Epilepsy & Behavior最新文献

{"title":"Perceptions in the experience of transition from pediatric to adult care of patients with childhood-onset epilepsy in Japan","authors":"Takumi Sasaki ,&nbsp;Wataru Irie ,&nbsp;Akiko Sugahara ,&nbsp;Kazutaka Jin ,&nbsp;Nobukazu Nakasato ,&nbsp;Hitoshi Shiwaku","doi":"10.1016/j.yebeh.2024.110119","DOIUrl":"10.1016/j.yebeh.2024.110119","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to clarify perceptions of the transition from pediatric to adult care for patients with childhood-onset epilepsy in Japan.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study design was used. Semi-structured interviews were conducted with patients with childhood-onset epilepsy who had transitioned to adult care attending a tertiary hospital’s adult outpatient care unit specializing in treating epilepsy. Data were analyzed using content analysis to extract perceptions regarding the transition from pediatric to adult care.</div></div><div><h3>Result</h3><div>Six male and seven female patients between the ages of 18 and 49 years participated in the study. Seventeen perception categories regarding the experience of transitioning from pediatric to adult care were identified: {I followed a specific transfer process}, {I want to transition to adult care}, {I want to remain in pediatrics},{I have noticed something after transitioning to adult care}, {I recall trust in pediatricians}, {increased motivation for self-management}, and {I want detailed explanations about illness}.</div></div><div><h3>Conclusions</h3><div>The patients wanted to transition to adult medicine, but were passive, waiting for their physicians to suggest the transition. Furthermore, their perceptions of their own self-care varied. Pediatric healthcare providers should discuss and support the decision to transition from pediatric to adult care and provide information to help patients with childhood-onset epilepsy accept their future and understand their self-management requirements. These patients may become independent through the transition to adult care, and collaboration between pediatric and adult medicine is important to pass the responsibility of self-support to medical providers in adult care.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110119"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592987","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":"Characterisation of psychological and neurocognitive processes accompanying functional seizures","authors":"Lana Higson ,&nbsp;Terence J O’Brien ,&nbsp;Zhibin Chen ,&nbsp;Genevieve Rayner ,&nbsp;Rubina Alpitsis ,&nbsp;Toby Winton-Brown","doi":"10.1016/j.yebeh.2024.110117","DOIUrl":"10.1016/j.yebeh.2024.110117","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the relationship between clinical, psychological, and cognitive characteristics of adults with functional seizures. <strong>Methods:</strong> This study describes baseline characteristics of one-hundred and seven participants with a documented diagnosis of functional seizures recruited to the Re-PROGRAM randomised controlled trial. Participants completed a semi-structured interview, neuropsychological assessment, and questionnaire measures via Telehealth. <strong>Results:</strong> Participants reported low levels of trust in body sensations, high levels of negative ruminative thinking, dissociation, somatisation, anxiety, depression, severe levels of functional impairment, and poor quality of life. At a group level, they had normal neurocognitive function, including mental control, processing speed, attention, and executive function. Anxiety (73%), depression (68%), post-traumatic stress disorder (49%), migraine (63%) and chronic pain (52%) were common comorbidities. Forty-three percent reported a family history of dementia. Somatic symptoms were associated with depression, anxiety, dissociation, ruminative negative thinking, and lower scores on the ’Not-distracting’ interoception scale. Poorer psychosocial functioning was associated with depression and dissociation. Reduced mental quality of life was associated with higher levels of depression, anxiety, dissociation, ruminative negative thinking, and lower scores on the ‘Trusting’ interoception scale. There were no associations between the clinical or psychological variables and seizure frequency or seizure classification. Neither cognitive impairment nor failure on effort testing were associated with the clinical or psychological factors, quality of life or psychosocial functioning. <strong>Significance:</strong> This study highlights the burden of psychiatric and physical comorbidity; and the relationship between psychological factors and functional impairment in a large cohort of patients with functional seizures despite normal cognitive function.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110117"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592985","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":"Repeated acoustic stimulation (audiogenic kindling) induces estrous arrest in the Wistar audiogenic Rat (WAR) strain. A model of pseudopregnancy?","authors":"Matheus Credendio Eiras ,&nbsp;Carolina Gennari Verruma ,&nbsp;Artur Fernandes ,&nbsp;Ester Silveira Ramos ,&nbsp;Cristiana Libardi Miranda Furtado ,&nbsp;Norberto Garcia-Cairasco ,&nbsp;Rosana Maria dos Reis","doi":"10.1016/j.yebeh.2024.110125","DOIUrl":"10.1016/j.yebeh.2024.110125","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a chronic disorder characterized by a predisposition to epileptic seizures, affecting more than 50 million people worldwide.</div></div><div><h3>Methods</h3><div>Wistar and Wistar Audiogenic Rats (WAR) females were evaluated regarding estrous cycle and seizures episodes during repeated (kindling) acoustic stimulation at different stages of the estrous cycle.</div></div><div><h3>Results</h3><div>Acoustic stimulation did not affect the estrous cycle of most Wistar females in either control (91.6 %) or kindled (70.0 %) groups. They also had no seizures episodes. In WAR females, most of the control group (91.6 %) showed regular cycles during acoustic stimulation. In the kindling group, all females showed irregular cycles during acoustic stimulation with diestrus arrest for several days (11.8 ± 1.46 days) and 12 of them (92.3 %) showed, at least, four mesencephalic seizure behaviors during the acoustic stimulation (1 ≤ cSI ≤ 8). In this group, 7 females (53.84 %) also showed limbic seizures (2 ≤ LI ≤ 4). When WAR females were stratified by estrous cycle stage, the group that started the acoustic stimulation during estrus had five females (45.4 %) with diestrus arrest for several days (11.4 ± 0.89 days) and, eight females (72.7 %) exhibited, at least, two seizure behaviors (1 &lt; cSI &lt; 8). When acoustic stimulation was started in the metestrus stage, six females (54.5 %) exhibited diestrus arrest for several days (10.5 ± 3.27 days). In the metestrus group, ten females (90.9 %) presented five or six seizure episodes (1 &lt; cSI &lt; 8).</div></div><div><h3>Conclusion</h3><div>Our results showed that chronic audiogenic seizures (audiogenic kindling) affect the estrous cycle of WAR females, resulting in a consistent diestrus arrest for 10–12 days, which is consistent with the phenomenon of pseudopregnancy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110125"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592988","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":"Factors influencing the adequacy of determining hemispheric language lateralization in presurgical epilepsy patients using functional transcranial Doppler sonography (fTCD)","authors":"Nadine Conradi ,&nbsp;Marion Hug ,&nbsp;Malina Enger ,&nbsp;Nina Merkel ,&nbsp;Annika Suess ,&nbsp;Catrin Mann ,&nbsp;Felix Rosenow ,&nbsp;Adam Strzelczyk","doi":"10.1016/j.yebeh.2024.110113","DOIUrl":"10.1016/j.yebeh.2024.110113","url":null,"abstract":"<div><div>As the adequacy of determining hemispheric language lateralization (HLL) is of special importance for the planning of epilepsy surgery, this study aimed to identify predictive factors for receiving inconclusive HLL results using functional transcranial Doppler sonography (fTCD).</div><div>Data from 495 epilepsy patients who received fTCD in a standardized fashion was analyzed retrospectively. HLL was left-sided in 324 patients (65.5 %), right-sided in 76 (15.4 %), and inconclusive in 95 (19.2 %). Univariate logistic regression analyses revealed significant positive associations between inconclusive HLL results and a multiregional localization of epilepsy. Significant negative associations with higher educational qualification, more years of education, and better letter verbal fluency were found. In multiple logistic regression analyses, a multiregional localization of epilepsy (OR = 2.74, <em>p</em> &lt; 0.001) and years of education (OR = 0.86, <em>p</em> &lt; 0.001) remained independent predictors. A cut-off value of 10.77 years of education determined by discriminant function analyses is provided.</div><div>Our findings indicate that the adequacy of determining HLL using fTCD is highly dependent on the extension of the epileptogenic lesion and the patients’ years of education. We therefore recommend not to use the same paradigm for all patients, but to adapt the selection of adequate test materials to their cognitive abilities.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110113"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592986","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":"Evolving treatment strategies for early-life seizures in Tuberous Sclerosis Complex: A review and treatment algorithm","authors":"Debopam Samanta","doi":"10.1016/j.yebeh.2024.110123","DOIUrl":"10.1016/j.yebeh.2024.110123","url":null,"abstract":"<div><div>Tuberous sclerosis Complex (TSC) is a genetic disorder characterized by multisystem involvement, with epilepsy affecting 80–90% of patients, often beginning in infancy. Early-life seizures in TSC are associated with poor neurodevelopmental outcomes, underscoring the importance of timely and effective management. This review explores the evolving treatment landscape for TSC-associated seizures in young children, focusing on three recently approved or license-expanded therapies: vigabatrin, everolimus, and cannabidiol. The efficacy and safety profiles of these treatments are examined based on clinical trials and real-world evidence, with a focus on their use in treating seizures in young children. The preemptive use of vigabatrin in clinical studies has also been carefully reviewed. A treatment algorithm is proposed, emphasizing early diagnosis, prompt initiation of appropriate therapy, and a stepwise approach to managing both infantile spasms and focal seizures. The algorithm incorporates these newer therapies alongside traditional antiseizure medications and non-pharmacological approaches. Challenges in optimizing treatment strategies, minimizing side effects, and improving long-term outcomes are discussed. This review aims to guide clinicians in navigating the complex landscape of early-life seizures associated with TSC, ultimately striving for improved seizure control and better developmental outcomes in this vulnerable population.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110123"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564074","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":"Tonic and tonic-clonic seizures in the first year of life: Insights from electrographic features","authors":"Marta Conti ,&nbsp;Mattia Mercier ,&nbsp;Domenico Serino ,&nbsp;Ludovica M. Piscitello ,&nbsp;Marta E. Santarone ,&nbsp;Federico Vigevano ,&nbsp;Nicola Specchio ,&nbsp;Lucia Fusco","doi":"10.1016/j.yebeh.2024.110120","DOIUrl":"10.1016/j.yebeh.2024.110120","url":null,"abstract":"<div><h3>Objective</h3><div>We studied the electrographic features of tonic seizures (TS) with bilateral contraction and tonic-clonic seizures (TCS) without focal signs occurring during the first year of life to evaluate if there is a correlation with outcome.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients aged 1 to 12 months with at least one TS or TCS recorded with video-EEG between 2011 and 2021 in our Epilepsy Monitoring Unit. We analyzed the following electrographic features: seizure duration, presence and duration of focal ictal EEG onset, and post-ictal generalized EEG suppression (PGES). Among clinical variables, we collected age at epilepsy onset, age at TS and TCS recording, response to anti-seizure medications, genetic and neuroimaging findings, epileptic syndrome classification.</div></div><div><h3>Results</h3><div>Overall, we recorded 2577 seizures in 1769 patients. One-hundred-twenty-eight seizures (5%) were clinically labeled either as TS or TCS in 41 patients (2%). Out of 41 patients, 17 (41%) presented with TS, and 24 (59%) with TCS. Thirteen patients (32%) had a Self-limited Epilepsy, and 28 (68%) a Developmental and Epileptic Encephalopathy (DEE). Seventy-two percent of genetically tested patients had pathogenic gene variants. None had structural epilepsy.</div><div>Mean age at epilepsy onset was 4.48 months (range 3 days-12 months). Age at seizure onset was earlier in patients presenting with TS <em>versus</em> patients presenting with TCS (2.31 months <em>vs</em>. 6.01 months; p = 0.001) and in DEEs <em>versus</em> Self-limited Epilepsies (3.23 months <em>vs</em>. 7.16 months; p = 0.001). TS were exclusively present in DEEs (p = 0.001), and TCS were recorded in both DEEs and Self-limited Epilepsies. Focal ictal EEG onset was evident in 92 % of TCS, and in none of TS. Generalized ictal EEG onset was documented in 100 % of TS, and in 8 % of TCS. Focal ictal EEG onset occurred more frequently (100 % <em>vs</em>. 32 %; p = 0.000) and was significantly longer (30.61 s <em>vs</em>. 16.22 s; p = 0.020) in Self-limited Epilepsies <em>versus</em> DEEs. PGES was observed in 18 out of 41 (44 %) and was more frequent in Self-limited Epilepsies (p = 0.026).</div></div><div><h3>Significance</h3><div>This study provides insights into the electroclinical features of TS and TCS in infants that may help distinguish Self-limited Epilepsies from DEEs soon after epilepsy onset.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110120"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564082","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":"Genetic association between epilepsy and gliomas: Insights from Mendelian randomization and single-cell transcriptomic analyses","authors":"Liguo Ye ,&nbsp;Hao Xing ,&nbsp;Yu Wang,&nbsp;Wenbin Ma","doi":"10.1016/j.yebeh.2024.110114","DOIUrl":"10.1016/j.yebeh.2024.110114","url":null,"abstract":"<div><h3>Background</h3><div>Seizures are prevalent in glioma patients, especially in those with low-grade gliomas. The interaction between gliomas and epilepsy involves complex biological mechanisms that are not fully understood.</div></div><div><h3>Methods</h3><div>We collected Genome-Wide Association Study data for epilepsy and gliomas, performed differential expression analysis, and conducted Gene Ontology (GO) enrichment analysis on the identified genes. Single-cell RNA sequencing data (scRNA-seq) from GSE221534 dataset in Gene Expression Omnibus (GEO) were used to analyze cell–cell interactions within glioma samples from patients with and without epilepsy.</div></div><div><h3>Results</h3><div>Mendelian Randomization (MR) analysis revealed significant associations between genetic variants related to epilepsy and glioma risk, suggesting a potential causal relationship, especially in astrocytomas. Differential expression analysis identified epilepsy-related genes that were significantly upregulated in astrocytoma tissues compared to normal brain tissues. GO enrichment analysis indicated that these genes are involved in critical biological processes such as neurogenesis and cellular signaling. The scRNA-seq analysis showed, compared to non-epileptic samples, glioma stem cells, microglia, and NK cells are increased in the core regions of astrocytomas in epileptic patients. Additionally, intercellular communication between tumor cells and other non-tumor cells is markedly enhanced in astrocytoma samples from epileptic patients.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of a genetic association between epilepsy and gliomas and elucidates the biological mechanisms through which epilepsy may influence glioma progression.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110114"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564076","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":"Obstructive sleep apnea is associated with risk for sudden unexpected death in epilepsy (SUDEP) using rSUDEP-7","authors":"Atiwat Soontornpun ,&nbsp;Christian Mouchati ,&nbsp;Noah D. Andrews ,&nbsp;James Bena ,&nbsp;Madeleine M. Grigg-Damberger ,&nbsp;Nancy Foldvary-Schaefer","doi":"10.1016/j.yebeh.2024.110121","DOIUrl":"10.1016/j.yebeh.2024.110121","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Evaluate relationships between PSG-confirmed OSA and SUDEP risk using the revised SUDEP Risk Inventory (rSUDEP-7).</div></div><div><h3>Methods</h3><div>Identified adults with epilepsy (AWE) who underwent PSG 2004–2016 at Cleveland Clinic. OSA was defined as apnea-hypopnea index (AHI)- ≥-5/h sleep; moderate/severe OSA as AHI≥15. SUDEP risk was assessed using rSUDEP-7: higher rSUDEP-7 score, greater SUDEP risk. Associations between rSUDEP-7 score and OSA groups (AHI≥15 vs. &lt;15) were evaluated using Wilcoxon rank-sum tests and multivariable linear models adjusting for age, sex, BMI, and smoking status. Spearman correlations measured relationships between rSUDEP-7 score with AHI and oxygen desaturation indices (ODI).</div></div><div><h3>Results</h3><div>OSA was present in 134 (62.6 %) of 214 AWE; moderate/severe in 75 (35 %). AWE with AHI≥15 were more likely to be male and older, had higher BMI, greater frequency of tonic-clonic seizures (TCS), longer epilepsy duration, and more likely to have drug-resistant epilepsy (DRE) and sleep-related seizures (all p&lt; 0.05). The median rSUDEP-7 score was 1 (0,3) but 37.4 % had a score ≥3 (high SUDEP risk), and 11.7 % ≥5 (highest SUDEP risk). rSUDEP-7 scores were higher in those with AHI≥15 (3 vs. 1, p = 0.001). Higher AHI and ODI 3% positively correlated with rSUDEP-7 (p=0.002 and p=0.016) while SpO₂ nadir negatively correlated with rSUDEP-7 (p=0.007). After adjustments, AWE with AHI≥15 had mean rSUDEP-7 score 1.14 points (95% CI 0.55–1.72, p&lt;0.001) higher than those with AHI&lt;15.</div></div><div><h3>Discussion</h3><div>AWE with PSG-confirmed moderate/severe OSA especially those who are older and have GTC had higher rSUDEP-7 scores potentially increasing their risk for SUDEP. Our findings support routine screening for OSA in AWE. Further studies confirming the significance and impact of OSA on SUDEP risk are needed.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110121"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564079","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":"Bidirectional association between abnormal cardiac conditions and epilepsy: A two-sample Mendelian randomization study","authors":"Renfu Liu ,&nbsp;Yu Tian ,&nbsp;Xiangtao Zhang ,&nbsp;Xiaodan Zhang ,&nbsp;Yuanxiang Lin","doi":"10.1016/j.yebeh.2024.110111","DOIUrl":"10.1016/j.yebeh.2024.110111","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies have consistently indicated a significant correlation between abnormal cardiac conditions and epilepsy. However, the association and direction of this relationship remain a subject of debate. This study employs a two-sample bidirectional Mendelian randomization (MR) approach to investigate the association between abnormal cardiac conditions and epilepsy.</div></div><div><h3>Methods</h3><div>Instrumental variables, represented by single nucleotide polymorphisms (SNPs) associated with epilepsy and various abnormal cardiac conditions, were derived from large-scale genome-wide association studies databases, including FinnGen and UK Biobank. Bidirectional MR analysis was conducted to estimate the association between epilepsy and abnormal cardiac conditions. Sensitivity analyses were performed using MR-Egger, weighted median, Inverse Variance Weighted, and MR pleiotropy residual sum and outlier methods.</div></div><div><h3>Results</h3><div>The forward MR analysis suggested a potential positive effect of atrial fibrillation and flutter (AF) and valvular heart diseases (VHD) on the risk of epilepsy. Conversely, the reverse MR analysis indicated that epilepsy might increase the susceptibility to AF, VHD, and heart failure.</div></div><div><h3>Conclusion</h3><div>The findings support a bidirectional relationship between AF, VHD, and epilepsy, indicating that AF and VHD can elevate the risk of developing epilepsy, while epilepsy, in turn, can also increase the risk of developing AF and VHD. Furthermore, the study suggest that epilepsy may contribute to the development of heart failure. These results underscore the importance of screening for cardiac abnormalities in patients with epilepsy and vice versa, to better understand their clinical significance and potential as modifiable risk factors.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110111"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564071","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":"Is lateralization concordance between preoperative video-EEG, ictal SPECT, and MRI to be associated with positive psychiatric outcomes after cortico-amygdalohippocampectomy in patients with pharmacoresistant temporal lobe epilepsy associated to mesial temporal sclerosis? A retrospective cohort study","authors":"Bruna de Faria Dutra Andrade Karam,&nbsp;Michael Peres de Medeiros,&nbsp;Lucia Helena Neves Marques,&nbsp;Gerardo Maria de Araújo Filho","doi":"10.1016/j.yebeh.2024.110115","DOIUrl":"10.1016/j.yebeh.2024.110115","url":null,"abstract":"<div><h3>Objective</h3><div>The occurrence of comorbid psychiatric disorders (PD) in patients with pharmacoresistant temporal lobe epilepsy (TLE) associated to mesial temporal sclerosis (MTS) can be considered as a result of the complex interaction between biological and psychosocial factors, as well as the effects of antiseizure medications (ASM). Regarding biological aspects, despite the growing amount of knowledge, there is still a scarcity of data in literature clarifying whether a more precise definition of the seizure onset zone (SOZ) could be associated with a more favorable post-surgical psychiatric outcome. In the present study, the clinical and sociodemographic pre-surgical variables, including the results of neurophysiological and neuroimaging exams, were evaluated in patients with pharmacoresistant TLE-MTS aiming to investigate possible risk factors for the presence of PD after cortico-amygdalohippocampectomy (CAH).</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis of medical records from initially 106 pre-surgical patients with pharmacoresistant TLE-MTS with PD (n = 51; 48.1 %) and without PD (n = 55; 51.9 %) proceeded. Pre-surgical clinical and sociodemographic data were compared between both groups and the predictors for the presence of post-surgical PD were characterized up to one and two years after CAH.</div></div><div><h3>Results</h3><div>Seventeen patients (16 %) had lost their follow-up in the first year after surgery, and 89 (84 %) had completed the study. No clinical and sociodemographic differences were observed between both groups of patients (p &gt; 0.05), except for a history of previous psychiatric treatment (p = 0.001). Eighteen patients (35.29 %) with pre-surgical history of PD had remission of PD after CAH, while eight (14.5 %) developed de novo PD. The previous history of PD was directly associated with the development of post-surgical PD one year after CAH (p &lt; 0.0001). Previous psychiatric treatment (p &lt; 0.01), previous history of mood (p = 0.002) and anxiety (p = 0.03) disorder, as well as discordance in lateralization between MRI, SPECT, and EEG (p = 0.02), were predictors for the development of PD two years after CAH. Post-surgical psychiatric outcomes were associated to seizure outcome based on the Engel classification (p &lt; 0,0001).</div></div><div><h3>Conclusion</h3><div>The present data observed an association between lateralization concordance of results of pre-surgical investigative exams and positive postoperative psychiatric outcomes in patients with pharmacoresistant TLE-MTS. These results could suggest that a more precise definition of the SOZ could be associated with a more favorable post-surgical psychiatric outcome after CAH.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"161 ","pages":"Article 110115"},"PeriodicalIF":2.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560909","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}