Epilepsy Research最新文献

{"title":"Healthcare resource utilization in adults with focal onset seizures before and after initiating cenobamate: A US database analysis","authors":"Alessandro Lovera ,&nbsp;Elena Alvarez-Baron ,&nbsp;Rafia Bosan ,&nbsp;Caroline Clare Benoist ,&nbsp;Paola Lipone ,&nbsp;Maria Teresa Rosignoli ,&nbsp;Alessandro Comandini ,&nbsp;Enrica Salvatori ,&nbsp;Hsiu-Ching Chang ,&nbsp;Queenie Paltanwale ,&nbsp;Efe Eworuke ,&nbsp;John Paul Leach ,&nbsp;Agnese Cattaneo","doi":"10.1016/j.eplepsyres.2026.107739","DOIUrl":"10.1016/j.eplepsyres.2026.107739","url":null,"abstract":"<div><h3>Background</h3><div>Antiseizure medications (ASMs) are the mainstay of treatment for patients with epilepsy, though over one third remain uncontrolled after treatment with at least two ASMs. Cenobamate is an ASM indicated for the treatment of adults with focal onset seizures (FOS) in the United States. In Europe cenobamate is approved for the adjunctive treatment of FOS in adult patients with epilepsy who have not been adequately controlled despite at least 2 previous ASMs. Real-world data helps to better describe the impact of cenobamate long-term effectiveness and tolerability/safety balance. Evidence reflecting a reduction of the impact of epilepsy on the daily lives of patients would be important when assessing and eventually predicting the benefit of treatments.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using the IQVIA PharMetrics Plus database among adult patients with both a claim for cenobamate between April 1, 2020, to April 30, 2023, and a diagnosis of FOS prior to the first cenobamate dispensing date (identified in the baseline period). Demographic characteristics were captured on the index date and clinical characteristics were captured in the 6 months baseline period; treatment patterns and healthcare resource utilization (HCRU) were assessed across 3 epochs forming 3 non-mutually exclusive cohorts: Cohort A, 6 months follow-up; Cohort B, 12 months follow-up; Cohort C, 18 months follow-up. Designated treatment regimen was defined by recorded ASMs prescribed in the 90 days following cenobamate dispensing (treatment regimen evaluation window), and patients were classified as ‘monotherapy’, ‘stable polytherapy’, or ‘changing treatment regimen’.</div></div><div><h3>Results</h3><div>Among the 1132 patients included in Cohort A, approximately half (45.1 %) had stable polytherapy, 1.5 % had monotherapy, and 53.5 % had a changing treatment regimen following initiation of cenobamate. Similar distribution of designation was present among the 800 patients in Cohort B and 554 patients in Cohort C. A lower proportion of patients required hospitalization and emergency department visits in the 6 months after cenobamate initiation compared to the 6-month pre-index period (Cohort A: 15.4 % vs. 21.9 % and 24.9 % vs. 30.9 % respectively). Lower HCRU reduction rates (%) per patient per month were found at 6, 12 and 18 months of follow-up.</div></div><div><h3>Conclusion</h3><div>Epilepsy-related hospitalizations and Emergency Room visits (indicators of seizures) were reduced in adult FOS patients with epilepsy 6, 12 and 18 months after initiating cenobamate as monotherapy or stable polytherapy, leading to reduced HCRUs and epilepsy costs.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107739"},"PeriodicalIF":2.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026045","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":"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":"Seizure recurrences after temporal lobe epilepsy surgery in childhood and adolescence: predictive factors, patterns of recurrence, and long-term outcomes","authors":"Ming-Chen Tsai ,&nbsp;Keith Starnes ,&nbsp;Anthony L. Fine ,&nbsp;Katherine C. Nickels ,&nbsp;Elaine C. Wirrell ,&nbsp;Jamie J. Van Gompel ,&nbsp;Kai J. Miller ,&nbsp;Lily C. Wong-Kisiel","doi":"10.1016/j.eplepsyres.2026.107732","DOIUrl":"10.1016/j.eplepsyres.2026.107732","url":null,"abstract":"<div><h3>Background</h3><div>Temporal lobe epilepsy (TLE) is the leading cause of drug-resistant focal epilepsy. Surgery is effective, yet many patients experience postoperative seizure recurrence.</div></div><div><h3>Objective</h3><div>To identify predictors of recurrence and characterize recurrence patterns, treatment responses, and long-term outcomes using a 16-year surgical database.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed children and adolescents (0–19 years) with TLE who underwent resective or destructive temporal lobe surgery at Mayo Clinic, Rochester (2008–2024). All patients underwent scalp EEG phase I monitoring and 1.5 T or 3 T MRI, with invasive monitoring and advanced imaging studies utilized in selected patients when clinically indicated. Patients with prior epilepsy surgery, &lt;1-year follow-up, or without research authorization were excluded. Data were analyzed using descriptive statistics, survival analysis, and Cox proportional hazard models. Seizure recurrence was categorized as acute post-operative seizures (APOS, ≤1 week post-surgery), early recurrence (&gt;1 week–2 years), and late recurrence (&gt;2 years). Delayed seizure freedom was defined as ≥1 year seizure-free before last follow-up after recurrence.</div></div><div><h3>Results</h3><div>Among 61 patients, 34 (55.7 %) had recurrence over a median follow-up of 49 months. Median time to first recurrence was 48 months. Four patients (6.5 %) had APOS; all developed early recurrence. APOS predicted early recurrence (HR = 6.02, 95 % CI = 1.64–22.04, p = 0.006). Delayed seizure freedom was achieved with medication trials in 19 % (5/26) of early and 75 % (6/8) of late recurrences. At last follow-up, 68 % (42/61) were seizure free: 44 % (27/61) since the first surgery and 24 % (15/61) after recurrence.</div></div><div><h3>Conclusion</h3><div>Temporal lobe epilepsy surgery provides durable seizure control in two-thirds of pediatric and adolescent patients. APOS may predict early recurrence, which is often less medically responsive and may warrant repeat surgery.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107732"},"PeriodicalIF":2.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006812","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":"Status epilepticus in scrub typhus versus tuberculous meningitis: A comparative study","authors":"Jayantee Kalita ,&nbsp;Firoz M. Nizami ,&nbsp;Prakash C. Pandey ,&nbsp;Archna Gupta","doi":"10.1016/j.eplepsyres.2026.107737","DOIUrl":"10.1016/j.eplepsyres.2026.107737","url":null,"abstract":"<div><h3>Background</h3><div>Scrub typhus (ST) and tuberculous meningitis (TBM) are common infections in tropical regions and can present with various neurological manifestations, including seizures and status epilepticus (SE). This study compared the demographic profiles, clinical features, treatment responses, and outcomes of SE in patients with TBM and ST, using data from our patient cohort and existing literature.</div></div><div><h3>Methods</h3><div>Patients with TBM or ST presenting with SE were identified from ongoing prospective registries. Detailed demographic, clinical, laboratory, EEG, and MRI findings, along with treatment response and outcomes, were recorded and compared between the groups.</div></div><div><h3>Results</h3><div>Twenty-eight out of 587 meningitis patient had SE; 17 had TBM and 11 ST. ST patients had lower hemoglobin (p = 0.005), lower platelet counts (p &lt; 0.001), and higher serum creatinine (p = 0.01), bilirubin (p = 0.01), and ALT (p = 0.02) than TBM-SE patients. MRI was abnormal in all TBM-SE patients, but normal in ST-SE. TBM patients had delayed SE (88.2 %), whereas all the ST patients had early onset SE (p &lt; 0.001). TBM-SE required 3 or more antiseizure medications (ASM) and had often refractory (58.8 % vs. 27.3 %) and super-refractory SE (17.6 % vs. 0 %). Mortality was higher in TBM-SE (47.1 %), whereas all ST-SE patients recovered. Only 33 % TBM survivors had good recovery at 6 months. None of the ST patients had recurrence or breakthrough seizure after withdrawal of ASM.</div></div><div><h3>Conclusions</h3><div>SE in TBM is more refractory and associated with higher mortality and disability than in ST. ASM may be safely withdrawn early in ST-SE, whereas TBM-SE requires prolonged treatment.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107737"},"PeriodicalIF":2.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009406","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":"Assessing an fMRI-guided titration paradigm for microburst VNS therapy","authors":"Kristl Vonck ,&nbsp;Ryan Verner ,&nbsp;Giovanni Ranuzzi ,&nbsp;Roshani Patel ,&nbsp;William O. Tatum ,&nbsp;Lesley Kaye ,&nbsp;Cornelia Drees ,&nbsp;Muhammad Zafar ,&nbsp;Rebecca O’Dwyer ,&nbsp;Jason Begnaud ,&nbsp;Jerzy P. Szaflarski ,&nbsp;on behalf of the Microburst Study Group","doi":"10.1016/j.eplepsyres.2026.107734","DOIUrl":"10.1016/j.eplepsyres.2026.107734","url":null,"abstract":"<div><h3>Rationale</h3><div>VNS is an efficacious therapy for people with epilepsy (PwE), but personalized implementation of VNS dosing and titration could be improved by measuring therapeutic engagement of cortical and subcortical physiology.</div></div><div><h3>Methods</h3><div>People with Drug-Resistant Epilepsy (DRE) were enrolled into a feasibility study using investigational microburst VNS (NCT03446664). An investigational VNS system with conditional approval for stimulation in the magnetic environment was titrated using an fMRI-guided titration approach to determine VNS therapy settings for each individual participant over 6 months. Stimulation parameter combinations that evoked the highest thalamic BOLD response were chosen in an individual participant as the preferred VNS therapy setting.</div></div><div><h3>Results</h3><div>Thirty-two participants were implanted and 31 participants attended the 6-month study visit and at least one prior fMRI study visit. In all participants, significant VNS-evoked thalamic BOLD responses were found. Participants who experienced significant thalamic BOLD signal among multiple stimulation parameter combinations over multiple visits were most likely to respond to µVNS. Participants responded to µVNS with a median reduction in seizure frequency of 42.6 % at 6 months. There were no MRI-related safety issues associated with active VNS during scanning.</div></div><div><h3>Conclusion</h3><div>Titration of VNS using an fMRI-guided approach is feasible and safe in PwE (when using appropriate investigational devices), but our specific biomarker, used in this specific study design, was ultimately too variable to be used for patient-specific titration. An increase in thalamic BOLD signal that occurred across multiple stimulation parameter combinations and multiple visits with microburst settings was associated with seizure response that could be visualized early in the titration process.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"221 ","pages":"Article 107734"},"PeriodicalIF":2.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060854","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":"A systematic review of highly purified cannabidiol in developmental and epileptic encephalopathies and complex treatment-resistant epilepsies: Changes in seizure frequency and adverse events","authors":"Antonietta Coppola ,&nbsp;Lisa Moore-Ramdin ,&nbsp;Marco Navetta ,&nbsp;Debopam Samanta","doi":"10.1016/j.eplepsyres.2026.107731","DOIUrl":"10.1016/j.eplepsyres.2026.107731","url":null,"abstract":"<div><h3>Objective</h3><div>The efficacy and safety of a highly purified plant-derived cannabidiol (CBD) oral solution (Epidiolex® [US]/Epidyolex® [EU], EPX) have been established for the treatment of seizures in patients with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. These conditions involve diverse etiologies, suggesting EPX may have broad utility across different seizure types. This systematic literature review (SLR) evaluated studies reporting CBD effectiveness and tolerability in patients with other developmental and epileptic encephalopathies (DEEs) and complex treatment-resistant epilepsies (TREs).</div></div><div><h3>Methods</h3><div>In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an SLR was conducted in March 2024 using Embase, PubMed, and Cochrane libraries for publications on complex TREs, CBD, seizure outcomes, and adverse events (AEs). Results were narratively summarized according to epilepsy type.</div></div><div><h3>Results</h3><div>Seizure frequency-related changes were reported in 57 studies including 37 DEEs/TREs comprising 971 patients; most (n=33)(n = 33) were case reports/small case series. Most common diagnoses were focal/multifocal-onset epilepsy (n=401)(n = 401) and Angelman syndrome (n=188).(n = 188). Overall, 47 studies reported seizure frequency reduction in ≥1≥ 1 patient; definitions/thresholds included seizure reduction (n = 18 studies; 20–100 % of patients) and mean/median percent seizure reduction (n = 8 studies; 12–99 % reduction). Twenty-two studies reported ≥ 1 patient was seizure-free for ≥ 48 days.</div><div>AEs experienced while taking CBD were generally mild or moderate and most commonly gastrointestinal, including diarrhea (17–50 %), decreased appetite (7–45 %), and vomiting (5–86 %).</div></div><div><h3>Conclusion</h3><div>CBD may reduce seizure frequency in patients with a range of DEEs and complex TREs. These findings support future studies in these populations.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"220 ","pages":"Article 107731"},"PeriodicalIF":2.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009412","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}