Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110141
Beth K. Rush , Luke Kim , Steve Savinoff , Meagan Watson , Laura Strom
Treatment trials for functional seizure (FS) help improve functioning and reduce disability in affected individuals. Clinical trials have prioritized clinician-defined outcomes, but no studies have directly asked adults with FS what they hope to accomplish. This study examined patient-defined goals for treatment in a consecutive cohort of 826 adults with FS referred for outpatient treatment. Goals were reviewed and sorted into 6 categories with 32.5% of goals related to seizure management, 21.8% to abstract functional improvement, 20.3% to concrete functional improvement, 14.8% to seizure education, 10.1% to psychiatry tools, and 0.5% to Other. Although treatment trials have prioritized reduced event frequency as a primary outcome, people with FS most frequently prioritize goals for functional improvement. Data suggests that rehabilitation metrics of FS treatment outcome may be just as, or more important to adults with FS than what medical providers prioritize for outcome success. Study findings have implications for how to define FS treatment success and suggest equal prioritization of patient-centered goals to medically-defined goals in trial design.
{"title":"Ask the Patient: Goals for Functional seizure treatment","authors":"Beth K. Rush , Luke Kim , Steve Savinoff , Meagan Watson , Laura Strom","doi":"10.1016/j.yebeh.2024.110141","DOIUrl":"10.1016/j.yebeh.2024.110141","url":null,"abstract":"<div><div>Treatment trials for functional seizure (FS) help improve functioning and reduce disability in affected individuals. Clinical trials have prioritized clinician-defined outcomes, but no studies have directly asked adults with FS what they hope to accomplish. This study examined patient-defined goals for treatment in a consecutive cohort of 826 adults with FS referred for outpatient treatment. Goals were reviewed and sorted into 6 categories with 32.5% of goals related to seizure management, 21.8% to abstract functional improvement, 20.3% to concrete functional improvement, 14.8% to seizure education, 10.1% to psychiatry tools, and 0.5% to Other. Although treatment trials have prioritized reduced event frequency as a primary outcome, people with FS most frequently prioritize goals for functional improvement. Data suggests that rehabilitation metrics of FS treatment outcome may be just as, or more important to adults with FS than what medical providers prioritize for outcome success. Study findings have implications for how to define FS treatment success and suggest equal prioritization of patient-centered goals to medically-defined goals in trial design.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110141"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616598","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}
Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110140
Cheng Yu , Shijiu Jiang , Bingjie Lv , Xuejun Deng , Da Xu
Background
Observational studies suggest that hypertension and epilepsy have a high co-occurrence, and antihypertensive medications may have impacts on the prevention and treatment of epilepsy. However, the directionality of causation between them is elusive.
Method
By leveraging genome-wide association studies (GWAS) summary data of each trait, we firstly performed bidirectional univariate Mendelian randomization (UVMR) to assess the strength and direction of the associations between pairs of traits, then multivariate MR (MVMR) was conducted to adjust for potential confounders in causalities. Cochran’s Q statistics, leave-one-out analysis, MR-Egger regression and MR-Pleiotropy Residual Sum and Outlier methods (MR-PRESSO) were employed to evaluate the robustness of the results. Drug target MR was proceeded to assess the association between five classes of first-line antihypertensive medications and epilepsy. Specifically, single nucleotide polymorphisms (SNPs) extracted from GWAS data on systolic blood pressure (SBP)/diastolic blood pressure (DBP), along with expression quantitative trait loci (eQTL) were utilized as proxies for antihypertensive medications, respectively.
Results
Forward UVMR results provided evidence that genetically predicted blood pressure traits and hypertension have causal effects on epilepsy, while reverse UVMR indicated no causal impacts of epilepsy on blood pressure traits or hypertension. The sensitivity analysis results were robust. The causalities between DBP, hypertension and epilepsy remained remarkable after adjustment by MVMR. Inverse-variance-weighted MR (IVW-MR) yielded evidence of positive association only between Beta-Blockers target genes based on DBP GWAS screening and epilepsy. Summary-data-based MR (SMR) identified a positive correlation between Beta-Blockers target gene ADRA1D and epilepsy risk.
Conclusions
Hypertension has a causal effect on epilepsy and managing DBP in patients with hypertension through Beta-Blockers may help prevent epilepsy.
{"title":"Dissecting the association between blood pressure traits, hypertension, antihypertensive medications and epilepsy: A Mendelian randomization study","authors":"Cheng Yu , Shijiu Jiang , Bingjie Lv , Xuejun Deng , Da Xu","doi":"10.1016/j.yebeh.2024.110140","DOIUrl":"10.1016/j.yebeh.2024.110140","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies suggest that hypertension and epilepsy have a high co-occurrence, and antihypertensive medications may have impacts on the prevention and treatment of epilepsy. However, the directionality of causation between them is elusive.</div></div><div><h3>Method</h3><div>By leveraging genome-wide association studies (GWAS) summary data of each trait, we firstly performed bidirectional univariate Mendelian randomization (UVMR) to assess the strength and direction of the associations between pairs of traits, then multivariate MR (MVMR) was conducted to adjust for potential confounders in causalities. Cochran’s Q statistics, leave-one-out analysis, MR-Egger regression and MR-Pleiotropy Residual Sum and Outlier methods (MR-PRESSO) were employed to evaluate the robustness of the results. Drug target MR was proceeded to assess the association between five classes of first-line antihypertensive medications and epilepsy. Specifically, single nucleotide polymorphisms (SNPs) extracted from GWAS data on systolic blood pressure (SBP)/diastolic blood pressure (DBP), along with expression quantitative trait loci (eQTL) were utilized as proxies for antihypertensive medications, respectively.</div></div><div><h3>Results</h3><div>Forward UVMR results provided evidence that genetically predicted blood pressure traits and hypertension have causal effects on epilepsy, while reverse UVMR indicated no causal impacts of epilepsy on blood pressure traits or hypertension. The sensitivity analysis results were robust. The causalities between DBP, hypertension and epilepsy remained remarkable after adjustment by MVMR. Inverse-variance-weighted MR (IVW-MR) yielded evidence of positive association only between Beta-Blockers target genes based on DBP GWAS screening and epilepsy. Summary-data-based MR (SMR) identified a positive correlation between Beta-Blockers target gene ADRA1D and epilepsy risk.</div></div><div><h3>Conclusions</h3><div>Hypertension has a causal effect on epilepsy and managing DBP in patients with hypertension through Beta-Blockers may help prevent epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110140"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616600","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}
Understanding parental attitudes and health literacy is crucial for promoting safe and effective medication use, which is pivotal in managing epilepsy, a condition requiring consistent and informed treatment decisions. So, this study aimed to determine the impact of health literacy among parents of children with epilepsy on their attitudes towards rational drug use.
Method
This study, conducted at a university hospital’s Child Neurology Outpatient Clinic in Konya, Turkey from May to December 2023, employed a descriptive research design involving 234 parents of children with epilepsy who attended routine check-ups during this period. Data collection utilized a Demographic Information Form, the Parental Attitude Scale towards Rational Drug Use, and the Health Literacy Scale, analyzed using IBM SPSS Statistics Standard Concurrent User V 25. Analytical methods included descriptive statistics (number, percentage, mean, standard deviation, median, minimum, maximum), as well as One-Way ANOVA, Independent-Sample T Test, Correlation, and Linear Regression (Enter method), with statistical significance set at p < 0.05.
Results
It was determined that 67.1 % of the parents participating in the study were female, with a mean age of 35.85 ± 0.47 years, and the average age of the children was 7.93 ± 4.78 years. It was found that 66.7 % consult a doctor first about the medications they use and health concerns, 97 % do not use medication for their children without a doctor’s prescription, and of those who do use non-prescription medication, 32.9 % administer antipyretics. The average total score of the Health Literacy Scale was moderate (43.17 ± 10.99), and the average total score of the Parental Attitude Scale towards Rational Drug Use was high (164.09 ± 32.09). Parental education level, occupation, and income status variables showed statistically significant differences in health literacy and attitudes towards rational drug use. Additionally, a moderately significant positive correlation was found between parents’ health literacy and their attitudes towards rational drug use.
Conclusion
This study underscores the critical influence of health literacy on parental attitudes towards rational drug use in children with epilepsy, emphasizing responsible healthcare decision-making. It advocates for tailored interventions to enhance health literacy among parents, aiming to foster safer medication practices and improved health outcomes for children with epilepsy.
目的：了解家长的态度和健康素养对于促进安全有效的用药至关重要，而安全有效的用药是控制癫痫病的关键，癫痫病需要持续和知情的治疗决策。因此，本研究旨在确定癫痫患儿家长的健康素养对其合理用药态度的影响：本研究于 2023 年 5 月至 12 月在土耳其科尼亚一所大学医院的儿童神经科门诊进行，采用描述性研究设计，涉及 234 名在此期间接受常规检查的癫痫患儿家长。数据收集使用了人口信息表、家长合理用药态度量表和健康素养量表，并使用 IBM SPSS Statistics Standard Concurrent User V 25 进行分析。分析方法包括描述性统计（数字、百分比、平均数、标准差、中位数、最小值、最大值），以及单向方差分析、独立样本 T 检验、相关性和线性回归（输入法），统计显著性以 p 为限：参与研究的家长中，67.1%为女性，平均年龄为（35.85±0.47）岁，子女的平均年龄为（7.93±4.78）岁。研究发现，66.7%的家长在使用药物和健康问题上会先咨询医生，97%的家长不会在没有医生处方的情况下给孩子用药，在使用非处方药的家长中，32.9%的家长会给孩子服用退烧药。健康素养量表的平均总分为中等（43.17 ± 10.99），家长合理用药态度量表的平均总分为高（164.09 ± 32.09）。父母的教育水平、职业和收入状况变量在健康素养和对合理用药的态度方面显示出统计学上的显著差异。此外，研究还发现，家长的健康素养与他们对合理用药的态度之间存在中等程度的正相关：本研究强调了健康素养对家长对癫痫患儿合理用药态度的重要影响，强调了负责任的医疗决策。研究提倡采取有针对性的干预措施，提高家长的健康素养，以促进癫痫患儿更安全地用药，改善其健康状况。
{"title":"Health literacy and rational drug use attitudes in parents of children with epilepsy","authors":"Raheleh Sabetsarvestani , Semra Köse , Emine Geçkil , Abdullah Canbal","doi":"10.1016/j.yebeh.2024.110147","DOIUrl":"10.1016/j.yebeh.2024.110147","url":null,"abstract":"<div><h3>Purpose</h3><div>Understanding parental attitudes and health literacy is crucial for promoting safe and effective medication use, which is pivotal in managing epilepsy, a condition requiring consistent and informed treatment decisions. So, this study aimed to determine the impact of health literacy among parents of children with epilepsy on their attitudes towards rational drug use.</div></div><div><h3>Method</h3><div>This study, conducted at a university hospital’s Child Neurology Outpatient Clinic in Konya, Turkey from May to December 2023, employed a descriptive research design involving 234 parents of children with epilepsy who attended routine check-ups during this period. Data collection utilized a Demographic Information Form, the Parental Attitude Scale towards Rational Drug Use, and the Health Literacy Scale, analyzed using IBM SPSS Statistics Standard Concurrent User V 25. Analytical methods included descriptive statistics (number, percentage, mean, standard deviation, median, minimum, maximum), as well as One-Way ANOVA, Independent-Sample T Test, Correlation, and Linear Regression (Enter method), with statistical significance set at p < 0.05.</div></div><div><h3>Results</h3><div>It was determined that 67.1 % of the parents participating in the study were female, with a mean age of 35.85 ± 0.47 years, and the average age of the children was 7.93 ± 4.78 years. It was found that 66.7 % consult a doctor first about the medications they use and health concerns, 97 % do not use medication for their children without a doctor’s prescription, and of those who do use non-prescription medication, 32.9 % administer antipyretics. The average total score of the Health Literacy Scale was moderate (43.17 ± 10.99), and the average total score of the Parental Attitude Scale towards Rational Drug Use was high (164.09 ± 32.09). Parental education level, occupation, and income status variables showed statistically significant differences in health literacy and attitudes towards rational drug use. Additionally, a moderately significant positive correlation was found between parents’ health literacy and their attitudes towards rational drug use.</div></div><div><h3>Conclusion</h3><div>This study underscores the critical influence of health literacy on parental attitudes towards rational drug use in children with epilepsy, emphasizing responsible healthcare decision-making. It advocates for tailored interventions to enhance health literacy among parents, aiming to foster safer medication practices and improved health outcomes for children with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110147"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616617","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}
Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110150
Daniel D. Cummins , Zac Schulman , Christina Maher , Lea Tortolero , Adam Saad , Lizabeth Nunez Martinez , Richard J. Davidson , Lara V. Marcuse , Ignacio Saez , Fedor Panov
Objective
Mind-wandering is a pervasive human brain state and, when in excess, may promote negative affect and neuropsychiatric conditions. Mindfulness meditation may promote alternate brain states, improving affect and reducing stress. An understanding of the neural basis between these brain states could thus advance treatment of neuropsychiatric conditions, including those associated with epilepsy.
Methods
To explore the neural basis of mindfulness meditation versus mind-wandering, we enrolled eight patients in a trial of structured mindfulness meditation and open mind-wandering who underwent stereo electroencephalography (sEEG) within the mesial temporal lobe for seizure localization. Electrophysiology was compared between mind-wandering and mindfulness separately for epileptic and non-epileptic MTL. Using fitting-one-over-f modeling, periodic components of electrophysiology were compared in canonical frequency bands of theta (4–8 Hz), alpha (8–13 Hz), beta (13–30 Hz), and gamma (30–55 Hz). Aperiodic components of the power spectra were assessed by the model offset, knee, and exponent.
Results
We found a significant reduction in gamma power (30–55 Hz) within the mesial temporal lobe (MTL) during mindfulness meditation compared with mind-wandering in non-epileptic (p = 1.20E-4) but not in epileptic MTL (p = 0.352).There was also a significant difference between epileptic versus non-epileptic MTL in gamma power between conditions (p = 0.011). There were no significant changes in power across any frequency band within epileptic mesial temporal MTL between brain states. Conversely, there were significant differences between mind-wandering and mindfulness within epileptic MTL in aperiodic components (offset, knee, and exponent, all p < 0.05), while no differences in aperiodic components were seen in non-epileptic MTL (all p > 0.70).
Significance
Intracranial electrophysiologic modulations between brain state (mind-wandering versus mindfulness) may differ between epileptic and non-epileptic MTL. Modulations in gamma activity in non-epileptic MTL may represent functional changes in brain state, while aperiodic changes in epileptic MTL may modulate propensity for seizures.
{"title":"Influence of mindfulness meditation on intracranial EEG parameters in epileptic and non-epileptic brain areas","authors":"Daniel D. Cummins , Zac Schulman , Christina Maher , Lea Tortolero , Adam Saad , Lizabeth Nunez Martinez , Richard J. Davidson , Lara V. Marcuse , Ignacio Saez , Fedor Panov","doi":"10.1016/j.yebeh.2024.110150","DOIUrl":"10.1016/j.yebeh.2024.110150","url":null,"abstract":"<div><h3>Objective</h3><div>Mind-wandering is a pervasive human brain state and, when in excess, may promote negative affect and neuropsychiatric conditions. Mindfulness meditation may promote alternate brain states, improving affect and reducing stress. An understanding of the neural basis between these brain states could thus advance treatment of neuropsychiatric conditions, including those associated with epilepsy.</div></div><div><h3>Methods</h3><div>To explore the neural basis of mindfulness meditation versus mind-wandering, we enrolled eight patients in a trial of structured mindfulness meditation and open mind-wandering who underwent stereo electroencephalography (sEEG) within the mesial temporal lobe for seizure localization. Electrophysiology was compared between mind-wandering and mindfulness separately for epileptic and non-epileptic MTL. Using fitting-one-over-f modeling, periodic components of electrophysiology were compared in canonical frequency bands of theta (4–8 Hz), alpha (8–13 Hz), beta (13–30 Hz), and gamma (30–55 Hz). Aperiodic components of the power spectra were assessed by the model offset, knee, and exponent.</div></div><div><h3>Results</h3><div>We found a significant reduction in gamma power (30–55 Hz) within the mesial temporal lobe (MTL) during mindfulness meditation compared with mind-wandering in non-epileptic (p = 1.20E-4) but not in epileptic MTL (p = 0.352).There was also a significant difference between epileptic versus non-epileptic MTL in gamma power between conditions (p = 0.011). There were no significant changes in power across any frequency band within epileptic mesial temporal MTL between brain states. Conversely, there were significant differences between mind-wandering and mindfulness within epileptic MTL in aperiodic components (offset, knee, and exponent, all p < 0.05), while no differences in aperiodic components were seen in non-epileptic MTL (all p > 0.70).</div></div><div><h3>Significance</h3><div>Intracranial electrophysiologic modulations between brain state (mind-wandering versus mindfulness) may differ between epileptic and non-epileptic MTL. Modulations in gamma activity in non-epileptic MTL may represent functional changes in brain state, while aperiodic changes in epileptic MTL may modulate propensity for seizures.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110150"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616619","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}
Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110138
Ashwaq Alshahrani , Jorge G. Burneo , David A. Steven , Michelle-Lee Jones , Keith W. MacDougall , Jonathan C. Lau , Derek B. Debicki , Tenielle Gofton , David C. Diosy , Richard S. McLachlan , Ana Suller Marti
Objective
To investigate the effects of vagus nerve stimulation (VNS) on the seizure frequency in patients with drug-resistant epilepsy (DRE) and bilateral temporal lobe epilepsy (bi-TLE). Additionally, we aimed to determine the safety of VNS and its side effects.
Methods
Our retrospective study included 17 patients with bi-TLE who underwent VNS-device implantation at our center from 1997 to 2019. The main outcome was a reduction in seizure frequency. Bitemporal cases were confirmed using scalp electroencephalography (EEG) or invasive electroencephalography (iEEG).
Results
The median age at seizure onset was 18 years. Bi-TLE was confirmed by scalp EEG in 47 % and by iEEG in 53 % of the patients. The median follow-up period was 36 months. The median seizure frequency per month before and after VNS was 9.5 (IQR = 4.3–35.3) and 2 (IQR = 0.8–4.2), respectively. Compared to baseline, 70.5 % of the patients achieved ≥ 50 % reduction in seizure frequency, whereas 35.3 % experienced either no or minimal reduction in seizure frequency. The response rate (>50 % reduction in seizure frequency) was 87.5 % in patients who underwent scalp EEG and 55.5 % in those who underwent iEEG. For VNS treatment, the median follow-up was at 36 months (IQR = 17–46.5). Adverse effects were observed in 59 % of the patients, including cough and hoarseness.
Discussion
Therapeutic choices are limited in cases of drug-resistant bi-TLE. Our study on VNS-device implantation in bi-TLE suggests a positive outcome.
{"title":"Effect of vagal nerve stimulation on patients with bilateral temporal lobe epilepsy","authors":"Ashwaq Alshahrani , Jorge G. Burneo , David A. Steven , Michelle-Lee Jones , Keith W. MacDougall , Jonathan C. Lau , Derek B. Debicki , Tenielle Gofton , David C. Diosy , Richard S. McLachlan , Ana Suller Marti","doi":"10.1016/j.yebeh.2024.110138","DOIUrl":"10.1016/j.yebeh.2024.110138","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of vagus nerve stimulation (VNS) on the seizure frequency in patients with drug-resistant epilepsy (DRE) and bilateral temporal lobe epilepsy (bi-TLE). Additionally, we aimed to determine the safety of VNS and its side effects.</div></div><div><h3>Methods</h3><div>Our retrospective study included 17 patients with bi-TLE who underwent VNS-device implantation at our center from 1997 to 2019. The main outcome was a reduction in seizure frequency. Bitemporal cases were confirmed using scalp electroencephalography (EEG) or invasive electroencephalography (iEEG).</div></div><div><h3>Results</h3><div>The median age at seizure onset was 18 years. Bi-TLE was confirmed by scalp EEG in 47 % and by iEEG in 53 % of the patients. The median follow-up period was 36 months. The median seizure frequency per month before and after VNS was 9.5 (IQR = 4.3–35.3) and 2 (IQR = 0.8–4.2), respectively. Compared to baseline, 70.5 % of the patients achieved ≥ 50 % reduction in seizure frequency, whereas 35.3 % experienced either no or minimal reduction in seizure frequency. The response rate (>50 % reduction in seizure frequency) was 87.5 % in patients who underwent scalp EEG and 55.5 % in those who underwent iEEG. For VNS treatment, the median follow-up was at 36 months (IQR = 17–46.5). Adverse effects were observed in 59 % of the patients, including cough and hoarseness.</div></div><div><h3>Discussion</h3><div>Therapeutic choices are limited in cases of drug-resistant bi-TLE. Our study on VNS-device implantation in bi-TLE suggests a positive outcome.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110138"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616604","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}
Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110142
Judit Catalán-Aguilar , Irene Cano-López , Paula Tormos-Pons , Alejandro Lozano-García , Kevin G. Hampel , Vanesa Hidalgo , Alicia Salvador , Vicente Villanueva , Esperanza González-Bono
Introduction
Stress is one of the most common trigger factors for epileptic seizures and is strongly related to clinical and emotional variables. Despite its influence in the course of the disease, there is an absence of instruments for measuring perceived stress in people with drug-resistant epilepsy. Therefore, this study develops and validates the Epilepsy Perceived Stress Inventory for Adults (EPSI-A), a self-report inventory in Spanish designed to quantify perceived chronic stress in this population.
Method
The sample consisted of 236 patients with drug-resistant epilepsy who underwent a neuropsychological assessment in which anxiety, depression, and quality of life were explored. In addition, from 125 patients in the sample, 9 measures of salivary cortisol were collected during the evaluation.
Results
The EPSI-A consisted of 15 items, with higher scores indicating higher perceived stress. The exploratory factor analysis showed a four-factor solution: epilepsy concerns (5 items); impact on daily performance (4 items); social consequences (3 items); and epilepsy severity (3 items). These factors explained 63.3 % of the total variance. Internal consistency reliability measured with McDonald’s omega and Cronbach’s alpha coefficients was satisfactory, with values ≥ 0.78 (except for epilepsy severity with values of 0.59 and 0.58, respectively). Construct validity was demonstrated by its correlation with several psychological scales and clinical variables.
Conclusions
The results showed that the EPSI-A is a reliable and valid tool for assessing perceived chronic stress in people with epilepsy. Its conciseness, rapid administration time, and specificity make it an appropriate instrument for this population.
{"title":"Development and validation of the Epilepsy Perceived Stress Inventory for Adults (EPSI-A): A pilot study","authors":"Judit Catalán-Aguilar , Irene Cano-López , Paula Tormos-Pons , Alejandro Lozano-García , Kevin G. Hampel , Vanesa Hidalgo , Alicia Salvador , Vicente Villanueva , Esperanza González-Bono","doi":"10.1016/j.yebeh.2024.110142","DOIUrl":"10.1016/j.yebeh.2024.110142","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress is one of the most common trigger factors for epileptic seizures and is strongly related to clinical and emotional variables. Despite its influence in the course of the disease, there is an absence of instruments for measuring perceived stress in people with drug-resistant epilepsy. Therefore, this study develops and validates the Epilepsy Perceived Stress Inventory for Adults (EPSI-A), a self-report inventory in Spanish designed to quantify perceived chronic stress in this population.</div></div><div><h3>Method</h3><div>The sample consisted of 236 patients with drug-resistant epilepsy who underwent a neuropsychological assessment in which anxiety, depression, and quality of life were explored. In addition, from 125 patients in the sample, 9 measures of salivary cortisol were collected during the evaluation.</div></div><div><h3>Results</h3><div>The EPSI-A consisted of 15 items, with higher scores indicating higher perceived stress. The exploratory factor analysis showed a four-factor solution: <em>epilepsy concerns</em> (5 items); <em>impact on daily performance</em> (4 items); <em>social consequences</em> (3 items); and <em>epilepsy severity</em> (3 items). These factors explained 63.3 % of the total variance. Internal consistency reliability measured with McDonald’s omega and Cronbach’s alpha coefficients was satisfactory, with values ≥ 0.78 (except for epilepsy severity with values of 0.59 and 0.58, respectively). Construct validity was demonstrated by its correlation with several psychological scales and clinical variables.</div></div><div><h3>Conclusions</h3><div>The results showed that the EPSI-A is a reliable and valid tool for assessing perceived chronic stress in people with epilepsy. Its conciseness, rapid administration time, and specificity make it an appropriate instrument for this population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110142"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616599","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}
Pub Date : 2024-11-13DOI: 10.1016/j.yebeh.2024.110122
Maria Joy Khachan , Joakima Khachan , Nicole Tannous , Jad El Ahdab , Georges Raad , Kamal Kallab
Objectives
Previous research has linked epilepsy of the temporal lobe (TLE) with comorbidities of psychiatric nature, yet few studies have investigated personality psychopathology in patients with TLE. This is the first study on the topic in the Arab world and the first study using the Personality Inventory for DSM-5-Brief From (PID-5-BF). Thus, this study, which is cross-sectional by nature, aims to explore the potential relationship between TLE and personality psychopathology.
Methods
Utilizing the validated Arabic version of the Personality Inventory for DSM-5 − Brief Form (PID-5-BF), this study compared average total scores and domain scores among 24 TLE patients and 48 controls from the general population, using the Independent Samples t-test. Binary logistic regression used to assess the impact of gender and age on personality psychopathology in both the TLE and control group.
Results
Following adjustment for age and gender, notable disparities emerged in average total scores (p < 0.001), as well as negative affect (p < 0.0001), disinhibition (p < 0.04), and psychoticism scores (p < 0.01), with TLE patients exhibiting higher scores across these domains with a score of 1.28, 2.00, 1.08 and 1.25 respectively compared to controls with a score of 0.85, 1.08, 0.69 and 0.69 respectively. Nevertheless, analyses investigating age and gender as predictors for personality psychopathology yielded non-significant results in both groups.
Discussion
The study hints at a possible positive link between TLE and personality psychopathology, possibly attributable to limbic system involvement. This is the first study of its kind in the Arab world, highlighting a neglected topic in the region. While these results hold clinical implications, further research is warranted to validate these relationships.
研究目的以往的研究表明，颞叶癫痫（TLE）与精神病性质的并发症有关，但很少有研究对颞叶癫痫患者的人格心理病理学进行调查。这是阿拉伯世界的第一项相关研究，也是第一项使用 DSM-5 人格问卷（PID-5-BF）进行的研究。因此，这项横断面研究旨在探讨 TLE 与人格心理病理学之间的潜在关系：本研究使用经过验证的阿拉伯语版《DSM-5 人格问卷-简表》（PID-5-BF），通过独立样本 t 检验法比较了 24 名 TLE 患者和 48 名普通人群对照者的平均总分和领域分。二元逻辑回归用于评估性别和年龄对TLE患者和对照组人格精神病理学的影响：在对年龄和性别进行调整后，平均总分出现了显著差异（P 讨论）：该研究提示，TLE 与人格心理病理学之间可能存在积极联系，这可能归因于边缘系统的参与。这是阿拉伯世界的首项此类研究，凸显了该地区一个被忽视的课题。虽然这些结果具有临床意义，但还需要进一步研究来验证这些关系。
{"title":"Personality psychopathology in temporal lobe epilepsy: An Arabian study","authors":"Maria Joy Khachan , Joakima Khachan , Nicole Tannous , Jad El Ahdab , Georges Raad , Kamal Kallab","doi":"10.1016/j.yebeh.2024.110122","DOIUrl":"10.1016/j.yebeh.2024.110122","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous research has linked epilepsy of the temporal lobe (TLE) with comorbidities of psychiatric nature, yet few studies have investigated personality psychopathology in patients with TLE. This is the first study on the topic in the Arab world and the first study using the Personality Inventory for DSM-5-Brief From (PID-5-BF). Thus, this study, which is cross-sectional by nature, aims to explore the potential relationship between TLE and personality psychopathology.</div></div><div><h3>Methods</h3><div>Utilizing the validated Arabic version of the Personality Inventory for DSM-5 − Brief Form (PID-5-BF), this study compared average total scores and domain scores among 24 TLE patients and 48 controls from the general population, using the Independent Samples <em>t</em>-test. Binary logistic regression used to assess the impact of gender and age on personality psychopathology in both the TLE and control group.</div></div><div><h3>Results</h3><div>Following adjustment for age and gender, notable disparities emerged in average total scores (p < 0.001), as well as negative affect (p < 0.0001), disinhibition (p < 0.04), and psychoticism scores (p < 0.01), with TLE patients exhibiting higher scores across these domains with a score of 1.28, 2.00, 1.08 and 1.25 respectively compared to controls with a score of 0.85, 1.08, 0.69 and 0.69 respectively. Nevertheless, analyses investigating age and gender as predictors for personality psychopathology yielded non-significant results in both groups.</div></div><div><h3>Discussion</h3><div>The study hints at a possible positive link between TLE and personality psychopathology, possibly attributable to limbic system involvement. This is the first study of its kind in the Arab world, highlighting a neglected topic in the region. While these results hold clinical implications, further research is warranted to validate these relationships.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110122"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616621","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}
Pub Date : 2024-11-07DOI: 10.1016/j.yebeh.2024.110139
Stéphane Auvin , Nicola Specchio
Drug resistance is defined as the failure of adequate trials of two tolerated and appropriately chosen antiseizure medications to achieve sustained seizure freedom. In case of uncontrolled seizures, pseudo-drug-resistance (poor compliance, a worsening effect of an antiseizure medication, a diagnosis of psychogenic non-epileptic seizure) should be first ruled out in case of pediatric epilepsies. This paper discusses the process of choosing antiseizure medication and the concepts of rationale polytherapy and precision medicine. In drug-resistant epilepsy, when curative surgery is not feasible, the aim of the treatment is focused on the improvement of quality of life rather than on seizure count. In recent years, despite an increase in available antiseizure medications, the incidence of drug-resistant epilepsy has not changed. Precision medicine may offer in rare epilepsies a mechanism-driven treatment, but it is still unclear if this will end up in an improvement of efficacy in drug-resistant epilepsies. Gene therapy with antisense oligonucleotides or Adeno-associated Virus (AAV) is transitioning from the experimental side to the first human trial. It may modify the natural history of selected epileptic syndromes.
{"title":"Pharmacotherapeutic strategies for drug-resistant epilepsy in children","authors":"Stéphane Auvin , Nicola Specchio","doi":"10.1016/j.yebeh.2024.110139","DOIUrl":"10.1016/j.yebeh.2024.110139","url":null,"abstract":"<div><div>Drug resistance is defined as the failure of adequate trials of two tolerated and appropriately chosen antiseizure medications to achieve sustained seizure freedom. In case of uncontrolled seizures, pseudo-drug-resistance (poor compliance, a worsening effect of an antiseizure medication, a diagnosis of psychogenic non-epileptic seizure) should be first ruled out in case of pediatric epilepsies. This paper discusses the process of choosing antiseizure medication and the concepts of rationale polytherapy and precision medicine. In drug-resistant epilepsy, when curative surgery is not feasible, the aim of the treatment is focused on the improvement of quality of life rather than on seizure count. In recent years, despite an increase in available antiseizure medications, the incidence of drug-resistant epilepsy has not changed. Precision medicine may offer in rare epilepsies a mechanism-driven treatment, but it is still unclear if this will end up in an improvement of efficacy in drug-resistant epilepsies. Gene therapy with antisense oligonucleotides or Adeno-associated Virus (AAV) is transitioning from the experimental side to the first human trial. It may modify the natural history of selected epileptic syndromes.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110139"},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603943","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}
Pub Date : 2024-11-07DOI: 10.1016/j.yebeh.2024.110143
Saskia L. Vanderwiel , Brandon Jones , Katherine C. Nickels , Lily C. Wong-Kisiel , Anthony Fine , Jay Mandrekar , Elaine C. Wirrell
Introduction
Children with childhood absence epilepsy (CAE) are deemed to be at higher risk of attention deficit hyperactivity disorder (ADHD), however the magnitude of that risk has not been assessed in a population-based study.
Methods
The Rochester Epidemiology Project database was used to identify children with a new diagnosis of CAE while resident in Olmsted County, MN between 1980–2018. For each case, four age- and sex-matched controls without epilepsy were identified. Records of cases and controls screening positive for ADHD were reviewed to confirm this diagnosis. Those with comorbid ADHD and CAE were further assessed to determine if the ADHD diagnosis preceded or followed the epilepsy diagnosis, as well as the impact of ADHD treatment on possible seizure exacerbation and long-term epilepsy course.
Results
Forty-one cases of CAE were identified and matched to 164 controls. ADHD was diagnosed in 17 children (41.5 %) with CAE and 12 controls (7.3 %) (p < 0.001). Compared to those without epilepsy, the diagnosis of ADHD in CAE was more likely to be made by a mental health professional than a primary care provider (p = 0.047). ADHD in CAE typically followed the diagnosis of CAE and in 7/17 cases, was diagnosed after remission of epilepsy and discontinuation of antiseizure medication. There was no difference in the proportion of cases or controls treated with ADHD medication (16/17 cases and 12/12 controls). Both groups had high likelihood of favorable response to ADHD medication and no child with CAE experienced seizure exacerbation with ADHD treatment.
Conclusions
ADHD was 5.7-fold more common in CAE then in children without epilepsy in our population-based study. Treatment with stimulants is highly effective and not associated with worsening of seizures. Primary care providers must be vigilant to carefully screen this population for ADHD.
{"title":"Risk of ADHD in children with childhood absence epilepsy versus controls: A population-based study","authors":"Saskia L. Vanderwiel , Brandon Jones , Katherine C. Nickels , Lily C. Wong-Kisiel , Anthony Fine , Jay Mandrekar , Elaine C. Wirrell","doi":"10.1016/j.yebeh.2024.110143","DOIUrl":"10.1016/j.yebeh.2024.110143","url":null,"abstract":"<div><h3>Introduction</h3><div>Children with childhood absence epilepsy (CAE) are deemed to be at higher risk of attention deficit hyperactivity disorder (ADHD), however the magnitude of that risk has not been assessed in a population-based study.</div></div><div><h3>Methods</h3><div>The Rochester Epidemiology Project database was used to identify children with a new diagnosis of CAE while resident in Olmsted County, MN between 1980–2018. For each case, four age- and sex-matched controls without epilepsy were identified. Records of cases and controls screening positive for ADHD were reviewed to confirm this diagnosis. Those with comorbid ADHD and CAE were further assessed to determine if the ADHD diagnosis preceded or followed the epilepsy diagnosis, as well as the impact of ADHD treatment on possible seizure exacerbation and long-term epilepsy course.</div></div><div><h3>Results</h3><div>Forty-one cases of CAE were identified and matched to 164 controls. ADHD was diagnosed in 17 children (41.5 %) with CAE and 12 controls (7.3 %) (p < 0.001). Compared to those without epilepsy, the diagnosis of ADHD in CAE was more likely to be made by a mental health professional than a primary care provider (p = 0.047). ADHD in CAE typically followed the diagnosis of CAE and in 7/17 cases, was diagnosed after remission of epilepsy and discontinuation of antiseizure medication. There was no difference in the proportion of cases or controls treated with ADHD medication (16/17 cases and 12/12 controls). Both groups had high likelihood of favorable response to ADHD medication and no child with CAE experienced seizure exacerbation with ADHD treatment.</div></div><div><h3>Conclusions</h3><div>ADHD was 5.7-fold more common in CAE then in children without epilepsy in our population-based study. Treatment with stimulants is highly effective and not associated with worsening of seizures. Primary care providers must be vigilant to carefully screen this population for ADHD.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110143"},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603944","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}
Pub Date : 2024-11-06DOI: 10.1016/j.yebeh.2024.110116
Alexei A. Birkun
Introduction
Social media platforms have significant potential to enhance public knowledge on how to respond to generalised seizures. Among the platforms, TikTok emerges as a standout performer, demonstrating exceptional user engagement.
Study objective
This study aimed to assess the quality of content on first aid for seizures posted on TikTok.
Methods
TikTok videos providing instructions on first aid for generalised seizures and having at least 100,000 views were analysed for completeness and correctness of the advice using a 21-item checklist. Any misleading recommendations suggesting inappropriate actions were collected from the videos and users’ comments on the videos.
Results
Nineteen eligible videos had a total of 19,502,200 views. The videos frequently omitted key guidelines-concordant instructions on first aid for seizures, in particular, to lay the person down to prevent falling (missed in 84.2% of the videos), avoid moving the person unless they are in danger (89.5%), check the person’s breathing once the seizure has ended (89.5%) and commence cardiopulmonary resuscitation if the person remains unresponsive and not breathing normally (94.7%). Nine videos (47.4%) contained misleading instructions, most commonly to put the person on their side or otherwise move them during the seizure. Multiple comments to the videos advocated futile and dangerous actions, for instance, putting objects into the person’s mouth, restraining, or hitting the person.
Conclusion
TikTok videos convey information on first aid for seizures to multi-million audiences concurrently propagating incomplete, inaccurate and potentially harmful non-evidence-based advice. Urgent research and regulatory efforts are needed to develop effective strategies to combat the misinformation spread.
{"title":"Misinformation on first aid for seizures communicated through the fastest growing social media platform: A cross-sectional study of TikTok content","authors":"Alexei A. Birkun","doi":"10.1016/j.yebeh.2024.110116","DOIUrl":"10.1016/j.yebeh.2024.110116","url":null,"abstract":"<div><h3>Introduction</h3><div>Social media platforms have significant potential to enhance public knowledge on how to respond to generalised seizures. Among the platforms, TikTok emerges as a standout performer, demonstrating exceptional user engagement.</div></div><div><h3>Study objective</h3><div>This study aimed to assess the quality of content on first aid for seizures posted on TikTok.</div></div><div><h3>Methods</h3><div>TikTok videos providing instructions on first aid for generalised seizures and having at least 100,000 views were analysed for completeness and correctness of the advice using a 21-item checklist. Any misleading recommendations suggesting inappropriate actions were collected from the videos and users’ comments on the videos.</div></div><div><h3>Results</h3><div>Nineteen eligible videos had a total of 19,502,200 views. The videos frequently omitted key guidelines-concordant instructions on first aid for seizures, in particular, to lay the person down to prevent falling (missed in 84.2% of the videos), avoid moving the person unless they are in danger (89.5%), check the person’s breathing once the seizure has ended (89.5%) and commence cardiopulmonary resuscitation if the person remains unresponsive and not breathing normally (94.7%). Nine videos (47.4%) contained misleading instructions, most commonly to put the person on their side or otherwise move them during the seizure. Multiple comments to the videos advocated futile and dangerous actions, for instance, putting objects into the person’s mouth, restraining, or hitting the person.</div></div><div><h3>Conclusion</h3><div>TikTok videos convey information on first aid for seizures to multi-million audiences concurrently propagating incomplete, inaccurate and potentially harmful non-evidence-based advice. Urgent research and regulatory efforts are needed to develop effective strategies to combat the misinformation spread.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110116"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592984","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}
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