Epilepsia. Official Journal of the International League Against Epilepsy

Abstract

Objective

Typical absence seizures are underreported. We aimed to improve patient care using a wearable electroencephalograph (wEEG) at home and assess a machine learning (ML) pipeline for absence detection.

Methods

Patients with typical absences used a wEEG device 12–24 h 1 week after antiseizure medication (ASM) adjustments. Three-hertz generalized spike–wave discharges (SWDs) ≥ 3 s were used as absence surrogates. After manual inspection, we used the results to guide medical treatment. The outcomes were seizure freedom, number of consecutive measurements without relapse, and side effects. Afterward, we ...

Abstract

Objective

The TANC2 gene encodes a scaffolding synaptic protein with essential roles in synaptic transmission. This study aims to explore the association between TANC2 and epilepsy and the mechanism underlying phenotypic variation.

Methods

Trio-based exome sequencing was performed in patients with epilepsy from the China Epilepsy 1.0 cohort. The association between TANC2 and epilepsy was validated with a Drosophila model. The role of TANC2 in development was investigated by single-cell RNA sequencing in cerebral organoids and spatiotemporal expression across brain regions.

Results

De novo TANC2 ...

Abstract

Objective

To implement parallel transmit (pTx) 7T magnetic resonance imaging (MRI) in the pre-surgical evaluation of 3T-negative patients with drug-resistant focal epilepsy, and to compare quality to conventional single transmit (specifically, circularly polarized [CP]) 7T MRI.

Methods

We implemented a comparative protocol comprising both pTx and CP 7T MRI in consecutive adult candidates for epilepsy surgery who had negative or equivocal 3T MRI imaging. Here we report the outcomes from the first 31 patients. We acquired pTx and CP T₁, T₂, fluid-attenuated inversion ...

Abstract

Objective

In temporal lobe epilepsy (TLE), detection of the epileptogenic zone predicts a good surgical outcome. When submitted to ¹⁸F-fluorodeoxyglucose positron emission tomography (PET), some patients display lateralized, focal hypometabolism in the temporal lobe (PET+), whereas others appear normometabolic (PET−). However, the mechanism behind this metabolic difference remains unclear. This study aimed to identify differential molecular mechanisms in these patient subtypes.

Methods

Neocortical and hippocampal biopsies of TLE patients (n = 3 PET+, n = 3 PET−) and nonepileptic postmortem controls (n = 3) were analyzed for lipid distribution ...

Abstract

Objective

Reduced-channel wearable electroencephalography (EEG) may overcome the accessibility and patient comfort limitations of traditional ambulatory electrographic seizure monitoring during extended-duration use. Automated algorithms are necessary for review of extended-duration reduced-channel EEG, yet current clinical support software is designed only for full-montage recordings.

Methods

The performance of a novel automated seizure detection algorithm for reduced-channel EEG (Epitel) was evaluated in a clinical validation study involving 50 participants (31 with seizures) with diverse demographic and seizure representation.

Results

The algorithm demonstrated an event-level sensitivity of 86.2% ...

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 ...