Results: </strong>Most (11/13) of our cases showed temporal lobe origin of seizures, with distinctive ictal encephalogram patterns including rhythmic delta activity. Piloerection was consistently accompanied by other autonomic or psychic symptoms. Most patients responded to anti-seizure medications.</p><p><strong>Conclusions: </strong>Pilomotor seizures are associated with temporal lobe epilepsy and are frequently associated with specific etiologies such as autoimmune encephalitis.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782850","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":"Clinical characteristics and factors associated with psychiatric comorbidity among people with epilepsy in Ganzi Tibetan autonomous prefecture of China: a cross-sectional study.","authors":"Chunxia Wang, Deng Chen, Liusha Zhao, Fangzhou Liu, Ling Zhang, Xiaoyan Liu, Ling Liu","doi":"10.1186/s42494-026-00256-4","DOIUrl":"10.1186/s42494-026-00256-4","url":null,"abstract":"<p><strong>Background: </strong>This study was conducted to determine the prevalence of epilepsy in Daofu County, Sichuan Province, China, and to identify factors associated with comorbid depression, anxiety, and impaired quality of life among people with epilepsy (PWE).</p><p><strong>Methods: </strong>In this community-based, cross-sectional study, a door-to-door survey of epilepsy was performed among 37,390 permanent residents of Daofu County. The survey identified 164 confirmed cases of epilepsy. Of them, 127 participants (aged ≥ 16 years) who were able to complete self-reported questionnaires were enrolled for final analysis. Depression and anxiety symptoms were assessed using the Chinese versions of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) and the Generalized Anxiety Disorder-7 (GAD-7) scale, respectively. Health-related quality of life was evaluated with the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Factors associated with depression and anxiety were examined using logistic regression analyses, while factors influencing QOLIE-31 scores were assessed by linear regression.</p><p><strong>Results: </strong>The estimated prevalence of epilepsy in Daofu County was 4.4‰ (95% CI: 3.7-5.1‰). Independent factors associated with the comorbid depression included a low monthly household income per capita (aOR = 4.41, 95% CI: 1.82-10.71; P = 0.001) and active epilepsy (aOR = 4.87, 95% CI: 1.74-13.62; P = 0.003). Independent factors associated with the comorbid anxiety included a low monthly household income per capita (aOR = 5.03, 95% CI: 1.88-13.5; P = 0.001) and active epilepsy (aOR = 4.84, 95% CI: 1.95-12.01; P = 0.001). Furthermore, factors including a low monthly household income per capita, a history of status epilepticus, and active epilepsy were significantly associated with a lower QOLIE-31 score.</p><p><strong>Conclusions: </strong>There is a high burden of depression and anxiety among PWE in the Tibetan areas of China. Active epilepsy is the most potent, independent risk factor of psychiatric comorbidities and poorer quality of life. These findings suggest the urgent need for integrated epilepsy management and mental health services in this resource-limited region.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628710","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":"Phenobarbital monotherapy for convulsive seizures in rural Northwest China: a 12-year longitudinal study.","authors":"Xiaozhi Qiao, Yuanyuan Wang, Xiaomu Wang, Xiao Ma, Xuan Wang, Fang Yang, Changgeng Song, Lei Ma, Wen Jiang","doi":"10.1186/s42494-026-00252-8","DOIUrl":"10.1186/s42494-026-00252-8","url":null,"abstract":"<p><strong>Background: </strong>This study was conducted as part of the China Epilepsy Prevention and Control Management Project. The research aimed to investigate the efficacy of phenobarbital (PB) and prognostic factors for convulsive seizures in rural areas of northwest China.</p><p><strong>Methods: </strong>Patients with convulsive seizures were recruited from seven rural regions in Shaanxi Province, Northwest China, between January 2011 and December 2022. Patients over 6 years old and had at least one convulsive seizure at baseline (within 12 months prior to screening) were included. They were prescribed PB monotherapy according to a standardized protocol. During follow-up, the efficacy of PB was annually estimated by the reduction in seizure frequency. At the five-year follow-up, prognosis was assessed by the proportion of patients who achieved three consecutive seizure-free years.</p><p><strong>Results: </strong>A total of 1001 patients (mean age 40.9 years, 56.8% male) were included. The median follow-up duration was 5 years (interquartile range [IQR], 3-8; maximum 12 years). The median baseline seizure frequency was 5 seizures (IQR 3-12) per year. The proportion of patients achieving a 50% reduction in seizure frequency was 62.1% (622/1001) in the first year and 93.0% (133/143) by the tenth year, respectively. In total, 528 individuals achieved 3-year remission (3YR), 473 participants did not achieve 3YR. Patients who achieved 3YR demonstrated significantly higher rates of seizure freedom within the initial 24-month treatment period compared to non-3YR patients (89% vs 37%, respectively, P < 0.001). Multivariate analysis revealed that patients with a baseline seizure frequency exceeding 10 seizures per year had a significantly higher risk of failure to achieve 3YR (OR 2.13, 95%CI 1.63-2.78, P < 0.001). Adverse effects of PB were mostly mild, with 490 patients (48.9%) recording adverse reactions one month after prescription and decreased to 238 patients (23.8%) at their last visit (median follow-up 4 [IQR 2-7] years).</p><p><strong>Conclusions: </strong>Our study demonstrated that convulsive seizures could be effectively controlled with PB monotherapy with mild adverse effects in rural areas in Northwest China. Early treatment response, particularly seizure freedom within the first two years, is a strong indicator of long-term remission. High baseline seizure frequency is an independent risk factor for poor prognosis.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610122","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":"Trends in the studies of pharmacoresistant epilepsy- a review based on literature analysis (2015-2025).","authors":"Menghan Li, Yang Yuan, Junxiu Ye, Xiongfeng Guo, Xin Tian, Cenglin Xu","doi":"10.1186/s42494-026-00249-3","DOIUrl":"10.1186/s42494-026-00249-3","url":null,"abstract":"<p><p>Drug-resistant epilepsy (DRE) is a complex neurological disease that accounts for 30%-40% of all epilepsy cases. Its pathogenesis and treatment have always been research hotspots in this field. In recent years, interdisciplinary research on DRE has gradually become a hot topic owing to the research and application of gene sequencing, neuroimaging, new antiepileptic therapies, and artificial intelligence. To reveal the knowledge structure and research trends in this field, this study conducted a bibliometric analysis based on the literature from 2015 to 2025 in the PubMed database, utilizing tools such as R-bibliometrix and CiteSpace to reveal the research trends, core authors, hot topics, and future directions in the DRE field. The analysis showed that from the sorted documents, Professor Bartolomei Fabrice is the most productive author and has published 80 articles on drug-resistant epilepsy. The Capital Medical University of China was the most active institution. The USA, China, and Italy are the countries with the most research contributions, accounting for 25.67%, 15.71%, and 8.09%, respectively. Through keyword analysis and theme evolution, hotspots (such as the ketogenic diet and cannabidiol) and trends (the shift from anti-seizure medications to new therapies) in drug-resistant epilepsy research were explored, revealing dynamic changes in research directions in the field, and that the DRE field is experiencing a paradigm shift from empirical treatment to precision medicine. Robot and artificial intelligence-assisted diagnosis and treatment may become important research directions in the future. This literature analysis study may provide an overview of the research field and references for future research directions in the DRE.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595260","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":"Investigation of the implementation and utilization of ketogenic diet therapy in China : For the Commission on Standardized Development of Epilepsy Centers and Commission on Ketogenic Diet, China Association Against Epilepsy.","authors":"Wenjie Xi, Yicong Lin, Shujuan Tian, Jianxiang Liao, Yuping Wang","doi":"10.1186/s42494-026-00242-w","DOIUrl":"10.1186/s42494-026-00242-w","url":null,"abstract":"<p><strong>Background: </strong>Ketogenic diet therapy (KDT), characterized by a high-fat, low-carbohydrate composition with adequate protein and other nutrients for growth, has emerged as an effective therapeutic approach for drug-resistant epilepsy. This study was designed to investigate the existing challenges in KDT implementation and evaluate its current utilization status within the Chinese healthcare context.</p><p><strong>Methods: </strong>From August 27 to September 5, 2024, a comprehensive questionnaire was disseminated to 418 epilepsy centers throughout China via the Commission on Standardized Development of Epilepsy Centers and the Commission on KDT, which operate under the auspices of the China Association Against Epilepsy (CAAE). The distribution leveraged both email and WeChat platforms to ensure broad reach and accessibility. The survey instrument encompassed five key domains: (1) baseline characteristics of surveyed epilepsy centers, (2) clinical application of KDT, (3) the efficacy of KDT: perspectives from epilepsy centers, (4) the adverse effects of KDT, and (5) implementation challenges and recommendations for KDT adoption. All the collected data were analyzed using descriptive statistical methods.</p><p><strong>Results: </strong>We received 258 completed questionnaires, for a response rate of 62%. Among the responding epilepsy centers, the classic KDT (cKDT) was utilized by 63% of the centers, the modified Atkins diet (MAD) was utilized by 40% of the centers, the low-glycemic-index treatment (LGIT) was utilized by 20% of the centers, and the medium-chain triglyceride (MCT) diet was utilized by 25% of the centers. The most significant barrier to KDT implementation was identified as limited KDT-related expertise among clinical practitioners, reported by 83% of the respondents. Additionally, improving patient and family education programs on KDT management was the most frequently cited factor (93%) for increasing KDT utilization. The data revealed strong clinical need for promoting KDT implementation, particularly in the management of super-refractory status epilepticus and refractory status epilepticus. Among the 120 epilepsy centers that implemented KDT, 27 reported cases of gastrointestinal adverse reactions.</p><p><strong>Conclusions: </strong>This study constitutes the first nationwide comprehensive investigation into the clinical application of KDT in China. The results reveal a notably limited adoption of KDT across epilepsy centers, despite its well-documented therapeutic efficacy and favorable safety profile. The current implementation remains limited to a select number of specialized centers and a relatively small patient population, primarily due to insufficient awareness and understanding among healthcare practitioners. These findings provide evidence-based insights that underscore the necessity for strategic initiatives to promote wider implementation of KDT in clinical practice.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595228","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}