Brain & Development最新文献

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Letter to the editor: ‘Prevalence and management of gastrointestinal complications of Duchenne muscular dystrophy: A retrospective cohort study’ 致编辑的信:“杜氏肌营养不良症胃肠道并发症的患病率和管理:一项回顾性队列研究”
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-21 DOI: 10.1016/j.braindev.2025.104402
Sabri Selcuk Atamanalp
{"title":"Letter to the editor: ‘Prevalence and management of gastrointestinal complications of Duchenne muscular dystrophy: A retrospective cohort study’","authors":"Sabri Selcuk Atamanalp","doi":"10.1016/j.braindev.2025.104402","DOIUrl":"10.1016/j.braindev.2025.104402","url":null,"abstract":"","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104402"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between epilepsy and attention deficit/hyperactivity disorder – correlation between interictal epileptiform discharges and behavioral disturbances 癫痫与注意缺陷/多动障碍之间的关系——癫痫样放电与行为障碍之间的关系
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-19 DOI: 10.1016/j.braindev.2025.104403
Hideaki Kanemura
{"title":"Association between epilepsy and attention deficit/hyperactivity disorder – correlation between interictal epileptiform discharges and behavioral disturbances","authors":"Hideaki Kanemura","doi":"10.1016/j.braindev.2025.104403","DOIUrl":"10.1016/j.braindev.2025.104403","url":null,"abstract":"<div><div>A relationship between epileptic activities and neuropsychological dysfunction has been indicated in epileptic children. Epileptic activities including frequent/prolonged seizures and severe EEG abnormalities could be associated with cognitive decline and behavioral disturbances. Frequent, prolonged seizures could induce growth disturbances in the prefrontal cortex, leading to behavioral disturbance. Meanwhile, frequent epileptic seizures or EEG abnormalities, including interictal epileptiform discharges (IEDs), are evident in attention deficit/hyperactivity disorder (ADHD). Subclinical IEDs could lead to neuropsychological dysfunction in epileptic and ADHD children. The concurrence of IED frequency and prolonged periods of high-frequency IEDs may predict the atypical evolution of self-limited epilepsy with centrotemporal spikes. In developmental and epileptic encephalopathy with spike-wave activation during sleep, cognitive/behavioral disturbances correlate with frequent IEDs such as secondary bilateral synchrony (SBS). On the other hand, EEG manifestations, particularly IED locations, could represent important predictors of optimal outcome in epilepsy and ADHD. Abnormal paroxysms in the frontal region could lead to neuropsychological dysfunctions, so frontal IEDs could be associated with cognitive/behavioral disturbances in epilepsy and ADHD. Frontal IEDs could predict atypical clinical features including behavioral disturbance and ultimate neuropsychological outcomes in epileptic/ADHD children. Early remission of clinical seizures and reduction of IEDs might be necessary to accomplish optimal outcomes for children presenting with behavioral disturbances. A therapeutic strategy comprising prompt suppression of IEDs (including frontal IEDs/SBS) could improve quality of life in at least some children with epilepsy and ADHD.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104403"},"PeriodicalIF":1.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recognition of Japanese kanji words in children with specific learning disorders: a preliminary study using magnetoencephalography 特殊学习障碍儿童日语汉字识别:脑磁图的初步研究
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-19 DOI: 10.1016/j.braindev.2025.104400
Yuka Egashira , Yoshimi Kaga , Atsuko Gunji , Yousuke Kita , Motohiro Kimura , Naruhito Hironaga , Hiroshige Takeichi , Sayuri Hayashi , Yuu Kaneko , Hidetoshi Takahashi , Takashi Hanakawa , Takashi Okada , Masumi Inagaki
{"title":"Recognition of Japanese kanji words in children with specific learning disorders: a preliminary study using magnetoencephalography","authors":"Yuka Egashira ,&nbsp;Yoshimi Kaga ,&nbsp;Atsuko Gunji ,&nbsp;Yousuke Kita ,&nbsp;Motohiro Kimura ,&nbsp;Naruhito Hironaga ,&nbsp;Hiroshige Takeichi ,&nbsp;Sayuri Hayashi ,&nbsp;Yuu Kaneko ,&nbsp;Hidetoshi Takahashi ,&nbsp;Takashi Hanakawa ,&nbsp;Takashi Okada ,&nbsp;Masumi Inagaki","doi":"10.1016/j.braindev.2025.104400","DOIUrl":"10.1016/j.braindev.2025.104400","url":null,"abstract":"<div><h3>Introduction</h3><div>In Western countries, reading disorders are believed to be caused by phonological processing problems. Conversely, Japanese children with developmental dyslexia (DD) and developmental dysgraphia often have difficulty learning kanji that are ideographic characters. It is believed that kanji learning and alphabet learning have different pathologies, as the latter uses phonetic character. In this study, we aimed to clarify the characteristics of kanji word recognition in Japanese children with DD and developmental dysgraphia using magnetoencephalography with high spatial resolution.</div></div><div><h3>Methods</h3><div>Seven Japanese children with learning disorders, including 4 with DD and 3 with developmental dysgraphia, and 14 typically developing Japanese children (TDC) underwent magnetoencephalography while presented with kanji compounds and pseudo-kanji character sequences in their parafoveal visual fields, along with a foveal silent movie.</div></div><div><h3>Results</h3><div>No differences were found between conditions or groups, except significantly smaller source activation in the posterior transverse region of the collateral sulcus (ptCoS) in the patient group, when presenting pseudo-kanji than presenting kanji, or than TDC when presenting deviant pseudo-kanji. The ptCoS activity from kanji exhibited a positive correlation with writing skills in the patient group, independently of attention deficit hyperactivity disorder (ADHD) symptom scores.</div></div><div><h3>Conclusions</h3><div>These results suggest that ptCoS activity during the presentation of kanji characters in Japanese children with DD and developmental dysgraphia reflects their writing ability, regardless of ADHD symptoms. Some forms of ptCoS dysfunction may be related to the neural basis of specific kanji writing functions in Japanese patients with DD and developmental dysgraphia.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104400"},"PeriodicalIF":1.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Natural history of timed rise from floor in young individuals with Duchenne muscular dystrophy: A single-center retrospective study 杜氏肌营养不良症年轻患者定时从地板上爬起来的自然史:一项单中心回顾性研究
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-18 DOI: 10.1016/j.braindev.2025.104396
Shota Yoneno , Eri Takeshita , Yuko Shimizu-Motohashi , Mari Oba , Takatoshi Hara , Masahiro Hirayama , Hirofumi Komaki
{"title":"Natural history of timed rise from floor in young individuals with Duchenne muscular dystrophy: A single-center retrospective study","authors":"Shota Yoneno ,&nbsp;Eri Takeshita ,&nbsp;Yuko Shimizu-Motohashi ,&nbsp;Mari Oba ,&nbsp;Takatoshi Hara ,&nbsp;Masahiro Hirayama ,&nbsp;Hirofumi Komaki","doi":"10.1016/j.braindev.2025.104396","DOIUrl":"10.1016/j.braindev.2025.104396","url":null,"abstract":"<div><h3>Introduction</h3><div>Motor function in patients with Duchenne muscular dystrophy (DMD) is commonly evaluated using the 6-min walk test, North Star Ambulatory Assessment, and timed function tests. However, few reports have examined the progression of timed rise from floor (TRF) in patients with DMD undergoing steroid therapy in Japan. We investigated the natural history of TRF in patients with DMD treated in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively assessed TRF by age group based on data collected from October 2010 to August 2023. We used Kaplan–Meier curves to analyze the loss of the ability to rise from the floor. Additionally, receiver operating characteristic analysis was performed to predict the loss of the ability to stand up after 1 year.</div></div><div><h3>Results</h3><div>In total, 165 males with DMD were enrolled. The median TRF peaked at 6 years of age and deteriorated thereafter. The median age of the loss of the ability to rise from the floor was 11.9 years (95 % confidence interval = 10.6–13.2). Using a TRF cutoff of 6.2 s, the sensitivity, specificity, and area under the curve for predicting loss of the ability to rise from the floor in 1 year were 71 %, 90 %, and 0.914, respectively.</div></div><div><h3>Conclusion</h3><div>This study provided insights into the deterioration of TRF in patients with DMD receiving steroid treatment in Japan. As a simple and easily measurable parameter, TRF is a useful tool for predicting the progression of motor function.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104396"},"PeriodicalIF":1.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Valproate and lamotrigine combination therapy in children with drug-resistant focal epilepsy: an observational analysis focusing on neuroimaging abnormalities 丙戊酸和拉莫三嗪联合治疗儿童耐药局灶性癫痫:一项针对神经影像学异常的观察性分析
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-11 DOI: 10.1016/j.braindev.2025.104395
Shiena Watanabe , Takashi Enokizono , Mitsuyo Nishimura , Kazushi Maruo , Tomoya Iwasaki , Yui Tsunoda , Yuichi Ueno , Mai Tanaka , Yui Takada , Ryuta Tanaka , Kota Araki , Yosuke Masuda , Eiichi Ishikawa , Hidetoshi Takada
{"title":"Valproate and lamotrigine combination therapy in children with drug-resistant focal epilepsy: an observational analysis focusing on neuroimaging abnormalities","authors":"Shiena Watanabe ,&nbsp;Takashi Enokizono ,&nbsp;Mitsuyo Nishimura ,&nbsp;Kazushi Maruo ,&nbsp;Tomoya Iwasaki ,&nbsp;Yui Tsunoda ,&nbsp;Yuichi Ueno ,&nbsp;Mai Tanaka ,&nbsp;Yui Takada ,&nbsp;Ryuta Tanaka ,&nbsp;Kota Araki ,&nbsp;Yosuke Masuda ,&nbsp;Eiichi Ishikawa ,&nbsp;Hidetoshi Takada","doi":"10.1016/j.braindev.2025.104395","DOIUrl":"10.1016/j.braindev.2025.104395","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the efficacy of valproate and lamotrigine (VPA–LTG) combination therapy in pediatric patients with drug-resistant focal epilepsy (DRFE), focusing on the presence of neuroimaging abnormalities.</div></div><div><h3>Methods</h3><div>Pediatric patients with epilepsy who visited the University of Tsukuba Hospital and Ibaraki Children's Hospital between October 2021 and September 2024 were included in this retrospective chart review. Patients with DRFE who received VPA–LTG combination therapy were enrolled.</div></div><div><h3>Results</h3><div>Data from 21 patients, including 16 males and 5 females, in the age range of 1.8–13.9 years were examined. The median numbers of previously failed anti-seizure medications (ASMs) and concurrent ASMs were 4 (range: 2–7) and 3 (range: 2–5), respectively. The overall responder rate (defined as the percentage of patients achieving ≥50 % seizure reduction over the last 12 months) was 38 %. The responder rate in patients without MRI abnormalities (67 %) was significantly higher than that in patients with MRI abnormalities (16 %). Patients with MRI abnormalities had more structural etiologies (42 %), whereas those without MRI abnormalities had more unknown etiologies (89 %).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that VPA–LTG combination therapy is a promising option for pediatric patients with DRFE without neuroimaging abnormalities.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104395"},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of withdrawal seizures in children with refractory status epilepticus who responded favorably to continuous midazolam therapy 难治性癫痫持续状态患儿对持续咪达唑仑治疗反应良好的戒断性癫痫发作特征
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-11 DOI: 10.1016/j.braindev.2025.104394
Hirokazu Takeuchi , Kenjiro Kikuchi , Rikako Takeda , Yuko Hirata , Ryuki Matsuura , Reiko Koichihara , Ikuya Ueta , Shin-Ichiro Hamano
{"title":"Characteristics of withdrawal seizures in children with refractory status epilepticus who responded favorably to continuous midazolam therapy","authors":"Hirokazu Takeuchi ,&nbsp;Kenjiro Kikuchi ,&nbsp;Rikako Takeda ,&nbsp;Yuko Hirata ,&nbsp;Ryuki Matsuura ,&nbsp;Reiko Koichihara ,&nbsp;Ikuya Ueta ,&nbsp;Shin-Ichiro Hamano","doi":"10.1016/j.braindev.2025.104394","DOIUrl":"10.1016/j.braindev.2025.104394","url":null,"abstract":"<div><h3>Background</h3><div>This study investigates the characteristics of children with refractory status epilepticus (RSE) who experienced withdrawal seizures and responded favorably to continuous midazolam (cMDL) therapy.</div></div><div><h3>Methods</h3><div>Patients who experienced RSE and achieved seizure cessation with cMDL were included in the study. Withdrawal seizure was defined as a seizure occurring from the initiation of cMDL tapering until 48 h after the discontinuation of cMDL. The patients were categorized into two groups: seizure cessation and withdrawal seizure groups.</div></div><div><h3>Results</h3><div>Nineteen patients with RSE achieved seizure cessation with cMDL. The seizure cessation group comprised 11 patients, while eight patients (42.1 %) were classified into the withdrawal seizure group. The median maintenance dose of cMDL were 0.1 mg/kg/h (interquartile range [IQR]: 0.1–0.2) for the seizure cessation group, and 0.25 mg/kg/h (IQR: 0.15–0.3) for the withdrawal seizure group. The median maintenance periods were 27 h (IQR: 12–32.5) for the seizure cessation group, and 52.5 h (IQR: 23–65.5) for the withdrawal seizure group. The seizure cessation group had a median cumulative MDL of 2.7 mg/kg (IQR: 1.6–4.9), while the withdrawal seizure group had 11.6 mg/kg (IQR: 4.5–24.5).</div></div><div><h3>Conclusion</h3><div>Although statistical analysis was not conducted due to the small sample size, maintenance dose of cMDL is potentially correlated with withdrawal seizure. A multi-center study with large sample size and statistical analysis of this relationship may contribute to the establishment of an optimized cMDL tapering protocol.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104394"},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unraveling the connections between migraine and psychiatric comorbidities: A narrative review 揭示偏头痛和精神合并症之间的联系:叙述性回顾
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-08 DOI: 10.1016/j.braindev.2025.104392
Jungyon Yum , Min Kyung Chu
{"title":"Unraveling the connections between migraine and psychiatric comorbidities: A narrative review","authors":"Jungyon Yum ,&nbsp;Min Kyung Chu","doi":"10.1016/j.braindev.2025.104392","DOIUrl":"10.1016/j.braindev.2025.104392","url":null,"abstract":"<div><div>The close association between migraine and psychiatric comorbidities is well documented. Migraine frequently co-occurs with mood disorders, particularly depression and anxiety, exhibiting a bidirectional relationship across various populations, including children and adolescents. Emerging research has also highlighted significant associations between migraine and bipolar disorder, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). Shared pathophysiological mechanisms, including genetic predisposition, neurotransmitter imbalances, hormonal influences, and environmental factors, contribute to these comorbidities. Diagnosing migraine in individuals with ASD and ADHD presents unique challenges due to overlapping symptoms and communication barriers. Furthermore, psychiatric medications may influence migraine symptoms, necessitating careful management. This review explores the relationship between migraine and psychiatric disorders, emphasizing shared mechanisms, diagnostic considerations, and treatment strategies to optimize patient care. This review highlights the necessity for integrated clinical approaches that address both migraine and psychiatric comorbidities, ultimately improving health outcomes for affected individuals.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104392"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biallelic novel CCDC186 loss-of-function variant disrupting the gene function causes neurodevelopmental phenotype and review of the literature 新型双等位基因CCDC186功能缺失变异破坏基因功能导致神经发育表型及文献综述
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-08 DOI: 10.1016/j.braindev.2025.104393
Alper Gezdirici , Sultan Buse Turk , Tuna Eren Esen , Cuneyd Yavas , Ekrem Akbulut , Halil Ibrahim Yilmaz , Zeynep Oz Dagdelen , Pinar Arican , Mustafa Dogan
{"title":"Biallelic novel CCDC186 loss-of-function variant disrupting the gene function causes neurodevelopmental phenotype and review of the literature","authors":"Alper Gezdirici ,&nbsp;Sultan Buse Turk ,&nbsp;Tuna Eren Esen ,&nbsp;Cuneyd Yavas ,&nbsp;Ekrem Akbulut ,&nbsp;Halil Ibrahim Yilmaz ,&nbsp;Zeynep Oz Dagdelen ,&nbsp;Pinar Arican ,&nbsp;Mustafa Dogan","doi":"10.1016/j.braindev.2025.104393","DOIUrl":"10.1016/j.braindev.2025.104393","url":null,"abstract":"<div><h3>Background</h3><div>Coiled-coil domain-containing protein 186 (CCDC186) is essential for the transport of secretory dense-core vesicles (DCVs), specialized organelles responsible for storing and releasing neurotransmitters and other modulatory molecules in neurons and endocrine cells, thereby playing a crucial role in physiological processes such as synaptic plasticity, neurotransmission, and hormonal regulation. Resent reports have suggested that biallelic loss-of-function (LOF) variants in <em>CCDC186</em> may be associated with neurodevelopmental disorders and a range of systemic manifestations.</div></div><div><h3>Methods</h3><div>Whole exome sequencing (WES) was performed, and co-segregation analysis of the family was conducted using sanger sequencing. Additionally, five patients with <em>CCDC186</em>-associated phenotypes previously described in the literature were evaluated. Followed by cDNA synthesis and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to analyze gene expression levels. Bioinformatics tools, including RoseTTAFold for protein modeling and STRING for protein-protein interaction networks, were employed to assess the structural and functional consequences of the mutation.</div></div><div><h3>Results</h3><div>We identified a homozygous NM_018017.4:c.535C&gt;T (p.Arg179Ter) nonsense variant in the <em>CCDC186</em> gene. This variant was associated with a marked downregulation of CCDC186 expression in the proband, with moderate reductions observed in heterozygous family members, suggesting dysregulated gene expression resulting from the mutation. Protein modeling indicated structural alterations, including a shift from intrinsically disordered regions to helix-loop-helix motifs in the mutant protein, as well as reduced binding probabilities for most interacting partners.</div></div><div><h3>Conclusion</h3><div>In this study, we presented the comprehensive clinical and genetic profiles of a Turkish child with a novel <em>CCDC186</em> variant, along with five previously reported patients from the literature. Our findings support that the homozygous LOF variants of the <em>CCDC186</em> gene are associated with a novel neurodevelopmental phenotype.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104393"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A dilemma in pediatric migraine: Headache or school performance? – A comparison of topiramate and flunarizine 儿童偏头痛的困境:头痛还是学习表现?-托吡酯和氟桂利嗪的比较
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-03 DOI: 10.1016/j.braindev.2025.104390
Ünal Akca , Gülfer Akca , Şeyma Karatekin
{"title":"A dilemma in pediatric migraine: Headache or school performance? – A comparison of topiramate and flunarizine","authors":"Ünal Akca ,&nbsp;Gülfer Akca ,&nbsp;Şeyma Karatekin","doi":"10.1016/j.braindev.2025.104390","DOIUrl":"10.1016/j.braindev.2025.104390","url":null,"abstract":"<div><h3>Background</h3><div>Migraine prophylaxis reduces pain severity and duration in pediatric patients, improving school and social adaptation. Topiramate (TPM) and flunarizine (FLN) are effective monotherapies for migraine prevention. This study compares their efficacy in pain management and impact on school and social life.</div></div><div><h3>Methods</h3><div>This two-group comparative study (2018–2023) included pediatric patients (aged 9–18 years) diagnosed with episodic or chronic migraine based on International Classification of Headache Disorders, 3rd edition (ICHD-3 beta) criteria. Patients were assessed for demographic characteristics, pain duration, pain frequency, pain intensity using the Visual Analogue Scale (VAS), Pediatric Migraine Disability Assessment Scale (PedMIDAS) scores, side effects, and treatment attitudes at baseline and after three months of TPM or FLN treatment.</div></div><div><h3>Results</h3><div>Among 226 patients, TPM showed a greater reduction in pain frequency than FLN (9.0 vs. 7.5; <em>p</em> = 0.007). The percentage reduction in monthly pain frequency was higher with TPM (83.5 % vs. 70.7 %; <em>p</em> = 0.022). Side effects were significantly lower in the FLN group. TPM caused weight loss, paresthesia, speech/memory impairment, and appetite reduction, while FLN caused weight gain (<em>p</em> &lt; 0.001). TPM was more effective in reducing pain frequency (relative risk [RR] = 0.118; 95 % confidence interval [CI] -0.946 to -0.681; <em>p</em> = 0.011), pain duration (RR = 0.858, 95 % CI -2.640 to -1.350; <em>p</em> &lt; 0.001), and pain intensity (RR = 0.729, 95 % CI -1.849 to -0.539; p &lt; 0.001). However, FLN was superior in PedMIDAS scores, particularly in school attendance and participation (p &lt; 0.001). No patients withdrew, but some were reluctant to use TPM due to concerns about stigmatization. Notably, substantial placebo effects have been observed in pediatric migraine trials, and the current evidence for the efficacy of preventive medications in this population remains limited.</div></div><div><h3>Conclusion</h3><div>TPM and FLN are effective migraine treatments. TPM is superior for pain reduction, while FLN has fewer side effects and benefits school attendance and participation. Weight changes and stigma should be considered when prescribing TPM.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 4","pages":"Article 104390"},"PeriodicalIF":1.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between cerebrospinal fluid cytokines/chemokines and clinical impact of myelin oligodendrocyte glycoprotein antibody-associated disorders in children 脑脊液细胞因子/趋化因子与儿童髓鞘少突胶质细胞糖蛋白抗体相关疾病临床影响的关系
IF 1.4 4区 医学
Brain & Development Pub Date : 2025-07-03 DOI: 10.1016/j.braindev.2025.104389
SunMin Lee , Juhyun Kong , Sooyoung Lyu , Sang Ook Nam , Taek Jin Lim , Ji-Yeon Song , Gyu Min Yeon , Young Mi Kim , Ara Ko , Yun-Jin Lee
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