Abstract:
OBJECTIVES:To test the hypothesis that neuropsychiatric symptomatology is predictive of the success of seizure control in patients newly treated with antiepileptic drugs (AEDs), and that this predictive value adds to that provided by other clinical, imaging, and genomic factors in a multivariate model. METHODS:One hundred seventy newly treated patients with epilepsy completed the A-B Neuropsychological Assessment Scale (ABNAS) before commencing AED therapy and were prospectively followed up for 12 months. Patients were classified as nonresponsive if they had at least 1 seizure not explained by medication noncompliance or other significant provoking factors. RESULTS:Of the 138 patients in whom a drug response phenotype at 12 months was able to be determined, nonresponsive patients (n = 45) had a higher pretreatment ABNAS score than patients whose seizures were controlled (n = 93) (p = 0.007). A lesion on MRI was also associated with a higher risk of seizure recurrence (p = 0.003). On multivariate logistic regression, the ABNAS score, the MRI results, and a genomic classifier were all independently predictive of treatment outcome. For AED pharmacoresponse, this multivariate model had diagnostic values of 91% sensitivity, 64% specificity, 84% positive predictive, and 78% negative predictive values. The predictive value of the ABNAS score was validated in a second prospective cohort of 74 newly treated patients with epilepsy (p = 0.005). CONCLUSIONS:The ABNAS provides prognostic information regarding successful seizure control in patients newly treated with AEDs. Furthermore, these results demonstrate the multifactorial nature of the determinants of AED response, with neuropsychological, structural, and genomic factors all contributing to the complex response phenotype.
journal_name
Neurologyjournal_title
Neurologyauthors
Petrovski S,Szoeke CE,Jones NC,Salzberg MR,Sheffield LJ,Huggins RM,O'Brien TJdoi
10.1212/WNL.0b013e3181f25b16subject
Has Abstractpub_date
2010-09-14 00:00:00pages
1015-21issue
11eissn
0028-3878issn
1526-632Xpii
75/11/1015journal_volume
75pub_type
杂志文章相关文献
NEUROLOGY文献大全abstract:BACKGROUND:Patients with ALS commonly exhibit pseudobulbar affect. METHODS:The authors conducted a multicenter, randomized, double-blind, controlled, parallel, three-arm study to test a defined combination of dextromethorphan hydrobromide (DM) and quinidine sulfate (Q) (AVP-923) for the treatment of pseudobulbar affec...
journal_title:Neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1212/01.wnl.0000142042.50528.2f
更新日期:2004-10-26 00:00:00
abstract::Our understanding of the pathogenesis of Alzheimer's disease (AD) had advanced rapidly, particularly in the area of genetics. Clinical trials of agents that offer the promise of going beyond symptomatic treatment to actually slowing the progression of disease, perhaps by enhancing the viability of neurons, are under w...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.48.5_suppl_7.2s
更新日期:1997-05-01 00:00:00
abstract::Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis (HS) and a history of febrile convulsions (HFC). The authors investigated 292 patients with TLE due to HS. Left HS occurred more frequently (57%) than right HS (43%, p = 0.01). Forty-seven percent of the patients had HFC. In patients with...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/01.wnl.0000052823.29467.a0
更新日期:2003-04-08 00:00:00
abstract::We measured plasma norepinephrine levels in patients with familial amyloid polyneuropathy. Patients with orthostatic hypotension had low basal plasma norepinephrine levels, which did not increase after postural change. On the basis of biochemical findings that suggest depletion of peripheral norepinephrine, DL-threo-3...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.31.10.1323
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To determine whether there is a relationship between aortic plaques and intracranial (IC) atherosclerosis. METHODS:We reviewed 922 patients with stroke who had both transesophageal echocardiography and cerebral angiography. The plaques of these patients were classified as either complex aortic plaques (CAP),...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000238511.72927.3c
更新日期:2006-10-10 00:00:00
abstract::The clinical and angiographic correlations of small deep infarcts seen on computed tomography (CT) scan were studied in 297 consecutive patients. Some of these showed the features described by Fisher as part of the lacunar syndrome. In a large number, a source of emboli from either a cardiac or a carotid source was hi...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.30.10.1090
更新日期:1980-10-01 00:00:00
abstract:BACKGROUND:Pharmacologic interventions (e.g., beta blockers) and thalamic lesions have failed to alter the pathophysiology of essential tremor (ET) beyond a reduction in tremor amplitude. Deep brain stimulation (DBS) of the ventral intermediate (VIM) nucleus of the thalamus successfully reduces tremor rating scores. It...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/01.wnl.0000086371.78447.d2
更新日期:2003-10-14 00:00:00
abstract::A man with onset of obsessive-compulsive disorder (OCD) at age 62 had a large right posterior frontal infarct and occlusion of the ipsilateral internal carotid artery. We review additional cases from the literature with obsessive or compulsive behaviors and structural lesions. OCD may have a structural correlate, and ...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.45.12.2130
更新日期:1995-12-01 00:00:00
abstract::We present four patients with typical neonatal onset non-ketotic hyperglycinemia (NKH) who developed hydrocephalus requiring shunting in early infancy. Brain imaging revealed acute hydrocephalus, a megacisterna magna or posterior fossa cyst, pronounced atrophy of the white matter, and an extremely thin corpus callosum...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.54.3.754
更新日期:2000-02-08 00:00:00
abstract::We evaluated the effects of isoniazid on tremor in 13 patients with MS. Patients were evaluated before treatment, after 1 month of therapy (1,000 mg daily), and 1 month after the last dose. Ten patients improved on at least one of three methods of evaluation. Transient side effects were common, possibly because there ...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.35.12.1772
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:In children with sickle cell disease (SCD), silent cerebral infarcts are the most frequent cause of neurologic injury. We determined the sensitivity and specificity of selective neurocognitive measures when separating children with silent cerebral infarcts and SCD from sibling controls. Additionally, we teste...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.50.6.1678
更新日期:1998-06-01 00:00:00
abstract::Inhibitory antibody to von Willebrand factor (vWF)-cleaving protease (ADAMTS13) was detected in a patient with intravascular lymphomatosis. The increased serum level of the antibody paralleled an increase in the expression of uncleaved vWF, which might cause microvascular thrombosis and platelet consumption. Malignant...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000143065.55002.67
更新日期:2004-11-09 00:00:00
abstract:OBJECTIVES:To describe the frequency of cervical arterial abnormalities in children with acute arterial ischemic stroke (AIS), to examine predictors of this, and to characterize observed abnormalities in terms of specific diagnoses. METHODS:Review of case notes of children with AIS (2002-2009) and analysis of their ne...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318205d4d5
更新日期:2011-01-11 00:00:00
abstract::The authors identified a novel mtDNA mutation (T9176G) in the ATPase 6 gene in a family in which a 10-year-old girl had a severe neurodegenerative disorder, her elder sister had died of Leigh syndrome (LS), and a maternal uncle had a spinocerebellar disorder. Biochemical studies disclosed a reduced rate of ATP synthes...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.56.5.687
更新日期:2001-03-13 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the effect of pump-infused intrathecal baclofen infusion (ITB) in therapeutic doses on sleep quality and on daytime and nighttime respiratory function in patients with severe spasticity. METHODS:We prospectively evaluated 20 consecutive patients (mean +/- SD age 45 +/- 13 years). We...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000239827.38036.23
更新日期:2006-10-24 00:00:00
abstract::Two patients with visual agnosia underwent visual recognition and neuropsychological tests to characterize their perceptual functioning. Both had an initial "apperceptive profile" and evolved from cortical blindness. One had carbon monoxide intoxication and incidental agenesis of the splenium of the corpus callosum; t...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.11.1754
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:To analyze the associations between cardiovascular fitness at age 18 years and future risk of epilepsy. METHODS:Population-based cohort study of Swedish male conscripts (n = 1,173,079) born in 1950-1987, who were followed for up to 40 years. Data on cardiovascular fitness were collected during conscription e...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3182a4a4c0
更新日期:2013-09-17 00:00:00
abstract:OBJECTIVE:To analyze differences in functional brain images collected in patients with type 2 and type 1 narcolepsy compared to normal controls and the relationship among brain images, objective neuropsychologic tests, and sleep findings. METHODS:Data collection included comprehensive clinical investigation, study of ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000005346
更新日期:2018-04-24 00:00:00
abstract::We evaluated the relationship between mesial temporal seizure focus and serum prolactin (PRL) in patients before and after they underwent anterior temporal lobectomy (ATL) for medically intractable temporal lobe epilepsy (TLE). These patients had a confirmed unilateral epileptogenic focus in mesial temporal structures...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.49.2.528
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To identify the cause of hypokalemic periodic paralysis (HOKPP) in a family whose disease is not caused by a mutation in the dihydropyridine-sensitive (DHP) receptor alpha1-subunit gene (CACNA1S). BACKGROUND:Hypokalemic periodic paralysis is primarily caused by mutations within CACNA1S. Genetic heterogeneity...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.9.1932
更新日期:1999-12-10 00:00:00
abstract::Motivationally responsive motor deficits may occur in isolation or as part of more general neglect syndromes. We describe three patients with two discrete syndromes of isolated motor neglect, differentiated primarily by their performance in motor tasks enacted within or toward the contralesional hemispace. The lesions...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.45.3.525
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Epidemiologic and laboratory studies suggest that nonsteroidal antiinflammatory drugs (NSAIDs) reduce risk of Alzheimer disease (AD). We therefore investigated the association between use of NSAIDs, aspirin, and the non-NSAID analgesic acetaminophen with incidence of dementia and AD. METHODS:Participants in...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000284596.95156.48
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To investigate patient susceptibility to neuropsychiatric symptoms in the context of progression of more classic motor symptoms in amyotrophic lateral sclerosis (ALS) and to examine the impact of neuropsychiatric symptoms on survival. METHODS:The study cohort consisted of 219 patients with ALS (limb onset =...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000000023
更新日期:2014-01-14 00:00:00
abstract::We used electrophysiologic methods in the diagnosis of torsion dystonia and the evaluation of therapy in a 7-year-old child. Electromyographic (EMG) activity patterns in five leg muscles were recorded during specific voluntary and passive movements as well as during gait. We found patterns of coactivation in leg muscl...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.33.8.1083
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVES:To investigate the relationship between markers of vitamin B(12) status and brain volume loss per year over a 5-year period in an elderly population. METHODS:A prospective study of 107 community-dwelling volunteers aged 61 to 87 years without cognitive impairment at enrollment. Volunteers were assessed year...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000325581.26991.f2
更新日期:2008-09-09 00:00:00
abstract::To determine whether the complete correction of hyperglycemia of diabetes can rapidly improve abnormal peripheral nerve function, eight hyperglycemic insulin-requiring diabetics underwent 3 days of glucose control with an artificial endocrine pancreas, the BIOSTATOR Glucose Controller. Comparison of neurologic assessm...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/wnl.31.11.1375
更新日期:1981-11-01 00:00:00
abstract::Information about 255 children and adults with Pompe disease was gathered through a questionnaire. Disease severity was associated with disease duration and not with age; an early manifestation of the disease implied earlier wheelchair or ventilator dependency. The patient group under age 15 included a subgroup with a...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.WNL.0000165979.46537.56
更新日期:2005-06-28 00:00:00
abstract:OBJECTIVE:To characterize brain functional connectivity in subjects with prechiasmatic visual system damage and relate functional connectivity features to extent of vision loss. METHODS:In this case-control study, resting-state, eyes-closed EEG activity was recorded in patients with partial optic nerve damage (n = 15)...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/WNL.0000000000000672
更新日期:2014-08-05 00:00:00
abstract:OBJECTIVE:The presence of cranial autonomic symptoms often leads to a misdiagnosis of "sinus headache" in adult migraineurs, leading to unnecessary treatments and delaying appropriate migraine therapy. In this study, we examined the frequency of cranial autonomic symptoms in pediatric/adolescent patients with migraine....
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0b013e31829d872a
更新日期:2013-07-30 00:00:00
abstract:OBJECTIVE:To investigate whether the correlation of age and sex with the risk of recurrence and death seen in patients with previous ischemic stroke is also evident in patients with embolic stroke of undetermined source (ESUS). METHODS:We pooled datasets of 11 stroke registries from Europe and America. ESUS was define...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004199
更新日期:2017-08-08 00:00:00