Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

γ-Aminobutyric acid type A (GABA_A) receptor positive allosteric modulators (PAMs) that lack α-subunit selectivity, including benzodiazepines such as diazepam, exhibit antiseizure actions in animal models and in humans. ENX-101 is a deuterated analog of the ⍺2,3,5-selective GABA_A receptor PAM L-838,417. The purpose of this study was to characterize the α-subunit selectivity of ENX-101 and evaluate its antiseizure potential in preclinical seizure and epilepsy models.

Methods

ENX-101 potentiation of GABA chloride current responses in cells expressing recombinant GABA_A receptors were evaluated using an ...

Abstract

SIGRs (single-item global ratings) are gaining popularity among clinicians and health researchers as efficient tools to assess patient-reported outcomes. There has been no systematic assessment of domains explored, methodological aspects, and validation efforts of SIGRs in epilepsy. We aimed to critically appraise and provide recommendations on the use and reporting of SIGRs in epilepsy research. We performed a systematic scoping review using the Joanna Briggs Institute’s recommendations. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) method was used ...

Abstract

Objective

Cenobamate is an antiseizure medication (ASM) with a dual mechanism of action that was recently approved for the treatment of focal seizures in adults. This analysis aimed to describe the outcomes at 12 and 24 weeks after starting cenobamate therapy in a real-world setting.

Methods

BLESS [NCT05859854] is an ongoing, observational, retrospective and prospective cohort study to evaluate the real-world effectiveness and safety of adjunctive cenobamate in adults with uncontrolled focal epilepsy. Subgroup analysis was performed in subjects with 2 to 3 previous ...

Abstract

Objective

The identification of epileptic lesions is crucial for improving surgical outcomes. Nevertheless, substantial focal cortical dysplasia (FCD) may be invisible on magnetic resonance imaging (MRI). We aimed to characterize the expression pattern of 18-kDa translocator protein (TSPO) in FCD and to evaluate the effectiveness of this inflammation-reflective molecular imaging technique for detecting FCD.

Methods

Patients clinically diagnosed with FCD, based on clinical features, interictal electroencephalographic (EEG) findings, and MRI characteristics, underwent positron emission tomography (PET) imaging using ¹⁸F-DPA714 and ¹⁸F-fluorodeoxyglucose (FDG) tracers. ...

Abstract

Objective

Temporal lobe epilepsy (TLE) has been recognized as a network disorder with widespread gray matter atrophy. However, the role of connectome architecture in shaping morphological alterations and identifying atrophy epicenters remains unclear. Furthermore, individualized modeling of atrophy epicenters and their potential clinical applications have not been well established. This study aims to explore how gray matter atrophy correlates with normal connectome architecture, identify potential atrophy epicenters, and employ individualized modeling approach to evaluate the impact of different epicenter patterns on ...

Abstract

Objective

Subjects with left temporal lobe epilepsy may either show altered hemispheric language lateralization or retain typical, left lateralization. Examining the integrity of white matter pathways involved in the adaptation or maintenance of language lateralization in these patients could have important clinical implications for preserving or potentiating compensatory language mechanisms.

Methods

We combined task functional magnetic resonance imaging and structural diffusion metrics to determine the dependency of lobe-based language laterality on white matter integrity in healthy participants and left temporal lobe epilepsy (TLE) ...

Abstract

Objective

Although the role of subcortical structures in the generation of epileptic spasms has been proposed, supporting evidence remains limited. This study aimed to provide neurophysiological evidence of thalamocortical network involvement during epileptic spasms.

Methods

We analyzed four patients (ages 2.7–16.9 years) with epileptic spasms who underwent intracranial electroencephalography (EEG) monitoring with thalamic sampling in preparation for potential neurostimulation. Epileptic spasms were initially assessed using visual inspection and time–frequency analysis. We then evaluated undirected connectivity through coherence analysis and directed connectivity using spectral Granger ...

Abstract

Objective

Although previous research shows that generalized and focal epilepsies have at least some distinct genetic influences, it remains uncertain why some families manifest both types of epilepsy. We tested two hypotheses: (1) families with both generalized and focal epilepsy carry separate risk alleles for both types; and (2) within mixed families, the type of epilepsy each individual manifests is influenced by the relative burden of separate risk alleles for generalized epilepsies and focal epilepsies.

Methods

The Epi4K cohort included 711 individuals with ...

Abstract

Despite significant research into more flexible methods of ketogenic diet therapy initiation, there is only limited literature on the best practices to discontinue it. Both tradition and guidelines suggest weaning this treatment over 2–3 months; however, a more abrupt discontinuation has also been reported. Fifteen children and adults on ketogenic diet therapy, with various levels of seizure control, had their ketogenic diet therapy immediately discontinued. All were coincidentally admitted to inpatient units (typically an epilepsy monitoring unit), with intravenous access and ...