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Bush KJ, Cullen E, Mills S, Chin RFM, Thomas RH, Kingston A, Pickrell WO, Ramsay SE. Assessing the extent and determinants of socioeconomic inequalities in epilepsy in the UK: a systematic review and meta-analysis of evidence. Lancet Public Health 2024; 9:e614-e628. [PMID: 39095136 DOI: 10.1016/s2468-2667(24)00132-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Socioeconomic inequalities in epilepsy incidence and its adverse outcomes are documented internationally, yet the extent of inequalities and factors influencing the association can differ between countries. A UK public health response to epilepsy, which prevents epilepsy without widening inequalities, is required. However, the data on UK epilepsy inequalities have not been synthesised in a review and the underlying determinants are unknown. METHODS In this systematic review and meta-analysis, we searched six bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Scopus) and grey literature published between Jan 1, 1980, and Feb 21, 2024, to identify UK studies reporting epilepsy incidence or epilepsy-related adverse outcomes by socioeconomic factors (individual level or area level). We included longitudinal cohort studies, studies using routinely collected health-care data, cross-sectional studies, and matched cohort studies and excluded conference abstracts and studies not reporting empirical results in the review and meta-analysis. Multiple reviewers (KJB, EC, SER, WOP, and RHT) independently screened studies, KJB extracted data from included studies and a second reviewer (SM or EC) checked data extraction. We used Critical Appraisal Skills Programme checklists to assess quality. We used random-effects meta-analysis to pool incident rate ratios (IRRs) and synthesised results on adverse outcomes narratively. This study was registered on PROPSPERO (CRD42023394143). FINDINGS We identified 2471 unique studies from database searches. We included 26 studies, ten of which reported epilepsy incidence and 16 reported epilepsy-related adverse outcomes according to socioeconomic factors. Misclassification, participation, and interpretive biases were identified as study quality limitations. Meta-analyses showed an association between socioeconomic deprivation and epilepsy incidence, with greater risks of epilepsy incidence in groups of high-deprivation (IRR 1·34 [95% CI 1·16-1·56]; I2=85%) and medium-deprivation (IRR 1·23 [95% CI 1·08-1·39]; I2=63%) compared with low-deprivation groups. This association persisted in the studies that only included children (high vs low: IRR 1·36 [95% CI 1·19-1·57]; I2=0%). Only two studies examined factors influencing epilepsy incidence. There is limited evidence regarding UK inequalities in adverse outcomes. INTERPRETATION Socioeconomic inequalities in epilepsy incidence are evident in the UK. To develop an evidence-based public health response to epilepsy, further research is needed to understand the populations affected, factors determining the association, and the extent of inequalities in adverse outcomes. FUNDING Epilepsy Research Institute UK.
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Affiliation(s)
- Kathryn J Bush
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Emer Cullen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Susanna Mills
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Richard F M Chin
- Muir Maxwell Epilepsy Centre, Department of Child Life and Health and the Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - William Owen Pickrell
- Swansea University Medical School, Swansea University, Swansea, UK; Neurology Department, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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2
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Enkhtuya B, Bayarsaikhan A, Lkhagvasuren B, Sainbat U, Bayanmunkh B, Avirmed T, Tsend B. Emotional intelligence in children with epilepsy. IBRO Neurosci Rep 2024; 16:260-266. [PMID: 39007084 PMCID: PMC11240295 DOI: 10.1016/j.ibneur.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/17/2023] [Accepted: 01/27/2024] [Indexed: 07/16/2024] Open
Abstract
Objective Epilepsy is a prevalent neurological disorder in the pediatric population, often accompanied by comorbidities, drug-related burdens, and psychosocial issues. Emotional intelligence (EI) is a crucial aspect of neurocognitive functioning that may be impaired in various clinical conditions. This study aimed to assess EI and its associated risk factors in children with epilepsy. Methods In a case-control design, we recruited 47 children with epilepsy (37 males, mean age 10.5 ± 3.1 years) and age- and gender-matched controls. Participants were evaluated using the Emotional Quotient Inventory: Youth Version (EQ-I:YV). We included risk factors, including comorbidities, perinatal complications, epilepsy characteristics, and magnetic resonance imaging results to predict EI. Results Results indicate that children with epilepsy demonstrated significantly lower EI scores compared to controls (Total EQ score: p = 0.031, intrapersonal: p < 0.001, adaptability: p = 0.03, and general mood: p < 0.001). Multiple linear regression analysis indicated that lower total EQ scores were associated with the number of anti-epileptic drugs, age, seizure frequency, MRI abnormalities, aura, and early onset of seizures. Conclusions The study provides evidence that children with epilepsy exhibit lower EQ scores than control group, with notable differences in intrapersonal skills, adaptability, and general mood. Additionally, age, and some seizure-related factors predicted decreased total EQ scores. These findings emphasize the need to consider EI in the context of pediatric epilepsy, as impaired EI may contribute to further psychosocial challenges faced by affected children.
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Affiliation(s)
- Battamir Enkhtuya
- Department of Pediatrics, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Amgalan Bayarsaikhan
- Department of Pediatrics, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Battuvshin Lkhagvasuren
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Uranbileg Sainbat
- Mongolian Psychology Diagnostic and Training Methodology Center, Ulaanbaatar, Mongolia
| | - Binderiya Bayanmunkh
- Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar, Mongolia
| | - Tovuudorj Avirmed
- Department of Neurology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Bayarmaa Tsend
- Department of Psychology, Mongolian National University of Education, Ulaanbaatar, Mongolia
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Eisner J, Harvey D, Dunn D, Jones J, Byars A, Fastenau P, Austin J, Hermann B, Oyegbile-Chidi T. Long-term characterization of cognitive phenotypes in children with seizures over 36 months. Epilepsy Behav 2024; 154:109742. [PMID: 38554647 DOI: 10.1016/j.yebeh.2024.109742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/19/2024] [Accepted: 03/10/2024] [Indexed: 04/02/2024]
Abstract
RATIONALE Children with new-onset epilepsies often exhibit co-morbidities including cognitive dysfunction, which adversely affects academic performance. Application of unsupervised machine learning techniques has demonstrated the presence of discrete cognitive phenotypes at or near the time of diagnosis, but there is limited knowledge of their longitudinal trajectories. Here we investigate longitudinally the presence and progression of cognitive phenotypes and academic status in youth with new-onset seizures as sibling controls. METHODS 282 subjects (6-16 years) were recruited within 6 weeks of their first recognized seizure along with 167 unaffected siblings. Each child underwent a comprehensive neuropsychological assessment at baseline, 18 and 36 months later. Factor analysis of the neuropsychological tests revealed four underlying domains - language, processing speed, executive function, and verbal memory. Latent trajectory analysis of the mean factor scores over 36 months identified clusters with prototypical cognitive trajectories. RESULTS Three unique phenotypic groups with distinct cognitive trajectories over the 36-month period were identified: Resilient, Average, and Impaired phenotypes. The Resilient phenotype exhibited the highest neuropsychological factor scores and academic performance that were all similar to controls; while the Impaired phenotype showed the polar opposite with the worst performances across all test metrics. These findings remained significant and stable over 36 months. Multivariate logistic regression indicated that age of onset, EEG, neurological examination, and sociodemographic disadvantage were associated with phenotype classification. CONCLUSIONS This study demonstrates the presence of diverse latent cognitive trajectory phenotypes over 36 months in youth with new-onset seizures that are associated with a stable neuropsychological and academic performance longitudinally.
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Affiliation(s)
- Jordan Eisner
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA
| | - Danielle Harvey
- Department of Public Health Sciences, University of California Davis, Davis, CA 95616, USA
| | - David Dunn
- Departments of Psychiatry and Neurology, Indiana University, Indianapolis, IN 46202, USA
| | - Jana Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
| | - Anna Byars
- Department of Pediatrics, Cincinnati Children's Hospital at the University of Cincinnati, Cincinnati, OH 45229, USA
| | - Philip Fastenau
- Department of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Joan Austin
- Distinguished Professor Emerita, School of Nursing, Indiana University, Indianapolis, IN 46202, USA
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
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Thomas BR, Ludwig NN, Falligant JM, Kurtz PF, Smith-Hicks C. Severe behavior problems in SYNGAP1-related disorder: A summary of 11 consecutive patients in a tertiary care specialty clinic. Epilepsy Behav 2024; 150:109584. [PMID: 38096660 DOI: 10.1016/j.yebeh.2023.109584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
SYNGAP1-related disorder (SYNGAP1-RD) is a neurodevelopmental disorder that is commonly associated with epilepsy, autism spectrum disorder (ASD), and disruptive behaviors. In this study, behavior problems in 11 consecutive patients with SYNGAP1-RD are described and quantified based on a behavioral screening conducted within the context of a multi-disciplinary tertiary care specialty clinic visit. The behavioral phenotype was then compared to published samples of behavior problems in ASD and other genetic cause of epilepsy occurring in the context of neurodevelopmental disorders using results from the Aberrant Behavior Checklist-Community (ABC-C), an empirically derived outcome measure. We report common antecedent and consequent events surrounding problem behavior across individuals. Additionally, we report on the management approach of caregivers and the impact of problem behaviors on the family. Our results suggest a number of commonalities between behavioral profiles in SYNGAP1-RD with ASD and other genetic causes of developmental and epileptic encephalopathies, and also highlight severe behavior problems as a specific behavioral phenotype of SYNGAP1-RD.
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Affiliation(s)
- Benjamin R Thomas
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA.
| | - Natasha N Ludwig
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - John Michael Falligant
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - Patricia F Kurtz
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
| | - Constance Smith-Hicks
- Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA; Johns Hopkins University School of Medicine, USA
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Woodfield J, Chin RFM, van Schooneveld MMJ, van den Heuvel M, Bastin ME, Braun KPJ. The association of structural connectome efficiency with cognition in children with epilepsy. Epilepsy Behav 2023; 148:109462. [PMID: 37844437 DOI: 10.1016/j.yebeh.2023.109462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE Cognitive impairment is common in children with epilepsy (CWE), but understanding the underlying pathological processes is challenging. We aimed to investigate the association of structural brain network organisation with cognition. METHODS This was a retrospective cohort study of CWE without structural brain abnormalities, comparing whole brain network characteristics between those with cognitive impairment and those with intact cognition. We created structural whole-brain connectomes from anatomical and diffusion tensor magnetic resonance imaging using the number of streamlines and tract-averaged fractional anisotropy. We assessed the differences in average path length and global network efficiency between children with cognitive impairment and those without,using multivariable analyses to account for possible clinical group differences. RESULTS Twenty-eight CWE and cognitive impairment had lower whole brain network global efficiency compared with 34 children with intact cognition (0.54, standard deviation (SD):0.003 vs. 0.56, SD:0.002, p < 0.001), which is equivalent to longer normalized network average path lengths (1.14, SD:0.05 vs. 1.10, SD:0.02, p = 0.003). In multivariable logistic regression cognitive impairment was not significantly associated with age of onset, duration of epilepsy, or number of antiseizure medications, but was independently associated with daily seizures (p = 0.04) and normalized average path length (p = 0.007). CONCLUSIONS Higher structural network average path length and lower global network efficiency may be imaging biomarkers of cognitive impairment in epilepsy. Understanding what leads to changes in structural connectivity could aid identification of modifiable risk factors for cognitive impairment. These findings are only applicable to the specific cohort studied, and further confirmation in other cohorts is required.
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Affiliation(s)
- Julie Woodfield
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom; Department of Clinical Neurosciences, NHS Lothian, Edinburgh, United Kingdom; Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, United Kingdom.
| | - Richard F M Chin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom; Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, United Kingdom; Royal Hospital for Children and Young People, NHS Lothian, Edinburgh, United Kingdom
| | | | - Martijn van den Heuvel
- Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mark E Bastin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Kees P J Braun
- Department of Paediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
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Zhong R, Zhang H, Han Y, Guo X, Lin W. Social support for and features of Chinese adults with epilepsy. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-022-00087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The lack of social support for adults with epilepsy (AWEs) is receiving increased attention, as it may result in low quality of life. This study was aimed to confirm the demographic characteristics of and clinical factors associated with social support for AWEs.
Methods
AWEs were consecutively recruited from our hospital. The 10-term Social Support Rating Scale (SSRS) was used to measure social support. A linear regression analysis with stepwise selection was performed to analyze the independent variables associated with social support for AWEs.
Results
In total, 165 AWEs were consecutively included in the present study. Linear regression analysis showed that the marital status (t = -3.550, β = -0.272, P = 0.001), the age at onset (t = 2.545, β = 0.192, P = 0.012), and the QOLIE-31 score (t = 3.144, β = 0.221, P = 0.002) were independent variables associated with social support for AWEs.
Conclusions
Our findings suggest that the poor social support is associated with childhood onset of epilepsy and the unmarried status. This study also confirmed a negative influence of low social support on quality of life in AWEs.
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Tschamper MK, Wahl AK, Hermansen Å, Jakobsen R, Larsen MH. Parents of children with epilepsy: Characteristics associated with high and low levels of health literacy. Epilepsy Behav 2022; 130:108658. [PMID: 35358855 DOI: 10.1016/j.yebeh.2022.108658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
Abstract
Parents of children with epilepsy play a key role in the management of their child's condition. Their level of health literacy (HL), which refers to their ability to seek, understand, assess, remember, and utilize health information, is essential for handling the child optimally. The aim of this study was to investigate characteristics associated with high and low levels of different dimensions of HL in parents. HL was assessed with the multidimensional Health Literacy Questionnaire (parents' version) and the electronic Health Literacy Scale, using data from a cohort of 254 parents of children <12 years. Bivariate correlation and multiple hierarchal linear regression (STATA version 16 SE) were used to investigate variables associated with HL. Self-efficacy (St. β = 0.14-0.34) was the only variable that predicted higher scores on every HL scale. Being older than 35 years (St. β = 0.18-0.21), level of education (St. β = 0.16-0.27), and the child having a coordinator of services (St. β = 0.16-0.28) were associated with higher scores, while sick leave due to the child's epilepsy (St. β = -0.13 to -0.16), child comorbidities (St. β = -0.15 to -0.19), and higher levels of mental distress (St. β = -0.13 to -0.19) were associated with lower scores in several of the different HL dimensions. A total of 44.8% of the parents scored over the cutoff (≥1.85) predicting a mental disorder on the Hopkins symptom checklist. This is the first study to investigate multidimensional parental HL in a childhood epilepsy context. Our results highlight the need to investigate multiple variables, especially mental distress, to determine characteristics that may predict low parental HL. Further qualitative studies are needed to explore the underlying reasons for the parents' HL scores and to develop inventions tailored to meet different HL needs.
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Affiliation(s)
- Merete K Tschamper
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Norway.
| | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Norway
| | - Åsmund Hermansen
- Faculty of Social Sciences, Oslo Metropolitan University, Norway
| | - Rita Jakobsen
- Lovisenberg Diaconal University College, Oslo, Norway
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Malhi P, Annam A, Singhi P. Screening children with epilepsy for behavioral problems: Utility of the strength and the difficulties questionnaire. Ann Indian Acad Neurol 2022; 25:143-145. [PMID: 35342252 PMCID: PMC8954323 DOI: 10.4103/aian.aian_226_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/11/2021] [Accepted: 06/09/2021] [Indexed: 12/02/2022] Open
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9
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Hunter MB, Chin RFM. Impaired social attention detected through eye movements in children with early-onset epilepsy. Epilepsia 2021; 62:1921-1930. [PMID: 34142371 DOI: 10.1111/epi.16962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Children with early-onset epilepsy (CWEOE; epilepsy onset before 5 years) exhibit impaired social functioning, but social attention has not yet been examined. In this study we sought to explore visual attention via eye tracking as a component of social attention and examine its relationship with social functioning and Autism Spectrum Disorder (ASD) risk scores. METHODS Forty-seven CWEOE (3-63 months) and 41 controls (3-61 months) completed two eye-tracking tasks: (1) preference for social versus nonsocial naturalistic scenes, and (2) face region preference task. ASD risk was measured via the Modified Checklist for Autism in Toddlers or Conners Early Childhood Total Score. Social functioning was assessed via the Greenspan Social-Emotional Growth Chart, or Infant-Toddler Social & Emotional Assessment Competence Scale, or Conners Early Childhood Social Functioning Scale, depending on age. Fixation preferences for social scenes and eyes were compared between groups and evaluated by age and social functioning scores. RESULTS Regression analysis revealed that CWEOE viewed the social scene to a significantly less degree than controls. The greatest difference was found between the youngest CWEOE and controls. Fixation duration was independently and significantly related to social functioning scores. There were no significant differences between CWEOE and controls in the face scanning task, and there was no significant relationship between either task and ASD risk scores. SIGNIFICANCE CWEOE exhibit task-specific atypical social attention early in the course of the disease. This may be an early marker of impaired social development, and it suggests abnormal social brain development.
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Affiliation(s)
- Matthew B Hunter
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and MRC Centre for Reproductive Health, Child Life and Health, The University of Edinburgh, Edinburgh, UK
| | - Richard F M Chin
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and MRC Centre for Reproductive Health, Child Life and Health, The University of Edinburgh, Edinburgh, UK.,Department of Paediatric Neurosciences, Royal Hospital for Children and Young People, Edinburgh, UK
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10
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Tang F, Xiao D, Chen L, Gao H, Li X. Role of Munc18-1 in the biological functions and pathogenesis of neurological disorders (Review). Mol Med Rep 2021; 23:198. [PMID: 33495808 PMCID: PMC7821349 DOI: 10.3892/mmr.2021.11837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 11/06/2022] Open
Abstract
The release of neurotransmitters following the fusion of synaptic vesicles and the presynaptic membrane is an important process in the transmission of neuronal information. Syntaxin-binding protein 1 (Munc18-1) is a synaptic fusion protein binding protein, which mainly regulates synaptic vesicle fusion and neurotransmitter release by interacting with soluble N-ethylmaleimide sensitive factor attachment protein receptor. In addition to affecting neurotransmitter transmission, Munc18-1 is also involved in regulating neurosynaptic plasticity, neurodevelopment and neuroendocrine cell release functions (including thyroxine and insulin release). A number of previous studies have demonstrated that Munc18-1 has diverse and vital biological functions, and that its abnormal expression serves an important role in the pathogenesis of a variety of neurological diseases, including epileptic encephalopathy, schizophrenia, autism, Parkinsons disease, Alzheimers disease, multiple sclerosis, Duchennes muscular dystrophy and neuronal ceroid lipofuscinosis. The present review summarizes the function of Munc18-1 and its possible relationship to the pathogenesis of various neurological diseases.
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Affiliation(s)
- Fajuan Tang
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Dongqiong Xiao
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lin Chen
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Hu Gao
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xihong Li
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Hunter MB, Yoong M, Sumpter RE, Verity K, Shetty J, McLellan A, Chin RFM. Incidence of early-onset epilepsy: A prospective population-based study. Seizure 2019; 75:49-54. [PMID: 31874359 DOI: 10.1016/j.seizure.2019.12.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/05/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The first five years of life reflect a critical period of development prior to formal education yet few epidemiological studies focus on children with early-onset epilepsy (CWEOE; onset <60 months). This study aimed to determine early-onset epilepsy incidence using a comprehensive case identification strategy, and examined socioeconomic status (SES) and ethnicity as risk factors. METHODS Through a prospective, population-based study, newly diagnosed CWEOE from Fife and Lothian, Scotland, were identified using multiple-source, active surveillance capture-recapture between May 2013 and June 2015. Crude, ascertainment-adjusted, age-adjusted, age- and gender-specific, and epilepsy-type incidence rates were determined. Risk ratios (RR) were calculated to examine SES and ethnicity as risk factors. RESULTS 59 (36 Male) CWEOE were identified. Ascertainment was 98% (95% CI 94-103). Crude annual incidence of epilepsy in children 0-59 months was 60.2 (95% CI 44.8-75.5) per 100,000 per year; ascertainment-adjusted annual incidence was 61.7 (95% CI 46.2-77.3) per year. Cumulative incidence of West Syndrome/Infantile Spasms was 6.7 per 10,000 live births (95% CI 3.6-12.3). Aetiology was unknown in almost two-thirds of CWEOE. Compared to White-British Isles (BI) children, Asian children (RR 2.6 [95% CI 1.2-5.7], p = .02) and White-non-BI children (RR 2.5 [95% CI 1.2-5.2], p = .02) had increased risk. SES was not a risk factor. CONCLUSION The high incidence of early-onset epilepsy is similar to previous studies and demonstrates a substantial disease burden. Cause of epilepsy remains unknown in almost two thirds of CWEOE. Ethnicity but not SES affects early-onset epilepsy risk.
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Affiliation(s)
- Matthew B Hunter
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK.
| | - Michael Yoong
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK
| | - Ruth E Sumpter
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK
| | - Kirsten Verity
- Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
| | - Jay Shetty
- Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
| | - Ailsa McLellan
- Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
| | - Richard F M Chin
- Muir Maxwell Epilepsy Centre, University of Edinburgh, Edinburgh, UK; Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK
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12
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Canzian J, Müller TE, Franscescon F, Michelotti P, Fontana BD, Costa FV, Rosemberg DB. Modeling psychiatric comorbid symptoms of epileptic seizures in zebrafish. J Psychiatr Res 2019; 119:14-22. [PMID: 31542703 DOI: 10.1016/j.jpsychires.2019.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/31/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022]
Abstract
Epilepsy is a debilitating neurological disorder characterized by recurrent unprovoked seizures. Anxiety, cognitive deficits, depressive-like symptoms, and social dysfunction are psychiatric comorbidities with high prevalence in epileptic patients. Due to the genetic and behavioral tractability, the zebrafish is a promising model organism to understand the neural bases involved in epilepsy-related comorbidities. Here, we aimed to characterize some behavioral phenotypes paralleling those observed in epilepsy-related comorbidities after a single pentylenetetrazole (PTZ) exposure in zebrafish. We also analyzed the influence of whole-body cortisol levels in the behavioral responses measured. Fish were exposed to 10 mM PTZ for 20 min to induce epileptic seizures. After 24 h recovery period, locomotion and anxiety-like responses (novel tank and light-dark tests), social interaction (shoaling behavior task), and memory retention (inhibitory avoidance protocol) were assessed. Basically, PTZ impaired habituation to novelty stress, evoked anxiogenic-like behaviors, disrupted shoaling, and caused memory consolidation deficits in zebrafish without changing whole-body cortisol levels. In conclusion, our novel findings further validate the use of zebrafish as a suitable tool for modeling epilepsy-related comorbidities in translational neuropsychiatric research.
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Affiliation(s)
- Julia Canzian
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil.
| | - Talise E Müller
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil
| | - Francini Franscescon
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil
| | - Paula Michelotti
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil
| | - Barbara D Fontana
- Brain and Behaviour Laboratory, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Fabiano V Costa
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil
| | - Denis B Rosemberg
- Laboratory of Experimental Neuropsychobiology, Department of Biochemistry and Molecular Biology, Natural and Exact Sciences Center, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, 1000 Roraima Avenue, Santa Maria, RS, 97105-900, Brazil; The International Zebrafish Neuroscience Research Consortium (ZNRC), 309 Palmer Court, Slidell, LA, 70458, USA.
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Reilly C, Atkinson P, Memon A, Jones C, Dabydeen L, Helen Cross J, Das KB, Gillberg C, Neville BGR, Scott RC. Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy. Seizure 2019; 71:233-239. [PMID: 31425870 DOI: 10.1016/j.seizure.2019.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/30/2019] [Accepted: 08/07/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To provide data on the prevalence of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and parent reported behaviour difficulties in young children with epilepsy, and to compare results with children with neurodisability (neurodevelopmental/neurological difficulties) without epilepsy. METHOD Children with epilepsy (1-7 years, n = 48) and children with neurodisability (1-7 years, n = 48) matched for gender, chronological and developmental age underwent psychological assessment. Parents completed measures of behaviour including the Strengths and Difficulties Questionnaire (SDQ). DSM-5 diagnoses of ASD and ADHD were made at consensus case conferences. Factors associated with child behaviour were analysed using linear regression. RESULTS Of the children with epilepsy, 18% met ASD criteria and 40% met ADHD criteria (corresponding figures in the non-epilepsy group were 41% and 27%). A large proportion (76%-78%) in both groups scored in the at-risk range on the SDQ and frequently had difficulties across multiple behavioural domains. Children with epilepsy had more concerns expressed regarding attention and mood. None of the epilepsy factors were significantly associated with scores on the behavioural measures. SIGNIFICANCE Young children with epilepsy had a very high level of parent reported behavioural difficulties and a high risk for ADHD and ASD highlighting the need for comprehensive multidisciplinary assessment. Behavioural concerns were not greater than for other children with non-epilepsy related neurodisability with the exception of attention and mood. Epilepsy related factors were not associated with child behaviour, suggesting that seizures per se do not confer a unique risk for behavioural difficulties.
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Affiliation(s)
- Colin Reilly
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK.
| | - Patricia Atkinson
- Child Development Centre, Crawley Hospital, West Green Drive, Crawley, RH11 7DH, West Sussex, UK
| | - Ayesha Memon
- Child Development Centre, Crawley Hospital, West Green Drive, Crawley, RH11 7DH, West Sussex, UK
| | - Chloe Jones
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK
| | - Lyvia Dabydeen
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK
| | - J Helen Cross
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Krishna B Das
- UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Christopher Gillberg
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Gillberg Neuropsychiatry Centre, University of Gothenburg, Kungsgatan 12, Gothenburg, Sweden
| | - Brian G R Neville
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK
| | - Rod C Scott
- UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK; Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, VT, USA
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