Acta Epileptologica最新文献

{"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":"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":2.6,"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":2.6,"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":2.6,"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":2.6,"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":2.6,"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}

{"title":"Epilepsy awareness among physicians in plains and plateau regions of western China: a cross-sectional study.","authors":"Xi Xiao, Jing Xiao, Changqiong Zhou, Chunge Pan, Yu Hao, Minghao Jin, Mingzhe Han, Shuang Jiang, Jiawei Liu, Yingying Tang, Xintong Wu, Bo Yan, Xiaoting Hao","doi":"10.1186/s42494-026-00251-9","DOIUrl":"10.1186/s42494-026-00251-9","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a common neurological disorder affecting about 50 million people worldwide. Disparities in healthcare resources lead to geographical variation in its diagnosis, treatment, and management. In particular, the gap between plains and plateau regions in western China remains understudied. Assessing healthcare professionals' expertise and delivering targeted training represent effective strategies to narrow this treatment gap. We compare epilepsy knowledge between physicians in more developed plains regions and less developed plateau regions of western China in order to inform targeted interventions to address regional disparities.</p><p><strong>Methods: </strong>In this cross-sectional study, physicians attending epilepsy training sessions in three cities representative of the western plains region of China (Chengdu) and of the western plateau region (Lhasa and Xichang) completed a questionnaire assessing knowledge in several modules of the disease, including its diagnosis, preoperative evaluation, drug and surgical treatments, and management during pregnancy.</p><p><strong>Results: </strong>Of the 349 participants given questionnaires, 325 (93.1%) were included in the final analysis. Physicians from the plateau region scored significantly lower than physicians from the plains region on knowledge about epilepsy diagnosis (Number of questions with discrepancies / Total number of questions in this module, i.e., 7/7, P < 0.05), definition of drug-resistant epilepsy (2/2 questions P < 0.05), preoperative evaluation and surgical treatments (7/14 questions P < 0.05), status epilepticus (2/2 questions P < 0.05), epilepsy comorbidities (2/2 questions P < 0.05), and epilepsy management during pregnancy (3/3 questions P < 0.05). However, no significant differences were found between neurology specialists in plateau regions and those in plain regions across all six epilepsy knowledge modules and the overall score (0.542 < P < 0.829).</p><p><strong>Conclusions: </strong>Significant gaps persist in epilepsy care knowledge among physicians in western plateau of China, particularly in diagnosis, treatment, and specialized management. Both plateau and plains regions lack awareness of advanced preoperative evaluation techniques. Targeted training and capacity-building interventions are needed, with effectiveness evaluated through longitudinal studies.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436058","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":"Unraveling the mechanisms of slack channel mutations in epileptic disorders.","authors":"Yue Wei, Aqeela Zahra, Qun Wang, Jianping Wu","doi":"10.1186/s42494-026-00246-6","DOIUrl":"10.1186/s42494-026-00246-6","url":null,"abstract":"<p><p>Sodium-activated potassium channels (K_Na) are extensively expressed throughout the central nervous system (CNS) and play a pivotal role in modulating neuronal excitability. The K_Na achieve this by regulating the threshold for action potential initiation and the magnitude of post-hyperpolarization. The KCNT1 gene encodes the α subunit of K_Na, also known as Slack channel, is crucial for governing the membrane excitability of neurons. Mutations in the KCNT1 gene impair the function of these potassium channels, leading to seizures and a spectrum of epileptic disorders. These conditions are often intractable and can range in severity from moderate to profound. This article delves into the subject of Slack channel detailing their architecture, physiological functions, distribution, and expression patterns, as well as their essential role in the nervous system. Additionally, we address the topic of epilepsy resulting from mutations in the KCNT1 gene and the therapeutic strategies currently available for managing these challenging conditions.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327423","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 research progress of wearable digital health technologies in epilepsy management.","authors":"Xinyi Zhao, Tiancheng Wang","doi":"10.1186/s42494-026-00247-5","DOIUrl":"10.1186/s42494-026-00247-5","url":null,"abstract":"<p><p>Epilepsy is one of the most common neurological disorders, characterized by recurrent, unpredictable seizures. Due to the unpredictability of seizures, epilepsy presents unique challenges in monitoring and management. While video electroencephalogram (EEG) monitoring is the gold standard for diagnosing epilepsy, its application is limited to clinical settings and is not suitable for long-term monitoring in daily life. In recent years, the development of wearable digital health technologies has provided new solutions for epilepsy management. These technologies, utilizing artificial intelligence algorithms, can monitor the physiological state of epilepsy patients in real time, predict and record seizures, thereby optimizing the management and response to seizures, reducing injuries, and potentially lowering the risk of sudden unexpected death in epilepsy (SUDEP). This article reviews the current applications and challenges of wearable technology in epilepsy monitoring and management, and explores the future directions of its development in epilepsy care, aiming to provide insights for effective monitoring and prevention.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327371","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":"Automatic EEG artifact detection using a local-global feature fusion network in time and time-frequency domains.","authors":"Qindong Yu, Chuan Lin, Weibo Wang, Zhanhui Feng, Ming Wen","doi":"10.1186/s42494-026-00248-4","DOIUrl":"10.1186/s42494-026-00248-4","url":null,"abstract":"<p><strong>Background: </strong>Video electroencephalographies (VEEGs) are often affected by artifacts, which can diminish clinicians' efficiency in interpreting VEEG data and potentially result in diagnostic errors. Conversely, certain ictal VEEG artifacts caused by automatisms, such as rhythmic chewing and blinking, may offer significant diagnostic clues for temporal lobe epilepsy. To address the challenges mentioned above, this study aims to develop an algorithm capable of automatically identifying and classifying artifact types, assisting clinicians in distinguishing interference signals from seizure signals.</p><p><strong>Methods: </strong>This paper proposes a Local-Global Feature Fusion Network based on Time-Domain and Time-Frequency Domain (LG-TDTFD-Net) for detecting and classifying temporal lobe epilepsy artifacts. The model processes time-domain and time-frequency signals separately, leveraging convolutional neural network (CNN) to extract local features from both domains. Additionally, convolution operations are performed on the features extracted by the Transformer to capture deep local features, resulting in a feature set that simultaneously encompasses global, deep, and shallow local information.</p><p><strong>Results: </strong>Experimental results demonstrate that the proposed method excels in detecting and classifying temporal lobe epilepsy artifacts, outperforming existing baseline models on clinical and public datasets.</p><p><strong>Conclusions: </strong>The method effectively exploits the complementarity among the three feature types by utilizing feature concatenation and CNN-based fusion, enhancing feature representation and improving model generalization.</p><p><strong>Trial registration: </strong>The Chinese Clinical Trial Registry, ChiCTR2300079319. Registered 30 December 2023, https://www.chictr.org.cn/showproj.html?proj=214123 .</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322353","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":"Predictors of cognitive impairment in drug-resistant epilepsy: the role of interictal EEG abnormalities.","authors":"Saleh Baeesa, Fawzi Babtain, Ahmad Albeshri, Amal Alkhotani, Rakan Bokhari, Motaz Fadul, Mohammed Karami, Mazen Basheikh, Adnan Badahdah, Ahmed Bamaga, Mohammed Alshurem, Raed Gasemaltayeb, Wareef Alzahrani, Ahmed Najjar, Yasser Alamri, Humaira Waseem, Amber Hassan, Maher Kurdi","doi":"10.1186/s42494-026-00244-8","DOIUrl":"10.1186/s42494-026-00244-8","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) affects approximately one-third of patients with drug-resistant epilepsy (DRE), underscoring the need for accessible predictors. Interictal electroencephalographic (EEG) abnormalities have been proposed as potential indicators of cognitive dysfunction; however, their independent diagnostic utility is unclear. This study aimed to investigate the association between interictal EEG patterns and CI in adults with DRE, with a specific focus on evaluating their incremental predictive value beyond established clinical predictors.</p><p><strong>Methods: </strong>In this cross-sectional study of 90 adults with DRE were recruited over a six-month period. Participants were stratified into two groups based on their Montreal Cognitive Assessment (MoCA): those with cognitive impairment (Cases; n = 45; MoCA < 26) and those with preserved cognition (Controls; n = 45; MoCA ≥ 26). All participants underwent routine interictal scalp EEG, An EEG recording was classified as abnormal if epileptiform discharges or significant background slowing was identified. The relationships between cognitive status and various clinical variables-including age, monthly seizure frequency and epilepsy type were analyzed using multivariable logistic regression, with expressed as odds ratios alongside their 95% confidence intervals.</p><p><strong>Results: </strong>The frequency of monthly seizures was significantly higher in the CI group compared to the control group (9.6 ± 2.8 vs. 5.4 ± 2.1 seizures/month, P < 0.001). Interictal EEG abnormalities were also more prevalant in CI group (77.8% vs. 57.8%; OR = 2.56, 95% CI: 1.02-6.41, P = 0.041). However, in the adjusted multivariable model, only seizure frequency reained a signifcant independent association with CI (adjusted OR = 0.46, 95% CI: 0.32-0.65, P < 0.001), indicating that EEG abnormalities did not confer significant additional predictive power after accounting for seizure burden.</p><p><strong>Conclusions: </strong>Seizure burden emerged as the predominant predictor of CI with DRE, while interictal EEG abnormalities demonstrated a univariate correlation with cogntive status, this association was not independent in the adjusted analysis. EEG findings may still provide contextual or supportive clinical context, emphasize that a comprehensive approach integrating seizure management with cognitive assessments is warranted, rather than relying primarily on interictal EEG for cognitive risk stratification.</p>","PeriodicalId":33628,"journal":{"name":"Acta Epileptologica","volume":"8 1","pages":"5"},"PeriodicalIF":1.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114357","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}