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https://www.readbyqxmd.com/read/29780310/mobile-software-as-a-medical-device-samd-for-the-treatment-of-epilepsy-development-of-digital-therapeutics-comprising-behavioral-and-music-based-interventions-for-neurological-disorders
#1
Pegah Afra, Carol S Bruggers, Matthew Sweney, Lilly Fagatele, Fareeha Alavi, Michael Greenwald, Merodean Huntsman, Khanhly Nguyen, Jeremiah K Jones, David Shantz, Grzegorz Bulaj
Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders...
2018: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29774009/signaling-pathways-and-cellular-mechanisms-regulating-mossy-fiber-sprouting-in-the-development-of-epilepsy
#2
REVIEW
Christin M Godale, Steve C Danzer
The sprouting of hippocampal dentate granule cell axons, termed mossy fibers, into the dentate inner molecular layer is one of the most consistent findings in tissue from patients with mesial temporal lobe epilepsy. Decades of research in animal models have revealed that mossy fiber sprouting creates de novo recurrent excitatory connections in the hippocampus, fueling speculation that the pathology may drive temporal lobe epileptogenesis. Conducting definitive experiments to test this hypothesis, however, has been challenging due to the difficulty of dissociating this sprouting from the many other changes occurring during epileptogenesis...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29770117/clinical-application-of-epilepsy-genetics-in-africa-is-now-the-time
#3
Alina I Esterhuizen, Gemma L Carvill, Rajkumar S Ramesar, Symon M Kariuki, Charles R Newton, Annapurna Poduri, Jo M Wilmshurst
Over 80% of people with epilepsy live in low- to middle-income countries where epilepsy is often undiagnosed and untreated due to limited resources and poor infrastructure. In Africa, the burden of epilepsy is exacerbated by increased risk factors such as central nervous system infections, perinatal insults, and traumatic brain injury. Despite the high incidence of these etiologies, the cause of epilepsy in over 60% of African children is unknown, suggesting a possible genetic origin. Large-scale genetic and genomic research in Europe and North America has revealed new genes and variants underlying disease in a range of epilepsy phenotypes...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29764485/the-role-of-inflammation-in-the-development-of-epilepsy
#4
REVIEW
Amna Rana, Alberto E Musto
Epilepsy, a neurological disease characterized by recurrent seizures, is often associated with a history of previous lesions in the nervous system. Impaired regulation of the activation and resolution of inflammatory cells and molecules in the injured neuronal tissue is a critical factor to the development of epilepsy. However, it is still unclear as to how that unbalanced regulation of inflammation contributes to epilepsy. Therefore, one of the goals in epilepsy research is to identify and elucidate the interconnected inflammatory pathways in systemic and neurological disorders that may further develop epilepsy progression...
May 15, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29760947/incorporating-epilepsy-genetics-into-clinical-practice-a-360%C3%A2-evaluation
#5
Stephanie Oates, Shan Tang, Richard Rosch, Rosalie Lear, Elaine F Hughes, Ruth E Williams, Line H G Larsen, Qin Hao, Hans Atli Dahl, Rikke S Møller, Deb K Pal
We evaluated a new epilepsy genetic diagnostic and counseling service covering a UK population of 3.5 million. We calculated diagnostic yield, estimated clinical impact, and surveyed referring clinicians and families. We costed alternative investigational pathways for neonatal onset epilepsy. Patients with epilepsy of unknown aetiology onset < 2 years; treatment resistant epilepsy; or familial epilepsy were referred for counseling and testing. We developed NGS panels, performing clinical interpretation with a multidisciplinary team...
2018: NPJ Genomic Medicine
https://www.readbyqxmd.com/read/29758341/effect-of-zembrin-%C3%A2-and-four-of-its-alkaloid-constituents-on-electric-excitability-of-the-rat-hippocampus
#6
Wilfried Dimpfel, Richard Franklin, Nigel Gericke, Leonie Schombert
ETHNOPHARMACOLOGICAL RELEVANCE: Sceletium tortuosum (Mesembryanthemaceae), a succulent plant indigenous to South Africa. is consumed in the form of teas, decoctions and tinctures and is sometimes smoked and used as snuff. In recent years, Sceletium has received a great deal of commercial interest for relieving stress in healthy people, and for treating a broad range of psychological, psychiatric and inflammatory conditions. MATERIAL AND METHODS: The whole extract (Zembrin®) was tested ex vivo in the hippocampus slice preparation after one week of daily oral administration of 5 and 10mg/kg...
May 11, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29753573/impact-of-prior-authorization-of-antiepileptic-drugs-in-children-with-epilepsy
#7
Elaine C Wirrell, Alexander J Vanderwiel, Lauren Nickels, Saskia L Vanderwiel, Katherine C Nickels
OBJECTIVE: We assessed how commonly prior authorization results in treatment delay or missed doses in children with epilepsy. METHODS: Parents of 462 children followed in a pediatric epilepsy clinic were surveyed regarding prior authorization in the preceding year. Epilepsy and insurance details were collected. If prior authorization was required, parents were asked whether it resulted in (1) delayed initiation of a newly-prescribed antiepileptic drug, and/or (2) lapse in coverage of a current medication...
April 3, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29752488/open-resection-of-hypothalamic-hamartomas-for-intractable-epilepsy-revisited-using-intraoperative-mri
#8
Libby van Tonder, Sasha Burn, Anand Iyer, Jo Blair, Mohammed Didi, Michael Carter, Timothy Martland, Conor Mallucci
INTRODUCTION: Hypothalamic hamartomas (HHs) are rare non-neoplastic lesions which cause drug-resistant epilepsy with associated behavioural, psychiatric and endocrine issues. With the development of new minimally invasive techniques for the treatment of HH, there is a need to reappraise the effectiveness and safety of each approach. We review the outcomes of HH patients treated surgically, utilizing intraoperative magnetic resonance imaging (IOMRI), by a team of Alder Hey NHS Foundation Trust tumour and epilepsy neurosurgeons since 2011...
May 11, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29747241/stiripentol-add-on-therapy-for-focal-refractory-epilepsy
#9
REVIEW
Francesco Brigo, Stanley C Igwe, Nicola Luigi Bragazzi
BACKGROUND: This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. OBJECTIVES: To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29745347/febrile-infection-related-epilepsy-syndrome-fires-an-overview-of-treatment-and-recent-patents
#10
Kam Lun E Lun Hon, Alexander K C Leung, Alcy R Torres
BACKGROUND: New-onset refractory status epilepticus (NORSE) refers to a clinical presentation in a patient without active epilepsy or other existing relevant neurological disorder, with new onset of refractory status epilepticus in the absence of a clear acute or active structural, metabolic, or toxic cause. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE that requires a febrile infection between 24 hours and 2 weeks prior to the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus, and with no restriction to the age of the patient...
May 8, 2018: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/29744790/comparative-efficacy-of-antiepileptic-drugs-for-patients-with-generalized-epileptic-seizures-systematic-review-and-network-meta-analyses
#11
Marília Silveira de Almeida Campos, Lorena Rocha Ayres, Manuela Roque Siane Morelo, Fabiana Angelo Marques Carizio, Leonardo Régis Leira Pereira
Background Valproate is a widely prescribed antiepileptic drug for generalized epilepsies, due to the extensive knowledge on its efficacy since it is on the market for many decades. However, a large number of new antiepileptic medicines was introduced into clinical practice and may be better options for treatment, considering that these medicines differ in terms of efficacy spectrum. Despite extensive research, questions regarding which medicine would constitute the first option for the monotherapy treatment of generalized epilepsy remain...
May 9, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29743978/clarified-a%C3%A3-a%C3%A3-euterpe-oleracea-juice-as-an-anticonvulsant-agent-in-vitro-mechanistic-study-of-gabaergic-targets
#12
Gabriela P F Arrifano, Mathieu P Lichtenstein, José Rogério Souza-Monteiro, Marcelo Farina, Hervé Rogez, José Carlos Tavares Carvalho, Cristina Suñol, Maria Elena Crespo-López
Seizures affect about 50 million people around the world. Approximately 30% of seizures are refractory to the current pharmacological arsenal, so, the pursuit of new therapeutic alternatives is essential. Clarified Euterpe oleracea (EO) juice showed anticonvulsant properties similar to diazepam in an in vivo model with pentylenetetrazol, a GABAA receptor blocker. This study investigated the effects of EO on the main GABAergic targets for anticonvulsant drugs, analyzing the effect on the GABA receptor's benzodiazepine and picrotoxinin binding sites and the GABA uptake...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29740975/similarities-between-the-responses-to-ant-dbs-and-prior-vns-in-refractory-epilepsy
#13
Toni Kulju, Joonas Haapasalo, Kai Lehtimäki, Sirpa Rainesalo, Jukka Peltola
OBJECTIVES: Neurostimulation has offered new treatment options in refractory epilepsy, first with vagus nerve stimulation (VNS) and more recently with deep brain stimulation (DBS). There is a lack of previous detailed data assessing the relationship between VNS and ANT-DBS. The aim of this study was to investigate the potential correlation between therapeutic responses to VNS and ANT-DBS. MATERIALS AND METHODS: A total of 11 patients with previous VNS therapy underwent ANT-DBS implantation...
May 8, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29737210/excavating-anticonvulsant-compounds-from-prescriptions-of-traditional-chinese-medicine-in-the-treatment-of-epilepsy
#14
Zefeng Zhao, Xirui He, Cuixia Ma, Shaoping Wu, Ye Cuan, Ying Sun, Yajun Bai, Linhong Huang, Xufei Chen, Tian Gao, Xiaohui Zheng
Traditional Chinese medicine (TCM) has a long history and been widely used in prevention and treatment of epilepsy in China. This paper is intended to review the advances in the active anticonvulsant compounds isolated from herbs in the prescription of TCM in the treatment of epilepsy. These compounds were introduced with the details including classification, CAS number specific structure and druggability data. Meanwhile, much of the research in these compounds in the last two decades has shown that they exhibited favorable pharmacological properties in treatment of epilepsy both in in vivo and in vitro models...
May 8, 2018: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/29723773/different-ketogenesis-strategies-lead-to-disparate-seizure-outcomes
#15
Alison Dolce, Polan Santos, Weiran Chen, Ahmet Hoke, Adam L Hartman
BACKGROUND: Despite the introduction of new medicines to treat epilepsy over the last 50 years, the number of patients with poorly-controlled seizures remains unchanged. Metabolism-based therapies are an underutilized treatment option for this population. We hypothesized that two different means of systemic ketosis, the ketogenic diet and intermittent fasting, would differ in their acute seizure test profiles and mitochondrial respiration. METHODS: Male NIH Swiss mice (aged 3-4 weeks) were fed for 12-13 days using one of four diet regimens: ketogenic diet (KD), control diet matched to KD for protein content and micronutrients (CD), or CD with intermittent fasting (24 h feed/24 h fast) (CD-IF), tested post-feed or post-fast...
April 27, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29710809/anti-oxidant-and-anti-inflammatory-activity-of-ketogenic-diet-new-perspectives-for-neuroprotection-in-alzheimer-s-disease
#16
REVIEW
Alessandro Pinto, Alessio Bonucci, Elisa Maggi, Mariangela Corsi, Rita Businaro
The ketogenic diet, originally developed for the treatment of epilepsy in non-responder children, is spreading to be used in the treatment of many diseases, including Alzheimer&rsquo;s disease. The main activity of the ketogenic diet has been related to improved mitochondrial function and decreased oxidative stress. B-Hydroxybutyrate, the most studied ketone body, has been shown to reduce the production of reactive oxygen species (ROS), improving mitochondrial respiration: it stimulates the cellular endogenous antioxidant system with the activation of nuclear factor erythroid-derived 2-related factor 2 (Nrf2), it modulates the ratio between the oxidized and reduced forms of nicotinamide adenine dinucleotide (NAD⁺/NADH) and it increases the efficiency of electron transport chain through the expression of uncoupling proteins...
April 28, 2018: Antioxidants (Basel, Switzerland)
https://www.readbyqxmd.com/read/29709877/affective-and-behavioral-dysfunction-under-antiepileptic-drugs-in-epilepsy-development-of-a-new-drug-sensitive-screening-tool
#17
Lea Julia Mertens, Juri-Alexander Witt, Christoph Helmstaedter
OBJECTIVE: Behavioral problems and psychiatric symptoms are common in patients with epilepsy and have a multifactorial origin, including adverse effects of antiepileptic drugs (AEDs). In order to develop a screening tool for behavioral AED effects, the aim of this study was to identify behavioral problems and symptoms particularly sensitive to AED drug load and the presence/absence of AEDs with known negative psychotropic profiles. METHODS: Four hundred ninety-four patients with epilepsy were evaluated who had been assessed with three self-report questionnaires on mood, personality, and behavior (Beck Depression Inventory, BDI; Neurological Disorders Depression Inventory for Epilepsy extended, NDDI-E; and Fragebogen zur Persönlichkeit bei zerebralen Erkrankungen, FPZ)...
April 27, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29708182/neurologist-patient-communication-about-epilepsy-in-the-united-states-spain-and-germany
#18
John M Stern, Fernando Cendes, Frank Gilliam, Patrick Kwan, Philippe Ryvlin, Joseph Sirven, Brien Smith, Aleksandra Adomas, Lauren Walter
Background: Effective communication between patients and their health care providers is recognized as critically important to improve the quality of health services for individuals with epilepsy. We aimed to describe in-office neurologist-patient conversations about epilepsy and focus on disease identification, shared decision-making, and care planning. Methods: Transcripts and audio recordings of conversations between patients and neurologists in the United States, Spain, and Germany were analyzed linguistically in the topic areas of epilepsy identification and diagnosis, disease education, treatments, and care planning...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29691835/rufinamide-add-on-therapy-for-refractory-epilepsy
#19
REVIEW
Mariangela Panebianco, Hemanshu Prabhakar, Anthony G Marson
BACKGROUND: Epilepsy is a central nervous system disorder (neurological disorder). Epileptic seizures are the result of excessive and abnormal cortical nerve cell electrical activity in the brain. Despite the development of more than 10 new antiepileptic drugs (AEDs) since the early 2000s, approximately a third of people with epilepsy remain resistant to pharmacotherapy, often requiring treatment with a combination of AEDs. In this review, we summarised the current evidence regarding rufinamide, a novel anticonvulsant medication, which, as a triazole derivative, is structurally unrelated to any other currently used anticonvulsant medication, when used as an add-on treatment for refractory epilepsy...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29691120/neuroprotective-effect-of-nrf2-activator-dimethyl-fumarate-on-the-hippocampal-neurons-in-chemical-kindling-model-in-rat
#20
Neha Singh, Sheekha Vijayanti, Lekha Saha, Alka Bhatia, Dibyajyoti Banerjee, Amitava Chakrabarti
BACKGROUND: Nuclear factor erythroid-2 related factor 2 (Nrf2) is a transcription factor, which activates the anti-oxidative stress response pathway. In epilepsy, oxidative stress is one of the key factors in the progression of the disease. So, the neuroprotective role of dimethyl fumarate (DMF), a Nrf2 pathway activator was explored in pentylenetetrazole (PTZ) induced kindling model of epilepsy in rats. METHODS: Male Wistar rats were subjected to different doses of DMF (15, 30, 60 mg/kg) to evaluate the effect on the PTZ induced kindling in rats...
April 21, 2018: Epilepsy Research
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