What determines the timing of epilepsy surgery in children with cortical malformations and low-grade epilepsy-associated tumors?

Objectives: Timely referral and efficient presurgical evaluation are important to optimize postoperative seizure and developmental outcomes in epilepsy surgery patients. We aimed to identify determinants of time intervals from epilepsy diagnosis to referral to specialized centers and epilepsy surgery in children with malformations of cortical development (MCDs) and low-grade epilepsy-associated tumors (LEATs).

Methods: We performed a retrospective cohort study in 3 European centers, including children with MCD or LEAT who underwent epilepsy surgery between 2010 and 2020.

Antiseizure medication reduction in long-term video-electroencephalographic monitoring for presurgical evaluation: A multicenter safety and efficacy analysis.

Objective: In people with refractory focal epilepsy, long-term video-electroencephalographic monitoring (LT-VEEG) is a valuable tool for surgical evaluation. Antiseizure medication (ASM) is often tapered during LT-VEEG. ASM reduction may increase the risk of complications such as status epilepticus, and efficacy has not been established.

B-STARS2: Early contralesional continuous theta burst stimulation (cTBS) to promote upper limb recovery after stroke - Rationale and design of a phase-3 multicentre, randomised, sham-controlled, clinical trial.

Rationale: Many stroke survivors have persisting upper limb impairment. In a phase-2 trial, early contralesional continuous theta burst stimulation (cTBS) improved upper limb recovery and functional outcome after stroke, but confirmation of this benefit in a larger, phase-3 trial is required before this can be recommended as standard of care.

Aim: We aim to assess whether 10 sessions of cTBS of the contralesional primary motor cortex, combined with regular care upper limb training, started within 3 weeks after stroke onset and continued for 2 weeks, reduces upper limb impairment at 90 days after stroke as compared to sham stimulation.

Exploring determinants of time to school re-entry after pediatric epilepsy surgery.

After epilepsy surgery, it varies when children re-enter school. The aim of this study was to identify determinants for this variation. Parents of 21 school-attending children participated in semi-structured interviews during their child's hospitalization for epilepsy surgery and one year afterward (based on the standard neuropsychological post-surgical follow-up).

Blueprint for clinical N-of-1 strategies with off-label precision treatments in monogenic epilepsies.

Precision treatments for monogenic epilepsies, i.e. treatments that can at least partially reverse the biochemical consequences of a pathogenic gene variant, have been gradually emerging over the years.

Comparison of children and adults undergoing subdural grid electrode implantation or stereoelectroencephalography in a refractory epilepsy cohort from four European centers.

Objective: Children with refractory focal epilepsy differ from adults, although many centers will offer invasive electroencephalography (iEEG) to both. Outcomes in terms of likelihood of resection and subsequent seizure outcome after either subdural grid electrode implantation (SDE) or stereoelectroencephalography (SEEG) have, however, not been directly compared between age groups.

Methods: We retrospectively included adults and children undergoing iEEG monitoring at four European centers.

Determinants of intellectual and developmental outcomes in a multicenter pediatric hemispherotomy cohort.

Objective: This study aimed to identify the determinants of intellectual and developmental outcomes following pediatric hemispherotomy in a large, contemporary multicenter cohort.

Methods: We retrospectively analyzed the intellectual and developmental outcomes of 296 children and adolescents who underwent hemispherotomy between 2000 and 2016 and received a standardized postsurgical evaluation of intelligence or developmental quotient (IQ/DQ). Outcomes at the last follow-up were classified into four categories: normal (IQ/DQ > 85), mildly impaired (IQ/DQ = 70-84), moderately impaired (IQ/DQ = 55-69), or severely impaired (IQ/DQ < 55).

Machine learning for (non-)epileptic tissue detection from the intraoperative electrocorticogram.

Objective: Clinical visual intraoperative electrocorticography (ioECoG) reading intends to localize epileptic tissue and improve epilepsy surgery outcome. We aimed to understand whether machine learning (ML) could complement ioECoG reading, how subgroups affected performance, and which ioECoG features were most important.

Methods: We included 91 ioECoG-guided epilepsy surgery patients with Engel 1A outcome.

Three Prospective Case Studies Examining Mifepristone's Efficacy in Patients with Treatment-Resistant PTSD.

Despite the availability of various treatment approaches for patients with posttraumatic stress disorder (PTSD), some patients do not respond to these therapies, and novel treatment approaches are needed. This study investigated the efficacy of mifepristone, a glucocorticoid receptor antagonist, in treatment-resistant PTSD patients. Three patients with PTSD who were resistant to standard psychological and pharmacological treatments were prescribed mifepristone (600-1,200 mg/day) for 1 week.

Footprint of publication selection bias on meta-analyses in medicine, environmental sciences, psychology, and economics.

Publication selection bias undermines the systematic accumulation of evidence. To assess the extent of this problem, we survey over 68,000 meta-analyses containing over 700,000 effect size estimates from medicine (67,386/597,699), environmental sciences (199/12,707), psychology (605/23,563), and economics (327/91,421). Our results indicate that meta-analyses in economics are the most severely contaminated by publication selection bias, closely followed by meta-analyses in environmental sciences and psychology, whereas meta-analyses in medicine are contaminated the least.

Variation in seizure risk increases from antiseizure medication withdrawal among patients with well-controlled epilepsy: A pooled analysis.

Objective: Guidelines suggest considering antiseizure medication (ASM) discontinuation in seizure-free patients with epilepsy. Past work has poorly explored how discontinuation effects vary between patients. We evaluated (1) what factors modify the influence of discontinuation on seizure risk; and (2) the range of seizure risk increase due to discontinuation across low- versus high-risk patients.

Determinants of Functional Outcome after Pediatric Hemispherotomy.

Objective: We aimed to evaluate determinants of functional outcome after pediatric hemispherotomy in a large and recent multicenter cohort.

Methods: We retrospectively investigated the functional outcomes of 455 children who underwent hemispherotomy at 5 epilepsy centers in 2000-2016. We identified determinants of unaided walking, voluntary grasping with the hemiplegic hand, and speaking through Bayesian multivariable regression modeling using missing data imputation.

Methodology reporting improved over time in 176,469 randomized controlled trials.

Objectives: To describe randomized controlled trial (RCT) methodology reporting over time.

Study Design And Setting: We used a deep learning-based sentence classification model based on the Consolidated Standards of Reporting Trials (CONSORT) statement, considered minimum requirements for reporting RCTs. We included 176,469 RCT reports published between 1966 and 2018.

Continuous Theta-Burst Stimulation of the Contralesional Primary Motor Cortex for Promotion of Upper Limb Recovery After Stroke: A Randomized Controlled Trial.

Background: Despite improvements in acute stroke therapies and rehabilitation strategies, many stroke patients are left with long-term upper limb motor impairment. We assessed whether an inhibitory repetitive transcranial magnetic stimulation treatment paradigm started within 3 weeks after stroke onset promotes upper limb motor recovery.

Methods: We performed a single-center randomized, sham-controlled clinical trial.

Antiseizure Medication Withdrawal Practice Patterns: A Survey Among Members of the American Academy of Neurology and EpiCARE.

Background And Objectives: To describe neurologist practice patterns, challenges, and decision support needs pertaining to withdrawal of antiseizure medications (ASMs) in patients with well-controlled epilepsy.

Methods: We sent an electronic survey to (1) US and (2) European physician members of the American Academy of Neurology and (3) members of EpiCARE, a European Reference Network for rare and complex epilepsies. Analyses included frequencies and percentages, and we showed distributions through histograms and violin plots.

Unrestricted weighted least squares represent medical research better than random effects in 67,308 Cochrane meta-analyses.

Objectives: To evaluate how well meta-analysis mean estimators represent reported medical research and establish which meta-analysis method is better using widely accepted model selection measures: Akaike information criterion (AIC) and Bayesian information criterion (BIC).

Study Design And Setting: We compiled 67,308 meta-analyses from the Cochrane Database of Systematic Reviews (CDSR) published between 1997 and 2020, collectively encompassing nearly 600,000 medical findings. We compared unrestricted weighted least squares (UWLS) vs.

Not surgical technique, but etiology, contralateral MRI, prior surgery, and side of surgery determine seizure outcome after pediatric hemispherotomy.

Objective: We aimed to assess determinants of seizure outcome following pediatric hemispherotomy in a contemporary cohort.

Methods: We retrospectively analyzed the seizure outcomes of 457 children who underwent hemispheric surgery in five European epilepsy centers between 2000 and 2016. We identified variables related to seizure outcome through multivariable regression modeling with missing data imputation and optimal group matching, and we further investigated the role of surgical technique by Bayes factor (BF) analysis.

Antiseizure medication withdrawal risk estimation and recommendations: A survey of American Academy of Neurology and EpiCARE members.

Objective: Choosing candidates for antiseizure medication (ASM) withdrawal in well-controlled epilepsy is challenging. We evaluated (a) the correlation between neurologists' seizure risk estimation ("clinician predictions") vs calculated predictions, (b) how viewing calculated predictions influenced recommendations, and (c) barriers to using risk calculation.

Methods: We asked US and European neurologists to predict 2-year seizure risk after ASM withdrawal for hypothetical vignettes.