Epilepsy & Behavior最新文献

{"title":"Biomarker discovery in Lennox-Gastaut syndrome: Advances and challenges in electrophysiological, genetic, neuroimaging, and neuroinflammatory approaches","authors":"Debopam Samanta ,&nbsp;Cemal Karakas ,&nbsp;Anthony L. Fine ,&nbsp;Amanda W. Pong ,&nbsp;Hyun Yong Koh ,&nbsp;Cynthia Keator ,&nbsp;Tobias Loddenkemper ,&nbsp;Ismail S. Mohamed ,&nbsp;Gozde Erdemir ,&nbsp;Tracy Dixon-Salazar ,&nbsp;Fábio A. Nascimento ,&nbsp;Sonal Bhatia ,&nbsp;Babitha Haridas ,&nbsp;Aaron E.L. Warren ,&nbsp;Anup D. Patel","doi":"10.1016/j.yebeh.2025.110834","DOIUrl":"10.1016/j.yebeh.2025.110834","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"176 ","pages":"Article 110834"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with epilepsy: what characterizes the everyday life of adults with epilepsy in Western countries? A systematic synthesis of qualitative studies","authors":"Ellen Gabrielsen Hjelle ,&nbsp;Irma Pinxsterhuis ,&nbsp;Unni Sveen ,&nbsp;Line Kildal Bragstad","doi":"10.1016/j.yebeh.2025.110828","DOIUrl":"10.1016/j.yebeh.2025.110828","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is a complex neurological disease affecting millions worldwide. Beyond seizure management, individuals with epilepsy face significant emotional, cognitive, and social challenges that impact their quality of life and societal participation. This qualitative systematic review explored the lived experiences of adults with epilepsy in Western countries, focusing on their participation in daily life.</div></div><div><h3>Methods</h3><div>A meta-aggregated synthesis was conducted, guided by the Joanna Briggs Institute’s recommendations. Sixteen qualitative studies published between 2016 and 2024 were included, representing 391 participants and 3,580 online posts.</div></div><div><h3>Results</h3><div>The three key themes: “Understanding the condition and the need for tailored information”, “self-management and support” and “stigma and the dilemma of disclosure or concealment” encompass multifaceted aspects of living with epilepsy. These include the disruptive and unpredictable nature of epilepsy, the critical role of personalized information in disease management, and the importance of effective coping and self-management strategies. Participants reported challenges such as stigma, discrimination, and difficulties in forming and maintaining relationships. Support from family, peers, and healthcare professionals was identified as critical but often insufficient. Stigma emerged as a pervasive issue, with many concealing their condition to avoid judgment, despite the risks. Public education and peer support were highlighted as essential to reducing stigma and fostering inclusion.</div></div><div><h3>Conclusions</h3><div>Living with epilepsy requires more than seizure management; it involves navigating a complex interplay of physical, emotional, and social challenges. A comprehensive approach including medication, individualized care, and support for lifestyle adjustments is recommended. Public education is suggested to reduce the stigma associated with epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110828"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Driving habits and difficulties in people with epilepsy: A survey","authors":"Lucile Guillermier ,&nbsp;Cécile Sabourdy ,&nbsp;Emeline Four ,&nbsp;Nicolas Mezouar ,&nbsp;Laurence Paire-Ficout ,&nbsp;Maud Ranchet","doi":"10.1016/j.yebeh.2025.110824","DOIUrl":"10.1016/j.yebeh.2025.110824","url":null,"abstract":"<div><div>Epilepsy is a neurological condition that can interfere with driving abilities through seizures and cognitive impairments. While legal frameworks often regulate driving eligibility, little is known about how people with epilepsy perceive and adapt their driving in everyday life. This study aimed to examine driving habits, self-perceived difficulties, and adaptive behaviors in people with epilepsy compared to a control group. A total of 665 participants (103 individuals with epilepsy and 562 individuals without epilepsy) completed an online questionnaire covering driving habits, avoidance behaviors, and compensatory strategies. Statistical analyses were conducted to compare responses between groups. Contrary to expectations, individuals with epilepsy do not report more driving difficulties than controls. On the other hand, they appear to have more avoidance behavior and compensatory strategies. They were more likely to avoid certain situations (e.g., night driving, long trips) and to implement proactive adjustments (e.g., driving only when feeling well, taking shorter trips). People with epilepsy appear to implement self-regulation strategies that reduce their exposure to difficult driving conditions. These strategies likely help maintain safe driving practices but may also restrict mobility and autonomy. Given that these data are based on self-reports the interpretation of the results must be cautious, particularly since people with epilepsy did not report more difficulties than controls. We propose two interpretations (i.e., adaptive hypothesis and anticipatory hypothesis) that are not mutually exclusive. Future studies should integrate these perspectives with objective assessments to provide more robust evidence for clinical and regulatory recommendations.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110824"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social cognition after epilepsy surgery in temporal lobe epilepsy: A long-term follow-up","authors":"Martin Simcik ,&nbsp;Ross Andel ,&nbsp;Viktoria Pytelova ,&nbsp;Alena Javurkova ,&nbsp;Jakub Zalud ,&nbsp;Adam Kalina ,&nbsp;Michaela Kalinova ,&nbsp;Katerina Stanzelova ,&nbsp;Petr Marusic ,&nbsp;Jana Amlerova","doi":"10.1016/j.yebeh.2025.110839","DOIUrl":"10.1016/j.yebeh.2025.110839","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have suggested that social cognition abilities do not change following surgical treatment for temporal lobe epilepsy (TLE). However, the follow-up period in these studies was no longer than 14 months. The present study investigated the long-term effects of epilepsy surgery on social cognition, extending the follow-up period to an average of 12 years (range 7–15 years).</div></div><div><h3>Methods</h3><div>We assessed 24 patients with drug-resistant TLE (mean age = 37 ± 11 years; 14 males) who underwent temporal lobe resection. Social cognition was measured using the Emotion Recognition Test (ERT, measuring emotion recognition) and the Faux-Pas Test (FPT, measuring Theory of Mind). Linear mixed-effects models accounted for repeated measures. Baseline scores for both ERT and FPT were standardized as Z-scores.</div></div><div><h3>Results</h3><div>ERT scores remained stable over time (estimate = 0.01, p = 0.405), while FPT performance declined gradually (estimate = −0.04, p = 0.009). Later epilepsy onset predicted higher initial FPT scores (estimate = 0.02, p = 0.036) but faster decline (estimate = −0.01, p = 0.013). Epilepsy duration, side, IQ, sex, and depressive symptoms had no significant effect.</div></div><div><h3>Conclusion</h3><div>While ERT appeared to remain stable over the extended period, FPT showed a gradual decline across the post-surgery follow-up independent of age. Later age at epilepsy onset was associated with steeper FPT deterioration. Our results extend previous findings, confirming stability in emotion recognition and suggesting decline in recognition of Faux-Pax after epilepsy surgery.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110839"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose adjustment of the anti-seizure medications levetiracetam and lamotrigine during the postpartum period. Schedule plan, safety and efficacy","authors":"Nadejda Khmelev ,&nbsp;Firas Fahoum ,&nbsp;Lilach Goldstein","doi":"10.1016/j.yebeh.2025.110858","DOIUrl":"10.1016/j.yebeh.2025.110858","url":null,"abstract":"<div><h3>Introduction</h3><div>Lamotrigine (LTG) and Levetiracetam (LEV) are anti-seizure medications (ASMs) widely used for treatment of women with epilepsy (WWE) of childbearing age due to low teratogenic potential. Physiological changes during gestation results in enhanced clearance. Drug level monitoring and frequent dose adjustments are required to avoid decline in serum levels and compromised seizure control. Postpartum, physiological changes reverse and ASM clearance trends back to pre-pregnancy rate. Rapid metabolic changes make drug level monitoring and dose adjustments challenging. A delay in dose decrement could result in toxicity. The optimal postpartum dose reduction rate hasn’t been established.</div></div><div><h3>Methods</h3><div>We retrospectively examined medical records of pregnant WWE followed at Tel Aviv Sourasky Medical Center from 2018 to 2023. Initially, patients were instructed to continue therapeutic drug monitoring (TDM) postpartum. Starting October 2020, an empiric taper regimen was implemented with dose adjustments scheduled 1, 7, and 21 days postpartum. Individualized regimens were provided during last prenatal visit. We recorded ASM dose, serum levels, seizure frequency, and side effects.</div></div><div><h3>Results</h3><div>Eighty-one pregnancies in 75 WWE were included. Forty-two were treated with LEV, 35 with LTG, and 4 with both. In 24 pregnancies patients continued TDM postpartum, and 57 followed empiric protocol. Among seizure-free WWE before and during pregnancy, none of 44 in the empiric group and 2 of 16 in TDM group had postpartum seizures. Side effects occurred in 6 of 54 empiric group and 5 of 21 TDM group.</div></div><div><h3>Conclusion</h3><div>Empiric postpartum tapering was not linked to increased seizure risk and was well tolerated.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110858"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life measure for children with Epilepsy: A psychometric evaluation of the Italian version","authors":"Carlotta Tagliaferro ,&nbsp;Elena Cavallini ,&nbsp;Pietro Cappelletto ,&nbsp;Chloe Lau ,&nbsp;Martina Preti ,&nbsp;Claudia Marino ,&nbsp;Simona Pellacani ,&nbsp;Gabriel M. Ronen ,&nbsp;Francesca Chiesi ,&nbsp;Carmen Barba","doi":"10.1016/j.yebeh.2025.110857","DOIUrl":"10.1016/j.yebeh.2025.110857","url":null,"abstract":"<div><h3>Objective</h3><div>To report on the Italian validation of the Child Epilepsy Quality of Life Questionnaire (CHEQOL-25), including both the child self-report and parent-proxy versions.</div></div><div><h3>Methods</h3><div>The validation procedure was conducted at a single Italian centre between July 2024 and July 2025, involving 252 children with epilepsy and their parents. A forward–backward translation process was carried out in line with established best-practice guidelines. Data collection included family interviews and medical chart reviews. Psychometric evaluation covered reliability and validity.</div></div><div><h3>Results</h3><div>All items exceeded the accepted thresholds (≥ 0.78) for both content validity and comprehensibility. The factor structure closely replicated the original five-factor model, with certain items showing stronger loadings than the original study within the <em>Interpersonal/Social</em> and <em>Intrapersonal/Emotional</em> domains in both related versions. The <em>Secrecy</em> factor showed greater variability (h² = 0.06–.83), possibly reflecting differences in parental interpretation or their sensitivity to the epilepsy concealment. Children who engaged in playful activities scored higher across most subscales, particularly in the <em>Interpersonal/Social</em> and the <em>Quest for Normality</em> domains of the self-report version. Importantly, children not receiving school support reported higher scores across several subscales, suggesting fewer perceived psychosocial challenges. Agreement between child self-reports and parent proxy-reports ranged from moderate to strong (ICC = 0.53–.71).</div></div><div><h3>Conclusions</h3><div>The Italian version of the <em>CHEQOL-25</em> measure demonstrates strong psychometric properties (consistent with the original version) and reinforces the value of assessing quality of life in children with epilepsy across diverse cultural contexts.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110857"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between seizure severity and quality of life in focal epilepsy: the mediating role of sleep quality","authors":"Huiting Wu ,&nbsp;Yingying Zhou ,&nbsp;Chunmei Wu ,&nbsp;Xu Zhao ,&nbsp;Xiaoyan Liu ,&nbsp;Suiqiang Zhu ,&nbsp;Shanshan Huang","doi":"10.1016/j.yebeh.2025.110832","DOIUrl":"10.1016/j.yebeh.2025.110832","url":null,"abstract":"<div><h3>Objective</h3><div>The association between sleep quality and quality of life (QOL) in patients with focal epilepsy remains poorly understood. This study aimed to evaluate sleep quality within this population and investigate its mediating effect on QOL.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled 161 adult patients with focal epilepsy. Sleep quality, seizure severity, and QOL were assessed using the Pittsburgh Sleep Quality Index (PSQI), Liverpool Seizure Severity Scale 2.0 (LSSS 2.0), and Quality of Life in Epilepsy-31 (QOLIE-31) inventory, respectively. Logistic regression analysis was conducted to identify factors associated with sleep quality. Correlation and mediation analyses were performed to examine the relationships between sleep quality, seizure severity, and QOL.</div></div><div><h3>Results</h3><div>The mean overall QOLIE-31 score was 65.57 ± 14.22. Poor sleep quality (PSQI &gt; 5) was identified in 68 patients (42.24 %). Longer disease duration (OR = 2.326, 95 %CI: 1.151 to 4.698, <em>P</em> = 0.019) and higher seizure severity (OR = 1.029, 95 %CI: 1.002 to 1.056, <em>P</em> = 0.029) were independent factors significantly associated with poor sleep quality. Both sleep quality and seizure severity showed significant correlations with QOL. Mediation analysis confirmed the significant mediating role of sleep quality in the relationship between seizure severity and QOL (β = −0.131, 95 %CI: −0.207 to −0.065).</div></div><div><h3>Conclusion</h3><div>This study demonstrated a significant association between greater seizure severity and reduced QOL in patients with focal epilepsy, with sleep quality acting as a significant mediator. These findings underscore the significance of addressing sleep disturbances and integrating sleep management into comprehensive interventions for focal epilepsy.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110832"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic delay and associated clinical factors in a sample of South African patients with functional seizures","authors":"Gabriele Vilyte ,&nbsp;Victoria Ives-Deliperi ,&nbsp;James Butler ,&nbsp;Chrisma Pretorius","doi":"10.1016/j.yebeh.2025.110843","DOIUrl":"10.1016/j.yebeh.2025.110843","url":null,"abstract":"<div><h3>Purpose</h3><div>Functional seizures (FS) are often associated with substantial diagnostic delay. This can impact patients’ quality of life, delay appropriate treatment and cause iatrogenic harms. The delay is also hypothesised to be worse in low- to middle-income countries (LMICs), but there is a dearth of information on the extent and reasons for this in LMIC settings, such as South Africa.</div></div><div><h3>Methods</h3><div>We used retrospective medical chart data from 368 consecutive video-EEG confirmed patients with FS from a private (n = 301) and a public (n=67) sector epilepsy monitoring units (EMUs). Data on 39 clinical factors were used to test for association with delay to documented FS diagnosis.</div></div><div><h3>Results</h3><div>The overall mean diagnostic delay was 5 years, with a median of 2 years (IQR 0.58, 6). In the private hospital group, the mean delay was 4.7 years, compared to 7.5 years in the public hospital group. Of the 39 studied clinical factors, the use of antiseizure medications (ASMs) emerged as the most important determinant of diagnostic delay in our studied settings. Current ASM use was associated with a median diagnostic delay of 0.6 years (95 % CI 0.10, 1.10) per additional ASM at the private hospital and 3 years (95 % CI 1.03, 4.97) at the public hospital.</div></div><div><h3>Conclusion</h3><div>This study is the first in South Africa to investigate the clinical factors associated with delayed diagnosis in FS. The study highlighted particularly long delays in the public sector. Current and repeated ASM use emerged as the key contributors in the two hospitals, highlighting the need for early referral in the face of multiple ASM failures.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110843"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype–phenotype analysis of pathogenic copy number variations in pediatric epilepsy","authors":"Hao Zheng ,&nbsp;JiaLi Dai ,&nbsp;Miao Xiong ,&nbsp;Xiao Xiao ,&nbsp;Li Jiang ,&nbsp;Yue Hu","doi":"10.1016/j.yebeh.2025.110842","DOIUrl":"10.1016/j.yebeh.2025.110842","url":null,"abstract":"<div><div>To summarize the genotype–phenotype characteristics of pediatric epilepsy with pathogenic copy number variations (CNVs) and explore the potential pathogenic mechanisms of the CNVs, we recruited a cohort of 418 epilepsy patients (age: 0–18 years) from the Children’s Hospital of Chongqing Medical University between June 2016 to June 2024. Patients were evaluated using CNV sequencing (CNV-seq). Functional enrichment for dosage-sensitive genes in the CNVs were performed using ClusterProfiler. Protein–protein interaction (PPI) networks for the proteins encoded by these genes were analyzed using the STRING database. We identified 40 patients carrying at least one pathogenic CNVs [detection rate: 9.57 % (40/418)]. A total of 39 microdeletions and five microduplications were identified, ranging in size from 0.11 Mb to 45.53 Mb. The 16p11.2 microdeletion was the most frequently detected (16/418). Thirty patients presented with comorbidities, including 11 with congenital heart disease and 9 exhibiting distinctive facial dysmorphism. Dosage-sensitive genes were significantly enriched in forebrain development, telencephalon development, and the neuronal cell body. Proteins encoded by these dosage-sensitive genes exhibited extensive interaction networks. In conclusion,<!--> <!-->CNVs are an important cause of pediatric epilepsy and involve dosage-sensitive genes that may cause disease by affecting cortical development and the neuronal cell body. There is a higher probability of identifying a pathogenic CNV when epilepsy is co-morbid with intellectual disability or other systemic diseases.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110842"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional and environmental differences in public attitudes toward epilepsy in Japan: A Post-hoc analysis of the SAPE-J nationwide survey","authors":"Izumi Kuramochi ,&nbsp;Denny Kerkhoff ,&nbsp;Takayuki Iwayama ,&nbsp;Sayaka Kobayashi ,&nbsp;Haruo Yoshimasu ,&nbsp;Axel Mayer","doi":"10.1016/j.yebeh.2025.110862","DOIUrl":"10.1016/j.yebeh.2025.110862","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy-related stigma remains a global concern that hinders treatment adherence and psychosocial well-being. In Japan, negative cultural connotations of epilepsy persist despite medical and legal reforms. However, little is known about how public attitudes toward epilepsy differ across regions or between urban and rural environments within Japan. This study examined regional and environmental variations in prejudice and personal experience related to epilepsy and evaluated whether such differences persist after accounting for sociodemographic factors.</div></div><div><h3>Methods</h3><div>A nationwide online survey was conducted among 1,000 adults stratified by age, gender, and residence across Japan’s eight major regions. Participants completed the four Caveness Questions (CQs) assessing prejudice toward people with epilepsy (PWE) and four experience-related items. A Prejudice Index (0–4) and Personal Experience Index (0–3) were computed. Two-way ANOVAs tested the effects of region (eight levels) and upbringing environment (urban vs. rural). Multiple regression and sensitivity analyses using z-standardized residuals and generalized linear models (Poisson and negative binomial) were performed to confirm robustness. Pearson’s correlations examined bivariate associations among key variables.</div></div><div><h3>Results</h3><div>Overall, 33.7 % of respondents expressed resistance to children’s association with PWE, 27.1 % regarded epilepsy as a mental illness, 35.0 % opposed equal employment, and 40.2 % opposed marriage with a person who has seizures. The mean Prejudice Index was 1.36 ± 1.13 (SD), and the mean Experience Index was 0.60 ± 0.95 (SD). Rural upbringing significantly predicted higher prejudice (p = 0.012, η² = 0.008), whereas regional effects were non-significant after adjustment. Residualized and GLM analyses yielded consistent findings. Greater personal experience correlated with lower prejudice (r = –0.32, p &lt; 0.001), while demographic factors showed minimal associations.</div></div><div><h3>Conclusions</h3><div>Prejudice toward epilepsy in Japan persists at moderate levels, with roughly one in three to four adults endorsing at least one discriminatory attitude. The findings indicate that stigma is shaped more by upbringing and experiential factors than by regional location, highlighting the importance of targeted education and contact-based interventions to reduce epilepsy-related prejudice nationwide.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"175 ","pages":"Article 110862"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762256","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}