Seizure-European Journal of Epilepsy最新文献

{"title":"Exploration of the potential association between newer antiseizure medications and arrhythmias: Integrating pharmacovigilance and bioinformatics evidence","authors":"Jianxing Zhou ,&nbsp;Zhenhui Chen ,&nbsp;Mengjun Zhang ,&nbsp;Yanrong Ye ,&nbsp;Yun Shen ,&nbsp;Xuemei Wu","doi":"10.1016/j.seizure.2024.10.011","DOIUrl":"10.1016/j.seizure.2024.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Arrhythmias resulting from newer antiseizure medications (ASMs) may significantly impact the safety and quality of life of patients with epilepsy. This study investigated the potential association between new first-line or second-line ASMs and arrhythmias.</div></div><div><h3>Methods</h3><div>Pharmacovigilance analysis was conducted using data from the Food and Drug Administration Adverse Event Reporting System (FAERS) from 2004 to 2023. A disproportionality analysis was performed to compare newer ASMs with other drugs, using carbamazepine and valproate as positive controls. Newer ASMs were categorized into sodium channel (SCN) main mechanism, SCN possible mechanism, and non-SCN group. The bioinformatics analysis involved retrieving therapeutic gene targets for ASMs from the DrugBank and OMIM databases, as well as identifying arrhythmia disease targets from the GeneCards database. Additionally, enrichment analysis of gene ontology functions and KEGG pathways was conducted.</div></div><div><h3>Results</h3><div>A total of 3,457 cases of arrhythmias associated with newer ASMs were identified in the FAERS database. Disproportionality analysis indicates that brivaracetam (IC025 = 0.08), zonisamide (IC025 = 0.13), eslicarbazepine (IC025 = 0.39), and lacosamide (IC025 = 0.84) exhibited a positive signal for arrhythmias, with signals predominantly observed in the SCN main mechanism group. Furthermore, bioinformatics analysis revealed the involvement of adrenergic signaling in cardiac myocytes, as well as the participation of sodium channel genes in ASM-induced arrhythmias.</div></div><div><h3>Conclusion</h3><div>Our findings suggest a potential association between SCN-ASMs and arrhythmias, highlighting the importance of monitoring and evaluating the safety profiles of newer ASMs in clinical practice. Further research is necessary to elucidate the underlying mechanisms and inform patient care strategies.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 26-33"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CCDC22 variants caused X-linked focal epilepsy and focal cortical dysplasia","authors":"Yu-Lei He ,&nbsp;Yi-Chen Ye ,&nbsp;Peng-Yu Wang ,&nbsp;Xiao-Yu Liang ,&nbsp;Yu-Jie Gu ,&nbsp;Si-Qi Zhang ,&nbsp;Dong-Qian Han ,&nbsp;Qi Chi ,&nbsp;Wen-Hui Liu ,&nbsp;Peng Zhou ,&nbsp;Qiong-Xiang Zhai ,&nbsp;Bing-Mei Li ,&nbsp;Yong-Hong Yi ,&nbsp;Sheng Luo ,&nbsp;Heng Meng ,&nbsp;China Epilepsy Gene 1.0 Project","doi":"10.1016/j.seizure.2024.10.007","DOIUrl":"10.1016/j.seizure.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>The <em>CCDC22</em> gene plays vital roles in regulating the NF-κB pathway, an essential pathway for neuroinflammation, neurodevelopment, and epileptogenesis. Previously, variants in <em>CCDC22</em> were reported to be associated with intellectual disability. This study aimed to explore the association between <em>CCDC22</em> and epilepsy.</div></div><div><h3>Methods</h3><div>Trios-based whole-exome sequencing (WES) was performed in a cohort of patients with epilepsy of unknown cause recruited from the China Epilepsy Gene 1.0 Project. Damaging effects of variants were analysed using protein modelling.</div></div><div><h3>Results</h3><div>Hemizygous missense <em>CCDC22</em> variants were identified in three unrelated cases. These variants had no hemizygous frequencies in controls. All missense variants identified in this study were predicted to be “damaging” by multiple <em>in silico</em> tools and to alter the hydrogen bonds with surrounding residues and/or protein stability. The three patients presented with focal epilepsy of varying severity, including one with refractory seizures and focal cortical dysplasia (FCD) and two with seizures responding to antiseizure medicine. Notably, the variant associated with the severe phenotype was located in the coiled-coil domain and predicted to alter hydrogen bonding and protein stability, whereas the two variants associated with mild epilepsy were located outside functional domains and had moderate molecular alterations. Analysis of spatiotemporal expression indicated that <em>CCDC22</em> was expressed in brain subregions with three peaks in the fetal stage, infancy, and early adulthood, especially in the fetal stage, explaining the occurrence of developmental abnormities.</div></div><div><h3>Significance</h3><div><em>CCDC22</em> variants are potentially associated with X-linked focal epilepsy and FCD. The molecular subregional effects supported the occurrence of FCD.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 1-8"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic implications of etiology-specific diagnosis of early-onset developmental and epileptic encephalopathies (EO-DEEs): A nationwide Turkish cohort study","authors":"Seda Kanmaz ,&nbsp;Hasan Tekgul ,&nbsp;Hulya Kayilioglu ,&nbsp;Yavuz Atas ,&nbsp;Pinar Ozkan Kart ,&nbsp;Nihal Yildiz ,&nbsp;Hakan Gumus ,&nbsp;Kursad Aydin","doi":"10.1016/j.seizure.2024.09.021","DOIUrl":"10.1016/j.seizure.2024.09.021","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the etiology-specific diagnosis of early-onset developmental epileptic encephalopathies (EO-DEEs) in a nationwide Turkish cohort to determine the implications for therapeutic management.</div></div><div><h3>Methods</h3><div>The cohort comprised 1450 patients who underwent EO-DEE. The utility of genetic testing was assessed with respect to the initial phases of next generation sequencing (NGS) (2005–2013) and the current NGS era (2014–2022). A predefined four-stepwise diagnostic model was evaluated using cost-effectiveness analysis. The diagnostic and potential therapeutic yields of the genetic tests were subsequently determined.</div></div><div><h3>Results</h3><div>Gene-related EO-DEEs were identified in 48.3 % (<em>n</em> = 701) of the cohort: non-structural genetic (62.6 %), metabolic genetic (15.1 %), and structural genetic (14.1 %). The most common nonstructural genetic variants were <em>SCN1A</em> (<em>n</em> = 132, 18.8 %), <em>CDKL5</em> (<em>n</em> = 30, 4.2 %), <em>STXBP1</em> (<em>n</em> = 21, 2.9 %), <em>KCNQ2</em> (<em>n</em> = 21, 2.9 %), and <em>PCDH19</em> (<em>n</em> = 17, 2.4 %). The rate of ultra-rare variants (&lt; 0.5 %) was higher in the NGS era (52 %) than that in the initial phase (36 %). The potential therapeutic yields with precision therapy and antiseizure drug modification were defined in 34.5 % and 56.2 % in genetic-EO-DEEs, respectively. The diagnostic model provided an etiology-specific diagnosis at a rate of 78.7 %: structural (nongenetic) (31.4 %), genetic (38.5 %), metabolic (6.1 %), and immune-infectious (2.8 %). Based on a cost-effectiveness analysis, the presented diagnostic model indicated the early implementation of whole-exome sequencing for EO-DEEs.</div></div><div><h3>Significance</h3><div>In the present cohort, the higher rate (48.3 %) of gene-related EO-DEE diagnoses in the NGS era provides a potential therapeutic management plan for more patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 17-25"},"PeriodicalIF":2.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden unexpected atraumatic arterial dissection-related death after seizures","authors":"Jose L. Vega ,&nbsp;Nurose Karim ,&nbsp;Caroline Hall","doi":"10.1016/j.seizure.2024.10.005","DOIUrl":"10.1016/j.seizure.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>To date, it has been assumed that acute seizures which arise in the context of sudden, spontaneous, atraumatic, acute, arterial dissections (SAAADs) are downstream consequences of the dissections driven by syncope or focal brain lesions (FBLs). As this subject has not been formally investigated, likely due to its rarity, we reviewed published case reports (CRs) to examine the veracity of this assumption.</div></div><div><h3>Methods</h3><div>We included CR describing patients diagnosed with both acute seizures and arterial dissections in order to ascertain the temporal sequence between acute seizures and typical SAAAD symptoms. In addition, we quantified the frequency with which hypotension, bradycardia, and FBLs are associated with acute seizures in such cases.</div></div><div><h3>Results</h3><div>We found 45 published CRs, six (13.3%) of which involved traumatic arterial dissections and 39 (86.7%) which involved SAAADs. Of the latter, twenty-one (53.8%) described seizures that followed typical SAAAD symptoms (SAFO), and 18 (46.2%) that preceded all such symptoms (SATO). On average, blood pressure and heart rate for both groups exceeded the normal range. Of the CRs that included magnetic resonance imaging (MRI) scans, 8 (100%) SAFO but only 6 (54.5%) SATO patients demonstrated FBLs (p&lt;0.03). A conspicuously large fraction of SATO patients had known epilepsy compared with SAFO patients, (33.3% vs 4.8%; p&lt;0.02). In addition, SATO epilepsy patients’ seizure semiologies frequently resembled their breakthrough seizures (BTS). The most common SAAAD associated with acute seizures was aortic dissection (AoD; 17/45; 37.8%). Nine CRs (20%) described patients who died soon after presentation, seven of which were associated with AoDs, including one epilepsy patient. Six of these seven AoDs occurred in patients who suffered from chronic hypertension (CHTN). All five deaths in the SATO group followed first ever seizures (FES) [four AoDs and one coronary artery dissection (CoAD)].</div></div><div><h3>Conclusion</h3><div>Acute seizures arising in the context of SAAADs are not necessarily associated with hypotension or FBLs, and frequently appear to precede the associated dissections. These results suggest that seizures could act as triggers for SAAADs. In addition, sudden unexpected atraumatic acute arterial dissection-related death after seizure (SUADAS) might be a distinct cause of sudden death in epilepsy patients.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 43-48"},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of vigabatrin for infantile epileptic spasm syndrome categorized by etiologies","authors":"Hirokazu Takeuchi ,&nbsp;Kenjiro Kikuchi ,&nbsp;Rikako Takeda ,&nbsp;Yuko Hirata ,&nbsp;Ryuki Matsuura ,&nbsp;Reiko Koichihara ,&nbsp;Daiju Oba ,&nbsp;Hirofumi Ohashi ,&nbsp;Shin-ichiro Hamano","doi":"10.1016/j.seizure.2024.10.003","DOIUrl":"10.1016/j.seizure.2024.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to assess the effectiveness of vigabatrin (VGB) in patients diagnosed with infantile epileptic spasm syndrome (IESS) and categorize these patients based on their etiologies.</div></div><div><h3>Methods</h3><div>This retrospective study included patients diagnosed with IESS who exhibited epileptic spasms before the age of 2 years between January 1, 2015, and October 31, 2023 at Saitama Children's Medical Center. Patients with tuberous sclerosis as the identified etiology were excluded. The effectiveness of VGB was assessed based on the resolution of ES for three months with the absence of hypsarrhythmia on interictal electroencephalogram.</div></div><div><h3>Results</h3><div>This study analyzed 41 patients (26 boys). The etiologies included genetic, congenital structural, acquired structural, and unknown in 12, 11, 10, and 8 patients, respectively. Patient characteristics did not significantly differ among the four groups. The overall effectiveness of VGB for IESS was 39.0 % (16/41). Categorized based on etiology, VGB was effective in 41.7 % (5/12), 9.1 % (1/11), 50 % (5/10), and 75 % (6/8) in the genetic, congenital structural, acquired structural, and unknown groups, respectively. Statistical analysis revealed a significant difference in effectiveness among the four groups (<em>p</em> = 0.03). Categorized based on diseases, VGB was effective in 28.6 % (2/7) and 50 % (4/8) in trisomy 21 and perinatal brain injury, respectively.</div></div><div><h3>Conclusion</h3><div>The effectiveness of VGB in patients with IESS varied with etiology. Further investigations into the effectiveness of VGB in etiological subtypes of IESS could facilitate the development of tailored treatment algorithms for each etiology, representing valuable guidelines for future medical practice.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 113-118"},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of self-reported variables in epilepsy monitoring and management. A systematic scoping review","authors":"Andrea Biondi ,&nbsp;Nicolas Zabler ,&nbsp;Sotirios Kalousios ,&nbsp;Sara Simblett ,&nbsp;Petroula Laiou ,&nbsp;Pedro F. Viana ,&nbsp;Matthias Dümpelmann ,&nbsp;Andreas Schulze-Bonhage ,&nbsp;Mark P. Richardson","doi":"10.1016/j.seizure.2024.10.004","DOIUrl":"10.1016/j.seizure.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Self-reported records of seizure occurrences, seizure triggers and prodromal symptoms via paper or electronic tools are essential components of epilepsy management. Despite recent studies indicating that this information could hold important clinical value, the adoption of self-reported information in clinical practice is inconsistent and of uncertain value.</div></div><div><h3>Methods</h3><div>We performed a systematic scoping review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A combination of different digital libraries was used (Embase, MEDLINE, Global Health, PsycINFO). The review examined acceptability, adherence, and ability to self-report or predict seizures, along with innovative applications of self-reported data. We comprehensively outline study characteristics, key results, and identified strengths and limitations.</div></div><div><h3>Results</h3><div>Sixty-eight full-text and two abstracts were included, where a total of 10 electronic tools were identified. Studies revealed high patient interest and acceptable adherence, particularly when tools were well-designed, and data shared with healthcare providers. While patients faced challenges in self-reporting or predicting seizures, a subgroup exhibited higher accuracy and compliance. Studies underscored the value of self-report information in identifying seizure clusters, understanding associations between self-reported seizure frequency and triggers, developing personalized seizure risk, forecasting and prediction models, and the potential benefits when integrated with wearable or implantable devices. Limitations included population selection, repeated dataset use, and the absence of gold standards for seizure counting.</div></div><div><h3>Conclusion</h3><div>Personalizing tools to collect self-report information, integrating them with wearable technologies, utilizing collected data for clinical outcomes, and merging them with electronic health records could provide a reliable resource for epilepsy monitoring and management.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 119-143"},"PeriodicalIF":2.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure medication-induced hypersensitivity reactions: Data from a large healthcare system","authors":"Benjamin Cadle ,&nbsp;Feride Un Candan ,&nbsp;Zulfi Haneef ,&nbsp;Christopher Ryan Barton ,&nbsp;Dylan Brock ,&nbsp;Irfan Ali ,&nbsp;Jaime Shoup ,&nbsp;Cemal Karakas","doi":"10.1016/j.seizure.2024.09.018","DOIUrl":"10.1016/j.seizure.2024.09.018","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Data on hypersensitivity reactions (HR) to individual anti-seizure medications (ASMs), and reactions to additional ASMs, is often limited by sample size. This data is vital in helping clinicians identify initial and subsequent ASMs to use in treating persons with epilepsy (PWE). Using a very large dataset, our study attempts to quantify the occurrence of HR across 31 different ASMs. We also attempt to investigate whether certain pairs of ASMs are associated with a higher frequency of HR.</div></div><div><h3>Methods</h3><div>The Slicer-Dicer tool in the Epic electronic medical records system was used to analyze patients seen between 2012 and 2022 at a large healthcare system in Kentucky with recorded exposures to 31 different ASMs. Incidence of HR with these ASMs were identified, both with single drugs or pairs of drugs, as well as incidence of HR stratified by sex and ASM structure.</div></div><div><h3>Results</h3><div>A total of 573,571 patients with 967,168 exposures were analyzed. Phenobarbital had the highest rate of HR at 12.9 %. Usage of aromatic ASMs were most associated with patients having HR to other ASMs. HR to 13/31 studied ASMs was more likely to occur in females, while HR was more likely in males with lacosamide. Aromatic ASMs were more likely (<em>p</em> &lt; 0.0001<em>)</em> to be associated with HR compared to non-aromatic ASMs. Carbamazepine and the related drugs oxcarbazepine and eslicarbazepine were associated with the greatest number of drug pairings in which the patient had HR to both medications at any time point.</div></div><div><h3>Discussion</h3><div>Our data reveals important patterns in HR to ASMs that may be valuable to clinicians treating PWE. Clinicians should monitor closely for HR when beginning a new ASM in a patient who has taken an aromatic ASM, especially carbamazepine, oxcarbazepine, or eslicarbazepine as well as phenobarbital.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 172-178"},"PeriodicalIF":2.7,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of preoperative MRI lesion identification algorithm in pediatric and young adult focal cortical dysplasia-related epilepsy","authors":"Kara L. Hom ,&nbsp;Venkata Sita Priyanka Illapani ,&nbsp;Hua Xie ,&nbsp;Chima Oluigbo ,&nbsp;L. Gilbert Vezina ,&nbsp;William D. Gaillard ,&nbsp;Taha Gholipour ,&nbsp;Nathan T. Cohen","doi":"10.1016/j.seizure.2024.09.024","DOIUrl":"10.1016/j.seizure.2024.09.024","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the performance and generalizability of an automated, interpretable surface-based MRI classifier for the detection of focal cortical dysplasia.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort incorporating MRIs from the epilepsy surgery (FCD and MRI-negative) and neuroimaging (healthy controls) databases at Children's National Hospital (CNH), and a publicly-available FCD Type II dataset from Bonn, Germany. Clinical characteristics and outcomes were abstracted from patient records and/or existing databases. Subjects were included if they had 3T epilepsy-protocol MRI. Manually-segmented FCD masks were compared to the automated masks generated by the Multi-centre Epilepsy Lesion Detection (MELD) FCD detection algorithm. Sensitivity/specificity were calculated.</div></div><div><h3>Results</h3><div>From CNH, 39 FCD pharmacoresistant epilepsy (PRE) patients, 19 healthy controls, and 19 MRI-negative patients were included. From Bonn, 85 FCD Type II were included, of which 68 passed preprocessing. MELD had varying performance (sensitivity) in these datasets: CNH FCD-PRE (54 %); Bonn (68 %); MRI-negative (44 %). In multivariate regression, FCD Type IIB pathology predicted higher chance of MELD automated lesion detection. All four patients who underwent resection/ablation of MELD-identified clusters achieved Engel I outcome.</div></div><div><h3>Significance</h3><div>We validate the performance of MELD automated, interpretable FCD classifier in a diverse pediatric cohort with FCD-PRE. We also demonstrate the classifier has relatively good performance in an independent FCD Type II cohort with pediatric-onset epilepsy, as well as simulated real-world value in a pediatric population with MRI-negative PRE.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 64-70"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-quality and morphometric MRI analysis to identify focal cortical dysplasia: An exploratory study","authors":"E.N. Zuidhoek ,&nbsp;J.N.P. Zwemmer ,&nbsp;G.H. Visser ,&nbsp;JW. Dankbaar ,&nbsp;G. Widman","doi":"10.1016/j.seizure.2024.09.025","DOIUrl":"10.1016/j.seizure.2024.09.025","url":null,"abstract":"<div><h3>Background</h3><div>In the pre-surgical evaluation of people with focal epilepsy and a normal MRI, Morphometric Analysis Program v2018 (MAP18) aids in detecting visually inconspicuous focal cortical dysplasia (FCD). We investigated the impact of MRI scans with reduced signal-to-noise ratio (SNR) and spatial resolution (SR) on FCD detection by MAP18, aiming to improve the chances of achieving seizure freedom through epilepsy surgery.</div></div><div><h3>Methods</h3><div>Thirty MRI scans with the identified lesion using MAP18 radiologically confirmed as FCD by a neuroradiologist, were retrospective analysed. SNR and SR were artificially reduced in ten steps, and their impact on MAP18 outcomes was assessed using multilevel analysis.</div></div><div><h3>Results</h3><div>There was a significant effect after reducing SR and SNR for z-score and volume of the FCD cluster, the total number of detected clusters, and volume of these clusters. After SNR reduction, there was also a significant effect for z-score of the total number of detected clusters. FCD became undetectable by MAP18 after six steps of SR reduction (voxel size 2.8 × 2.8 × 2.8 mm³) and after two steps of SNR reduction.</div></div><div><h3>Conclusions</h3><div>This exploratory study suggests that reduced SR and SNR negatively affect FCD detection with MRI post-processing (MAP18). The MAP18 evaluator should screen MRI quality before post-processing, particularly for scans with significant visual noise or voxel sizes of 2.8 × 2.8 × 2.8 mm³ and upwards, as repeating a low-quality MRI scan is less burdensome than the adverse effects of continued seizures due to failure to detect FCD.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"123 ","pages":"Pages 37-42"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy trends in Kazakhstan: A retrospective longitudinal study using data from unified national electronic health system 2014–2020","authors":"Ruslan Akhmedullin ,&nbsp;Bermet Kozhobekova ,&nbsp;Arnur Gusmanov ,&nbsp;Temirgali Aimyshev ,&nbsp;Zhasulan Utebekov ,&nbsp;Gaziz Kyrgyzbay ,&nbsp;Azat Shpekov ,&nbsp;Abduzhappar Gaipov","doi":"10.1016/j.seizure.2024.09.022","DOIUrl":"10.1016/j.seizure.2024.09.022","url":null,"abstract":"<div><h3>Objective</h3><div>This study is designed to estimate the epidemiology of epilepsy in Kazakhstan, using a large-scale administrative health database during 2014–2020.</div></div><div><h3>Methods</h3><div>Using the Unified National Electronic Health System of Kazakhstan over a seven-year span, we explored incidence and prevalence rates, disability-adjusted life years (DALY), and all-cause mortality. Regression models using Cox proportional hazards were used to analyze the sociodemographic, mental, behavioral, and neurological factors affecting survival. Overall analyses were performed using STATA (V.16).</div></div><div><h3>Results</h3><div>The total cohort comprised of 82,907 patients, with a significant increase in the incidence of epilepsy from 26.15 in 2014 to 88.80 in 2020 per 100,000 people. Similar trends were observed in the prevalence rates, which tripled from 26.06 in 2014 to 73.10 in 2020. While mortality rates fluctuated, the elderly and children had the greatest rates of 9.97 and 2.98 per 1000 person-years respectively. DALYs revealed a substantial disease burden, with 153,532 DALYs (824.5 per 100,000) being lost during the study period. A few comorbidities, such as cerebral palsy (adjusted hazard ratio (aHR) 2.23) and central nervous system atrophy (aHR, 27.79), markedly elevated all-cause mortality. Furthermore, extrapyramidal and movement disorders (aHR 2.16, <em>p</em> = 0.06) and demyelinating diseases of the central nervous system (aHR 6.36, <em>p</em> = 0.06) showed a trend toward increased mortality risk.</div></div><div><h3>Conclusion</h3><div>To the best of our knowledge, this is the first study from Central Asia exploring a large epilepsy cohort. The findings highlight the need for targeted interventions to address the growing burden of epilepsy, particularly among children, male sex, and those with neurological comorbities.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"122 ","pages":"Pages 58-63"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}