Article
Clinical Neurology
Robert J. Quon, Edward J. Camp, Stephen Meisenhelter, Yinchen Song, Sarah A. Steimel, Markus E. Testorf, Angeline S. Andrew, Robert E. Gross, Bradley C. Lega, Michael R. Sperling, Michael J. Kahana, Barbara C. Jobst
Summary: The study investigated the impact of interictal epileptiform discharges (IEDs) on memory performance, finding that increased IED rate, white matter propagation, and localization in the left middle temporal region were associated with poorer memory performance. Specifically for lateral temporal IEDs, there was a significant interaction between IED white matter classification and amplitude, where higher amplitude and white matter propagation were linked to reduced memory performance. Additionally, changes in alpha power after an IED were positively correlated with memory performance.
Review
Clinical Neurology
Emoke Anna Csernus, Tom Werber, Anita Kamondi, Andras Attila Horvath
Summary: Hyperexcitability is recognized as a contributor to Alzheimer's disease (AD), with subclinical epileptiform activity (SEA) being a neurophysiological sign of cortical hyperexcitability. This review summarizes studies on SEA in AD from three perspectives: defining SEA, explaining the importance of diagnosing SEA, and discussing methods of diagnosing SEA. The review also discusses the impact of SEA on cognitive function and the sensitivity of overnight electroencephalography (EEG) in detecting epileptiform discharges. Lastly, the review presents important research questions and potential solutions regarding SEA.
FRONTIERS IN NEUROLOGY
(2022)
Editorial Material
Clinical Neurology
Jonathan K. Kleen, Kathryn A. Davis
Summary: Do transient bursts of interictal epileptiform activity have a clinically relevant effect on cognition? This study examines the impact of such bursts on cognitive impairment and reaction times. Scalp EEG has demonstrated focal effects of discharges within a particular hemisphere or lobe, while recent intracranial work has provided more functional-anatomic detail and mechanistic studies. However, most clinicians still hesitate to treat the interictal EEG without clear quantitative guidance.
Article
Multidisciplinary Sciences
Marisol Soula, Anna Maslarova, Ryan E. Harvey, Manuel Valero, Sebastian Brandner, Hajo Hamer, Antonio Fernandez-Ruiz, Gyorgy Buzsaki
Summary: Interictal epileptiform discharges (IEDs) are common electrophysiological events observed in epilepsy and other neurological diseases. This study characterizes and compares IEDs in human epilepsy patients and AD transgenic mice, finding similar features and effects on the hippocampal circuit. The findings suggest that IEDs may play a role in cognitive deficits and memory interference.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2023)
Article
Clinical Neurology
Anna Sakovics, Gabor Csukly, Csaba Borbely, Marta Virag, Anna Kelemen, Robert Bodizs, Lorand Eross, Daniel Fabo
Summary: The study found that hippocampal interictal epileptic discharges (hIEDs) have an impact on neocortical spindle activity, particularly when spindles coincide with epileptic discharges. This finding may shed light on how epileptic discharges disrupt memory processes and provide a potential therapeutic target. Additionally, the study revealed that the direction of coupling between hIEDs and spindles varies among individuals.
Article
Behavioral Sciences
Emma Gimenez DeGeorge, Chrystal Fullen, Jennifer Gess, Jennifer Kleiner, Linda Larson-Prior
Summary: Research shows that early age of onset of epilepsy is related to lower auditory attention span and working memory, while larger antiepileptic drug (AED) load is associated with lower visuospatial memory. However, there is no relationship between age of onset or AED load and quality of life in epilepsy, but depression is highly correlated with quality of life. These findings underscore the importance of balancing epilepsy control and AED effects, and being aware of specific cognitive domains affected by epilepsy to effectively monitor and treat it.
EPILEPSY & BEHAVIOR
(2021)
Editorial Material
Clinical Neurology
David King-Stephens
Summary: The study revealed that sleep disruption in patients with epilepsy is associated with both ictal and interictal epileptic activity. The increase in interictal epileptic activity before arousals suggests its involvement in sleep disruption. The additional spike rate increase during arousals may be attributed to a sleep-wake boundary instability, indicating a bidirectional relationship.
Article
Psychology, Clinical
Moshe Maiman, Victor A. Del Bene, Eileen Farrell, William S. MacAllister, Sloane Sheldon, Miguel Arce Renteria, Mitchell Slugh, Deana M. Gazzola, William B. Barr
Summary: The RBANS has utility in evaluating cognition in patients with epilepsy and can differentiate between TLE and non-TLE patients. The number of antiepileptic drugs appears to be associated with global cognitive performance in adults with epilepsy.
ARCHIVES OF CLINICAL NEUROPSYCHOLOGY
(2021)
Article
Behavioral Sciences
Alessia Longo, Marion Houot, Bastien Herlin, Marie Mere, Marisa Denos, Severine Samson, Sophie Dupont
Summary: The study found that the localization of the epileptic focus within the lateral temporal lobe affects the neuropsychological characteristics of patients with LTLE, resulting in differences in learning, executive performance, and language difficulties. Antiepileptic drugs have a greater impact on patient performance, while age, education level, and gender also influence cognitive performance.
EPILEPSY & BEHAVIOR
(2021)
Editorial Material
Clinical Neurology
Wyatt P. Bensken, Ivan Sanchez Fernandez
Summary: One in four people in the United States who take prescription drugs face difficulties affording them, including patients with epilepsy. Health plans often restrict coverage for newer antiseizure medications, leading to delays in treatment. Neurologists can address this issue by understanding the causes and finding actionable solutions.
Article
Clinical Neurology
Franz Furbass, Johannes Koren, Manfred Hartmann, Georg Brandmayr, Sebastian Hafner, Christoph Baumgartner
Summary: This study quantifies the effects of sleep and seizures on IED rates and classifies patients with epilepsy based on their IED activation patterns. Five sub-cohorts with distinct IED activation patterns were identified, showing associations with circadian rhythms, sleep stages, and seizure occurrence.
CLINICAL NEUROPHYSIOLOGY
(2021)
Article
Multidisciplinary Sciences
Robert B. Duckrow, Enea Ceolini, Hitten P. Zaveri, Cornell Brooks, Arko Ghosh
Summary: By monitoring smartphone touchscreen interactions, utilizing an artificial neural network model, and analyzing electrographic data, researchers were able to establish a strong correlation between behavioral patterns and epileptiform activity in epilepsy patients.
Article
Clinical Neurology
Beatrice Lemesle, Emmanuel J. Barbeau, Emilie Milongo Rigal, Marie Denuelle, Luc Valton, Jeremie Pariente, Jonathan Curot
Summary: The study confirmed objective deficits in very long-term memory in patients with TLE, even when not detected by standard memory assessments. Epireal showed better performance in capturing autobiographical memory and detecting memory deficits in TLE patients.
Article
Clinical Neurology
Mengrong Miao, Yaqian Han, Ying Zhang, Yuehua Xu, Liyuan Zhang, Yitian Yang, Mingyang Sun, Jiaqiang Zhang
Summary: The study found that the incidence of epileptiform EEG events in children during sevoflurane anesthesia varied from 19.1% to 59.2%. Using a low initial concentration of sevoflurane induction can reduce the incidence of these epileptiform discharges, while longer exposure to high concentration sevoflurane may increase the rate of epileptiform discharges.
CLINICAL NEUROPHYSIOLOGY
(2022)
Article
Clinical Neurology
Fabio A. Nascimento, Jaden D. Barfuss, Alex Jaffe, M. Brandon Westover, Jin Jing
Summary: This study designed an algorithm to quantify the six IFCN criteria for identifying interictal epileptiform discharges (IEDs) and estimate the likelihood of a candidate IED being epileptiform. The model's performance was excellent but lower than human experts or a deep neural-network model. The six features of candidate IEDs were of different importance in determining their epileptiform nature, with waveform asymmetry being the most important and duration being the least discriminative. This model may assist clinical electroencephalographers in decision-making and trainees in learning to identify IEDs.
CLINICAL NEUROPHYSIOLOGY
(2023)
Article
Clinical Neurology
Archana A. Patel, Sookee An, Mark Schomer, Kristina Julich, Christopher Elitt, Jamie Heath, Melissa S. Putman, Tobias Loddenkemper
PEDIATRIC NEUROLOGY
(2020)
Review
Clinical Neurology
Avantika Singh, Coral M. Stredny, Tobias Loddenkemper
Article
Clinical Neurology
Chellamani Harini, Elanagan Nagarajan, Ann M. Bergin, Phillip Pearl, Tobias Loddenkemper, Masanori Takeoka, Peter F. Morrison, David Coulter, Gita Harappanahally, Candice Marti, Kanwaljit Singh, Christopher Yuskaitis, Annapurna Poduri, Mark H. Libenson
Review
Neurosciences
Christian Meisel, Tobias Loddenkemper
Review
Clinical Neurology
Claire Ufongene, Rima El Atrache, Tobias Loddenkemper, Christian Meisel
CLINICAL NEUROPHYSIOLOGY
(2020)
Article
Multidisciplinary Sciences
Aarti Sathyanarayana, Rima El Atrache, Michele Jackson, Aliza S. Alter, Kenneth D. Mandl, Tobias Loddenkemper, William J. Bosl
SCIENTIFIC REPORTS
(2020)
Article
Clinical Neurology
Marta Amengual-Gual, Ivan Sanchez Fernandez, Alejandra Vasquez, Tobias Loddenkemper
Article
Behavioral Sciences
Solveig Vieluf, Tanuj Hasija, Peter J. Schreier, Rima El Atrache, Sarah Hammond, Fatemeh Mohammadpour Touserkani, Rani A. Sarkis, Tobias Loddenkemper, Claus Reinsberger
Summary: The study aimed to evaluate interactions of multimodal peripheral ANS measures before and after seizures as compared to controls for seizure detection and forecasting. Results showed that bimodal correlations were highest before seizures and lowest postictally in patients with seizures.
EPILEPSY & BEHAVIOR
(2021)
Article
Multidisciplinary Sciences
Solveig Vieluf, Rima El Atrache, Sarah Cantley, Michele Jackson, Justice Clark, Theodore Sheehan, William J. Bosl, Bo Zhang, Tobias Loddenkemper
Summary: This study tested the differences in 24-hour modulation patterns between patients with and without seizures and explored the potential of using these differences to forecast seizure risk. The results suggest that monitoring and forecasting seizure risk can be achieved by analyzing wearable recordings in combination with clinical variables.
SCIENTIFIC REPORTS
(2022)
Article
Clinical Neurology
Fatemeh Mohammad Alizadeh Chafjiri, Latania Reece, Lillian Voke, Asaf Landschaft, Justice Clark, Amir A. Kimia, Tobias Loddenkemper
Summary: This study compared the identification of refractory status epilepticus (rSE) cases through human electronic health record (EHR) review and a natural language processing (NLP)-assisted rSE screen followed by manual review. The NLP-assisted model showed higher sensitivity compared to human review in identifying rSE cases through EHRs.
Article
Clinical Neurology
Solveig Vieluf, Sarah Cantley, Michele Jackson, Bo Zhang, William J. Bosl, Tobias Loddenkemper
Summary: This study utilized wearable devices to record physiological data of pediatric patients with epilepsy, and combined with clinical data for seizure likelihood prediction. Results showed that heart rate and electrodermal activity played important roles in predicting impending seizures.
PEDIATRIC NEUROLOGY
(2023)
Article
Clinical Neurology
Mustafa Halimeh, Michele Jackson, Solveig Vieluf, Tobias Loddenkemper, Christian Meisel
Summary: This study used wearable devices to record seizure characteristics and improved the accuracy of seizure logging through deep learning algorithms. It identified factors that affect logging performance, such as patient age, antiseizure medication use, seizure type, and duration.
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
(2023)
Article
Computer Science, Artificial Intelligence
Solveig Vieluf, Tanuj Hasija, Maurice Kuschel, Claus Reinsberger, Tobias Loddenkemper
Summary: This study aims to identify biomarkers for evaluating seizure-related differences and proposes a biomarker that can classify pre-ictal and inter-ictal data from epilepsy patients. By analyzing the data of 42 pediatric epilepsy patients, it is found that DCCA analysis based on changes in heart rate and electrodermal activity can predict seizure occurrence.
EXPERT SYSTEMS WITH APPLICATIONS
(2023)
Article
Health Care Sciences & Services
Michele C. Jackson, Alejandra Vasquez, Oluwafemi Ojo, Alexandra Fialkow, Sarah Hammond, Coral M. Stredny, Annalee Antonetty, Tobias Loddenkemper
Summary: This study describes the acute seizure care pathway for pediatric patients and identifies barriers encountered by caregivers in seizure care management. Proposed interventions to address these challenges are also presented. The study highlights twenty-nine care gaps in acute seizure care management for pediatric patients. Identifying these care barriers is crucial for implementing interventions and strategies that can potentially impact patient outcomes.
INTERNATIONAL JOURNAL OF INTEGRATED CARE
(2022)
Article
Pediatrics
Ahmet Tanritanir, Xiaofan Wang, Tobias Loddenkemper
Summary: The study found that Eslicarbazepine acetate (ESL) had a good response rate in patients with pharmacologically intractable epilepsy, with about one-third of patients developing adverse events.
JOURNAL OF PEDIATRIC EPILEPSY
(2021)