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Cognitive Orientation to daily Occupational Performance Approach using telerehabilitation with parents to improve performance issues in children/adolescents with Dravet Syndrome 基于认知取向的日常职业表现方法:与家长一起进行远程康复以改善患有Dravet综合征的儿童/青少年的表现问题
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.yebeh.2025.110803
Patrizia Gabriella Ianes , Rose Martini , Silvia Frazzetta , Yann Bertholom , Maria Giulia Montecchi , Valentina De Luca , Simone Di Lisa , Costanza Cutrona , Federica Moriconi , Michela Quintiliani , Simona Borroni , Filomena Rita Rega , Daniela Pia Rosaria Chieffo , Domenica Immacolata Battaglia

Introduction

The Cognitive Orientation to Occupational Performance (CO-OP) Approach, a problem-solving intervention process, has been shown to improve activity performance in children with Dravet Syndrome (DS). However, some individuals with DS have cognitive, language and/or behavioral deficits that preclude their ability to participate in the problem-solving process. To date, the CO-OP Approach has never been applied to parents with the goal of enhancing children/adolescent’s performance.

Objective

Explore the feasibility of a telerehabilitation-based CO-OP Approach with parents of individuals with DS to improve their child/adolescent’s performance in daily activities.

Methods

A quasi-experimental single group design with pretest-post-test and 1-month follow-up was used with 9 parents of children/adolescents with DS (aged 9–18 years), who received eight online CO-OP sessions. Five goals were chosen, three of which were treated. Parents rated performance and satisfaction on the Canadian Occupational Performance Measure (COPM). Activity performance was rated using the Performance Quality Rating Scale (PQRS). Wilcoxon signed-rank tests were conducted to assess intervention changes.

Results

COPM results, for trained and untrained goals, for both performance and satisfaction, improved significantly at post and follow-up. PQRS results for trained goals improved significantly at post and follow-up. Positive trends were also observed for untrained goals, but significance was achieved only at follow-up.

Conclusion

These findings provide preliminary evidence that the CO-OP Approach can be implemented with parents to improve their child/adolescent’s performance on both trained and untrained goals.
认知导向职业表现(CO-OP)方法是一种解决问题的干预过程,已被证明可以改善德拉韦综合征(DS)儿童的活动表现。然而,一些患有退行性障碍的人有认知、语言和/或行为缺陷,使他们无法参与解决问题的过程。迄今为止,以提高儿童/青少年表现为目标的家长从未采用过合作模式。目的探讨以远程康复为基础的合作模式对残疾儿童/青少年日常活动能力的改善作用。方法采用准实验单组设计,采用前测后测和1个月的随访,对9名9 - 18岁儿童/青少年DS患儿家长进行8次在线CO-OP治疗。选择了五个进球,其中三个被处理。家长们对加拿大职业绩效评估(COPM)的表现和满意度进行了评分。使用绩效质量评定量表(PQRS)对活动绩效进行评定。采用Wilcoxon sign -rank检验来评估干预的变化。结果在培训后和随访中,scopm结果在培训目标和未培训目标、绩效和满意度方面均有显著提高。训练目标的PQRS结果在事后和随访中显著改善。未经训练的目标也观察到积极的趋势,但只有在后续行动中才有意义。这些发现提供了初步的证据,表明合作教学方法可以在父母中实施,以提高他们的孩子/青少年在训练和未训练目标上的表现。
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引用次数: 0
Effective connectivity of face and fear processing in juvenile myoclonic epilepsy 青少年肌阵挛性癫痫面孔和恐惧加工的有效连通性
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.yebeh.2025.110863
Christina Münchberger , Kristina Krause , Louise Linka , Sascha Strehlau , Anna Sophia Huber , Julia Freigang , Andreas Jansen , Katja Menzler , Susanne Knake , Kristin M. Rusch

Objective

Individuals with Juvenile Myoclonic Epilepsy (JME) exhibit impaired facial emotion perception, especially regarding fear. However, the underlying neural mechanisms remain to be fully understood. Particularly, the connectivity between emotion-related regions, such as the amygdala, and visual face-processing areas, specifically the Fusiform Face Area (FFA), appears to be relevant for typical facial fear processing. We therefore explored the effective connectivity within the FFA-amygdala network in JME.

Methods

Fourteen individuals diagnosed with JME and 14 healthy controls matched for age, sex, and alexithymia (i.e., emotional awareness) participated in an fMRI face-viewing experiment. Participants were presented with images of neutral and fearful faces, as well as houses. Using Dynamic Causal Modelling, we examined endogenous connectivity, modulation by task conditions, and the influence of experimental inputs within the bilateral FFA-amygdala network (n = 24), incorporating both intra- and interhemispheric connections.

Results

Compared to healthy controls, we found alterations mainly in the task-independent endogenous structure of the FFA-amygdala network in JME. The self-connection of the right amygdala was particularly enhanced, with the same tendency observed for the left amygdala and the right FFA. Furthermore, aberrations were indicated in the interhemispheric transfer between the amygdalae under the modulation of fear. Exploratory analyses revealed correlations of neural activity, and neural network parameters with both the onset and duration of epilepsy.

Conclusion

Overall, we found initial evidence of alterations in the FFA-amygdala network in JME. Particularly, the right amygdala showed a greater inhibitory self-connection, which suggests a generally reduced sensitivity to external input and might affect social and emotional processing. This emphasizes further exploring the network structure, its behavioural implications, and connectivity with other regions in larger samples.
目的:青少年肌阵挛性癫痫(JME)患者表现出面部情绪感知障碍,尤其是恐惧。然而,潜在的神经机制仍有待充分了解。特别是,情绪相关区域(如杏仁核)和视觉面部处理区域(特别是Fusiform Face Area, FFA)之间的连通性似乎与典型的面部恐惧处理有关。因此,我们探索了JME中ffa -杏仁核网络的有效连通性。方法14例JME患者和14例年龄、性别和述情障碍(即情绪意识)相匹配的健康对照者参加了fMRI面部观察实验。研究人员向参与者展示了中立和恐惧的面孔以及房屋的图像。利用动态因果模型,我们研究了内源性连通性、任务条件的调节以及双侧ffa -杏仁核网络(n = 24)中实验输入的影响,包括半球内和半球间的连接。结果与健康对照组相比,我们发现JME主要在任务无关的ffa -杏仁核网络内源性结构上发生了变化。右杏仁核的自我连接特别增强,左杏仁核和右FFA也有同样的趋势。此外,在恐惧的调节下,杏仁核之间的半球间转移也出现了畸变。探索性分析揭示了神经活动和神经网络参数与癫痫发作和持续时间的相关性。总的来说,我们发现了JME中ffa -杏仁核网络改变的初步证据。特别是,右侧杏仁核显示出更大的抑制性自我连接,这表明对外部输入的敏感性普遍降低,可能会影响社交和情绪处理。这强调在更大的样本中进一步探索网络结构,其行为含义以及与其他区域的连通性。
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引用次数: 0
Does seizure duration matter? A quantitative and qualitative study on the burden and unmet needs of prolonged seizures in people living with epilepsy and their caregivers 癫痫发作持续时间重要吗?关于癫痫患者及其照料者长时间癫痫发作的负担和未满足需求的定量和定性研究
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-27 DOI: 10.1016/j.yebeh.2025.110831
Danya Kaye , Rebecca Burns , Cédric Laloyaux , Michelle Manzo , Andrea L. Wilkinson , Tanya Bhatia , Shalee Cunneen , Susan Linn , Shelly Meitzler , Jesús Eric Piña-Garza , Joseph I. Sirven

Objectives

To describe the experiences of people with epilepsy (PwE) with prolonged seizures (PS) and their caregivers, identify unmet needs, determine greatest burdens, and assess perceived impact of PS on quality of life (QoL).

Methods

Mixed methods research on PwE and caregivers (∼15-min web-survey; 90–120-min interviews); September 2023-January 2024. This study included US-based PwE age ≥ 18 years and adult caregivers of PwE age ≥ 12 years; PwE were currently experiencing/had history of PS (typically lasting ≥ 2 min/usually not stopping on their own/worsening over time).

Results

Living with PS has a profound negative impact on perceived QoL for PwE and caregivers (n = 35) across areas including work/career, social life/relationships, physical/cognitive impacts, and mental health/emotional wellbeing (highest impact reported). Twenty-one (60 %) participants reported receiving medication or therapy to manage their mental health. Increased burden of PS was associated with increased frequency and emotional impact of emergency response; 25 (71 %) participants reported they/the PwE they care for were currently experiencing PS. PwE currently experiencing PS were 3.6-times more likely to call an ambulance than those not currently experiencing PS. PwE with PS reported post-ictal recovery as physically/cognitively/emotionally challenging; 29 (83 %) participants correlated seizure duration with longer recovery time; even outside of hospitalization/emergency healthcare, reported recovery time from PS was 0.5–3 days. Participants who did not report such correlation typically reported shorter recovery (<few hours) and well-controlled seizures.

Conclusions

The negative health impact and burden of PS on PwE and caregivers was profound. Better social, emotional, and psychological support is needed for PwE with PS and their families.
目的描述长时间癫痫发作(PS)的癫痫患者(PwE)及其照顾者的经历,确定未满足的需求,确定最大负担,并评估PS对生活质量(QoL)的感知影响。方法采用混合方法对护理人员和护理人员进行调查(网络调查~ 15分钟;访谈90 ~ 120分钟);2023年9月至2024年1月。本研究纳入美国年龄≥18岁的PwE和年龄≥12岁的PwE的成人照顾者;PwE目前正在经历/有PS病史(通常持续≥2分钟/通常不会自行停止/随着时间的推移而恶化)。结果:与PS一起生活对PwE和照顾者(n = 35)的感知生活质量有深远的负面影响,包括工作/职业、社会生活/人际关系、身体/认知影响和心理健康/情绪健康(报告的影响最大)。21名(60%)参与者报告接受药物或治疗来管理他们的心理健康。PS负担的增加与应急响应频率和情绪影响的增加有关;25名(71%)参与者报告说,他们/他们所照顾的PwE目前正在经历PS。目前经历PS的PwE呼叫救护车的可能性是没有经历PS的PwE的3.6倍。患有PS的PwE报告说,在身体/认知/情感上恢复具有挑战性;29名(83%)参与者将癫痫发作时间与较长的恢复时间相关联;即使在住院/紧急医疗之外,报告的PS恢复时间为0.5-3天。没有报告这种相关性的参与者通常报告较短的恢复(几个小时)和控制良好的癫痫发作。结论PS对PwE和照顾者的负面健康影响和负担是深刻的。有PS的PwE及其家人需要更好的社会、情感和心理支持。
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引用次数: 0
Beyond the genome: Ethical, social and legal implications of epilepsy genetics 超越基因组:癫痫遗传学的伦理、社会和法律影响
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.yebeh.2026.110922
Parthasarathy Satishchandra , Birrie Deresse , Priya Ranganath
<div><h3>Purpose</h3><div>Epilepsy genetics is a rapidly evolving field focused on identifying new epilepsy-related genes, enhancing our understanding of the mechanisms underlying epilepsy, and developing precision medicine approaches for targeted treatments. However, genetic testing raises ethical, legal, and social issues for people with epilepsy and their families. This review summarizes the implications of genetic testing in epilepsy, focusing on the ethical dilemmas, societal impacts, and legal considerations in clinical practice. This manuscript is structured as a narrative review that integrates real-world clinical case vignettes to illustrate how ethical, social, and legal challenges arise in everyday epilepsy genetics practice. Our aim is to synthesize practical ethical considerations for clinicians working in diverse healthcare settings.</div></div><div><h3>Methods</h3><div>We conducted a narrative review of the current literature and integrated illustrative cases to examine the ethical, social, and legal dimensions of epilepsy genetics.</div></div><div><h3>Results</h3><div>Ethical issues in epilepsy genetic testing include ensuring informed consent, respecting autonomy, protecting confidentiality and privacy, and balancing the interests of individuals, parents, and society, particularly in the case of genetic testing for minors. Informed consent requires that patients fully understand the risks, benefits, and limitations of testing, including its potential health, emotional, and family impacts. Healthcare professionals must inform patients about the implications of genetic test results and potential risks to family members. Clear communication helps patients understand the information, encourages family discussions, and supports informed consent for disclosure. Disclosure of genetic information to family members without patient consent may be justified under certain conditions. Genetic testing for epilepsy can lead to significant social impacts, such as anxiety, stress, and depression. It may also worsen stigma, discrimination, and social isolation already associated with epilepsy. The concept of “courtesy stigma” may arise when epilepsy is perceived as a hereditary condition, leading to stigma extending beyond the affected individual to their family members. Genetic test results could be used to discriminate against individuals in employment or insurance settings. Genetic testing for epilepsy raises ethical concerns grounded in the principle of justice, particularly equitable access to testing, which may subsequently require legal and policy interventions.</div></div><div><h3>Conclusion</h3><div>While genetic testing for epilepsy offers substantial benefits for improving treatment and enabling early intervention, it also raises significant ethical, legal, and social challenges for individuals with epilepsy and their families. Robust legal and ethical frameworks are essential to protect patient rights and to maximize the benefits of ge
目的癫痫遗传学是一个快速发展的领域,专注于发现新的癫痫相关基因,增强我们对癫痫机制的理解,并为靶向治疗开发精准医学方法。然而,基因检测给癫痫患者及其家庭带来了伦理、法律和社会问题。本文综述了癫痫基因检测的意义,重点是临床实践中的伦理困境、社会影响和法律考虑。这份手稿的结构是作为一个叙述性的审查,整合了现实世界的临床病例小插图,以说明如何伦理,社会和法律挑战出现在日常癫痫遗传学实践。我们的目标是综合实际伦理考虑的临床医生工作在不同的医疗保健设置。方法我们对目前的文献进行了叙述性的回顾,并整合了具有说明性的案例,以检查癫痫遗传学的伦理、社会和法律层面。结果癫痫基因检测涉及的伦理问题包括确保患者知情同意、尊重患者自主权、保护患者隐私和隐私,以及平衡个人、父母和社会的利益,尤其是未成年人基因检测。知情同意要求患者充分了解检测的风险、益处和局限性,包括其潜在的健康、情感和家庭影响。医疗保健专业人员必须告知患者基因检测结果的含义和对家庭成员的潜在风险。清晰的沟通有助于患者理解信息,鼓励家庭讨论,并支持知情同意披露。在某些情况下,未经患者同意向家庭成员透露遗传信息可能是合理的。癫痫基因检测可导致显著的社会影响,如焦虑、压力和抑郁。它还可能加剧已经与癫痫有关的耻辱、歧视和社会孤立。当癫痫被认为是一种遗传性疾病时,可能会出现“礼貌耻辱”的概念,导致耻辱从受影响的个人延伸到其家庭成员。基因检测结果可以用来在就业或保险环境中歧视个人。癫痫基因检测引发了基于正义原则的伦理问题,特别是公平获得检测,这可能随后需要法律和政策干预。结论:虽然癫痫基因检测为改善治疗和早期干预提供了实质性的好处,但它也给癫痫患者及其家庭带来了重大的伦理、法律和社会挑战。健全的法律和道德框架对于保护患者权利和最大限度地发挥基因检测的好处,同时尽量减少潜在危害至关重要。解决这些新出现的问题需要决策者、医疗保健专业人员和遗传咨询师之间的合作。由国际抗癫痫联盟(ILAE)和国际癫痫局(IBE)等专业机构领导,与各国政府和癫痫协会合作,协调一致的政策应对对于促进道德标准、公平获取和文化上适当的做法至关重要。
{"title":"Beyond the genome: Ethical, social and legal implications of epilepsy genetics","authors":"Parthasarathy Satishchandra ,&nbsp;Birrie Deresse ,&nbsp;Priya Ranganath","doi":"10.1016/j.yebeh.2026.110922","DOIUrl":"10.1016/j.yebeh.2026.110922","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Epilepsy genetics is a rapidly evolving field focused on identifying new epilepsy-related genes, enhancing our understanding of the mechanisms underlying epilepsy, and developing precision medicine approaches for targeted treatments. However, genetic testing raises ethical, legal, and social issues for people with epilepsy and their families. This review summarizes the implications of genetic testing in epilepsy, focusing on the ethical dilemmas, societal impacts, and legal considerations in clinical practice. This manuscript is structured as a narrative review that integrates real-world clinical case vignettes to illustrate how ethical, social, and legal challenges arise in everyday epilepsy genetics practice. Our aim is to synthesize practical ethical considerations for clinicians working in diverse healthcare settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a narrative review of the current literature and integrated illustrative cases to examine the ethical, social, and legal dimensions of epilepsy genetics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Ethical issues in epilepsy genetic testing include ensuring informed consent, respecting autonomy, protecting confidentiality and privacy, and balancing the interests of individuals, parents, and society, particularly in the case of genetic testing for minors. Informed consent requires that patients fully understand the risks, benefits, and limitations of testing, including its potential health, emotional, and family impacts. Healthcare professionals must inform patients about the implications of genetic test results and potential risks to family members. Clear communication helps patients understand the information, encourages family discussions, and supports informed consent for disclosure. Disclosure of genetic information to family members without patient consent may be justified under certain conditions. Genetic testing for epilepsy can lead to significant social impacts, such as anxiety, stress, and depression. It may also worsen stigma, discrimination, and social isolation already associated with epilepsy. The concept of “courtesy stigma” may arise when epilepsy is perceived as a hereditary condition, leading to stigma extending beyond the affected individual to their family members. Genetic test results could be used to discriminate against individuals in employment or insurance settings. Genetic testing for epilepsy raises ethical concerns grounded in the principle of justice, particularly equitable access to testing, which may subsequently require legal and policy interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;While genetic testing for epilepsy offers substantial benefits for improving treatment and enabling early intervention, it also raises significant ethical, legal, and social challenges for individuals with epilepsy and their families. Robust legal and ethical frameworks are essential to protect patient rights and to maximize the benefits of ge","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110922"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073930","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
Emotion recognition deficits in temporal lobe epilepsy are non-lateralized and independent of surgery 颞叶癫痫的情绪识别缺陷是非偏侧的,与手术无关
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.yebeh.2026.110906
Jana Amlerova , Viktoria Pytelova , Francesco Angelucci , Ross Andel , Jakub Hort , Alena Javurkova , Petr Marusic
To examine whether patients with unilateral temporal lobe epilepsy (TLE) show deficits in recognizing emotions from facial expressions and vocal prosody, and whether these impairments differ by seizure focus or surgical status.

Methods:

Thirty-four patients with TLE were evaluated before or after temporal lobe resection for drug-resistant epilepsy. Thirty right-handed healthy controls without neurological or psychiatric history were included. Emotion recognition was assessed using the Emotion Recognition Test (ERT), consisting of a Facial ERT (adapted from Ekman and Friesen’s facial expression set) and a Prosody ERT developed in collaboration with professional actors using two neutral Czech sentences. Both subtests included five emotions: anger, disgust, fear, happiness, and sadness.

Results:

TLE patients showed a general impairment in emotion recognition across both modalities. Total prosody and facial emotion scores were significantly lower than in controls. Prosody deficits and facial emotion scores were independent of age, disease duration, and education. No significant differences were found between right and left TLE, or between pre- and postoperative groups.

Significance:

Deficits in emotion recognition from face and voice in patients with TLE were not lateralized and did not differ between pre- and postoperative TLE groups. This may indicate persistent socio-emotional processing abnormalities that may contribute to the social and behavioral difficulties observed in TLE people. Longitudinal studies are needed in this field.
研究单侧颞叶癫痫(TLE)患者在面部表情和声音韵律识别情绪方面是否存在缺陷,以及这些缺陷是否因发作灶或手术状态而异。方法:对34例颞叶切除治疗耐药癫痫患者进行评价。30名没有神经或精神病史的右撇子健康对照。使用情绪识别测试(ERT)评估情绪识别,包括面部ERT(改编自Ekman和Friesen的面部表情集)和与专业演员合作开发的韵律ERT,使用两个中立的捷克语句子。两个子测试都包括五种情绪:愤怒、厌恶、恐惧、快乐和悲伤。结果:TLE患者在两种模式下均表现出情绪识别的普遍损伤。总韵律和面部情绪得分明显低于对照组。韵律缺陷和面部情绪得分与年龄、疾病持续时间和教育程度无关。右侧和左侧TLE之间,以及术前和术后组之间均无显著差异。意义:TLE患者的面部和声音情绪识别缺陷没有侧化,并且在TLE术前和术后组之间没有差异。这可能表明持续的社会情绪处理异常可能导致在TLE患者中观察到的社会和行为困难。这一领域需要进行纵向研究。
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引用次数: 0
Illness Perception, Coping, and psychosocial outcomes in children with functional neurological disorders compared to children with epilepsy 与癫痫儿童相比,功能性神经障碍儿童的疾病感知、应对和社会心理结局
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.yebeh.2026.110910
Barbara Zuro Jakovac , David Hevey , Phillip Coey , Clare Harris , Gary Byrne
This study explored differences in illness perceptions, coping, and psychosocial outcomes in children with functional neurological disorders (FND) and epilepsy. It also examined moderating and mediating role of coping between illness perceptions and psychosocial outcomes.
A cross-sectional design was used. Thirty-three children with FND and thirty-two with epilepsy completed measures of illness perceptions, coping, anxiety, depression, and health-related quality of life.
Children with FND reported more threatening illness perceptions, higher levels of anxiety and depression, and poorer quality of life. In both groups, threatening illness perceptions were positively correlated with anxiety, and negatively with quality of life. A positive correlation between illness perceptions and depression was found only among children with FND. Coping moderated these relationships differently across groups. In the FND group, it moderated the association between illness perceptions and quality of life, whereas in the epilepsy group, it moderated the association between illness perceptions and depression.
These findings highlight the importance of addressing illness perceptions and supporting children to use coping strategies they find helpful. Moreover, screening for illness perceptions and coping may help identify the most vulnerable children and inform treatment targets.
本研究探讨了功能性神经障碍(FND)和癫痫患儿在疾病认知、应对和心理社会结局方面的差异。它还研究了疾病认知和心理社会结果之间的调节和调解作用。采用横断面设计。33名FND患儿和32名癫痫患儿完成了疾病认知、应对、焦虑、抑郁和健康相关生活质量的测量。患有FND的儿童报告了更多的威胁性疾病感知,更高水平的焦虑和抑郁,以及更差的生活质量。在两组中,威胁性疾病感知与焦虑呈正相关,与生活质量负相关。疾病认知和抑郁之间的正相关仅在FND患儿中被发现。在不同的群体中,应对对这些关系的调节是不同的。在FND组中,它调节了疾病感知和生活质量之间的关联,而在癫痫组中,它调节了疾病感知和抑郁之间的关联。这些发现强调了解决疾病认知和支持儿童使用他们认为有用的应对策略的重要性。此外,对疾病认知和应对的筛查可能有助于确定最脆弱的儿童,并告知治疗目标。
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引用次数: 0
Exploring health information and resource needs of women with epilepsy in Ireland from preconception to postpartum: A qualitative study 从孕前到产后探索爱尔兰癫痫妇女的健康信息和资源需求:一项定性研究
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.yebeh.2025.110825
Jade Parnell , Veronica Lambert , Sinéad Murphy , Fergal O’Shaughnessy , Aisling Walsh
Many women with epilepsy (WWE) navigate complex decisions regarding their reproductive health. In order to support these women throughout the stages of preconception to postpartum, it is important they are equipped with the relevant information and resources. The current study used an inductive qualitative method to understand the experiences and perspectives of WWE navigating health information across the stages of preconception to postpartum in Ireland. Thirty-two WWE aged 20–50 years, who have received healthcare in Ireland, participated in an online narrative interview. Responses were analysed using Reflexive Thematic Analysis. WWE reported several important factors related to their information needs. Three themes were developed: 1) what I need to know, to know what to expect (i.e., WWE’s need for information earlier to make informed decisions), 2) my information is impacted by access and support, and 3) my experiences impact whether I trust health information. Strategies to improve the timing and delivery of resources should be prioritised to increase the overall quality of communication of information for WWE to ensure their health needs are met.
许多患有癫痫的妇女在生殖健康方面做出了复杂的决定。为了支持这些妇女从孕前到产后的各个阶段,为她们提供相关的信息和资源是很重要的。目前的研究采用归纳定性的方法来了解经验和观点的WWE导航健康信息跨越孕前到产后的阶段在爱尔兰。32名年龄在20-50岁之间的WWE在爱尔兰接受了医疗保健,他们参加了一个在线叙事采访。使用反身性主题分析对回答进行分析。WWE报告了与他们的信息需求相关的几个重要因素。研究提出了三个主题:1)我需要知道什么,知道会发生什么(即WWE需要更早地获得信息以做出明智的决定),2)我的信息受到获取和支持的影响,以及3)我的经历影响我是否相信健康信息。应优先考虑改善资源的时机和交付的战略,以提高WWE信息传播的总体质量,确保满足其健康需求。
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引用次数: 0
Identification of cognitive phenotypes in temporal lobe epilepsy and genetic generalized epilepsy using robotic assessment 利用机器人评估识别颞叶癫痫和遗传性全身性癫痫的认知表型。
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-02-03 DOI: 10.1016/j.yebeh.2025.110875
Theodore S. Aliyianis , Spencer Finn , Karla Batista Garcia-Ramo , Brooke C. Beattie , Lysa Boissé Lomax , Garima Shukla , Stephen H. Scott , Gavin P. Winston

Background

Cognitive dysfunction is common in people with epilepsy (PWE). Although expectations exist for deficits based on diagnosis, phenotypic variation of cognitive deficits is observed within epilepsy subtypes. Classification by severity and type of cognitive deficits has been shown across multiple studies of people with temporal lobe epilepsy (TLE). In this study, we replicate these findings using robotic assessment in TLE and apply the same method in genetic generalized epilepsy (GGE) to uncover potential cognitive phenotypes.

Method

Participants with TLE and GGE were recruited to participate in robotic assessment battery of neurocognitive function. We used 7 task scores to form clusters that includes functions from various cognitive and motor domains. Calinski-Harabasz method seeded at zero was used to find the optimal value of c, and fuzzy C-means clustering was used to assess the cluster membership from the data in c-groups.

Results

We found 3 clusters among TLE (n = 33): minimal deficits (45 % of participants with TLE), partial deficits (27 %), and global deficits (27 %). Likewise, we found 3 clusters among GGE (n = 25): memory and executive deficits (40 % of participants with GGE), processing speed deficits (36 %), and complex motor deficits (24 %).

Conclusions

Robotic assessment can be used with clustering methods to classify cognitive dysfunction in epilepsy. These clusters show similar patterns to previous research, which suggests that robotic assessment can distinguish the cognitive phenotypes of PWE.
背景:认知功能障碍在癫痫患者(PWE)中很常见。尽管存在基于诊断的认知缺陷的期望,但在癫痫亚型中观察到认知缺陷的表型变异。对颞叶癫痫(TLE)患者的多项研究表明,认知缺陷的严重程度和类型已得到分类。在这项研究中,我们在TLE中使用机器人评估来重复这些发现,并在遗传性全身性癫痫(GGE)中应用相同的方法来发现潜在的认知表型。方法:招募TLE和GGE患者参加机器人神经认知功能评估组。我们使用7个任务分数来形成包括不同认知和运动领域功能的集群。采用Calinski-Harabasz方法在0处播种来寻找c的最优值,并采用模糊c均值聚类从c组数据中评估聚类隶属度。结果:我们在TLE (n = 33)中发现了3个集群:最小缺陷(45%的TLE参与者),部分缺陷(27%)和整体缺陷(27%)。同样,我们在GGE中发现了3个集群(n = 25):记忆和执行缺陷(40%的GGE参与者),处理速度缺陷(36%)和复杂运动缺陷(24%)。结论:机器人评估可与聚类方法一起用于癫痫患者认知功能障碍的分类。这些集群显示出与先前研究相似的模式,这表明机器人评估可以区分PWE的认知表型。
{"title":"Identification of cognitive phenotypes in temporal lobe epilepsy and genetic generalized epilepsy using robotic assessment","authors":"Theodore S. Aliyianis ,&nbsp;Spencer Finn ,&nbsp;Karla Batista Garcia-Ramo ,&nbsp;Brooke C. Beattie ,&nbsp;Lysa Boissé Lomax ,&nbsp;Garima Shukla ,&nbsp;Stephen H. Scott ,&nbsp;Gavin P. Winston","doi":"10.1016/j.yebeh.2025.110875","DOIUrl":"10.1016/j.yebeh.2025.110875","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive dysfunction is common in people with epilepsy (PWE). Although expectations exist for deficits based on diagnosis, phenotypic variation of cognitive deficits is observed within epilepsy subtypes. Classification by severity and type of cognitive deficits has been shown across multiple studies of people with temporal lobe epilepsy (TLE). In this study, we replicate these findings using robotic assessment in TLE and apply the same method in genetic generalized epilepsy (GGE) to uncover potential cognitive phenotypes.</div></div><div><h3>Method</h3><div>Participants with TLE and GGE were recruited to participate in robotic assessment battery of neurocognitive function. We used 7 task scores to form clusters that includes functions from various cognitive and motor domains. Calinski-Harabasz method seeded at zero was used to find the optimal value of c, and fuzzy C-means clustering was used to assess the cluster membership from the data in c-groups.</div></div><div><h3>Results</h3><div>We found 3 clusters among TLE (n = 33): minimal deficits (45 % of participants with TLE), partial deficits (27 %), and global deficits (27 %). Likewise, we found 3 clusters among GGE (n = 25): memory and executive deficits (40 % of participants with GGE), processing speed deficits (36 %), and complex motor deficits (24 %).</div></div><div><h3>Conclusions</h3><div>Robotic assessment can be used with clustering methods to classify cognitive dysfunction in epilepsy. These clusters show similar patterns to previous research, which suggests that robotic assessment can distinguish the cognitive phenotypes of PWE.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110875"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112618","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
Right vagal nerve stimulation for epilepsy – case series and systematic review of the literature 右迷走神经刺激治疗癫痫病例系列及文献系统回顾。
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI: 10.1016/j.yebeh.2025.110695
Kenneth Ong , Michael A Rizzuto , Maggie Hou , Annika Weir , Chantelle Hrazdil , Ash Singhal , Mostafa Fatehi

Background

Vagus nerve stimulation (VNS) is an established therapy for refractory epilepsy, traditionally implanted on the left to avoid potential cardiac complications attributed to right-sided placement (R-VNS). These concerns are largely based on animal models, with limited human evidence.

Methods

To gain a deeper understanding of the field, we conducted a systematic review of all published cases of R-VNS and a retrospective review of all patients in our quaternary neurosurgical center (Vancouver General Hospital) who underwent R-VNS.

Results

The review identified nine studies involving 53 patients. Transient cardiac abnormalities occurred in four patients. Ten patients experienced non-cardiac side effects, typically wheezing or other respiratory side effects, with three requiring device deactivations. Seizure control was comparable in 74.2% of patients. Our institutional series of seven patients identified no cardiac complications. Three experienced transient non-cardiac symptoms, and one experienced hoarseness and stridor requiring stimulation adjustment. Six patients had prior L-VNS, with R-VNS providing similar seizure control in four cases. Two instances of unreliable heart rate detection by VNS were reported in our cohort.

Conclusion

This study presents an updated systematic review and institutional case series to better characterize the safety and efficacy of R-VNS. Although traditionally avoided due to cardiac concerns, symptomatic cardiac complications with R-VNS were not regularly documented compared to L-VNS. Instances of unreliable heart rate detection limited the value of cardiac auto-stimulation and should be further investigated. R-VNS appears safe and effective in select patients, though larger studies are needed to clarify long-term safety, and respiratory side effects have been described.
背景:迷走神经刺激(VNS)是治疗难治性癫痫的一种既定疗法,传统上在左侧植入以避免由于右侧放置(R-VNS)而引起的潜在心脏并发症。这些担忧主要基于动物模型,人类证据有限。方法:为了更深入地了解该领域,我们对所有已发表的R-VNS病例进行了系统回顾,并对我们第四神经外科中心(温哥华总医院)所有接受R-VNS的患者进行了回顾性回顾。结果:本综述确定了涉及53例患者的9项研究。4例患者出现短暂性心脏异常。10名患者出现了非心脏副作用,典型的是喘息或其他呼吸系统副作用,其中3名患者需要停用设备。74.2%的患者癫痫发作控制具有可比性。我们的机构系列的7名患者没有发现心脏并发症。3例出现短暂的非心脏症状,1例出现声音嘶哑和喘鸣,需要调整刺激。6例患者有L-VNS, 4例有R-VNS提供类似的癫痫控制。在我们的队列中报告了两例VNS心率检测不可靠的病例。结论:本研究提出了一项更新的系统综述和机构病例系列,以更好地表征R-VNS的安全性和有效性。虽然由于心脏方面的考虑,传统上避免了R-VNS,但与L-VNS相比,R-VNS的症状性心脏并发症没有定期记录。心率检测不可靠的实例限制了心脏自动刺激的价值,应进一步研究。R-VNS在特定患者中似乎是安全有效的,尽管需要更大规模的研究来阐明长期安全性,并且已经描述了呼吸系统的副作用。
{"title":"Right vagal nerve stimulation for epilepsy – case series and systematic review of the literature","authors":"Kenneth Ong ,&nbsp;Michael A Rizzuto ,&nbsp;Maggie Hou ,&nbsp;Annika Weir ,&nbsp;Chantelle Hrazdil ,&nbsp;Ash Singhal ,&nbsp;Mostafa Fatehi","doi":"10.1016/j.yebeh.2025.110695","DOIUrl":"10.1016/j.yebeh.2025.110695","url":null,"abstract":"<div><h3>Background</h3><div>Vagus nerve stimulation (VNS) is an established therapy for refractory epilepsy, traditionally implanted on the left to avoid potential cardiac complications attributed to right-sided placement (R-VNS). These concerns are largely based on animal models, with limited human evidence.</div></div><div><h3>Methods</h3><div>To gain a deeper understanding of the field, we conducted a systematic review of all published cases of R-VNS and a retrospective review of all patients in our quaternary neurosurgical center (Vancouver General Hospital) who underwent R-VNS.</div></div><div><h3>Results</h3><div>The review identified nine studies involving 53 patients. Transient cardiac abnormalities occurred in four patients. Ten patients experienced non-cardiac side effects, typically wheezing or other respiratory side effects, with three requiring device deactivations. Seizure control was comparable in 74.2% of patients. Our institutional series of seven patients identified no cardiac complications. Three experienced transient non-cardiac symptoms, and one experienced hoarseness and stridor requiring stimulation adjustment. Six patients had prior L-VNS, with R-VNS providing similar seizure control in four cases. Two instances of unreliable heart rate detection by VNS were reported in our cohort.</div></div><div><h3>Conclusion</h3><div>This study presents an updated systematic review and institutional case series to better characterize the safety and efficacy of R-VNS. Although traditionally avoided due to cardiac concerns, symptomatic cardiac complications with R-VNS were not regularly documented compared to L-VNS. Instances of unreliable heart rate detection limited the value of cardiac auto-stimulation and should be further investigated. R-VNS appears safe and effective in select patients, though larger studies are needed to clarify long-term safety, and respiratory side effects have been described.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110695"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197541","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
Biomarker discovery in Lennox-Gastaut syndrome: Advances and challenges in electrophysiological, genetic, neuroimaging, and neuroinflammatory approaches lenox - gastaut综合征的生物标志物发现:电生理、遗传、神经影像学和神经炎症途径的进展和挑战
IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.yebeh.2025.110834
Debopam Samanta , Cemal Karakas , Anthony L. Fine , Amanda W. Pong , Hyun Yong Koh , Cynthia Keator , Tobias Loddenkemper , Ismail S. Mohamed , Gozde Erdemir , Tracy Dixon-Salazar , Fábio A. Nascimento , Sonal Bhatia , Babitha Haridas , Aaron E.L. Warren , Anup D. Patel
In Lennox-Gastaut Syndrome (LGS), a severe developmental and epileptic encephalopathy, the absence of validated biomarkers limits our ability to detect disease early, predict outcomes, and guide treatment strategies. This review synthesizes advances in biomarker research spanning electrophysiological, genetic, neuroimaging, and neuroinflammatory domains. Interictal electroencephalography (EEG) patterns such as slow spike-wave (SSW) and generalized paroxysmal fast activity (GPFA) remain diagnostic hallmarks and show potential as markers of disease progression and treatment response, though further standardization and validation are needed. Genetic testing reveals pathogenic variants in a substantial subset of patients, creating opportunities for precision medicine guided by disease mechanisms. Neuroimaging approaches, including diffusion magnetic resonance imaging (MRI), fluorodeoxyglucose–positron emission tomography (FDG-PET), and EEG–functional magnetic resonance imaging (EEG-fMRI), demonstrate widespread network abnormalities that may provide prognostic or treatment-relevant insights. Circulating molecular and inflammatory markers, such as microRNAs and cytokines, also show promise but remain in early stages of investigation. Overall, the development of reliable biomarkers in LGS will require multimodal integration, multicenter validation, and the application of artificial intelligence to advance toward predictive, preventive, and personalized care.
lenox - gastaut综合征(LGS)是一种严重的发育性和癫痫性脑病,缺乏有效的生物标志物限制了我们早期发现疾病、预测预后和指导治疗策略的能力。本文综述了生物标志物在电生理、遗传、神经影像学和神经炎症领域的研究进展。间隔期脑电图(EEG)模式,如慢峰波(SSW)和全面性阵发性快速活动(GPFA)仍然是诊断标志,并显示出潜在的疾病进展和治疗反应的标志,尽管需要进一步的标准化和验证。基因检测揭示了大量患者的致病变异,为以疾病机制为指导的精准医疗创造了机会。神经成像方法,包括扩散磁共振成像(MRI)、氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)和脑电图功能磁共振成像(EEG-fMRI),显示了广泛的网络异常,可能提供预后或治疗相关的见解。循环分子和炎症标志物,如microrna和细胞因子,也显示出希望,但仍处于早期研究阶段。总体而言,在LGS中开发可靠的生物标志物将需要多模式集成、多中心验证和人工智能的应用,以推进预测、预防和个性化护理。
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引用次数: 0
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Epilepsy & Behavior
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