A novel way to use cross-validation to measure connectivity by machine learning allows epilepsy surgery outcome prediction.

The rate of success of epilepsy surgery, ensuring seizure-freedom, is limited by the lack of epileptogenicity biomarkers. Previous evidence supports the critical role of functional connectivity during seizure generation to characterize the epileptogenic network (EN). However, EN dynamics is highly variable across patients, hindering the development of diagnostic biomarkers.

Methods for Identifying Epilepsy Surgery Targets Using Invasive EEG: A Systematic Review.

Background: The pre-surgical evaluation for drug-resistant epilepsy achieves seizure freedom in only 50-60% of patients. Efforts to identify quantitative intracranial EEG (qEEG) biomarkers of epileptogenicity are needed. This review summarizes and evaluates the design of qEEG studies, discusses barriers to biomarker adoption, and proposes refinements of qEEG study protocols.

A comparative study between a power and a connectivity sEEG biomarker for seizure-onset zone identification in temporal lobe epilepsy.

Background: Ictal stereo-encephalography (sEEG) biomarkers for seizure onset zone (SOZ) localization can be classified depending on whether they target abnormalities in signal power or functional connectivity between signals, and they may depend on the frequency band and time window at which they are estimated.

New Method: This work aimed to compare and optimize the performance of a power and a connectivity-based biomarker to identify SOZ contacts from ictal sEEG recordings. To do so, we used a previously introduced power-based measure, the normalized mean activation (nMA), which quantifies the ictal average power activation.

Cognitive outcome after stereo-electroencephalography-guided radiofrequency thermocoagulation in temporal lobe epilepsy.

Objective: Stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) is being used incrementally in the invasive diagnosis of epilepsy. There is currently a lack of information regarding the potential cognitive consequences of the extended use of this technique. This work describes, for the first time, the cognitive outcomes after RFTC in patients with temporal lobe epilepsy (TLE), evaluated longitudinally and using a control group.

Decision Support Frameworks in Public Health Emergencies: A Systematic Review of Dynamic Models in Complex Contexts.

Public health emergencies are extraordinary events of disease spread, with health, economic, and social consequences, which require coordinated actions by governments and society. This work aims to analyze scopes, application possibilities, challenges, and gaps of decision support frameworks in PHE management, using the components of the Health Emergency and Disaster Risk Management Framework (H-EDRM) and the Preparedness, Prevention, Response and Recovery Model (PPRR Model), providing guidelines for the development of new models. A systematic literature review was carried out using the Web of Science, Scopus, and Pubmed knowledge databases on studies published between 2016 and 2023, and thirty-six articles were selected.

More than trees: Stand management can be used to improve ecosystem diversity, structure and functioning 20 years after forest restoration in drylands.

In Mediterranean drylands, extensive areas have been restored by reforestation over the past decades to improve diversity, soil fertility, and tree natural regeneration, contributing to halting desertification and land degradation. However, evaluating reforestation success usually relies on tree survival, while holistic and long-term evaluations of reforestation success based on ecosystem diversity, structure and functioning are scarce. In this work, we provide the first assessment that combines the evaluation of planted trees and indicators of ecosystem diversity, structure, and functioning in established reforestations with three native Mediterranean species along a climatic gradient.

Rapid intravenous loading of brivaracetam during invasive and non-invasive video-EEG monitoring.

Purpose: The pharmacokinetics of Brivaracetam (BRV) and its ability to penetrate the blood-brain barrier quickly make it a suitable drug for emergencies. In this study, our aim was to investigate the tolerability, safety, and acute efficacy of rapid intravenous (IV) loading of BRV during invasive and non-invasive video-EEG monitoring in patients with drug-resistant focal epilepsy (DRFE).

Methods: Eleven adult patients, six during stereo-electroencephalography (SEEG) and five in scalp video-EEG evaluation, received a 10-minute IV infusion of BRV 100 mg after a period of total withdrawal from antiseizure medications (ASMs).

Insular Role in Blood Pressure and Systemic Vascular Resistance Regulation.

Objectives: The insula is a brain area involved in the modulation of autonomic responses. Previous studies have focused mainly on its heart rate regulatory function, but its role in vascular control is not well defined. Ictal/postictal blood pressure (BP) fluctuations may have a role in the pathogenesis of sudden unexpected death in epilepsy.

Stereo-electroencephalography-guided radiofrequency thermocoagulation in patients with MRI-negative focal epilepsy.

Objective: Coupled with stereo-electroencephalography (SEEG), radiofrequency thermocoagulation (RFTC) has emerged as a therapeutic alternative for patients with refractory focal epilepsy, with proven safe but highly variable results across studies. The authors aimed to describe the outcomes and safety of SEEG-RFTC, focusing on patients with MRI-negative epilepsy.

Methods: A retrospective observational study was conducted on patients evaluated by SEEG in the authors' center.

Local-scale factors matter for tree cover modelling in Mediterranean drylands.

Forests contribute directly to ecosystem structure and functioning, maintaining biodiversity, acting as a climate regulator and reducing desertification. To better manage forests, it is essential to have high-resolution forest models and appropriate spatial-explicit variables able to explain tree cover at different scales, including the management scale. Most tree cover models rely only on broad-scale variables (>500 m), such as macroclimate, while only few studies include also local-scale variables (<500 m).

Validation of direct cortical stimulation in presurgical evaluation of epilepsy.

Objective: Direct cortical stimulation (DCS) is standard for intracranial presurgical evaluation in drug-resistant epilepsy (DRE). Few studies have reported levels of concordance between spontaneous seizure generators and triggered seizures during DCS. The present work reports validity measures of DCS for detecting the seizure onset zone (SOZ) during stereoelectroencephalography (SEEG).

Mood Disturbances, Anxiety, and Impact on Quality of Life in Patients Admitted to Epilepsy Monitoring Units.

The overall combined prevalence of anxiety and depression in patients with epilepsy has been estimated at 20.2 and 22.9%, respectively, and is considered more severe in drug-refractory epilepsy.

COVID-19 prevalence and mortality in people with epilepsy: A nation-wide multicenter study.

Background: To assess the prevalence, severity, and mortality of COVID-19 in people with epilepsy (PWE) and evaluate seizure control in PWE during and after COVID-19.

Methods: Retrospective, observational, multicenter study conducted in 14 hospitals. Medical records of randomly selected PWE followed at neurology outpatient clinics were reviewed.

Characterization of the Insular Role in Cardiac Function through Intracranial Electrical Stimulation of the Human Insula.

Objective: The link between brain function and cardiovascular dynamics is an important issue yet to be elucidated completely. The insula is a neocortical brain area that is thought to have a cardiac chronotropic regulatory function, but its role in cardiac contractility is unknown. We aimed to analyze the variability in heart rate and cardiac contractility after functional activation of different insular regions through direct electrical stimulation (E-stim) in humans.

SYLVIUS: A multimodal and multidisciplinary platform for epilepsy surgery.

Background And Objective: We present SYLVIUS, a software platform intended to facilitate and improve the complex workflow required to diagnose and surgically treat drug-resistant epilepsies. In complex epilepsies, additional invasive information from exploration with stereoencephalography (SEEG) with deep electrodes may be needed, for which the input from different diagnostic methods and clinicians from several specialties is required to ensure diagnostic efficacy and surgical safety. We aim to provide a software platform with optimal data flow among the different stages of epilepsy surgery to provide smooth and integrated decision making.

Volitional learning promotes theta phase coding in the human hippocampus.

Electrophysiological studies in rodents show that active navigation enhances hippocampal theta oscillations (4-12 Hz), providing a temporal framework for stimulus-related neural codes. Here we show that active learning promotes a similar phase coding regime in humans, although in a lower frequency range (3-8 Hz). We analyzed intracranial electroencephalography (iEEG) from epilepsy patients who studied images under either volitional or passive learning conditions.

[Long-term effects of dibenzazepines on metabolic parameters: retrospective comparison of carbamazepine, oxcarbazepine and eslicarbazepine acetate in the real world].

Introduction: Although carbamazepine (CBZ) has strong enzyme-inducing properties, oxcarbazepine (OXC) and eslicarbazepine acetate (ESL) are thought to have a milder effect. These drugs are known to have effects on lipid metabolism and may cause hyponatremia and changes in blood cell counts and liver function tests.

Aim: To compare the long-term effects of three antiepileptic drugs (CBZ, OXC and ESL) on these variables.

Accuracy of Emergency Department Clinical Findings for Diagnosis of Coronavirus Disease 2019.

Study Objective: We seek to describe the medical history and clinical findings of patients attending the emergency department (ED) with suspected coronavirus disease 2019 (COVID-19) and estimate the diagnostic accuracy of patients' characteristics for predicting COVID-19.

Methods: We prospectively enrolled all patients tested for severe acute respiratory syndrome coronavirus 2 by reverse-transcriptase polymerase chain reaction in our ED from March 9, 2020, to April 4, 2020. We abstracted medical history, physical examination findings, and the clinical probability of COVID-19 (low, moderate, and high) rated by emergency physicians, depending on their clinical judgment.

Mapping the Insula with Stereo-Electroencephalography: The Emergence of Semiology in Insula Lobe Seizures.

Objective: Insula epilepsy is rare and can be evaluated effectively by Stereotactic intracerebral EEG (SEEG). Many previous studies of insulo-opercular seizures have been unable to separate insular and opercular onset. With adequate sampling of the insula, this study shows this is possible.

Perampanel effect on sleep architecture in patients with epilepsy.

Purpose: Among patients with epilepsy, sleep disturbances can worsen seizure control. This prospective open-label study determined the effect of the antiepileptic drug perampanel on sleep architecture in patients with refractory epilepsy.

Methods: Adult patients with refractory epilepsy received add-on perampanel, starting at 2 mg/day at bedtime, increased by 2 mg after 2 weeks and then monthly until the target dose of 4-8 mg/day was reached.