A critical review of high-frequency activity for functional mapping in SEEG.

Mapping functional brain networks is a critical component of stereo-electroencephalography (SEEG) evaluations. Although direct cortical stimulation (DCS) is the clinical gold standard, it has important limitations-particularly in mapping distributed, complex functions such as language and memory, where deficits may still occur despite preservation of DCS-positive sites, impacting quality of life. More broadly, there is increasing emphasis on preserving cognitive function in epilepsy surgery.

The role of neuropsychology in stereo-EEG: A narrative review.

Stereo-EEG is accompanied by unique neuropsychological challenges in the workup, during the admission, and following the procedure. While established principles from epilepsy surgery programs provide a guiding framework for clinical practice, specialized guidelines to inform the role of neuropsychology in stereo-EEG warrant further consideration. In this review, we consider the role of neuropsychological assessments in assisting with localization of the epileptogenic network in the context of discordant noninvasive investigations, the paucity of research examining the cognitive risks associated with radiofrequency thermocoagulation, and the role for neuropsychological counseling in stereo-EEG.

Preliminary psychometric validation of a novel patient-based measure evaluating outcomes following treatment for functional seizures.

Background: A consistent measure of patient reported outcomes following treatment for functional seizures is lacking. This study presents evidence regarding preliminary validation of a novel brief questionnaire, the Functional Seizures Pre-Post Intervention Comparison Survey (FSPICS) designed to measure patient relevant metrics following treatment.

Methods: Exploratory and confirmatory factor analyses were conducted to assess the latent structure of the FSPICS.

Revisiting Hughlings Jackson's dreamy state: dissociative symptoms in temporal lobe epilepsy.

Background: Transient, dissociative experiences have been attributed to temporal lobe epilepsy (TLE) since at least the time of John Hughlings Jackson in the 1870s, who described how different dissociative symptoms might have distinct clinical potential. While dissociative symptoms are well-understood as a semiological feature of mesial TLE, they can also occur interictally yet remain poorly understood. We systematically examined the frequency, nature, and clinical correlates of dissociative experiences in TLE in an initial effort to better understand their phenotypic features.

Validation of the Seizure-Related Impact Assessment Scale: A Novel Patient-Reported Outcome Measure for Epilepsy.

Background And Objectives: There is a clear need in epilepsy clinical trials and practice for a measure that captures the trade-off between seizure and treatment-related adverse effects, which is reliable over time and across different treatment regimens. We aimed to create and validate the Seizure-Related Impact Assessment Scale (SERIAS) to fill this need.

Methods: This was a prospective longitudinal study of adults with epilepsy recruited from an Australian comprehensive epilepsy center.

Development of a qualitative data analysis codebook for peri-ictal behavior in suspected functional seizures.

Objective: Factors that can precipitate and/or prolong functional seizure events are often challenging to identify. We aimed to develop a methodology to investigate peri-ictal behaviors in subjects experiencing functional seizures and those around them in their home environment.

Methods: We conducted an iterative, four-phase process to develop a codebook for operationalizing peri-functional seizure behavior that involved observation of 37 functional seizures across 14 participants in the pre-ictal, ictal, and post-ictal phases.

Diagnostic Challenges in the Neuropsychology of Epilepsy: Report of the ILAE Neuropsychology Task Force Diagnostic Methods Commission: 2021-2025.

Increasingly, it has been recognized that non-seizure-related factors influence how people with epilepsy perform on neuropsychological tests. Therefore, neuropsychologists need to recognize the constellation of factors that can contribute to the neurocognitive presentation of a person with epilepsy and consider these factors in the interpretation of their assessment results. In this paper, we highlight common scenarios prompting the need to account for such factors when conducting and interpreting neuropsychological assessments.

Cortical stimulation predicts language decline following SEEG radiofrequency thermocoagulation.

Stereo-EEG (SEEG) cortical stimulation enables individualized mapping of language networks. Regions associated with induced language deficits are marked as 'language-positive' and considered important in supporting function. It remains unclear, however, whether small lesions in 'language-positive' sites created by radiofrequency thermocoagulation are sufficient to cause language deficits.

Psychoses of Epilepsy: Unravelling the Phenotypic and Genotypic Features.

Objectives: We analyzed the genotypic and phenotypic features of patients with psychosis of epilepsy (POE).

Methods: Patients with POE recruited to an epilepsy genetics research program underwent phenotyping and genetic analysis. The latter included screening for rare pathogenic variants in epilepsy genes, and polygenic risk score (PRS) calculation for common risk variants associated with schizophrenia.

Neuropsychological Outcomes After Stereo-EEG Radiofrequency Thermocoagulation.

Background And Objectives: Stereo-EEG-guided radiofrequency thermocoagulation (RFTHC) has been proposed as relatively safe from a cognitive perspective; however, there is a lack of evidence based on neuropsychological assessments supporting this. This study is the first prospective evaluation of neuropsychological outcomes associated with stereo-EEG-guided RFTHC in patients with focal drug-resistant epilepsy.

Methods: This cohort study involved prospective recruitment of consecutive patients undergoing stereo-EEG from 2 Australian centers.

Characterisation of psychological and neurocognitive processes accompanying functional seizures.

Objectives: To examine the relationship between clinical, psychological, and cognitive characteristics of adults with functional seizures.

Methods: This study describes baseline characteristics of one-hundred and seven participants with a documented diagnosis of functional seizures recruited to the Re-PROGRAM randomised controlled trial. Participants completed a semi-structured interview, neuropsychological assessment, and questionnaire measures via Telehealth.

Paternal exposure to antiseizure medications and offspring outcomes: a systematic review.

Background: Concerns have recently been raised about risks to the fetus resulting from paternal exposure to antiseizure medications (ASMs). To address these concerns, we conducted a systematic review of the literature to assess neurodevelopmental and anatomical outcomes in offspring born to fathers taking ASMs at the time of conception.

Methods: Electronic searches of MEDLINE, PsycINFO, and Embase were conducted to identify human studies published in English that reported on outcomes, comprising neurodevelopmental disorders, major congenital malformations, small-for-gestational age or low birth weight, in offspring of fathers taking ASMs at conception.

Re-PROGRAM: The evaluation of a brief intervention program for patients with functional seizures in an outpatient hospital setting.

Objective: Functional seizures (FS) account for 20%-25% of referrals to specialist epilepsy clinics. They are associated with major disability, increased mortality, and frequent and costly health care use. Current guidelines emphasize the importance of implementing clinical pathways to coordinate and deliver effective treatment, but there are few targeted evidence-based interventions that reliably improve patient outcomes, and treatment resources are limited.

"What are your seizures telling you?": A therapeutic tool for functional seizures.

Background: Understanding illness representations is considered important for improving health outcomes, yet how people with functional seizures reflect on the possible psychological function of their seizures has not been studied.

Methods: A semi-structured interview comprising open and closed questions was administered to 99 participants with a documented diagnosis of functional seizures. One item, 'What do you think your functional seizure symptoms are telling you?" sought to explore how individuals reflect on the possible function of their seizures.

Validation of the Seizure-Related Impact Assessment Scale (SERIAS): a study protocol.

Introduction: This study aims to validate the Seizure-Related Impact Assessment Scale (SERIAS). This novel patient-reported outcome measure (PROM) compares the 'trade-off' between seizures and treatment-related adverse effects, and measures epilepsy disability qualitatively and quantitively. It fills an important gap in PROMs for epilepsy clinical trials and practice.

Neurodevelopmental and Functional Outcomes Following In Utero Exposure to Antiseizure Medication: A Systematic Review.

Background And Objectives: To undertake a systematic review of the available literature to examine the relationship between prenatal antiseizure medication (ASM) exposure and adverse postnatal neurodevelopmental outcomes, focusing on social, emotional, behavioral, and adaptive domains of human function, and the frequency of neurodevelopmental and psychiatric disorders in ASM-exposed offspring.

Methods: Electronic searches of MEDLINE, PsychINFO, and EMBASE were conducted and limited to studies published between 1990 and 2023 in English. Studies were eligible if they prospectively or retrospectively reported neurodevelopmental outcomes of ASM-exposed offspring.

Comparative effectiveness of digital mental healthcare models for adults with epilepsy: A study protocol of a randomized controlled trial.

Objective: Mental health complaints are prevalent among people with epilepsy, yet there are major barriers that prevent access to psychological care, including high out-of-pocket costs and a lack of accessible specialized services. The purpose of the current study is to examine the comparative efficacy, acceptability, cost-effectiveness, and long-term outcomes of a digital psychological intervention when delivered under two models of care (i.e.

Content or context? A study protocol for a three-arm parallel randomised controlled trial of R-PROGRAM, a brief internet-based intervention for patients with functional seizures.

Introduction: Functional seizures (FS) mimic epilepsy but are not caused by epileptic electrical activity in the brain and are believed to have a psychological origin. There is a well-documented gap between the needs of patients with FS and available therapeutic resources. While there is potential for reducing seizure burden in patients via psychosocial intervention, there is no evidence-based care pathway or consistent availability of treatment and no effective pharmacological treatment.

An international survey of SEEG cortical stimulation practices.

Objective: Cortical stimulation is an important component of stereoelectroencephalography (SEEG). Despite this, there is currently no standardized approach and significant heterogeneity in the literature regarding cortical stimulation practices. Via an international survey of SEEG clinicians, we sought to examine the spectrum of cortical stimulation practices to reveal areas of consensus and variability.

Principles for delivering improved care of people with functional seizures: Closing the treatment gap.

Patients diagnosed with functional (psychogenic nonepileptic) seizures have similar or greater levels of disability, morbidity and mortality than people with epilepsy, but there are far fewer treatment services. In contrast to epilepsy, the current understanding of pathophysiological mechanisms and the development of evidence-based treatments for functional seizures is rudimentary. This leads to high direct healthcare costs and high indirect costs to the patient, family and wider society.

The "make or break" impact of family dynamics on psychological outcomes in focal epilepsy.

Objective: Living with epilepsy can shape the dynamics of the whole family unit. The first objective of this study was to establish the reliability and validity of our purpose-built online family mapping tool: "Living with Epilepsy." Our second objective was to identify distinct patterns of emotional closeness between family members (family typologies), and to explore (1) whether family typologies are shaped by epilepsy-related factors, and (2) which typologies confer optimal psychological outcomes to people with epilepsy.

Body image dissatisfaction: A novel predictor of poor quality of life in epilepsy.

Objective: People with epilepsy have long reported reduced quality of life (QoL) compared to healthy peers. This initial study seeks to broaden our understanding of QoL in adults with epilepsy, by examining the adverse impact of body image dissatisfaction for the first time. This aim stems from the observation that both seizures and their medical treatment can cause unwanted changes to physical appearances, such as weight change, hirsutism, and acne.

Childhood trauma in patients with epileptic vs nonepileptic seizures.

Objective: Childhood trauma has been implicated as a risk factor for the etiology of psychogenic nonepileptic seizures (PNES). Relatively little attention has been paid to whether profiles of specific trauma types differ between patients with epilepsy and PNES. Investigating childhood trauma profiles in these patient groups may identify psychological vulnerabilities that predispose to developing PNES, and aid early diagnoses, prevention, and treatment.