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Zhou Z, Zhang P, Ya D, Liu J, Xu Y, Zhang Y, Tang W, Zhou D, Liao R, Liu L. Withaferin A protects against epilepsy by promoting LCN2-mediated astrocyte polarization to stopping neuronal ferroptosis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155892. [PMID: 39032282 DOI: 10.1016/j.phymed.2024.155892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/15/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Epilepsy is among the most frequent severe brain diseases, with few treatment options available. Neuronal ferroptosis is an important pathogenic mechanism in epilepsy. As a result, addressing ferroptosis appears to be a promising treatment approach for epilepsy. Withaferin A (WFA) is a C28 steroidal lactone that has a broad range of neuroprotective properties. Nonetheless, the antiepileptic action of WFA and the intrinsic mechanism by which it inhibits ferroptosis following epilepsy remain unknown. PURPOSE This study aimed at investigating to the antiepileptic potential of WFA in epilepsy, as well as to propose a potential therapeutic approach for epilepsy therapy. METHODS We conducted extensive research to examine the impacts of WFA on epilepsy and ferroptosis, using the kainic acid (KA)-treated primary astrocyte as an in vitro model and KA-induced temporal lobe epilepsy mice as an in vivo model. To analyze the neuroprotective effects of WFA on epileptic mice, electroencephalogram (EEG) recording, Nissl staining, and neurological function assessments such as the Morris water maze (MWM) test, Y-maze test, Elevated-plus maze (O-maze) test, and Open field test were used. Furthermore, the mechanism behind the neuroprotective effect of WFA in epilepsy was investigated using the transcriptomics analysis and verified on epileptic patient and epileptic mouse samples using Western blotting (WB) and immunofluorescence (IF) staining. In addition, WB, IF staining and specific antagonists/agonists were used to investigate astrocyte polarization and the regulatory signaling pathways involved. More critically, ferroptosis was assessed utilizing lipocalin-2 (LCN2) overexpression cell lines, siRNA knockdown, JC-1 staining, WB, IF staining, flow cytometry, electron microscopy (TEM), and ferroptosis-related GSH and MDA indicators. RESULTS In this study, we observed that WFA treatment reduced the number of recurrent seizures and time in seizure, and the loss of neurons in the hippocampal area in in epileptic mice, and even improved cognitive and anxiety impairment after epilepsy in a dose depend. Furthermore, WFA treatment was proven to enhance to the transformation of post-epileptic astrocytes from neurotoxic-type A1 to A2 astrocytes in both in vivo and in vitro experiments by inhibiting the phosphoinositide 3-kinase /AKT signaling pathway. At last, transcriptomics analysis in combination with functional experimental validation, it was discovered that WFA promoted astrocyte polarity transformation and then LCN2 in astrocytes, which inhibited neuronal ferroptosis to exert neuroprotective effects after epilepsy. In addition, we discovered significant astrocytic LCN2 expression in human TLE patient hippocampal samples. CONCLUSIONS Taken together, for the first, our findings suggest that WFA has neuroprotective benefits in epilepsy by modulating astrocyte polarization, and that LCN2 may be a novel potential target for the prevention and treatment of ferroptosis after epilepsy.
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Affiliation(s)
- Zixian Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China
| | - Pengcheng Zhang
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Dongshan Ya
- Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, 541004, PR China
| | - Jiao Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China
| | - Yinchun Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China
| | - Yu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China
| | - Wenfu Tang
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China
| | - Rujia Liao
- Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, 541004, PR China.
| | - Ling Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
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Li L, Liu Z. SRF Facilitates Transcriptional Inhibition of Gem Expression by m6A Methyltransferase METTL3 to Suppress Neuronal Damage in Epilepsy. Mol Neurobiol 2024:10.1007/s12035-024-04396-x. [PMID: 39190265 DOI: 10.1007/s12035-024-04396-x] [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: 11/01/2023] [Accepted: 07/21/2024] [Indexed: 08/28/2024]
Abstract
A bioinformatics analysis was conducted to screen for relevant expression datasets of the transcription factor SRF knockout mice. The aim was to investigate the relationship between SRF and m6A-related genes, predict how SRF regulates the m6A modification of GEM genes mediated by METTL3, and explore potential molecular mechanisms associated with neurotrauma. Disease gene databases such as GeneCards, DisGeNET, and Phenolyzer, and transcription factor databases TFDB and TRRUST, were used to obtain epilepsy-related genes and transcription factors. The intersection was then selected. Expression data of SRF knockout epilepsy mice were obtained from the GEO database and used to filter differentially expressed genes. Important module genes related to the disease were selected through WGCNA co-expression analysis. The intersection between these genes and the differentially expressed genes was performed, followed by PPI network analysis and GO/KEGG enrichment analysis. Furthermore, the core genes were selected using the cytoHubba plugin of the Cytoscape software. Differential expression analysis was performed on m6A-related factors in the GEO dataset, and the relationship between SRF and m6A-related factors and core genes was analyzed. The m6A binding sites of SRF with the METTL3 promoter and target gene Gem were predicted using the AnimalTFDB and SRAMP websites, respectively. We found that the transcription factor SRF may be a key gene in epilepsy during neuronal development. Further WGCNA analysis showed that 129 module genes were associated with SRF knockout epilepsy, and these differentially expressed genes were mainly enriched in the neuroactive ligand-receptor interaction pathway. The final results indicate that knocking out SRF may inhibit the transcription of METTL3, thereby inhibiting the m6A modification of Gem and leading to upregulation of Gem expression, thereby playing an important role in neuronal damage. Knocking out the SRF gene may inhibit the transcription of m6A methyltransferase METTL3, thereby inhibiting the m6A modification of GEM genes mediated by METTL3, promoting GEM gene expression, and leading to the occurrence of epilepsy-related neuron injury. Further investigation revealed that SRF overexpression can potentially enhance the transcription of METTL3, thus promoting m6A modification of GEM, resulting in downregulation of GEM expression. This process regulates oxidative stress in epileptic mouse neurons, suppresses inflammatory responses, and mitigates associated damage. Additionally, an in vitro neuronal epileptic model was established, and experimental techniques such as qRT-PCR and WB were employed to assess the expression of SRF, METTL3, and GEM in hippocampal tissues and neurons. The experimental results were consistent with our predictions, demonstrating that overexpression of SRF can inhibit the development of epilepsy-related neuronal damage. This study reveals that knockout of the SRF gene may suppress the transcription of m6A methyltransferase METTL3, thereby inhibiting m6A modification of the GEM gene mediated by METTL3 and subsequently promoting the expression of the GEM gene, leading to the occurrence of epilepsy-related neuronal damage.
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Affiliation(s)
- Lianling Li
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan Province, P. R. China.
| | - Zhiguo Liu
- Department of Neurosurgery, Centtal Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, P. R. China
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Shan T, Zhu Y, Fan H, Liu Z, Xie J, Li M, Jing S. Global, regional, and national time trends in the burden of epilepsy, 1990-2019: an age-period-cohort analysis for the global burden of disease 2019 study. Front Neurol 2024; 15:1418926. [PMID: 39233683 PMCID: PMC11373253 DOI: 10.3389/fneur.2024.1418926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/30/2024] [Indexed: 09/06/2024] Open
Abstract
Background Epilepsy is a non-communicable chronic brain disease that affects all age groups. There are approximately 50 million epilepsy patients worldwide, which is one of the most common neurological disorder. This study reports the time trends in the burden of epilepsy from 1999 to 2019. Methods We evaluated the disease burden and its temporal trends of epilepsy using the prevalence and years lived with disability (YLDs), which was estimated based on the Global Burden of Disease (GBD) 2019 study. The age-period-cohort (APC) model was used to estimate the temporal trends of the epilepsy prevalence and YLDs rates, and to analyze the relative risks of age, periods and queues (age/period/queue effects). Results In the past 30 years, the global age-standardized prevalence rate and age-standardized rate has increased by 29.61% and 27.02%, respectively. Globally, the APC model estimated the net drift of prevalence and YLDs were 0.88% (95% CI: 0.83-0.93) and 0.80% (95% CI: 0.75-0.85) per year. Among 204 countries and territories, the YLDs in 146 and prevalence 164 showed an increasing trend. And the risk of YLDs and prevalence increases with age, with the lowest risk among 0-4 years old and the highest risk among 75-79 years old. Unfavorable increasing period and cohort risks of YLDs and prevalence were observed. Conclusion Over the past 30 years, the YLDs and prevalence of epilepsy have gradually increased globally and unfavorable increasing period and cohort risks were observed. Emphasizing epilepsy prevention, strengthening epilepsy health education, optimizing older adults epilepsy diagnosis and treatment plans, and actively promoting epilepsy diagnosis and treatment plans can effectively reduce new cases of epilepsy and related disabilities.
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Affiliation(s)
- Tao Shan
- Department of Outpatient, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- School of Information Management, Nanjing University, Nanjing, China
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- Institute of Medical Informatics and Management, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center for Chronic Disease Big Data Application and Intelligent Health Service, Nanjing, China
| | - Yahui Zhu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Haozhi Fan
- Jiangsu Institute of Clinical Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- School of Cyber Science and Engineering, Southeast University, Nanjing, China
| | - Zeye Liu
- Department of Cardiac Surgery, Peking University People's Hospital, Peking University, Beijing, China
| | - Jing Xie
- Department of Pharmacy, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Mao Li
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shenqi Jing
- Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- Institute of Medical Informatics and Management, Nanjing Medical University, Nanjing, China
- Jiangsu Province Engineering Research Center for Chronic Disease Big Data Application and Intelligent Health Service, Nanjing, China
- Center for Data Management, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- Department of Information Management, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Zhao J, Li S, Zhang N, Cui C, Wang T, Fan M, Zeng J, Xie Y. Felt stigma and associated factors in children and adolescents with epilepsy: a multicenter cross-sectional study in China. Front Neurol 2024; 15:1459392. [PMID: 39206293 PMCID: PMC11349658 DOI: 10.3389/fneur.2024.1459392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Objective Epilepsy-related stigma is a global problem, yet there has been an inadequate focus on children and adolescents. The purpose of this study was to determine the status quo of stigma and its determinants among children and adolescents with epilepsy in China. Methods A multicenter cross-sectional study was conducted across nine hospitals in eight cities within six provinces in China from 10 October 2023 to 15 June 2024. Participants included patients aged 8 to 18 years with epilepsy and their caregivers. Felt stigma was assessed with the Kilifi Stigma Scale for Epilepsy (KSSE). Social support and self-efficacy were collected through the Social Support Rating Scale (SSRS) and the Generalized Self-Efficacy Scale (GSES). The data were analyzed using t-tests, analysis of variance (ANOVA), Spearman correlation analysis, and multiple linear regression analysis. Results The study enrolled 281 children and adolescents, with a mean age of 12.25 years (SD = 2.56), including 46.6% females. A total of 35.6% participants had self-reported felt stigma. The mean KSSE score is 9.58 (SD = 7.11). Meanwhile, stigma scores correlated strongly with reduced social support (r = -0.55, p < 0.01) and self-efficacy (r = -0.43, p < 0.01). Place of residence (rural vs. non-rural), academic performance (average and above vs. fair or poor), region (western region vs. non-western region), duration of epilepsy (≤5 years vs. >5 years), drug-resistant epilepsy (yes vs. no), comorbidities (yes vs. no), social support and self-efficacy are major influencing factors among the complex factors influencing the felt stigma among children and adolescents. Conclusion Medical staff should be more aware of stigma among children and adolescents with epilepsy, especially those who live in rural and western areas, have poor academic performance, have epilepsy duration of more than 5 years, have drug-resistant epilepsy, and have comorbidities, who are at higher risk of stigma. It is recommended that effective measures be taken to alleviate stigma by improving children and adolescents' self-efficacy and providing more social support for them and their families.
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Affiliation(s)
- Jing Zhao
- Department of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Shuangzi Li
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ni Zhang
- Department of Traditional Chinese Medicine, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Cui Cui
- Department of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ting Wang
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Mingping Fan
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Junqi Zeng
- Department of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yuan Xie
- Department of Nursing, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Chen X, Wu D, Chen Z. Biomedical applications of stimuli-responsive nanomaterials. MedComm (Beijing) 2024; 5:e643. [PMID: 39036340 PMCID: PMC11260173 DOI: 10.1002/mco2.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/23/2024] Open
Abstract
Nanomaterials have aroused great interests in drug delivery due to their nanoscale structure, facile modifiability, and multifunctional physicochemical properties. Currently, stimuli-responsive nanomaterials that can respond to endogenous or exogenous stimulus display strong potentials in biomedical applications. In comparison with conventional nanomaterials, stimuli-responsive nanomaterials can improve therapeutic efficiency and reduce the toxicity of drugs toward normal tissues through specific targeting and on-demand drug release at pathological sites. In this review, we summarize the responsive mechanism of a variety of stimulus, including pH, redox, and enzymes within pathological microenvironment, as well as exogenous stimulus such as thermal effect, magnetic field, light, and ultrasound. After that, biomedical applications (e.g., drug delivery, imaging, and theranostics) of stimuli-responsive nanomaterials in a diverse array of common diseases, including cardiovascular diseases, cancer, neurological disorders, inflammation, and bacterial infection, are presented and discussed. Finally, the remaining challenges and outlooks of future research directions for the biomedical applications of stimuli-responsive nanomaterials are also discussed. We hope that this review can provide valuable guidance for developing stimuli-responsive nanomaterials and accelerate their biomedical applications in diseases diagnosis and treatment.
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Affiliation(s)
- Xiaojie Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang ProvinceSchool of Pharmaceutical SciencesDepartment of NeurologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
| | - Di Wu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang ProvinceSchool of Pharmaceutical SciencesDepartment of NeurologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang ProvinceSchool of Pharmaceutical SciencesDepartment of NeurologyThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
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Leng X, Hu G, Wang X, Zhang Y, Guo Y, Song C, Yang F, Jiang W, Wang Y, Wang X. Risk of COVID-19 infection and seizure exacerbation among patients with epilepsy during the peak of Omicron wave. Epilepsia Open 2024; 9:1416-1425. [PMID: 38795316 PMCID: PMC11296108 DOI: 10.1002/epi4.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/07/2024] [Accepted: 05/12/2024] [Indexed: 05/27/2024] Open
Abstract
OBJECTIVES Existing data regarding the risk of COVID-19 infection and its effects on seizure control in patients with epilepsy (PWE) are inconclusive. Our research aims to investigate the PWE who are susceptible to COVID-19 and what factors contribute to seizure exacerbation. METHODS From Dec 28, 2022 to Feb 19, 2023, a cross-sectional questionnaire survey among adult PWE was conducted. The demographics, epilepsy-related information, COVID-19-related variables, and seizure outcomes after COVID-19 infection were collected. Multivariate logistic analyses were performed to determine the risk factors associated with COVID-19 infection and exacerbated seizures. RESULTS Of 1557 PWE, 829 (53.2%) were infected with COVID-19 and 136 (16.4%) developed seizure exacerbation after COVID-19 infection. Overweight/obesity (OR 1.372, 95% CI 1.075-1.753, p = 0.011), immunocompromised (OR 3.301, 95% CI 1.093-9.974, p = 0.031), active epilepsy (OR 1.700, 95% CI 1.378-2.097, p < 0.001), and antiseizure medication (ASM) polytherapy (OR 1.314, 95% CI 1.065-1.621, p = 0.011) were associated with COVID-19 infection. Active epilepsy (OR 4.696, 95% CI 2.568-8.586, p < 0.001) and fever-associated seizures (OR 4.298, 95%CI 2.659-6.946, p < 0.001) were associated with seizure exacerbation. SIGNIFICANCE PWE with overweight/obesity, immunocompromised, active epilepsy, and ASM polytherapy were at higher risk of COVID-19 infection. Once infected with COVID-19, seizures were exacerbated in PWE with active epilepsy and fever-associated seizures. PLAIN LANGUAGE SUMMARY Patients with epilepsy (PWE) do not appear to be more susceptible to COVID-19 infection than general population. Once infected with COVID-19, 16.4% of PWE had seizure exacerbation. The PWE who have experienced seizures within the past 12 months before infection tend to contract COVID-19 more often, and are more likely to experience seizure exacerbations following COVID-19 infection.
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Affiliation(s)
- Xiuxiu Leng
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Gengyao Hu
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Xuan Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yingchi Zhang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yaomin Guo
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Changgeng Song
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Fang Yang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Wen Jiang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Yuanyuan Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
| | - Xiaomu Wang
- Department of Neurology, Xijing HospitalAir Force Medical UniversityXi'anChina
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Wang ZB, Liu JY, Jiang SL, Zhuo W, Xie P, Dai WT, Mao XY, Liu ZQ. Unveiling the shield: Troglitazone's impact on epilepsy-induced nerve injury through ferroptosis inhibition. CNS Neurosci Ther 2024; 30:e14911. [PMID: 39145422 PMCID: PMC11325165 DOI: 10.1111/cns.14911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Epilepsy is a widespread central nervous system disorder with an estimated 50 million people affected globally. It is characterized by a bimodal incidence peak among infants and the elderly and is influenced by a variety of risk factors, including a significant genetic component. Despite the use of anti-epileptic drugs (AEDs), drug-refractory epilepsy develops in about one-third of patients, highlighting the need for alternative therapeutic approaches. AIMS The primary aim of this study was to evaluate the neuroprotective effects of troglitazone (TGZ) in epilepsy and to explore the potential mechanisms underlying its action. METHODS We employed both in vitro and in vivo models to assess TGZ's effects. The in vitro model involved glutamate-induced toxicity in HT22 mouse hippocampal neurons, while the in vivo model used kainic acid (KA) to induce epilepsy in mice. A range of methods, including Hoechst/PI staining, CCK-8 assay, flow cytometry, RT-PCR analysis, Nissl staining, scanning electron microscopy, and RNA sequencing, were utilized to assess various parameters such as cellular damage, viability, lipid-ROS levels, mitochondrial membrane potential, mRNA expression, seizure grade, and mitochondrial morphology. RESULTS Our results indicate that TGZ, at doses of 5 or 20 mg/kg/day, significantly reduces KA-induced seizures and neuronal damage in mice by inhibiting the process of ferroptosis. Furthermore, TGZ was found to prevent changes in mitochondrial morphology. In the glutamate-induced HT22 cell damage model, 2.5 μM TGZ effectively suppressed neuronal ferroptosis, as shown by a reduction in lipid-ROS accumulation, a decrease in mitochondrial membrane potential, and an increase in PTGS2 expression. The anti-ferroptotic effect of TGZ was confirmed in an erastin-induced HT22 cell damage model as well. Additionally, TGZ reversed the upregulation of Plaur expression in HT22 cells treated with glutamate or erastin. The downregulation of Plaur expression was found to alleviate seizures and reduce neuronal damage in the mouse hippocampus. CONCLUSION This study demonstrates that troglitazone has significant therapeutic potential in the treatment of epilepsy by reducing epileptic seizures and the associated brain damage through the inhibition of neuronal ferroptosis. The downregulation of Plaur expression plays a crucial role in TGZ's anti-ferroptotic effect, offering a promising avenue for the development of new epilepsy treatments.
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Affiliation(s)
- Zhi-Bin Wang
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, P.R. China
| | - Jun-Yan Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Shi-Long Jiang
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Wei Zhuo
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Pan Xie
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Wen-Ting Dai
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Xiao-Yuan Mao
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
- Institute of Clinical Pharmacology, Engineering Research Center for Applied Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha, P.R. China
| | - Zhao-Qian Liu
- Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
- Institute of Clinical Pharmacology, Engineering Research Center for Applied Technology of Pharmacogenomics of Ministry of Education, Central South University, Changsha, P.R. China
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Shi W, Sun H, Peng W, Chen Z, Wang Q, Lin W, Ding M, Sun H, Wang X, Wang T, Wang X, Liu Y, Chen Y, Zhu G, Zhou D, Li J. A cross-sectional, multicenter survey of the prevalence and influencing factors for migraine in epilepsy. Epilepsia Open 2024; 9:1406-1415. [PMID: 38808742 PMCID: PMC11296102 DOI: 10.1002/epi4.12977] [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: 03/08/2024] [Revised: 04/27/2024] [Accepted: 05/12/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES Epilepsy and migraine are common chronic neurological disease. Epidemiologic studies and shared pathophysiology and treatment suggest that these two diseases overlap. However, migraine is often underestimated among patients with epilepsy. This study aimed to evaluate the prevalence of migraine and identify the related influencing factors among adult patients with epilepsy. METHODS Adult patients with epilepsy were recruited at the outpatient epilepsy clinic of 13 tertiary hospitals in China from February to September 2022. ID Migraine questionnaire was applied to evaluate for migraine. Both univariable and multivariable logistic regression models were used to explore the influencing factors of migraine. RESULTS A total of 1326 patients with epilepsy were enrolled in this study. The prevalence of migraine among patients with epilepsy was 19.2% (254/1326). In the multivariable analysis, being female (OR = 1.451, 95% CI: 1.068-1.975; p = 0.018), focal and focal to bilateral tonic-clonic seizures (OR = 1.583, 95% CI: 1.090-2.281; p = 0.015), and current seizure attack in the last 3 months (OR = 1.967, 95% CI: 1.282-3.063; p = 0.002) were the influencing factors for migraine. However, <10% of patients with epilepsy received analgesics for migraine. SIGNIFICANCE Approximately 20% of patients with epilepsy screened positive for migraine. Being female, focal and focal to bilateral tonic-clonic seizures, and current seizure attack in the last 3 months were the influencing factors for migraine. Neurologists should pay more attention to the screening and management of the migraine among patients with epilepsy in China. PLAIN LANGUAGE SUMMARY Epilepsy and migraine are common chronic neurological disease with shared pathophysiological mechanisms and therapeutic options. However, migraine is often underestimated among patients with epilepsy. This multicenter study aimed to evaluate the prevalence of migraine and current status of treatment. In this study, approximately 20% of patients with epilepsy screened positive for migraine. Female, focal and focal to bilateral tonic-clonic seizures, and current seizure attack in the last 3 months were identified as independent influencing factors for migraine. Despite the high prevalence, the treatment for migraine was not optimistic, neurologists should pay more attention to the screening and management of migraine.
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Affiliation(s)
- Wenyan Shi
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Hanlin Sun
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Wei Peng
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Ziyi Chen
- Department of Neurology, the First Affiliated HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Qun Wang
- Department of NeurologyBeijing Tiantan Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Weihong Lin
- Department of NeurologyThe First Hospital of Jilin UniversityChangchunChina
| | - Meiping Ding
- Department of NeurologyThe Second Affiliated Hospital of Zhejiang UniversityHangzhouChina
| | - Hongbin Sun
- Department of NeurologySichuan Provincial People's HospitalChengduChina
| | - Xiangqing Wang
- Department of NeurologyChinese People's Liberation Army (PLA) General HospitalBeijingChina
| | - Tiancheng Wang
- Department of NeurologyLanzhou University Second HospitalLanzhouChina
| | - Xuefeng Wang
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yonghong Liu
- Department of NeurologyAir Force Medical University Xijing HospitalXi'AnChina
| | - Yangmei Chen
- Department of NeurologyThe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Guoxing Zhu
- Department of Neurology, Huashan HospitalFudan UniversityShanghaiChina
| | - Dong Zhou
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
| | - Jinmei Li
- Department of Neurology, West China HospitalSichuan UniversityChengduChina
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Zhou X, Ding D, Wang W, Zhou D, Sander JW. Mortality of Epilepsy in Chinese Populations: A Comprehensive Review. Neuroepidemiology 2024:1-14. [PMID: 39074464 DOI: 10.1159/000540426] [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: 04/07/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Premature mortality is a significant part of the epilepsy burden and may vary across populations, especially between high-income and lower- and middle-income countries. People with epilepsy in China are approximately a fifth of the global population with epilepsy. Previous studies were unlikely to represent the situation in China due to limitations in design, methods, sample size, follow-up time, and other inherent population heterogeneity. SUMMARY By summarising the evidence on the mortality characteristics in Chinese populations with epilepsy in the last 6 decades, we found a median mortality rate of 14.7 (6.8-74.4)/1,000 person-years and a median standardised mortality ratio (SMR) of 4.4 (2.6-12.9) in population-based studies, and a median mortality rate of 12.3 (9.5-101.5)/1,000 person-years and a median SMR of 3.0 (1.5-5.1) in hospital-based studies. Vascular diseases, complications of diabetes, and accidental injuries were the leading causes of death. Risk factors for mortality were reported as older age, male, longer duration, and higher frequency of seizures. Case fatality ratios of status epilepticus in adults were higher than in children, and both increased with follow-up time. Mortality in people with symptomatic epilepsy was high and varied across different primary diseases. KEY MESSAGES The highest mortality rate and sudden unexpected death in epilepsy (SUDEP) incidence were reported from the least developed areas in China. Accidental injuries were the most common causes of epilepsy-related deaths, while the incidence of SUDEP may be underestimated in Chinese populations. Further research is warranted to improve the understanding of premature mortality risk so that preventative measures can be introduced to improve the situation.
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Affiliation(s)
- Xiaowen Zhou
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China,
| | - Ding Ding
- Institute of Neurology, National Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenzhi Wang
- Beijing Neurosurgical Institute, Beijing, China
| | - Dong Zhou
- Department of Neurology, West of China Hospital, Sichuan University, Chengdu, China
| | - Josemir W Sander
- Department of Neurology, West of China Hospital, Sichuan University, Chengdu, China
- UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Chalfont St Peter, UK
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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10
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Zhang Y, Ding W, Dai X, Wang H, Cheng Y, Dai J, Zhu X, Xu X. Burden of multiple high-risk factors in pregnancy before and after the universal two-child policy in Chinese women: An observational study. J Glob Health 2024; 14:04134. [PMID: 39024620 PMCID: PMC11257705 DOI: 10.7189/jogh.14.04134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background The prevalence of high-risk pregnancy increased after the implementation of two-child policy in China, but the impact of this policy change on the burden and profile of multiple high-risk factors in pregnancy (MHFP) has been insufficiently explored. We hypothesised that the profile of MHFP might have changed after the two-child policy was implemented and aimed to estimate the prevalence, intercorrelation, and outcomes of MHFP before and after its introduction. Methods We obtained data on the population of pregnant women before (2015) and after (2020/2021) the implementation of universal two-child policy in Huai'an. We then included 33 risk factors in our analysis based on the Five-Colour Management framework and defined MHFP as an individual having two or more of these factors. We also estimated the changes of the prevalence of each single factor and their coexistence. Lastly, we performed a network analysis to assess the intercorrelations across these factors and used logistic regression models to evaluate MHFP-related pregnancy outcomes. Results We observed an increase in the prevalence of MHFP after the implementation of the universal two-child policy (25.8% in 2015 vs 38.4% in 2020/2021, P < 0.01). Chronic conditions (e.g. gestational diabetes mellitus, abnormal body mass index) had the largest increase among the included factors, while cardiovascular disease and hypertensive disorders were central factors of the network structures. The correlations of advanced maternal age with abnormal pregnancy histories and scarred uteri increased significantly from 2015 to 2020/2021. MHFP was associated with multiple pregnancy outcomes, including preterm birth (adjusted odds ratio (aOR) = 2.57; 95% confidence interval (CI) = 2.39-2.75), low birthweight (aOR = 2.77; 95% CI = 2.54-3.02), low Apgar score (aOR = 1.41; 95% CI = 1.19-1.67), perinatal death (aOR = 1.75; 95% CI = 1.44-2.12), and neonatal death (aOR = 1.76; 95% CI = 1.42-2.18). Moreover, an increasing number and certain combinations of MHFP were associated with higher odds of pregnancy outcomes. For example, the aOR of preterm birth increased from 1.67 (95% CI = 1.52-1.87) for one risk factor to 8.03 (95% CI = 6.99-9.22) for ≥4 risk factors. Conclusions Chinese women experienced a higher burden of multiple high-risk factors after the introduction of the two-child policy, particularly those with advanced maternal age, obesity, and chronic conditions. Strategies targeting chronic conditions for women with MHFP should be prioritised and a shift to a multiple-factor-oriented framework is needed in the expanding Chinese maternal health care system.
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Affiliation(s)
- Yue Zhang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Weijie Ding
- Health Care Department, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an City, Jiangsu Province, China
| | - Xiaochen Dai
- Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, Washington, USA
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Hui Wang
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Health Care Department, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an City, Jiangsu Province, China
| | - Yangyang Cheng
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Jiyue Dai
- Health Care Department, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an City, Jiangsu Province, China
| | - Xiaoqin Zhu
- Health Care Department, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an City, Jiangsu Province, China
| | - Xiaolin Xu
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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11
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Lou D, Song Y, Li D, Shi Y, Wang B, Yang L. COVID-19 vaccination uptake in children with epilepsy and vaccine hesitancy among their parents: a survey. Eur J Pediatr 2024; 183:2763-2768. [PMID: 38558312 DOI: 10.1007/s00431-024-05537-z] [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: 01/26/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
This study explored the coronavirus disease 2019 (COVID-19) vaccination coverage among children with epilepsy (CwE), factors affecting vaccination coverage, and the effect of COVID-19 vaccines on epilepsy after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A questionnaire was administered to CwE and their parents at the Pediatric Neurology Clinic of the Second Affiliated Hospital of Xi'an Jiaotong University between December 12, 2022, and February 28, 2023. Data were analyzed using the t-tests, chi-square tests, and logistic regression. The analysis included 250 CwE who responded to the survey; of these, 152 (60.8%) had been vaccinated against COVID-19. COVID-19 vaccine hesitancy in parents whose CwE were not vaccinated was mostly due to concerns of vaccine-related exacerbation of seizures and of vaccine-related adverse reactions (44.30% and 41.90% of the respondents, respectively). Univariate analysis showed that vaccination and number of doses of vaccine did not affect seizure incidence within 1 month of SARS-CoV-2 infection. Logistic regression analysis showed that CwE below primary school age, and those taking two or more antiseizure medication (ASMs) were less likely to be vaccinated (p = 0.007). Conclusion: The primary reasons for vaccine hesitancy among parents of unvaccinated CwE were concerns regarding seizure exacerbation and adverse reactions following COVID-19 vaccination. CwE who were below primary school age and those who took two or more ASMs were less likely to be vaccinated. Addressing parents' concerns is necessary to build their confidence in COVID-19 vaccines and ensure that CwE are vaccinated. What is Known: • People with epilepsy have a higher risk of severe and fatal COVID-19 than those without epilepsy but, despite this, COVID-19 vaccination coverage is considerably lower in people with epilepsy than in people without epilepsy. What is New: • In unvaccinated children with epilepsy, the foremost reasons for COVID-19 vaccine hesitancy among parents were concerns about seizure exacerbation and vaccine-related adverse reactions. • Vaccination and number of doses of vaccine did not exacerbate seizures in children with epilepsy, those below primary school level and those taking two or more antiseizure medications were less likely to be vaccinated.
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Affiliation(s)
- Dandan Lou
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Ye Song
- Department of Pediatrics, The First Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Dan Li
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Yongjin Shi
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Bo Wang
- Department of Pediatrics, Xi'an Gaoxin Hospital, Xi'an, People's Republic of China
| | - Lin Yang
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, People's Republic of China.
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12
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Wang H, Wang J, Lin B, Zhang H, Sun Y, Wu Y, Ye W, Miao J. Effect of Age, Comedications, and CYP3A4/5 Polymorphisms on Perampanel Exposure in Chinese Pediatric Patients With Epilepsy. J Clin Pharmacol 2024; 64:737-743. [PMID: 38381330 DOI: 10.1002/jcph.2415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/22/2024] [Indexed: 02/22/2024]
Abstract
Perampanel (PER) is a new type of antiseizure medication used for partial or generalized seizures. However, the plasma concentration shows obvious individual variability in children. The present study aims to ascertain the effect of age, comedications, and cytochrome P450 (CYP) 3A4/5 polymorphisms on PER exposure in Chinese pediatric patients with epilepsy. Clinical data were retrospectively collected in a tertiary children's hospital medical records system from January 2021 to December 2022. The influence factors on the daily dose, plasma concentration, and concentration-to-dose ratio (CDR) of PER were investigated. A total of 135 pediatric patients with 178 blood samples were involved. With a median daily dose of 4.0 mg (interquartile range, 3.0-5.0 mg), the median plasma concentration was 409.4 ng/mL (interquartile range, 251.7-639.4 ng/mL). The CDR in patients aged less than 4 years was significantly decreased by 48.0% and 39.1% compared with those aged 4-11 years and 12 years or older, respectively. Enzyme inducers significantly decreased the CDR of PER by 34.5%, while valproic acid showed an increase of 71.7%. In addition, genotype CYP3A5*3/*3 carriers presented a significant increase of 21.5% compared to the CYP3A5*1/*3 expresser. No correlations were observed between the CDR and CYP3A4∗1G polymorphism. PER showed high variations in individual plasma concentrations. Age younger than 4 years, comedication with enzyme inducers or valproic acid, and possession of the CYP3A5*3 genotype potentially predicted PER exposure in pediatric patients with epilepsy.
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Affiliation(s)
- Huijuan Wang
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Research Center for Clinical Pharmacy, Zhejiang University, Hangzhou, China
| | - Junyan Wang
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Bin Lin
- Department of Pharmacy, Changxing People's Hospital; Changxing Branch, Second Affiliated Hospital of Zhejiang University School of Medicine, Huzhou, China
- Key Laboratory of Intelligent Pharmacy and Individualized Therapy of Huzhou, Huzhou, China
| | - Huifen Zhang
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yangyang Sun
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yuanyuan Wu
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weifeng Ye
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jing Miao
- Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- Research Center for Clinical Pharmacy, Zhejiang University, Hangzhou, China
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13
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Han Y, Hao G, Wang Z, Wang C, Qi X, Liang G, Li X. Association between serum apolipoprotein E and cognitive function in Chinese patients with temporal lobe epilepsy. Epilepsy Behav 2024; 154:109750. [PMID: 38552413 DOI: 10.1016/j.yebeh.2024.109750] [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: 11/01/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To investigate the effect of serum apolipoprotein E (APOE) levels on cognitive function in patients with temporal lobe epilepsy (TLE). METHODS Clinical data were collected from 190 subjects including 110 TLE patients and 80 healthy people. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R) scale. Serum levels of APOE were measured using ELISA kits. Genotyping of APOE in peripheral blood was detected by microarray hybridization. RESULTS Patients with TLE had significantly lower ACE-R total score, memory and verbal fluency scores compared to the healthy group. Serum levels of APOE were significantly higher in TLE patients than in the healthy subjects. Serum APOE levels were significantly negatively correlated with ACE-R total score, memory and verbal fluency scores. The cognitive function score of TLE with APOE ε4 allele was lower than that of TLE without APOE ε4 allele. SIGNIFICANCE Our study showed that serum APOE levels were higher in TLE patients than in the healthy population. And serum APOE levels were associated with cognitive dysfunction in TLE patients. APOE ε4 allele carriers have poor cognitive function in TLE patients.
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Affiliation(s)
- Yuwei Han
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guangzhi Hao
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Zhen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Chenchen Wang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xin Qi
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Guobiao Liang
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China
| | - Xiaoming Li
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, 110016, China.
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14
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Wu Z, Li X, Huang Y, Huang K, Xiao B, Chi Y, Feng L, Yang H. Effects of a Nurse-Led Cognitive Behavioral Intervention for Parents of Children With Epilepsy. Pediatr Neurol 2024; 154:70-78. [PMID: 38552337 DOI: 10.1016/j.pediatrneurol.2024.03.003] [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: 12/20/2022] [Revised: 02/18/2024] [Accepted: 03/03/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND This study aimed to evaluate the effects of a nurse-led cognitive behavioral intervention for parents of children with epilepsy (CWE). METHODS The study recruited 238 CWE from the neurology ward of Xiangya Hospital from March 2019 to August 2022. According to the interventions after discharge, the children and their parents were randomly divided into 117 parent-child dyads in the intervention group and 121 parent-child dyads in the control group. The seizure severity and treatment compliance in CWE as well as the parents' psychological states and satisfaction with the care provided by nurses were compared before and after intervention. RESULTS The follow-up six months after discharge showed that the seizure frequency among CWE in the intervention group was significantly less than the controls (P = 0.048). Compared with the controls, the intervention group also reported fewer symptoms of anxiety and depression, better sleep quality, and more positive attitudes toward epilepsy, as well as higher nursing satisfaction (P < 0.001). The correlation analysis indicated the correlation of CWE's seizure severity was correlated with the compliance, parents' psychological states, and parents' satisfaction with the care provided by nurses. CONCLUSIONS The adoption of the nurse-led cognitive behavioral intervention on parents of CWE can improve the parents' mental health status and their satisfaction with the nurses, which can have a positive association with the seizure severity of CWE. In light of this information, this nursing intervention may be a new method for the long-term disease management of CWE.
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Affiliation(s)
- Zhongling Wu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Clinical Nursing Teaching and Research Section, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaolei Li
- Department of Cardiology, Laizhou People's Hospital, Yantai, Shandong, China
| | - Yuanxin Huang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Clinical Nursing Teaching and Research Section, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunfang Chi
- Department of Cardiology, Laizhou People's Hospital, Yantai, Shandong, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Neurology, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, Jiangxi, China.
| | - Haojun Yang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China.
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15
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Kong X, Dai G, Zeng Z, Zhang Y, Gu J, Ma T, Wang N, Gu J, Wang Y. Integrating Proteomics and Transcriptomics Reveals the Potential Pathways of Hippocampal Neuron Apoptosis in Dravet Syndrome Model Mice. Int J Mol Sci 2024; 25:4457. [PMID: 38674042 PMCID: PMC11050081 DOI: 10.3390/ijms25084457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/07/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
An important component contributing to the onset of epilepsy is the death of hippocampal neurons. Several studies have shown that Dravet syndrome model mice: Scn1a KO mice have a high number of apoptotic neurons following seizures, but the precise mechanism underlying this remains unclear. The aim of this research was to elucidate the potential molecular mechanism of neuronal apoptosis in Scn1a KO mice by integrating proteomics and transcriptomics, with the ultimate goal of offering better neuroprotection. We found that apoptotic processes were enriched in both proteomic and transcriptomic GO analyses, and KEGG results also indicated that differential proteins and genes play a role in neurotransmission, the cell cycle, apoptosis, and neuroinflammation. Then, we examined the upstream and downstream KGML interactions of the pathways to determine the relationship between the two omics, and we found that the HIF-1 signaling pathway plays a significant role in the onset and apoptosis of epilepsy. Meanwhile, the expression of the apoptosis-related protein VHL decreased in this pathway, and the expression of p21 was upregulated. Therefore, this study suggests that VHL/HIF-1α/p21 might be involved in the apoptosis of hippocampal neurons in Scn1a KO mice.
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Affiliation(s)
- Xuerui Kong
- School of Basic Medicine, Ningxia Medical University, Yinchuan 750004, China; (X.K.); (T.M.); (N.W.)
- Key Laboratory of Craniocerebral Diseases, Ningxia Medical University, Yinchuan 750004, China; (G.D.); (Y.Z.)
| | - Gaohe Dai
- Key Laboratory of Craniocerebral Diseases, Ningxia Medical University, Yinchuan 750004, China; (G.D.); (Y.Z.)
| | - Zhong Zeng
- School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China;
| | - Yi Zhang
- Key Laboratory of Craniocerebral Diseases, Ningxia Medical University, Yinchuan 750004, China; (G.D.); (Y.Z.)
| | - Jiarong Gu
- School of Public Health, Ningxia Medical University, Yinchuan 750004, China;
| | - Teng Ma
- School of Basic Medicine, Ningxia Medical University, Yinchuan 750004, China; (X.K.); (T.M.); (N.W.)
| | - Nina Wang
- School of Basic Medicine, Ningxia Medical University, Yinchuan 750004, China; (X.K.); (T.M.); (N.W.)
| | - Jinhai Gu
- Key Laboratory of Craniocerebral Diseases, Ningxia Medical University, Yinchuan 750004, China; (G.D.); (Y.Z.)
| | - Yin Wang
- School of Basic Medicine, Ningxia Medical University, Yinchuan 750004, China; (X.K.); (T.M.); (N.W.)
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Zhang J, Zuo H, Fu Y, Cao Y, Li Q, Zhang Q, Zheng Y, Wang Y, Wu D, Chen W, Fang J. Intranasal delivery of phenytoin loaded layered double hydroxide nanoparticles improves therapeutic effect on epileptic seizures. J Nanobiotechnology 2024; 22:144. [PMID: 38566094 PMCID: PMC10985904 DOI: 10.1186/s12951-024-02405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Improving the efficiency of antiseizure medication entering the brain is the key to reducing its peripheral toxicity. A combination of intranasal administration and nanomedicine presents a practical approach for treating epileptic seizures via bypassing the blood-brain barrier. In this study, phenytoin (PHT) loaded layered double hydroxide nanoparticles (BSA-LDHs-PHT) were fabricated via a coprecipitation - hydrothermal method for epileptic seizure control. In this study, we expound on the preparation method and characterization of BSA-LDHs-PHT. In-vitro drug release experiment shows both rapid and continuous drug release from BSA-LDHs-PHT, which is crucial for acute seizure control and chronic epilepsy therapy. In-vivo biodistribution assays after intranasal administration indicate excellent brain targeting ability of BSA-LDHs. Compared to BSA-Cyanine5.5, BSA-LDHs-Cyanine5.5 were associated with a higher brain/peripheral ratio across all tested time points. Following intranasal delivery with small doses of BSA-LDHs-PHT, the latency of seizures in the pentylenetetrazole-induced mouse models was effectively improved. Collectively, the present study successfully designed and applied BSA-LDHs-PHT as a promising strategy for treating epileptic seizures with an enhanced therapeutic effect.
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Affiliation(s)
- Jingxin Zhang
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Huali Zuo
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Yanlu Fu
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Yina Cao
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Qiwei Li
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Qi Zhang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yuyi Zheng
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yi Wang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Di Wu
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Weiyu Chen
- Department of Respiratory and Critical Care Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China.
| | - Jiajia Fang
- Department of Neurology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China.
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17
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Zheng G, Kong H. Exploring the correlation between serum α-synuclein and abnormal electroencephalography patterns in children with epilepsy, as well as electroencephalographic discharge index. Int J Neurosci 2024:1-8. [PMID: 38506641 DOI: 10.1080/00207454.2024.2332958] [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: 02/20/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND This study investigates the correlation between serum α-synuclein and abnormal electroencephalography patterns as well as the electroencephalographic discharge index in children with epilepsy. METHODS Fasting venous blood of 4 ml were collected from the participants, centrifuged at 3000 rpm with a centrifuge radius of 15 cm for 20 min, and stored in a -70 °C freezer for serum α-synuclein examination. Normal EEG: Exhibits symmetrical α or β rhythm primarily in the occipital region. RESULTS The electroencephalogram (EEG) examination results showed that out of the 110 children with epilepsy, 9 had normal EEGs, 35 had mild EEG abnormalities, 46 had moderate EEG abnormalities, and 20 had severe EEG abnormalities. It is noteworthy that the control group did not exhibit any abnormalities in EEG. In the epilepsy group, serum α-synuclein levels were higher than those in the normal group, while α-wave power and θ-wave power were lower than in the normal group (p < 0.05). Among children with epilepsy, those with mild EEG abnormalities, moderate EEG abnormalities, and severe EEG abnormalities had higher serum α-synuclein levels and electroencephalographic discharge indices compared to children with normal EEGs (p < 0.05). Additionally, among children with EEG abnormalities, those with mild, moderate, and severe EEG abnormalities had progressively increasing serum α-synuclein levels and electroencephalographic discharge indices (p < 0.05). CONCLUSIONS Children with epilepsy exhibit elevated serum α-synuclein levels, and there is a positive correlation between α-synuclein levels and the grading of EEG abnormalities as well as the electroencephalographic discharge index.
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Affiliation(s)
- Guoyuan Zheng
- Center for Rehabilitation Medicine, Department of Neuroelectrophysiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Haibo Kong
- Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Wen F, Tan Z, Huang D, Xiang J. Molecular mechanism analyses of post-traumatic epilepsy and hereditary epilepsy based on 10× single-cell transcriptome sequencing technology. CNS Neurosci Ther 2024; 30:e14702. [PMID: 38572804 PMCID: PMC10993349 DOI: 10.1111/cns.14702] [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: 06/19/2023] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Single-cell RNA sequencing analysis has been usually conducted on post-traumatic epilepsy (PET) and hereditary epilepsy (HE) patients; however, the transcriptome of patients with traumatic temporal lobe epilepsy has rarely been studied. MATERIALS AND METHODS Hippocampus tissues isolated from one patient with PTE and one patient with HE were used in the present study. Single cell isolates were prepared and captured using a 10× Genomics Chromium Single-Cell 3' kit (V3) according to the manufacturer's instructions. The libraries were sequenced on an Illumina NovaSeq 6000 sequencing system. Raw data were processed, and the cells were filtered and classified using the Seurat R package. Uniform Manifold Approximation and Projection was used for visualization. Differentially expressed genes (DEGs) were identified based on a p-value ≤0.01 and log fold change (FC) ≥0.25. Gene Ontology (GO, http://geneontology.org/) and KEGG (Kyoto Encyclopedia of Genes and Genomes, www.genome.jp/kegg) analyses were performed on the DEGs for enrichment analysis. RESULTS The reads obtained from the 10× genomic platform for PTE and HE were 39.56 M and 30.08 M, respectively. The Q30 score of the RNA reads was >91.6%. After filtering, 7479 PTE cells and 9357 HE cells remained for further study. More than 96.4% of the reads were mapped to GRCh38/GRCm38. The cells were differentially distributed in two groups, with higher numbers of oligodendrocytes (6522 vs. 2532) and astrocytes (133 vs. 52), and lower numbers of microglial cells (2242 vs. 3811), and neurons (3 vs. 203) present in the HE group than in the PTE group. The DEGs in four cell clusters were identified, with 25 being in oligodendrocytes (13 upregulated and 12 downregulated), 87 in microglia cells (42 upregulated and 45 downregulated), 222 in astrocytes (115 upregulated and 107 downregulated), and 393 in neurons (305 upregulated and 88 downregulated). The genes MTND1P23 (downregulated), XIST (downregulated), and RPS4Y1 (upregulated) were commonly expressed in all four cell clusters. The DEGs in microglial cells and astrocytes were enriched in the IL-17 signaling pathway. CONCLUSION Our study explored differences in cells found in a patient with PE compared to a patient with HE, and the transcriptome in the different cells was analyzed for the first time. Studying inflammatory and immune functions might be the best approach for investigating traumatic temporal lobe epilepsy in neurons.
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Affiliation(s)
- Fang Wen
- Department of NeurologyThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Zhigang Tan
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Dezhi Huang
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
| | - Jun Xiang
- Department of NeurosurgeryThe Second Xiang‐Ya Hospital of Central South UniversityChangshaHunanChina
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Mai J, Li H, He Y, Huang T, Lin C, Lan S, Xiao X, He S, Lu X, Chen L, Li B, Luo X, Wang H, Liao J, Cao D. Efficacy and safety of perampanel as the first add-on therapy for children with epilepsy: A real-world multicenter prospective observational study. Seizure 2024; 117:44-49. [PMID: 38308908 DOI: 10.1016/j.seizure.2024.01.011] [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: 09/26/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE Perampanel (PER) is a new anti-seizure medication (ASM) with a novel mechanism of action. This study aimed to determine the efficacy and safety of PER when added to monotherapy in children and adolescents (age, 4-18 years) with epilepsy. METHOD A multicenter prospective observational study was performed on children and adolescents (age, 4-18 years) with epilepsy who did not respond to ASM monotherapy between July 2021 and October 2022. PER was used as the first add-on therapy for the enrolled patients. Seizure-free rate, response rate, inefficacy rate, and drug retention rate were the main observation indicators during the 6 months of treatment. The patients were grouped based on treatment efficacy, and factors affecting efficacy were statistically analyzed. Adverse reactions were also recorded. RESULTS In this study, 93 patients with epilepsy were enrolled; among them, 9 patients were lost to follow-up (attrition rate, 9.7 %), and 84 were included in the analysis. Five patients with unknown efficacy discontinued taking PER early due to intolerable adverse reactions, and 79 patients (48 males, 31 females; mean age, 11.0 ± 3.9 years) finally remained. Genetic epilepsy and structural epilepsy were found in 22 patients and 36 patients, respectively. The mean duration of epilepsy history at the time of PER initiation was 4.0 ± 3.8 years, and the mean maintenance dosage of add-on PER was 4.5 ± 1.8 mg/day (equivalent to 0.14 ± 0.07 mg/kg/day). Among the 79 patients, 28 patients were diagnosed with epilepsy syndrome, including 13 patients having self-limited epilepsy with centrotemporal spikes, among whom 9 patients were seizure-free after adding PER during the 6-month follow-up (seizure-free rate, 69.2 %). For these 79 patients, the seizure-free, response, and retention rates at the end of follow-up were 45.6 %, 74.7 %, and 82.1 %, respectively. Among the 84 patients included in the analyses, adverse reactions occurred in 20 patients, mainly dizziness (8 patients), somnolence (6 patients), and irritability (4 patients), and 4 patients developed two adverse reactions simultaneously. Univariate analyses revealed statistically significant differences in efficacy between groups with structural and non-structural epilepsy and between groups with different baseline concomitant ASMs, suggesting that these factors affected the efficacy of PER as the first add-on therapy. CONCLUSION The overall response rate of PER as the first add-on therapy for children and adolescents with epilepsy who were followed up for 6 months was 74.7 %, indicating a relatively favorable safety and tolerability profile. The group of the baseline concomitant ASM administered and the etiological classification of epilepsy as either structural or non-structural were the factors influencing the efficacy of PER as the first add-on therapy.
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Affiliation(s)
- Jiahui Mai
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Hua Li
- Department of Pediatrics, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Yinghui He
- Department of Pediatrics, Huizhou Central People's Hospital, Huizhou, China
| | - Tieshuan Huang
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Caimei Lin
- Department of Neurology, Xiamen Children's Hospital, Xiamen, China
| | - Song Lan
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Xiaohua Xiao
- Department of Geriatrics, Shenzhen Second People's Hospital, Shenzhen, China
| | - Suli He
- Department of Pediatrics, Shantou Chaonan Minsheng Hospital, Shantou, China
| | - Xinguo Lu
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Li Chen
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Bing Li
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Xufeng Luo
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Han Wang
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Jianxiang Liao
- Department of Pediatrics, Shantou Chaonan Minsheng Hospital, Shantou, China
| | - Dezhi Cao
- Department of Neurology, Shenzhen Children's Hospital, No.7019, Yitian Road, Futian Distract, Shenzhen city, Guangdong province, China.
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Yin X, Niu S, Yu Q, Xuan Y, Feng X. Fear of disease in patients with epilepsy - a network analysis. Front Neurol 2024; 15:1285744. [PMID: 38515450 PMCID: PMC10954812 DOI: 10.3389/fneur.2024.1285744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 03/23/2024] Open
Abstract
Background Disease-related fear among patients with epilepsy has significantly impacted their quality of life. The Disease-Related Fear Scale (D-RFS), comprising three dimensions, serves as a relatively well-established tool for assessing fear in these patients. However, certain problems potentially exist within the D-RFS's attribution of items, and its internal structure is still unclear. To establish an appropriate dimensional structure and gain deeper comprehension of its internal structure-particularly its core variables-is vital for developing more effective interventions aimed at alleviating disease-related fear among patients with epilepsy. Methods This study employed a cross-sectional survey involving 609 patients with epilepsy. All participants underwent assessment using the Chinese version of the D-RFS. We used exploratory network analysis to discover a new structure and network analysis to investigate the interrelationships among fear symptom domains. In addition to the regularized partial correlation network, we also estimated the node and bridge centrality index to identify the importance of each item within the network. Finally, it was applied to analyze the differences in network analysis outcomes among epilepsy patients with different seizure frequencies. Results The research findings indicate that nodes within the network of disease-related fear symptoms are interconnected, and there are no isolated nodes. Nodes within groups 3 and 4 present the strongest centrality. Additionally, a tight interconnection exists among fear symptoms within each group. Moreover, the frequency of epileptic episodes does not significantly impact the network structure. Conclusion In this study, a new 5-dimension structure was constructed for D-RFS, and the fear of disease in patients with epilepsy has been conceptualized through a network perspective. The goal is to identify potential targets for relevant interventions and gain insights for future research.
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Affiliation(s)
| | | | | | | | - Xiuqin Feng
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), Hangzhou, China
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21
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Zhao YL, You YX, Chen YL, Zhang Y, Du Y, Tang DQ. Fabrication of a surface molecularly imprinted polymer membrane based on a single template and its application in the separation and extraction of phenytoin, phenobarbital and lamotrigine. RSC Adv 2024; 14:8353-8365. [PMID: 38469200 PMCID: PMC10926979 DOI: 10.1039/d4ra00294f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
An innovative molecularly imprinted polymer membrane (MIPM) was prepared with polyvinylidene difluoride (PVDF) as the support, phenytoin (PHT) as the single template, methacrylic acid as the functional monomer, ethylene glycol dimethacrylate as the cross-linking reagent, azobisisobutyronitrile as the initiator, and acetonitrile-dimethylformamide (1 : 1.5, v/v) as the porogen. These materials were characterized via scanning electron microscopy, Fourier transform infrared spectroscopy, Brunauer-Emmett-Teller measurements and X-ray photoelectron spectroscopy. Their adsorption performances were evaluated through a series of experiments including isothermal adsorption, kinetic adsorption, selective adsorption, adsorption-desorption, reusability, and preparation reproducibility. Additionally, the application was explored by investigating the extraction recovery of MIPMs towards PHT, phenobarbital (PHB) and lamotrigine (LTG) in different matrices including methanol, normal saline (NS), phosphate buffer solution (PBS) and plasma. The results showed that MIPMs with rough and porous surfaces were successfully constructed, which offered good preparation reproducibility, reusability and selectivity. The adsorption capacities of MIPMs towards PHT, PHB and LTG were 2.312, 2.485 and 2.303 mg g-1, respectively, while their corresponding imprinting factors were 8.538, 12.122 and 4.562, respectively. The adsorption equilibrium of MIPMs was achieved within 20 min at room temperature without stirring or ultrasonication. The extraction recoveries of MIPMs for PHT, PHB or LTG in methanol, NS and PBS were more than 80% with an RSD% value of less than 3.64. In the case of plasma, the extraction recovery of MIPMs for PHT and PHB was more than 80% with an RSD% value of less than 2.41, while that of MIPMs for LTG was more than 65% with an RSD% value of less than 0.99. All the results indicated that the preparation method for MIPMs was simple, stable, and reliable, and the prepared MIPMs possessed excellent properties to meet the extraction application of PHT, PHB and LTG in different matrices.
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Affiliation(s)
- Yan-Lin Zhao
- Department of Pharmacy, Suining People's Hospital Affiliated to Xuzhou Medical University Suining 221202 China
| | - Yu-Xin You
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University 209 Tongshan Road Xuzhou 221004 Jiangsu Province China +86 516 83263313 +86 516 83263313
| | - Yu-Lang Chen
- Department of Pharmacy, Suining People's Hospital Affiliated to Xuzhou Medical University Suining 221202 China
| | - Ying Zhang
- Department of Pharmacy, Suining People's Hospital Affiliated to Xuzhou Medical University Suining 221202 China
| | - Yan Du
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University 209 Tongshan Road Xuzhou 221004 Jiangsu Province China +86 516 83263313 +86 516 83263313
- State Key Laboratory of Pharmaceutical Biotechnology, Chemistry and Biomedicine Innovation Center (ChemBIC), Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University Nanjing 210093 China
| | - Dao-Quan Tang
- Department of Pharmacy, Suining People's Hospital Affiliated to Xuzhou Medical University Suining 221202 China
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University 209 Tongshan Road Xuzhou 221004 Jiangsu Province China +86 516 83263313 +86 516 83263313
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Feng J, Zhuo S, Liu D, Peng H, Guo D, Li N, Sun H, Zhang C, Zhao J. H 2S inhibits LiCl/pilocarpine-induced seizures and promotes neuroprotection by regulating TRPV2 expression via the AC3/cAMP/PKA pathway. Neurochem Int 2024; 174:105677. [PMID: 38290616 DOI: 10.1016/j.neuint.2024.105677] [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: 10/24/2023] [Revised: 12/26/2023] [Accepted: 01/11/2024] [Indexed: 02/01/2024]
Abstract
It is widely acknowledged that epilepsy is a neurological disorder characterized by recurrent and atypical neuronal discharges, resulting in transient dysfunction within the brain. The protective role of hydrogen sulfide (H2S) in epilepsy has been elucidated by recent studies, but the underlying mechanisms remain poorly understood. To investigate this, the concentration of H2S was measured by spectrophotometry and a fluorescent probe in LiCl/Pilocarpine (LiCl/Pilo)-induced seizures in rats. The localization of proteins was examined using immunofluorescence. Electroencephalogram and behavioral tests were employed to evaluate the occurrence of seizures. Neuropathological changes in the hippocampus were examined by hematoxylin-eosin staining, Nissl staining, and transmission electron microscopy. Through proteomics and bioinformatics analysis, we identified the differential proteins in the hippocampus of rats following H2S intervention. Protein changes were detected through western blotting. The results showed that H2S treatment significantly alleviated seizures and minimized post-seizures neurological damage in rats. Proteomics analysis revealed adenylate cyclase 3 (AC3) as a protein potentially targeted by H2S. Moreover, the AC3 activator forskolin reversed the downregulation effect of H2S on the AC3/cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/transient receptor potential vanilloid 2 (TRPV2) signaling pathway. In conclusion, H2S targets and downregulates the expression of AC3, thereby modulating the AC3/cAMP/PKA signaling pathway to regulate the expression of TRPV2 in LiCl/Pilo-induced seizures, ultimately leading to seizure inhibition and neuroprotection.
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Affiliation(s)
- Jigao Feng
- Department of Neurosurgery, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Department of Neurosurgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, Hainan, China
| | - Shenghua Zhuo
- Department of Neurosurgery, the First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Dayuan Liu
- Department of Neurosurgery, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Hao Peng
- Department of Neurosurgery, the Second People's Hospital of Hainan Province, Haikou, Hainan, China
| | - Dachuang Guo
- Department of Neurosurgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, Hainan, China
| | - Ning Li
- Department of Neurosurgery, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Hu Sun
- Department of Neurosurgery, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Caicai Zhang
- Department of Physiology, Hainan Medical University, Haikou, Hainan, China.
| | - Jiannong Zhao
- Department of Neurosurgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, Hainan, China.
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Ke P, Liu J, Chen C, Luo S, Gu H, Gu J, Liu Y, Ma Y, Meng Y, Hu L, Tian X, Xiao F. Zinc Oxide Nanoparticles Exacerbate Epileptic Seizures by Modulating the TLR4-Autophagy Axis. Int J Nanomedicine 2024; 19:2025-2038. [PMID: 38476283 PMCID: PMC10927376 DOI: 10.2147/ijn.s442623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Background Zinc oxide nanoparticles (ZnO NPs) has been widely used in various fields and has had an important impact on human public health. In addition, it inevitably damages human health, including neurological diseases. Therefore, this study explored the effect of ZnO NPs on epilepsy. Methods The effect of ZnO NPs on epilepsy was observed by behavioral analysis. TLR4 expression and autophagy related pathways were detected by RNA-seq and Western blot. In addition, the cell types of autophagy were detected by immunofluorescence. Further, the electrophysiological changes of ZnO NPs induced autophagy were detected by whole-cell patch-clamp. Finally, the recovery experiment was carried out by TLR4 inhibitor (TAK-242). Results We found that ZnO NPs enhanced epilepsy susceptibility and severity. Through RNA-seq analysis and Western blot, it was found that ZnO NPs affected the changes of TLR4 and autophagy related pathways. In addition, we found that ZnO NPs mainly affects autophagy of inhibitory neurons, resulting in excitation/inhibition imbalance. The autophagy and epileptic phenotypes were reversed with TAK-242. In general, ZnO NPs exacerbate epileptic seizures by modulating the TLR4-autophagy axis. Conclusion ZnO NPs enhanced the susceptibility and severity of epilepsy. Mechanistically, ZnO NPs affected autophagy by changing the expression of TLR4. In particular, the ZnO NPs mainly affected the synaptic function of inhibitory neuron, leading to excitation/inhibition imbalances.
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Affiliation(s)
- Pingyang Ke
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Jing Liu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
- Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, People’s Republic of China
| | - Chengzhi Chen
- Department of Occupational and Environmental Health, School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Sen Luo
- Department of Occupational and Environmental Health, School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Huiwen Gu
- Department of Occupational and Environmental Health, School of Public Health and Management, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Juan Gu
- Key Laboratory of Medical Electrophysiology of Ministry of Education and Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Yan Liu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Yuanlin Ma
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Yuan Meng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Liqin Hu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Xin Tian
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
| | - Fei Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing, People’s Republic of China
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He X, Chen X, Yang Y, Xie Y, Liu Y. Medicinal plants for epileptic seizures: Phytoconstituents, pharmacology and mechanisms revisited. JOURNAL OF ETHNOPHARMACOLOGY 2024; 320:117386. [PMID: 37956914 DOI: 10.1016/j.jep.2023.117386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/16/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Epilepsy is a neurological disorder that presents with recurring and spontaneous seizures. It is prevalent worldwide, affecting up to 65 million people, with 80% of cases found in lower-income countries. Medicinal plants are commonly employed for managing and treating epilepsy and convulsions due to their unique therapeutic properties. With increasing research and clinical application, medicinal plants are gaining attention globally due to their potent therapeutic effects and fewer side effects. The development of new plant-based antiepileptic/anticonvulsant agents has become a major focus in the pharmaceutical industry. AIM OF THE REVIEW This article summarizes recent research on medicinal plants with reported antiepileptic/anticonvulsant effects. It provides pharmacological and molecular mechanism of action information for the crude extracts and related active constituents evaluated in preclinical research for the treatment of epilepsy and convulsions, and offers a reference for the development of future related studies in this area. MATERIALS AND METHODS Articles related to ethnopharmacological and antiepileptic studies on plants or natural products from 2018 to 2023 were collected from PubMed, Web of Science and Scopus, etc. using keywords related to epilepsy, medicinal plants, and natural products, etc. RESULTS: Eighty plant species are commonly used to treat epilepsy and convulsions in African and Asian countries. Sixty natural products showing potential for antiepileptic/anticonvulsant effects have been identified from these medicinal plants. These products can be broadly classified as alkaloids, coumarins, flavonoids, saponins, terpenoids and other compounds. The antiepileptic action of plant extracts and their active ingredients can be classified according to their abilities to modulate the GABAergic and glutamatergic systems, act as antioxidants, exhibit anti-neuroinflammatory effects, and provide neuroprotection. In addition, we highlight that some medicinal plants capable of pharmacologically relieving epilepsy and cognition may be therapeutically useful in the treatment of refractory epilepsy. CONCLUSIONS The review highlights the fact that herbal medicinal products used in traditional medicine are a valuable source of potential candidates for antiepileptic drugs. This confirms and encourages the antiepileptic/anticonvulsant activity of certain medicinal plants, which could serve as inspiration for further development. However, the aspects of structural modification and optimization, metabolism, toxicology, mechanisms, and clinical trials are not fully understood and need to be further explored.
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Affiliation(s)
- Xirui He
- Shool of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, China.
| | - Xufei Chen
- Key Laboratory of Western Resource Biology and Modern Biotechnology, Northwest University, 710065, Shaanxi, Xi'an, China
| | - Yan Yang
- Shool of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, China
| | - Yulu Xie
- Shool of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, China
| | - Yujie Liu
- Shool of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, China
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Zhang M, Jin Y, Li W, He C, Di X, Duan Y, Chen L, Wang Z. Quantitation of levetiracetam concentrations in plasma and saliva samples by ultra-performance liquid chromatography-tandem mass spectrometry: Application to therapeutic drug monitoring for pregnant women with epilepsy. Biomed Chromatogr 2024; 38:e5777. [PMID: 37990827 DOI: 10.1002/bmc.5777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023]
Abstract
Although levetiracetam (LEV) has favorable linear pharmacokinetic properties, therapeutic drug monitoring (TDM) is necessary for pregnant women with epilepsy. This study aims to build a simple, reliable, and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for determining LEV concentrations in plasma and saliva samples, to support the routine TDM of LEV in Chinese pregnant women with epilepsy. The stable isotope-labeled LEV-d6 was used as the internal standard. The extracted samples were analyzed using a UPLC-MS/MS system with positive electrospray ionization. Mobile phase A was water containing 5 mM ammonium acetate and 0.1% formic acid, and phase B was 1:1 methanol-acetonitrile with 0.1% formic acid. The method was validated and utilized to determine LEV concentrations in non-pregnant and pregnant patients with epilepsy. The developed method was validated in both plasma and saliva samples over a concentration range of 0.1-50 μg/mL. The intra- and inter-batch accuracy for LEV ranged from -7.0% to 2.9%, with precisions between 2.7% and 9.3%. In pregnant patients, the mean dose-standardized LEV trough plasma concentrations were significantly lower than those in non-pregnant patients (4.73 ± 2.99 vs. 7.74 ± 3.59 ng/mL per mg/day; P < 0.0001). It is recommended that the TDM of LEV should be routinely performed during the different stages of pregnancy.
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Affiliation(s)
- Mengyu Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Ying Jin
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wanling Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Chaoqun He
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Xiangjie Di
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yifei Duan
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Lei Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Zhenlei Wang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Pharmacy, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Clinical Trial Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
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Xiong W, Yang X, Lu L, Ma X, Wang C, Yan B, Zhang Q, Mu J, Li Z, Sander JW, Wang Y, Zhou D. Quality indicators for epilepsy management in China: The development of a tool to assess care and first three-year report. Epilepsy Res 2024; 200:107295. [PMID: 38278099 DOI: 10.1016/j.eplepsyres.2024.107295] [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: 09/25/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVES Epilepsy care in China has expanded considerably in the last decade but still remains largely unknown; we developed an easy-to-use tool to assess its quality. METHODS We adapted the Epilepsy Update Quality Measurement, produced by the American Academy of Neurology (AAN) for use in China: The Quality Indicator for Epilepsy Treatment-China National Action (QUIET-CHINA). This tool incorporates a standardized case report form initially for logging quality indicators for people with epilepsy during in-patient stays. Nine quality indicators covered seizures, drugs, diagnostics, screening for co-morbid conditions, counseling for woman of child bearing age, and a composite indicator was further proposed by total number of interventions performed divided by the total number of people eligible in each indicator. The tool also has an electronic reporting and data feedback system. 96 epilepsy centers in 31 jurisdictions in mainland China have been piloted since 2017. RESULTS Data from 11,600 individuals with epilepsy in the first 3-year study period were analyzed. The median age was 31; 60% were male. The composite indicators were 74%. Seizure freedom rate was less than 25% in all epilepsy types and post-surgical seizure freedom rate was 21%. 90% had seizure type and frequency, antiepileptic drugs recorded, while only 70% with active epilepsy were on regular antiepileptic drugs treatment. Investigations for diagnosis and etiology were performed in around 90% but screening for co-morbid conditions and counseling for women of childbearing potential was 38% and 15% respectively. Severe side effect happened in 2% individuals during the treatment. CONCLUSION The preliminary results of the national action provided some baseline information. Except for an overall improvement, a significant treatment gap still exists, and psychiatric co-morbidities or issues affecting women are not seen as a priority. QUIET-CHINA will be expanded to more and other levels of hospitals, to help narrow the treatment gap and equalize the comprehensive epilepsy care on the national level.
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Affiliation(s)
- Weixi Xiong
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Yang
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Lu Lu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xudong Ma
- National Health and Family Planning Commission of the People's Republic of China, 100044 Beijing, China.
| | - Caiyun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Bo Yan
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Qin Zhang
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jie Mu
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
| | - Zixiao Li
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Josemir W Sander
- Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, China; Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; National Health and Family Planning Commission of the People's Republic of China, 100044 Beijing, China.
| | - Dong Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
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Wang Q, Ren Z, Yue M, Zhao Y, Wang B, Zhao Z, Wen B, Hong Y, Chen Y, Zhao T, Wang N, Zhao P, Hong Y, Han X. A model for the diagnosis of anxiety in patients with epilepsy based on phase locking value and Lempel-Ziv complexity features of the electroencephalogram. Brain Res 2024; 1824:148662. [PMID: 37924926 DOI: 10.1016/j.brainres.2023.148662] [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: 04/27/2023] [Revised: 09/09/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE Anxiety disorders (AD) are critical factors that significantly (about one-fifth) impact the quality of life (QoL) in patients with epilepsy (PWE). Objective diagnostic methods have contributed to the identification of PWE susceptible to AD. This study aimed to identify AD in PWE by constructing a diagnostic model based on the phase locking value (PLV) and Lempel-Ziv Complexity (LZC) features of the electroencephalogram (EEG). METHODS EEG data from 131 patients with epilepsy (PWE) were enrolled in this study. Patients were divided into two groups, anxiety disorder (AD, n = 61) and non-anxiety disorder (NAD, n = 70), according to the Hamilton Rating Scale for Anxiety (HAM-A). Support vector machine (SVM) and K-Nearest-Neighbor(KNN) algorithms were used to construct three models - the PLVEEG, LZCEEG, and PLVEEG + LZCEEG feature models. Finally, the area under the receiver operating characteristic curve (AUC) and statistical analyses were performed to evaluate the model performance. RESULTS The efficiency of the KNN-based PLCEEG + LZCEEG feature model was the best, and the accuracy, precision, recall, F1-score, and AUC of the model after five-fold cross-validations scores were 87.89 %, 82.27 %, 98.33 %, 88.95 %, and 0.89, respectively. When the model efficiency was optimal, 29 EEG features were suggested. Further analysis of these features indicated 22 EEG features that were significantly different between the two groups, including 50 % features of the alpha (α)-band. CONCLUSIONS The PLVEEG + LZCEEG model features can identify AD in PWE. The PLVEEG and LZCEEG characteristics of the α-band may further be explored as potential biomarkers for AD in PWE.
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Affiliation(s)
- Qi Wang
- Department of Neurology, Zhengzhou University People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Zhe Ren
- Department of Neurology, Zhengzhou University People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Mengyan Yue
- Department of Rehabilitation, The First Hospital of Shanxi Medical University, Shanxi Province, Taiyuan 030000, China
| | - Yibo Zhao
- Department of Neurology, Zhengzhou University People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Bin Wang
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Zongya Zhao
- School of Medical Engineering, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Bin Wen
- School of Life Sciences and Technology, Xi'an Jiaotong University, Xi'an 710000, Shaanxi Province, China
| | - Yang Hong
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Yanan Chen
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Ting Zhao
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Na Wang
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Pan Zhao
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China
| | - Yingxing Hong
- Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, Henan Province, Zhengzhou 450003, China.
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Li Y, Guo H, Hu Y, Wang J, Zhang Y, Huang J, Xu J, Chen J, Lu X, Chen F. Effectiveness and safety of mono- and add-on perampanel in pediatric patients with epilepsy: Experience from a single-center retrospective study. Epilepsia Open 2024; 9:268-277. [PMID: 37943144 PMCID: PMC10839354 DOI: 10.1002/epi4.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE To evaluate the effectiveness and safety of perampanel (PER) monotherapy (MT) or add-on therapy (AT) in Chinese children with epilepsy, as well as to evaluate the data from routine therapeutic drug monitoring (TDM) of PER for these pediatric patients. METHODS This retrospective and observational study was carried out on children with epilepsy (n = 340) from 2020 to 2022 at the Children's Hospital of Nanjing Medical University. Outcome measures were the responder rate (50% or greater seizure reduction), long-term efficacy, and tolerability (number and types of adverse events) in MT and AT groups. Concentrations of plasma PER obtained from these patients, if available, were analyzed too. RESULTS A total of 279 patients achieved at least 3 months of therapy, and 58.1% responded to PER therapy. 53 of the responders were seizure-free (32.7%). The retention rate dropped from 88.0% at 3 months to 40.6% at 12 months after treatment. Patients with MT achieved better seizure control than those with AT (P < 0.001). Intriguingly, PER exerted a very weak effect on patients who took more than 2 ASMs or were diagnosed with drug-resistant epilepsy. There were no significant differences in tolerability between the two groups. In addition, 179 patients were routinely monitored for PER, and the trough concentrations (C0 ) for these patients ranged from 30.0 to 992.0 ng/mL. However, no significant difference in C0 was observed between responders and nonresponders (333 ng/mL vs 325.5 ng/mL, P = 0.264). SIGNIFICANCE This study provides effectiveness and safety data on Chinese children with epilepsy treated with PER either as MT or as AT. The efficacy of patients receiving MT was much better than cases administered with more than 2 ASMs or diagnosed with drug-resistant epilepsy. In addition, no association was found between the plasma PER concentration and efficacy or safety. PLAIN LANGUAGE SUMMARY The study reports the effects of perampanel on seizures and adverse effects in Chinese patients with epilepsy younger than 18 years. Seizures decreased in 58.1% of patients (responders); in a third of these responders, seizures stopped. After treatment was started, 88% of patients were still on perampanel at 3 months and 40.6% at 12 months. People who were treated with perampanel only were more likely to respond than those who received perampanel and other antiseizure treatments, although perampanel was tolerated equally well in these groups. Plasma perampanel concentration did not predict seizure response or adverse effects.
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Affiliation(s)
- Yue Li
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Hong‐Li Guo
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Ya‐Hui Hu
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Jie Wang
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Yuan‐Yuan Zhang
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Jian Huang
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Jing Xu
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Jing Chen
- Department of NeurologyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Xiao‐Peng Lu
- Department of NeurologyChildren's Hospital of Nanjing Medical UniversityNanjingChina
| | - Feng Chen
- Pharmaceutical Sciences Research CenterDepartment of PharmacyChildren's Hospital of Nanjing Medical UniversityNanjingChina
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Shu Y, Wu Z, Yang X, Song M, Ye Y, Zhang C, Yuan Q, Wang L. The burden of epilepsy in the People's Republic of China from 1990 to 2019: epidemiological trends and comparison with the global burden of epilepsy. Front Neurol 2023; 14:1303531. [PMID: 38146443 PMCID: PMC10749336 DOI: 10.3389/fneur.2023.1303531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Epilepsy is associated with a significant global burden of disease, affecting over 50 million people worldwide. The specific aim of this study is to compare the burden of epilepsy in the People's Republic of China (PRC) with the global burden, and to analyze the epidemiological trends of epilepsy, the relationship between the burden of epilepsy and social demographic index (SDI), and the relative contributions of epidemiological factors. Methods This is a retrospective population-based study, data were obtained from the Global Burden of Disease (GBD) study in 2019. We employed Joinpoint software and the age-period-cohort (APC) model to analyze epilepsy's epidemiological trends. Health inequality analysis was conducted to investigate the impact of SDI on epilepsy burden. Decomposition analysis was performed to examine the relative contributions of age, population, and epidemiological changes to epilepsy. Results Between 1990 and 2019, the incidence rate in the PRC increased by 45%, significantly surpassing the global incidence of epilepsy. However, Disability-Adjusted Life Years (DALY) decreased notably, and the proportion of Years of Life Lost (YLL) decreased from 62.73 to 39.03%. Concerning incidence, the period Rate Ratio (RR) in the PRC initially increased and then decreased, while the cohort RR in the PRC and globally exhibited a consistent upward trend. In terms of mortality, period RR and cohort RR in the PRC displayed a gradual decrease, with mortality starting higher but eventually falling below the global mortality. The net drifts of incidence were greater than 0, whereas the net drifts of mortality were less than 0, both were lower in the PRC than at the global level. Decomposition analysis indicated that the changes of incidence and mortality in the PRC were mainly attributed to epidemiological changes. Additionally, global disparities in epilepsy decreased, with the burden concentrating in low SDI countries. Conclusion The incidence of epilepsy in the PRC rose during the 30-year study period, while epilepsy mortality decreased. The improved survival rate in the PRC is predominantly attributable to epidemiological changes. The burden of epilepsy in the PRC predominantly affects males, children, and the elderly, Chinese government should focus on specific populations.
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Affiliation(s)
- Yun Shu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhifeng Wu
- Department of Pediatrics, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xiaolin Yang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Min Song
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yangyang Ye
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunqing Zhang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qing Yuan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Wang
- Department of Neurology, Second Affiliated Hospital, Army Medical University, Chongqing, China
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Wang S, Zhang X, Wang Y, Zhou J. Medication compliance of children with epilepsy: a cross-sectional survey. Ital J Pediatr 2023; 49:153. [PMID: 37974267 PMCID: PMC10655363 DOI: 10.1186/s13052-023-01525-5] [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: 02/21/2023] [Accepted: 09/06/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Good medication compliance is very important for the prognosis of children with epilepsy. We aimed to evaluate the status and influencing factors of medication compliance in children with epilepsy and to provide insights to the clinical nursing care of children with epilepsy. METHODS We selected epileptic children admitted to Children's Hospital of Nanjing Medical University from February 1, 2022 to August 31, 2022. Self-designed questionnaire and medication compliance scale were used to evaluate the characteristics and medication compliance of children with epilepsy. Pearson correlation analysis and multivariate logistic regression were used to analyze the influencing factors of medication compliance. RESULTS A total of 156 children with epilepsy were included, the incidence of poor compliance in children with epilepsy was 37.18%. Pearson correlation analysis indicated that age(r = 0.622), courses of epilepsy(r = 0.553), parental education level(r = 0.506), monthly household income(r = 0.652) and number of drugs taken(r = 0.577) were correlated with the compliance(all P<0.05). Logistic regression analyses indicated that age ≤ 6 y(OR = 2.104, 95%CI: 1.712 ~ 2.527), courses of epilepsy ≤ 3 years(OR = 2.661, 95%CI: 2.089 ~ 2.941), low parental education level(OR = 1.977, 95%CI: 1.314 ~ 2.351), monthly household income ≤ 5000 RMB(OR = 2.812, 95%CI: 2.194 ~ 3.181), number of drugs taken ≥ 3(OR = 3.025, 95%CI: 2.336 ~ 3.475) were the influencing factors of medication compliance in children with epilepsy(all P<0.05). CONCLUSIONS The medication compliance of children with epilepsy needs to be improved, and the medication compliance of children is affected by age, courses of epilepsy, parental education level, monthly household income and number of drugs taken. Clinical medical personnel take targeted nursing measures against these factors to improve the medication compliance of children with epilepsy.
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Affiliation(s)
- Shanshan Wang
- Department of Neurology, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Xu Zhang
- Department of Neurology, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Yongqian Wang
- Department of Neurology, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Jinfang Zhou
- Department of Neurology, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China.
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Lu Y, Zhang P, Xu F, Zheng Y, Zhao H. Advances in the study of IL-17 in neurological diseases and mental disorders. Front Neurol 2023; 14:1284304. [PMID: 38046578 PMCID: PMC10690603 DOI: 10.3389/fneur.2023.1284304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Interleukin-17 (IL-17), a cytokine characteristically secreted by T helper 17 (Th17) cells, has attracted increasing attention in recent years because of its importance in the pathogenesis of many autoimmune or chronic inflammatory diseases. Recent studies have shown that neurological diseases and mental disorders are closely related to immune function, and varying degrees of immune dysregulation may disrupt normal expression of immune molecules at critical stages of neural development. Starting from relevant mechanisms affecting immune regulation, this article reviews the research progress of IL-17 in a selected group of neurological diseases and mental disorders (autism spectrum disorder, Alzheimer's disease, epilepsy, and depression) from the perspective of neuroinflammation and the microbiota-gut-brain axis, summarizes the commonalities, and provides a prospective outlook of target application in disease treatment.
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Affiliation(s)
- Yu Lu
- Department of Pediatrics, Jinan Central Hospital, Shandong University, Jinan, China
| | - Piaopiao Zhang
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fenfen Xu
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yuan Zheng
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hongyang Zhao
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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Liu Q, Tan B, Zhang J, Jin Y, Lei P, Wang X, Li M, Jia X, Zhang Q. Premature mortality risk in individuals with convulsive epilepsy: Results from a longitudinal, prospective, population-based study. Epilepsy Res 2023; 197:107243. [PMID: 37839339 DOI: 10.1016/j.eplepsyres.2023.107243] [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: 04/03/2023] [Revised: 09/02/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To assess premature mortality and identify associated risk factors among individuals with convulsive epilepsy in resource-poor settings using a longitudinal, prospective, population-based approach. METHOD The study recruited people with convulsive epilepsy who underwent assessment and management of epilepsy at primary healthcare centers in rural Northwest China, including newly diagnosed individuals and previously identified prevalent cases. All participants were confirmed to have epilepsy by neurologists according to strict criteria and were followed up monthly by primary care physicians. Demographic data and cause of death (COD) were obtained from death certificates or verbal autopsies conducted by neurologists, following the International Classification of Diseases, 10th Edition. The standardized mortality ratio (SMR) and proportionate mortality ratio (PMR) for each cause of death were estimated using the Cause-Of-Death Surveillance Dataset of China (2020). Survival analysis was used to identify risk factors associated with all-cause mortality and death directly due to epilepsy. RESULTS During 5.9 years of follow-up with 40,947 person-years, there were 781 (11.2%) deaths among 6967 participants. The risk of premature death in people with convulsive epilepsy was 2.7-fold higher than that in the general population. Young participants had a significantly higher risk (standardized mortality ratio 26.5-52.5) of premature death. The proportionate mortality ratio was higher for cerebrovascular disease (15%), sudden unexpected death in epilepsy (SUDEP) (13.4%), cardiovascular disease (11.7%), status epilepsy (SE) (11.3%), and epilepsy-related accidents (14.0%) than other premature mortality cause of deaths. Additionally, the highest standardized proportional mortality ratio (SPMR) was observed from drowning in all cause of death (10.4, 95% confidence interval [CI]: 7.6-13.8), followed by burning (9.0, 95% CI: 3.7-18.9). Factors that increased the risk of all-cause mortality included male sex, late age of onset, short disease duration, high body mass index, monotherapy, and the frequency of generalized tonic-clonic seizures (GTCS). High frequency of generalized tonic-clonic seizures (> 3 attacks in the last year) was an independent risk factor for premature death directly due to epilepsy (including sudden unexpected death in epilepsy, status epilepsy, and epilepsy-related accidents), while early age of onset (≤ 14 years) and long duration of epilepsy (> 20 years) were independent risk factors for sudden unexpected death in epilepsy. In addition, short duration of epilepsy (≤ 20 years) was an independent risk factor for status epilepsy. CONCLUSIONS This study demonstrated that individuals with poorly controlled seizures are more likely to experience premature death, with most deaths being epilepsy-related and preventable. These findings underline the importance of effective seizure treatment and the potential impact on reducing premature mortality among people with convulsive epilepsy.
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Affiliation(s)
- Qiang Liu
- Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan 750004, Ningxia Province, China; Graduate College of Ningxia Medical University, Yinchuan 750004, Ningxia Province, China
| | - Bofei Tan
- Graduate College of Ningxia Medical University, Yinchuan 750004, Ningxia Province, China
| | - Jie Zhang
- Graduate College of Ningxia Medical University, Yinchuan 750004, Ningxia Province, China
| | - Yanzi Jin
- Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan 750004, Ningxia Province, China
| | - Pingping Lei
- Ningxia Center for Disease Prevention and Control, Yinchuan 750004, Ningxia Province, China
| | - Xu Wang
- Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan 750004, Ningxia Province, China
| | - Mengyun Li
- Graduate College of Ningxia Medical University, Yinchuan 750004, Ningxia Province, China
| | - Xiaodan Jia
- Graduate College of Ningxia Medical University, Yinchuan 750004, Ningxia Province, China
| | - Qing Zhang
- Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan 750004, Ningxia Province, China.
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Zhu J, Lu J, He Y, Shen X, Xia H, Li W, Zhang J, Fan X. Association of ABCB1 Polymorphisms with Efficacy and Adverse Drug Reactions of Valproic Acid in Children with Epilepsy. Pharmaceuticals (Basel) 2023; 16:1536. [PMID: 38004402 PMCID: PMC10675623 DOI: 10.3390/ph16111536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Genetic polymorphisms in ATP-binding cassette subfamily B member 1 (ABCB1, also known as MDR1) have been reported to be possibly associated with the regulation of response to antiseizure medications. The aim of this study was to investigate the association of ABCB1 polymorphisms with the efficacy of and adverse drug reactions to valproic acid among Chinese children with epilepsy. A total of 170 children from southern China with epilepsy treated with valproic acid for more than one year were recruited, including 61 patients with persistent seizures and 109 patients who were seizure-free. Two single nucleotide polymorphisms of ABCB1, rs1128503 and rs3789243, were genotyped using the Sequenom MassArray system. The two single nucleotide polymorphisms of ABCB1 were found to be significantly associated with treatment outcomes of valproic acid in children with epilepsy. Carriers with the TT genotype of ABCB1 rs1128503 were more inclined to exhibit persistent seizures after treatment with valproic acid (p = 0.013). The CC genotype of rs3789243 was observed to be a potential protective factor for valproic acid-induced gastrointestinal adverse drug reactions (p = 0.018), but possibly increased the risk of valproic acid-induced cutaneous adverse drug reactions (p = 0.011). In contrast, the CT genotype of rs3789243 was associated with a lower risk of valproic acid-induced cutaneous adverse drug reactions (p = 0.011). Haplotype analysis showed that CC haplotype carriers tended to respond better to valproic acid treatment (p = 0.009). Additionally, no significant association was found between ABCB1 polymorphisms and serum concentrations of valproic acid. This study revealed that the polymorphisms and haplotypes of the ABCB1 gene might be associated with the treatment outcomes of valproic acid in Chinese children with epilepsy.
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Affiliation(s)
- Jiahao Zhu
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Jieluan Lu
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
| | - Yaodong He
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Xianhuan Shen
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Hanbing Xia
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Wenzhou Li
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Jianping Zhang
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
| | - Xiaomei Fan
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
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Wu X, Xie D, Zheng Q, Peng S, Liu Y, Ma P, Ye L, Mo X, Feng Z. Downregulation of NHE1 expression attenuates apoptosis of primary hippocampal neurons of an epilepsy model through the calpain-1 pathway. Neurosci Lett 2023; 815:137494. [PMID: 37748674 DOI: 10.1016/j.neulet.2023.137494] [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: 05/24/2023] [Revised: 09/10/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Na(+)/H(+) exchanger isoform 1 (NHE1), a membrane protein that regulates intracellular pH, is abundantly expressed in brain tissues. It is associated with pathophysiologies in several brain diseases. The present study aimed to investigate the effects of NHE1 on the apoptosis of primary neurons of an epilepsy model. METHODS Primary hippocampal neurons were cultured in an Mg2+-free medium to establish an epilepsy cell model. Designed shNHE1 lentivirus was used to silence NHE1 level in primary neurons. Nonselective pharmacological inhibitor MDL-28170 (20 μmol/L) was used to inhibit calpain-1 protein in neurons treated with Mg2+-free medium. The expression levels of NHE1 and calpain-1, intracellular Ca2+ (Ca2+i) and H+ (H+i) levels, and the expression levels of apoptosis-related proteins Bcl-2 and Bax were detected in neurons. TUNEL staining was performed to determine apoptosis in different groups. RESULTS NHE1 expression was increased in primary neurons treated with an Mg2+-free medium, and it was correlated with increased expression of calpain-1 and cell apoptosis. Neurons from the in vitro epilepsy model showed significantly decreased Bcl-2 protein expression and significantly increased Bax protein expression. In the presence of LV-shNHE1 and the calpain-1 inhibitor MDL-28170, the changes in the expression of apoptosis-related proteins Bcl-2 and Bax were blocked in the epileptic model, and the percentage of apoptotic neurons among neurons from the in vitro epilepsy model was significantly decreased. The increase in calpain-1 expression was suppressed by LV-shNHE1; however, the inhibition of calpain-1 did not affect NHE1 expression. CONCLUSION These results demonstrate that NHE1 participates in the promotion of neuronal apoptosis of epilepsy model in vitro through the calpain-1 pathway. Downregulation of NHE1 expression could exert a neuroprotective effect on epilepsy.
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Affiliation(s)
- Xuling Wu
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Dongjun Xie
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Qian Zheng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shuang Peng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Ying Liu
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Pengfei Ma
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Lan Ye
- The Medical Science Function Laboratory of Experimental Teaching Center of Basic Medicine, School of Basic Medical Science, Guizhou Medical University, Guiyang, China.
| | - Xiangang Mo
- Department of Comprehensive Care Ward, Affiliated Hospital of Guizhou Medical University, Guiyang, China.
| | - Zhanhui Feng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China.
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Yin X, Niu S, Yu Q, Xuan Y, Chen L, Feng X. Validity and reliability of the Chinese version of the disease-related fear scale in patients with epilepsy. Epilepsy Behav 2023; 147:109404. [PMID: 37683426 DOI: 10.1016/j.yebeh.2023.109404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/05/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This study aims to test the validity and reliability of the Chinese version of the Disease-Related Fear Scale (D-RFS) in order to understand the experience of fear in patients with epilepsy (PWE). METHODS The researchers obtained translation permission and followed international guidelines to develop a Chinese version of the D-RFS. A total of 609 PWE were recruited from a general tertiary hospital in Hangzhou, China, between January 2023 and June 2023. We evaluated the psychometric properties of the D-RFS, including content validity, reliability, test-retest reliability, internal consistency, and construct validity. RESULTS Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted on two separate samples with a sample size of 307 and 302. The results of EFA indicated that the scale could be divided into three dimensions, which were supported by the structure in CFA. We named the three dimensions as follows: "fear of seizure consequences", "fear of poor epilepsy management", and "fear of social restrictions", respectively. The Cronbach's alpha coefficient for the entire scale was 0.960, with a coefficient of 0.907, 0.953, and 0.917 on three dimensions. CONCLUSION The Chinese version of the D-RFS was found to be an effective and reliable tool to measure the experience of fear in adult PWE in China. The study could lay the foundation for future investigations to explore associated factors of epilepsy-related fear and establish intervention strategies to alleviate patients' fear in clinical practice.
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Affiliation(s)
- Xiaoxiao Yin
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China
| | - Shan Niu
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China
| | - Qun Yu
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China
| | - Yejing Xuan
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China
| | - Lan Chen
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China
| | - Xiuqin Feng
- Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 Zhejiang Province, China.
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Liu X, Wang Q, Ren L, Fang X, He Z, Ding J, Wang K, Xu H, Zhang H, Song Y, Lu Q, Sun M, Han X, Cao L, Lin W, Li X, Zhang Q, Ding Y, Wang F, Wang T, Wang J, Liu X, Wu Y, Chen Y, Feng Z, Wang S, Wang X, Guan Y, Xie X, Huang H, Zhang M, Wang X, Hong Z, Jiang W, Han Y, Deng Y, Zhao J, Liao J, Wang Y, Lian Y. COVID-19 vaccination for patients with epilepsy: A Chinese expert consensus. Epilepsy Behav 2023; 147:109387. [PMID: 37625346 DOI: 10.1016/j.yebeh.2023.109387] [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: 04/08/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
Coronavirus disease-2019 (COVID-19) first emerged in late 2019 and has since spread worldwide. More than 600 million people have been diagnosed with COVID-19, and over 6 million have died. Vaccination against COVID-19 is one of the best ways to protect humans. Epilepsy is a common disease, and there are approximately 10 million patients with epilepsy (PWE) in China. However, China has listed "uncontrolled epilepsy" as a contraindication for COVID-19 vaccination, which makes many PWE reluctant to get COVID-19 vaccination, greatly affecting the health of these patients in the COVID-19 epidemic. However, recent clinical practice has shown that although a small percentage of PWE may experience an increased frequency of seizures after COVID-19 vaccination, the benefits of COVID-19 vaccination for PWE far outweigh the risks, suggesting that COVID-19 vaccination is safe and recommended for PWE. Nonetheless, vaccination strategies vary for different PWE, and this consensus provides specific recommendations for PWE to be vaccinated against COVID-19.
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Affiliation(s)
- Xuewu Liu
- Department of Neurology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan, China.
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Liankun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Clinical Research Center for Epilepsy, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Disorders, Beijing, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China; Institute of Epilepsy, Shandong University, Jinan, China
| | - Zhiyi He
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kang Wang
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Huiqin Xu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hua Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Xi'an JiaoTong University, Xi'an, China
| | - Yijun Song
- Hematology Hospital, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Tianjing, China
| | - Qiang Lu
- Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China
| | - Meizhen Sun
- Departmen of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lili Cao
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xiaoyi Li
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Qing Zhang
- Department of Neurology, General Hospital of Ningxia Medical University, Yinchuang, China
| | - Yao Ding
- Department of Neurology, Epilepsy Center, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Furong Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tiancheng Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jiwen Wang
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaorong Liu
- Department of Neurology, Second Affiliated Hospital of Guangzhou Medical University, China
| | - Yuan Wu
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Guangzhou, China
| | - Yangmei Chen
- Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhanhui Feng
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shoulei Wang
- Department of Pediatrics, Qinghai Province Women and Children's Hospital, Xining, China
| | - Xiangqing Wang
- Department of Neurology, The First Medical Center of PLA General Hospital, Beijnig, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijnig, China
| | - Xufang Xie
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ming Zhang
- Department of Neurology, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshan Wang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Hong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Jiang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yanbing Han
- Department of Neurology, First Affiliated Hospital Kunming Medical University, Kunming, China
| | - Yulei Deng
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangming Zhao
- Department of Neurology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, China
| | - Jianxiang Liao
- Department of Pediatrics, Shenzhen Children's Hospital, Shenzhen, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yajun Lian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Duan Y, Zhang Z, Zhao X, Cheng H, Zhang S, Guo S, Jin B, Wu X, Aung T. Validation of different predictive scoring scales in patients with new-onset epileptic seizures or epilepsy related to neuronal surface antibody-mediated autoimmune encephalitis. Epilepsy Behav 2023; 147:109403. [PMID: 37660404 DOI: 10.1016/j.yebeh.2023.109403] [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: 06/16/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To validate the different predictive scoring scales in the Chinese population with new-onset epileptic seizures or epilepsy of unknown etiology related to neuronal surface antibody (Ab)-mediated autoimmune encephalitis (AE). METHODS We retrospectively reviewed the charts of 174 consecutive patients from October 2018 to December 2022, whose serum and cerebrospinal fluid samples were tested for neuronal surface Abs. The antibody prevalence in epilepsy and encephalopathy (APE2), antibodies contributing to focal epilepsy signs and symptoms (ACES), "obvious" indications for neural antibody testing in epilepsy or seizures (ONES) checklist, and the combinations were used to validate the predictive models of neuronal surface Ab-mediated AE. RESULTS A total of 139 patients with new-onset epileptic seizures or epilepsy of unknown etiology were enrolled. Abs were detected in 37 patients (26.6%). The APE2/ONES reflex score had the highest sensitivity (89.2%) and lowest specificity (41.7%). The ACES score had the lowest sensitivity (67.5%) and highest specificity (64.7%). Variations in the performance were observed in the different types of AE. 100% of patients with anti-γ-aminobutyric acid B-B receptor encephalitis were predicted by ONES, APE2/ONES reflex, and ACES/ONES reflex scores. Only 75% of patients with anti-N-methyl-D-aspartate receptor encephalitis were predicted by the APE2/ONES and ACES/ONES reflex scores. CONCLUSION Our study was the first to validate various predictive scoring scales in the Chinese cohort of patients with new-onset epileptic seizures or epilepsy of unknown etiology related to neuronal surface Ab-mediated AE. Based upon clinical suspicion, more than one scoring scale should be performed to predict the chance of AE in those patients.
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Affiliation(s)
- Yiqun Duan
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Zheyu Zhang
- Department of Neurology, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Xiaoyu Zhao
- Center for Rehabilitation Medicine, Department of Neurophysiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hui Cheng
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sheng Zhang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Shunyuan Guo
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Bo Jin
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
| | - Xiaoyan Wu
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
| | - Thandar Aung
- Department of Neurology, Epilepsy Center, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Wu Y, Zhang R, Tang J, Li X, Wang Y, Li T, Wu F, Dou X, Wang D, Jiang L. Multi-dimensional influence of pediatric epilepsy on children and their families: A cross-sectional study. Epilepsy Behav 2023; 146:109360. [PMID: 37499581 DOI: 10.1016/j.yebeh.2023.109360] [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: 02/18/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE In this study, we aimed to evaluate the effects of pediatric epilepsy on family burden, parental anxiety, depression states, and quality of life of both parents and children. METHODS The study was undertaken between March and December 2021 using an online questionnaire that included the Family Burden Scale of Disease, the 7-item Generalized Anxiety Disorder scale, the 9-item Patient Health Questionnaire, the WHO Quality of Life Scale (WHOQOL-BREF), and the PedsQL 4.0 Generic Core Scales (parent-proxy report). RESULTS A total of 288 parents of children aged 2-18 years were included. Overall, 94.8% of the participating families experienced high levels of disease burden, 67.0% of parents suffered from anxiety states, 57.0% suffered from depression states, and 56.2% of children with epilepsy suffered from comorbid neuropsychiatric symptoms. The mean WHOQOL-BREF score for parental quality of life was 53.7 ± 12.8, while the median PedsQL score for children's quality of life was 65.4 (49.6-81.7). Parental depression states contributed the most to family burden and parental quality of life, whereas comorbidities of epilepsy contributed the most to children's quality of life. Seizure frequency significantly influenced parental anxiety states, and family burden was the most significant predictor of parental depression states. CONCLUSION Heavy disease burden, anxiety states, and depression states are prevalent in families with children suffering from epilepsy, and most have a poor quality of life. There is a need for greater focus on the quality of life of this patient population and their caregivers, as well as increased resources to help combat anxiety, depression, and poor quality of life.
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Affiliation(s)
- You Wu
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China; Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Rui Zhang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Jianyong Tang
- Department of Laboratory Medicine, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Xia Li
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Yan Wang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Taoli Li
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Fang Wu
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Xiangjun Dou
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China
| | - Dong Wang
- Department of Neurology, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shannxi, China.
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
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He X, Yang Y, Yuan X, Sun Y, Li Y. Chemical composition and anticonvulsant activities of herb pair of Gastrodia elata Blume-Acorus tatarinowii Schott decoction on experimentally induced seizures in mice. Metab Brain Dis 2023; 38:1877-1893. [PMID: 37043151 DOI: 10.1007/s11011-023-01211-9] [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: 01/10/2023] [Accepted: 04/02/2023] [Indexed: 04/13/2023]
Abstract
Epilepsy is a serious public health problem in the world. At present, over 30% of affected patients remain refractory to currently available treatment. Medicinal plants as pharmaceuticals and healthcare treatments have been frequently used in the management of epilepsy in China for many centuries. Gastrodia elata-Acous tatarinowii (GEAT), as a classic and most commonly used herb pair in traditional Chinese medicine (TCM), has been employed to control seizures for thousands of years. However, the animal experiment data on its anticonvulsant effect is limited in the literature. Thus, this study aimed to reveal the therapeutic actions of GEAT decoction against seizures in mice. UHPLC-MS/MS was performed to analyze the chemical components of GEAT decoction. The mice were given GEAT decoction for 7 days, and MES, PTZ, and 3-MP injection was given 30 min after the last administration. Video monitoring was performed for comparisons. In addition, the PTZ-induced kindling models were conducted to investigate the seizure severity, anxiety and cognitive profile, inflammation, and oxidative stress parameters in mice. The results showed that GEAT decoction dose-dependently protected mice against MES, 3-MP, and PTZ-induced acute seizures. Furthermore, GEAT decoction significantly ameliorated seizure severity, decreased the accumulation of inflammatory mediators TNF-α, IL-1β, and IL-6, mitigated oxidative stress, as well as alleviated anxious-like behavior and cognitive deficits in PTZ-kindled mice. These results suggest that GEAT decoction possesses certain anticonvulsant properties, which might be clinically useful as phytotherapy alone or as an adjunct therapy for the prevention and treatment of seizures and epilepsy.
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Affiliation(s)
- Xirui He
- College of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, People's Republic of China.
| | - Yan Yang
- College of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, People's Republic of China
| | - Xufang Yuan
- College of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong, 519041, People's Republic of China
| | - Yin Sun
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), Ministry of Education, Xi'an, Shaanxi, 710169, People's Republic of China
| | - Yongsheng Li
- Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, People's Republic of China.
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Sun X, Zhao J, Guo C, Zhu X. Early Prediction of Epilepsy after Encephalitis in Childhood Based on EEG and Clinical Features. Emerg Med Int 2023; 2023:8862598. [PMID: 37485251 PMCID: PMC10359137 DOI: 10.1155/2023/8862598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 07/25/2023] Open
Abstract
Objective The present study was designed to establish and evaluate an early prediction model of epilepsy after encephalitis in childhood based on electroencephalogram (ECG) and clinical features. Methods 255 patients with encephalitis were randomly divided into training and verification sets and were divided into postencephalitic epilepsy (PE) and no postencephalitic epilepsy (no-PE) according to whether epilepsy occurred one year after discharge. Univariate and multivariate logistic regression analyses were used to screen the risk factors for PE. The identified risk factors were used to establish and verify a model. Results This study included 255 patients with encephalitis, including 209 in the non-PE group and 46 in the PE group. Univariate and multiple logistic regression analysis showed that hemoglobin (OR = 0.968, 95% CI = 0.951-0.958), epilepsy frequency (OR = 0.968, 95% CI = 0.951-0.958), and ECG slow wave/fast wave frequency (S/F) in the occipital region were independent influencing factors for PE (P < 0.05).The prediction model is based on the above factors: -0.031 × hemoglobin -2.113 × epilepsy frequency + 7.836 × occipital region S/F + 1.595. In the training set and the validation set, the area under the ROC curve (AUC) of the model for the diagnosis of PE was 0.835 and 0.712, respectively. Conclusion The peripheral blood hemoglobin, the number of epileptic seizures in the acute stage of encephalitis, and EEG slow wave/fast wave frequencies can be used as predictors of epilepsy after encephalitis.
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Affiliation(s)
- Xiaojuan Sun
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Jinhua Zhao
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Chunyun Guo
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Xiaoxiao Zhu
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
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Liu Y, Zhang L, Ai M, Xia D, Chen H, Pang R, Mei R, Zhong L, Chen L. Upregulation of SLITRK5 in patients with epilepsy and in a rat model. Synapse 2023; 77:e22266. [PMID: 36811190 DOI: 10.1002/syn.22266] [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: 11/14/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
SLIT and NTRK-like protein-5 (SLITRK5) is one of the six members of SLITRK protein family, which is widely expressed in central nervous system (CNS). In brain, SLITRK5 plays important roles in neurite outgrowth, dendritic branching, neuron differentiation, synaptogenesis, and signal transmission of neurons. Epilepsy is a common, chronic neurological disorder characterized by recurrent spontaneous seizures. The pathophysiological mechanism of epilepsy remains unclear. Neuronal apoptosis, abnormal nerve excitatory transmission, and synaptic remodeling are thought to be involved in the development of epilepsy. To explore whether there is a potential relationship between SLITRK5 and epilepsy, we investigated the expression and distribution of SLITRK5 in patients with temporal lobe epilepsy (TLE) and a rat model of epilepsy. We collected cerebral cortex samples from patients with drug-refractory temporal lobe epilepsy, and a rat model of epilepsy induced by lithium chloride/pilocarpine was established. The ways of immunohistochemistry, double-immunofluorescence labeling and western blot have been used in our study to research the expression and distribution of SLITRK5 in the temporal lobe epilepsy patients and epilepsy animal model. All of the results have shown that SLITRK5 is mainly localized in the cell cytoplasm of neurons both in patients with TLE and in epilepsy model. In addition, compared with nonepileptic controls, the expression of SLITRK5 was upregulated in the temporal neocortex of TLE patients. And both in the temporal neocortex and hippocampus of pilocarpine-induced epilepsy rats, the expression of SLITRK5 was increased at 24 h after status epilepticus (SE), with a relatively high level within 30 days, and reached the peak on the 7th day after SE. Our preliminary results revealed that SLITRK5 may have a potential relationship with epilepsy, which may be a foundation for the further study of the underlying mechanism between SLITRK5 and epilepsy and the therapeutic targets of antiepileptic drugs.
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Affiliation(s)
- Yan Liu
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Linming Zhang
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Mingda Ai
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Di Xia
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Hongyu Chen
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ruijing Pang
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Rong Mei
- Department of Neurology, Yunnan Provincial Clinical Research Center for Neurological Disease, Kunming, Yunnan, China
| | - Lianmei Zhong
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Department of Neurology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Ling Chen
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Department of Neurology, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China
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Dong F, Yuan Z, Wu D, Jiang L, Liu J, Hu W. Novel seizure detection algorithm based on multi-dimension feature selection. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Huang X, Kang Y, Wang M, Liu Q, Wang F, Zeng M. WeChat-based remote follow-up management reduces the burden of home care and anxiety on parents of children with refractory epilepsy: A randomized controlled study. Medicine (Baltimore) 2023; 102:e34070. [PMID: 37352033 PMCID: PMC10289595 DOI: 10.1097/md.0000000000034070] [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: 03/30/2023] [Revised: 05/08/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVE The present research was designed to study the effect of WeChat-based remote follow-up management on the burden of home care and anxiety on parents of children with refractory epilepsy. METHODS 161 refractory epileptic children were included in this study. They were divided into control group and WeChat group according to their management protocols after discharge, namely, control group with traditional follow-up (n = 81) and WeChat group with remote follow-up based on WeChat (n = 81). We evaluated home care burden by family caregiver task Inventory (FCTI) scale and zarit burden interview (ZBI) scale, and evaluated negative emotion by self-rating anxiety Scale (SAS) scale and self-Rating depression scale (SDS) scale. RESULTS There was no significant difference in the demographic characteristics of epileptic children and their parents and the scores of FCTI, ZBI, SAS and SDS before treatment between the 2 groups (all P > .05), and the score of FCTI (20.86 ± 4.26), ZBI (39.63 ± 4.46), SAS (44.49 ± 4.15) and SDS (50.02 ± 4.13) in WeChat group were all significantly lower than the score of FCTI (25.25 ± 3.71), ZBI (45.47 ± 4.61), SAS (52.75 ± 4.93) and SDS (54.51 ± 6.59) in control group (all P < .05). CONCLUSION WeChat-based remote follow-up management reduces the burden of home care and anxiety on parents of children with refractory epilepsy.
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Affiliation(s)
- Xiaofen Huang
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Yueming Kang
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Meixin Wang
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Qianqian Liu
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Feng Wang
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Mingzhu Zeng
- Department of Neurosurgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Zhou S, Zhang D, Chang J, Xia Z, Li J, Ni M, Li H. Effect of SARS-CoV-2 infection on seizure, anxiety, and depression in 107 patients with epilepsy. Epilepsy Behav 2023; 145:109290. [PMID: 37406559 PMCID: PMC10267500 DOI: 10.1016/j.yebeh.2023.109290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE To study the effects of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) on epileptic seizures, anxiety, and depression in patients with epilepsy. METHODS Based on the inclusion and exclusion criteria, an ambispective cohort study was hereby conducted on patients with epilepsy infected with SARS-CoV-2 who visited the outpatient and ward of the Department of Neurology of Xinyang Central Hospital from December 2022 (when the domestic epidemic prevention and control policy was lifted) to February 2023. A face-to-face questionnaire survey involving factors including basic information, vaccination with inactivated COVID-19 vaccines, number of seizures within 2 months before and after SARS-CoV-2 infection, and scores of anxiety and depression was carried out. RESULTS A total of 107 patients with epilepsy satisfying the inclusion and exclusion criteria completed the follow-up after 2 months. It was found that enrolled patients maintained the original dose of antiepileptic drugs, but the frequency of seizures after COVID-19 infection could not be controlled. After infection with SARS-CoV-2, the frequency of seizures in patients with epilepsy in 2 months increased compared with that before infection (P < 0.05). Meanwhile, compared with the vaccinated group, the high-frequency seizure rate of epilepsy in the unvaccinated group was higher. (P < 0.05), and the anxiety and depression scores of patients with epilepsy were worse than those before they were infected (P < 0.05). CONCLUSION Being infected with SARS-CoV-2 can increase the number of seizures and aggravate the degree of anxiety and depression in patients with epilepsy. The inactivated vaccine is protective, and the inactivated SARS-CoV-2 vaccine can reduce the rate of high-frequency seizures.
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Affiliation(s)
- Sichao Zhou
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Dexin Zhang
- Department of General ICU,Xinyang Central Hospital ,Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000, Henan, China
| | - Jianjun Chang
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Zhilun Xia
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Jing Li
- Department of Emergency Xinyang Central Hospital, Xinyang 464000, Henan, China
| | - Menghan Ni
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Hao Li
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China.
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Wang M, Tang HP, Wang S, Hu WJ, Li JY, Yu AQ, Bai QX, Yang BY, Kuang HX. Acorus tatarinowii Schott: A Review of Its Botany, Traditional Uses, Phytochemistry, and Pharmacology. Molecules 2023; 28:molecules28114525. [PMID: 37299001 DOI: 10.3390/molecules28114525] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Acorus tatarinowii Schott (A. tatarinowii) is a natural medicinal plant. It plays an indispensable role in the treatment of diseases by the empirical medicine system and has achieved remarkable curative effects. A. tatarinowii is often used to treat various diseases, such as depression, epilepsy, fever, dizziness, heartache, stomachache, etc. More than 160 compounds of different structural types have been identified in A. tatarinowii, including phenylpropanoids, terpenoids, lignans, flavonoids, alkaloids, amides, and organic acids. These bioactive ingredients make A. tatarinowii remarkable for its pharmacological effects, including antidepressant, antiepileptic, anticonvulsant, antianxiety, neuroprotective, antifatigue, and antifungal effects, improving Alzheimer's disease, and so on. It is noteworthy that A. tatarinowii has been widely used in the treatment of brain diseases and nervous system diseases and has achieved satisfactory therapeutic effects. This review focused on the research publications of A. tatarinowii and aimed to summarize the advances in the botany, traditional uses, phytochemistry, and pharmacology, which will provide a reference for further studies and applications of A. tatarinowii.
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Affiliation(s)
- Meng Wang
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Hai-Peng Tang
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Shuang Wang
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Wen-Jing Hu
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Jia-Yan Li
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Ai-Qi Yu
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Qian-Xiang Bai
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Bing-You Yang
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
| | - Hai-Xue Kuang
- Key Laboratory of Basic and Application Research of Beiyao, Ministry of Education, Heilongjiang University of Chinese Medicine, Harbin 150040, China
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Sun M, Lu P, Luo Y, Lu J, Xu Z, Guo Y. Evaluation of the knowledge, awareness, and attitudes toward epilepsy among general practitioners in Eastern China. Epilepsy Behav 2023; 144:109267. [PMID: 37257337 DOI: 10.1016/j.yebeh.2023.109267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE We aimed to assess the knowledge, awareness, and attitudes toward epilepsy among general practitioners (GPs) from community health service centers (CHCs) in Hangzhou, Eastern China. METHODS One hundred twenty three GPs working at CHCs participated in this cross-sectional study in 2022. A custom-built electronic questionnaire, which comprised four domains, including 12 items for general condition data, 10 items for awareness (including first aid), a 16-item scale for attitudes, and 6 items for demographic data, was administered to the GPs. Descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis H test, and Spearman's rank correlation analysis were used to analyze the non-normal distribution of the data set. RESULTS The GPs' average score on the awareness of epilepsy section was 18.14 ± 3.34 (aggregate score: 34), the first aid knowledge of epilepsy section scored 4.89 ± 1.54 (aggregate score: 7), and the epilepsy attitude section scored 62.28 ± 10.15 (aggregate score: 80). Age (rs = 0.218, P = 0.015), professional title (rs = 0.215, P = 0.017), and length of service (rs = 0.240, P = 0.008) correlated significantly with mean awareness of epilepsy scores. Age (rs = -0.234, P = 0.009) and educational background (rs = 0.199, P = 0.028) correlated significantly with attitudes toward epilepsy. Furthermore, when GPs faced newly diagnosed people with epilepsy (PWE), a referral was usually recommended (89.43%) and some would give Chinese traditional treatment (13.01%). In addition, the difficulties the GPs encountered in managing included PWE rarely appearing in the community (82.93%), the community lacking corresponding medical equipment (82.11%), and GPs lacking epilepsy-related experience (73.17%). CONCLUSION The awareness and attitudes of GPs toward epilepsy in the CHCs were suboptimal. General practitioners age, professional title, length of service, and educational background influenced awareness and attitudes toward PWE. Effective public intervention programs, epilepsy training based on National Guidelines, and referral routes need to improve in China to enhance the care of PWE.
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Affiliation(s)
- Mengtian Sun
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Yunhe Street Community Health Service Center, Linping District, Hangzhou, China
| | - Panpan Lu
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of General Practice, Taizhou Municipal Hospital, Taizhou, China
| | - Yuan Luo
- Xiaoying Street Community Health Service Center, Shangcheng District, Hangzhou, China
| | - Jianhong Lu
- Nanxing Street Community Health Service Center, Shangcheng District, Hangzhou, China
| | - Zhengyanran Xu
- Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Guo
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
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Zhang S, Qin Y, Wang J, Yu Y, Wu L, Zhang T. Noninvasive Electrical Stimulation Neuromodulation and Digital Brain Technology: A Review. Biomedicines 2023; 11:1513. [PMID: 37371609 DOI: 10.3390/biomedicines11061513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
We review the research progress on noninvasive neural regulatory systems through system design and theoretical guidance. We provide an overview of the development history of noninvasive neuromodulation technology, focusing on system design. We also discuss typical cases of neuromodulation that use modern noninvasive electrical stimulation and the main limitations associated with this technology. In addition, we propose a closed-loop system design solution of the "time domain", "space domain", and "multi-electrode combination". For theoretical guidance, this paper provides an overview of the "digital brain" development process used for noninvasive electrical-stimulation-targeted modeling and the development of "digital human" programs in various countries. We also summarize the core problems of the existing "digital brain" used for noninvasive electrical-stimulation-targeted modeling according to the existing achievements and propose segmenting the tissue. For this, the tissue parameters of a multimodal image obtained from a fresh cadaver were considered as an index. The digital projection of the multimodal image of the brain of a living individual was implemented, following which the segmented tissues could be reconstructed to obtain a "digital twin brain" model with personalized tissue structure differences. The "closed-loop system" and "personalized digital twin brain" not only enable the noninvasive electrical stimulation of neuromodulation to achieve the visualization of the results and adaptive regulation of the stimulation parameters but also enable the system to have individual differences and more accurate stimulation.
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Affiliation(s)
- Shuang Zhang
- The School of Artificial Intelligence, Neijiang Normal University, Neijiang 641000, China
- The School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610056, China
- The NJNU-OMNISKY Smart Medical Engineering Applications Joint Laboratory, Neijiang Normal University, Neijiang 641004, China
- The High Field Magnetic Resonance Brain Imaging Laboratory of Sichuan, Chengdu 610056, China
| | - Yuping Qin
- The School of Artificial Intelligence, Neijiang Normal University, Neijiang 641000, China
- The NJNU-OMNISKY Smart Medical Engineering Applications Joint Laboratory, Neijiang Normal University, Neijiang 641004, China
| | - Jiujiang Wang
- The School of Artificial Intelligence, Neijiang Normal University, Neijiang 641000, China
- The NJNU-OMNISKY Smart Medical Engineering Applications Joint Laboratory, Neijiang Normal University, Neijiang 641004, China
| | - Yuanyu Yu
- The School of Artificial Intelligence, Neijiang Normal University, Neijiang 641000, China
- The NJNU-OMNISKY Smart Medical Engineering Applications Joint Laboratory, Neijiang Normal University, Neijiang 641004, China
| | - Lin Wu
- The School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610056, China
- The High Field Magnetic Resonance Brain Imaging Laboratory of Sichuan, Chengdu 610056, China
| | - Tao Zhang
- The School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610056, China
- The High Field Magnetic Resonance Brain Imaging Laboratory of Sichuan, Chengdu 610056, China
- The Sichuan Institute for Brain Science and Brain-Inspired Intelligence, Chengdu 610056, China
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Tu J, Sun Y, Tian D, Chen X, Shi S, Zhe X, Zhang S, Wang N, Hui Y, Gao F. Impact of metacognition on attitudes toward epilepsy in medical students. Epilepsy Behav 2023; 143:109243. [PMID: 37182501 DOI: 10.1016/j.yebeh.2023.109243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/02/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE This study evaluated medical students' knowledge and attitudes toward epilepsy and the influence of metacognition thereon. METHOD Valid questionnaires were administered to medical students including undergraduate, professional postgraduate, and standardized residency training students (N = 503). The questionnaire had 4 parts: demographic information, knowledge of epilepsy, attitudes toward epilepsy, and metacognitive assessment. The Chinese Public Attitudes Toward Epilepsy scale and 30-Item Metacognition Questionnaire were used to assess attitudes and metacognition, respectively. RESULTS Almost all participants had heard of epilepsy; 38.8% had witnessed a seizure and 25% were acquainted with a person with epilepsy. The proportion of correct answers to epilepsy-related knowledge ranged from 40.6% (Putting an object into the mouth of a person experiencing an epileptic seizure) to 97% (Convulsion is a symptom of epilepsy). However, knowledge of epilepsy was not able to affect attitudes toward epilepsy. Age, years of clinical experience, having witnessed a seizure, positive belief of worry, and need to control thinking were correlated with the different domains of attitude toward epilepsy. When participants were divided into 2 groups-i.e., those with high and low knowledge of epilepsy, participants in the former group who had a positive belief of worry or had not witnessed any seizures were more likely to have negative attitudes toward epilepsy. CONCLUSION Medical students showed good awareness of the etiology and symptoms of epilepsy. Overall, attitudes toward epilepsy were negative. A positive belief of worry was associated with a more negative attitude toward epilepsy among respondents with greater knowledge of epilepsy.
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Affiliation(s)
- Jing Tu
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Yanhui Sun
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Dandan Tian
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Xiuqing Chen
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China; Xi'an Medical University, Xi'an, China
| | - Shaoting Shi
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Xiao Zhe
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Shijun Zhang
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | | | | | - Fei Gao
- Department of Neurology, the First Affiliated Hospital of Xi'an Medical University, Xi'an, China.
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Wang Q, Shi NR, Lv P, Liu J, Zhang JZ, Deng BL, Zuo YQ, Yang J, Wang X, Chen X, Hu XM, Liu TT, Liu J. P2Y12 receptor gene polymorphisms are associated with epilepsy. Purinergic Signal 2023; 19:155-162. [PMID: 35175489 PMCID: PMC9984642 DOI: 10.1007/s11302-022-09848-4] [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: 11/01/2021] [Accepted: 02/01/2022] [Indexed: 10/19/2022] Open
Abstract
The basic research indicated that microglial P2Y12 receptors (P2Y12Rs) are involved in the pathophysiology of epilepsy through regulated microglial-neuronal interactions, aberrant neurogenesis, or immature neuronal projections. However, whether the clinic case of epilepsy would be associated with P2Y12 receptor gene polymorphisms is presented with few data. In our study, a total of 176 patients with epilepsy and 50 healthy controls were enrolled. Two single-nucleotide polymorphisms, namely rs1491974 and rs6798347, were selected for analysis. The results revealed that carriers of the G allele of rs1491974 G>A or rs6798347 G>A may be associated with an increased risk of epilepsy (OR = 0.576, 95% CI = 0.368-0.901, p = 0.015; OR = 0.603, 95% CI = 0.367-0.988, p = 0.043). Interestingly, we found that the rs1491974 G>A genotype and allele frequencies have only a significant difference in female instead of male case (p = 0.004 for genotype; p = 0.001 for allele). The subgroup analysis demonstrated that individuals with the rs1491974 G>A genotype might have more frequent seizure (OR = 0.476, 95% CI = 0.255-0.890; p = 0.019). These data implied that both rs1491974 and rs6798347 polymorphisms of P2Y12R would be able to play import roles in epilepsy susceptibility, whereas the rs1491974 polymorphism may be specifically related to seizure frequency.
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Affiliation(s)
- Qi Wang
- School of Clinical Medicine, Southwest Medical University, 646000, Luzhou, China
| | - Nan-Rui Shi
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Peng Lv
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Juan Liu
- School of Sports Medicine and Health, Sports Medicine Key Laboratory of Sichuan Province, Chengdu Sport University, Chengdu, 610041, China
| | - Ji-Zhou Zhang
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Bin-Lu Deng
- School of Clinical Medicine, Southwest Medical University, 646000, Luzhou, China
| | - Yan-Qin Zuo
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Jie Yang
- Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xin Wang
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Xiang Chen
- School of Clinical Medicine, Southwest Medical University, 646000, Luzhou, China
| | - Xiu-Min Hu
- School of Acupuncture and Tuina, Chengdu University of Traditional Medicine, Chengdu, 610075, China
| | - Ting-Ting Liu
- Sichuan Academy of Medical Sciences &, Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Jie Liu
- School of Clinical Medicine, Southwest Medical University, 646000, Luzhou, China. .,Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China. .,Sichuan Academy of Medical Sciences &, Sichuan Provincial People's Hospital, Chengdu, 610072, China.
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Liu W, Xu Y, Lin Y, Wang L, Zhou M, Yin P, Zhao G. Burden of epilepsy in China and its provinces, 1990 to 2019: findings from the Global Burden of Disease Study 2019. Chin Med J (Engl) 2023; 136:305-312. [PMID: 36752807 PMCID: PMC10106145 DOI: 10.1097/cm9.0000000000002526] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. METHODS We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. RESULTS In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92-1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33-133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03-98.74%) and 35.72% (95% UI: 0.47-86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43-5.66]/100,000), Qinghai (1.80 [95% UI: 1.15-2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88-1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39-0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44-0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41-0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. CONCLUSIONS The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.
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Affiliation(s)
- Wei Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yangyang Xu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yicong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
| | - Lijun Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
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