AAN2023 · 癫痫专栏 | 第75届美国神经病学学会年会热点话题回顾

2023年4月22-27号，美国神经病学年会在波士顿召开。美国神经病学年会是世界上影响力最大的神经科学盛会，届时来自世界各地的神经科学家会一起探讨最前沿的科学研究。在诊断、治疗大脑疾病和神经系统疾病（例如阿尔兹海默病、偏头痛、癫痫、脑损伤等）等方面带来前言进展分享，本文我们简单梳理一下AAN 2023期间癫痫相关热点话题，以便与会者能更好地参与学习。

01 癫痫共患病越来越受到关注，本次AAN也有许多相关内容，此外卒中后/伴癫痫的报道也有不少。

• Impact of a Free Anti-seizure Medication Intervention on Anxiety and Depression in People Living with Epilepsy in the Republic of Guinea

• Feasibility and Insights from Automated Depression and Anxiety Screening for People with Epilepsy

• Machine Learning Prediction of Seizures after Ischemic Strokes

• Mortality and functional outcomes in patients with post-stroke epileptic seizures: a systematic review and meta-analysis

• Post-stroke Epilepsy and its Association with Stroke Location - Meta-analysis

02 癫痫患者的综合管理也是近来比较热门的话题，在2023年癫痫诊疗指南中国分册中也单独提到，癫痫的管理不仅仅涉及药物的用法用量，还有更重要的是对于患者长期生活质量的改善。

• Epilepsy Quality Performance Over Time: A National Veterans Health Administration Quality Improvement Study

• Nationwide Patterns of Healthcare Utilization and Health related Quality of Life among US Adults with Epilepsy

03 难治性癫痫占比约30%，既往对于难治性癫痫的理解更多的是药物的调整或者添加方案，目前对于难治性癫痫，也有越来越多的创新治疗方式开始被探索和应用。

• Overproduction of Pro-inflammatory Cytokines in New-Onset Refractory Status Epilepticus (NORSE)

• Care priorities of patients with drug-resistant epilepsy

• Corpus Callosotomy for Drug Resistant Epilepsy. Long Term Outcome in Adult Population.

04 借助神经影像或电生理等技术对于癫痫复发的管理和预测也在被广泛应用，并且借助大数据和AI等数字手段，帮助临床高效的开展随访工作。

• Predicting Seizure Freedom through Computational Processing of Routine EEG

• Prediction of post-surgical neuropsychological outcomes from high-gamma modulation language mapping and cortical resections

• Machine-learning Assisted Differentiation Between Physiological Oscillation Epochs and Muscle or Epileptiform activity in EEGs

• Inter-Rater Reliability of EEG-Based Encephalopathy Grading

• Comparison of Machine Learning Algorithms for Somatosensory Functional Mapping

• Focal epilepsy: EEG interictal patterns and etiology correlation

05 分子通路和机制的不断探索也有助于发现更多的治疗手段，例如离子通路和局灶的关系是什么？局灶性发作主要是什么通路起到作用？GABA的研究也在不断深入，目前也有许多新药仍旧是通过GABA发挥作用，而这个通路本身的作用也值得更多的探索和发现。

• PRAX-562 is a Well-Tolerated, Novel Persistent Sodium Channel Blocker with Broad Anticonvulsant Activity in Multiple DEE Mouse Models

• Comparing Mutability of Clinically Significant Voltage-Gated Sodium Channel Subunits

• Single-Cell RNA and TCR Sequencing Reveals Novel Immune Cell Networks in Poorly Controlled Epilepsy

• Pathophysiology of Epilepsy in Inherited Metabolic Disorders of GABA Metabolism

• Development of De novo Functional Seizures after Epilepsy Surgery

06 癫痫综合征相对比较复杂，无论是诊断还是治疗都更棘手，儿科所面临的综合征问题除了Dravet、LGT、SeLECT以外，由于基因筛查的普及越来越多新的综合征被发现，相信以后对于基因疗法或者特异性的酶治疗手段也会更精准的帮助这些癫痫综合征患儿，有效控制发作的同时改善生活质量。

• Impact of Fenfluramine on Drop Seizure Frequency in Adults or Dose-Capped Patients With Lennox-Gastaut Syndrome: Comparative Analysis of Clinical Trial Data

• Long-Term Treatment Effects of Soticlestat in Patients with Dravet Syndrome or Lennox–Gastaut Syndrome: Interim Data from the ENDYMION 1 Trial

07 其他话题

• A Retrospective Textual Analysis of Sexual and Reproductive Health Counseling for Adolescent and Young Adult Women with Epilepsy

• Association of Cognitive and Structural Correlates of Brain Aging and Incident Epilepsy. The Framingham Heart Study

• Microburst Vagus Nerve Stimulation: Safety and Efficacy Outcomes