Epilepsy & Behavior最新文献

{"title":"Development of a questionnaire to measure patient-relevant needs and benefits in the treatment of epilepsy (PBI-Epilepsy)","authors":"Toni Maria Janke ,&nbsp;Jeanne Cuny ,&nbsp;Christine Blome ,&nbsp;Doris Wittig-Moßner ,&nbsp;Hajo Hamer","doi":"10.1016/j.yebeh.2024.110152","DOIUrl":"10.1016/j.yebeh.2024.110152","url":null,"abstract":"<div><h3>Objective</h3><div>Therapeutic goals in epilepsy treatment may be highly individual. The aim of the present study was to develop a questionnaire assessing patients’ needs and benefits of epilepsy treatment, the Patient Benefit Index on Epilepsy (PBI-Epilepsy).</div></div><div><h3>Methods</h3><div>We recruited adult patients during their stay at a university based epilepsy centre. Patients completed a survey asking about their burden and treatment goals. Data were categorised using qualitative content analysis. The final category system was discussed in an expert panel. The questionnaire was pre-tested using cognitive debriefing and adapted until no changes were required anymore.</div></div><div><h3>Results</h3><div>In the open survey, 25 people with epilepsy participated (60.0 % female, 33.2 years, 1–55 years epilepsy). The final category system included nine main categories (namely psyche, working life, seizures, therapy, leisure activities, social relationships, mobility, body, everyday life activities). From this, the expert panel developed a first draft of the PBI-Epilepsy. The questionnaire went through five rounds of cognitive debriefing with 29 patients (51.7 % female, 34.6 years, 2–37 years epilepsy). We decided to develop two versions of the questionnaire depending on the patient’s treatment (medical or surgical). A bipolar response scale was used in the part asking about treatment benefits, as epilepsy treatment can lead to both improvement and deterioration. The final questionnaire consists of two parts (patient needs and treatment benefits) each encompassing 21 items.</div></div><div><h3>Conclusion</h3><div>We aimed to reflect the wide range of issues that are relevant for people with epilepsy while developing a questionnaire that is short and easy for patients to understand.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110152"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744493","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}

{"title":"The impact of a walking program on self-management, anxiety, stress, depression, quality of life, and seizure frequency in patients with epilepsy: A mixed methods approach using the COM-B behaviour change model","authors":"Esin Kavuran ,&nbsp;Cemal Özalp ,&nbsp;Emrah Ay","doi":"10.1016/j.yebeh.2024.110149","DOIUrl":"10.1016/j.yebeh.2024.110149","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the effect of a walking program based on the COM-B Behavior Change Model on self-management, anxiety, stress, depression, quality of life, and seizure frequency in individuals with epilepsy.</div></div><div><h3>Methods</h3><div>A prospective, parallel-group controlled experimental design and mixed methods were used. A total of 78 individuals with epilepsy were included in the study and randomly assigned to the intervention (n = 38) and control (n = 40) groups. The intervention group participated in a weekly, twice-a-week, walking program for 12 weeks. The program was based on the COM-B model, focusing on increasing individuals’ capability, opportunity, and motivation levels. The control group received standard treatment. Self-management, anxiety, stress, depression, and quality of life were measured using scales. Seizure frequency was measured using daily logs. Qualitative data was collected through semi-structured interviews with 10 participants to understand barriers to walking in individuals with epilepsy.</div></div><div><h3>Results</h3><div>Qualitative data revealed time constraints, lack of motivation, and safety concerns as barriers to walking participation. After a 12-week intervention, a significant increase in self-management levels, a significant decrease in anxiety, stress, and depression levels, a significant improvement in quality of life, and a significant reduction in seizure frequency were observed in the intervention group. No significant changes were observed in these variables in the control group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that a walking program based on the COM-B Behavior Change Model had a positive impact on self-management, mental health, and quality of life in individuals with epilepsy and may help reduce seizure frequency.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110149"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744398","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}

{"title":"Efficacy and tolerability of celastrol and edaravone in the multiple-hit rat model of infantile spasms","authors":"Oleksii Shandra ,&nbsp;Yongjun Wang ,&nbsp;Lisa D. Coles ,&nbsp;Wenzhu B. Mowrey ,&nbsp;Qianyun Li ,&nbsp;Wei Liu ,&nbsp;Solomon L. Moshé ,&nbsp;Aristea S. Galanopoulou","doi":"10.1016/j.yebeh.2024.110159","DOIUrl":"10.1016/j.yebeh.2024.110159","url":null,"abstract":"<div><h3>Objective</h3><div>To test whether anti-inflammatory and antioxidant drugs that inhibit the nuclear factor kappa light chain enhancer of activated B cells (NF-kB), celastrol and edaravone, suppress spasms and improve developmental outcomes in the multiple-hit rat model of refractory infantile spasms (IS) due to structural lesions.</div></div><div><h3>Methods</h3><div>Postnatal day 3 (PN3) Sprague-Dawley rats were treated according to the multiple-hit IS model protocol. Using a randomized, blinded, vehicle-controlled, dose- and time-response study design, we tested the effects of single celastrol [1, 2, or 4 mg/kg intraperitoneally (i.p.), 10–14 rats/group] or edaravone (1, 10 or 30 mg/kg i.p., 14–17 rats/group) injections vs their vehicles on behavioral and electroclinical spasms and developmental milestones. Video-EEG monitoring was done on PN6-7 (n = 11–12 rats/group). Pulse celastrol treatment effects (PN4: 4 mg/kg, PN5-6: 2 mg/kg/day i.p.) were determined on spasms, developmental milestones and Barnes maze. Celastrol and edaravone pharmacokinetics in plasma and neocortex were assessed. Linear mixed model analysis of raw or normalized log-transformed spasm frequencies, considering repeated observations was used.</div></div><div><h3>Results</h3><div>Single (2–4 mg/kg i.p) or pulse celastrol, but not edaravone, reduced behavioral and electroclinical spasms frequencies within 5hrs. Pulse celastrol did not affect spasm-freedom, survival, developmental milestones or Barnes maze performance. Celastrol had erratic i.p. absorption with maximum concentrations observed between 2–4 h, when effects on spasms were seen. Edaravone had low blood-to-brain permeability.</div></div><div><h3>Conclusions</h3><div>Celastrol’s efficacy on spasms is partially explained by its better brain penetration than edaravone’s. NFkB inhibitors may be useful in treating drug-resistant IS but delivery methods with improved bioavailability and brain permeability are needed.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110159"},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692823","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}

{"title":"Letter to the Editor: Status epilepticus and peri-ictal MRI abnormalities","authors":"Simona Lattanzi ,&nbsp;Stefano Meletti","doi":"10.1016/j.yebeh.2024.110160","DOIUrl":"10.1016/j.yebeh.2024.110160","url":null,"abstract":"","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"162 ","pages":"Article 110160"},"PeriodicalIF":2.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686361","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}

{"title":"Organoids as a model of status epilepticus","authors":"J.S. Street,&nbsp;C. Zourray,&nbsp;G. Lignani","doi":"10.1016/j.yebeh.2024.110145","DOIUrl":"10.1016/j.yebeh.2024.110145","url":null,"abstract":"<div><div>Status epilepticus (SE) is a neurological emergency that can be studied in animal models, particularly mice. However, these models are labour-intensive and require large numbers of animals, which raises ethical and logistical challenges. Additionally, rodent-based models could lack direct relevance to human physiology. While reduced models offer some insights, they fail to replicate the full complexity of brain connectivity and interactions with other organs. To address this, human forebrain assembloids, formed by both cortical excitatory and subpallial inhibitory neurons, could be an alternative SE model. Assembloids offer a middle ground, enabling high-throughput screening of potential treatments while maintaining relevant human cell biology. This approach could serve as an intermediate step before transitioning to animal models, ultimately reducing the time and number of animals required for SE research. This paper is based on a presentation made at the 9th<!--> <!-->London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures in April 2024.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110145"},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652133","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}

{"title":"Executive functions disorders in children with frontal and temporal epilepsy","authors":"Amanda Guerra ,&nbsp;Rafika Fliss ,&nbsp;Mélodie Campiglia ,&nbsp;Julie Remaud ,&nbsp;Olivier Cadeau ,&nbsp;Caroline Seegmuller ,&nbsp;Clotilde Boulay ,&nbsp;Lucas Gauer ,&nbsp;Patrick Van Bogaert ,&nbsp;Nathalie de Grissac-Moriez ,&nbsp;Maria Paola Valenti Hirsch ,&nbsp;Mathieu Kuchenbuch ,&nbsp;Jean-Luc Roulin ,&nbsp;Nathalie Fournet ,&nbsp;Didier Le Gall ,&nbsp;Arnaud Roy","doi":"10.1016/j.yebeh.2024.110124","DOIUrl":"10.1016/j.yebeh.2024.110124","url":null,"abstract":"<div><h3>Introduction</h3><div>Children with focal epilepsy often present with executive functions (EFs) deficits. EFs deficits can contribute to adaptive challenges and have a negative impact on academic achievement. The purpose of this study was to investigate the EFs profiles of children diagnosed with frontal lobe epilepsy or temporal lobe epilepsy. Also, we aimed to examine the impact of medical and sociodemographic features on executive functioning and to compare the results of performance-based tests and ratings measures.</div></div><div><h3>Method</h3><div>EFs were assessed using performance based-tests and rating scales. The Child Executive Functions Battery (CEF-B) and the Behavior Rating Inventory of Executive Function (BRIEF) for parents and teachers were used.</div></div><div><h3>Results</h3><div>Fifty children aged 6–16 years participated in the study, 28 diagnosed with frontal lobe epilepsy and 22 diagnosed with temporal lobe epilepsy. Results showed that approximately 30 % of both groups of epilepsy patients had significant deficits in EFs compared to normative data. Deficits were observed across various domains of EFs (inhibition, working memory, flexibility and planning). Most patients exhibited deficits in one or two of the 4 domains. Worse executive performances were significantly associated with older age at assessment time, longer duration of epilepsy, higher seizure frequency, earlier age at onset and higher number of anti-seizure medication. Additionally, correlation and congruence analyses showed significant discrepancies between the performance-based and rating measures of executive functioning.</div></div><div><h3>Conclusion</h3><div>Our findings provide substantial evidence of significant executive deficits in children with FLE and TLE and support the clinical validity of the CEF-B battery in this population. The low level of agreement between performance tests and daily life questionnaires suggests that the two methods are complementary for understanding children’s executive functioning. Comprehensive assessment and targeted interventions to address EFs difficulties are recommended for this particular population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110124"},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638597","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}

{"title":"Assessing spatial memory using the Brown Location Test: Lateralizing seizures in a presurgical cohort of patients with temporal lobe epilepsy","authors":"Nicholas W.G. Murray ,&nbsp;Madison E. Choma ,&nbsp;Ada Lo ,&nbsp;Zoe Thayer ,&nbsp;Petra L. Graham ,&nbsp;Evelyn E. Harvey","doi":"10.1016/j.yebeh.2024.110137","DOIUrl":"10.1016/j.yebeh.2024.110137","url":null,"abstract":"<div><h3>Objective</h3><div>Whilst the dominant temporal lobe has a well-established role in memory, the functions of its nondominant counterpart remain enigmatic. We compared the lateralizing ability of a promising spatial memory task (Brown Location Test, BLT) to other commonly used verbal and visual memory tasks in a sample of patients with unilateral temporal lobe epilepsy (TLE).</div></div><div><h3>Methods</h3><div>Neuropsychological data from 48 TLE patients (right <em>n</em> = 28 and left <em>n</em> = 20) were compared on several verbal and nonverbal memory tasks. Univariate logistic regression analyses were used to examine the relationship between test scores and the odds of being categorised as right or left TLE, while multivariable logistic regression and decision tree analyses were used to establish the optimal <em>combination</em> of cognitive measures for lateralizing the epileptogenic zone (EZ).</div></div><div><h3>Results</h3><div>Relative to normative expectations, the right TLE group was specifically impaired on BLT measures, whereas the left TLE group was impaired on verbal <em>and</em> nonverbal memory tasks. The combination of BLT Delayed Recall and Delayed Recall on the Rey Auditory Verbal Learning Task (RAVLT) was identified as optimal for correctly predicting EZ laterality (AUC = 0.79). These two variables were also optimal predictors in the decision tree analysis, correctly predicting 79% of the overall sample (AUC = 0.83).</div></div><div><h3>Conclusions</h3><div>Our findings support the BLT as a measure of right temporal lobe function. They demonstrate its superior sensitivity compared to another commonly used nonverbal memory test (i.e., Visual Reproduction; VR) and highlight the added lateralizing value of combining both verbal <em>and</em> nonverbal memory measures in the neuropsychological evaluation of epilepsy surgery candidates.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110137"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638595","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}

{"title":"The future treatment of status epilepticus","authors":"Thomas P. Bleck","doi":"10.1016/j.yebeh.2024.110146","DOIUrl":"10.1016/j.yebeh.2024.110146","url":null,"abstract":"<div><div>To attempt an analysis of the future of treatment for status epilepticus, the author divided the goals of status treatment into several categories: clinical, research, economic, and equity. This paper is based on a lecture presented at the 9th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures, in London 8–10 April 2024.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110146"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616622","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}

{"title":"Video-based automatic seizure detection in pharmacoresistant epilepsy: A prospective exploratory study","authors":"Fredrik K. Andersson ,&nbsp;Helena Gauffin ,&nbsp;Hans Lindehammar ,&nbsp;Patrick Vigren","doi":"10.1016/j.yebeh.2024.110118","DOIUrl":"10.1016/j.yebeh.2024.110118","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to evaluate the diagnostic yield and clinical utility of an automated AI video-based seizure detection device, Nelli®, (SDD) in pharmacoresistant epilepsy patients. The SDD captures and automatically classifies nocturnal motor behavior suggestive of epileptic seizures or non-epileptic motor behavior of potential clinical value.</div></div><div><h3>Methods</h3><div>Patients with focal epilepsy and pharmacoresistance referred for inpatient long-term video-EEG monitoring were prospectively recruited. Participants were monitored in their home at night with the SDD for a median of 15.5 nights. Captured video recordings were analyzed by clinical experts and each SDD-registration session was classified as diagnostic or not. Clinical utility for each participant was assessed from pre-specified utility measures. The outcome measures were compared between major focal motor and subtle focal motor seizures.</div></div><div><h3>Results</h3><div>One SDD-registration session in each of the 20 participants was performed and analyzed. Video recordings were captured in 18 sessions. Diagnostic yield was found in 11 registration sessions (55.0 %) and clinical utility in 8 registration sessions (40.0 %). No significant difference was found between the AI-algorithm classification and clinical experts’ consensus assessment of captured video recordings as epileptic or not. Positive predictive value was 81.8 % for registration sessions containing video recordings classified as epileptic seizures. The diagnostic yield and clinical utility were significantly higher among major focal motor seizures (81.8 % and 63.6 %) compared to subtle focal motor seizures.</div></div><div><h3>Significance</h3><div>The SDD is useful to evaluate patients with pharmacoresistant epilepsy and major focal motor seizures (hyperkinetic, tonic, clonic, focal to bilateral tonic-clonic seizures); it may facilitate the diagnostic process in patients referred for long-term inpatient video-EEG evaluation and beneficially change anti-seizure treatments. The SDD provided accurate classification of major focal motor seizures as epileptic, or non-epileptic, and may serve as a useful diagnostic tool to distinguish epileptic and non-epileptic episodic events with a prominent motor component.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110118"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616625","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}

{"title":"Drug-resistant epilepsy: Is there an overlooked association between drug resistant epilepsies and neuropsychiatric comorbidities?","authors":"Alan Talevi","doi":"10.1016/j.yebeh.2024.110144","DOIUrl":"10.1016/j.yebeh.2024.110144","url":null,"abstract":"<div><div>Despite the introduction of several first-in-class antiseizure medications in the last 15 years and the recent generation of new hypotheses to explain the drug-resistant phenotype in epilepsy, the proportion of patients with refractory epilepsy remains apparently unchanged. Therefore, it is essential to provide new perspectives (or, perhaps, revive old perspectives) to develop more effective therapeutic interventions. Some of the complex comorbid disorders associated with epilepsy, which present similar rates of unresponsive patients and whose refractoriness is possibly mediated by similar causes, could provide keys to implement novel therapeutic interventions. In this article, based on Swanson’s ABC model to develop scientific hypotheses, we establish (or rescue) some interesting connections between depression and epilepsy, focusing on the relationship between drug-resistant epilepsy and depression.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110144"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616602","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}