Epilepsy & Behavior最新文献_第6页

Examining parental participation in a successful psychological intervention for young people with epilepsy and mental health difficulties: Results from a longitudinal qualitative study within a randomised controlled trial 研究父母参与对患有癫痫和精神疾病的青少年的成功心理干预的情况：随机对照试验中的纵向定性研究结果。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110169

Jonathan A. Smith , Isabella E. Nizza , Sophie D. Bennett , J. Helen Cross , Isobel Heyman , Anna E. Coughtrey , James Blackstone , Emma Dalrymple , Bruce Chorpita , MICE Study Group, Roz Shafran

Objective

Children with epilepsy may have significant mental health needs with detrimental impact on quality of life, and families often request support and intervention. This paper explores the change experienced by parents of young people with epilepsy and mental health difficulties receiving an integrated mental health intervention.

Methods

A qualitative study was conducted within a randomised controlled trial evaluating the Mental Health Intervention for Children with Epilepsy (MICE) psychological therapy in addition to usual care. Twenty-four families receiving the intervention were interviewed twice, at baseline and at six months, about their experience with their child’s mental and physical health, and therapy. Transcripts were analysed inductively, idiographically and longitudinally using a combination of Interpretative Phenomenological Analysis (IPA) and Framework Analysis (FA). This combination allows us to begin our analysis with the detailed analysis of cases and then move to an appropriately higher level of generalization across the corpus.

Results

Analysis shows changes in how the parents report their experience of their child’s difficulties between baseline and 6-month interviews. While parents tended to show some understanding of epilepsy and its effects on their child in the first interview, comparisons with the second interview show enhanced understanding along with improvements in their relationship with their child, and feelings about themselves as parents. These findings were particularly relevant for parents of children with autism spectrum disorders and/or intellectual disability.

Study limitations

Not all families were able to benefit equally from the therapy, with some declining to participate or being lost to follow up and mothers being more forthcoming than fathers to take part in the research. It would have been interesting to also interview families 12 months post-baseline to gain insight on the longer-term impacts of the intervention.

Conclusions

The qualitative findings presented here offer new insights into parental experiences of living with and attempting to assist a child with a complex condition. We would also hope the study will be helpful to researchers and clinicians working with a range of illnesses which impact families.

目的：癫痫患儿可能有严重的心理健康需求，对生活质量产生不利影响，家庭往往要求支持和干预。本文探讨了接受综合心理健康干预的青少年癫痫和心理健康困难患者的父母所经历的变化。方法：在一项随机对照试验中进行定性研究，评估癫痫儿童心理健康干预（MICE）在常规护理之外的心理治疗。接受干预的24个家庭在基线和六个月时接受了两次采访，了解他们对孩子身心健康和治疗的经历。采用解释现象学分析（IPA）和框架分析（FA）相结合的方法对转录本进行归纳、具体和纵向分析。这种结合使我们能够以案例的详细分析开始我们的分析，然后在语料库中移动到适当的更高层次的泛化。结果：分析显示，在基线和6个月的访谈中，父母报告孩子困难经历的方式发生了变化。虽然父母在第一次访谈中倾向于对癫痫及其对孩子的影响有所了解，但与第二次访谈相比，他们与孩子的关系有所改善，对自己作为父母的感觉也有所改善。这些发现与自闭症谱系障碍和/或智力残疾儿童的父母尤其相关。研究局限性：并非所有家庭都能从治疗中获得同等的好处，有些家庭拒绝参与或失去了随访，母亲比父亲更愿意参与研究。在基线后12个月对家庭进行采访，以深入了解干预的长期影响，这将是一件有趣的事情。结论：这里提出的定性研究结果为父母与患有复杂疾病的孩子一起生活并试图帮助他们的经历提供了新的见解。我们也希望这项研究能对研究影响家庭的一系列疾病的研究人员和临床医生有所帮助。

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引用次数: 0

Ligand-receptor interactions: A key to understanding microglia and astrocyte roles in epilepsy 配体-受体相互作用：理解小胶质细胞和星形胶质细胞在癫痫中的作用的关键。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110219

Peravina Thergarajan , Terence J. O’Brien , Nigel C. Jones , Idrish Ali

Epilepsy continues to pose significant social and economic challenges on a global scale. Existing therapeutic approaches predominantly revolve around neurocentric mechanisms, and fail to control seizures in approximately one-third of patients. This underscores the pressing need for novel and complementary treatment approaches to address this gap. An increasing body of literature points to a role for glial cells, including microglia and astrocytes, in the pathogenesis of epilepsy. Notably, microglial cells, which serve as pivotal inflammatory mediators within the epileptic brain, have received increasing attention over recent years. These immune cells react to epileptogenic insults, regulate neuronal processes, and play diverse roles during the process of epilepsy development. Additionally, astrocytes, another integral non-neuronal brain cells, have garnered increasing recognition for their dynamic contributions to the pathophysiology of epilepsy. Their complex interactions with neurons and other glial cells involve modulating synaptic activity and neuronal excitability, thereby influencing the aberrant networks formed during epileptogenesis. This review explores the alterations in microglial and astrocytic function and their mechanisms of communication following an epileptogenic insult, examining their contribution to epilepsy development. By comprehensively studying these mechanisms, potential avenues could emerge for refining therapeutic strategies and ameliorating the impact of this complex neurological disease.

癫痫继续在全球范围内构成重大的社会和经济挑战。现有的治疗方法主要围绕神经中枢机制，并且在大约三分之一的患者中无法控制癫痫发作。这强调了迫切需要新的和互补的治疗方法来解决这一差距。越来越多的文献指出神经胶质细胞，包括小胶质细胞和星形胶质细胞，在癫痫的发病机制中的作用。值得注意的是，在癫痫大脑中作为关键炎症介质的小胶质细胞近年来受到越来越多的关注。这些免疫细胞对致痫性损伤作出反应，调节神经元过程，并在癫痫发展过程中发挥多种作用。此外，星形胶质细胞，另一个完整的非神经元脑细胞，已获得越来越多的认识，其动态贡献的病理生理癫痫。它们与神经元和其他神经胶质细胞的复杂相互作用涉及调节突触活动和神经元兴奋性，从而影响癫痫发生期间形成的异常网络。这篇综述探讨了癫痫性损伤后小胶质细胞和星形胶质细胞功能的改变及其通讯机制，探讨了它们对癫痫发展的贡献。通过全面研究这些机制，可能会出现改进治疗策略和改善这种复杂神经系统疾病影响的潜在途径。

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引用次数: 0

Development of a nomogram model for early prediction of refractory convulsive status epilepticus 早期预测难治性惊厥持续状态的nomogram模型的建立。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110235

Ying Wang , Zhipeng Liu , Wenting Huang , Shumin Mao , Xu Zhang , Lekai Chen , Wenqiang Fang , Pinglang Hu , Xianchai Hong , Yanru Du , Huiqin Xu

Introduction

We aim to identify risk factors that predict refractory convulsive status epilepticus (RCSE) and to develop a model for early recognition of patients at high risk for RCSE.

Methods

This study involved 200 patients diagnosed with convulsive status epilepticus (CSE), of whom 73 were RCSE and 127 were non-RCSE. Variables included demographic information, lifestyle factors, medical history, comorbidities, clinical symptoms, neuroimaging characteristics, laboratory tests, and nutritional scores. A predictive model was developed through multivariable logistic regression analysis. The model’s predictive performance and clinical utility were evaluated using various metrics, including the area under the receiver operating characteristic (AUROC) curve, GiViTI calibration belt, and decision curve analysis (DCA). Additionally, we performed internal five-fold cross-validation for this model.

Results

We developed a nomogram model with six predictors: age ≤ 40 years, prior history of epilepsy, presence of epileptic foci, duration of CSE > 30 min, c-reactive protein > 6 mg/L, and nutritional risk screening ≥ 3 points. Our model has a high AUROC (0.838) and good consistency (P = 0.999). In DCA, the curve of our model exhibits a positive net benefit across the entire range of threshold probabilities. Moreover, our model achieved an accuracy of 0.778 and a Kappa value of 0.519 in the five-fold cross-validation.

Conclusion

We developed an objective, simple and accessible model to assess the risk of RCSE. This model shows promise as a valuable tool for evaluating the individual risk of RCSE.

前言：我们的目的是确定预测难治性惊厥癫痫持续状态（RCSE）的危险因素，并建立一个早期识别高危患者的模型。方法：本研究纳入200例诊断为惊厥性癫痫持续状态（CSE）的患者，其中73例为RCSE， 127例为非RCSE。变量包括人口统计信息、生活方式因素、病史、合并症、临床症状、神经影像学特征、实验室检查和营养评分。通过多变量logistic回归分析建立预测模型。使用各种指标评估模型的预测性能和临床效用，包括受试者工作特征（AUROC）曲线下面积、GiViTI校准带和决策曲线分析（DCA）。此外，我们对该模型进行了内部五重交叉验证。结果：我们建立了一个包含6个预测因素的nomogram模型：年龄≤40岁、既往癫痫史、癫痫灶存在、CSE持续时间> 30 min、c反应蛋白> 6 mg/L、营养风险筛查≥3分。我们的模型AUROC高（0.838），一致性好（P = 0.999）。在DCA中，我们模型的曲线在整个阈值概率范围内显示出正的净效益。此外，我们的模型在五重交叉验证中获得了0.778的精度和0.519的Kappa值。结论：我们建立了一个客观、简单、可及的模型来评估RCSE的风险。该模型有望成为评估RCSE个体风险的有价值的工具。

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引用次数: 0

Improving the health literacy of persons with epilepsy 提高癫痫患者的健康素养。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110237

Alan Leviton, Tobias Loddenkemper

Improving health literacy can improve health. This essay reviews the resources available to help improve epilepsy health literacy, including websites, drug inserts/labels/information leaflets, patient educators, handouts, plain language, lay summaries, and other efforts to close the gaps between research and epilepsy health literacy.

提高卫生知识素养可以改善健康。本文综述了有助于提高癫痫健康素养的现有资源，包括网站、药物说明书/标签/信息传单、患者教育者、讲义、通俗语言、lay摘要和其他努力，以缩小研究与癫痫健康素养之间的差距。

引用次数: 0

Spirituality, religion, and personal beliefs in Brazilian adults with epilepsy 巴西成年癫痫患者的精神、宗教和个人信仰。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110223

Gloria M.A.S. Tedrus

Objective

To evaluate the relationship between S/R, demographic data, and clinical variables of Brazilian adult patients with epilepsy (PWE).

Methodology

The scores of the WHO Quality of Life for Assessment of Spirituality, Religion, and Personal Beliefs (WHOQOL-SRPB) were related to demographic and clinical aspects, the Spirituality Self-Rating Scale (SSRS), and the Spiritual/Religious Coping Scale (SRC) of 60 PWE.

Results

The mean age was 42.8y and 35 (58.3%) patients reported regular religious practice. In the WHOQOL-SRPB, greater inner peace and harmony were observed in women, greater wholeness and integration, hope and optimism in married patients, and greater spiritual connection in patients with religious practice. The use of polytherapy with antiseizure medication (ASM) was associated with lower spiritual connection, wholeness, integration, and S/N in the WHOQOL-SRPB. The higher seizure frequency was associated with lower spiritual connection. Facet scores and total scores of the WHOQOL-SRPB were significantly correlated with positive and negative coping and a greater perception of spiritual guidance.

Conclusion

In the PWE, the use of S/R differed according to gender, marital status, and religious practice. Clinical variables influenced the perception of S/R, which differed according to the use of ASM, frequency, and type of epileptic seizures. The greater use of coping and spiritual guidance was associated with different facets of S/R and personal beliefs.

目的：探讨巴西成年癫痫患者（PWE）的S/R、人口学数据和临床变量之间的关系。方法：世卫组织精神、宗教和个人信仰生活质量评估量表（WHOQOL-SRPB）得分与60名PWE的人口学和临床方面、精神自我评定量表（SSRS）和精神/宗教应对量表（SRC）相关。结果：平均年龄42.8岁，35岁（58.3%）的患者有规律的宗教活动。在WHOQOL-SRPB中，女性观察到更大的内心平静与和谐，已婚患者观察到更大的整体性和整合性，希望和乐观，宗教实践患者观察到更大的精神联系。在WHOQOL-SRPB中，综合治疗与抗癫痫药物（ASM）的使用与较低的精神联系、整体性、整合性和S/N相关。较高的发作频率与较低的精神联系有关。WHOQOL-SRPB小面得分和总分与积极应对和消极应对以及更高的精神引导感知显著相关。结论：在PWE中，S/R的使用因性别、婚姻状况和宗教信仰而异。临床变量影响感知的S/R，根据ASM的使用，频率和癫痫发作的类型不同。更多地使用应对和精神指导与S/R和个人信仰的不同方面有关。

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引用次数: 0

Knowledge and attitudes of preclinical and clinical medical students toward epilepsy: A cross-sectional study from Turkey 临床前和临床医学生对癫痫的知识和态度：一项来自土耳其的横断面研究。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110242

Fettah Eren , Sumeyye Aydogmus , Furkan Oral , Mine Aleyna Saka , Aslihan Kocatas , Muhammed Mustafa Esmer , Shams Guliyeva , Mustafa Safa Cibik , Salih Emre Gungor , Kemal Oguz , Melike Somuncu , Ceren Cinar , Omer Yazgan , Nesibe Ozkaya , Adem Yildiz

Objective

The aim of this study is to evaluate the epilepsy-related knowledge and attitudes toward epilepsy in medical students. In addition, these parameters were evaluated according to national geographic regions, preclinical and clinical characteristics.

Methods

This study was a cross-sectional, observational design and it was conducted among medical students in a centrally located city, Turkey. Participants were divided into two groups as preclinical (1st, 2nd and 3rd year) and clinical (4th, 5th, and 6th year). Structured questionnaires were used to evaluate knowledge about epilepsy and attitudes toward epilepsy. All items were converted into an online format.

Results

In general, clinical students exhibited better knowledge about epilepsy than preclinical students (p = 0.001), however there was no statistical difference between groups in terms of attitudes toward epilepsy (p = 0.561). In the knowledge scale, the lowest rate was “Brain operation can be effective treatment in some patients” (43.9 %); and in the attitudes scale, the lowest rate was “I would marry someone who has epilepsy” (51.1 %). A weak negative correlation was detected between knowledge and attitudes scores (p = 0.027, r = -0.103). Scores in knowledge about epilepsy and attitude toward epilepsy were not difference in national geographic regions (p = 0.637). Knowledge score was higher in students who witnessed an epileptic seizure (p = 0.001).

Conclusion

The study demonstrated that medical students had insufficient knowledge, mainly about treatment in epilepsy. Negative attitudes, especially about marriage or dating, were detected. Students’ perceptions about epilepsy could be improved with training program. Medical regular curriculum should be reorganized about this line.

目的：了解医学生对癫痫的相关知识和态度。此外，根据国家地理区域、临床前和临床特征对这些参数进行评估。方法：本研究采用横断面观察设计，在土耳其一个中心城市的医学生中进行。参与者分为临床前（1、2、3年）和临床（4、5、6年）两组。采用结构化问卷对患者的癫痫知识和对癫痫的态度进行评估。所有项目都被转换成在线格式。结果：总体而言，临床生对癫痫的认知程度高于临床前生（p = 0.001），但两组间对癫痫的态度差异无统计学意义（p = 0.561）。在知识量表中，“脑手术能有效治疗部分患者”的比例最低（43.9%）；在态度量表中，“我会嫁给癫痫患者”的比例最低（51.1%）。知识与态度得分呈弱负相关（p = 0.027, r = -0.103）。在癫痫知识和对待癫痫态度得分方面，各国家地理区域差异无统计学意义（p = 0.637）。癫痫发作的学生知识得分较高（p = 0.001）。结论：研究表明医学生对癫痫的认识不足，主要表现在对癫痫治疗的认识不足。消极的态度，尤其是对婚姻和约会的态度。通过培训可以提高学生对癫痫的认识。医学常规课程应围绕这一思路进行重组。

{"title":"Knowledge and attitudes of preclinical and clinical medical students toward epilepsy: A cross-sectional study from Turkey","authors":"Fettah Eren , Sumeyye Aydogmus , Furkan Oral , Mine Aleyna Saka , Aslihan Kocatas , Muhammed Mustafa Esmer , Shams Guliyeva , Mustafa Safa Cibik , Salih Emre Gungor , Kemal Oguz , Melike Somuncu , Ceren Cinar , Omer Yazgan , Nesibe Ozkaya , Adem Yildiz","doi":"10.1016/j.yebeh.2024.110242","DOIUrl":"10.1016/j.yebeh.2024.110242","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to evaluate the epilepsy-related knowledge and attitudes toward epilepsy in medical students. In addition, these parameters were evaluated according to national geographic regions, preclinical and clinical characteristics.</div></div><div><h3>Methods</h3><div>This study was a cross-sectional, observational design and it was conducted among medical students in a centrally located city, Turkey. Participants were divided into two groups as preclinical (1st, 2nd and 3rd year) and clinical (4th, 5th, and 6th year). Structured questionnaires were used to evaluate knowledge about epilepsy and attitudes toward epilepsy. All items were converted into an online format.</div></div><div><h3>Results</h3><div>In general, clinical students exhibited better knowledge about epilepsy than preclinical students (p = 0.001), however there was no statistical difference between groups in terms of attitudes toward epilepsy (p = 0.561). In the knowledge scale, the lowest rate was “Brain operation can be effective treatment in some patients” (43.9 %); and in the attitudes scale, the lowest rate was “I would marry someone who has epilepsy” (51.1 %). A weak negative correlation was detected between knowledge and attitudes scores (p = 0.027, r = -0.103). Scores in knowledge about epilepsy and attitude toward epilepsy were not difference in national geographic regions (p = 0.637). Knowledge score was higher in students who witnessed an epileptic seizure (p = 0.001).</div></div><div><h3>Conclusion</h3><div>The study demonstrated that medical students had insufficient knowledge, mainly about treatment in epilepsy. Negative attitudes, especially about marriage or dating, were detected. Students’ perceptions about epilepsy could be improved with training program. Medical regular curriculum should be reorganized about this line.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"Article 110242"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infantile epileptic spasms syndrome: When spasms come out of the blue 婴儿癫痫性痉挛综合征：当痉挛突然出现。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110180

Marta Conti , Sara Matricardi , Ludovica M. Piscitello , Marina Auconi , Ida Cursio , Alessandra Terracciano , Federico Vigevano , Nicola Specchio , Carla Marini , Lucia Fusco

BACKGROUND

This study evaluates the electroclinical features of infantile epileptic spasms syndrome (IESS) suddenly appearing in previously normal patients, aiming to describe clinical outcomes and independent predictors. METHOD: We retrospectively selected a homogeneous group of patients with IESS from two Italian centers. All patients had normal development prior to IESS onset and a follow-up period lasting at least one year. Patients with clinically relevant risk factors, other seizure types, brain structural abnormalities or known genetic diseases were excluded. The BASED score was used to standardize interictal EEG patterns. RESULTS: Forty-three patients were enrolled, with a median age at IESS onset of 6 months; median follow-up was 43 months. At onset, 65.11 % exhibited mild behavioral changes, including irritability and poor social smile. At firstEEG, epileptic encephalopathy (EE) was prevalent during wakefulness (69.76 %; median BASED score 4) and sleep (81.40 %; median BASED score 5). Within 15 days of treatment, 83.72 % achieved seizure freedom, primarily with ACTH depot (90.70 %). After six months, all patients were seizure- and EE-free. At the last follow-up, 81.40 % had normal cognitive functioning; in the remaining, specific neurodevelopmental disorders, predominantly involving language were reported. No statistically significant differences were found in the electroclinical presentation and neuropsychological outcome. CONCLUSION: We describe a subgroup of IESS patients with prompt response to treatment, long-term seizure freedom, and absence of severe neurodevelopmental impact. Our data suggest that within the IESS spectrum, there is a distinctive subgroup with global favorable outcome. Key clinical features predictors of good outcome could include normal development prior to IESS and early response to treatment.

背景：本研究评估了之前正常患者突然出现的婴儿癫痫痉挛综合征（IESS）的电临床特征，旨在描述临床结局和独立预测因素。方法：我们回顾性地从两个意大利中心选择了一组同质的IESS患者。所有患者在IESS发病前发育正常，随访期至少1年。排除有临床相关危险因素、其他癫痫类型、脑结构异常或已知遗传疾病的患者。basis评分用于标准化间歇期脑电图模式。结果：纳入43例患者，IESS发病时的中位年龄为6个月；中位随访时间为43个月。开始时，65.11%表现出轻微的行为改变，包括易怒和不善社交的微笑。在第一次steeg中，癫痫性脑病（EE）在清醒期间普遍存在(69.76%；basis评分中位数为4)和睡眠(81.40%；在治疗15天内，83.72%的患者实现了癫痫发作自由，主要是ACTH库（90.70%）。6个月后，所有患者均无癫痫发作和ee。最后一次随访时，81.40%的患者认知功能正常；在剩下的病例中，有特定的神经发育障碍，主要涉及语言。电临床表现和神经心理结果无统计学差异。结论：我们描述了一个对治疗反应迅速，长期癫痫发作自由，没有严重神经发育影响的IESS患者亚组。我们的数据表明，在IESS频谱中，有一个独特的亚组具有全局有利的结果。良好预后的关键临床特征预测因素可能包括IESS前的正常发育和对治疗的早期反应。

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引用次数: 0

Psychometric properties of the Malay and Chinese Epilepsy Self-Stigma Scale (ESSS) 马来和华人癫痫自我污名量表（ESSS）的心理测量特征。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110176

Woon-Hin Ching , Ming-Yi Soon , Joe-Lynn Yee , Zhi-Jien Chia , Kheng-Seang Lim , Si-Lei Fong , Xuen Yu , Zhi-Qian Ong , Izumi Kuramochi

Objective

Self-stigma means internalizing negative beliefs and attitudes associated with stigmatized identity. This study aimed to translate and validate the Malay and Chinese versions of the Epilepsy Self-Stigma Scale (ESSS).

Methods

The Epilepsy Self-Stigma Scale was translated into the Malay (ESSS-M) and Chinese versions (ESSS-C) according to standard principles and were tested in 100 Malay and 100 Chinese-speaking people with epilepsy (PWE) respectively. Psychometric evaluations were done based on equal item variance, convergent and discriminant validity, construct validity and reliability. Correlation analyses were carried out between the ESSS and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Generalized Anxiety Disorder-7 (GAD-7).

Results

For the ESSS-M, 100 Malay-speaking PWE with a mean age of 42.25 years (±15.18) were recruited. Exploratory factor analysis identified eight items loaded on three factors: “Internalization of stigma”, “Societal incomprehension”, and “Confidentiality”. However, item 1 was loaded under a different component from the initial paper, conceptualized as confidentiality.

For the ESSS-C, 100 Chinese-speaking participants with a mean age of 41.07 years (±15.57). Exploratory factor analysis identified three loading factors similar to the original scale: “Internalization of stigma”, “Societal incomprehension”, and “Confidentiality”. Both ESSS-M and ESSS-C scales showed significant correlations with NDDI-E and GAD-7 scores, showcasing substantial construct validity.

The Cronbach’s alpha values were α = 0.822 for the ESSS-M and α = 0.831 for the ESSS-C.

Conclusion

Both the ESSS-M and ESSS-C were reliable and valid for measuring epilepsy self-stigma among the Malay- and Chinese-speaking PWE in Malaysia.

目的：自我污名化是指内化与污名化身份相关的消极信念和态度。本研究的目的是翻译和验证马来文和中文版本的癫痫自我污名量表（ESSS）。方法：将《癫痫自我耻感量表》按标准原则翻译成马来文（ESSS-M）和中文（ESSS-C），分别对100名马来文和100名华语癫痫患者（PWE）进行测试。心理测量以等项目方差、收敛效度和判别效度、构念效度和信度为基础进行评价。将ESSS与癫痫神经障碍抑郁量表（NDDI-E）和广泛性焦虑障碍-7 （GAD-7）进行相关性分析。结果：在ess - m中，招募了100名平均年龄为42.25岁（±15.18）的讲马来语的PWE。探索性因素分析确定了8个项目，加载在三个因素上：“耻辱内化”、“社会不理解”和“保密”。但是，项目1载入了与最初文件不同的组成部分，其概念是保密。在ess - c中，100名说中文的参与者，平均年龄41.07岁（±15.57岁）。探索性因子分析确定了与原量表相似的三个负荷因子：“污名内化”、“社会不理解”和“保密”。sess - m和sess - c量表均与ndi - e和GAD-7得分呈显著相关，具有较高的结构效度。sss - m和sss - c的Cronbach α值分别为α = 0.822和α = 0.831。结论：ESSS-M和ESSS-C在马来西亚马来语和汉语PWE中测量癫痫自我耻辱是可靠和有效的。

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引用次数: 0

How accurate are machine learning models in predicting anti-seizure medication responses: A systematic review 机器学习模型在预测抗癫痫药物反应方面的准确性如何？系统综述。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110212

Ahmed Abdaltawab , Lin-Ching Chang , Mohammed Mansour , Mohamad Koubeissi

Importance

Current epilepsy management protocols often depend on anti-seizure medication (ASM) trials and assessment of clinical response. This may delay the initiation of the ASM regimen that might optimally balance efficacy and tolerability for individual patients. Machine learning (ML) can offer a promising tool for efficiently predicting ASM response.

Objective

The objective of this review is to synthesize the available information about the effectiveness and limitations of ML models in predicting and classifying the response of patients with epilepsy to ASMs, and to assess the impact of various data inputs on prediction performance.

Evidence Review

We conducted a comprehensive search of studies utilizing ML models for ASM response prediction using PubMed and Scopus up until November 2024.

Findings

The review included 37 studies. Various data types, including clinical information, brain MRI, EEG, and genetic data, are useful in predicting responses to ASMs. Tree-based ML algorithms and Support Vector Machines are the most used models. Reported results vary widely, with certain models achieving near-perfect accuracy and others performing similar to random classifiers. The review also highlights the limitations of this research field, especially concerning the quality and quantity of data.

Conclusions and Relevance

The findings indicate that while ML models show great promise in predicting ASM responses in epilepsy, further research is required to refine these models for practical clinical application. The review underscores both the potential of ML in advancing precision medicine in epilepsy management and the need for continued research to improve prediction accuracy.

重要性：目前的癫痫管理方案往往依赖于抗癫痫药物（ASM）试验和临床反应评估。这可能会延迟ASM方案的开始，ASM方案可能会最佳地平衡个体患者的疗效和耐受性。机器学习（ML）可以为有效预测ASM响应提供一个有前途的工具。目的：本综述的目的是综合有关ML模型在预测和分类癫痫患者对asm的反应方面的有效性和局限性的现有信息，并评估各种数据输入对预测性能的影响。证据回顾：我们使用PubMed和Scopus对截至2024年11月利用ML模型进行ASM反应预测的研究进行了全面搜索。研究结果：该综述包括37项研究。各种数据类型，包括临床信息、脑MRI、脑电图和遗传数据，都有助于预测asm的反应。基于树的机器学习算法和支持向量机是最常用的模型。报告的结果差异很大，某些模型实现了近乎完美的准确性，而其他模型的表现与随机分类器相似。这篇综述也强调了这一研究领域的局限性，特别是在数据的质量和数量方面。结论和相关性：研究结果表明，虽然ML模型在预测癫痫的ASM反应方面有很大的希望，但需要进一步的研究来完善这些模型以用于实际临床应用。这篇综述强调了机器学习在癫痫管理中推进精准医学的潜力，以及继续研究以提高预测准确性的必要性。

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引用次数: 0

Association between behavioral problems and parental stress in children and adolescents with epilepsy 儿童和青少年癫痫患者的行为问题与父母压力之间的关系。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-02-01 DOI: 10.1016/j.yebeh.2024.110229

Sai Sirisha , Sireesha Jala , Sudhindra Vooturi , Anuja Patil , Shanmukhi Somayajula , Sita Jayalakshmi

Objective

The current study evaluated the association between behavioral problems in children and adolescents with epilepsy and parental stress.

Methods

A prospective observational study of 314 consecutive parents of children and adolescents with epilepsy who attended the out-patient epilepsy clinic of a tertiary care hospital was done between June 2022 and September 2023. Self-reported Child Behaviour Check List (CBCL) was reported by parents; who also reported the parental stress scale (PSS). The data as per CBCL guidelines was evaluated in three groups of children and adolescents with epilepsy aged 1.5 to 5 years; 6 to 10 years and 11 to 18 years. The associations between score on CBCL with reported score on PSS was evaluated.

Results

Among the 314 children and adolescents with epilepsy, 37(11.8 %) were aged between 1.5 to 5 years; while 108(34.4 %) aged between six to 10 years, the remaining 169(53.8 %) aged between 11 to 18 years. In children below 5 years of age, internalizing factors like anxiety/depression, somatic symptoms were significantly higher. Importantly, the reported scores on PSS were lower in parents of adolescents than children with epilepsy. When evaluated for correlation of CBCL with PSS, internalizing characteristics like withdrawal were strongly associated with parental stress in children below the age of 5 years. On the contrary, in children aged above five years, and in adolescents externalizing characteristics showed strong correlations with parental stress. Child’s higher school performance had a negative correlation with PSS(R-Square: −0.499; p < 0.001) and requirement for special school or child not attending school had positive correlation with PSS(R-square: 0.433;p < 0.001).

Conclusion

Behavioral problems in children and adolescents with epilepsy differ with age. Parental stress is associated with internalizing behavior in pre-school children whereas externalizing behavior dominated in children and adolescents. Poor performance of children at school and requirement for special school is associated with high parental stress.

目的：本研究评估儿童和青少年癫痫行为问题与父母压力的关系。方法：对2022年6月至2023年9月在某三级医院癫痫门诊就诊的314名癫痫儿童和青少年的连续父母进行前瞻性观察研究。家长自行报告儿童行为检查表（CBCL）；他们还报告了父母压力量表（PSS）。根据CBCL指南对三组1.5至5岁癫痫儿童和青少年进行了数据评估；6到10年，11到18年。评估CBCL评分与PSS报告评分之间的相关性。结果：314例癫痫儿童和青少年中，37例（11.8%）年龄在1.5 ~ 5岁；6 ~ 10岁的有108人（34.4%），11 ~ 18岁的有169人（53.8%）。在5岁以下的儿童中，焦虑/抑郁、躯体症状等内化因素明显更高。重要的是，青少年父母的PSS评分比癫痫儿童低。当评估CBCL与PSS的相关性时，5岁以下儿童的退缩等内化特征与父母压力密切相关。相反，在5岁以上的儿童和青少年中，外化特征与父母压力有很强的相关性。儿童的高中成绩与PSS呈负相关(r方：-0.499；结论：儿童和青少年癫痫患者的行为问题随年龄不同而不同。父母压力与学龄前儿童的内化行为有关，而外化行为在儿童和青少年中占主导地位。孩子在学校的表现不佳和特殊学校的要求与父母的高压力有关。

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