Epilepsy & Behavior最新文献_第7页

Psychometric validation of the quality of life Inventory − Disability (QI-Disability) among patients with Lennox-Gastaut syndrome and Dravet syndrome lenox - gastaut综合征和Dravet综合征患者生活质量量表-残疾（qi -残疾）的心理计量学验证

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-12-02 DOI: 10.1016/j.yebeh.2025.110840

Drishti Shah , Peter Jacoby , Helen Doll , Hoan Do , J. Scott Andrews , Heather Romero , Gregor Gibson , Jenny Downs

Backgound.

To evaluate the psychometric properties of the Quality of Life Inventory −Disability (QI-Disability) for individuals with Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS), two rare developmental and epileptic encephalopathy conditions.

Methods

Cross-sectional data for individuals were drawn from the Adelphi DS & LGS Disease Specific Programme including the caregiver-reported QI-Disability and EQ-5D-5L, and physician-reported (7-point Likert scale) rating or quality of life. Factor structure of the QI-Disability was assessed using confirmatory factor analysis with goodness-of-fit statistics and internal consistency was assessed using Cronbach’s alpha. Convergent validity was assessed by evaluating relationships between QI-Disability, EQ-5D-5L scores, and physician QOL ratings.

Results

There were 154 patients with DS and 196 patients with LGS. The mean (SD) total QI-Disability score was 57.3 (SD 11.9) for DS and 58.9 (SD 13.8) for LGS. Fit statistics for the 6-factor QI-Disability model were mostly satisfactory; the factor loading for one item was unsatisfactory. Good internal consistency (alpha > 0.7) was found for all QI-Disability domains and for the total score in both LGS and DS groups. Convergent validity was demonstrated with correlations being as expected between QI-Disability and EQ-5D-5L scores, for example, strong correlations between the QI-Disability Physical Health and EQ-5D pain/discomfort dimension scores. There was a mean increase of approximately 3 points in the QI-Disability total score per unit category change in the physician-rated QOL scale.

Conclusions

QI-Disability had mostly satisfactory evidence of validity and reliability for DS and LGS and appears suitable for use in clinical practice and clinical trials.

Backgound。评估患有Dravet综合征（DS）或lenox - gastaut综合征（LGS）这两种罕见的发育性和癫痫性脑病的个体的生活质量量表-残疾（qi -残疾）的心理测量特性。方法个人的横断面数据来自Adelphi DS &； LGS疾病特定计划，包括护理人员报告的qi -残疾和EQ-5D-5L，以及医生报告的（7点李克特量表）生活质量评级。采用拟合优度统计的验证性因子分析评估qi -残疾的因素结构，采用Cronbach 's alpha评估内部一致性。通过评估QI-Disability、EQ-5D-5L评分和医师QOL评分之间的关系来评估收敛效度。结果DS患者154例，LGS患者196例。DS组和LGS组的平均（SD）总分分别为57.3分（SD 11.9）和58.9分（SD 13.8）。6因素QI-Disability模型的拟合统计结果大多令人满意；有一个项目的因子负载不令人满意。在所有QI-Disability域和LGS组和DS组的总分中发现了良好的内部一致性（alpha > 0.7）。QI-Disability与EQ-5D- 5l评分之间的相关性证明了收敛效度，例如，QI-Disability Physical Health与EQ-5D疼痛/不适维度评分之间存在强相关性。在医生评定的生活质量量表中，每单位类别变化的qi -残疾总分平均增加约3分。结论si -残障量表对DS和LGS的效度和信度证据基本满意，适用于临床实践和临床试验。

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引用次数: 0

Talking SUDEP: Gaps, confidence and training needs among Spanish epilepsy professionals 谈论猝死：西班牙癫痫专业人员的差距、信心和培训需求

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-12-02 DOI: 10.1016/j.yebeh.2025.110836

Je Ssy Low , Lance Watkins , Kevin Hampel , Laura Vilella , Rodrigo Rocamora , Paul Bassett , Rohit Shankar , Vicente Villanueva

Objective

Sudden Unexpected Death in Epilepsy (SUDEP) is a major cause of epilepsy-related mortality, yet discussions about SUDEP in clinical settings remain inconsistent. This study aimed to assess the perspectives, practices, and barriers related to SUDEP counselling for epilepsy professionals in Spain.

Methods

A cross-sectional online survey of 17 Likert style questions was disseminated via the Spanish Epilepsy Society between September 2023 and February 2024 to epilepsy professionals in Spain using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The survey was a validated instrument previously employed in similar international studies. Questions revolved around SUDEP communication and counselling. Descriptive and comparative analyses were conducted.

Results

54 professionals responded, with the majority being adult neurologists-epileptologists. While most respondents acknowledged the importance of SUDEP counselling, none reported discussing it with all patients. SUDEP was typically discussed in response to risk changes (85 %) or patient enquiry (47 %). Only 9 % used structured communication tools, and 28 % had access to bereavement support services. Perceived low clinical risk (74 %), concern about patient distress (62 %), and limited consultation time (57 %) were the most common barriers. Comparative analysis revealed no statistically significant differences between adult neurologists and paediatric neurologists, though paediatricians reported more negative counselling experiences.

Conclusions

Despite strong recognition of its importance, SUDEP communication in Spain is infrequent and inconsistent. Key barriers include clinical judgment, time constraints, and limited resources. The findings underscore the need for national guideline, structured tools, and targeted training to support routine SUDEP counselling in Spanish clinical practice.

目的癫痫猝死（SUDEP）是癫痫相关死亡的主要原因，但临床对SUDEP的讨论仍不一致。本研究旨在评估与西班牙癫痫专业人员猝死症咨询相关的观点、做法和障碍。方法于2023年9月至2024年2月期间，通过西班牙癫痫协会向西班牙的癫痫专业人员分发了17个Likert式问题的横断面在线调查，采用非概率抽样的非歧视性指数滚雪球技术。这项调查是以前在类似的国际研究中使用的一种有效的工具。问题围绕着SUDEP的沟通和咨询。进行了描述性和比较性分析。结果54名专业人员回应，其中大多数是成人神经科-癫痫科医生。虽然大多数受访者承认SUDEP咨询的重要性，但没有人报告与所有患者讨论过。SUDEP通常在应对风险变化（85%）或患者询问（47%）时进行讨论。只有9%的人使用结构化的沟通工具，28%的人可以获得丧亲支持服务。感知到较低的临床风险（74%）、对患者痛苦的担忧（62%）和有限的咨询时间（57%）是最常见的障碍。对比分析显示，成人神经科医生和儿科神经科医生之间没有统计学上的显著差异，尽管儿科医生报告的负面咨询经历更多。结论：尽管人们强烈认识到SUDEP的重要性，但在西班牙，SUDEP的沟通并不频繁且不一致。主要障碍包括临床判断、时间限制和有限的资源。研究结果强调了在西班牙临床实践中需要国家指南、结构化工具和有针对性的培训来支持常规SUDEP咨询。

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引用次数: 0

Post-vagus nerve stimulation mood and cognitive burden in dual epileptic–functional seizure patients 迷走神经刺激后癫痫-功能双重发作患者的情绪和认知负担

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-12-02 DOI: 10.1016/j.yebeh.2025.110837

Vishva Natarajan , Ravi Sandhu , Charles Mazof , Nicole Odom , Jennifer Hong

Objective

To evaluate neuropsychiatric burden in the understudied population of patients with dual diagnoses of epileptic seizures (ES) and functional seizures (FS) who have received vagus nerve stimulation (VNS).

Methods

In this retrospective study, adults with dual diagnoses of ES and FS who underwent VNS at a tertiary care center between 2015 and 2024 were identified via ICD-10 codes and confirmed by video-electroencephalography (VEEG). Propensity score matching generated two control groups: (1) patients with ES only with VNS, and (2) patients with dual ES and FS without VNS. Longitudinal patient-reported outcomes, including seizure frequency, NDDI-E, and the QOLIE-31 Cognitive subscale, were analyzed using time-weighted averaging and nonparametric statistics.

Results

Eight patients with dual ES and FS who received VNS were matched to eight in each control group. The dual-diagnosis patients with VNS implants had significantly higher seizure frequency than those without VNS implants (median seizure frequency = 14.1 vs. 2.2, p = 0.001). Among patients with VNS implants, those with dual diagnoses had significantly greater depressive symptoms (median NDDI-E = 16.4 vs. 8.8, p = 0.015) compared to those with ES alone. Significant differences in cognitive quality of life were not observed.

Significance

Dual-diagnosis patients exhibited higher seizure reporting after VNS therapy compared to those without VNS and higher depressive burden compared to patients with ES alone, patterns that may reflect the underlying severity of FS-related comorbidity. These exploratory results support careful pre-implant counselling and highlight the need for prospective studies with baseline assessments to clarify outcomes in this complex population.

目的评估接受迷走神经刺激（VNS）治疗的癫痫性发作（ES）和功能性发作（FS）双重诊断患者的神经精神负担。方法回顾性研究2015年至2024年间在三级保健中心接受VNS治疗的ES和FS双重诊断的成人，通过ICD-10代码进行识别，并通过视频脑电图（VEEG）进行确认。倾向评分匹配产生两个对照组：(1)仅伴VNS的ES患者和(2)伴VNS的双ES和FS患者。纵向患者报告的结果，包括癫痫发作频率、NDDI-E和QOLIE-31认知量表，采用时间加权平均和非参数统计进行分析。结果8例接受VNS治疗的双ES和FS患者与对照组8例相匹配。双重诊断的VNS植入患者的癫痫发作频率明显高于未植入VNS的患者（中位癫痫发作频率= 14.1比2.2,p = 0.001）。在植入VNS的患者中，与单独植入ES的患者相比，双重诊断的患者抑郁症状明显加重（中位NDDI-E = 16.4 vs. 8.8, p = 0.015）。在认知生活质量方面未观察到显著差异。双重诊断的患者在接受VNS治疗后癫痫发作报告高于未接受VNS治疗的患者，抑郁负担高于单独接受ES治疗的患者，这些模式可能反映了fs相关合并症的潜在严重程度。这些探索性结果支持仔细的植入前咨询，并强调需要进行基线评估的前瞻性研究，以明确这一复杂人群的结果。

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引用次数: 0

The seen and unseen facets of Dravet syndrome across the disease trajectory: Insights from European ethnographic research 德拉韦综合征在疾病轨迹上可见和不可见的方面：来自欧洲人种学研究的见解

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-28 DOI: 10.1016/j.yebeh.2025.110809

Liam Dorris , Luis Miguel Aras , Marion Danse , Nadine Benzler , Caroline Hachon-Le Camus , Francesca Darra , Carmen Fons , Robert Robinson , Nils Holert , Pauline Afonso , Perrine Hugon , Selva Gaberscek , Letizia Nardi , Nicola Specchio , Rima Nabbout

Background

We investigated the lived experiences of individuals within the ecosystem of Dravet syndrome (DS) (patients, families, healthcare professionals, patient representatives) to gain a holistic understanding of the reality of caring for an individual with DS.

Methods and Results

Using ethnographic methodology, we interviewed and observed five families (seven parents) of children (aged 2–10 years) with DS, 21 healthcare professionals at five specialized epilepsy units, and 16 personnel working for patient organizations across France, Germany, Italy, Spain, and the UK, to explore aspects of daily life with DS. Observations from the study participants demonstrated that families are impacted by multiple factors within the DS ecosystem, in terms of position in society, daily life and environment, and family dynamics. Parents’ informational, logistical, economic, and psychological needs differ over the course of the disease (first seizure, quest for diagnosis, diagnosis, reconfiguration, trial and error, stabilization, adjustments, adolescence, adulthood) in response to practical and emotional challenges. A framework was developed to define how parents cope and manage the information provided to them and the choices they must negotiate as the DS journey evolves. Four key territories of opportunity were identified.

Conclusions

Families of children with DS have complex and changing challenges related to different phases of their child’s development and disease progression. Our findings may assist those working with families to identify key challenges and provide support specific to individual needs. Our findings could help clinicians adapt their communication, ultimately improving the quality of care provided and the quality of life of the different stakeholders.

背景：我们调查了Dravet综合征（DS）生态系统中个体（患者、家庭、医疗保健专业人员、患者代表）的生活经历，以全面了解照顾DS患者的现实。方法和结果采用民族志方法，我们采访并观察了5个儿童（2-10岁）的家庭（7名家长），5个癫痫专科医院的21名医护人员，以及来自法国、德国、意大利、西班牙和英国患者组织的16名工作人员，以探讨DS患者的日常生活方面。研究参与者的观察结果表明，在DS生态系统中，家庭受到社会地位、日常生活和环境以及家庭动态等多种因素的影响。父母的信息、后勤、经济和心理需求在疾病的整个过程中（首次发作、寻求诊断、诊断、重新配置、试错、稳定、调整、青春期、成年期）不同，以应对实际和情感上的挑战。制定了一个框架来定义家长如何处理和管理提供给他们的信息，以及随着DS旅程的发展，他们必须协商的选择。确定了四个关键的机会领域。结论退行性痴呆患儿的家庭面临着复杂多变的挑战，与患儿发育和疾病进展的不同阶段有关。我们的研究结果可以帮助那些与家庭一起工作的人识别主要挑战，并为个人需求提供具体的支持。我们的研究结果可以帮助临床医生调整他们的沟通，最终提高所提供的护理质量和不同利益相关者的生活质量。

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引用次数: 0

Epilepsy beyond seizures: embracing a holistic perspective. Proceedings of the 2nd meeting (Episicily) of the epilepsy study group of the Italian Society of neurology 超越癫痫发作的癫痫：拥抱整体视角。意大利神经病学学会癫痫研究小组第2次会议论文集

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-26 DOI: 10.1016/j.yebeh.2025.110756

Angelo Labate , Eleonora Palma , Vincenzo Belcastro , Paolo Bonanni , Antonio Cerasa , Emanuele Cerulli Irelli , Duma Gian Marco , Maurizio Elia , Edoardo Ferlazzo , Francesco Fortunato , Alfredo D’Aniello , Felice D’Arco , Carlo Di Bonaventura , Giancarlo Di Gennaro , Antonino F Germanò , Loretta Giuliano , Francesca Granata , Angelina Laganà , Claudio Liguori , Adriana Magaudda , Marco Mula

The purpose of the second meeting of the Epilepsy Study Group of the Italian Society of Neurology, held in Sicily, Italy, and titled “Episicily” was on a new holistic approach to people with epilepsy. The most important points that the experts at the conference addressed and considered significant were the modern clinical approach of a physician dedicated to epilepsy that requests multidisciplinary collaboration and a dynamic vision throughout new diagnostic procedures. Then, the new antiseizures medications and their peculiarities, the role of neuroinflammation and finally the bidirectional relationship with sleep disorders.

意大利神经病学学会癫痫研究小组第二次会议在意大利西西里岛举行，会议题为“Episicily”，会议的目的是对癫痫患者采取一种新的整体方法。专家们在会议上讨论并认为意义重大的最重要的一点是，癫痫医生的现代临床方法要求多学科合作和贯穿新诊断程序的动态视野。然后，新的抗癫痫药物及其特点，神经炎症的作用，最后与睡眠障碍的双向关系。

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引用次数: 0

Determinants of quality of life in Pediatric Epilepsy: A study from a single tertiary center 儿童癫痫患者生活质量的决定因素：来自单一三级中心的研究。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-25 DOI: 10.1016/j.yebeh.2025.110807

Farheen Ahmed , Hanem Abdalla Ali , Abrar Musa , Mahmoud Fawzi , Ruba Benini

Objective

Epilepsy profoundly impacts a child’s Quality of Life (QoL). This study sought to identify factors affecting QoL in children with epilepsy (CWE) at a single pediatric tertiary hospital, identifying key influencing factors to guide interventions.

Study Design: A cross-sectional study was conducted involving 400 CWE (5–18 years) and their caregivers using the Pediatric Quality of Life Inventory^TM (PedsQL^TM). Demographic and clinical variables were obtained. Statistical analysis was used to identify predictors of QoL.

Results

Participants were predominantly from the MENA and South Asia regions; 59 % had epilepsy onset before age 5; 53 % were on monotherapy and 32 % were seizure-free in the prior year. Male gender and school attendance were associated with higher QoL scores. In contrast, early seizure onset, polytherapy, comorbidities, previous epilepsy surgery, and frequent seizures were linked to lower QoL scores. Domain-level analysis highlighted significant age-related declines in the cognitive functioning, sleep/fatigue, and mood/behavior domains. In multiple linear regression, older age and comorbidities independently predicted lower QoL, while school attendance predicted higher QoL. Caregiver identity also influenced scores, with mothers reporting lower QoL for their children. The model explained ∼ 38 % of the variance in parent-reported QoL. In binary logistic regression, comorbidities and mother as respondent were the strongest predictors of lower odds of favorable QoL (model fit p = 0.09; R² ≈ 0.35). For child-reported QoL, univariate associations were limited, and multivariable modeling was not performed.

Conclusions

QoL in CWE is influenced by both medical and psychosocial factors, emphasizing the need for holistic, individualized epilepsy care.

目的：癫痫对儿童生活质量的影响。本研究旨在确定影响某一儿科三级医院癫痫患儿生活质量的因素，确定关键影响因素以指导干预措施。研究设计：采用儿童生活质量量表（PedsQLTM）对400名CWE（5-18岁）及其护理人员进行横断面研究。获得人口学和临床变量。采用统计分析确定生活质量的预测因素。结果：参与者主要来自中东和北非和南亚地区；59%的患者在5岁前癫痫发作；53%的患者接受单药治疗，32%的患者上一年无癫痫发作。男性性别和学校出勤率与较高的生活质量得分有关。相反，早期癫痫发作、多种治疗、合并症、既往癫痫手术和频繁癫痫发作与较低的生活质量评分有关。领域水平的分析强调了认知功能、睡眠/疲劳和情绪/行为领域与年龄相关的显著下降。在多元线性回归中，年龄和合并症独立预测较低的生活质量，而上学率预测较高的生活质量。照顾者的身份也会影响得分，母亲报告说她们孩子的生活质量较低。该模型解释了父母报告的生活质量中约38%的差异。在二元logistic回归中，合并症和母亲作为应答者是较低的良好生活几率的最强预测因子（模型拟合p = 0.09; R2≈0.35）。对于儿童报告的生活质量，单变量关联有限，未进行多变量建模。结论：CWE患者的生活质量受到医学和社会心理因素的影响，强调需要全面、个性化的癫痫护理。

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引用次数: 0

Advances in multimodal artificial intelligence models for epilepsy research 癫痫多模态人工智能模型研究进展。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-24 DOI: 10.1016/j.yebeh.2025.110811

Xinye Xie , Peng Chen , Huixian Liu , Dedong Wang , Yue Wang , Ruohong Xue , Mengyuan Xu , Siqi Wang , Yuanfang Duan , Mengyao Zhou , Kang Du , Haohao Wu

Epilepsy, a prevalent and complex neurological disorder,poses significant challenges in clinical diagnosis and treatment due to its heterogeneous classifications,diverse etiologies,frequent lack of physician-witnessed episodes, and varied therapeutic approaches. The deep integration of Artificial Intelligence (AI) into healthcare has emerged as a promising solution. However, most existing epilepsy-related AI models primarily rely on single-data inputs, which struggle to address the complexity of epilepsy. Consequently, in recent years, the research and development of multimodal AI models-leveraging diverse and complex datasets, have gained momentum and demonstrated substantial advantages.

This article reviews the current applications of multimodal AI models in epilepsy detection devices, diagnosis, treatment, and outcome prognosis, summarizing research hotspots and future trends. It aims to provide valuable insights for building more precise and comprehensive AI-driven epilepsy management systems.

癫痫是一种普遍而复杂的神经系统疾病，由于其分类不同、病因多样、经常缺乏医生目击发作以及治疗方法多样，在临床诊断和治疗方面面临重大挑战。人工智能（AI）与医疗保健的深度整合已成为一种有前途的解决方案。然而，大多数现有的癫痫相关人工智能模型主要依赖于单一数据输入，难以解决癫痫的复杂性。因此，近年来，利用多样化和复杂数据集的多模态人工智能模型的研究和开发势头强劲，并显示出巨大的优势。本文综述了多模态AI模型在癫痫检测装置、诊断、治疗、预后预测等方面的应用现状，总结了研究热点和未来发展趋势。它旨在为建立更精确和全面的人工智能驱动的癫痫管理系统提供有价值的见解。

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引用次数: 0

Replication of an evidence-based epilepsy self-management program in Georgia (USA): The HOBSCOTCH trial 格鲁吉亚（美国）循证癫痫自我管理项目的复制：HOBSCOTCH试验。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-23 DOI: 10.1016/j.yebeh.2025.110805

Cam Escoffery , Archna Patel , Katie L Bullinger , Robin E. McGee , Jerik Leung , Taylor Shade , Shreya Shankar , Erica K. Johnson , Barbara C. Jobst , Elaine T. Kiriakopoulos

Background

The efficacy of Managing Epilepsy Well Network (MEWN) self-management programs is well-established. The purpose of this study was to replicate the HOBSCOTCH program to evaluate program implementation and assess effectiveness on patient cognition, quality of life and self-management behaviors.

Methods

Participants from clinical and community settings were recruited and randomized to intervention vs waitlist control. Program outcomes assessing quality of life, cognition, treatment adherence, depressive symptoms, and self-management behavior were measured at baseline and 3 months. Program staff provided survey data guided by the RE-AIM model regarding program delivery and acceptability, appropriateness, and feasibility. Data were analyzed using descriptive statistics, linear regression, and qualitative methods.

Results

This predominantly female (69 %) and White (64 %) sample (N = 61) with active epilepsy (66 % had a seizure in the past year) also had a higher portion of Black (32 %) participants. Analyses yielded significant differences in cognition, quality of life and self-management behaviors between the two groups at follow-up. Staff indicated the packaged intervention, remote delivery, trained coaches and investment of leaders/clinical staff as intervention benefits. Implementation barriers included difficulty contacting participants and mental health concerns. Program appropriateness and feasibility ratings were high; 98 % reported that they very much or moderately enjoyed working with their coach and would recommend the program to others.

Conclusion

HOBSCOTCH was effective in increasing cognition and quality of life in people with epilepsy in this replication study. A novel finding highlighted changes in the frequency of participants’ self-management behaviors. These findings have implications for healthcare systems incorporating evidence-based self-management programs for their patients.

背景：管理癫痫网络（MEWN）自我管理项目的有效性是公认的。本研究的目的是复制HOBSCOTCH计划，以评估计划的实施情况，并评估患者认知、生活质量和自我管理行为的有效性。方法：从临床和社区环境中招募参与者，随机分为干预组和候补组。评估生活质量、认知、治疗依从性、抑郁症状和自我管理行为的项目结果在基线和3个月时进行测量。项目人员根据RE-AIM模型提供了关于项目交付、可接受性、适当性和可行性的调查数据。数据分析采用描述性统计、线性回归和定性方法。结果：这主要是女性（69%）和白人（64%）样本（N = 61）活动性癫痫（66%在过去一年中发作）也有较高比例的黑人（32%）参与者。分析结果显示，两组患者在认知、生活质量和自我管理行为方面存在显著差异。员工认为干预的好处包括一揽子干预、远程交付、训练有素的教练和领导/临床人员的投入。实施障碍包括难以联系参与者和心理健康问题。方案适宜性和可行性评分较高；98%的受访者表示，他们非常或比较喜欢和教练一起工作，并会把这个项目推荐给其他人。结论：在这项重复性研究中，HOBSCOTCH可有效提高癫痫患者的认知能力和生活质量。一项新的发现强调了参与者自我管理行为频率的变化。这些发现对医疗保健系统纳入基于证据的自我管理方案的患者具有启示意义。

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引用次数: 0

Serum metabolome and gut microbiome to analyze potential mechanisms of catamenial epilepsy 血清代谢组和肠道微生物组分析羊膜癫痫的潜在机制

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-22 DOI: 10.1016/j.yebeh.2025.110808

Yujie Chen , Yiting Deng , Enhui Zhang, Nanya Hao, Zhujing Ou, Raowei Yan, Muke Zhou, Hesheng Zhang, Dong Zhou, Xintong Wu

Background

Catamenial epilepsy (CE) is marked by an increase in seizure frequency during specific phases of the menstrual cycle. Advanced techniques such as serum metabolomics and 16S rRNA sequencing are being employed to investigate potential mechanisms and therapeutic approaches for managing CE.

Methods

A total of 30 epilepsy patients (15 with CE and 15 temporal epilepsy) along with 15 healthy controls, were enrolled in this study. Human fecal samples and serum were collected for metabolomics analysis and 16S rDNA sequencing, respectively.

Results

A total of 117 candidate metabolites and eight gut microbiota specific to CE were identified. Glycerophospholipid pathways were the most enriched among the candidate metabolites. Notably, serum lysophosphatidylinositol (LPI) 20:4 was associated with an increased seizure frequency. Additionally, differential gut metabolites were found to affect γ-aminobutyric acid degradation. A network linking sex hormones, metabolites, and gut microorganisms was constructed.

Conclusion

Findings clarify metabolite-microbiome-brain axis interactions, aiding CE pathogenesis understanding.

背景：羊膜性癫痫（CE）的特点是在月经周期的特定阶段发作频率增加。血清代谢组学和16S rRNA测序等先进技术被用于研究CE的潜在机制和治疗方法。方法选取30例癫痫患者（CE 15例，颞叶癫痫15例）和15例健康对照。采集人类粪便和血清分别进行代谢组学分析和16S rDNA测序。结果共鉴定出117个候选代谢物和8个CE特异性肠道微生物群。在候选代谢物中，甘油磷脂途径是最丰富的。值得注意的是，血清溶血磷脂酰肌醇（LPI） 20:4与癫痫发作频率增加有关。此外，发现不同的肠道代谢物影响γ-氨基丁酸的降解。一个连接性激素、代谢物和肠道微生物的网络被构建。结论研究结果阐明了代谢物-微生物组-脑轴的相互作用，有助于了解CE的发病机制。

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引用次数: 0

Localization and duration dependent effects of pediatric refractory epilepsy on language function 小儿难治性癫痫对语言功能的定位和持续时间依赖性影响

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-22 DOI: 10.1016/j.yebeh.2025.110813

Brian Ervin , Yash Agarwal , Jason Buroker , Craig Scholle , Leonid Rozhkov , Taylor Cummins , Anna W. Byars , Paul S. Horn , Jesse Skoch , Francesco T. Mangano , Katherine D. Holland , Jeffrey R. Tenney , Hansel M. Greiner , Ravindra Arya

Introduction

We studied effects of duration of epilepsy and location of epileptogenic zone (EZ) on visual naming (VN) and auditory naming (AN) response latencies in pediatric focal drug-resistant epilepsy. We also analyzed temporal profiles of high-gamma modulations (HGMs) during VN and AN in peri-sylvian language areas, with respect to AN and VN response latencies.

Methods

Kernel density distributions of AN and VN response latencies were k-means clustered, and the resulting groups were compared for relevant outcomes. Response latencies and kernel densities were analyzed as functions of age, age of seizure onset, and duration of epilepsy using linear mixed-effects models.

Results

Shorter response latencies and higher peak densities (more consistent response times) were associated with shorter duration of epilepsy, older age at seizure onset, localized EZ, and higher proportion of seizure-freedom (80 % vs 41 %). Response latencies shortened with age and age of seizure onset and lengthened with increasing duration of epilepsy. Peak kernel densities, indicating consistency of responses, increased with age and age of seizure onset, and decreased with duration of epilepsy. Epilepsy duration over 5.9 years for AN and over 5.3 years for VN were associated with a higher likelihood of prolonged response latencies. Temporal envelopes for HGM during AN were different in the Broca’s area for patients with short and long response latencies. Also, HGM envelopes during VN were different in the visual cortex for these 2 groups.

Conclusion

The duration-dependent network dysfunction in refractory epilepsy, interfering with naming, supports early surgical intervention before language function is irreversibly compromised.

我们研究了癫痫持续时间和癫痫区（EZ）位置对小儿局灶性耐药癫痫视觉命名（VN）和听觉命名（AN）反应潜伏期的影响。我们还分析了周边语言区在VN和AN期间的高伽马调制（HGMs）的时间分布，以及AN和VN的响应延迟。方法采用k均值聚类方法对AN和VN反应潜伏期的核密度分布进行聚类，并比较结果组的相关结果。使用线性混合效应模型分析反应潜伏期和核密度作为年龄、癫痫发作年龄和癫痫持续时间的函数。结果更短的反应潜伏期和更高的峰密度（更一致的反应时间）与癫痫持续时间更短、癫痫发作年龄更大、局部EZ和癫痫自由比例更高（80%对41%）相关。反应潜伏期随年龄和癫痫发作年龄而缩短，随癫痫持续时间的增加而延长。峰核密度，表明反应的一致性，随着年龄和癫痫发作的年龄而增加，随着癫痫的持续时间而减少。AN患者癫痫持续时间超过5.9年，VN患者癫痫持续时间超过5.3年与反应潜伏期延长的可能性较高相关。对于反应潜伏期短和反应潜伏期长的患者，AN期间HGM的颞包膜在Broca区是不同的。两组视皮层HGM包膜在VN期间也存在差异。结论难治性癫痫患者的持续时间依赖性网络功能障碍干扰命名，支持在语言功能出现不可逆损害前进行早期手术干预。

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