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  • 1
    Online Resource
    Online Resource
    Analysis of shared heritability in common disorders of the brain
    American Association for the Advancement of Science (AAAS) ; 2018
    In:  Science Vol. 360, No. 6395 ( 2018-06-22)
    Details
    In: Science, American Association for the Advancement of Science (AAAS), Vol. 360, No. 6395 ( 2018-06-22)
    Abstract: Disorders of the brain can exhibit considerable epidemiological comorbidity and often share symptoms, provoking debate about their etiologic overlap. We quantified the genetic sharing of 25 brain disorders from genome-wide association studies of 265,218 patients and 784,643 control participants and assessed their relationship to 17 phenotypes from 1,191,588 individuals. Psychiatric disorders share common variant risk, whereas neurological disorders appear more distinct from one another and from the psychiatric disorders. We also identified significant sharing between disorders and a number of brain phenotypes, including cognitive measures. Further, we conducted simulations to explore how statistical power, diagnostic misclassification, and phenotypic heterogeneity affect genetic correlations. These results highlight the importance of common genetic variation as a risk factor for brain disorders and the value of heritability-based methods in understanding their etiology.
    Type of Medium: Online Resource
    ISSN: 0036-8075 , 1095-9203
    URL: Article
    DOI: 10.1126/science.aap8757
    RVK:
    TA 1000
    RVK:
    WA 15000
    Language: English
    Publisher: American Association for the Advancement of Science (AAAS)
    Publication Date: 2018
    detail.hit.zdb_id: 128410-1
    detail.hit.zdb_id: 2066996-3
    detail.hit.zdb_id: 2060783-0
    SSG: 11
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  • 2
    Online Resource
    Online Resource
    Antiepileptic Drugs Impair Shortening of Isolated Cardiomyocytes
    Frontiers Media SA ; 2017
    In:  Frontiers in Neurology Vol. 8 ( 2017-04-03)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 8 ( 2017-04-03)
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2017.00133
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2017
    detail.hit.zdb_id: 2564214-5
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  • 3
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    First epileptic seizure and epilepsies in adulthood : Abridged version of the S2k guideline of the German Society for Neurology in cooperation with the German Society for Epileptology
    Springer Science and Business Media LLC ; 2024
    In:  Clinical Epileptology
    Details
    In: Clinical Epileptology, Springer Science and Business Media LLC
    Abstract: The new S2k guideline “First epileptic seizure and epilepsies in adulthood” provides recommendations on clinically relevant issues in five major topics: management of first epileptic seizures, pharmacotherapy, epilepsy surgery, complementary and supportive treatment, and psychosocial aspects. For the topic management of first epileptic seizures , the guideline provides recommendations on identifying the two major differential diagnoses, syncope and psychogenic non-epileptic seizure. The importance of additional examinations such as EEG, MRI and cerebrospinal fluid for syndromic classification and etiological allocation is discussed. Recommendations on neuropsychological and psychiatric screening tests are also given. The topic pharmacotherapy issues recommendations on antiseizure medication in monotherapy for focal, generalized and unclassified epilepsies; patient groups with special challenges such as the aged, women of childbearing potential and people with mental retardation are emphasized. Further issues are indications for measuring serum concentrations of antiseizure medication and possible risks of switching manufacturers. In the topic epilepsy surgery , indications for presurgical assessment and the multiple therapeutic approaches, such as resection, laser ablation, and neurostimulation are presented. Recommendations on postoperative management of patients, including rehabilitation and psychosocial counselling, are given. The topic complementary and supportive therapeutic approaches comprises recommendations on the diagnostics and treatment of common psychiatric comorbidities of epilepsy, such as anxiety disorder, depression and psychosis. Another important issue is the management of psychogenic non-epileptic seizures as a neuropsychiatric differential diagnosis or comorbidity of epileptic seizures. Furthermore, recommendations on the potential role of ketogenic diet and on acupuncture, homeopathy and other complementary approaches are made. The recommendations on psychosocial aspects comprise practical issues, such as fitness to drive a car, training and occupation, medical rehabilitation, sport, transition, patients’ self-help, education programs for patients and next of kin, adherence, advise on SUDEP.
    Type of Medium: Online Resource
    ISSN: 2948-104X , 2948-1058
    URL: Article
    DOI: 10.1007/s10309-024-00663-y
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2024
    detail.hit.zdb_id: 3154797-7
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  • 4
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    Online Resource
    How coupled slow oscillations, spindles and ripples coordinate neuronal processing and communication during human sleep
    Springer Science and Business Media LLC ; 2023
    In:  Nature Neuroscience Vol. 26, No. 8 ( 2023-08), p. 1429-1437
    Details
    In: Nature Neuroscience, Springer Science and Business Media LLC, Vol. 26, No. 8 ( 2023-08), p. 1429-1437
    Abstract: Learning and plasticity rely on fine-tuned regulation of neuronal circuits during offline periods. An unresolved puzzle is how the sleeping brain, in the absence of external stimulation or conscious effort, coordinates neuronal firing rates (FRs) and communication within and across circuits to support synaptic and systems consolidation. Using intracranial electroencephalography combined with multiunit activity recordings from the human hippocampus and surrounding medial temporal lobe (MTL) areas, we show that, governed by slow oscillation (SO) up-states, sleep spindles set a timeframe for ripples to occur. This sequential coupling leads to a stepwise increase in (1) neuronal FRs, (2) short-latency cross-correlations among local neuronal assemblies and (3) cross-regional MTL interactions. Triggered by SOs and spindles, ripples thus establish optimal conditions for spike-timing-dependent plasticity and systems consolidation. These results unveil how the sequential coupling of specific sleep rhythms orchestrates neuronal processing and communication during human sleep.
    Type of Medium: Online Resource
    ISSN: 1097-6256 , 1546-1726
    URL: Article
    DOI: 10.1038/s41593-023-01381-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1494955-6
    SSG: 12
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  • 5
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    Online Resource
    Sudden unexpected death in epilepsy : mechanisms, prevalence, and prevention
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Current Opinion in Neurology Vol. 25, No. 2 ( 2012-04), p. 201-207
    Details
    In: Current Opinion in Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 2 ( 2012-04), p. 201-207
    Type of Medium: Online Resource
    ISSN: 1350-7540
    URL: Article
    DOI: 10.1097/WCO.0b013e3283506714
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 2026967-5
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  • 6
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    Online Resource
    Structural network topology in limbic encephalitis is associated with amygdala enlargement, memory performance and serostatus
    Wiley ; 2020
    In:  Epilepsia Vol. 61, No. 10 ( 2020-10)
    Details
    In: Epilepsia, Wiley, Vol. 61, No. 10 ( 2020-10)
    Abstract: Limbic encephalitis (LE) forms a spectrum of autoimmune diseases involving temporal lobe epilepsy and memory impairment. Imaging features of LE are known to depend on the associated antibody and to occur on the brain network level. However, first studies investigating brain networks in LE have either focused on one distinct antibody subgroup or on distinct anatomical regions. In this study, brain graphs of 17 LE patients with autoantibodies against glutamic acid decarboxylase 65 (GAD‐LE), four LE patients with autoantibodies against leucine‐rich glioma‐inactivated 1, five LE patients with autoantibodies against contactin‐associated protein‐like 2, 26 age‐ and gender‐matched healthy control subjects, and 20 epilepsy control patients with hippocampal sclerosis were constructed based on T1‐weighted structural magnetic resonance imaging scans and diffusion tensor imaging. GAD‐LE showed significantly altered global network topology in terms of integration and segregation as compared to healthy controls and patients with hippocampal sclerosis ( P   〈  .01, analysis of variance with Tukey‐Kramer post hoc tests). Linear regression linked global network measures with amygdala volume and verbal memory performance ( P   〈  .05). Alterations of local network topology show serotype dependence in hippocampus, amygdala, insula, and various cortical regions. Our findings reveal serotype‐dependent patterns of structural connectivity and prove the relevance of in silico network measures on clinical grounds.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v61.10
    DOI: 10.1111/epi.16691
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2002194-X
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  • 7
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    Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs
    Wiley ; 2016
    In:  Epilepsia Vol. 57, No. S1 ( 2016-01), p. 4-16
    Details
    In: Epilepsia, Wiley, Vol. 57, No. S1 ( 2016-01), p. 4-16
    Abstract: The risk of dying suddenly and unexpectedly is increased 24‐ to 28‐fold among young people with epilepsy compared to the general population, but the incidence of sudden unexpected death in epilepsy ( SUDEP ) varies markedly depending on the epilepsy population. This article first reviews risk factors and biomarkers for SUDEP with the overall aim of enabling identification of epilepsy populations with different risk levels as a background for a discussion of possible intervention strategies. The by far most important clinical risk factor is frequency of generalized tonic–clonic seizures ( GTCS ), but nocturnal seizures, early age at onset, and long duration of epilepsy have been identified as additional risk factors. Lack of antiepileptic drug ( AED ) treatment or, in the context of clinical trials, adjunctive placebo versus active treatment is associated with increased risks. Despite considerable research, reliable electrophysiologic (electrocardiography [ ECG ] or electroencephalography [ EEG ]) biomarkers of SUDEP risk remain to be established. This is an important limitation for prevention strategies and intervention studies. There is a lack of biomarkers for SUDEP , and until validated biomarkers are found, the endpoint of interventions to prevent SUDEP must be SUDEP itself. These interventions, be they pharmacologic, seizure‐detection devices, or nocturnal supervision, require large numbers. Possible methods for assessing prevention measures include public health community interventions, self‐management, and more traditional (and much more expensive) randomized clinical trials.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.2016.57.issue-S1
    DOI: 10.1111/epi.13234
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2002194-X
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  • 8
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    Predictors of focal to bilateral tonic‐clonic seizures during long‐term video‐EEG monitoring
    Wiley ; 2020
    In:  Epilepsia Vol. 61, No. 3 ( 2020-03), p. 489-497
    Details
    In: Epilepsia, Wiley, Vol. 61, No. 3 ( 2020-03), p. 489-497
    Abstract: To determine predictors of focal to bilateral tonic‐clonic seizures (FBTCS) during video–electroencephalography (EEG) monitoring (VEM). Methods All adult patients undergoing presurgical VEM from 2014 to 2015 in the department of epileptology were eligible (N = 229). Those with refractory focal epilepsy and epileptic seizures recorded during VEM were analyzed (N = 188, Group 1). To assess the effects of antiepileptic drug (AED) taper, the total AED load was calculated as the sum of the ratios of prescribed daily dose and defined daily dose of all AEDs per VEM day and was correlated with the occurrence of focal seizures without bilateral tonic‐clonic seizures (FwoBTCS) and FBTCS. To validate the findings, data of patients undergoing VEM in 2004 and 2005 (Group 2, eligible N = 243, analyzed N = 203) were also investigated. Results In Group 1, 53 patients had FBTCS and 135 patients had exclusively FwoBTCS during VEM. Reduced AED load at seizure onset was the most important modifiable risk factor for FBTCS (receiver‐operating characteristic [ROC]: area under the curve [AUC]  = 0.78). Furthermore, the risk of FBTCS varied with the history and frequency of FBTCS prior to VEM. For instance, patients had a 50% risk of FBTCS by reducing the AED load to ~20% when no information about history of FBTCS was taken into account, to ~30% when a positive history of FBTCS was taken into account, and to ~50% when a high frequency of FBTCS prior to VEM was taken into account. These findings were largely replicated in Group 2 (59 patients with FBTCS and 144 exclusively with FwoBTCS). Significance The risk of FTBCS during VEM depends on the history and frequency of FTBCS prior to VEM and is particularly associated with the extent of AED reduction. Our data underscore the need for appropriate tapering regimens in VEM units.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v61.3
    DOI: 10.1111/epi.16454
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2002194-X
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  • 9
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    Online Resource
    Performance of ECG‐based seizure detection algorithms strongly depends on training and test conditions
    Wiley ; 2021
    In:  Epilepsia Open Vol. 6, No. 3 ( 2021-09), p. 597-606
    Details
    In: Epilepsia Open, Wiley, Vol. 6, No. 3 ( 2021-09), p. 597-606
    Abstract: To identify non‐EEG‐based signals and algorithms for detection of motor and non‐motor seizures in people lying in bed during video‐EEG (VEEG) monitoring and to test whether these algorithms work in freely moving people during mobile EEG recordings. Methods Data of three groups of adult people with epilepsy (PwE) were analyzed. Group 1 underwent VEEG with additional devices (accelerometry, ECG, electrodermal activity); group 2 underwent VEEG; and group 3 underwent mobile EEG recordings both including one‐lead ECG. All seizure types were analyzed. Feature extraction and machine‐learning techniques were applied to develop seizure detection algorithms. Performance was expressed as sensitivity, precision, F 1 score, and false positives per 24 hours. Results The algorithms were developed in group 1 (35 PwE, 33 seizures) and achieved best results ( F 1 score 56%, sensitivity 67%, precision 45%, false positives 0.7/24 hours) when ECG features alone were used, with no improvement by including accelerometry and electrodermal activity. In group 2 (97 PwE, 255 seizures), this ECG‐based algorithm largely achieved the same performance ( F 1 score 51%, sensitivity 39%, precision 73%, false positives 0.4/24 hours). In group 3 (30 PwE, 51 seizures), the same ECG‐based algorithm failed to meet up with the performance in groups 1 and 2 ( F 1 score 27%, sensitivity 31%, precision 23%, false positives 1.2/24 hours). ECG‐based algorithms were also separately trained on data of groups 2 and 3 and tested on the data of the other groups, yielding maximal F 1 scores between 8% and 26%. Significance Our results suggest that algorithms based on ECG features alone can provide clinically meaningful performance for automatic detection of all seizure types. Our study also underscores that the circumstances under which such algorithms were developed, and the selection of the training and test data sets need to be considered and limit the application of such systems to unseen patient groups behaving in different conditions.
    Type of Medium: Online Resource
    ISSN: 2470-9239 , 2470-9239
    URL: Issue
    URL: Article
    DOI: 10.1002/epi4.v6.3
    DOI: 10.1002/epi4.12520
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2863427-5
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  • 10
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    Online Resource
    Digital health applications in the self‐management of epilepsy—A survey on patients' perspective
    Wiley ; 2023
    In:  Epilepsia Open
    Details
    In: Epilepsia Open, Wiley
    Abstract: Digital health applications can be prescribed since 2019 in Germany, which is likely to facilitate a broad use of epilepsy self‐management applications, possibly directly connected to clinical systems via telematics infrastructures. This article reports on patients' interest in digital support for epilepsy self‐management, influencing factors and patients' knowledge about digitization of health care in Germany. Methods This work is based on self‐reported data from 115 people with epilepsy participating in an anonymous online survey with a total of 54 questions covering several topics, including sociodemographics and epilepsy manifestation, use of technology in general and for treatment support, training programs, affinity for technology, knowledge on the digital infrastructure in Germany, and self‐efficacy in dealing with chronic illness. The self‐constructed questionnaire uses existing instruments like TA‐EG, SES6G, and Hoffmeyer‐Zlotnik sociodemographic questionnaire. To analyze the knowledge about digitalization in health care, a combination of self‐assessment and knowledge quiz was used. The analysis was performed using descriptive methods and inferential statistics ( t ‐test, reliability analysis, and correlations). Results Participants were most interested in seizure alerting and documentation with the possibility to share documentation with physicians. The analysis of technology affinity showed medium enthusiasm, with positively perceived consequences being rated higher than the negatively perceived consequences of technology use. Knowledge on national health infrastructures was mediocre and training on this was judged to be essential and desired. Furthermore, a significant correlation was found between interest in use and affinity for technology (enthusiasm for technology [ r  = 0.29; P  = 0.00]) and positively perceived consequences of technology ( r  = 0.33; P  = 0.00). Significance Our results underline the high relevance of digital solutions for patients and the importance of individual training opportunities in digital health literacy, thereby enabling patients to decide competently for or against offered digital solutions.
    Type of Medium: Online Resource
    ISSN: 2470-9239 , 2470-9239
    URL: Article
    DOI: 10.1002/epi4.12788
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2863427-5
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