Epilepsy Research Journal
Epilepsy Research RSS feed. Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.Benefits to authorsWe also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services.Please see our Guide for Authors for information on article submission. If you require any further information or help, please visit our support pages: http://support.elsevier.com
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The quality of and access to health care has been the focus of rural health research; however, health disparities can involve a complex interaction of factors including race/ethnicity, age, sex, educational level, income level, insurance status and place of residence. (Burneo et al., 2009; Hartley, 2004; Johnson et al., 2008; Marmot, 2005; Scott and Wilson, 2011; Smedley et al., 2001; Szaflarski, 2014) Healthy People 2020 lists geographic region (rural/urban residence) as an important social determinant of health (Healthy People 2020, 2015) Rural/urban residence may affect health through individual (use of self-care, no routine source of care, lifestyle and behavior) or environmental (poverty, income inequality, access to care, health care shortages) factors.
Poor adherence to prescribed treatment is considered one of the most serious obstacles to the management of epilepsy (Faught, 2012; Samsonsen et al., 2014). It is of major importance to acknowledge that uncontrolled epilepsy does not necessarily reflect drug-resistant epilepsy. Recently, the International League Against Epilepsy defined drug-resistant epilepsy as uncontrolled seizures in spite of adequate trials of at least two tolerated, appropriately chosen and appropriately used antiepileptic drug (AED) schedules (Kwan et al., 2010).
Reflex seizures are epileptic events triggered by specific motor, sensory or cognitive stimulation. Frequently, reflex seizures occur in association with spontaneous seizures, and are considered as “seizure types” (Engel, 2001). The term of reflex epilepsy is traditionally applied to rare conditions in which all, or almost all seizures are provoked by one specific stimulus (Wolf & Koepp, 2012). Currently, only Idiopathic Photosensitive Occipital Lobe Epilepsy, Primary Reading Epilepsy (PRE), Startle Epilepsy and other Visual Sensitive Epilepsies are recognized as specific reflex epileptic syndromes (Engel, 2001).
The sensitivity and significance of lateralized interictal slow activity on magnetoencephalography in focal epilepsy
Drug resistant focal epilepsy results in significant morbidity, but many patients can become free of seizures with surgical resection or ablation, although epilepsy surgery remains under-utilized (Cascino, 2008; Englot, 2015; Englot et al., 2012). Successful epilepsy surgery depends critically on accurate delineation of the epileptogenic zone (EZ), resulting in seizure freedom in approximately two-thirds of patients with temporal lobe epilepsy (TLE) and one-half of individuals with extra-temporal lobe epilepsy (ETLE) (Englot et al., 2013; Englot et al., 2014; Spencer and Huh, 2008).
Contraceptive management in women with epilepsy is critical owing to the potential maternal and fetal risks if contraception or seizure management fails. A wide range of hormonal contraceptive methods are available for women, including injectable progestogens and oral contraceptive (OC) pills. The combination OC pills are composed of low-dose synthetic estrogen and progestogen and are usually taken for 21 days with a 7 day gap. Ethinyl estradiol (EE) is a major estrogen constituent in OCs including monophasic, biphasic, triphasic and extended-cycle regimens (Reddy, 2010).
The anticonvulsant action of the galanin receptor agonist NAX-5055 involves modulation of both excitatory- and inhibitory neurotransmission
The most abundant excitatory and inhibitory neurotransmitters in the mammalian brain are glutamate and γ-aminobutyric acid (GABA), respectively. Under physiological conditions the ratio between glutamatergic and GABAergic synapses is about 9 (Attwell and Laughlin, 2001) and an imbalance in this relationship appears to be involved in a number of neurological disorders such as Alzheimer's disease, schizophrenia and epilepsy (Sonnewald and Kondziella, 2003; Barker-Haliski et al., 2014; Schousboe et al.
Lesion guided stereotactic radiofrequency thermocoagulation for palliative, in selected cases curative epilepsy surgery
Resective epilepsy surgery is an established treatment option for patients with pharmacoresistant focal epilepsy resulting in significantly better seizure free outcomes than continued medical treatment alone (Jobst and Cascino, 2015). Yet, not every patient who enters a formal presurgical work-up can finally be recommended resective epilepsy surgery. Some patients suffer from multifocal epilepsy or have vast, badly demarcated, or complex organized epileptogenic zones with only a low chance for seizure freedom.
Proton magnetic resonance spectroscopy in juvenile myoclonic epilepsy: a systematic review and meta-analysis
Juvenile myoclonic epilepsy (JME), as an idiopathic generalized epilepsy syndrome, has three primary clinical seizure types, including myoclonia, generalized tonic–clonic seizures (GTCS), and few absences (Panayiotopoulos et al., 1994). JME patients have no structural alterations in the conventional magnetic resonance imaging (MRI) and computed tomography; however, structural and functional neuroimaging provides us with visible structural and functional alterations in the brains of patients with epilepsy, which has promoted a transformation in the conceptualization of epileptogenesis from ‘locality’ to ‘networks’ in recent years (Koepp, 2005; van Diessen et al., 2013).
A screening tool to identify surgical candidates with drug refractory epilepsy in a resource limited settings
Access to epilepsy surgery remains a considerable challenge in contemporary healthcare systems. Given the limitations in resources and demand for Epilepsy Monitoring Unit (EMU) assessments, information that can be used to expedite the process is of great value. The purpose of this study was to identify variables prior to EMU admission that may be associated with candidacy for prospective epilepsy surgery.
Anti-seizure effects of diuretics were first reported in 1938 for sulfanilamide (Maa et al., 2011). It was suggested that treatment with chlorothiazide or furosemide is associated with a decrease risk of unprovoked seizure and these drugs are anticonvulsant. Both furosemide and chlorothiazide can suppress the occurrence of maximal electroshock-induced seizures in mice (Hesdorffer et al., 2001).
Long-term safety and seizure outcome in Japanese patients with Lennox–Gastaut syndrome receiving adjunctive rufinamide therapy: an open-label study following a randomized clinical trial
Lennox-Gastaut syndrome (LGS) is an epileptic encephalopathy characterized by various types of epileptic seizures (mainly tonic seizures), diffuse slow spike-and-wave complex patterns on the electroencephalogram (EEG), and impairment of cognitive function. The long-term prognosis for mental function and seizures is generally devastating (Arzimanoglou et al., 2009; Beaumanoir, 1985; Blatter-Arifi, 1991; Oguni et al., 1996; Ohtsuka et al., 1990; Yagi, 1996). A high risk of sudden falls due to tonic and/or atonic seizures often affects the quality of life.
The efficacy and safety of rufinamide in drug-resistant epilepsy: A meta-analysis of double-blind, randomized, placebo controlled trials
Epilepsy is one of the most common types of human neurological disorder, and 30% of patients with epilepsy continue to seizure, despite tailored medical therapy (drug-resistant epilepsy) (Bialer and White, 2010). Although surgical resection of the epileptic focus may abolish epileptic seizures, many individuals are poor surgical candidates because of multifocal seizure origin or the epileptic focus being near the eloquent cortex (Berg, 2011; Wiebe, 2014). Moreover, about one third of patients, who seem seizure free after surgical therapy will resume seizures in 3-5 years (Salanova et al., 2002; Tellez-Zenteno et al., 2005; Thom et al., 2010).
Absence epilepsy is a genetic epilepsy syndrome with generalized seizures that originate from local areas and rapidly engage bilaterally distributed networks (Berg et al., 2010). Typical absence seizures make up the primary seizure type in a number of absence epilepsy syndromes, including childhood absence epilepsy and juvenile absence epilepsy (ILAE, 1989), which differ mainly in age of onset. Seizures commonly manifest between the age of four years and early adolescence and are more prevalent in females.
Screening in a cohort of 26 lateral temporal lobe epilepsy patients with auditory aura from Turkey detects a novel mutation
Lateral temporal lobe epilepsy (LTLE) is a group of conditions with specific seizure characteristics including auditory aura or aphasic symptoms with a high tendency to generalize. Non-lesional LTLE characterized by negative magnetic resonance imaging (MRI) findings has been described for a number of familial and sporadic cases. Familial non-lesional LTLE, namely Autosomal Dominant Lateral Temporal Lobe Epilepsy (ADLTE; OMIM 600512) is inherited in an autosomal dominant fashion presenting reduced penetrance with an overall estimate of 66% (Ho et al., 2012).
Attention devoted to the pathophysiologic mechanisms underlying cognitive and behavior impairment in Dravet syndrome (DS), one of the traditional primary examples of infantile epileptic encephalopathy, has been increasing in the scientific community. DS is an early onset epileptic syndrome that begins in the first year of life with prolonged febrile or afebrile generalized clonic or preferably hemiclonic seizures. Other key epileptic signs are hyperthermia-induced seizures and frequent episodes of status epilepticus.
Lennox-Gastaut Syndrome (LGS) is a severe epilepsy syndrome, typically of onset in early childhood, which has the key features of recurrent tonic seizures and intellectual impairment. Seizures are usually intractable, with daily, or multiple daily seizures commonly seen. LGS represents an estimated 1-10% of childhood epilepsies (Hancock and Cross, 2003). When epileptic discharges of LGS such as generalized paroxysmal fast activity are examined with combined electroencephalogram (EEG) and functional magnetic resonance imaging (fMRI), there is widespread recruitment of association cortex (Pillay et al., 2013) and reduced neuronal activity in primary cortical areas (Archer et al., 2014b).
Status epilepticus: clinical characteristics and EEG patterns associated with and without MRI diffusion restriction in 69 patients
Status epilepticus (SE) is defined as a seizure that shows no clinical signs of arresting after a duration encompassing the great majority of seizures of that type or recurrent seizures without interictal resumption of baseline central nervous system function (Blume et al., 2001). SE has an incidence of 15-20 per 100 000 per year and a mortality of 20% in first SE in adults and of 40% in refractory SE (Knake et al., 2001; Logroscino et al., 2005; Rosenow et al., 2007). In particular older age (>65 years) is an unfavourable prognostic predictor (DeLorenzo et al., 1996, Sutter and Rüegg, 2013).
In patients with mesial temporal lobe epilepsy (MTLE), glucose hypometabolism often extends beyond the temporal lobe. Among them, glucose hypometabolism in the prefrontal cortex is associated with cognitive changes (Jokeit et al., 1997; Takaya et al., 2006), suggesting that functional deficit zones exist in the remote cortical regions (Rosenow and Luders, 2001).
White matter structural connectivity changes correlate with epilepsy duration in temporal lobe epilepsy
Temporal lobe epilepsy (TLE) is the most common form of epilepsy in adults and is thought to be a network disease (Engel et al., 2013; Spencer, 2002). Diffusion tensor imaging (DTI) has been used to study the underlying white matter structural integrity in TLE, finding changes in temporal and extratemporal white matter structures (Arfanakis et al., 2002; Govindan et al., 2008; Gross, 2011; Gross et al., 2006; Thivard et al., 2005). The reason for white matter changes in TLE is unclear. However, various mechanisms have been suggested, including changes related to the underlying epileptogenic process, axonal degeneration due to seizures or epileptiform discharges, and compensatory white matter reorganization (Gross, 2011; Otte et al., 2012).
Ketogenic diet change cPLA2/clusterin and autophagy related gene expression and correlate with cognitive deficits and hippocampal MFs sprouting following neonatal seizures
A ketogenic diet (KD) is a high-fat, low-carbohydrate and restricted-protein diet that is a world-widely used last resort for medically intractable epilepsy. Recent evidence also suggests that KD may have some beneficial effects in a lot of metabolic diseases such as obesity, diabetes, GLUT1 deficiency syndrome and pyruvate dehydrogenase (PDH) deficiencies (Gano LB et al., 2014; Veggiotti P et al., 2014). In animal studies, CD-1 mouse neonates whose mothers were fed a KD prior to and during gestation demonstrated altered maternal metabolic status as well as offspring physiological growth and brain structure (Sussman D et al., 2013.).