Epilepsy Research最新文献

{"title":"Factors influencing pediatric epilepsy outcomes: Predictive variables and adherence to clinical practice guidelines","authors":"Vaibhav R. Suryawanshi ,&nbsp;Kavita Srivastava ,&nbsp;Anshu Priya ,&nbsp;Bhakti Sarangi ,&nbsp;Asavari Raut","doi":"10.1016/j.eplepsyres.2026.107738","DOIUrl":"10.1016/j.eplepsyres.2026.107738","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric epilepsy constitutes significant challenges for long-term management in resource-limited settings. This study determined factors influencing epilepsy outcomes in children (predictive variables) and assessed adherence to clinical practice guidelines (CPG) and its effect on clinical outcomes, addressing the evidence gap in Indian settings.</div></div><div><h3>Methods</h3><div>We enrolled prospectively followed 170 children (&lt;18 years) diagnosed with epilepsy, treated and monitored at a tertiary-care university hospital from ‘January 2021 to December 2024’. Adherence to clinical practice guidelines (CPG) was assessed using ‘Indian Academy of Pediatrics’ and ‘American Epilepsy Society’ standards. Clinical outcomes were studied and classified as ‘favorable (seizure freedom)’ and ‘unfavorable (seizure recurrence at 6 months of ASM initiation AND/OR active epilepsy ≥1 year of ASM initiation AND/OR time to seizure freedom exceeding 15 months after ASM initiation)’. Factors predictive of unfavorable epilepsy outcomes were analyzed using multivariate regression, and the event probabilities were estimated using Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Of 170 children, 117 (68.8 %) diagnosed with new‑onset epilepsy (NOE) and 53 (31.2 %) with drug‑resistant epilepsy (DRE). The median (IQR) age was 4.6 (3.1 – 11.5) years. Male preponderance was observed [93 (54.7 %)]. Overall adherence to CPG was 70 %, with deviations noted in 28.2 % of NOE cases and in 34 % of DRE cases. Seizure recurrence at 6 months of ASM initiation [82.4 % versus 64.7 %, P = 0.034] and active epilepsy for ≥ 1 year of ASM initiation [60.8 % versus 32.8 %, P = 0.001] was higher in CPG non-adherent group. Seizure freedom was observed in a total of 100 (58.8 %) children. Patients from CPG non-adherent group took longer (&gt;15 months) to gain seizure freedom (P &lt; 0.042). Of 11 studied factors predictive of unfavorable epilepsy outcomes, 2 factors in NOE and 5 factors in DRE achieved statistical significance. Kaplan-Meier analysis demonstrated increased hazards of unfavorable epilepsy outcomes in patients with DRE compared to NOE, (HR 2.3, 95 % CI 1.2–4.7, P = 0.0147).</div></div><div><h3>Conclusion</h3><div>Adherence to CPG was associated with favorable epilepsy outcomes, while non‑adherence predicted higher risk of seizure recurrence and prolonged active epilepsy. DRE cases demonstrated significantly greater risk of unfavorable epilepsy outcomes compared to NOE, underscoring the importance of guideline‑based management in optimizing pediatric epilepsy care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107738"},"PeriodicalIF":2.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalisation burden among persons with epilepsy attending an outpatient neuroscience specialist clinic in Singapore","authors":"Anushika Raheja ,&nbsp;Zhibin Tan ,&nbsp;Kaavya Narasimhalu","doi":"10.1016/j.eplepsyres.2026.107736","DOIUrl":"10.1016/j.eplepsyres.2026.107736","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy carries significant clinical and socioeconomic burden, largely driven by hospitalisations. Although hospitalisation rates are well described internationally, data from Asia remain limited. We aimed to quantify hospitalisation rates among persons with epilepsy (PwE) attending an outpatient neuroscience specialist clinic in Singapore and assess whether anti-seizure medication (ASM) polytherapy is associated with hospitalisation.</div></div><div><h3>Methods</h3><div>This exploratory secondary analysis included PwE enrolled in a prospective cohort at a tertiary adult neurology clinic in Singapore from August 2020 to December 2022, and followed up to mid-July 2025. Polytherapy was defined as concurrent use of ≥ 2 ASMs. Incidence rate ratios (IRRs) were calculated and multivariate logistic regression identified factors associated with hospitalisation.</div></div><div><h3>Results</h3><div>A total of 54 PwE were followed up at the outpatient neuroscience specialist clinic for a median of 3.5 years (range 2.6–4.6). The incidence rates of all-cause hospitalisations and seizure-related hospitalisations was 0.679 hospitalisations per person-year (95 % CI: 0.401 – 1.150) and 0.189 hospitalisations per person-year (95 % CI: 0.071 – 0.501), respectively. PwE on polytherapy had significantly higher incidence rates of all-cause (incidence rate ratio, IRR 3.45, 95 % CI 1.24 – 9.90, <em>p</em> = 0.021) and epilepsy-related hospitalisation (IRR 7.59, 95 % CI 1.76 – 32.7, <em>p</em> = 0.007). On multivariate analysis, PwE on polytherapy had a higher risk of at least one all-cause hospitalisation (OR = 5.952, 95 % CI 1.504 – 23.553, <em>p</em> = 0.011) during the study period.</div></div><div><h3>Conclusion</h3><div>We report hospitalisation incidence in PwE in Singapore for the first time and describe our finding that ASM polytherapy is associated with all-cause hospitalisations. These findings may help plan further studies on the morbidity of epilepsy and how it may be better addressed.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107736"},"PeriodicalIF":2.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and developmental variability of spike-wave discharges in the taiep rat: A model of H-ABC leukodystrophy","authors":"Carmen Cortes ,&nbsp;Juan M. Ibarra-Hernández ,&nbsp;Gilles van Luijtelaar ,&nbsp;Jose R. Eguibar","doi":"10.1016/j.eplepsyres.2026.107733","DOIUrl":"10.1016/j.eplepsyres.2026.107733","url":null,"abstract":"<div><div><em>Taiep</em> rat has a leukodystrophy caused by a tubulinopathy affecting the β-tubulin 4 A (TUBB4A) gene characterized by hypomyelination and progressive demyelination of the central nervous system. In magnetic resonance imaging <em>taiep</em> rats showed hypomyelination and atrophy of the putamen and cerebellum that resemble human leukodystrophy named hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC). In addition, <em>taiep</em> rat has spike-wave discharges (SWDs) in the electroencephalogram (EEG) associated with behavioral interruption of the ongoing activity. This study aims to analyze the characteristics and circadian distribution of SWDs in both sexes throughout the first year of life. We chronically implanted male and female <em>taiep</em> rats aged 3, 6, 9, and 12 months with electrodes in the cerebral cortex, neck muscles, and right eye orbit for 24-hour video-EEG recordings. Offline, we analyzed the number, mean and total duration of SWDs, the latency of the first SWD, and the spectral content using Fast Fourier Transform. A cosinor analysis was applied to 24-hour data to describe circadian distributions of SWD number and mean duration. In both sexes, the number, mean, and total duration of SWDs increased with age; onset occurred earlier in males at 3 months with respect to females that have SWDs at 6 months. The acrophase of the mean duration rhythm was delayed in females. These findings indicate a sexual dimorphism in the SWDs expression and timing during the circadian cycle. In both sexes, the interspike frequency of SWDs was 6.31 showing no change with age, suggesting similar thalamo-cortical circuit properties across all groups. In conclusion, these results clearly demonstrate that hypomyelination and demyelination affect the expression and circadian dynamics of SWDs in both sexes throughout development in <em>taiep</em> rats. In conclusion, <em>taiep</em> rats had a leukodystrophy associated to spike-wave discharges and behavioral arrest that are absence-like epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107733"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure medication effects on sleep architecture in epilepsy: Glymphatic insights and implications for cognitive decline","authors":"Justyna Swierz ,&nbsp;Michael Doherty ,&nbsp;Sung Ji ,&nbsp;Jeffrey Iliff ,&nbsp;Yeilim Cho","doi":"10.1016/j.eplepsyres.2025.107730","DOIUrl":"10.1016/j.eplepsyres.2025.107730","url":null,"abstract":"<div><div>Disruptions in sleep architecture may contribute to cognitive decline in people with epilepsy (PWE), potentially through impaired glymphatic clearance. In this narrative review, we explore how antiseizure medications (ASMs) influence key sleep stages, particularly slow-wave sleep (SWS) and rapid eye movement (REM) sleep, and consider how these changes may intersect with glymphatic function and cognitive outcomes. SWS supports glymphatic clearance of interstitial waste, including neurotoxic solutes such as amyloid-β and tau. Some ASMs appear to enhance SWS, while others suppress it, suggesting the possibility of differential long-term cognitive effects. We propose that sleep disruption may represent an important but underappreciated factor linking epilepsy and neurocognitive decline. While sleep impairment in epilepsy is often attributed to seizures or interictal activity, ASM-induced alterations in sleep architecture may also play a role. However, this relationship remains largely theoretical and requires further experimental study. We also review the use of diffusion tensor image analysis along the perivascular space (DTI-ALPS) as an emerging imaging method to approximate glymphatic activity. Although DTI-ALPS provides a non-invasive proxy for perivascular water diffusivity, it does not directly measure glymphatic clearance and may be affected by factors such as partial volume effects. Its role in epilepsy research remains exploratory and should be interpreted cautiously. To date, no study has directly examined the combined effects of ASMs, sleep structure, and glymphatic function in a single cohort. We outline opportunities for future research integrating neuroimaging, sleep assessment, and cognitive testing to better understand how sleep-targeted strategies might preserve brain health in epilepsy.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107730"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of epilepsy in 8p-related disorders","authors":"Megan Abbott ,&nbsp;Katie Angione ,&nbsp;Megan Stringfellow ,&nbsp;Kristina Malik ,&nbsp;Margarita Saenz ,&nbsp;Andrea Miele ,&nbsp;Kaiti Syverson ,&nbsp;Bina Maniar ,&nbsp;Jacob Borello ,&nbsp;Lauren Chaby ,&nbsp;Scott Demarest","doi":"10.1016/j.eplepsyres.2025.107720","DOIUrl":"10.1016/j.eplepsyres.2025.107720","url":null,"abstract":"<div><div>8p-related disorders are genetic conditions associated with chromosomal rearrangements on the short arm of chromosome 8. This study aimed to characterize the epilepsy phenotype in patients with 8p-related disorders seen at Children’s Hospital Colorado (CHCO) and/or recorded in the Project 8p Foundation Natural History Study. Key objectives included determining epilepsy prevalence, typical age of seizure onset, efficacy of treatment, and EEG features. A retrospective chart review was conducted for patients seen in the CHCO Neurogenetics Multidisciplinary Clinic and Project 8p Database. Clinical data including demographics, genotype, epilepsy history, and EEG findings were collected. The cohort included 162 unique patients with 8p-related disorders (42 at CHCO, 120 from the Project 8p Natural History Study). Overall, 32 % of patients (53/162) had experienced at least one lifetime seizure: 37 % (30/81) of those with Invdupdel(8p), 35 % (16/46) with 8p deletions, and 15 % (4/26) with 8p duplications. Average age of seizure onset was 3.4 years, with a range from neonatal onset to 16.9 years of age. Among CHCO patients with epilepsy (14/42, 33 %), only one had intractable epilepsy, while 9 became seizure-free, including 5 off medications. EEG abnormalities were present in 18/42, 43 % of the CHCO patients. This study provides the first detailed analysis of epilepsy in a large cohort of patients with 8p-related disorders. While epilepsy is relatively common, it is typically well controlled. Genotype-specific patterns emerged, with Invdupdel(8p) associated with the highest epilepsy prevalence and 8p duplication with the lowest. Further research in larger cohorts is warranted to validate these findings.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107720"},"PeriodicalIF":2.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary prophylaxis of seizures in post-hemorrhagic stroke rehabilitation patients","authors":"Valeria Pingue ,&nbsp;Diego Franciotta","doi":"10.1016/j.eplepsyres.2025.107719","DOIUrl":"10.1016/j.eplepsyres.2025.107719","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Prophylactic use of antiseizure medications (ASMs) for optimal management of post-hemorragic stroke (HS) seizures remains controversial. We retrospectively evaluated the influence of seizures on functional outcome, and, in a perspective of prescriptive appropriateness, the association between primary and secondary ASM prophylaxis and seizure occurrence in a large cohort of post-HS rehabilitation patients.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study included 399 adult patients consecutively admitted to our unit, after acute HS, for neurorehabilitation, between January 1, 2014 and December 31, 2023. The main variables were primary or secondary use of ASMs, and occurrence of acute symptomatic (ASyS), or unprovoked seizures (US). Independent predictors of rehabilitation outcome, measured with the Functional Independence Measure (FIM) scale, were analysed with multiple linear regression.</div></div><div><h3>Results</h3><div>Based on the Glasgow Coma Scale scores on admission, HS was classified as mild in 32.3 % of cases, moderate in 42.6 %, and severe in 25.1 %. Seizures occurred in 92/399 patients (23.1 %). US were associated with worse FIM scores on admission (p = 0.042), and on discharge (p = 0.020). Eleven/98 patients on primary ASM prophylaxis developed US vs 2/209 without ASM (p = 0.0002). The patients on primary, or on secondary prophylaxis presented the worst FIM scores at baseline and on discharge (p &lt; 0.0001 for both). Occurrence of US (p = 0.001), primary (p = 0.047), and secondary prophylaxis (p = 0.047) predicted poor functional outcome independently from age and HS severity. Second generation ASMs were associated with poor outcome more frequently than first generation ASMs (p = 0.013).</div></div><div><h3>Conclusions</h3><div>This study confirms the association between the severity of brain damage and seizures, and supports the notion that long-term prophylaxis with ASMs might not prevent the onset of US and epilepsy after HS. Our findings reinforce the recommendations by the European Stroke Organization and the American Heart Association, and expand the rationale of not using ASMs as primary prophylaxis in post-HS rehabilitation patients.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107719"},"PeriodicalIF":2.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SLC13A5 citrate transporter disorder epilepsy phenotype","authors":"Can Ozlu ,&nbsp;Emily M. Spelbrink ,&nbsp;Tanya L. Brown ,&nbsp;Kimberly L. Nye ,&nbsp;Rayan M. Solidum ,&nbsp;Sydney Cooper ,&nbsp;Carrie R. Best ,&nbsp;Dallas Armstrong ,&nbsp;Judy Liu ,&nbsp;Kimberly Goodspeed ,&nbsp;Brenda E. Porter","doi":"10.1016/j.eplepsyres.2025.107718","DOIUrl":"10.1016/j.eplepsyres.2025.107718","url":null,"abstract":"<div><div>The <em>SLC13A5</em> gene encodes a sodium citrate co-transporter, with loss of function variants causing autosomal recessive developmental and epileptic encephalopathy 25, DEE25. DEE25 is an ultra-rare genetic disorder, known to cause neonatal onset epilepsy as well as later neurocognitive and motor impairments. Here, we characterize the epilepsy phenotype from 30 children and adults enrolled in a prospective natural history study, with frequent visits over 2 years. Our findings reveal that the highest seizure burden and number of ER visits occurred during the first decade of life, with decreased seizure burden and ER visits after 10 years of age. However, older patients remained on an average of 3 antiseizure medications, and some had breakthrough seizures, suggesting ongoing epilepsy risk. Many antiseizure medications were used across patients. Multiple antiseizure medications were felt to be of benefit by caregivers, with valproic acid having the highest utilization with 22 patients and 80 % of caregivers reporting it to be helpful or very helpful. Higher doses of valproic acid correlated with caregiver reported benefit. All DEE25 pediatric epilepsy quality of life module scores were low, consistent with poor quality of life, and stable across the two years, with cognitive impairment, executive functioning being lower than mood and behavior. Most EEGs were abnormal, but less than a third had frequent or abundant interictal epileptiform activity, suggesting that interictal epileptiform activity was not a primary driver of neurocognitive dysfunction.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107718"},"PeriodicalIF":2.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy and stroke: A mendelian Randomization study","authors":"Siyuan Chen ,&nbsp;Madison Crago ,&nbsp;Alain Lekoubou","doi":"10.1016/j.eplepsyres.2025.107714","DOIUrl":"10.1016/j.eplepsyres.2025.107714","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies have established a relationship between stroke and epilepsy. While most studies have reported an increased risk of epilepsy following a stroke, fewer have concluded that a diagnosis of epilepsy increases the risk of future strokes. Precisely describing the causal relationship between epilepsy and stroke has clinical and public health implications.</div></div><div><h3>Methods</h3><div>We performed a two-sample Mendelian Randomization (MR) to analyze the relationship between epilepsy and stroke. We identified genetic instruments from the Stroke Multiancestry Genome-Wide Association Study [GCST005838 (67,162 cases and 454,450 controls)] and the International League Against Epilepsy Consortium on Complex Epilepsies [Generalized epilepsy: GCST007343 (n_case=3769, n_control=29677), Focal epilepsy: GCST007352 (n_case=9671, n_control=29677)]. We used a significance threshold of p-value &lt;5 × 10⁽⁻⁵⁾ for genetic instrument identification. We included the following epilepsy phenotypes: generalized epilepsy (GE), focal epilepsy (FE), childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), generalized epilepsy with tonic-clonic seizures (GTCS), focal epilepsy with hippocampal sclerosis (focal HS), and focal lesion-negative epilepsy. Linkage disequilibrium (LD) reference panel of 1000 Genome Project pruning with Pearson correlation <span><math><msup><mrow><mi>r</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> &lt; 0.2 was applied to ensure that the analysis is restricted to independent variants. We used Steiger filtering for reverse causality and Z-scores for generalized epilepsy and focal epilepsy. We employed the following methods for causal effect estimation: inverse-variance weighted (IVW), MR-Egger, MR-RAPS, and MRPRESSO.</div></div><div><h3>Results</h3><div>For the association between GE and stroke (GE&gt; stroke), stroke and GE (stroke &gt; GE), FE and stroke (FE&gt;stroke), and stroke and FE (stroke&gt;FE), the number of SNPs was respectively 253, 213, 187, and 210. GE was associated with an increased risk of stroke [IVW, 95 % confidence interval: 0.058 (0.028–0.088)], and stroke was also associated with an increased risk of GE [IVW: 0.059 (0.026–0.092)]. FE was associated with an increased risk of stroke [IVW: 0.066 (0.029–0.102)] and stroke was associated with an increased risk of FE [IVW: 0.037(0.005–0.068)]. The analysis by epilepsy subtypes revealed an increased risk only among patients with stroke and for the following epilepsy subtypes: JAE, CAE, Focal HS, and Focal lesion negative epilepsy.</div></div><div><h3>Conclusion</h3><div>Our findings support a bidirectional relationship between stroke and epilepsy. Studies on post-stroke epilepsy should account for this bidirectional relationship.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107714"},"PeriodicalIF":2.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated thalamic blood flow in self-limited epilepsy with centrotemporal spikes","authors":"Niki Iasinovschi ,&nbsp;Elizabeth Tong ,&nbsp;Lucia Bicknell ,&nbsp;Fiona Mitchell Baumer","doi":"10.1016/j.eplepsyres.2025.107716","DOIUrl":"10.1016/j.eplepsyres.2025.107716","url":null,"abstract":"<div><div>Children with self-limited epilepsy syndrome with centrotemporal spikes (SeLECTS) exhibit altered thalamocortical connectivity, but whether thalamic function itself is abnormal remains unclear. We investigated whether thalamic blood flow, a marker of metabolism, differs between children with SeLECTS and controls, and examined the effects of spike distribution and antiseizure medications (ASMs) on thalamic perfusion. In this retrospective cohort study, we identified consecutive children with SeLECTS who underwent magnetic resonance imaging (MRI) for epilepsy evaluation (n = 44) and age- and sex-matched children who underwent MRI for non-epilepsy indications (n = 35). We quantified thalamic blood flow via manual segmentation of cerebral blood flow (CBF) sequences obtained from arterial spin labeling MRI. Clinical variables including sedation use during MRI, daily ASM use, and spike distribution (unilateral or bilateral) were extracted from medical records. Children with SeLECTS demonstrated elevated thalamic blood flow compared to controls, with the most pronounced differences in specific subgroups. Children with unilateral spikes showed the highest CBF, particularly in the thalamus contralateral to spike activity. ASM use significantly modulated thalamic blood flow: children taking oxcarbazepine showed the highest CBF, while those on levetiracetam had CBF similar to controls. Unmedicated children showed intermediate elevations. These findings demonstrate that elevated thalamic blood flow may be intrinsic to SeLECTS pathophysiology, with different ASMs producing distinct neurobiological effects. The differential medication effects may relate to their clinical efficacy and provide neurobiological rationale for treatment selection in this common childhood epilepsy syndrome.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107716"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of cenobamate in the management in patients with drug resistant focal epilepsy – A retrospective real world observational study of patients attending NHS Greater Glasgow and Clyde","authors":"M. Taha ,&nbsp;L. Stephen ,&nbsp;S. Nichol ,&nbsp;S. Yule ,&nbsp;S. MacBride-Stewart ,&nbsp;AD Marshall ,&nbsp;CA Heath","doi":"10.1016/j.eplepsyres.2025.107717","DOIUrl":"10.1016/j.eplepsyres.2025.107717","url":null,"abstract":"<div><h3>Introduction</h3><div>Cenobamate (CNB) is the latest ASM to be licensed in the UK as an adjunctive treatment for adults with focal epilepsy. Early clinical trials have been encouraging with up to 50.4 % of patients showing a 50 % improvement at 12 weeks and 71 % were still receiving Cenobamate at 48 months. Regulatory studies of this nature provide useful information, but real-world data is often more informative.</div><div>Since Scottish Medicine Consortium approval in 2022, we have been collecting audit data on outcomes from patients receiving cenobamate.</div></div><div><h3>Methods</h3><div>Adult patients were included if they received at least one prescription for cenobamate between March 2022 and April 2024 and had at least 12 months of data available before their first prescription.</div><div>Patients dispensed cenobamate were identified from the national Prescribing Information System (PIS) to ensure complete patient capture.</div><div>A manual review of electronic patient records was undertaken. The primary outcome of interest was change in seizure frequency on a stable dose. Secondary outcomes included epilepsy-related admissions, changes in ASMs and healthcare resource utilisation costs.</div></div><div><h3>Results</h3><div>145 patients received at least 1 CNB prescription, 144 of whom had reached an endpoint. 94/144 (65.2 %) had a favourable response. The median length of treatment was 655 days (range 180–922 days), with a median dose of 150 mg/d (range 25–400 mg/d). The median number of previous ASM was 5 (1−13).</div><div>48/145 (33.1 %) discontinued CNB – 35 due to adverse effects, 6 due to lack of efficacy. 2 patients died.</div><div>Early analysis suggest a reduction in Health care resource use although long term follow up is required.</div></div><div><h3>Conclusion</h3><div>These results offer insights for clinicians regarding the real-world effectiveness, retention rates, and healthcare cost implications of CNB therapy in a cohort consisting largely of patients with severe drug resistant epilepsy. Further studies are ongoing to assess the efficacy of CNB when used earlier and also to provide a comprehensive assessment of health care resource use in this real world settings.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107717"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}