Behavioral phenotypes of temporal lobe epilepsy

Hermann, Bruce P.; Struck, Aaron F.; Dabbs, Kevin; Seidenberg, Mike; Jones, Jana E.

doi:10.1002/epi4.12488

Cited by 10 publications

(19 citation statements)

References 50 publications

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“…Although Cluster 3 demonstrated greater severity of behavioral concerns overall, it made up a small proportion of the TLE cohort indicating that the internalizing cluster is less common but a highly relevant clinical group. Unlike previous reports, 29 the behavioral phenotype groups identified here were characterized by specific psychopathological features as opposed to a progressive increase in psychopathology, which may reflect the BASC as a more sensitive measure.…”

Section: Behavioral Phenotypescontrasting

confidence: 87%

“…Clusters 2 and 3 demonstrated greater impairment in motor, immediate memory, and delayed memory factors. Cluster 3 demonstrated further challenges with language, motor functioning, and delayed memory, representing the notion that cognitive and behavioral abnormalities “travel together” and reflect a model of multimorbidity 21,28,29 . Another important factor to consider is whether difficulties with motor speed and memory performance may also be related directly to mood concerns.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with TLE demonstrated worse behavioral problems compared to controls and cluster analysis identified three phenotypes: normal (Cluster 1, 42% of sample), mildly abnormal (Cluster 2, 35% of sample), and globally impaired (Cluster 3, 23% of sample). Significant associations were observed between cluster membership and education, perceived seizure severity, bitemporal lobe seizure onset, and neuropsychological functioning; however, structural imaging was only minimally associated with cluster groupings 29 …”

Section: Introductionmentioning

confidence: 91%

“…This finding was intriguing given an extensive literature on behavioral challenges in TLE, yet consistent with previous work characterizing behavioral phenotypes in pediatric and adult epilepsy. 28,29 Therefore, only considering the generally available elevated mean scores on measures of psychopathology in pediatric TLE hides the substantial proportion of grossly normal youth.…”

Section: Behavioral Phenotypesmentioning

confidence: 99%

“…Significant associations were observed between cluster membership and education, perceived seizure severity, bitemporal lobe seizure onset, and neuropsychological functioning; however, structural imaging was only minimally associated with cluster groupings. 29 A comparable approach has not been undertaken to identify syndrome-specific behavioral phenotypes in pediatric TLE, which is the primary purpose of this work. Using a common parent-questionnaire of child behavioral and emotional problems, the aims of this particular investigation were to: (1) apply a cluster analytic approach to identify latent patient groups indicative of types/patterns and varying risk of psychopathology in pediatric TLE; (2) identify correlates of phenotypic membership including demographic (age, gender, minority status), seizure-related (age at onset, seizure frequency, current antiseizure medication (ASM), failed ASMs, seizure laterality, hippocampal sclerosis, referral type), psychosocial…”

Section: Introductionmentioning

confidence: 99%

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Behavioral phenotypes of pediatric temporal lobe epilepsy

et al. 2022

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Objective A broad spectrum of emotional‐behavioral problems have been reported in pediatric temporal lobe epilepsy (TLE), but with considerable variability in their presence and nature of expression, which hampers precise identification and treatment. The present study aimed to empirically identify latent patterns or behavioral phenotypes and their correlates. Methods Data included parental ratings of emotional‐behavioral status on the Behavior Assessment System for Children, 2nd Edition (BASC‐2) of 81 children (mean age = 11.79, standard deviation [SD] = 3.93) with TLE. The nine clinical subscales were subjected to unsupervised machine learning to identify behavioral subgroups. To explore concurrent validity and the underlying composition of the identified clusters, we examined demographic factors, seizure characteristics, psychosocial factors, neuropsychological performance, psychiatric status, and health‐related quality of life (HRQoL). Results Three behavioral phenotypes were identified, which included no behavioral concerns (Cluster 1, 43% of sample), externalizing problems (Cluster 2, 41% of sample), and internalizing problems (Cluster 3, 16% of sample). Behavioral phenotypes were characterized by important differences across clinical seizure variables, psychosocial/familial factors, everyday executive functioning, and HRQoL. Cluster 2 was associated with younger child age, lower maternal education, and higher rate of single‐parent households. Cluster 3 was associated with older age at epilepsy onset and higher rates of hippocampal sclerosis and parental psychiatric history. Both Cluster 2 and 3 demonstrated elevated family stress. Concurrent validity was demonstrated through the association of psychiatric (i.e., rate of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) disorders and psychotropic medication) and parent‐rated HRQoL variables. Significance Youth with TLE present with three distinct behavioral phenotypes that correspond with important clinical and sociodemographic markers. The current findings demonstrate the variability of behavioral presentations in youth with TLE and provide a preliminary framework for screening and targeting intervention to enhance support for youth with TLE and their families.

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Section: Behavioral Phenotypescontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Behavioral Phenotypesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Behavioral phenotypes of pediatric temporal lobe epilepsy

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Behavioral phenotypes of temporal lobe epilepsy

et al. 2021

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Advances in understanding the pathogenesis of epilepsy: Unraveling the molecular mechanisms

Shariff,

Nouh,

Inshutiyimana

et al. 2024

Health Science Reports

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IntroductionEpilepsy is characterized by having two or more unprovoked seizures. Understanding the pathogenesis of epilepsy, requires deep investigation into the molecular mechanisms. This helps develop diagnostic techniques, treatments, and pharmacotherapy. It also enhances precision medicine and individualized treatment processes. This article reviews all the molecular mechanisms predisposing to epileptogenesis, presents the current diagnostic techniques and drug therapy, and suggests future perspectives in treating Epilepsy in a more comprehensive and holistic approach.MethodologyFour authors searched keywords concerning epilepsy at a molecular level, Epilepsy diagnostic techniques and technologies, and antiepileptic drug therapy and precision medicine. Separate search strategies were conducted for each concern and retrieved articles were reviewed for relevant results.ResultsThe traditional diagnostic techniques for Epilepsy and its pathogenesis are insufficient in highlighting dynamic brain changes. For this, emerging technologies including genetic sequencing and profiling, and functional neuroimaging techniques are prevailing. Concerning treatment, the current approach focuses on managing symptoms and stopping seizures using antiseizure medications. However, their usage is limited by developing resistance to such drugs. Some therapies show promise, although most antiseizure drugs do not prevent epilepsy.DiscussionUnderstanding epileptogenesis at a molecular and genetic level aids in developing new antiepileptic pharmacotherapy. The aim is to develop therapies that could prevent seizures or modify disease course, decreasing the severity and avoiding drug resistance. Gene therapy and precision medicine are promising but applications are limited due to the heterogeneity in studying the Epileptic brain, dynamically. The dynamic investigation of the epileptic brain with its comorbidities works hand‐in‐hand with precision medicine, in developing personalized treatment plans.

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Behavioral phenotypes of temporal lobe epilepsy

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 10 publications

References 50 publications

Behavioral phenotypes of pediatric temporal lobe epilepsy

Behavioral phenotypes of pediatric temporal lobe epilepsy

Behavioral phenotypes of temporal lobe epilepsy

Advances in understanding the pathogenesis of epilepsy: Unraveling the molecular mechanisms

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