Pub Date : 2025-08-22DOI: 10.1016/j.eplepsyres.2025.107641
Stephanie DeGasperis, Rajesh RamachandranNair, Kevin C. Jones, Robyn Whitney
Introduction
Variants in SYNGAP1 cause a rare childhood-onset developmental and epileptic encephalopathy (DEE). Limited reports describe palliative surgical procedures such as corpus callosotomy (CC) and vagus nerve stimulation (VNS) in SYNGAP1-related DEE.
Methods
A retrospective chart review of de-identified medical records from the SynGAP Research Fund Citizen Health Database (Citizen) who underwent CC and/or VNS was conducted. This was supplemented with one child from our centre. Details related to epilepsy, comorbidities, genetics, electroencephalogram/neuroimaging findings and treatment response are summarized.
Results
We identified 185 children with likely pathogenic/pathogenic variants in SYNGAP1; 156 had epilepsy (n = 156/185, 84.3 %). Fifteen children had palliative procedures (15/156, 9.6 %). Eleven children had VNS (n = 11/15, 73.3 %), and the median follow-up was 3.3 years (IQR 5.6, 3.3). Seven children had an initial > 50 % seizure reduction (n = 7/11, 63.6 %), 2 had worsening (n = 2/11, 18.2 %), 1 had no change (n = 1/11, 9.1 %), and 1 had an unknown response (n = 1/11, 9.1 %). VNS response was sustained in 3 children (3/11, 27.3 %). Two children (n = 2/15, 13.3 %) had CC only with a mean follow-up of 3.1 years; 1 became seizure-free, and the other had > 50 % seizure reduction. Two children (n = 2/15, 13.3 %) underwent VNS then CC, 1 had a > 50 % overall seizure reduction, and one had minimal change; mean follow up from CC was 3.1 years. One child from our centre had a sustained > 80 % seizure reduction (1.5 years) following CC at 7 years.
Conclusion
The effect of VNS was variable and sustained in less children over time. CC appeared to be more effective in the few treated. Larger cohorts are required to confirm these findings in SYNGAP1-related DEE.
{"title":"SYNGAP-1 developmental and epileptic encephalopathy: Utility of corpus callosotomy and neuromodulation","authors":"Stephanie DeGasperis, Rajesh RamachandranNair, Kevin C. Jones, Robyn Whitney","doi":"10.1016/j.eplepsyres.2025.107641","DOIUrl":"10.1016/j.eplepsyres.2025.107641","url":null,"abstract":"<div><h3>Introduction</h3><div>Variants in <em>SYNGAP1</em> cause a rare childhood-onset developmental and epileptic encephalopathy (DEE). Limited reports describe palliative surgical procedures such as corpus callosotomy (CC) and vagus nerve stimulation (VNS) in <em>SYNGAP1</em>-related DEE.</div></div><div><h3>Methods</h3><div>A retrospective chart review of de-identified medical records from the SynGAP Research Fund Citizen Health Database (Citizen) who underwent CC and/or VNS was conducted. This was supplemented with one child from our centre. Details related to epilepsy, comorbidities, genetics, electroencephalogram/neuroimaging findings and treatment response are summarized.</div></div><div><h3>Results</h3><div>We identified 185 children with likely pathogenic/pathogenic variants in <em>SYNGAP1</em>; 156 had epilepsy (n = 156/185, 84.3 %). Fifteen children had palliative procedures (15/156, 9.6 %). Eleven children had VNS (n = 11/15, 73.3 %), and the median follow-up was 3.3 years (IQR 5.6, 3.3). Seven children had an initial > 50 % seizure reduction (n = 7/11, 63.6 %), 2 had worsening (n = 2/11, 18.2 %), 1 had no change (n = 1/11, 9.1 %), and 1 had an unknown response (n = 1/11, 9.1 %). VNS response was sustained in 3 children (3/11, 27.3 %). Two children (n = 2/15, 13.3 %) had CC only with a mean follow-up of 3.1 years; 1 became seizure-free, and the other had > 50 % seizure reduction. Two children (n = 2/15, 13.3 %) underwent VNS then CC, 1 had a > 50 % overall seizure reduction, and one had minimal change; mean follow up from CC was 3.1 years. One child from our centre had a sustained > 80 % seizure reduction (1.5 years) following CC at 7 years.</div></div><div><h3>Conclusion</h3><div>The effect of VNS was variable and sustained in less children over time. CC appeared to be more effective in the few treated. Larger cohorts are required to confirm these findings in <em>SYNGAP1</em>-related DEE.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107641"},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892179","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}
Pub Date : 2025-08-21DOI: 10.1016/j.eplepsyres.2025.107642
Ryan Budde , Laura RoaFiore , Pedro Irazoqui
Objective: Sudden unexpected death in epilepsy (SUDEP) is suggested to be a cardiorespiratory collapse that occurs shortly after a seizure. The impacts of seizure on medullary respiratory control remain poorly understood. Prior work in rats suggests that reflexive apneas are highly fatal during seizure but well tolerated otherwise. These reflexes share network connectivity in the medulla, particularly the caudal solitary nucleus (NTS) and ventral respiratory column (VRC), and possibly other intermediate structures. We sought to observe the activity in these regions in fatal ictal apneas. Methods: We collected data from urethane anesthetized long evans rats. To record neural activity we used either 125 µm silver wire in the caudal NTS or a Neuropixel 1.0 probe along a dorsoventral trajectory that spanned the caudal NTS to the VRC. We additionally recorded cardiorespiratory activity via several methods. We induced a reflexive apnea – the diving reflex – by nasal irrigation of cold water for several seconds, which produces a period of apnea, then gasping, and then a gradual return to eupnea. We repeated several trials while the animal was healthy and subsequently induced continuous seizure activity with kainate and repeated the reflexes, which are ultimately fatal during seizure. Results: Seizure activity confounds many established methods of analyzing high-density single unit data such as provided by Neuropixels probes, and so our analyses focus on averaging responses over larger anatomical regions (120 µm) covering small populations of neurons. Seizure produces broad increases in neuronal activity across the medullary tract, which by itself is not dangerous. Ictal reflexive apneas were broadly more inhibitory (producing a reduction in firing rate) than they were preictally, and fatal ictal responses resulted in a very rapid shutdown of all medullary activity. We only rarely observed ictal central apneas (apneas with no apparent stimuli), but when we did they were apparently safe, always survived, and produced no significant change in network activity (neither increase nor decrease). Conclusions: These data support the theory that central apnea events in seizure are relatively safe as we observed they produce little change in the medullary tract network, while stimuli-induced-reflexive-apneas are dangerous because they produce profound quieting across respiratory centers. Our data suggest that seizure spreads to this medullary tract at approximately the same rate and intensity as forebrain, as previously described in this model. These data are supportive of SUDEP mechanisms involving brainstem inhibition as a primary cause, such as spreading depolarization waves. These findings likely extend beyond nasal irrigation to any sensory reflexive apnea caused by airway irritation of any kind, and may bear relevance to similar deaths seen in infants.
{"title":"High density probes reveal medullary seizure and rapid medullary shutdown in a model of fatal apnea in seizure","authors":"Ryan Budde , Laura RoaFiore , Pedro Irazoqui","doi":"10.1016/j.eplepsyres.2025.107642","DOIUrl":"10.1016/j.eplepsyres.2025.107642","url":null,"abstract":"<div><div>Objective: Sudden unexpected death in epilepsy (SUDEP) is suggested to be a cardiorespiratory collapse that occurs shortly after a seizure. The impacts of seizure on medullary respiratory control remain poorly understood. Prior work in rats suggests that reflexive apneas are highly fatal during seizure but well tolerated otherwise. These reflexes share network connectivity in the medulla, particularly the caudal solitary nucleus (NTS) and ventral respiratory column (VRC), and possibly other intermediate structures. We sought to observe the activity in these regions in fatal ictal apneas. Methods: We collected data from urethane anesthetized long evans rats. To record neural activity we used either 125 <em>µ</em>m silver wire in the caudal NTS or a Neuropixel 1.0 probe along a dorsoventral trajectory that spanned the caudal NTS to the VRC. We additionally recorded cardiorespiratory activity via several methods. We induced a reflexive apnea – the diving reflex – by nasal irrigation of cold water for several seconds, which produces a period of apnea, then gasping, and then a gradual return to eupnea. We repeated several trials while the animal was healthy and subsequently induced continuous seizure activity with kainate and repeated the reflexes, which are ultimately fatal during seizure. Results: Seizure activity confounds many established methods of analyzing high-density single unit data such as provided by Neuropixels probes, and so our analyses focus on averaging responses over larger anatomical regions (120 <em>µ</em>m) covering small populations of neurons. Seizure produces broad increases in neuronal activity across the medullary tract, which by itself is not dangerous. Ictal reflexive apneas were broadly more inhibitory (producing a reduction in firing rate) than they were preictally, and fatal ictal responses resulted in a very rapid shutdown of all medullary activity. We only rarely observed ictal central apneas (apneas with no apparent stimuli), but when we did they were apparently safe, always survived, and produced no significant change in network activity (neither increase nor decrease). Conclusions: These data support the theory that central apnea events in seizure are relatively safe as we observed they produce little change in the medullary tract network, while stimuli-induced-reflexive-apneas are dangerous because they produce profound quieting across respiratory centers. Our data suggest that seizure spreads to this medullary tract at approximately the same rate and intensity as forebrain, as previously described in this model. These data are supportive of SUDEP mechanisms involving brainstem inhibition as a primary cause, such as spreading depolarization waves. These findings likely extend beyond nasal irrigation to any sensory reflexive apnea caused by airway irritation of any kind, and may bear relevance to similar deaths seen in infants.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107642"},"PeriodicalIF":2.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890017","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}
Pub Date : 2025-08-13DOI: 10.1016/j.eplepsyres.2025.107640
Syeda Amrah Hashmi , Mark Quigg , Anelyssa D’Abreu , Carol Manning , Jaideep Kapur , Ifrah Zawar
Objectives
Comorbid seizures occur in 2–11 % of frontotemporal dementia(FTD). Despite the high risk for seizures, the risk factors, clinical characteristics, and seizure outcomes in FTD patients with comorbid seizures remain understudied.
Methods
All patients who presented to our hospital from 5/1/2011–4/30/2024 with a clinical diagnosis of FTD were included and subclassified into behavioral-variant FTD(bvFTD), sematic-variant-primary-progressive-aphasia(svPPA), or non-fluent-primary-progressive-aphasia(nfPPA). Demographics, comorbidities, dementia characteristics, and seizure characteristics were obtained from electronic medical records. Patients were classified into those with(FTD+SZ) or without(FTD-SZ) clinically-diagnosed seizures. Seizure outcome was categorized as uncontrolled, controlled on anti-seizure-medications(ASMs), or self-resolving if resolved without ASMs. Data were analyzed using Pearson’s Chi-squared, Fisher Exact, or t-tests.
Results
Of 317 FTD patients(average age of dementia onset=64.18+9.07years,46.37 % female]), 24(7.6 %) reported seizures. FTD+SZ were more likely to have anxiety(FTD+SZ=7(29.17 %),FTD-SZ= 35(11.95 %),p = 0.0392).Traumatic brain injury(TBI) was the only risk factor for seizures(FTD+SZ=6(25 %),FTD-SZ= 18(6 %),p < 0.001). BvFTD was the most common subtype in FTD+SZ(54.17 %). Focal seizures were more common(50 %) than generalized (29.17 %), with temporal-lobe epilepsy(TLE) being the most common subtype of focal seizures(42 %). Levetiracetam was the most frequently used ASM(38.1 %). Seizures had a favorable prognosis, with 87.5 % achieving seizure control through ASMs, and seizures self-resolving in the rest. FTD+SZ were more likely to be older at death(FTD+SZ=78.63years,FTD-SZ=71.37,p = 0.03966).
Significance
The prevalence of comorbid seizures in FTD at our single-center is 7.6 %. They were most common in bvFTD, primarily focal, with TLE as the predominant subtype. Anxiety was more prevalent with comorbid seizures. Most achieved seizure control on ASMs. FTD+SZ were older at death. These findings address a critical gap, guiding diagnosis, management, and future research.
{"title":"Co-morbid seizures in frontotemporal dementia: What do they tell us?","authors":"Syeda Amrah Hashmi , Mark Quigg , Anelyssa D’Abreu , Carol Manning , Jaideep Kapur , Ifrah Zawar","doi":"10.1016/j.eplepsyres.2025.107640","DOIUrl":"10.1016/j.eplepsyres.2025.107640","url":null,"abstract":"<div><h3>Objectives</h3><div>Comorbid seizures occur in 2–11 % of frontotemporal dementia(FTD). Despite the high risk for seizures, the risk factors, clinical characteristics, and seizure outcomes in FTD patients with comorbid seizures remain understudied.</div></div><div><h3>Methods</h3><div>All patients who presented to our hospital from 5/1/2011–4/30/2024 with a clinical diagnosis of FTD were included and subclassified into behavioral-variant FTD(bvFTD), sematic-variant-primary-progressive-aphasia(svPPA), or non-fluent-primary-progressive-aphasia(nfPPA). Demographics, comorbidities, dementia characteristics, and seizure characteristics were obtained from electronic medical records. Patients were classified into those with(FTD+SZ) or without(FTD-SZ) clinically-diagnosed seizures. Seizure outcome was categorized as uncontrolled, controlled on anti-seizure-medications(ASMs), or self-resolving if resolved without ASMs. Data were analyzed using Pearson’s Chi-squared, Fisher Exact, or t-tests.</div></div><div><h3>Results</h3><div>Of 317 FTD patients(average age of dementia onset=64.18<u>+</u>9.07years,46.37 % female]), 24(7.6 %) reported seizures. FTD+SZ were more likely to have anxiety(FTD+SZ=7(29.17 %),FTD-SZ= 35(11.95 %),p = 0.0392).Traumatic brain injury(TBI) was the only risk factor for seizures(FTD+SZ=6(25 %),FTD-SZ= 18(6 %),p < 0.001). BvFTD was the most common subtype in FTD+SZ(54.17 %). Focal seizures were more common(50 %) than generalized (29.17 %), with temporal-lobe epilepsy(TLE) being the most common subtype of focal seizures(42 %). Levetiracetam was the most frequently used ASM(38.1 %). Seizures had a favorable prognosis, with 87.5 % achieving seizure control through ASMs, and seizures self-resolving in the rest. FTD+SZ were more likely to be older at death(FTD+SZ=78.63years,FTD-SZ=71.37,p = 0.03966).</div></div><div><h3>Significance</h3><div>The prevalence of comorbid seizures in FTD at our single-center is 7.6 %. They were most common in bvFTD, primarily focal, with TLE as the predominant subtype. Anxiety was more prevalent with comorbid seizures. Most achieved seizure control on ASMs. FTD+SZ were older at death. These findings address a critical gap, guiding diagnosis, management, and future research.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107640"},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865076","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}
Pub Date : 2025-08-09DOI: 10.1016/j.eplepsyres.2025.107639
Herbert Peeples , Emily Achter , Christopher Dieyi , Keshia Maughn
Objective
To describe access challenges, barriers to antiseizure medications (ASMs), and impact of ASM formulary policies for patients with epilepsy (PWE).
Methods
Observational study of de-identified claims from an all-payer claims database (2014–2021) and a formulary/payer policy database. Adults prescribed ≥ 1 ASM following initial epilepsy diagnosis, with continuous medical/pharmacy benefits, were included. Demographic characteristics, proximity to/use of a neurology health care professional (HCP), health care resource utilization (HCRU), and costs were assessed.
Results
In total, 35,351, 33,339, and 24,722 PWE with commercial, Medicare, and Medicaid insurance, respectively, were included. The Medicare group was older, had a higher comorbidity index score, more males, and fewer non-White and Hispanic individuals versus other groups. Most (> 58 %) commercially-insured PWE had coverage to all six first-generation ASMs examined, six to 12 second-generation ASMs, and all four third-generation ASMs; coverage rates were higher for Medicaid while data for Medicare were incomplete. Most commercial and Medicaid PWE had no access requirements to first-generation ASMs; approximately two-thirds and half of patients had access requirements for second- and third-generation ASMs, respectively. Although > 90 % of PWE used a neurology HCP during follow-up, only about one-third lived within proximity. Of PWE with formulary data (N = 77,787), > 80 % and < 8.0 % were prescribed second- and third-generation ASMs, respectively. There were no clear patterns in epilepsy-related HCRU/cost.
Conclusions
Data revealed difficulties in neurologist access and predominant use of second-generation ASMs, despite access restrictions for many PWE, suggesting obstacles in accessing treatment and specialist care.
{"title":"Health care burden of access barriers to epilepsy care in the United States: A claims-based analysis of payer channels","authors":"Herbert Peeples , Emily Achter , Christopher Dieyi , Keshia Maughn","doi":"10.1016/j.eplepsyres.2025.107639","DOIUrl":"10.1016/j.eplepsyres.2025.107639","url":null,"abstract":"<div><h3>Objective</h3><div>To describe access challenges, barriers to antiseizure medications (ASMs), and impact of ASM formulary policies for patients with epilepsy (PWE).</div></div><div><h3>Methods</h3><div>Observational study of de-identified claims from an all-payer claims database (2014–2021) and a formulary/payer policy database. Adults prescribed ≥ 1 ASM following initial epilepsy diagnosis, with continuous medical/pharmacy benefits, were included. Demographic characteristics, proximity to/use of a neurology health care professional (HCP), health care resource utilization (HCRU), and costs were assessed.</div></div><div><h3>Results</h3><div>In total, 35,351, 33,339, and 24,722 PWE with commercial, Medicare, and Medicaid insurance, respectively, were included. The Medicare group was older, had a higher comorbidity index score, more males, and fewer non-White and Hispanic individuals versus other groups. Most (> 58 %) commercially-insured PWE had coverage to all six first-generation ASMs examined, six to 12 second-generation ASMs, and all four third-generation ASMs; coverage rates were higher for Medicaid while data for Medicare were incomplete. Most commercial and Medicaid PWE had no access requirements to first-generation ASMs; approximately two-thirds and half of patients had access requirements for second- and third-generation ASMs, respectively. Although > 90 % of PWE used a neurology HCP during follow-up, only about one-third lived within proximity. Of PWE with formulary data (N = 77,787), > 80 % and < 8.0 % were prescribed second- and third-generation ASMs, respectively. There were no clear patterns in epilepsy-related HCRU/cost.</div></div><div><h3>Conclusions</h3><div>Data revealed difficulties in neurologist access and predominant use of second-generation ASMs, despite access restrictions for many PWE, suggesting obstacles in accessing treatment and specialist care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107639"},"PeriodicalIF":2.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890018","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}
Pub Date : 2025-08-05DOI: 10.1016/j.eplepsyres.2025.107637
Ima Ebong , Pam Eads , Georgette Charles
Objective
Many factors influence patients’ experience with epilepsy, including inequities based on socially defined race and ethnicity. We sought to better understand factors contributing to health disparities in Black people living with epilepsy (PWE), as perceived by neurologists, and the value of programs to help healthcare providers (HCPs) reduce these disparities.
Methods
An online, blinded, cross-sectional survey was administered to neurologists (November 8–18, 2022) whose population of PWE included ≥ 20 % of Black individuals and who had managed ≥ 10 PWE in the last 30 days. Questions assessed recognition of health disparities in PWE and the value of HCP-focused programs to address disparities. Statistical comparisons were performed by practice setting (academic vs. community).
Results
Of 101 neurologists, 48.5 % and 51.5 % worked in academic and community settings, respectively, 2.0 % of all neurologists were Black, and 28.3 % of neurologists’ patients were Black. Situations most commonly having a major/severe negative health impact were ‘inconsistent treatment adherence/compliance’ and ‘have significant comorbidities’ in all PWE, and ‘missed appointments’ and ‘mistrust in the healthcare system’ in Black PWE. In total, 27.7 % of neurologists (42.9 % academic vs. 13.5 % community-based; p < 0.05) completely agreed that racism is a social determinant of health (SDOH). HCP-focused programs were generally considered as somewhat/very important to improve outcomes in Black PWE.
Conclusions
Fewer than a third of neurologists completely agreed that racism is an SDOH, variably suggesting no perceived differences in their patient populations (leading to disagreement) or providing evidence of implicit/unconscious bias. Increasing neurologists' participation in HCP-focused programs may help counter health disparities in Black PWE, or at a minimum improve awareness that disparities exist.
{"title":"Perceptions of health disparities among neurologists treating Black patients with epilepsy: A survey study in the United States","authors":"Ima Ebong , Pam Eads , Georgette Charles","doi":"10.1016/j.eplepsyres.2025.107637","DOIUrl":"10.1016/j.eplepsyres.2025.107637","url":null,"abstract":"<div><h3>Objective</h3><div>Many factors influence patients’ experience with epilepsy, including inequities based on socially defined race and ethnicity. We sought to better understand factors contributing to health disparities in Black people living with epilepsy (PWE), as perceived by neurologists, and the value of programs to help healthcare providers (HCPs) reduce these disparities.</div></div><div><h3>Methods</h3><div>An online, blinded, cross-sectional survey was administered to neurologists (November 8–18, 2022) whose population of PWE included ≥ 20 % of Black individuals and who had managed ≥ 10 PWE in the last 30 days. Questions assessed recognition of health disparities in PWE and the value of HCP-focused programs to address disparities. Statistical comparisons were performed by practice setting (academic vs. community).</div></div><div><h3>Results</h3><div>Of 101 neurologists, 48.5 % and 51.5 % worked in academic and community settings, respectively, 2.0 % of all neurologists were Black, and 28.3 % of neurologists’ patients were Black. Situations most commonly having a major/severe negative health impact were ‘inconsistent treatment adherence/compliance’ and ‘have significant comorbidities’ in all PWE, and ‘missed appointments’ and ‘mistrust in the healthcare system’ in Black PWE. In total, 27.7 % of neurologists (42.9 % academic vs. 13.5 % community-based; p < 0.05) completely agreed that racism is a social determinant of health (SDOH). HCP-focused programs were generally considered as somewhat/very important to improve outcomes in Black PWE.</div></div><div><h3>Conclusions</h3><div>Fewer than a third of neurologists completely agreed that racism is an SDOH, variably suggesting no perceived differences in their patient populations (leading to disagreement) or providing evidence of implicit/unconscious bias. Increasing neurologists' participation in HCP-focused programs may help counter health disparities in Black PWE, or at a minimum improve awareness that disparities exist.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107637"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829607","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}
Pub Date : 2025-07-30DOI: 10.1016/j.eplepsyres.2025.107636
Anna Sákovics , Gábor Csukly , Csaba Borbély , Anna Kelemen , Zsófia Jordán , Boglárka Hajnal , Johanna Petra Szabó , Loránd Erőss , Dániel Fabó
Background
Cognitive disturbances are highly prevalent in focal epilepsy and are often attributed to multifactorial causes, though the specific contributions of various predictors remain poorly understood. This study aimed to identify and prioritize factors contributing to memory deficits in temporal lobe epilepsy, with a particular emphasis on interictal epileptiform discharges (IED).
Methods
In a cohort of 48 patients with temporal lobe epilepsy undergoing presurgical evaluation with invasive foramen ovale electrodes, we examined offline memory performance alongside language and attention as controls. Cognitive performance was correlated with mesial temporal IED rates recorded over 24 h and additional factors, including seizure characteristics, age at onset, epilepsy duration, temporal lobe lesions, and antiseizure medication use.
Results
A robust negative correlation emerged between mesial temporal IED rates and hippocampal-dependent cognitive scores (r = -0.43 - −0.29, p < 0.05), suggesting a direct impact of IEDs on memory consolidation processes. Epilepsy duration, antiseizure medication use and generalized seizures showed limited associations, but other variables including seizure frequency did not significantly correlate with cognitive performance.
Significance
Our findings suggest that IEDs may be the most relevant confounding factor contributing to sustained cognitive deficits in focal epilepsy. While IEDs are recognized markers of transient cognitive disruption, they have not yet demonstrated sufficient sensitivity or specificity as biomarkers of long-term cognitive dysfunction. Our study highlights the potential of IED frequency as a practical, clinically accessible biomarker for predicting chronic cognitive decline. These results emphasize the importance of developing targeted therapeutic strategies aimed at reducing interictal activity to improve cognitive outcomes.
{"title":"Interictal epileptiform discharges as the most significant confounding factor underlying memory impairment in focal epilepsy","authors":"Anna Sákovics , Gábor Csukly , Csaba Borbély , Anna Kelemen , Zsófia Jordán , Boglárka Hajnal , Johanna Petra Szabó , Loránd Erőss , Dániel Fabó","doi":"10.1016/j.eplepsyres.2025.107636","DOIUrl":"10.1016/j.eplepsyres.2025.107636","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive disturbances are highly prevalent in focal epilepsy and are often attributed to multifactorial causes, though the specific contributions of various predictors remain poorly understood. This study aimed to identify and prioritize factors contributing to memory deficits in temporal lobe epilepsy, with a particular emphasis on interictal epileptiform discharges (IED).</div></div><div><h3>Methods</h3><div>In a cohort of 48 patients with temporal lobe epilepsy undergoing presurgical evaluation with invasive foramen ovale electrodes, we examined offline memory performance alongside language and attention as controls. Cognitive performance was correlated with mesial temporal IED rates recorded over 24 h and additional factors, including seizure characteristics, age at onset, epilepsy duration, temporal lobe lesions, and antiseizure medication use.</div></div><div><h3>Results</h3><div>A robust negative correlation emerged between mesial temporal IED rates and hippocampal-dependent cognitive scores (r = -0.43 - −0.29, p < 0.05), suggesting a direct impact of IEDs on memory consolidation processes. Epilepsy duration, antiseizure medication use and generalized seizures showed limited associations, but other variables including seizure frequency did not significantly correlate with cognitive performance.</div></div><div><h3>Significance</h3><div>Our findings suggest that IEDs may be the most relevant confounding factor contributing to sustained cognitive deficits in focal epilepsy. While IEDs are recognized markers of transient cognitive disruption, they have not yet demonstrated sufficient sensitivity or specificity as biomarkers of long-term cognitive dysfunction. Our study highlights the potential of IED frequency as a practical, clinically accessible biomarker for predicting chronic cognitive decline. These results emphasize the importance of developing targeted therapeutic strategies aimed at reducing interictal activity to improve cognitive outcomes.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107636"},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842637","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}
Epilepsy affects approximately 50 million people worldwide. Antiseizure medications (ASMs) are essential for seizure control. However, adverse psychiatric effects, particularly hostility and aggression, affect treatment adherence and the quality of life. The risk factors and mechanisms underlying these adverse effects remain unclear.
Objective
This study aimed to classify ASM-induced hostility/aggression using the Food and Drug Administration Adverse Event Reporting System (FAERS), a global pharmacovigilance database, focusing on the risk factors and onset patterns of levetiracetam-induced hostility/aggression.
Methods
The FAERS database (2004 Q1–2022 Q1) was analyzed to calculate the reporting odds ratios for ASM-induced hostility/aggression, which were classified using a principal component analysis. Levetiracetam-induced adverse effects and the associated independent risk factors were examined. Weibull distribution analysis was used to assess the time-to-onset patterns
Results
Principal component analysis identified eight ASM-induced adverse effects, including "aggression," "anger,” “homicidal ideation," and "hostility." In those taking levetiracetam aged ≥ 12 years, male sex, younger age, and specific concomitant medications were independent risk factors for levetiracetam-induced adverse effects. Levetiracetam-induced adverse effects exhibited an early failure pattern, with a median onset of 4.5 days in patients aged ≥ 12 years and 1.5 days in those < 12 years.
Conclusion
In this study, we classified ASM-induced hostility/aggression and estimated the risk factors for levetiracetam-induced adverse effects. In particular, we identified early-onset patterns and high-risk patient profiles. These findings are consistent with clinical observations and provide insight into the mechanisms underlying these adverse effects, which will contribute to proactive risk management and personalized treatment strategies.
{"title":"Principal component analysis of antiseizure medication-induced hostility/aggression and factor analysis of levetiracetam using the food and drug administration adverse event reporting system","authors":"Ryuichiro Hosoya , Kento Kitajima , Koushirou Sogawa , Daigo Ikegami , Tomoko Terajima , Hideaki Kato , Masahiko Funada , Hajime Kagaya , Yoshihiro Uesawa","doi":"10.1016/j.eplepsyres.2025.107626","DOIUrl":"10.1016/j.eplepsyres.2025.107626","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy affects approximately 50 million people worldwide. Antiseizure medications (ASMs) are essential for seizure control. However, adverse psychiatric effects, particularly hostility and aggression, affect treatment adherence and the quality of life. The risk factors and mechanisms underlying these adverse effects remain unclear.</div></div><div><h3>Objective</h3><div>This study aimed to classify ASM-induced hostility/aggression using the Food and Drug Administration Adverse Event Reporting System (FAERS), a global pharmacovigilance database, focusing on the risk factors and onset patterns of levetiracetam-induced hostility/aggression.</div></div><div><h3>Methods</h3><div>The FAERS database (2004 Q1–2022 Q1) was analyzed to calculate the reporting odds ratios for ASM-induced hostility/aggression, which were classified using a principal component analysis. Levetiracetam-induced adverse effects and the associated independent risk factors were examined. Weibull distribution analysis was used to assess the time-to-onset patterns</div></div><div><h3>Results</h3><div>Principal component analysis identified eight ASM-induced adverse effects, including \"aggression,\" \"anger,” “homicidal ideation,\" and \"hostility.\" In those taking levetiracetam aged ≥ 12 years, male sex, younger age, and specific concomitant medications were independent risk factors for levetiracetam-induced adverse effects. Levetiracetam-induced adverse effects exhibited an early failure pattern, with a median onset of 4.5 days in patients aged ≥ 12 years and 1.5 days in those < 12 years.</div></div><div><h3>Conclusion</h3><div>In this study, we classified ASM-induced hostility/aggression and estimated the risk factors for levetiracetam-induced adverse effects. In particular, we identified early-onset patterns and high-risk patient profiles. These findings are consistent with clinical observations and provide insight into the mechanisms underlying these adverse effects, which will contribute to proactive risk management and personalized treatment strategies.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107626"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679882","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}
Pub Date : 2025-07-16DOI: 10.1016/j.eplepsyres.2025.107625
N. Pradhan , Manoj Kumar , M. Sandhya , P. Bairwa , PV Prathyusha , K. Raghavendra , LG Viswanathan , A. Asranna , RC Mundlamuri , DK Deelchand , Jitender Saini , Rose Dawn Bharath , Sanjib Sinha
Background
In this study, we used in vivo MEGA-PRESS spectroscopy to investigate GABA and Glu levels in patients with drug-resistant unilateral temporal lobe epilepsy (TLE) and also look for correlation between neurometabolites and clinical semiology assessed by other modalities.
Materials and methods
Twenty-five patients with TLE underwent MRS data acquisition on a 3.0 T MRI. Bilateral single-voxel MEGA-PRESS data was acquired from mesial temporal lobes, and data was post-processed using MRSpa and LC-Model for computing neurometabolites concentration. Tissue segmentation from spectroscopic voxel was performed for tissue metabolite and CSF correction. Statistical analysis was performed to analyze differences in neurometabolic between affected and normal-sides and clinical correlations.
Results
GABA, Glu, NAA, Cr, and Cho neurometabolites were computed. The group-wise statistical comparison revealed a significantly reduced NAA level from the affected compared to normal-side of the hippocampus (p-value=0.039). We observed reduced GABA (p-value=0.07) values and hippocampal volume (p-value<0.001) were observed from the affected side. A significant negative correlation was noted between affected-side hippocampal volume and NAA concentration (rho=-0.497, p-value=0.05). Glu/NAA ratios from both affected (rho=-0.692, p-value=0.012) and normal-sides (rho=-0.608, p-value=0.016) of the hippocampus were negatively correlated with age. Concordance between neurometabolites with video-EEG for lateralization demonstrates correct classification percentage for GABA was 86.7 %, indicating that there is an 86.7 % chance that GABA will be able to lateralize the unaffected side as detected by VEEG.
Conclusion
A novel exploratory study demonstrates an alternation of in-vivo GABA and Glu levels and hippocampal volume. This study may provide a direction for utilizing MEGA-PRES as a presurgical tool for assessing in-vivo neurometabolic profiles and add to the knowledge of the role of GABA and Glu in epilepsy and its interplay.
在这项研究中，我们使用体内MEGA-PRESS光谱研究耐药单侧颞叶癫痫（TLE）患者的GABA和Glu水平，并寻找神经代谢物与其他方式评估的临床符会学之间的相关性。材料与方法25例TLE患者在3.0 T MRI上进行MRS数据采集。从内侧颞叶获取双侧单体素MEGA-PRESS数据，并使用MRSpa和LC-Model对数据进行后处理，计算神经代谢物浓度。从光谱体素中进行组织分割，用于组织代谢物和CSF校正。统计学分析患侧与正常侧神经代谢差异及临床相关性。结果计算gaba、Glu、NAA、Cr、Cho神经代谢物。组间统计比较显示，与正常侧海马相比，受损侧海马的NAA水平显著降低（p值=0.039）。我们观察到患侧GABA减少（p值=0.07），海马体积减少（p值<；0.001）。患侧海马体积与NAA浓度呈显著负相关（rho=-0.497， p值=0.05）。海马受累侧（rho=-0.692， p值=0.012）和正常侧（rho=-0.608， p值=0.016）的Glu/NAA比值与年龄呈负相关。神经代谢物与视频脑电图侧化的一致性表明，GABA的正确分类率为86.7 %，表明VEEG检测到的GABA能够侧化未受影响的一侧的几率为86.7 %。结论一项新的探索性研究证实了体内GABA和Glu水平与海马体积的变化。本研究可能为利用MEGA-PRES作为术前评估体内神经代谢谱的工具提供方向，并增加对GABA和Glu在癫痫中的作用及其相互作用的认识。
{"title":"Investigation of in-vivo GABA+ and Glutamate levels in patients with drug resistant unilateral temporal lobe epilepsy using MEGA-PRESS and correlates with clinical semiology","authors":"N. Pradhan , Manoj Kumar , M. Sandhya , P. Bairwa , PV Prathyusha , K. Raghavendra , LG Viswanathan , A. Asranna , RC Mundlamuri , DK Deelchand , Jitender Saini , Rose Dawn Bharath , Sanjib Sinha","doi":"10.1016/j.eplepsyres.2025.107625","DOIUrl":"10.1016/j.eplepsyres.2025.107625","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we used in vivo MEGA-PRESS spectroscopy to investigate GABA and Glu levels in patients with drug-resistant unilateral temporal lobe epilepsy (TLE) and also look for correlation between neurometabolites and clinical semiology assessed by other modalities.</div></div><div><h3>Materials and methods</h3><div>Twenty-five patients with TLE underwent MRS data acquisition on a 3.0 T MRI. Bilateral single-voxel MEGA-PRESS data was acquired from mesial temporal lobes, and data was post-processed using MRSpa and LC-Model for computing neurometabolites concentration. Tissue segmentation from spectroscopic voxel was performed for tissue metabolite and CSF correction. Statistical analysis was performed to analyze differences in neurometabolic between affected and normal-sides and clinical correlations.</div></div><div><h3>Results</h3><div>GABA, Glu, NAA, Cr, and Cho neurometabolites were computed. The group-wise statistical comparison revealed a significantly reduced NAA level from the affected compared to normal-side of the hippocampus (p-value=0.039). We observed reduced GABA (p-value=0.07) values and hippocampal volume (p-value<0.001) were observed from the affected side. A significant negative correlation was noted between affected-side hippocampal volume and NAA concentration (rho=-0.497, p-value=0.05). Glu/NAA ratios from both affected (rho=-0.692, p-value=0.012) and normal-sides (rho=-0.608, p-value=0.016) of the hippocampus were negatively correlated with age. Concordance between neurometabolites with video-EEG for lateralization demonstrates correct classification percentage for GABA was 86.7 %, indicating that there is an 86.7 % chance that GABA will be able to lateralize the unaffected side as detected by VEEG.</div></div><div><h3>Conclusion</h3><div>A novel exploratory study demonstrates an alternation of <em>in-vivo</em> GABA and Glu levels and hippocampal volume. This study may provide a direction for utilizing MEGA-PRES as a presurgical tool for assessing <em>in-vivo</em> neurometabolic profiles and add to the knowledge of the role of GABA and Glu in epilepsy and its interplay.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107625"},"PeriodicalIF":2.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739530","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}
Pub Date : 2025-07-15DOI: 10.1016/j.eplepsyres.2025.107628
Indar Kumar Sharawat , Ananthanarayanan Kasinathan , Pragnya Panda , Lesa Dawman , Juhi Tiwari , RC Pavan Kumar , Prateek Kumar Panda
Background
Several trials and clinical studies have explored the efficacy and safety of magnesium sulfate (MgSO₄) in children with infantile epileptic spasms syndrome (IESS). However, no systematic review has been conducted to synthesize the available evidence.
Methods
This systematic review aimed to assess the efficacy and safety of MgSO₄ in children with IESS. The primary outcomes included the proportion of patients achieving spasm freedom, a favorable response in the number of spasms (defined as at least a 50 % reduction in daily spasms), resolution of hypsarrhythmia, improvement in developmental quotient, and the nature and frequency of adverse events. Additionally, we compared these variables between the ACTH+MgSO₄ combination therapy and ACTH monotherapy at various time points. We included all controlled and uncontrolled trials, as well as prospective and retrospective cohort studies.
Results
A total of four studies involving 1334 IESS patients were identified. The proportion of patients achieving a favorable response in daily spasm frequency, spasm freedom, hypsarrhythmia resolution, and EEG normalization was higher in the adrenocorticotropic hormone (ACTH)+MgSO₄ group than in the ACTH monotherapy group (RR=1.22, 95 % CI: 1.09–1.36, I²=0 %, p = 0.0004; RR=1.44, 95 % CI: 1.24–1.67, I²=29 %, p < 0.00001; RR=1.27, 95 % CI: 1.15–1.41, I²=0 %, p < 0.00001; and RR=1.46, 95 % CI: 1.06–2.02, I²=0 %, p = 0.02, respectively). The proportion of patients experiencing treatment-emergent adverse events and serious adverse events was comparable between the ACTH+MgSO₄ and ACTH monotherapy groups (RR=0.55, 95 % CI: 0.28–1.07, I²=49 %, p = 0.08; and RR=1.15, 95 % CI: 0.74–1.79, I²=0 %, p = 0.54, respectively). However, the frequency of hypertension was significantly lower in the ACTH+MgSO₄ group compared to the ACTH monotherapy group (RR=0.11, 95 % CI: 0.03–0.34, I²=0 %, p = 0.0002).
Conclusions
The combination of ACTH and MgSO₄ is more effective than ACTH monotherapy in achieving seizure control in children with IESS. Additionally, it is associated with a reduced risk of certain adverse events, such as hypertension.
{"title":"Efficacy and tolerability of magnesium sulfate in children with infantile epileptic spasms syndrome: A systematic review and meta-analysis","authors":"Indar Kumar Sharawat , Ananthanarayanan Kasinathan , Pragnya Panda , Lesa Dawman , Juhi Tiwari , RC Pavan Kumar , Prateek Kumar Panda","doi":"10.1016/j.eplepsyres.2025.107628","DOIUrl":"10.1016/j.eplepsyres.2025.107628","url":null,"abstract":"<div><h3>Background</h3><div>Several trials and clinical studies have explored the efficacy and safety of magnesium sulfate (MgSO₄) in children with infantile epileptic spasms syndrome (IESS). However, no systematic review has been conducted to synthesize the available evidence.</div></div><div><h3>Methods</h3><div>This systematic review aimed to assess the efficacy and safety of MgSO₄ in children with IESS. The primary outcomes included the proportion of patients achieving spasm freedom, a favorable response in the number of spasms (defined as at least a 50 % reduction in daily spasms), resolution of hypsarrhythmia, improvement in developmental quotient, and the nature and frequency of adverse events. Additionally, we compared these variables between the ACTH+MgSO₄ combination therapy and ACTH monotherapy at various time points. We included all controlled and uncontrolled trials, as well as prospective and retrospective cohort studies.</div></div><div><h3>Results</h3><div>A total of four studies involving 1334 IESS patients were identified. The proportion of patients achieving a favorable response in daily spasm frequency, spasm freedom, hypsarrhythmia resolution, and EEG normalization was higher in the adrenocorticotropic hormone (ACTH)+MgSO₄ group than in the ACTH monotherapy group (RR=1.22, 95 % CI: 1.09–1.36, I²=0 %, p = 0.0004; RR=1.44, 95 % CI: 1.24–1.67, I²=29 %, p < 0.00001; RR=1.27, 95 % CI: 1.15–1.41, I²=0 %, p < 0.00001; and RR=1.46, 95 % CI: 1.06–2.02, I²=0 %, p = 0.02, respectively). The proportion of patients experiencing treatment-emergent adverse events and serious adverse events was comparable between the ACTH+MgSO₄ and ACTH monotherapy groups (RR=0.55, 95 % CI: 0.28–1.07, I²=49 %, p = 0.08; and RR=1.15, 95 % CI: 0.74–1.79, I²=0 %, p = 0.54, respectively). However, the frequency of hypertension was significantly lower in the ACTH+MgSO₄ group compared to the ACTH monotherapy group (RR=0.11, 95 % CI: 0.03–0.34, I²=0 %, p = 0.0002).</div></div><div><h3>Conclusions</h3><div>The combination of ACTH and MgSO₄ is more effective than ACTH monotherapy in achieving seizure control in children with IESS. Additionally, it is associated with a reduced risk of certain adverse events, such as hypertension.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107628"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653410","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}
Pub Date : 2025-07-14DOI: 10.1016/j.eplepsyres.2025.107624
Yuwei Han , Shun Gong , Shimei Sun, Dan Yang, Bingying Zhang, Dandan Gao, Guanqian Yuan, Xiaoming Li, Guangzhi Hao, Guobiao Liang
Objective
Depressive symptoms were a prevalent comorbidity among patients with epilepsy, significantly impacting their quality of life and treatment outcomes. This study aims to investigate the prevalence and clinical correlates of depressive symptoms in Chinese patients with epilepsy.
Methods
A descriptive cross-sectional study was conducted at the Department of Neurosurgery, General Hospital of Northern Theater Command, from January 2018 to June 2023. Patients diagnosed with epilepsy aged 16 years or older were included, excluding those with severe illnesses, substance abuse disorders, or severe cognitive impairments. Demographic and epilepsy-related information was collected using a standardized clinical data collection form. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Statistical analyses were performed using SPSS version 27.0.
Results
The study included 513 patients with epilepsy, with a mean age of 37.48 years (SD= 15.09). Among these, 65.9 % were male, and 62.6 % were aged 40 years or older. The majority of patients were single (50.9 %) and had formal education (57.1 %). The mean age of epilepsy onset was 21.96 years (SD = 12.83), and the mean duration of illness was 11.02 years (SD= 13.64). Generalized tonic-clonic seizures were the most common type (62.0 %), and 32.7 % of patients experienced very frequent seizures. Polytherapy was used by 63.5 % of patients. Depressive symptoms were present in 137 patients, representing a prevalence of 26.7 % (95 % CI: 20.51–31.89). The severity of depressive symptoms was categorized as mild in 62.0 %, mild to moderate in 18.2 %, moderate in 10.2 %, and severe in 9.5 %. The prevalence of depressive symptoms was higher among females, separated/widowed individuals, those with lower educational attainment, and unemployed patients. Significant associations were found between depressive symptoms and seizure frequency, duration of seizures, and polytherapy. Multivariate analysis identified seizure frequency, duration of seizures, and polytherapy as independent predictors of depressive symptoms.
Conclusions
Depressive symptoms were highly prevalent among Chinese patients with epilepsy, with significant associations found between depressive symptoms and several sociodemographic and clinical characteristics. Routine screening for depressive symptoms and tailored interventions are crucial for improving the quality of life and treatment outcomes in this population. Future research should focus on longitudinal studies to explore causal relationships and develop targeted interventions.
{"title":"Depressive symptoms in Chinese patients with epilepsy: Prevalence and clinical correlates","authors":"Yuwei Han , Shun Gong , Shimei Sun, Dan Yang, Bingying Zhang, Dandan Gao, Guanqian Yuan, Xiaoming Li, Guangzhi Hao, Guobiao Liang","doi":"10.1016/j.eplepsyres.2025.107624","DOIUrl":"10.1016/j.eplepsyres.2025.107624","url":null,"abstract":"<div><h3>Objective</h3><div>Depressive symptoms were a prevalent comorbidity among patients with epilepsy, significantly impacting their quality of life and treatment outcomes. This study aims to investigate the prevalence and clinical correlates of depressive symptoms in Chinese patients with epilepsy.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted at the Department of Neurosurgery, General Hospital of Northern Theater Command, from January 2018 to June 2023. Patients diagnosed with epilepsy aged 16 years or older were included, excluding those with severe illnesses, substance abuse disorders, or severe cognitive impairments. Demographic and epilepsy-related information was collected using a standardized clinical data collection form. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Statistical analyses were performed using SPSS version 27.0.</div></div><div><h3>Results</h3><div>The study included 513 patients with epilepsy, with a mean age of 37.48 years (SD= 15.09). Among these, 65.9 % were male, and 62.6 % were aged 40 years or older. The majority of patients were single (50.9 %) and had formal education (57.1 %). The mean age of epilepsy onset was 21.96 years (SD = 12.83), and the mean duration of illness was 11.02 years (SD= 13.64). Generalized tonic-clonic seizures were the most common type (62.0 %), and 32.7 % of patients experienced very frequent seizures. Polytherapy was used by 63.5 % of patients. Depressive symptoms were present in 137 patients, representing a prevalence of 26.7 % (95 % CI: 20.51–31.89). The severity of depressive symptoms was categorized as mild in 62.0 %, mild to moderate in 18.2 %, moderate in 10.2 %, and severe in 9.5 %. The prevalence of depressive symptoms was higher among females, separated/widowed individuals, those with lower educational attainment, and unemployed patients. Significant associations were found between depressive symptoms and seizure frequency, duration of seizures, and polytherapy. Multivariate analysis identified seizure frequency, duration of seizures, and polytherapy as independent predictors of depressive symptoms.</div></div><div><h3>Conclusions</h3><div>Depressive symptoms were highly prevalent among Chinese patients with epilepsy, with significant associations found between depressive symptoms and several sociodemographic and clinical characteristics. Routine screening for depressive symptoms and tailored interventions are crucial for improving the quality of life and treatment outcomes in this population. Future research should focus on longitudinal studies to explore causal relationships and develop targeted interventions.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107624"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653411","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}
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