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Fiais GA, Ferreira DSDB, de Freitas RN, da Silva LGL, Kawaguchi M, Veras ASC, Teixeira GR, Antoniali C, Dornelles RCM, Nakamune ACDMS, Fakhouri WD, Chaves-Neto AH. Assessment of the toxic effects of levetiracetam on biochemical, functional, and redox parameters of salivary glands in male Wistar rats. Toxicology 2023; 496:153615. [PMID: 37572749 DOI: 10.1016/j.tox.2023.153615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/14/2023]
Abstract
Levetiracetam (LEV) is an anticonvulsant for epilepsy. The toxic effects of this medication in tissues have been associated with redox state imbalance, which can lead to salivary gland dysfunction. Therefore, the current work investigated the effects of LEV on the biochemical, functional, and redox parameters of the parotid and submandibular glands in rats. For this, male Wistar rats (Rattus norvegicus albinus) were randomly divided into 3 groups (n = 10/group): Control (0.9% saline solution), LEV100 (100 mg/kg), and LEV300 (300 mg/kg). After 21 consecutive days of intragastric gavage treatments, pilocarpine stimulated saliva secretion was collected for salivary biochemical analysis. The extracted salivary glands were utilized for histomorphometry and redox state analyses. Our results showed that LEV300 increased plasma hepatotoxicity markers and reduced salivary amylase activity and the acinar surface area of the parotid gland. Total oxidant capacity and oxidative damage to lipids and proteins were higher in the parotid gland, while total antioxidant capacity and uric acid levels were reduced in the submandibular gland of the LEV100 group compared to Control. On the other hand, total oxidant capacity, oxidative damage to lipids and proteins, total antioxidant capacity, and uric acid levels were lower in both salivary glands of the LEV300 group compared to Control. Superoxide dismutase and glutathione peroxidase activities were lower in the salivary glands of treated animals compared to Control. In conclusion our data suggest that treatment with LEV represents a potentially toxic agent, that contributes to drug-induced salivary gland dysfunction.
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Affiliation(s)
- Gabriela Alice Fiais
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | | | - Rayara Nogueira de Freitas
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação em Ciência Odontológica - Saúde Bucal da Criança, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Lucas Guilherme Leite da Silva
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Marcelo Kawaguchi
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Allice Santos Cruz Veras
- Departamento de Educação Física, Universidade Estadual Paulista (Unesp), Presidente Prudente, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Giovana Rampazzo Teixeira
- Departamento de Educação Física, Universidade Estadual Paulista (Unesp), Presidente Prudente, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Cristina Antoniali
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Rita Cássia Menegati Dornelles
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Ana Cláudia de Melo Stevanato Nakamune
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil
| | - Walid D Fakhouri
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, Houston, USA
| | - Antonio Hernandes Chaves-Neto
- Departmento de Ciências Básicas, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, Universidade Estadual Paulista (Unesp), Faculdade de Odontologia, Araçatuba, São Paulo, Brazil.
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Pazgan-Simon M, Jaroszewicz J, Simon K, Lorenc B, Sitko M, Zarębska-Michaluk D, Dybowska D, Tudrujek-Zdunek M, Berak H, Mazur W, Klapaczyński J, Janczewska E, Parfieniuk-Kowerda A, Flisiak R. Real-World Effectiveness and Safety of Direct-Acting Antivirals in Patients with Chronic Hepatitis C and Epilepsy: An Epi-Ter-2 Study in Poland. J Pers Med 2023; 13:1111. [PMID: 37511724 PMCID: PMC10381851 DOI: 10.3390/jpm13071111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION In Poland, active HCV infection affects between 0.4 and 0.5% of the population, i.e., about 150,000 people, while the number of patients with epilepsy is estimated to be 350,000-400,000. Currently available antiviral therapies show little interaction with neurological drugs. The aim of our study was to evaluate the effectiveness and safety of the treatment of chronic HCV infection in patients with coexisting epilepsy. METHODS A total of 184 epilepsy patients were selected from the group of 10,152 HCV-infected patients treated for HCV infection within the Epiter-2 database from 2015 to 2018. Comparing the effectiveness and safety of anti-HCV regimens between the patients with comorbid epilepsy and 3573 patients without comorbidities was our study's objective. RESULTS The effectiveness of anti-HCV treatment was high in both the sample and the control group. No statistically significant SVR difference was observed between the sample group, with ITT = 93.5% and mITT = 95.5%, and the control group, with ITT = 95.2% and mITT = 97.5%, regardless of the genotype and the stage of liver disease at the start of therapy. The treatment was safe in patients with epilepsy. CONCLUSIONS The effectiveness and safety of HCV treatment in patients with epilepsy are comparable to those of patients with no significant comorbidities.
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Affiliation(s)
- Monika Pazgan-Simon
- Department of Infectious Diseases, Regional Specialistic Hospital, 50-149 Wrocław, Poland
| | - Jerzy Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Krzysztof Simon
- Department of Infectious Diseases, Regional Specialistic Hospital, 50-149 Wrocław, Poland
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, 51-149 Wrocław, Poland
| | - Beata Lorenc
- Department of Infectious Diseases, Pomeranian Center of Infectious Diseases, University of Gdansk, 80-210 Gdańsk, Poland
| | - Marek Sitko
- Department of Infectious and Tropical Diseases, Collegium Medicum, Jagiellonian University, 30-252 Kraków, Poland
| | - Dorota Zarębska-Michaluk
- Department of Infectious Disease, Voivodeship Hospital, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Dorota Dybowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, 87-100 Bydgoszcz, Poland
| | | | - Hanna Berak
- Hospital for Infectious Diseases, Warsaw Medical University, 02-091 Warszawa, Poland
| | - Włodzimierz Mazur
- Clinical Department of Infectious Diseases, Medical University of Silesia, 40-055 Chorzów, Poland
| | - Jakub Klapaczyński
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of Internal Affairs and Administration, 02-241 Warszawa, Poland
| | - Ewa Janczewska
- Department of Basic Medical Sciences, School of Public Health in Bytom, Medical University of Silesia, 40-055 Bytom, Poland
- ID Clinic, Hepatology Outpatient Department, 41-400 Mysłowice, Poland
| | - Anna Parfieniuk-Kowerda
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland
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Ayele K, Wondiye H, Bogale EK. Lived experience of young people with epilepsy in Bahir Dar city government hospitals, Ethiopia, a qualitative interview study. PLoS One 2023; 18:e0278936. [PMID: 36689466 PMCID: PMC9870136 DOI: 10.1371/journal.pone.0278936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/23/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Epilepsy is the most common neurological disorder, which is characterized by persistent derangement of the nervous system due to an abrupt excessive discharge of the group of neurons from the cerebrum. For developing young people with epilepsy coping with the challenges of living with epilepsy and adjusting normative tasks associated with adolescence is stressful in all domains of the lives of young people with epilepsy. But in Ethiopia, published literature regarding the lived experience of young people with epilepsy is lacking. OBJECTIVES This study aims to explore lived experience of young people with epilepsy. METHODS A qualitative interview study was conducted in Bahir Dar city government specialized and referral Hospitals, from February to April, 2021. Using the rule of saturation, a total of 11 study participants (age 12-24) were selected using hetrogenious types of purposive sampling technique. The data were collected through semi structured interviews technique with the aid of audio recorder. Semi-structured interview guide and observation checklist for care context in health facilities were used. The collected data was transcribed word by word and translated conceptually. The Data were analyzed using thematic approach. The credibility, dependability, Conformability and transferability of the study were assured using different techniques such as peer debriefing, member checking; audit Trail, thick description and purposeful sampling. Atlas- ti version7 software was used to facilitate data analysis. RESULTS The participants' narratives revealed two main themes: 'experiences due epilepsy' and 'coping strategies to wards epilepsy'. Experience due to epilepsy' was described by young people with epilepsy in terms of psychosocial, physical, economical and health care related experiences. They described coping strategies towards epilepsy in terms of finding support from family and society as well as religious institutions and other traditions as copping strategy. CONCLUSION Even though young people with epilepsy had suffered a lot of hurtful experiences, they reported coping strategies towards epilepsy that include support from various sources. These types of findings have implications for social work interventions for young people living with epilepsy.
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Affiliation(s)
- Kokeb Ayele
- Health Promotion and Behavioral Sciences Department, Wollo University, Dessie, Ethiopia
| | - Habtamu Wondiye
- Health Promotion and Behavioral Sciences Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Health Promotion and Behavioral Sciences Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Prentice RN, Rizwan SB. Translational Considerations in the Development of Intranasal Treatments for Epilepsy. Pharmaceutics 2023; 15:pharmaceutics15010233. [PMID: 36678862 PMCID: PMC9865314 DOI: 10.3390/pharmaceutics15010233] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/29/2022] [Indexed: 01/13/2023] Open
Abstract
Epilepsy is a common and serious neurological disorder, to which a high proportion of patients continue to be considered "drug-resistant", despite the availability of a host of anti-seizure drugs. Investigation into new treatment strategies is therefore of great importance. One such strategy is the use of the nose to deliver drugs directly to the brain with the help of pharmaceutical formulation to overcome the physical challenges presented by this route. The following review explores intranasal delivery of anti-seizure drugs, covering the link between the nose and seizures, pathways from the nose to the brain, current formulations in clinical use, animal seizure models and their proposed application in studying intranasal treatments, and a critical discussion of relevant pre-clinical studies in the literature.
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Pellinen J. Treatment gaps in epilepsy. FRONTIERS IN EPIDEMIOLOGY 2022; 2:976039. [PMID: 38455298 PMCID: PMC10910960 DOI: 10.3389/fepid.2022.976039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 03/09/2024]
Abstract
Over 50 million people around the world have epilepsy, and yet, epilepsy recognition and access to care are ongoing issues. Nearly 80% of people with epilepsy live in low-and middle-income countries and face the greatest barriers to quality care. However, there are substantial disparities in care within different communities in high-income countries as well. Across the world, under-recognition of seizures continues to be an issue, leading to diagnostic and treatment delays. This stems from issues surrounding stigma, public education, basic access to care, as well as healthcare worker education. In different regions, people may face language barriers, economic barriers, and technological barriers to timely diagnosis and treatment. Even once diagnosed, people with epilepsy often face gaps in optimal seizure control with the use of antiseizure medications. Additionally, nearly one-third of people with epilepsy may be candidates for epilepsy surgery, and many either do not have access to surgical centers or are not referred for surgical evaluation. Even those who do often experience delays in care. The purpose of this review is to highlight barriers to care for people with epilepsy, including issues surrounding seizure recognition, diagnosis of epilepsy, and the initiation and optimization of treatment.
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Hou L, Peng B, Zhang D, Yang J, Wang Y, Tong L, Li S, Wang Q, Zhao J. Clinical Efficacy and Safety of Lacosamide as an Adjunctive Treatment in Adults With Refractory Epilepsy. Front Neurol 2021; 12:712717. [PMID: 34925202 PMCID: PMC8677652 DOI: 10.3389/fneur.2021.712717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/05/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Lacosamide (LCM), a novel AED (antiepileptic drug), was used as an adjunctive treatment in patients with partial-onset seizures or without secondary generalization. However, no meta-analysis was performed to evaluate the efficacy of LCM as an adjunctive treatment in post-marketing clinical studies. Aims: To assess the safety and efficacy of LCM as an adjunctive treatment in adults with refractory epilepsy, a systematic review and meta-analysis of randomized controlled trials (RCTs) and real-world studies were performed. Methods: All studies were identified from electronic databases. Both RCTs and observational prospective studies were included. Primary outcomes included responder rate, adverse effects (AEs) and withdraw rate. The pooled rates (PR) with their corresponding 95% confidence intervals (CI) were calculated. Publication bias was assessed with Begg's or Egger's tests. Results: Total 16 studies (3,191 patients) including 5 RCTs and 11 real-word studies were enrolled. The pooled 50% responder rate and seizure-free rate were 48% (95% CI: 0.42, 0.54) and 9% (95% CI: 0.06, 0.11) in all studies, respectively. Subgroup analysis showed that the pooled 50% responder rate were 53% (95% CI: 0.44, 0.62) from observational studies and 38% (95% CI: 0.35, 0.42) from RCTs, respectively; the pooled seizure-free rate were 13% (95% CI: 0.09, 0.18) from observational studies and 4% (95% CI: 0.06, 0.11) from RCTs, respectively. Similar incidence of AEs were reported in real-world studies (0.57, 95% CI: 0.43, 0.72) and RCTs (0.59, 95% CI: 0.42–0.76). Finally, a total of 13% (95%CI: 0.09, 0.16) and 13% (95% CI: 0.08, 0.16) of all patients prescribed with LCM was withdrawn in RCTs and real-world studies, respectively, due to the occurrence of AEs. Furthermore, similar to the 50% responder rate, seizure-free rate, incidence of AEs and withdraw rate were reported at 6-month or at least 12-month of LCM adjunction. Publication bias was not detected in these studies. Conclusions: Our results revealed that LCM adjunctive therapy even with long-term treatment was efficacious and well tolerated in adults with refractory epilepsy.
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Affiliation(s)
- Liyan Hou
- School of Public Health, Dalian Medical University, Dalian, China
| | - Bingjie Peng
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Dalian, China
| | - Defu Zhang
- Office of Academic Affairs, Dalian Medical University, Dalian, China
| | - Jingjing Yang
- Department of Neurology, The First Affiliated Hospital of DaLian Medical University, Dalian, China
| | - Ying Wang
- Department of Neurology, The First Affiliated Hospital of DaLian Medical University, Dalian, China
| | - Li Tong
- School of Public Health, Dalian Medical University, Dalian, China
| | - Sheng Li
- Department of Biochemistry and Molecular Biology, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Qingshan Wang
- School of Public Health, Dalian Medical University, Dalian, China.,National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Jie Zhao
- National-Local Joint Engineering Research Center for Drug-Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
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de Oliveira MCVA, Viana DCF, Silva AA, Pereira MC, Duarte FS, Pitta MGR, Pitta IR, Pitta MGR. Synthesis of novel thiazolidinic-phthalimide derivatives evaluated as new multi-target antiepileptic agents. Bioorg Chem 2021; 119:105548. [PMID: 34959174 DOI: 10.1016/j.bioorg.2021.105548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/19/2021] [Accepted: 12/05/2021] [Indexed: 12/25/2022]
Abstract
Epilepsy is a disease that affects millions of people around the globe and has a multifactorial cause. Inflammation is a process that can be involved in the development of seizures. Thus, the present study proposed the design and synthesis of new candidates for antiepileptic drugs that would also control the inflammatory process. Nine new derivatives of the substituted thiazophthalimide hybrid core were obtained with satisfactory purity ≥99% and yields between 27% and 87%. All compounds showed cell viability values greater than 90% in the culture of PBMC cells from healthy volunteers and, therefore, were not considered cytotoxic. These compounds modulated proinflammatory cytokines IFN-y and IL-17A and can mitigate inflammation. Acute toxicity studies of compound 7i in an animal model indicated that the compound has low toxicity and an LD50 greater than 2 g/kg in healthy adult rats. The same compound did not show positive results for anticonvulsant activity through the PTZ test. However, 7i demonstrates the interaction with the target GABA-A receptor in silico, indicating a possible activity as an agonist of that receptor. Thus, further studies are needed to investigate the anticonvulsant activity, in particular, using models in which the inflammatory process triggers epileptic seizures.
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Affiliation(s)
- Maria Cecilia V A de Oliveira
- Laboratory of Design and Drug Synthesis (LPSF), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Douglas C F Viana
- Laboratory of Design and Drug Synthesis (LPSF), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Anderson A Silva
- Laboratory of Experimental Neuropharmacology, Department of Physiology and Pharmacology, Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Michelly C Pereira
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Filipe S Duarte
- Laboratory of Experimental Neuropharmacology, Department of Physiology and Pharmacology, Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Maira G R Pitta
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Ivan R Pitta
- Laboratory of Design and Drug Synthesis (LPSF), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil; Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil
| | - Marina G R Pitta
- Laboratory of Design and Drug Synthesis (LPSF), Nucleus of Research in Therapeutical Innovation Suely Galdino (NUPIT SG), Biosciences Center, Federal University of Pernambuco, Recife, Brazil.
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Chakrabarti S, Swetapadma A, Pattnaik PK. A channel independent generalized seizure detection method for pediatric epileptic seizures. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 209:106335. [PMID: 34390934 DOI: 10.1016/j.cmpb.2021.106335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Epilepsy the disorder of the central nervous system has its worldwide presence in roughly 50 million people as estimated by the World Health Organization. Electroencephalogram (EEG) is one of the most common and non-invasive ways of analyzing and studying the subtle changes in neuronal activity of the brain during an epileptic seizure attack. These changes can be analyzed for developing an automated system that would assert the chances of an impending seizure. As changeable nature of seizure affects the patients from having a normal life, hence progress in developing new methods will improve the quality of life and also provide assistance in the medical sector. Objective of the proposed method is to avoid EEG channel selection and use all input EEG channel features to design a generalized epileptic seizure detection framework. METHOD In this work, a long short-term memory network has been proposed that is not complex and has the capability of effectively detecting epileptic seizures from both non-invasive and invasive electroencephalogram recordings. The proposed framework is simple and effective and designed in such capacity that raw electroencephalogram signals can be used to detect seizures. Also, a generalized approach has been followed that is channel independent such that EEG signals belonging to any hemisphere of the brain can be detected effectively by the proposed architecture. RESULTS The automated seizure detection system achieved high seizure detection sensitivity of 99.9%, and a low false-positive rate of 0.003 per hour for the Children's Hospital Boston-Massachusetts Institute of Technology dataset. While for the Sleep-Wake-Epilepsy-Center of the University Department of Neurology at the Inselspital Bern dataset, the sensitivity is 99.4% and false-positive rate of 0.006 per hour. Convergence analysis of the proposed model provides a significant amount of reliability and correctness in the efficient detection of epileptic seizures. CONCLUSION Assessment of the proposed framework on non-invasive as well as invasive EEG signals showed that the framework worked well for different type of EEG recordings as different metrics gave satisfactory results. As the framework is simple and did not require any additional parameter optimization techniques, it reduced the processing overheads without affecting the accuracy. Hence, it can be used as an efficient method for monitoring epileptic seizures.
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Affiliation(s)
- Satarupa Chakrabarti
- School of Computer Engineering, KIIT University, Bhubaneswar, Odisha 751024, India
| | - Aleena Swetapadma
- School of Computer Engineering, KIIT University, Bhubaneswar, Odisha 751024, India.
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Qaisar SM, Hussain SF. Effective epileptic seizure detection by using level-crossing EEG sampling sub-bands statistical features selection and machine learning for mobile healthcare. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 203:106034. [PMID: 33744752 DOI: 10.1016/j.cmpb.2021.106034] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
Mobile healthcare is an emerging approach which can be realized by using cloud-connected biomedical implants. In this context, a level-crossing sampling and adaptive-rate processing based innovative method is suggested for an effective and automated epileptic seizures diagnosis. The suggested solution can achieve a significant real-time compression in computational complexity and transmission activity reduction. The proposed method acquires the electroencephalogram (EEG) signal by using the level-crossing analog-to-digital converter (LCADC) and selects its active segments by using the activity selection algorithm (ASA). This effectively pilots the post adaptive-rate modules such as denoising, wavelet based sub-bands decomposition, and dimension reduction. The University of Bonn and Hauz Khas epilepsy-detection databases are used to evaluate the proposed approach. Experiments show that the proposed system achieves a 4.1-fold and 3.7-fold decline, respectively, for University of Bonn and Hauz Khas datasets, in the number of samples obtained as opposed to traditional counterparts. This results in a reduction of the computational complexity of the proposed adaptive-rate processing approach by more than 14-fold. It promises a noticeable reduction in transmitter power, the use of bandwidth, and cloud-based classifier computational load. The overall accuracy of the method is also quantified in terms of the epilepsy classification performance. The proposed system achieves100% classification accuracy for most of the studied cases.
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Affiliation(s)
- Saeed Mian Qaisar
- Electrical and Computer Engineering Department, Effat University, Jeddah, 22332, KSA; Communication & Signal Processing Lab, Energy & Technology Cenetr, Effat University, Jeddah, 22332, KSA.
| | - Syed Fawad Hussain
- Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi, Pakistan; Machine Learning and Data Science (MDS) lab, GIK Institute, Topi.
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Yi H, Liu H, Wang Z, Xue H, Sylvia S, Shi H, Teuwen DE, Han Y, Qin J. The competence of village clinicians in the diagnosis and management of childhood epilepsy in Southwestern China and its determinants: A cross-sectional study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 3:100031. [PMID: 34327383 PMCID: PMC8315368 DOI: 10.1016/j.lanwpc.2020.100031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Due to lack of neurologists in low- and middle-income countries, communities of patients living with epilepsy are calling for task-shifting of diagnosis and management from physicians to paramedical providers in the primary health care systems to narrow the huge treatment gap. Evidence to guide this work has been limited. This study assesses the competence of village clinicians (VC)- mostly paramedical providers- in the diagnosis and management of a presumptive case of childhood epilepsy and its determinants. METHODS A cross-sectional study was conducted in rural areas of a province in Southwestern China from July 2017 to January 2018. We randomly selected 370 VCs who practiced Western medicine and assumed the main responsibility of providing medical services in his/her clinic. A standardized clinical vignette based on national clinical practice guidelines was used to evaluate clinicians' competence in three domains: number and proportion of recommended (and essential) checklist (questions, examinations, and tests) completed, correctness of diagnosis, and correctness of case management. FINDINGS Though VCs completed 14•3% (IQR 9•5%-19•1%) of the recommended checklist, 63•2% (234/370, 95%CI 58•2%-68•0%) provided a correct diagnosis. Only 1•6% of VCs (6/370, 95%CI 0•7%-3•5%) gave correct management with both correct medication and referral, however 90•3% (334/370, 95%CI 86•8%-92•9%) provided partially correct management by referring patients to upper-level health facilities (89•5%, 331/370, 95%CI 85•9%-92•2%) or prescribing anti-epileptic drugs (AEDs) correctly (0•8%, 3/370, 95%CI 0•3%-2•4%). Around 1/4 VCs referred patients to Township Health Centers which usually were not staffed with pediatric neurologists. Fewer provided helpful medical advice to patients for daily management. The heuristic process was found to be negatively associated with the proportion of the recommended checklist that VCs completed, which is positively associated with correctness of diagnosis. INTERPRETATION Most VCs could diagnose and refer childhood epilepsy patients correctly; however, they lacked competence when it came to assuming the responsibility of primary care providers, referring efficiently, refilling AEDs, as well as supervising and instructing daily management of patients. FUNDING HY received the funding for this study from the "Health and Hope Fund" of the Business Development Center of the RCSC (Beijing) and UCB (Belgium). UCB provided support in the form of a salary for author DET.
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Affiliation(s)
- Hongmei Yi
- China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Room 408B, Wangkezhen Building, No. 5, Yiheyuan Road, Haidian, Beijing 100871, China
| | - Huidi Liu
- China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Room 408B, Wangkezhen Building, No. 5, Yiheyuan Road, Haidian, Beijing 100871, China
| | - Zhiping Wang
- Shanghai Children's Medical Center, Shanghai, China
| | - Hao Xue
- Stanford University, Stanford, CA, USA
| | - Sean Sylvia
- Department of Health Policy and Management and the Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Haonan Shi
- Business Development Center, Red Cross Society of China, Beijing, China
| | - Dirk E. Teuwen
- Corporate Societal Responsibility, UCB, Brussels, Belgium
| | - Ying Han
- Peking University First Hospital, Beijing, China
| | - Jiong Qin
- Peking University People's Hospital, Beijing, China
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Shringarpure M, Gharat S, Momin M, Omri A. Management of epileptic disorders using nanotechnology-based strategies for nose-to-brain drug delivery. Expert Opin Drug Deliv 2020; 18:169-185. [PMID: 32921169 DOI: 10.1080/17425247.2021.1823965] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Epilepsy, a major neurological disorder affects about 1% of the Indian population. The discovery of noninvasive strategies for epilepsy presents a challenge for the scientists. Different types of nose-to-brain dosage-forms have been studied for epilepsy management. It aims to give new perspectives for developing new and existing anti-epileptic drugs. Combining nanotechnology with nose-to-brain approach can help in promoting the treatment efficacy by site-specific delivery. Also, it will minimize the side-effects and patient noncompliance observed in conventional administration routes. Peptide delivery can be an interesting approach for the management of epilepsy. Drug-loaded intranasal nanoformulations exhibit diverse prospective potentials in the management of epilepsy. Considering that, nanotherapy using nose-to-brain delivery as a prospective technique for the efficient management of epilepsy is reviewed. AREAS COVERED The authors have compiled all recently available data pertaining to the nose-to-brain delivery of therapeutics using nanotechnological strategies. The fundamental mechanism of nose-to-brain delivery, claims for intranasal delivery and medical devices for epilepsy are discussed. EXPERT OPINION Drug-loaded intranasal nanoformulations exhibit different prospective potentials in the management of epilepsy. Considering the foregoing research done in the field of nanotechnology, globally, authors propose nose-to-brain delivery of nanoformulations as a potential technique for the efficient management of epilepsy.
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Affiliation(s)
- Mihika Shringarpure
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Sankalp Gharat
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Munira Momin
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India.,SVKM's Shri C B Patel Research Center for Chemistry and Biological Sciences, Mumbai, Maharashtra, India
| | - Abdelwahab Omri
- The Novel Drug and Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury, Canada
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The solute carrier transporters and the brain: Physiological and pharmacological implications. Asian J Pharm Sci 2019; 15:131-144. [PMID: 32373195 PMCID: PMC7193445 DOI: 10.1016/j.ajps.2019.09.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/17/2019] [Accepted: 09/27/2019] [Indexed: 02/05/2023] Open
Abstract
Solute carriers (SLCs) are the largest family of transmembrane transporters that determine the exchange of various substances, including nutrients, ions, metabolites, and drugs across biological membranes. To date, the presence of about 287 SLC genes have been identified in the brain, among which mutations or the resultant dysfunctions of 71 SLC genes have been reported to be correlated with human brain disorders. Although increasing interest in SLCs have focused on drug development, SLCs are currently still under-explored as drug targets, especially in the brain. We summarize the main substrates and functions of SLCs that are expressed in the brain, with an emphasis on selected SLCs that are important physiologically, pathologically, and pharmacologically in the blood-brain barrier, astrocytes, and neurons. Evidence suggests that a fraction of SLCs are regulated along with the occurrences of brain disorders, among which epilepsy, neurodegenerative diseases, and autism are representative. Given the review of SLCs involved in the onset and procession of brain disorders, we hope these SLCs will be screened as promising drug targets to improve drug delivery to the brain.
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