Objective: We conducted a survey to assess vaccination coverage, vaccination willingness, and variables associated with vaccination hesitancy to provide evidence on coronavirus disease (COVID-19) vaccination strategies.Methods: This anonymous questionnaire study conducted a multicenter, cross-sectional survey of outpatients and inpatients with epilepsy (PWE) registered in epilepsy clinics, in 2021, in 10 hospitals in seven cities of Shandong Province.Results: A total of 600 questionnaires were distributed, and 557 valid questionnaires were returned. A total of 130 people were vaccinated against COVID-19. Among 427 unvaccinated participants, 69.32% (296/427) were willing to receive the COVID-19 vaccine in the future, and the remaining 30.68% (131/427) were unwilling to receive vaccination. Most (89.9%) of the participants believed that the role of vaccination was crucial in response to the spread of COVID-19. A significant association was found between willingness to receive the COVID-19 vaccine and the following variables: age, marital status, level of education, occupation, residence, seizure type, and seizure control after antiepileptic drug therapy. It is noteworthy that education level, living in urban areas, and seizure freedom were significantly related to willingness to receive COVID-19 vaccination.Conclusions: Vaccination is a key measure for the prevention and control of COVID-19, and most PWE are willing to be vaccinated. Vaccine safety, effectiveness, and accessibility are essential in combatting vaccine hesitation and increasing vaccination rates.

ObjectivesSeveral COVID-19 vaccines list “uncontrolled epilepsy” as a contraindication for vaccination. This consequently restricts vaccination against COVID-19 in patients with epilepsy (PWE). However, there is no strong evidence that COVID-19 vaccination can exacerbate conditions in PWE. This study aims to determine the impact of COVID-19 vaccination on PWE.MethodsPWE were prospectively recruited from 25 epilepsy centers. We recorded the seizure frequency at three time periods (one month before the first vaccination and one month after the first and second vaccinations). A generalized linear mixed-effects model (GLMM) was used for analysis, and the adjusted incidence rate ratio (AIRR) with 95% CI was presented and interpreted accordingly.ResultsOverall, 859 PWE were included in the analysis. Thirty-one (3.6%) and 35 (4.1%) patients were found to have increased seizure frequency after the two doses, respectively. Age had an interaction with time. The seizure frequency in adults decreased by 81% after the first dose (AIRR=0.19, 95% CI:0.11–0.34) and 85% after the second dose (AIRR=0.16, 95% CI:0.08–0.30). In juveniles (<18), it was 25% (AIRR=0.75, 95% CI:0.42–1.34) and 51% (AIRR=0.49, 95% CI:0.25–0.95), respectively. Interval between the last seizure before vaccination and the first dose of vaccination (ILSFV) had a significant effect on seizure frequency after vaccination. Seizure frequency in PWE with hereditary epilepsy after vaccination was significantly higher than that in PWE with unknown etiology (AIRR=1.95, 95% CI: 1.17–3.24). Two hundred and seventeen (25.3%) patients experienced non-epileptic but not serious adverse reactions.DiscussionThe inactivated COVID-19 vaccine does not significantly increase seizure frequency in PWE. The limitations of vaccination in PWE should focus on aspects other than control status. Juvenile PWE should be of greater concern after vaccination because they have lower safety. Finally, PWE should not reduce the dosage of anti-seizure medication during the peri-vaccination period.

Parkinson's disease (PD) is the second most common neurodegenerative disease in the world. L166P mutant DJ-1 has been linked with a genetic form of the disease. Preventing neurotoxicity of DJ-1 familial mutations has become a new therapeutic target for PD. Adiponectin, the most abundantly secreted adipokine, has displayed its protective roles in pathologies of various types of diseases. In this study, we investigate whether adiponectin is protective against neurotoxicity induced by familial L166P mutant DJ-1 in PD. Our results demonstrate that adiponectin treatment could attenuate increased levels of reactive oxygen species and nitric oxide induced by the DJ-1L166P mutation. In addition, adiponectin could rescue impaired mitochondrial membrane potential induced by DJ-1L166P. Importantly, we verified that both adiponectin receptors, type 1 (AdipoR1) and type 2 (AdipoR2), are expressed in human neuroblastoma M17 cells. Our results also demonstrate that the protective effects of adiponectin against DJ-1L166P-induced neuronal cytotoxicity under 1-methyl-4-phenylpyridinium ion (MPP+) treatment require binding of adiponectin to its cell surface receptors. Finally, we found that the protective effects of adiponectin against DJ-1L166P depend on AMP-activated protein kinase (AMPK) activation mediated by the endosomal adaptor protein, APPL1 (adaptor protein with phosphotyrosine binding, pleckstrin homology domains and leucine zipper motif). These data suggest that adiponectin may have potential for implementation in novel therapies against PD.

Background: Previous study have shown that seizures may occur as a result of vaccination. This study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated with COVID-19 and to provide reference opinions for PWE to receive COVID-19 vaccine.Methods: We retrospectively enrolled PWE patients who were vaccinated against COVID-19 in the epilepsy centers of nine hospitals in China. The binary logistic regression analysis included variables with a P-value less than 0.1 in the univariate analysis.Results: The study included 290 patients, of which 40 (13.8%) developed seizures within 14 days after vaccination, whereas 250 (86.2%) remained seizure-free. The binary logistic regression analysis revealed statistical significance in seizures within three months before vaccination (P<0.001, OR=10.121, 95% CI: 4.301-23.816) and withdrawal or reduction of anti-seizures medications (ASM) during the peri-vaccination period (P=0.027, OR=4.452, 95% CI: 1.182-16.768). In addition, 32 of 33 patients (97.0%) who were seizure-free within three months before vaccination and had normal EEG results before vaccination did not have any seizures within 14 days following vaccination.Conclusions: SARS-CoV-2 may induce epilepsy through an inflammatory cascade. It is recommended to provide the COVID-19 vaccine to seizure-free patients for at least three months before vaccination, and the vaccination is safer if EEG result is normal. During peri-vaccination period, all PWE should be prohibited from reducing ASM dosage. PWE with well-controlled seizures who have discontinued ASM might consider resuming ASM during the peri-vaccination period if their EEG results are aberrant.

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BackgroundEpilepsy is one of the most common neurological diseases, affecting people of any age. Although the treatments of epilepsy are more and more diverse, the uncertainty regarding efficacy and adverse events still exists, especially in the control of childhood epilepsy.MethodsWe performed a systematic review and meta- analysis following the Cochrane Handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Four databases including PubMed, Embase, Web of Science and Cochrane library were searched. Studies reporting the use of brivaracetam monotherapy or adjuvant therapy in children (aged ≤18 years) were eligible for inclusion. Each stage of the review was conducted by two authors independently. Random-effects models were used to combine effect sizes for the estimation of efficacy and safety.ResultsA total of 1884 articles were retrieved, and finally 9 articles were included, enrolling 503 children with epilepsy. The retention rate of BRV treatment was 78% (95% CI: 0.64–0.91), the responder rate (reduction of seizure frequency ≥ 50%) was 35% (95% CI: 0.24–0.47), the freedom seizure rate (no seizure) was 18% (95% CI: 0.10–0.25), and the incidence rate of any treatment-emergent adverse events (TEAE) was 39% (95% CI: 0.09–0.68). The most common TEAE was somnolence, which had an incidence rate of 9% (95% CI: 0.07–0.12). And the incidence rate of mental or behavioral disorders was 12% (95% CI: 0.06–0.17).ConclusionOur systematic review and meta-analysis showed that BRV seemed to be safe and effective in the treatment of childhood epilepsy.

Background: Given that seizures may be triggered by vaccination, this study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy (PWE) after being vaccinated against coronavirus disease 2019 (COVID-19). Methods: This study retrospectively enrolled PWE who were vaccinated against COVID-19 in the epilepsy centers of 11 hospitals in China. We divided the PWE into two groups as follows: (1) patients who developed seizures within 14 days of vaccination were assigned to the SAV (with seizures after vaccination) group; (2) patients who were seizure-free within 14 days of vaccination were assigned to the SFAV (seizure-free after vaccination) group. To identify potential risk factors for seizure reccurence, the binary logistic regression analysis was performed. Besides, 67 PWE who had not been vaccinated were also included for elucidating the effects of vaccination on seizures recurrence, and binary logistic regression analysis was performed to determine whether vaccination would affect the recurrence rate of PWE who had drug reduction or withdrawal. Results: The study included a total of 407 patients; of which, 48 (11.8%) developed seizures within 14 days after vaccination (SAV group), whereas 359 (88.2%) remained seizure-free (SFAV group). The binary logistic regression analysis revealed that duration of seizure freedom ( P < 0.001) and withdrawal from anti-seizure medications (ASMs) or reduction in their dosage during the peri-vaccination period were significantly associated with the recurrence of seizures (odds ratio = 7.384, 95% confidence interval = 1.732–31.488, P = 0.007). In addition, 32 of 33 patients (97.0%) who were seizure-free for more than three months before vaccination and had a normal electroencephalogram before vaccination did not have any seizures within 14 days of vaccination. A total of 92 (22.6%) patients experienced non-epileptic adverse reactions after vaccination. Binary logistic regression analysis results showed that vaccine did not significantly affect the recurrence rate of PWE who had the behavior of ASMs dose reduction or withdrawal ( P = 0.143). Conclusions: PWE need protection from the COVID-19 vaccine. PWE who are seizure-free for >3 months before vaccination should be vaccinated. Whether the remaining PWE should be vaccinated depends on the local prevalence of COVID-19. Finally, PWE should avoid discontinuing ASMs or reducing their dosage during the peri-vaccination period.

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