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Effect of sex on neuropsychiatric comorbidities in childhood epilepsy
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110328
Nicholas Krant , Casey D. Krueger , Ana Carissa L. Homick, Claudia A. Tarrant, Gregory L. Holmes

Objective

Neuropsychiatric comorbidities are prevalent in children with epilepsy and often pose greater concerns than the seizures themselves. Identifying children at risk for these conditions is crucial for developing effective therapies. In prepubescent rodents, sex significantly influences cognitive dysfunction related to seizures, with prepubescent male rats exhibiting more severe adverse effects than females. However, it remains unclear whether sex plays a similar role in cognitive and behavioral outcomes in children. This review aims to assess the literature on whether sex is a biological factor affecting behavioral and cognitive outcomes in pediatric epilepsy.

Materials and Methods

We conducted a literature review to explore the impact of sex on cognitive and behavioral outcomes in children (up to age 18 years) with epilepsy of all types. Studies were categorized into observational and interventional types. We analyzed population studies involving children with epilepsy, as well as those addressing genetic factors, surgical interventions, status epilepticus, infantile spasms, pharmacological treatments, and the ketogenic diet.

Results

Few adequately powered studies have examined sex as a biological variable in relation to cognitive and behavioral impairments in children with epilepsy. In addition, many studies failed to examine sex-related differences in behavior and cognition in children without epilepsy. Generally, the sex-related differences in cognitive and behavioral impairments in children with epilepsy match those seen in children without epilepsy. One exception is that in several studies girls with epilepsy had a similar risk for attention deficit hyperactive disorder (ADHD) as boys, whereas in children without epilepsy ADHD is more common in boys than girls. Although there is a modest trend indicating worse cognitive outcomes for boys with epilepsy compared to girls, consistency across studies is lacking.

Conclusion

Sex is not yet a well-explored prognostic factor for outcomes following childhood epilepsy, though some small differences were identified for specific outcomes. More rigorously designed studies are necessary to report outcomes by sex while controlling for potential confounders. The variability in methods for assessing neurodevelopmental outcomes underscores the need for standardized and comprehensive evaluations of cognitive and behavior in children with epilepsy.
{"title":"Effect of sex on neuropsychiatric comorbidities in childhood epilepsy","authors":"Nicholas Krant ,&nbsp;Casey D. Krueger ,&nbsp;Ana Carissa L. Homick,&nbsp;Claudia A. Tarrant,&nbsp;Gregory L. Holmes","doi":"10.1016/j.yebeh.2025.110328","DOIUrl":"10.1016/j.yebeh.2025.110328","url":null,"abstract":"<div><h3>Objective</h3><div>Neuropsychiatric comorbidities are prevalent in children with epilepsy and often pose greater concerns than the seizures themselves. Identifying children at risk for these conditions is crucial for developing effective therapies. In prepubescent rodents, sex significantly influences cognitive dysfunction related to seizures, with prepubescent male rats exhibiting more severe adverse effects than females. However, it remains unclear whether sex plays a similar role in cognitive and behavioral outcomes in children. This review aims to assess the literature on whether sex is a biological factor affecting behavioral and cognitive outcomes in pediatric epilepsy.</div></div><div><h3>Materials and Methods</h3><div>We conducted a literature review to explore the impact of sex on cognitive and behavioral outcomes in children (up to age 18 years) with epilepsy of all types. Studies were categorized into observational and interventional types. We analyzed population studies involving children with epilepsy, as well as those addressing genetic factors, surgical interventions, status epilepticus, infantile spasms, pharmacological treatments, and the ketogenic diet.</div></div><div><h3>Results</h3><div>Few adequately powered studies have examined sex as a biological variable in relation to cognitive and behavioral impairments in children with epilepsy. In addition, many studies failed to examine sex-related differences in behavior and cognition in children without epilepsy. Generally, the sex-related differences in cognitive and behavioral impairments in children with epilepsy match those seen in children without epilepsy. One exception is that in several studies girls with epilepsy had a similar risk for attention deficit hyperactive disorder (ADHD) as boys, whereas in children without epilepsy ADHD is more common in boys than girls. Although there is a modest trend indicating worse cognitive outcomes for boys with epilepsy compared to girls, consistency across studies is lacking.</div></div><div><h3>Conclusion</h3><div>Sex is not yet a well-explored prognostic factor for outcomes following childhood epilepsy, though some small differences were identified for specific outcomes. More rigorously designed studies are necessary to report outcomes by sex while controlling for potential confounders. The variability in methods for assessing neurodevelopmental outcomes underscores the need for standardized and comprehensive evaluations of cognitive and behavior in children with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110328"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Evaluating the effectiveness of two video-based educational interventions to enhance knowledge about epilepsy in preschool children
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110339
Dana Buršíková Brabcová , Jiří Kohout , Ivana Mašková , Kateřina Lohrová

Objectives

Current research affirms that sufficiently high knowledge about epilepsy is crucial for reducing stigmatization and improving the quality of life for people with epilepsy. While educational interventions targeting older children, adolescents, and adults are relatively common, there is a notable lack of approaches suitable for preschool children. Building on our previous research, which focused on educational interventions using a game and a story, this study aims to evaluate the effectiveness of two video-based interventions, Campi the Seahorse and Adventure While Fishing, in children aged 5–6 years with no prior knowledge about epilepsy.

Methods

A total of 199 children participated in two intervention studies. Knowledge about epilepsy was assessed through interviews using an 11-item test that had been successfully employed in our previous intervention studies, demonstrating satisfactory internal consistency and construct validity. The level of knowledge was evaluated immediately after each intervention and one month later. Additionally, satisfaction with the intervention and its potential impact on epilepsy-related stigma were measured using a smiley-face scale.

Results

The Adventure While Fishing intervention demonstrated notable effectiveness compared to our previously developed intervention using an educational story. Its impact was also significant when compared to the level of knowledge observed in children aged 9–11 years with no prior exposure to epilepsy-related interventions. In contrast, the outcomes of the Campi the Seahorse intervention were significantly poorer across all comparisons, likely due to its insufficient coverage of key aspects of the topic.

Conclusions

The results indicated that the Adventure While Fishing intervention was an effective approach to establishing basic knowledge about epilepsy within the targeted age group. In contrast, the Campi the Seahorse intervention would require further extension and/or modification to achieve sufficient effectiveness for this purpose.
{"title":"Evaluating the effectiveness of two video-based educational interventions to enhance knowledge about epilepsy in preschool children","authors":"Dana Buršíková Brabcová ,&nbsp;Jiří Kohout ,&nbsp;Ivana Mašková ,&nbsp;Kateřina Lohrová","doi":"10.1016/j.yebeh.2025.110339","DOIUrl":"10.1016/j.yebeh.2025.110339","url":null,"abstract":"<div><h3>Objectives</h3><div>Current research affirms that sufficiently high knowledge about epilepsy is crucial for reducing stigmatization and improving the quality of life for people with epilepsy. While educational interventions targeting older children, adolescents, and adults are relatively common, there is a notable lack of approaches suitable for preschool children. Building on our previous research, which focused on educational interventions using a game and a story, this study aims to evaluate the effectiveness of two video-based interventions, <em>Campi the Seahorse</em> and <em>Adventure While Fishing</em>, in children aged 5–6 years with no prior knowledge about epilepsy.</div></div><div><h3>Methods</h3><div>A total of 199 children participated in two intervention studies. Knowledge about epilepsy was assessed through interviews using an 11-item test that had been successfully employed in our previous intervention studies, demonstrating satisfactory internal consistency and construct validity. The level of knowledge was evaluated immediately after each intervention and one month later. Additionally, satisfaction with the intervention and its potential impact on epilepsy-related stigma were measured using a smiley-face scale.</div></div><div><h3>Results</h3><div>The <em>Adventure While Fishing</em> intervention demonstrated notable effectiveness compared to our previously developed intervention using an educational story. Its impact was also significant when compared to the level of knowledge observed in children aged 9–11 years with no prior exposure to epilepsy-related interventions. In contrast, the outcomes of the <em>Campi the Seahorse</em> intervention were significantly poorer across all comparisons, likely due to its insufficient coverage of key aspects of the topic.</div></div><div><h3>Conclusions</h3><div>The results indicated that the <em>Adventure While Fishing</em> intervention was an effective approach to establishing basic knowledge about epilepsy within the targeted age group. In contrast, the <em>Campi the Seahorse</em> intervention would require further extension and/or modification to achieve sufficient effectiveness for this purpose.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110339"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Unseen yet overcounted: The paradox of seizure frequency reporting
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110335
Victoria Wong , Timothy Hannon , Kiran M. Fernandes , Mark J. Cook , Ewan S. Nurse

Objective

Seizure control is often assessed using patient-reported seizure frequencies. Despite its subjectivity, self-reporting remains essential for guiding anti-seizure medication (ASM) decisions and ongoing patient investigations. This study aims to compare patient-reported seizure frequencies with electrographic frequencies captured via ambulatory video EEG (avEEG).

Methods

Data from intake forms and seizure diaries were collected from patients undergoing home-based avEEG in Australia (April 2020–April 2022). Intake forms included monthly seizure frequency estimates. Only avEEG-confirmed epilepsy cases were analyzed. Univariate and multivariate analyses compared seizure frequencies reported via EEG, diaries, and surveys.

Results

Of 3,407 reports, 853 identified epilepsy cases, with 234 studies analyzed after excluding outliers. Diary-reported frequencies correlated with EEG frequency (p < 0.00001), but survey-reported frequencies did not (p > 0.05). Surveys significantly overestimated true seizure frequency (median = 3.98 seizures/month, p < 0.0001), while diaries showed substantially smaller differences (median = 0.01 seizures/month, p < 0.0001). Carer presence was associated with higher diary-reported frequencies (p = 0.047). Age negatively correlated with survey frequency estimation error (p = 0.016). Multivariate analysis identified age and carer status as significant predictors of residuals.

Conclusions

Most patients overestimate their true seizure frequency, potentially influencing therapeutic decisions and raising concerns about the reliability of some participants and carers to self-report seizures in clinical trials.

Significance

An “over-reporting, over-prescribing” cascade may affect epilepsy treatment and highlights the potential issue of clinical drug trials relying on self-reported seizure rates for primary endpoints.
{"title":"Unseen yet overcounted: The paradox of seizure frequency reporting","authors":"Victoria Wong ,&nbsp;Timothy Hannon ,&nbsp;Kiran M. Fernandes ,&nbsp;Mark J. Cook ,&nbsp;Ewan S. Nurse","doi":"10.1016/j.yebeh.2025.110335","DOIUrl":"10.1016/j.yebeh.2025.110335","url":null,"abstract":"<div><h3>Objective</h3><div>Seizure control is often assessed using patient-reported seizure frequencies. Despite its subjectivity, self-reporting remains essential for guiding anti-seizure medication (ASM) decisions and ongoing patient investigations. This study aims to compare patient-reported seizure frequencies with electrographic frequencies captured via ambulatory video EEG (avEEG).</div></div><div><h3>Methods</h3><div>Data from intake forms and seizure diaries were collected from patients undergoing home-based avEEG in Australia (April 2020–April 2022). Intake forms included monthly seizure frequency estimates. Only avEEG-confirmed epilepsy cases were analyzed. Univariate and multivariate analyses compared seizure frequencies reported via EEG, diaries, and surveys.</div></div><div><h3>Results</h3><div>Of 3,407 reports, 853 identified epilepsy cases, with 234 studies analyzed after excluding outliers. Diary-reported frequencies correlated with EEG frequency (p &lt; 0.00001), but survey-reported frequencies did not (p &gt; 0.05). Surveys significantly overestimated true seizure frequency (median = 3.98 seizures/month, p &lt; 0.0001), while diaries showed substantially smaller differences (median = 0.01 seizures/month, p &lt; 0.0001). Carer presence was associated with higher diary-reported frequencies (p = 0.047). Age negatively correlated with survey frequency estimation error (p = 0.016). Multivariate analysis identified age and carer status as significant predictors of residuals.</div></div><div><h3>Conclusions</h3><div>Most patients overestimate their true seizure frequency, potentially influencing therapeutic decisions and raising concerns about the reliability of some participants and carers to self-report seizures in clinical trials.</div></div><div><h3>Significance</h3><div>An “over-reporting, over-prescribing” cascade may affect epilepsy treatment and highlights the potential issue of clinical drug trials relying on self-reported seizure rates for primary endpoints.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110335"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a self-management tool for individuals with seizure clusters: Trial design and methodological report
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110333
Molly McVoy , Eytan Hirsch , Luisa Londono , Kari Colón-Zimmermann , Karlee Hanchin , Davina N. Patel , Jin Seok Cho , Evelyn K. Shih , Adrian L. Rabinowicz , Enrique Carrazana , Martha Sajatovic

Background

Despite advances in anti-seizure medications (ASMs) for people with epilepsy (PWE), adverse outcomes, negative health events (NHEs), and breakthrough seizures remain common. Rescue medication (RM) can better manage repetitive seizures, but barriers to RM use persist. Self-management for PWE and a history of NHEs (SMART) is an evidence-based epilepsy self-management program aimed at reducing barriers and maximizing facilitators to self-care in high-risk PWE.

Methods

This 2-phase, ongoing clinical trial adapts SMART to integrate RM support for PWE with repetitive seizures. Phase 1, now completed, used input from an advisory board (AB) of PWE, caregivers, and clinicians to adapt the SMART curriculum to include diazepam nasal spray, an RM. Phase 2 will test the adapted curriculum (SMART-RM) in a 6-month prospective trial among adult PWE, measuring seizure counts from baseline to 6-month follow-up. Secondary outcomes include changes in quality of life, NHEs, functional status, and depression severity.

Results

The AB for Phase 1 enrolled 6 individuals: 2 PWE, 2 caregivers, and 2 clinicians. Participants endorsed the need for evidence-based epilepsy self-management curricula that include RM support and positively reviewed the SMART curriculum’s format and duration. Additional content requests included: 1) A seizure action plan with RM, 2) RM education for caregivers, 3) Customized care plans for PWE to support caregivers, 4) An RM-specific goal template, and 5) A template for RM-related discussion topics with care providers.

Conclusions

Integrating RM into an evidence-based epilepsy self-management curriculum offers a comprehensive care package with potential to improve care for PWE with seizure clusters.
{"title":"Development of a self-management tool for individuals with seizure clusters: Trial design and methodological report","authors":"Molly McVoy ,&nbsp;Eytan Hirsch ,&nbsp;Luisa Londono ,&nbsp;Kari Colón-Zimmermann ,&nbsp;Karlee Hanchin ,&nbsp;Davina N. Patel ,&nbsp;Jin Seok Cho ,&nbsp;Evelyn K. Shih ,&nbsp;Adrian L. Rabinowicz ,&nbsp;Enrique Carrazana ,&nbsp;Martha Sajatovic","doi":"10.1016/j.yebeh.2025.110333","DOIUrl":"10.1016/j.yebeh.2025.110333","url":null,"abstract":"<div><h3>Background</h3><div>Despite advances in anti-seizure medications (ASMs) for people with epilepsy (PWE), adverse outcomes, negative health events (NHEs), and breakthrough seizures remain common. Rescue medication (RM) can better manage repetitive seizures, but barriers to RM use persist. Self-management for PWE and a history of NHEs (SMART) is an evidence-based epilepsy self-management program aimed at reducing barriers and maximizing facilitators to self-care in high-risk PWE.</div></div><div><h3>Methods</h3><div>This 2-phase, ongoing clinical trial adapts SMART to integrate RM support for PWE with repetitive seizures. Phase 1, now completed, used input from an advisory board (AB) of PWE, caregivers, and clinicians to adapt the SMART curriculum to include diazepam nasal spray, an RM. Phase 2 will test the adapted curriculum (SMART-RM) in a 6-month prospective trial among adult PWE, measuring seizure counts from baseline to 6-month follow-up. Secondary outcomes include changes in quality of life, NHEs, functional status, and depression severity.</div></div><div><h3>Results</h3><div>The AB for Phase 1 enrolled 6 individuals: 2 PWE, 2 caregivers, and 2 clinicians. Participants endorsed the need for evidence-based epilepsy self-management curricula that include RM support and positively reviewed the SMART curriculum’s format and duration. Additional content requests included: 1) A seizure action plan with RM, 2) RM education for caregivers, 3) Customized care plans for PWE to support caregivers, 4) An RM-specific goal template, and 5) A template for RM-related discussion topics with care providers.</div></div><div><h3>Conclusions</h3><div>Integrating RM into an evidence-based epilepsy self-management curriculum offers a comprehensive care package with potential to improve care for PWE with seizure clusters.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110333"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Neuromodulation in pediatric drug-resistant epilepsy
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110332
Ann Hyslop , Marytery Fajardo
This is a summary of the three commercially available neuromodulation devices for refractory epilepsy, highlighting their use in children. The article offers a high-level review of the proposed mechanisms of vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation, the pivotal trials leading to their approval for use in the United States, as well as their efficacy and associated adverse effects.
{"title":"Neuromodulation in pediatric drug-resistant epilepsy","authors":"Ann Hyslop ,&nbsp;Marytery Fajardo","doi":"10.1016/j.yebeh.2025.110332","DOIUrl":"10.1016/j.yebeh.2025.110332","url":null,"abstract":"<div><div>This is a summary of the three commercially available neuromodulation devices for refractory epilepsy, highlighting their use in children. The article offers a high-level review of the proposed mechanisms of vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation, the pivotal trials leading to their approval for use in the United States, as well as their efficacy and associated adverse effects.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110332"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Prevalence of depression in people with epilepsy: A hospital-based study in Cameroon
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-26 DOI: 10.1016/j.yebeh.2025.110326
Daniel Gams Massi , Richy Feudjio , Christian Eyoum , Lionel Paternoster , Annick Mélanie Magnerou , Nadine Tavares Ferreira , Jose-Antonio Elosegi , Callixte Kuate Tegueu , Njankouo Yacouba Mapoure

Introduction

depression is a psychiatric disorder present in many chronic diseases with varying prevalences. In people with epilepsy (PWE), it represents the most frequent psychiatric comorbidity associated with impaired quality of life, and increased risk of suicide. The aim of this research was to determine the prevalence and factors associated with depression in PWE.

Methods

this was a cross-sectional study with an age- and sex- matched control group, conducted between February 12 and May 15, 2024, in two referral hospital of Douala. It included individuals (PWE and controls) aged 18 years and older who agreed to participate in the study. Individuals (PWE and controls) with a serious general health problem that could have a significant impact on mental status (hypertension, HIV, diabetes, renal failure, heart failure, dementia, bipolar disorder) or an inability to communicate were excluded. Recruitment was done through an online and in-person survey using a form. We collected sociodemographic data, and data on epilepsy in PWE. Depression was evaluated using the PHQ-9 scale. We used the Generalized Anxiety Disorder Questionnaire (GAD-7) to assess anxiety disorders. Univariate and multivariate analysis (binary logistic regression) were used to identify the factors significantly associated with depression in PWE. The significance threshold was considered for a value of p < 0.05.

Results

a total of 633 individuals, including 211 PWE, were included in the study. The prevalence of depression was significantly higher in PWE (24.6 %) compared to controls (11.8 %) (OR: 2.0, 95 %CI: 1.433–2.905, p < 0.001). Anxiety disorders was significantly higher in PWE (OR: 1.6, 95 %CI: 1.101–2.397, p = 0.014). Factors independently associated to depression were female sex (OR: 2.7, 95 %CI: 1.115–6.343, p = 0.027), suicidal ideation (OR: 5.8, 95 %CI: 2.083–16.174, p = 0.001), and anxiety disorders (OR: 10.2, 95 %CI: 4.023–25.748, p < 0.001).

Conclusion

the prevalence of depression is high in PWE compared to controls in Douala. A systematic screening should be included in the follow-up of PWE.
{"title":"Prevalence of depression in people with epilepsy: A hospital-based study in Cameroon","authors":"Daniel Gams Massi ,&nbsp;Richy Feudjio ,&nbsp;Christian Eyoum ,&nbsp;Lionel Paternoster ,&nbsp;Annick Mélanie Magnerou ,&nbsp;Nadine Tavares Ferreira ,&nbsp;Jose-Antonio Elosegi ,&nbsp;Callixte Kuate Tegueu ,&nbsp;Njankouo Yacouba Mapoure","doi":"10.1016/j.yebeh.2025.110326","DOIUrl":"10.1016/j.yebeh.2025.110326","url":null,"abstract":"<div><h3>Introduction</h3><div>depression is a psychiatric disorder present in many chronic diseases with varying prevalences. In people with epilepsy (PWE), it represents the most frequent psychiatric comorbidity associated with impaired quality of life, and increased risk of suicide. The aim of this research was to determine the prevalence and factors associated with depression in PWE.</div></div><div><h3>Methods</h3><div>this was a cross-sectional study with an age- and sex- matched control group, conducted between February 12 and May 15, 2024, in two referral hospital of Douala. It included individuals (PWE and controls) aged 18 years and older who agreed to participate in the study. Individuals (PWE and controls) with a serious general health problem that could have a significant impact on mental status (hypertension, HIV, diabetes, renal failure, heart failure, dementia, bipolar disorder) or an inability to communicate were excluded. Recruitment was done through an online and in-person survey using a form. We collected sociodemographic data, and data on epilepsy in PWE. Depression was evaluated using the PHQ-9 scale. We used the Generalized Anxiety Disorder Questionnaire (GAD-7) to assess anxiety disorders. Univariate and multivariate analysis (binary logistic regression) were used to identify the factors significantly associated with depression in PWE. The significance threshold was considered for a value of p &lt; 0.05.</div></div><div><h3>Results</h3><div>a total of 633 individuals, including 211 PWE, were included in the study. The prevalence of depression was significantly higher in PWE (24.6 %) compared to controls (11.8 %) (OR: 2.0, 95 %CI: 1.433–2.905, p &lt; 0.001). Anxiety disorders was significantly higher in PWE (OR: 1.6, 95 %CI: 1.101–2.397, p = 0.014). Factors independently associated to depression were female sex (OR: 2.7, 95 %CI: 1.115–6.343, p = 0.027), suicidal ideation (OR: 5.8, 95 %CI: 2.083–16.174, p = 0.001), and anxiety disorders (OR: 10.2, 95 %CI: 4.023–25.748, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>the prevalence of depression is high in PWE compared to controls in Douala. A systematic screening should be included in the follow-up of PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110326"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Causal relationship between sleep traits and risk of Epilepsy: A Mendelian randomization study
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-24 DOI: 10.1016/j.yebeh.2025.110310
Kaiji Li , Haonan Li , Jinchao Wang , Xin Chen , Lei Li , Cong Wang , Shu Zhang , Jianning Zhang

Background

Observational studies have identified a strong correlation between epilepsy and sleep traits, highlighting their interactive relationship. However, no studies have specifically examined the associations between sleep traits and epilepsy. In this context, we conducted a Mendelian Randomization (MR) investigation to explore the causal nature of these associations.

Methods

We performed a two-sample Mendelian Randomization (MR) analysis model to genetically predict the causal effects of morning chronotype on epilepsy. Five MR analysis methods were conducted to analyze the final results. The inverse-variance weighted (IVW) method was used as the primary outcome. The other MR analysis methods (MR‐Egger; Weighted Mode; and Weighted median (WM)) were conducted as the complement to IVW. In addition, the robustness of the MR analysis results was assessed by leave-one-out analysis.

Results

In forward MR, epilepsy showed causal relationships with sleep duration (IVW beta = 0.008, P = 0.015). Specifically, doubling the odds of inheriting epilepsy may be associated with a 0.0075 standard deviation (SD) (95 % CI: 1.001 to 1.014) increase in sleep duration. In reverse MR, we found statistically significant associations between chronotype (evening preference) (OR = 1.397, p = 0.007) and insomnia (OR = 2.280, p = 0.025) and the risk of epilepsy.

Conclusion

Our two-sample Mendelian randomization analyses indicate that individuals with epilepsy frequently experience extended sleep duration. Additionally, we identified insomnia and chronotype (evening preference) as significant risk factors that increase the likelihood of developing epilepsy.
{"title":"Causal relationship between sleep traits and risk of Epilepsy: A Mendelian randomization study","authors":"Kaiji Li ,&nbsp;Haonan Li ,&nbsp;Jinchao Wang ,&nbsp;Xin Chen ,&nbsp;Lei Li ,&nbsp;Cong Wang ,&nbsp;Shu Zhang ,&nbsp;Jianning Zhang","doi":"10.1016/j.yebeh.2025.110310","DOIUrl":"10.1016/j.yebeh.2025.110310","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies have identified a strong correlation between epilepsy and sleep traits, highlighting their interactive relationship. However, no studies have specifically examined the associations between sleep traits and epilepsy. In this context, we conducted a Mendelian Randomization (MR) investigation to explore the causal nature of these associations.</div></div><div><h3>Methods</h3><div>We performed a two-sample Mendelian Randomization (MR) analysis model to genetically predict the causal effects of morning chronotype on epilepsy. Five MR analysis methods were conducted to analyze the final results. The inverse-variance weighted (IVW) method was used as the primary outcome. The other MR analysis methods (MR‐Egger; Weighted Mode; and Weighted median (WM)) were conducted as the complement to IVW. In addition, the robustness of the MR analysis results was assessed by leave-one-out analysis.</div></div><div><h3>Results</h3><div>In forward MR, epilepsy showed causal relationships with sleep duration (IVW beta = 0.008, P = 0.015). Specifically, doubling the odds of inheriting epilepsy may be associated with a 0.0075 standard deviation (SD) (95 % CI: 1.001 to 1.014) increase in sleep duration. In reverse MR, we found statistically significant associations between chronotype (evening preference) (OR = 1.397, p = 0.007) and insomnia (OR = 2.280, p = 0.025) and the risk of epilepsy.</div></div><div><h3>Conclusion</h3><div>Our two-sample Mendelian randomization analyses indicate that individuals with epilepsy frequently experience extended sleep duration. Additionally, we identified insomnia and chronotype (evening preference) as significant risk factors that increase the likelihood of developing epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110310"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reappraising self-report and proxy-report measures for assessing health-related quality of life in pediatric epilepsy: A scoping review
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-24 DOI: 10.1016/j.yebeh.2025.110334
Francesca Chiesi , Carlotta Tagliaferro , Pietro Cappelletto , Carmen Barba
This scoping review aimed to evaluate specific measures of health-related quality of life (HRQoL) in children with epilepsy including patient- and proxy-reports, to determine their suitability for use in the clinical setting. We searched PubMed, Web of Science, PsycINFO Scopus for studies on the childhood epilepsy questionnaires identified as having better measurement properties and/or including proxy and parent reports. Then, we selected the studies that analyzed the agreement between child and caregiver ratings. We identified five scales i.e., the QoLPES, the HARCES, the PedsQL-Epilepsy Module, and the CHEQoL-25 and observed a moderate to high agreement between the proxy-reports and child self-reports. The CHEQoL-25 appears to be preferable due to its well-documented psychometric properties, high usability, and adequate agreement between proxy and child versions. This scoping review highlights the need to use PROMs that allow to gather information from both the caregiver and child, with the CHEQoL-25 being the best candidate for assessing HRQol in children with epilepsy.
{"title":"Reappraising self-report and proxy-report measures for assessing health-related quality of life in pediatric epilepsy: A scoping review","authors":"Francesca Chiesi ,&nbsp;Carlotta Tagliaferro ,&nbsp;Pietro Cappelletto ,&nbsp;Carmen Barba","doi":"10.1016/j.yebeh.2025.110334","DOIUrl":"10.1016/j.yebeh.2025.110334","url":null,"abstract":"<div><div>This scoping review aimed to evaluate specific measures of health-related quality of life (HRQoL) in children with epilepsy including patient- and proxy-reports, to determine their suitability for use in the clinical setting. We searched PubMed, Web of Science, PsycINFO Scopus for studies on the childhood epilepsy questionnaires identified as having better measurement properties and/or including proxy and parent reports. Then, we selected the studies that analyzed the agreement between child and caregiver ratings. We identified five scales i.e., the QoLPES, the HARCES, the PedsQL-Epilepsy Module, and the CHEQoL-25 and observed a moderate to high agreement between the proxy-reports and child self-reports. The CHEQoL-25 appears to be preferable due to its well-documented psychometric properties, high usability, and adequate agreement between proxy and child versions. This scoping review highlights the need to use PROMs that allow to gather information from both the caregiver and child, with the CHEQoL-25 being the best candidate for assessing HRQol in children with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110334"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contribution of the Brown Location Test to the pre-surgical neuropsychological assessment of temporal lobe epilepsy
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-24 DOI: 10.1016/j.yebeh.2025.110330
Emma Colucci , Marie-Ève Landreville , Amélie Landry , Dang Khoa Nguyen , Arnaud Saj , Olivier Boucher
The nature of memory deficits in mesial temporal lobe epilepsy (mTLE) can depend on the side of the epileptogenic zone (EZ). Although left mTLE has been consistently associated with impairments in verbal memory, the association between right mTLE and non-verbal memory is less clear, which may be attributable to methodological limitations of existing visuospatial memory tests (e.g., possible use of verbalization strategies, involvement of psychomotor or visuospatial skills, task structure which differs between verbal and non-verbal memory tests). The Brown Location Test (BLT) was developed to evaluate visuospatial memory by addressing such limitations, and displays a good potential value for lateralizing the EZ. To our knowledge, no independent study has been conducted to assess the contribution of the BLT in lateralizing and localizing the EZ among patients undergoing pre-surgical assessment for drug-resistant focal epilepsy. This study aims to do so by comparing visuospatial and verbal memory performance of patients according to EZ lateralization (left vs. right) and localization (mesiotemporal vs. non-mesiotemporal). Eighty-nine adult patients with TLE were divided into four groups based on EZ (left mTLE, right mTLE, left non-mTLE, right non-mTLE) and were administered the BLT and the Rey Auditory Verbal Learning Test (RAVLT) pre-operatively. Memory performance was associated with sex, education and number of antiseizure medications. Only delayed recognition hits on the RAVLT showed the expected material-specific impairment associated with left mTLE, whereas BLT performance did not differ between groups. Therefore, caution is required when interpreting material-specific memory performances to localize and lateralize the EZ among patients undergoing pre-surgical assessment for drug-resistant epilepsy.
{"title":"Contribution of the Brown Location Test to the pre-surgical neuropsychological assessment of temporal lobe epilepsy","authors":"Emma Colucci ,&nbsp;Marie-Ève Landreville ,&nbsp;Amélie Landry ,&nbsp;Dang Khoa Nguyen ,&nbsp;Arnaud Saj ,&nbsp;Olivier Boucher","doi":"10.1016/j.yebeh.2025.110330","DOIUrl":"10.1016/j.yebeh.2025.110330","url":null,"abstract":"<div><div>The nature of memory deficits in mesial temporal lobe epilepsy (mTLE) can depend on the side of the epileptogenic zone (EZ). Although left mTLE has been consistently associated with impairments in verbal memory, the association between right mTLE and non-verbal memory is less clear, which may be attributable to methodological limitations of existing visuospatial memory tests (e.g., possible use of verbalization strategies, involvement of psychomotor or visuospatial skills, task structure which differs between verbal and non-verbal memory tests). The Brown Location Test (BLT) was developed to evaluate visuospatial memory by addressing such limitations, and displays a good potential value for lateralizing the EZ. To our knowledge, no independent study has been conducted to assess the contribution of the BLT in lateralizing and localizing the EZ among patients undergoing pre-surgical assessment for drug-resistant focal epilepsy. This study aims to do so by comparing visuospatial and verbal memory performance of patients according to EZ lateralization (left vs. right) and localization (mesiotemporal vs. non-mesiotemporal). Eighty-nine adult patients with TLE were divided into four groups based on EZ (left mTLE, right mTLE, left non-mTLE, right non-mTLE) and were administered the BLT and the Rey Auditory Verbal Learning Test (RAVLT) pre-operatively. Memory performance was associated with sex, education and number of antiseizure medications. Only delayed recognition hits on the RAVLT showed the expected material-specific impairment associated with left mTLE, whereas BLT performance did not differ between groups. Therefore, caution is required when interpreting material-specific memory performances to localize and lateralize the EZ among patients undergoing pre-surgical assessment for drug-resistant epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110330"},"PeriodicalIF":2.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The lived experience of the burden of normality: Explored through the lens of art therapy
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2025-02-21 DOI: 10.1016/j.yebeh.2025.110297
Sarah Brown , Honor Coleman , Tammy Shella , Sarah J Wilson
Within the clinical and research spheres, there is increasing recognition of the importance of understanding the lived experience of ongoing illness and incorporating this voice into research and clinical practice. The current paper provides insights into the lived experience of undergoing epilepsy surgery, explored through the lens of art therapy. Six pieces of self-portraiture are presented that highlight key features of the burden of normality as experienced by joint first author Sarah Brown (SB) after her epilepsy surgery. Self-reflections from SB about her artwork are integrated with findings from the empirical literature that detail experiences of post-operative adjustment, providing novel insights into the post-operative adjustment process from the lived experience perspective. This approach highlights ways in which key findings from the research literature, which summates experiences at the group level, can be applied to the individual situation. The study also underscores the potential value of art therapy as a complementary therapy for holistic post-operative rehabilitation practices.
{"title":"The lived experience of the burden of normality: Explored through the lens of art therapy","authors":"Sarah Brown ,&nbsp;Honor Coleman ,&nbsp;Tammy Shella ,&nbsp;Sarah J Wilson","doi":"10.1016/j.yebeh.2025.110297","DOIUrl":"10.1016/j.yebeh.2025.110297","url":null,"abstract":"<div><div>Within the clinical and research spheres, there is increasing recognition of the importance of understanding the lived experience of ongoing illness and incorporating this voice into research and clinical practice. The current paper provides insights into the lived experience of undergoing epilepsy surgery, explored through the lens of art therapy. Six pieces of self-portraiture are presented that highlight key features of the burden of normality as experienced by joint first author Sarah Brown (SB) after her epilepsy surgery. Self-reflections from SB about her artwork are integrated with findings from the empirical literature that detail experiences of post-operative adjustment, providing novel insights into the post-operative adjustment process from the lived experience perspective. This approach highlights ways in which key findings from the research literature, which summates experiences at the group level, can be applied to the individual situation. The study also underscores the potential value of art therapy as a complementary therapy for holistic post-operative rehabilitation practices.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"165 ","pages":"Article 110297"},"PeriodicalIF":2.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Epilepsy & Behavior
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