-OBJECTIVE: When magnetic resonance imaging (MRI) fails to detect an un-derlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower (20%-65% compared with 60%-90% if a lesion is detected). We investigated the possible effects of introducing hybrid 18F-fluo-rodeoxyglucose positron emission tomography (18F-FDG PET)/MRI into the de-cision algorithm for patients with lesioned and nonlesioned drug-resistant epilepsy. -METHODS: Three databases were searched from January 1990 to October 2022. We registered the protocol with International Platform of Registered Systematic Review and Meta-analysis Protocols. Studies in which 18F-FDG PET/ MRI was conducted with double dagger 12 months of postsurgical follow-up in patients with refractory epilepsy. Random-effects meta-analysis was used to calculate the proportion of patients with good outcomes. Metaregression was used to investigate sources of heterogeneity. -RESULTS: We identified 8105 studies, of which 23 (1292 patients in total) were included. The overall good postoperative outcome rate was 71% (95% confi-dence interval 63.6-74.9). Good outcome was associated with the location of the refractory epileptic lesion (temporal lobe or extratemporal; risk ratio 1.27 [95% confidence interval 1.01-1.52], P [ 0.009); Length of postoperative follow-up double dagger 40 months included in the same study accounted for 0.6% of the observed heterogeneity. -CONCLUSIONS: Seventy-one percent of patients with refractory epilepsy and 18F-FDG PET/MRI epileptogenic lesion features had a good outcome of epilepsy after surgery. Our findings can be incorporated into routine preoperative con-sultations and emphasize the importance of the complete resection of the temporal lobe epileptogenic zone for 18F-FDG PET/MRI detection when safe and feasible.

Review question / Objective: The purpose of this study was to examine the prognostic status of PET/MRI on surgery in patients with refractory epilepsy, and the methods chosen were randomized controlled trials, cohort studies, and case series of >15 patients. Condition being studied: Medically intractable epilepsy, characterized by recurrent episodes of tonicity, disorientation, spasms, and convulsions, affects 1-2% of the population because treatment trials with 3 or more different antiepileptic drugs have failed. Patients are selected for PET mainly because other standard noninvasive tests (especially MRI and EEG) fail to provide sufficiently reliable localization to allow precise excision of the epileptogenic zone and a good prognosis.

INPLASY202350054 Surgical effects of stereo EEG and MRI-guided laser interstitial fever in the treatment of refractory epilepsy: a systematic review and meta-analysis Keywords: Refractory epilepsy；…

Background Epilepsy is a neurological disorder caused by abnormal brain discharges. In recent years, genome-wide expression studies (GES) have been conducted using human patient samples and experimental models of epilepsy. Numerous molecular targets for epileptogenesis and treatment have been identified. However, there is still an urgent need to identify new biomarkers for epilepsy. Methods We performed a meta-analysis and convergence analysis of GES available from human samples and mouse and rat models to identify differentially expressed genes. Functional and pathway enrichment analysis of differentially expressed genes was performed using Sangerbox 3.0. Protein–protein interaction networks were mapped using STRING and subsequently visualized using Cytoscape. Disease gene–drug interactions were explored using the Comparative Toxicology Database and the Drug Gene Interaction Database. Results The ten most highly differentially expressed genes were, LRRTM1, STX1A, SNAP25, SYNPR, STXBP1, NRXN1, CPLX1, SYT4, SYT13 and GABRG2, which were supported by multi-lineage genomic evidence. A functional enrichment analysis identified several important classifications, including regulation of neuronal differentiation and regulation of vesicle-mediated transport. Potential druggable genes were also identified (e.g., LRRTM1, GABRG2, CYP4X1, CHGB and TMEM130). Conclusions We performed a meta-analysis and convergence analysis of GES from human samples and multiple animal models of epileptogenesis by integrating the results of several studies. We identified the top ten candidate genes and pathways for epileptogenesis. Among them, LRRTM1 and GABRG2 have been validated to have high druggable value. The other eight genes require further study to explore their potential as therapeutic targets in medial temporal lobe epilepsy with hippocampal sclerosis.

INPLASY2023110050 COVID-19-mediated neurologic symptoms of syndromes such as ataxia and myoclonus: a Meta-Analysis of Case Series Keywords: SARS-CoV-2; COVID-19;meta-analysis; neurological complica…