This study aims to illustrate the connection between seizure frequency (SF) and performance metrics in seizure forecasting, and to compare the effectiveness of a moving average (MA) model versus the commonly used permutation benchmark.

Precisely localizing the seizure onset zone (SOZ) is critical for focal epilepsy surgery. Existing methods mainly focus on high-frequency activities in stereo-electroencephalography, but often fail when seizures are not driven by high-frequency activities. Recognized as biomarkers of epileptic seizures, ictal spikes in SOZ induce epileptiform discharges in other brain regions. Based on this understanding, we aim to develop a universal algorithm to localize SOZ and investigate how ictal spikes within the SOZ induce seizures.

Neurofibromatosis type 1 (NF1) is a common neurocutaneous syndrome that predisposes patients to seizures. We aimed to estimate the prevalence, clinical characteristics and outcomes of seizures in NF1 patients, and analyze prognostic factors of seizures.

Monitoring seizure control metrics is key to clinical care of patients with epilepsy. Manually abstracting these metrics from unstructured text in electronic health records (EHR) is laborious. We aimed to abstract the date of last seizure and seizure frequency from clinical notes of patients with epilepsy using natural language processing (NLP).

The Hemispherectomy Outcome Prediction Scale (HOPS) was developed to aid both clinicians and patients in determining the chance of success after hemispheric surgery for medically refractory epilepsy. The original study generating HOPS had a multi-institutional, large cohort format yielding near perfect patient stratification. Evidence suggests that methodologies utilized to create such predictive models, including cross-validation as well as stratification utilizing the same data employed for model generation, may be at risk of an undesirable modeling phenomenon known as overfitting. We posed the question of whether overfitting may be influencing HOPS results and aimed for preliminary evidence of external validation with parameters from patients at our institution not included in the original HOPS study. We found HOPS to stratify our limited post-operative cohort adequately. However, the likelihood of complete seizure freedom among the patients predicted by HOPS to be at greatest chance of success was ∼75 %, about 20 points lower than in the original HOPS cohort. This reduction in absolute chance of success predicted by HOPS may represent some degree of overfitting. It will be informative to aim for external validation of HOPS utilizing patient cohorts entirely separate from those used for model generation. External validation of HOPS and similar models could optimize realistic prediction of success after intervention.

Prior research has indicated an association between epilepsy and psychosis. This review aimed to estimate the global prevalence rate of psychosis and schizophrenia in epilepsy and assess the odds of psychosis and schizophrenia among patients with epilepsy (PWE).

The present study was performed to investigate the associations among perceived stress, spiritual well-being, and alexithymia in people with epilepsy.

Epileptic spasms are the primary symptom of infantile epileptic spasms syndrome (IESS); however, their direct impact on blood-brain barrier (BBB) function is unknown. Matrix metallopeptidase-9 (MMP-9), degrades type IV collagen, a key component of the blood-brain barrier, while tissue inhibitor of metalloproteinase-1 (TIMP-1) suppresses its activity, protecting BBB integrity. This study aimed to assess serum MMP-9 and TIMP-1 levels in patients with IESS of unknown etiology.

This study aimed to test different AI-based face-swapping models applied to videos of epileptic seizures, with the goal of protecting patient privacy while retaining clinically useful seizure semiology. We hypothesized that specific models would show differences in semiologic fidelity compared to the original clinical videos.

The purpose of this epidemiological study was to assess the prevalence, comorbidities, and real-world management of childhood epilepsy to provide insights for enhancing epilepsy management and medical resource planning.

To evaluate the recurrence risk following a first unprovoked seizure using both single-factor and multiple-factor approaches, as well as to further analyze the potential risk factors associated with recurrence.

Accurate predictors of response to modified Atkins diet (MAD) are needed. MicroRNAs are potential biomarkers in epilepsy. This study aimed to explore the value of circulating miR-146a, miR-155, miR-22, miR-21 and miR-134 levels in predicting response to MAD.

To assess the potential of bypassing mitochondrial complex I with idebenone to overcome drug resistance in a Rotenone corneal kindling (RCK) mouse model of mitochondrial refractory epilepsy.

Bariatric surgeries may affect the pharmacokinetics of medications through alterations of the gastrointestinal physiology. Pharmacokinetic changes of first-line antiseizure medications such as lamotrigine and valproate following bariatric treatment have received little research attention so far.

An increasing number of research indicate that non-invasive neurostimulation techniques, like transcranial direct current stimulation (tDCS), can effectively control refractory epilepsy. While previous meta-analyses have primarily focused on randomized controlled trials (RCTs), this study expands the scope by including both RCTs and non-RCTs to provide a more comprehensive assessment of tDCS efficacy in treating refractory epilepsy. Through a systematic search of "PUBMED, Embase and Cochrane", we sought relevant studies related to the research topic. We utilized the Cochrane Collaboration tool to assess the risk of bias for the RCTs and the Methodological Index for Non-Randomized Studies (MINORS) tool to evaluate the quality of the non-RCTs included in this meta-analysis. In addition, a protocol for this meta-analysis was registered on PROSPERO (CRD42024496837 http://www.crd.york.ac.uk/ PROSPERO). A total of 14 studies, including 8 RCTs and 6 non-RCTs , involving 307 subjects with refractory epilepsy, were included in this meta-analysis. The combined analysis of RCTs and non-RCTs indicated that tDCS was effective in reducing seizure frequency (SF) in refractory epilepsy patients, with significant improvements observed both four weeks (MD = -4.54; p ＜ 0.01; 95 % CI = -5.69 to -3.38) and eight weeks (MD = -3.49; p ＜ 0.01; 95 % CI = -5.37 to -1.61) after stimulation. There were no statistically significant differences in Interictal Epileptiform Discharges (IEDs) shortly after stimulation (MD = -3.59; p = 0.42; 95 % CI = -12.33-5.16). However, a reduction was observed at four weeks (MD = -5.28; p ＜ 0.01; 95 % CI = -6.88 to -3.68) and eight weeks post-stimulation (MD = -3.37; p ＜ 0.01; 95 % CI = -5.35 to -1.40). The patient's adverse reactions were mild, and they could be relieved shortly after discontinuation of the stimulus. The quality of evidence across outcomes was assessed as moderate. The results indicate that tDCS demonstrates promising efficacy and safety in managing seizures in refractory epilepsy. While this meta-analysis provides valuable findings, additional large-scale randomized controlled trials are needed to further confirm the efficacy of tDCS for refractory epilepsy.

Structural epilepsy is a chronic neurologic condition that may be caused by in utero malformations of cortical development (MCD) or post-natal brain injuries resulting in encephalomalacia. We hypothesized that the timing of epileptogenic insult would lead to distinct electrographic seizure patterns. Specifically, we predicted that later life insults would lead to longer duration seizures with higher proportion of focal: focal to bilateral tonic-clonic (FBTC) seizures and low rates of bihemispheric onset seizures, as compared to early life insults. We performed a retrospective chart review of 70 adult patients - 33 with epilepsy secondary to brain injury (9 with injury occurring before 16 years and 24 with injury occurring at or after 16 years) with resultant encephalomalacia on MR imaging and 37 with epilepsy secondary to MCD - admitted to the University of Pittsburgh Epilepsy Monitoring Unit for presurgical evaluation. There were no significant differences in duration of epilepsy or number of trialed seizure medications between the groups. We examined scalp EEG data for all patients, as well as intracranial EEG data in a subset. We analyzed seizure duration, seizure frequency, and seizure type (focal, FBTC, and bihemispheric onset) in three cohorts: MCD patients, patients with brain injury occurring in early life (<16 years old), and patients with brain injury occurring in later life (≥16 years old). Patients with later life brain injury had significantly longer and less frequent seizures as compared to MCD cohorts. There were no differences between MCD and early life brain injury cohorts. Seizure duration findings were corroborated in a subset of patients who additionally underwent intracranial EEG monitoring. Additionally, later life brain injury patients had significantly different seizure types as compared to MCD cohorts, with high rates of FBTC and low rates of bihemispheric onset. Again, there was no significant differences in seizure type between early life brain injury and MCD cohorts. These novel findings indicate the relevance of timing of epileptogenic insult on the electrophysiological characteristics of structural epilepsies.

Clinical studies of repetitive transcranial magnetic stimulation (rTMS) do not provide consistent efficacy results, possibly due to variability in methodological parameters. Our aim is to systematically review preclinical rTMS protocols in murine models of epilepsy, offering insights from might facilitate the optimization of clinical trials.

Patients considering therapeutic epilepsy surgery often seek to decrease the number of anti-seizure medications (ASMs) they need. Predicting such reductions remains challenging. Although predictors of seizure freedom after epilepsy surgery are well-established, long-term outcomes remain modest and factors associated with ASM reduction, even in the absence of seizure freedom, may improve surgical planning to align with patient goals.

Adherence to anti-seizure medication (ASM) by people diagnosed with epilepsy in sub-Saharan Africa remains low. The factors for low adherence are not well understood. To improve adherence, it is important to understand the perceptions and views of healthcare professionals delivering epilepsy care to this population. The aim was to investigate the factors influencing ASM adherence.

Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RF-TC) is an invasive procedure based on stereotactic lesioning of cortical targets in the brain using bipolar current through electrode contacts within the SEEG implant. To date, several RF-TC protocols have been described in the literature; however, a consensus has yet to be reached. This work aims to analyze the electrical parameters during RF-TC processes, offering a method to objectively describe and compare different SEEG-guided RF-TC protocols.

Electrographic seizures in neonates are commonly associated with poor neurodevelopmental outcomes. However, there is conflict in evidence whether control of electrographic seizures translate into improved neurodevelopmental outcome. We aimed to evaluate whether treating all electrographic seizures compared with treating clinical seizures leads to a better neurodevelopmental outcome at 18-24 months in neonates.