Epilepsy & Behavior最新文献

{"title":"An rs-fMRI based neural marker for MRI-negative temporal lobe epilepsy with depression","authors":"Chunyan Huang ,&nbsp;Yujun Gao ,&nbsp;Ruoshi Liu ,&nbsp;Dongbin Li","doi":"10.1016/j.yebeh.2025.110873","DOIUrl":"10.1016/j.yebeh.2025.110873","url":null,"abstract":"<div><h3>Objective</h3><div>Depression is the most common comorbidity in epilepsy. Currently, the diagnosis of comorbid depression in epilepsy primarily relies on medical history and scales. However, this approach is highly subjective and heavily dependent on the physician’s experience, and prone to missed or misdiagnosis. The primary objective of this study was to evaluate the effectiveness of network homogeneity (NH) measurements analyzed via support vector machine (SVM) in diagnosing MRI-negative temporal lobe epilepsy with depression (MRI-negative TLED).</div></div><div><h3>Methods</h3><div>The study included a total of 217 participants, comprising 90 healthy controls, 45 patients with MRI-negative temporal lobe epilepsy (MRI-negative TLE) and 82 patients with MRI-negative TLED. All subjects underwent resting-state fMRI scans for data collection. For analytical purposes, NH were computed and combined with SVM techniques for comprehensive data analysis.</div></div><div><h3>Results</h3><div>Compared to healthy control individuals, MRI-negative TLED patients demonstrated significantly increased NH values in the right mid-cingulum, right precuneus and right supramarginal, accompanied by decreased NH in the bilateral inferior temporal gyrus, left parahippocampal gyrus (PHG) and the right medial superior frontal gyrus (mSFG). Compared to MRI-negative TLE patients, MRI-negative TLED patients demonstrated significantly decreased NH values in the left parahippocampal gyrus (PHG) and the left mid temporal<!--> <!-->pole (MTP). SVM was used to differentiate patients with MRI-negative TLED from healthy control individuals based on rs-fMRI data, and the decreased NH in the left PHG showed highe diagnostic accuracy (71.56%).</div></div><div><h3>Significance</h3><div>According to the results, decreased NH values in the left PHG could serve as neuroimaging marker for MRI-negative TLED, offering objective guidance for its diagnosis.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110873"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035129","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":"Does adjunctive Cenobamate lead to a reduction in the use of vagal nerve stimulation? A long-term observational study of patients on the epilepsy surgery pathway","authors":"Pyae Aung,&nbsp;Smriti Bose,&nbsp;Asha Patel,&nbsp;Salini Sumangala,&nbsp;Daniel White,&nbsp;Barbara Wysota,&nbsp;Shanika Samarasekera","doi":"10.1016/j.yebeh.2026.110902","DOIUrl":"10.1016/j.yebeh.2026.110902","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effectiveness of adjunctive Cenobamate (CNB) in reducing seizure frequency and influencing concomitant antiseizure medication (ASM) use for adults with refractory epilepsy on the VNS pathway. To assess whether addition of CNB leads to deferral of VNS insertion or deactivation in those with a VNS in situ.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluated adult patients on the epilepsy surgery pathway who were both awaiting and had already undergone VNS insertion (the latter conducted over two years prior to study onset and not requiring imminent battery replacement over a 36-month period. Seizure frequency, changes in concomitant ASMs and decisions regarding VNS were ascertained from electronic records at baseline (T1), 12-month (T2) and 36-month (T3) post initiation of Cenobamate.</div></div><div><h3>Results</h3><div>65 patients (29 male) were assessed, 42 patients (64.6 %) had a VNS in situ, the remainder were awaiting VNS. 64 patients had a minimum duration of epilepsy of 10 years. 18 patients (28 %) were classified as LGS spectrum.</div><div>At T2, 40 patients (61.5 %) attained significant seizure reduction of at least 50 % (p &lt; 0.0001). There was no significant difference between the LGS spectrum and non LGS cohorts. 9 of 23 patients awaiting VNS elected not to undergo insertion in light of seizure reduction. 22 (52 %) of the 42 VNS patients attained significant seizure reduction, of whom 3 (8 %) attained seizure freedom. 2 patients requested VNS deactivation. At T3, 13 patients of 23 deferred VNS insertion on account of seizure control with Cenobamate.</div></div><div><h3>Conclusions</h3><div>Adjunctive CNB has the potential to influence decision making in people with epilepsy. VNS deferral and/or deactivation as a result of significant seizure reduction with CNB has a significant economic impact.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110902"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974351","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":"The role of demographic factors of individuals with seizures in emergency care delivery","authors":"Christopher Saouda,&nbsp;Radwa Aly ,&nbsp;Sean M. Lee,&nbsp;Mohamad Z. Koubeissi","doi":"10.1016/j.yebeh.2026.110923","DOIUrl":"10.1016/j.yebeh.2026.110923","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether patient demographics, specifically race and ward of residence, are associated with differences in seizure-related emergency department (ED) care delivery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of adults presenting with epileptic or functional seizures to the ED at the George Washington University (2018–2020). Each visit was mapped to one of Washington, D.C.’s eight wards, and patients were stratified by race and ward (White vs. Black patients from wards 1–6 or wards 7–8). Key ED interventions and outcomes (antiseizure medication (ASM) administration, head CT imaging, toxicology screening, ED length of stay) were compared across groups using multivariable logistic regression and linear/mixed-effects models.</div></div><div><h3>Results</h3><div>Among 324 ED visits analyzed, Black patients had significantly higher odds of receiving an emergency ASM than White patients. They also experienced longer ED stays on initial visits. CT imaging appeared more common among patients from the most underserved wards (40% in Wards 7–8 vs ∼ 27% in other groups); however, in adjusted comparisons, neither CT nor toxicology utilization differed significantly by race/ward. No racial/ward differences in ED stay were observed in repeat-visit patients.</div></div><div><h3>Significance</h3><div>Black patients from disadvantaged wards made more frequent and prolonged ED visits for seizures, requiring urgent treatment more often than others. These findings suggest that systemic disparities in outpatient epilepsy care and resource access contribute to uneven acute care utilization, underscoring the need for interventions to ensure equitable seizure management.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110923"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073928","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":"Facial emotion recognition in temporal lobe epilepsy: Behavioral performance, reaction time and alexithymia","authors":"Ruken Simsekoglu ,&nbsp;Emre Akbas ,&nbsp;Hasan Demirci ,&nbsp;Serra Şandor ,&nbsp;Temel Tombul","doi":"10.1016/j.yebeh.2026.110924","DOIUrl":"10.1016/j.yebeh.2026.110924","url":null,"abstract":"<div><h3>Objective</h3><div>Facial emotion recognition (FER) deficits are well documented in temporal lobe epilepsy (TLE), but most studies have focused on recognition accuracy, with limited attention to reaction time (RT) and its relationship with alexithymia. This study aimed to compare FER accuracy, RT, and alexithymia levels between patients with TLE and healthy controls (HCs) and to examine associations between FER performance and alexithymia.</div></div><div><h3>Methods</h3><div>Twenty-two patients with unilateral TLE and 30 age-, sex-, and education-matched HCs were included. FER accuracy and RTs were assessed using a standardized facial emotion recognition task. Alexithymia was evaluated using the Toronto Alexithymia Scale (TAS-20). Group comparisons and correlation analyses were conducted, controlling for depression where appropriate.</div></div><div><h3>Results</h3><div>Compared with HCs, patients with TLE showed significantly lower recognition accuracy for happiness, fear, disgust and neutral facial expressions, along with significantly prolonged RTs across all emotion categories. Across emotions, longer RTs were consistently associated with poorer recognition accuracy. TLE patients exhibited significantly higher alexithymia scores, even after controlling for depression. Higher difficulty describing feelings was associated with poorer recognition of fearful facial expressions.</div></div><div><h3>Conclusion</h3><div>Facial emotion processing deficits in TLE extend beyond reduced recognition accuracy and are characterized by a marked slowing of emotional information processing. The close relationship between RT, recognition accuracy, and alexithymia suggests that FER impairments in TLE reflect inefficiencies within broader emotional-cognitive networks rather than isolated hemispheric dysfunction. Assessing FER in terms of both accuracy and processing speed, alongside alexithymic features, may enhance the clinical evaluation of social cognition in TLE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110924"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073985","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":"Survey of burnout in U.S. Epilepsy physicians","authors":"Brin E. Freund ,&nbsp;Alina V. Ivaniuk ,&nbsp;Cormac A. O’Donovan ,&nbsp;William O. Tatum ,&nbsp;Hiba A. Haider","doi":"10.1016/j.yebeh.2026.110887","DOIUrl":"10.1016/j.yebeh.2026.110887","url":null,"abstract":"<div><h3>Background</h3><div>Physician burnout is a significant public health concern. Epilepsy physicians may be at particularly higher risk, but previous studies have not solely focused on epilepsy specialty-specific burnout.</div></div><div><h3>Methods</h3><div>We distributed a survey targeting epilepsy attending physicians practicing in the U.S. The authors designed a 45-question survey to assess and quantify burnout, which was distributed between October 2024 and February 2025. Univariable and multivariable analyses were performed, evaluating individual and practice-related factors and burnout.</div></div><div><h3>Results</h3><div>A total of 176 responses were included, 96/176 (54.0 %) reported burnout, 35/176 (20.5 %) reported severe burnout, and 136/140 (96 %) feel burnout is a problem. Physicians reporting burnout and severe burnout were more likely to endorse they would not have become a physician (p &lt; 0.001) or epileptologist (p = 0.002 and p &lt; 0.001, respectively), and were more likely to plan to leave their job/medicine, or reduce hours (p = 0.016 and p = 0.001, respectively). In multivariable analysis, higher Mini-Z subscale 1 score (p &lt; 0.001), staffing support (p = 0.003), fellow coverage (p = 0.018), and male gender (p = 0.002) protected against burnout. Each additional patient admitted to the EMU increased burnout by 17 % (p = 0.023). White physicians were more likely to report burnout (p = 0.045). Higher Mini-Z subscale 1 (p &lt; 0.001) and 2 (p = 0.043), practicing in Northeast (p = 0.006) and South (p = 0.003) as compared to the Midwest, and male gender (p = 0.041) protect against severe burnout.</div></div><div><h3>Discussion</h3><div>Multiple institutional factors are associated with or protect against burnout, and women and those in the Midwest are at particularly higher risk. These results should alert organizational/institutional leaders to take action to prevent burnout, given implications for access, patient safety and physician attrition.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110887"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060903","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":"Quality of life in Epilepsy: a comparison between pediatric and adult onset","authors":"Beezhold Brenna ,&nbsp;Luca Farrugia ,&nbsp;Matthew R. Buras ,&nbsp;Charles S. Van Der Walt ,&nbsp;Kristin A. Kirlin ,&nbsp;Kellie K. Kruger ,&nbsp;Nicole R. Schuren ,&nbsp;Matthew T. Hoerth","doi":"10.1016/j.yebeh.2026.110896","DOIUrl":"10.1016/j.yebeh.2026.110896","url":null,"abstract":"<div><div>Epilepsy can affect people at any age and is known to impact quality of life (QOL). However, variations in QOL across age groups have not been investigated. The purpose of this study is to investigate the contrast between pediatric-onset and adult-onset epilepsy. The Mayo Clinic Arizona database of 568 epilepsy patients admitted to the Epilepsy Monitoring Unit who underwent neuropsychological testing from 2008 to 2019 was queried. Those diagnosed with epilepsy before age 25 were considered pediatric onset (n = 206), while those after 25 were considered adult onset (n = 125). Administered as part of the neuropsychological testing, the Quality of Life in Epilepsy Inventory (QOLIE-31) was reviewed. The average age of disease onset for the pediatric group was 13 years old and adult-onset group 48. Overall QOLIE scores were not found to be statistically significantly different (mean t score 42.8 pediatric vs 45.2 adult, p = 0.058). However, three of the seven QOLIE-31 subscores were found to be statistically significantly worsened in the pediatric population- social function (T score mean 42.4 vs 45.1, p = 0.030), emotional well-being (T score mean 46.7 vs 50.0, p = 0.008), and seizure worry (T score mean 44.0 vs 46.7, p = 0.035). This study indicates that while our pediatric epilepsy patients’ overall QOL was not found to be statistically significantly different, there are specific areas of concern unique to younger patient populations including social functioning, emotional well-being and worries surrounding their seizures. These differences must be considered when creating a treatment plan and providing support to this group of patients.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110896"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009317","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":"Sleep quality and impact factors in older adults with epilepsy","authors":"Yilin Fan ,&nbsp;Xiaowen Zhou ,&nbsp;Honglu Ping ,&nbsp;Yiling Chen ,&nbsp;Qianhua Zhao ,&nbsp;Ding Ding ,&nbsp;Jianhong Wang","doi":"10.1016/j.yebeh.2026.110889","DOIUrl":"10.1016/j.yebeh.2026.110889","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to describe sleep quality and the prevalence of poor sleepers in older adults with epilepsy (OAE), and to identify epilepsy-related factors associated with sleep quality.</div></div><div><h3>Method</h3><div>We conducted a case-control study including 175 OAE and 700 older adults without epilepsy. Demographic characteristics, clinical conditions, and epilepsy-related factors were collected. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), with scores &gt; 5 indicating poor sleep.</div></div><div><h3>Results</h3><div>OAE had significantly higher global PSQI scores than controls (6.1 [3.3] vs. 4.6 [3.2], p &lt; 0.001), with 48.6 % classified as poor sleepers compared to 19.9 % in controls (p &lt; 0.001). OAE had longer sleep latency, shorter sleep duration, lower sleep efficiency, more sleep disturbances, higher frequency of sleeping medication use, and greater daytime dysfunction (all p &lt; 0.05). Poor sleepers in the OAE group exhibited shorter sleep duration, more severe sleep disturbances, and daytime dysfunction (p &lt; 0.05) compared with controls. Multivariate linear regression models indicated that, epilepsy onset at older age was associated with greater sleep disturbances (β = 0.006, p = 0.005) and less sleep medication use (β = -0.011, p = 0.009); longer epilepsy duration was correlated with fewer sleep disturbances (β = -0.006, p = 0.006) and more sleep medication use (β = 0.011, p = 0.008); higher seizure frequency was associated with longer sleep duration (β = -0.228, p = 0.023).</div></div><div><h3>Conclusion</h3><div>OAE exhibited significantly poorer sleep quality compared to controls, with sleep disturbances closely linked to epilepsy-related factors. These findings underscore the need for comprehensive sleep assessment and management of seizures in clinical care for OAE, with the goal of improving their overall health outcomes.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110889"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003383","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":"Go! to sleep SM: a randomized, controlled trial for the treatment of chronic insomnia in adults epilepsy","authors":"Jad El Ahdab ,&nbsp;Madeleine Grigg-Damberger ,&nbsp;Christian Mouchati ,&nbsp;Sikawat Thanaviratananich ,&nbsp;Thapanee Somboon ,&nbsp;Jim Bena ,&nbsp;Nancy Foldvary-Schaefer","doi":"10.1016/j.yebeh.2025.110878","DOIUrl":"10.1016/j.yebeh.2025.110878","url":null,"abstract":"<div><h3>Objective</h3><div>Insomnia is a prevalent, treatable comorbidity in adults with epilepsy (AWE). Cognitive Behavioral Therapy for Insomnia (CBTI) is the gold standard treatment for insomnia, but its effectiveness in AWE has not been extensively studied. We conducted a randomized, single-blind, controlled trial to evaluate the effectiveness of computerized CBTI (cCBTI) using the Go! To Sleep^SM program on sleep-related outcomes in AWE and, for the first time, explored its effect on seizure control.</div></div><div><h3>Methods</h3><div>AWE with moderate-to-severe insomnia were randomized to cCBTI or sleep hygiene education alone (control). The primary outcome was change in Insomnia Severity Index (ISI) from baseline to end of study (EOS). Secondary Patient-Reported Outcomes (PROs) included the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Patient Sleep Quality Inventory (PSQI), Patient Health Questionnaire-9 (PHQ-9), self-reported sleep duration, and frequency of disabling seizures.</div></div><div><h3>Results</h3><div>Thirty-five subjects (mean age 39.5 ± 12.6 years; 57 % female) were analyzed. ISI scores decreased in both groups beyond the clinically meaningful threshold of 4 points (−9.0 with cCBTI vs. − 5.8 with control; both p &lt; 0.001); the between-group difference was not significant (p = 0.076). All PROs improved in cCBTI, while controls showed improvement in ESS, FSS, and PSQI only. PHQ-9 (−4.5, p = 0.003) and sleep duration (+1.07 h, p &lt; 0.001) improved significantly only in cCBTI. Seizure frequency, higher at baseline in cCBTI compared to controls (p = 0.028), was comparable by EOS (p = 0.30).</div></div><div><h3>Conclusion</h3><div>Both cCBTI and sleep hygiene significantly improved insomnia severity, daytime sleepiness, fatigue, and sleep quality. cCBTI was additionally associated with reduced depressive symptoms and increased sleep time. While no significant between-group difference in seizure frequency was observed, narrowing baseline differences suggests a potential benefit of cCBTI. Larger studies are warranted.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110878"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974353","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":"Caregivers’ experiences and expectations regarding seizure monitoring – A survey-based study","authors":"Hanna Grote ,&nbsp;Margarita Maltseva ,&nbsp;Jan Schönberger ,&nbsp;Victoria San Antonio-Arce ,&nbsp;Susanne Schubert-Bast ,&nbsp;Thomas Bast ,&nbsp;Walid Fazeli ,&nbsp;Julia Jacobs ,&nbsp;Kerstin Alexandra Klotz","doi":"10.1016/j.yebeh.2026.110914","DOIUrl":"10.1016/j.yebeh.2026.110914","url":null,"abstract":"<div><h3>Objective</h3><div>Monitoring devices for children with epilepsy may reduce parental stress and the risk of sudden unexpected death in epilepsy. This study explored caregiver’s experiences, expectations, and barriers related to seizure monitoring.</div></div><div><h3>Methods</h3><div>A survey of caregivers of children with epilepsy collected data on demographics, epilepsy characteristics, prior monitoring experience, expectations and reported issues.</div></div><div><h3>Results</h3><div>Between November 2023 and April 2024, 172 caregivers participated. The children’s median age was 9 years (IQR ± 8), 49% were female. Experience with monitoring was reported by 63%. Monitored children had more nocturnal and tonic–clonic seizures, more seizures with heart rate or breathing changes, higher rates of status epilepticus, and greater need for polytherapy and rescue medication (p &lt; 0.05). A median of two devices per child (IQR ± 1) were used; 79% were non–epilepsy-specific tools such as baby monitors, cameras, pulse oximeters, or ECG monitors. Key motivations for monitoring were recognizing life-threatening situations (83%), observing the child during seizures (79%) and improving parental stress and sleep (67%). These goals were achieved in 81% of cases. Main barriers were unreliable seizure detection and frequent false alarms, though these caused discontinuation in fewer than 7% of cases. Among caregivers without monitoring experience, 70% expressed interest in seizure detection devices, yet 88% reported that the option had never been discussed with their physician.</div></div><div><h3>Significance</h3><div>Non-specific devices are primarily used for seizure detection and largely meet caregivers’ needs for timely intervention and improved sleep. Barriers include false alarms, detection issues, and a lack of physician recommendations.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110914"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035067","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":"Cenobamate’s effect on mood and seizure frequency","authors":"Mert Karatas ,&nbsp;Alperan Yavuz ,&nbsp;Blake Newman ,&nbsp;Angela Peters ,&nbsp;Brian Johnson ,&nbsp;Sindhu Richards ,&nbsp;Pawan Rawal ,&nbsp;Adrian Rothenfluh ,&nbsp;Amir Arain","doi":"10.1016/j.yebeh.2026.110913","DOIUrl":"10.1016/j.yebeh.2026.110913","url":null,"abstract":"<div><h3>Objective</h3><div>Real-world experience with efficacy and tolerability of newly approved antiseizure medications (ASM) often diverges from findings in their controlled clinical trials. Cenobamate (CNB), demonstrated a high responder rate and seizure freedom in placebo-controlled trials. Since 40% of patients with epilepsy (PWE) experience comorbid depression, understanding the potential mood-related effects of CNB is critical. This retrospective study evaluates the impact of CNB on mood, tolerability, and seizure control when used as adjunctive therapy at our institution.</div></div><div><h3>Methods</h3><div>A single-center retrospective chart review was conducted of adult patients with refractory focal epilepsy who initiated CNB add-on therapy (May 2020–July 2023). We assessed changes in depressive symptoms and seizure frequency. Eligibility required ≥3 months on CNB, seizure frequency available at baseline and last follow-up (events/30 days), and paired Patient Health Questionnaire-9 (PHQ-9) scores. Seizure outcomes were analyzed as paired change (ΔSeizures), as log₂ fold-change, and percent change. We assessed response to treatment by assessing seizure-freedom, as well as ≥50% and ≥75% reduction in seizure frequency.</div></div><div><h3>Results</h3><div>73 adult PWE met study criteria. Median seizure frequency fell from 5 at baseline to 1.5 per 30 days at the last follow-up (p &lt; 0.001), with a 50% median reduction (95% CI: 70%–19%) in seizure frequency within a median of 488 days of follow-up. At the last follow-up, 29% of patients were seizure-free overall. PHQ-9 scores did not worsen (median ΔPHQ-9 = 0 (HL = 0; 95% CI –2 to 0; 0.34), and in multiple linear regressions of ΔPHQ-9, no prespecified covariates were associated with mood outcomes.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that CNB is a safe and effective adjunctive ASM that improves seizure control in PWE and that does not significantly change PHQ-9 scores. While better seizure control may mask the drug’s potential effects on mood—as reduced seizure burden itself could influence depressive symptoms—its impact on individual mood was variable. These results highlight the need for further research.</div></div><div><h3>Simple language summary</h3><div>Patients with epilepsy often experience depression, making it important to assess whether new antiseizure medications affect mood. This study reviewed medical records of patients prescribed cenobamate (Xcopri) between May 2020 and August 2023. The results showed that cenobamate helped improve seizure control, and most patients did not experience a worsening of mood. These findings suggest that cenobamate is a safe option for epilepsy treatment, although further research is needed.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110913"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073984","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}