Epilepsy & Behavior最新文献_第8页

Preserved social behavior recognition in patients with epilepsy 癫痫患者保留的社会行为识别

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-21 DOI: 10.1016/j.yebeh.2025.110796

Anna Rita Giovagnoli , Manfredi Sateriale , Giuseppe Didato , Roberta Di Giacomo

Objectives

Recognition of the social behaviors is a multifaceted function on the borderline between neuroscience and social science. In neurological patients, it may be influenced by brain damage, cognition, and psychological distress. This study aimed to clarify whether social behavior recognition can be preserved in patients with temporal lobe epilepsy (TLE) and whether empathy, executive functions and anxiety may play an influential role.

Methods

The Social Situations Test (SST), Empathy Questionnaire (EQ), State Trait Anxiety Inventory (STAI), Phonemic Word Fluency (PWF), and Raven Colored Progressive Matrices (RCPM) were used to assess the ability to recognize normative behaviors and violations, empathy, anxiety, strategic search, and abstraction in patients with TLE and healthy controls (HCs).

Results

Compared to 56 HCs, 75 patients with TLE obtained the same SST scores, but showed lower scores at the EQ, PWF, and RCPM and higher levels of anxiety. In the patients’ group, the SST scores were predicted by the EQ and PWF scores, while the RCPM and STAI scores, demographics, and epilepsy-related variables had no effects. In the HCs, the EQ score only predicted the SST scores. Patients with different temporal lobe lesions and HCs showed similar SST scores.

Conclusions

Patients with TLE maintain a good ability to recognize the appropriateness of social behavior and violations of social norms, which is closely linked to empathy and strategic research. This study, the first addressing these aspects together in TLE, adds positive information to the cognitive phenotype. Further studies are needed to understand social behavior in epilepsy.

目的社会行为的识别是神经科学与社会科学的交叉领域。在神经系统患者中，它可能受到脑损伤、认知和心理困扰的影响。本研究旨在阐明颞叶癫痫（TLE）患者的社会行为识别是否可以保留，以及共情、执行功能和焦虑是否可能发挥影响作用。方法采用社会情境测验（SST）、共情问卷（EQ）、状态特质焦虑量表（STAI）、音位词流畅性量表（PWF）和Raven Colored Progressive Matrices量表（RCPM）评估TLE患者和健康对照（hc）的规范行为和违规行为识别能力、共情能力、焦虑能力、策略搜索能力和抽象能力。结果与56例hc患者相比，75例TLE患者的SST得分相同，但EQ、PWF和RCPM得分较低，焦虑水平较高。在患者组中，SST分数由EQ和PWF分数预测，而RCPM和STAI分数、人口统计学和癫痫相关变量没有影响。在高收入者中，EQ分数仅预测SST分数。不同颞叶病变和hcc患者的SST评分相似。结论TLE患者对社会行为适当性和违反社会规范的认知能力较好，这与共情和策略研究密切相关。这项研究首次在TLE中对这些方面进行了研究，为认知表型增加了积极的信息。需要进一步的研究来了解癫痫的社会行为。

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引用次数: 0

Experiences of women of childbearing age with epilepsy throughout their motherhood journey: Results from a social media listening study 患有癫痫的育龄妇女在成为母亲过程中的经历：一项社交媒体倾听研究的结果

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-21 DOI: 10.1016/j.yebeh.2025.110799

Gus A. Baker , Dimitrios Bourikas , Agnes Koncz , A. Michelle Manzo , Michelle Shell , Konrad J. Werhahn , Andrea L. Wilkinson , Torie Robinson , Jessica K. Smith

Objectives

To provide insights into experiences of women with epilepsies (WWE) of childbearing age and identify their unmet needs.

Methods

We conducted a social media listening study (January 2020-January 2021) across public accounts from six countries to capture posts related to issues associated with the epilepsy motherhood journey.

Results

∼246,000 posts were analyzed. Keyword filtering identified conversation around key stages: preventing and planning pregnancy; conception and fertility; early/late pregnancy and childbirth; breastfeeding and parenthood. Thematic analysis revealed four key themes: (i) uncertainty and fear arise when changing treatments; (ii) worries are intensified by inconsistent communications from/among healthcare professionals (HCPs) and lack of information on how antiseizure medications (ASMs) may affect the developing embryo/fetus; fears about ASM safety grow due to concerns about fetus/child development; (iii) providing safe environment for fetus/infant becomes paramount, but balance is needed to achieve seizure control; (iv) WWE experience challenges, with multiple barriers to safe pregnancy and parenthood, including lack of access to information that supports shared decision making.

Conclusions

WWE want to be empowered through knowledge and need support in finding relevant information at the right time in their motherhood journey to increase their confidence in shared decision making. Often, information is not provided by clinicians or is difficult to obtain. WWE receive conflicting information, while questions remain unanswered, leading to confusion/heightened anxiety. WWE seek answers from sources other than HCPs, including peers. WWE and families need better support; providing relevant plain-language information at the right stage would enable a more informed motherhood journey experience.

目的了解育龄期癫痫妇女的经历，确定其未满足的需求。方法：我们对来自六个国家的公共账户进行了一项社交媒体倾听研究（2020年1月至2021年1月），以捕捉与癫痫母亲旅程相关问题的帖子。结果分析了约24.6万个帖子。关键词过滤识别关键阶段的对话：预防和计划怀孕；受孕和生育；早/晚怀孕和分娩；母乳喂养和为人父母。专题分析揭示了四个关键主题：(i)改变治疗方法时产生的不确定性和恐惧；（ii）医疗保健专业人员（HCPs）之间不一致的沟通和缺乏关于抗癫痫药物（asm）如何影响发育中的胚胎/胎儿的信息，加剧了人们的担忧；由于对胎儿/儿童发育的担忧，对ASM安全性的担忧日益增加；（iii）为胎儿/婴儿提供安全的环境是最重要的，但需要平衡以实现癫痫的控制；（iv） WWE面临挑战，在安全怀孕和生育方面存在多种障碍，包括缺乏获得支持共同决策的信息的途径。结论女性希望通过知识获得力量，并需要在母亲旅程的正确时间找到相关信息的支持，以增加她们共同决策的信心。通常，这些信息不是由临床医生提供的，或者很难获得。WWE收到相互矛盾的信息，而问题仍然没有答案，导致混乱/高度焦虑。WWE从hcp以外的来源寻求答案，包括同行。WWE和家庭需要更好的支持；在适当的阶段提供相关的简单语言信息将使母亲的旅程体验更加知情。

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引用次数: 0

Multimodal imaging biomarkers in intractable temporal lobe Epilepsy: A comparative study of structural–functional coupling and ALFF 难治性颞叶癫痫的多模态成像生物标志物：结构-功能耦合和ALFF的比较研究。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-19 DOI: 10.1016/j.yebeh.2025.110804

Chuanyong Qu , Zexiang Chen , Cuimi Luo , Lu Qin , Dongying Huang , Xiao Zhang , Ligen Fan , Jinou Zheng

Background

Intractable temporal lobe epilepsy (ITLE) remains a clinical challenge due to its resistance to standard treatments and its profound impact on cognitive function. Multimodal neuroimaging techniques offer potential biomarkers for diagnosis and treatment monitoring, yet comparative evaluations of their utility remain limited.

Methods

We conducted a longitudinal study comparing structural–functional coupling (SFC) and amplitude of low-frequency fluctuations (ALFF) between ITLE patients (pre- and post-treatment) and healthy controls. Regional features were extracted from resting-state functional Magnetic Resonance Imaging and diffusion tensor imaging, followed by machine learning-based classification and clustering analyses. Cognitive function was assessed via Montreal Cognitive Assessment (MoCA).

Results

Both SFC and ALFF were significantly altered in ITLE, with partial normalization after treatment. ALFF showed superior classification accuracy (92.45%) compared to SFC (81.13%), with abnormalities predominantly in the frontal lobe. In contrast, SFC alterations localized to the occipital lobe correlated more strongly with MoCA improvements. Subgroup clustering revealed that longitudinal changes in SFC better predicted cognitive recovery.

Conclusions

Our findings highlight the complementary value of ALFF and SFC in ITLE: ALFF excels in diagnostic differentiation, while SFC more effectively tracks cognitive outcomes. A multimodal framework incorporating both metrics may enhance personalized management strategies in ITLE.

背景：顽固性颞叶癫痫（ITLE）由于其对标准治疗的抵抗和对认知功能的深刻影响，仍然是一个临床挑战。多模态神经成像技术为诊断和治疗监测提供了潜在的生物标志物，但对其效用的比较评估仍然有限。方法：我们进行了一项纵向研究，比较了ITLE患者（治疗前和治疗后）与健康对照之间的结构-功能耦合（SFC）和低频波动幅度（ALFF）。从静息状态功能磁共振成像和扩散张量成像中提取区域特征，然后进行基于机器学习的分类和聚类分析。认知功能通过蒙特利尔认知评估（MoCA）进行评估。结果：ITLE患者SFC和ALFF均有明显改变，治疗后部分恢复正常。ALFF的分类准确率（92.45%）高于SFC(81.13%)，异常主要发生在额叶。相反，位于枕叶的SFC改变与MoCA改善的相关性更强。亚组聚类显示SFC的纵向变化能更好地预测认知恢复。结论：我们的研究结果突出了ALFF和SFC在tle中的互补价值：ALFF在诊断分化方面表现出色，而SFC更有效地追踪认知结果。结合这两种指标的多模式框架可以增强ITLE的个性化管理策略。

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引用次数: 0

Electrical stimulation for the induction of seizures is safe, well-tolerated and high-yield in children with drug-resistant epilepsy 电刺激诱导癫痫发作对耐药癫痫儿童是安全、耐受性良好和高产的。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-17 DOI: 10.1016/j.yebeh.2025.110740

Lucy Tarcha , Darcy A. Krueger , Hansel M. Greiner , Jesse Skoch , Francesco T. Mangano , Ravindra Arya , S. Katie Z. Ihnen

Introduction

Drug-refractory epilepsy (DRE) affects one-third of children with epilepsy and can be treated with surgery. The surgical target is determined by recording spontaneous seizures during stereoelectroencephalography (sEEG). In adults, induced seizures help define the surgical target and predict favorable outcomes. No studies focus on the safety, tolerability, and yield of electrical stimulation for the induction of seizures (ESIS) in children.

Methods

Stimulation at 1 Hz and 50 Hz was performed prospectively and comprehensively (all gray matter channels) during sEEG in children and young adults with DRE. Induced seizures were categorized as electroclinical habitual, clinical habitual (aura), subclinical and non-habitual. Primary safety outcome was rescue medication use. Tolerability was assessed by questionnaire. Yield was induced seizure rate.

Results

Sixty-seven patients (n = 30 female) participated during 70 admissions. Patients were 1–21 years old (mean ± SD, 11.1 ± 5.7). n = 10,135 stimulation trials were performed, requiring 175 ± 61 min per patient. One seizure required rescue medication. Tolerability ratings were favorable and improved from pre- to post-session. At least one induced seizure was obtained in 62/70 (89 %) sessions, representing 283/10,135 trials (2.8 %). Combined, habitual seizures and habitual auras accounted for 58 % of induced seizures; non-habitual seizures were uncommon (12 %). Of those with induced seizures, multiple seizure types occurred in 28/62 (45 %). Seizures were induced at 1 Hz and 50 Hz in 22/67 patients (33 %).

Significance

Seizure stimulation during sEEG is safe, well-tolerated, and high-yield in children at both 1 Hz and 50 Hz. These findings motivate a more systematic utilization of ESIS in pediatric patients.

药物难治性癫痫（DRE）影响三分之一的癫痫患儿，可通过手术治疗。手术目标是通过立体脑电图（sEEG）记录自发性癫痫发作来确定的。在成人中，诱发性癫痫发作有助于确定手术目标和预测良好的结果。没有研究关注电刺激诱导儿童癫痫发作（ESIS）的安全性、耐受性和产率。方法：对患有DRE的儿童和青年进行前瞻性和全面（所有灰质通道）的1hz和50hz刺激。诱发性癫痫发作分为电临床习惯性、临床习惯性（先兆）、亚临床和非习惯性。主要安全性指标为抢救用药。采用问卷法评估耐受性。产量为诱发癫痫发作率。结果：70例住院患者共67例（女性30例）。患者年龄1 ~ 21岁（平均±SD， 11.1±5.7）。共进行了10135次刺激试验，每位患者需要175±61分钟。有一次癫痫发作需要抢救药物。从治疗前到治疗后，耐受性评分是有利的。在62/70（89%）次试验中，即283/10,135次试验（2.8%）中至少发生了一次诱发性癫痫发作。习惯性发作和习惯性先兆合计占诱发性发作的58%；非习惯性癫痫发作不常见（12%）。在诱发性癫痫发作的患者中，有28/62（45%）发生多种癫痫发作类型。67例患者中有22例（33%）在1hz和50hz诱发癫痫发作。意义：在儿童中，1 Hz和50 Hz的癫痫刺激是安全的、耐受性良好的和高产的。这些发现促使在儿科患者中更系统地使用ESIS。

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引用次数: 0

Toward a multimodal model of internalized epilepsy stigma 内化癫痫病耻感的多模态模型。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-17 DOI: 10.1016/j.yebeh.2025.110812

Sarah Prieto , Elaine T. Kiriakopoulos , Allyson Goldstein , Sarah Kaden , Geoffrey Tremont , Kunal Mankodiya , Elijah Castillo , Shehjar Sadhu , Dhaval Solanki , Jennifer D. Davis , Seth A. Margolis

This work elaborates the theoretical foundations of the RISE ABOVE program and presents a Multimodal Model of Internalized Stigma among people with epilepsy (PWE). The model integrates established behavioral science theories—including stress and coping, self-efficacy, learned helplessness, and cognitive-behavioral frameworks—to explain how stigma-related triggers, appraisals, and maladaptive cognitive–emotional–behavioral cycles culminate in self-reinforcing internalized stigma that may intersect with other stigmatized aspects of identity. In contrast to the psychoanalytic and post-rationalist perspectives proposed by Di Gennaro, Grammaldo, and Tomasini, our model offers concrete, evidence-informed pathways for intervention through conscious self-regulation and coping skill development. RISE ABOVE applies this framework through structured self-management exercises that enhance understanding of internalized stigma, strengthen stress management and psychological flexibility, and empower adaptive responses to stigma-related challenges. Prior findings demonstrate reductions in perceived stigma and improvements in psychosocial outcomes following RISE ABOVE completion, supporting the model’s utility for informing stigma-focused interventions.

这项工作阐述了RISE ABOVE计划的理论基础，并提出了癫痫患者内化耻辱的多模式模型（PWE）。该模型整合了已建立的行为科学理论——包括压力和应对、自我效能、习得性无助和认知-行为框架——来解释与耻辱感相关的触发因素、评价和不适应的认知-情绪-行为循环是如何在自我强化的内化耻辱感中达到顶峰的，这种耻辱感可能与身份的其他耻辱感方面交叉。与Di Gennaro、Grammaldo和Tomasini提出的精神分析和后理性主义观点相反，我们的模型为通过有意识的自我调节和应对技能发展进行干预提供了具体的、循证的途径。RISE ABOVE通过结构化的自我管理练习来应用这一框架，增强对内化污名的理解，加强压力管理和心理灵活性，并增强对污名相关挑战的适应性反应。先前的研究结果表明，在完成RISE ABOVE后，感知到的耻辱感减少，心理社会结果改善，支持该模型在告知以耻辱感为重点的干预措施方面的效用。

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引用次数: 0

Influence of sex and age on the development of audiogenic kindling in the moderate seizure severity strain of the genetically epilepsy-prone rats 性别和年龄对遗传性癫痫易感大鼠中度发作严重品系听原点燃发育的影响。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-16 DOI: 10.1016/j.yebeh.2025.110810

Gleice Kelli Silva-Cardoso , Willian Lazarini-Lopes , Padmini Khandai , Patrick A. Forcelli , Prosper N’Gouemo

The genetically epilepsy-prone rat (GEPR) is a long-standing animal model for inherited epilepsy, with seizures triggered by high-intensity acoustic stimulation (audiogenic seizures), leading to generalized tonic-clonic seizures, which propagate through a well-characterized brainstem network and are known as brainstem seizures. Repeated exposure to acoustic stimuli can lead to the development of brainstem-triggered limbic seizures accompanied by cortical epileptiform activity, a process called audiogenic kindling (AK). Although the GEPR-3 strain has been in use for over 50 years, the influences of age and sex on the development of AK in GEPR-3s remain unknown; thus, this study aims to address this knowledge gap. Male and female GEPR-3s, aged 1, 2, 4, and 6 months, were exposed to acoustically evoked seizures once daily for 30 consecutive days. Seizure latency, duration, and severity were analyzed in relation to age and number of stimulations. The findings revealed that AK was age-dependent, with limbic motor seizures occurring exclusively in 4- and 6-month-old GEPR-3s, while younger GEPR-3s showed no limbic seizures. Female GEPR-3s developed AK more rapidly and experienced more severe seizures than males. Furthermore, as AK developed, brainstem seizures became more severe in the GEPR-3s. A subset of 4- and 6-month-old male and female GEPR-3s exhibited forelimb and hindlimb extensions or spontaneous limbic seizures. The results indicate that age and sex impact AK development in GEPR-3s, highlighting the need for further studies to understand their significance in advancing our understanding of epileptogenesis and developing more effective treatments.

遗传性癫痫易感大鼠（GEPR）是一种长期存在的遗传性癫痫动物模型，其癫痫发作由高强度的声刺激引发（听源性癫痫发作），导致全身性强直-阵挛性癫痫发作，这种癫痫发作通过一个具有良好特征的脑干网络传播，称为脑干癫痫发作。反复接触声刺激可导致脑干引发的边缘癫痫发作，并伴有皮质癫痫样活动，这一过程被称为听源性点燃（AK）。虽然GEPR-3菌株已经使用了50多年，但年龄和性别对GEPR-3中AK发育的影响尚不清楚；因此，本研究旨在解决这一知识差距。年龄分别为1、2、4和6个月的GEPR-3s男性和女性，每天1次，连续30天暴露于声诱发癫痫发作。分析发作潜伏期、持续时间和严重程度与年龄和刺激次数的关系。研究结果显示，AK具有年龄依赖性，边缘运动癫痫只发生在4和6个月大的gepr -3中，而更小的gepr -3则没有边缘运动癫痫。与男性相比，女性GEPR-3s发生AK的速度更快，癫痫发作也更严重。此外，随着AK的发展，GEPR-3s的脑干癫痫发作变得更加严重。4个月和6个月大的男性和女性GEPR-3s表现出前肢和后肢伸展或自发性边缘癫痫。结果表明，年龄和性别影响gepr -3中AK的发育，强调需要进一步研究以了解其在促进我们对癫痫发生的理解和开发更有效的治疗方法方面的意义。

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引用次数: 0

Artistic imperative and epilepsy of Van Gogh 梵高的艺术冲动与癫痫

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-07 DOI: 10.1016/j.yebeh.2025.110797

C.J. Winchester

An examination of the work process of the artist Vincent Van Gogh from a cultural- and medical-historical perspective, this article looks at the role of temporal lobe epilepsy in shaping of the painter’s impulse to create, his methodology, and characteristics of his work product. All artists employ disparate methodologies to merge the landscapes of internal and external experience, and the drivers of an individual artist’s creativity are multi-fold. In the case of Van Gogh, synthetic aspects of the artistic process, data of personal history and the exigencies of an illness contribute to a dynamic interplay. Previous research has investigated how epileptic activity of right temporal and temporooccipital origin affects the prolongation of dream states. The global repercussions of non-convulsive seizures on self-world relations with respect to the artist and the act of aesthetic creation merit further study.

本文从文化和医学历史的角度考察了艺术家文森特·梵高的工作过程，探讨了颞叶癫痫在塑造画家创作冲动、创作方法和作品特征中的作用。所有艺术家都采用不同的方法来融合内部和外部体验的景观，而单个艺术家的创造力的驱动因素是多方面的。就梵高而言，艺术过程的综合方面，个人历史的数据和疾病的紧急情况促成了一种动态的相互作用。以往的研究已经探讨了右颞和颞枕起源的癫痫活动如何影响梦状态的延长。非痉挛发作对艺术家和美学创作行为的自我世界关系的全球影响值得进一步研究。

引用次数: 0

Tracking of executive functions and attention in people with epilepsy: Czech validation of EpiTrack® 跟踪癫痫患者的执行功能和注意力：EpiTrack®的捷克验证

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-07 DOI: 10.1016/j.yebeh.2025.110800

Alena Javůrková , Jaroslava Raudenská , Tereza Březinová , Jana Zárubová , Jana Amlerová , Petr Marusič

Objective

Epilepsy treatment aims not only to control seizures but also to preserve patients’ cognitive abilities. EpiTrack® is a screening tool designed to monitor the influence of anti-seizure medications on executive functions and attention.

Methods

Czech version of EpiTrack® and selected neuropsychological tests, along with questionnaires measuring anxiety, depression, and health-related quality of life, were administered to consecutive epilepsy patients (n = 134) and matched by age, gender and premorbid intellect healthy controls (n = 121). Reliability and validity were assessed.

Results

Reliability was adequate, with acceptable internal consistency (Cronbach’s α = 0.75) and moderate test–retest reliability (rp = 0.59). Only 4 % of controls were classified as cognitive impaired, compared with 45 % of patients. Scores were sensitive to monthly seizure frequency, polytherapy, focal epilepsy, and were negatively correlated with premorbid intelligence, education, and activities of daily living (ps < 0.05). Multiple regression results suggested negative cognitive effects of anti-seizure medications (ps < 0.05) Principal component analysis yielded a two-factor solution (verbal and visuospatial) accounting for 58 % of the total variance in healthy controls, whereas in the patient group only one factor was extracted, accounting for 62 % of the variance, indicating a unified executive dysfunction profile. EpiTrack® scores correlated significantly with neuropsychological measures of attention and executive function in both healthy controls (rs = 0.37–0.65) and patients (rs = 0.35–0.72) (ps < 0.05), supporting convergent validity.

Conclusion

The Czech version of EpiTrack® demonstrated sufficient psychometric properties and is suitable for routine screening of executive function and attention in people with epilepsy.

目的癫痫治疗不仅要控制癫痫发作，而且要保持患者的认知能力。EpiTrack®是一种筛选工具，旨在监测抗癫痫药物对执行功能和注意力的影响。方法对连续134例癫痫患者（n = 134）进行捷克版EpiTrack®和选定的神经心理测试，以及测量焦虑、抑郁和健康相关生活质量的问卷调查，并与年龄、性别和病前智力健康对照（n = 121）进行匹配。评估信度和效度。结果信度足够，具有可接受的内部一致性（Cronbach’s α = 0.75）和中等的重测信度（rp = 0.59）。只有4%的对照组被归类为认知障碍，而45%的患者被归类为认知障碍。评分与月发作频率、多药治疗、局灶性癫痫敏感，与发病前智力、教育程度、日常生活活动呈负相关（p < 0.05）。多元回归结果显示抗癫痫药物对认知的负面影响（ps < 0.05）。主成分分析得出双因素解决方案（言语和视觉空间）占健康对照组总方差的58%，而在患者组中仅提取一个因素，占方差的62%，表明统一的执行功能障碍情况。在健康对照组（rs = 0.37-0.65）和患者（rs = 0.35-0.72）中，EpiTrack®评分与神经心理学测量的注意力和执行功能显著相关（ps < 0.05），支持收敛效度。结论捷克版EpiTrack®具有足够的心理测量特性，适用于癫痫患者执行功能和注意力的常规筛查。

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引用次数: 0

Intelligence outcomes in 17 patients with developmental and/or epileptic encephalopathy with spike-wave activation in sleep ((D)EE-SWAS) after remission of SWAS 17例发育性和/或癫痫性脑病伴睡眠尖波激活（(D)EE-SWAS）患者在SWAS缓解后的智力结果

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-04 DOI: 10.1016/j.yebeh.2025.110806

M.M.L. van Arnhem , H.C. van Teeseling , L. van den Berg , K.P.J. Braun , F.E. Jansen

Developmental and/or Epileptic encephalopathy with spike-wave activation in sleep ((D)EE-SWAS) is an age related epilepsy syndrome that is associated with, often profound, cognitive deterioration in childhood. Although the EEG pattern in (D)EE-SWAS resolves, cognitive deficits persist during adulthood. Studies assessing objective cognitive outcomes after resolution of the EEG SWAS pattern are scarce. In this study we assessed intelligence quotient (IQ) scores after remission of SWAS in seventeen patients with a history of (D)EE-SWAS. In all patients with IQ data available before the onset of SWAS there was a profound decline in IQ during (D)EE-SWAS (mean decline –22.1 IQ points, sd 9.3). When we plotted change in IQ over time we observed two different developmental trajectories: in 8 children there was a further decrease of IQ after remission of SWAS (mean decrease of 8.1 IQ points, sd 4.8) and in 9 children an increase (mean increase of 15.9 IQ points, sd 11.0). The group with a decrease of IQ had a significantly earlier first assessment of SWAS. Our results reinforce the classification of (D)EE-SWAS as a true epileptic encephalopathy and suggest that an earlier onset of SWAS is related to poorer neurodevelopmental outcome.

发展性和/或癫痫性脑病伴睡眠尖波激活（(D)EE-SWAS）是一种与年龄相关的癫痫综合征，通常与儿童期严重的认知衰退有关。尽管(D)EE-SWAS的脑电图模式得到了解决，但认知缺陷在成年期持续存在。评估脑电图SWAS模式解决后客观认知结果的研究很少。在这项研究中，我们对17例有(D)EE-SWAS病史的患者在SWAS缓解后的智商（IQ）评分进行了评估。在所有SWAS发病前有智商数据的患者中，(D)EE-SWAS期间智商显著下降（平均下降-22.1 IQ点，sd 9.3）。当我们绘制智商随时间的变化时，我们观察到两种不同的发展轨迹：8名儿童在SWAS缓解后智商进一步下降（平均下降8.1个智商点，标准差4.8），9名儿童智商增加（平均增加15.9个智商点，标准差11.0）。智商下降组的SWAS首次评估明显提前。我们的研究结果强化了(D)EE-SWAS作为一种真正的癫痫性脑病的分类，并表明SWAS的早期发病与较差的神经发育结果有关。

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引用次数: 0

To select or not to select: evaluating the effectiveness of SeLECT score in predicting the risk of post-stroke seizures: a systematic review 选择或不选择：评估select评分在预测卒中后癫痫发作风险中的有效性：一项系统综述。

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior

Pub Date : 2025-11-04 DOI: 10.1016/j.yebeh.2025.110794

Ahmed Ayaz , Syeda Amrah Hashmi , Muhammad Ibrahim , Sameer Sharma , Muhammad Asjad Abbas , Ifrah Zawar

Background

SeLECT score identifies patients at high risk of post-stroke epilepsy(PSE). This systematic review summarizes the effectiveness of SeLECT and its modified versions in predicting PSE risk.

Methods

A systematic search was done from inception to 21st July 2025. Studies using SeLECT score to predict the risk of PSE were included. Two authors independently screened and collected data. Due to the heterogeneity of the studies, a meta-analysis could not be done.

Results

Of 3079 articles, 15 were included. Over 10,000 S patients from eleven countries were studied. The original SeLECT score showed high predictive accuracy for PSE in cohorts from Switzerland, Austria, Germany, and Italy. In China, combining SeLECT with IL-1β increased the area under the curve(AUC) from 0.756 to 0.933. In Turkey, adding the severity of diabetes and leukoaraiosis to SeLECT raised AUC from 0.893 to 0.955. Japanese investigators proposed a modified SeLECT score by including cortical superficial siderosis, increasing the model’s accuracy(AUC = 0.84). SeLECT 2.0, SeLECT-ASyS, and SeLECT-EEG are modified versions of SeLECT, incorporating seizure type (status epilepticus vs. short seizure) and EEG findings to enhance PSE risk and mortality prediction. In multicenter cohorts, SeLECT 2.0 showed good discrimination (C-statistic = 0.78), while SeLECT-ASyS outperformed SeLECT in training (C = 0.68 vs. 0.58) and validation cohorts (C = 0.70 vs. 0.50). Among stroke patients without acute symptomatic seizures (ASyS), SeLECT-EEG improved time-to-PSE prediction (C = 0.75 vs. 0.71).

Conclusion

SeLECT is an easy-to-use tool that can predict PSE risk. Modification of SeLECT to include factors such as IL-1B, diabetes, leukoaraiosis, superficial siderosis, status epilepticus, ASyS, and EEG using an algorithmic approach should be investigated to increase the accuracy of predicting PSE risk.

背景：SeLECT评分可识别卒中后癫痫（PSE）高危患者。本系统综述总结了SeLECT及其修正版本在预测PSE风险方面的有效性。方法：系统检索自成立至2025年7月21日。纳入了使用SeLECT评分预测PSE风险的研究。两位作者独立筛选和收集数据。由于研究的异质性，不能进行meta分析。结果：3079篇文献中，纳入15篇。研究人员对来自11个国家的1万多名患者进行了研究。最初的SeLECT评分在来自瑞士、奥地利、德国和意大利的队列中显示出较高的PSE预测准确性。在中国，SeLECT与IL-1β联合使曲线下面积（AUC）从0.756增加到0.933。在土耳其，在SeLECT中加入糖尿病和白化病的严重程度将AUC从0.893提高到0.955。日本研究人员提出了一个改进的SeLECT评分，包括皮质浅表性铁沉着，提高了模型的准确性（AUC = 0.84）。SeLECT 2.0、SeLECT- asys和SeLECT-EEG是SeLECT的改进版本，结合了癫痫发作类型（癫痫持续状态vs.短暂发作）和脑电图结果，以提高PSE风险和死亡率预测。在多中心队列中，SeLECT 2.0具有良好的判别性（C-statistic = 0.78），而SeLECT- asys在训练队列（C = 0.68 vs. 0.58）和验证队列（C = 0.70 vs. 0.50）中优于SeLECT。在无急性症状性癫痫发作（ASyS）的脑卒中患者中，SeLECT-EEG改善了时间到pse的预测（C = 0.75 vs. 0.71）。结论：SeLECT是一种易于使用的预测PSE风险的工具。修改SeLECT以包括IL-1B、糖尿病、白质变、浅表性铁沉着、癫痫持续状态、ASyS和脑电图等因素，应采用算法方法进行研究，以提高预测PSE风险的准确性。

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