OBJECTIVETo review the recent development of functional MRI application in epilepsy.

DATA SOURCESBoth Chinese and English language literatures were researched using MEDLINE/CD ROM (1996 - 2005) and the Chinese Biomedical Literature Disk (1996 - 2005).

STUDY SELECTIONPublished articles about functional MRI application and epilepsy were selected.

DATA EXTRACTIONData were mainly extracted from 38 articles which are listed in the reference section of this review.

RESULTSfMRI can be used to localize seizure foci through detecting these cerebral hemodynamic changes produced by epileptiform discharges. EEG-triggered fMRI, which has higher spatial and temporal resolution, helps to detect the spatiotemporal pattern of spike origin and propagation, and define localization of the epileptogenic focus. fMRI is also useful in language and memory cognitive function assessment and presurgical assessment of refractory epilepsy. Atypically distributed cognitive function areas can be detected by fMRI, because of cortical language and memory areas reorganization during long-term epileptic activity in patients with epilepsy.

CONCLUSIONSfMRI technique plays a very important role in cognitive function and presurgical assessment of patients with epilepsy. It is meaningful for understanding pathogenesis of epilepsy.

Cognition ; Epilepsy ; diagnosis ; pathology ; psychology ; Humans ; Magnetic Resonance Imaging ; methods

OBJECTIVETo investigate the association between quality of life (QOL) and sociodemographic factors, clinical seizure factors, depression and anxiety in patients suffering from epilepsy.

METHODSWe examined 141 consecutive patients with epilepsy (mean age 25.8±9.6, 61.7% male). All patients completed the Self-Rating Depression Scale, Self-Rating Anxiety Scale, WHOQOL-BREF and QOLIE-31(Chinese version). Multiple linear regression analyses were applied to investigate factors impact on QOL.

RESULTSThe results revealed that scores on two domains of the WHOQOL-BREF (i.e., physical and psychological domains, P<0.05) were significantly lower in the epilepsy group compared with the control group. Multiple regression analyses showed that anxiety, depression and course explained approximately 40% of the variance in patients' QOL. Anxiety was consistently the strongest predictor of lower scores on almost all QOL domains. In addition, the severity of depressive symptoms was significantly associated with lower scores across many QOL domains.

CONCLUSIONOur findings suggest that QOLIE scores might be substantially affected by the presence and severity of anxiety symptoms and, to a lesser degree, of depressive symptoms and prolonged course of illness. In contrast, clinical seizure variables had a weaker association with QOL. Healthcare professionals should be aware of the significance of patients' emotional state and of the role it plays in their QOL.

Adolescent ; Adult ; Anxiety ; pathology ; Depression ; pathology ; Epilepsy ; physiopathology ; psychology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this study was to verify effects of the Empowering A Self-Efficacy (EASE) program on self-efficacy, self-management, and child attitude toward illness in children with epilepsy. METHODS: This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 10 to 15 year old children with epilepsy (11 in the experimental group and 10 in the control group) who were registered at one hospital in S city. The experimental group received the EASE program for 3 weeks. In the first week, a group meeting lasting 570 minutes was conducted on a single day. Over the next two weeks, telephone counselling was conducted twice a week. Data were analyzed using SPSS 18.0. RESULTS: There was a significant difference of pre-post evaluation of the epilepsy self-management scores in the experimental group. However, differences between the experimental group and the control group for seizure self-efficacy and child attitude toward illness were not significant. CONCLUSION: This is the first study in Korea to develop and evaluate an intervention program for children with epilepsy. Further studies are needed to confirm the effects of the EASE program.
Adolescent ; Attitude to Health ; Child ; Epilepsy/pathology/*psychology ; Female ; Humans ; Male ; *Power (Psychology) ; Program Development ; *Program Evaluation ; Self Care ; *Self Efficacy ; Surveys and Questionnaires ; Translating

OBJECTIVETo find out the rate of comorbidities of depression, anxiety disorder and attention deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy and to analyze the relevant affecting factors and impacts on quality of life.

METHODTotally 142 children with various types of epilepsy underwent neuropsychological assessment with the Depression Self-rating Scale for Children, the Screen for Child Anxiety Related Emotional Disorders and the ADHD Rating Scale-IV, an 18-item parent-rated questionnaire based on the diagnostic criteria for ADHD, the quality of life was measured in 100 cases on antiepileptic medications by the Quality of Life in Epilepsy Inventory (QOLIE-31). The comorbidity rates were calculated using t-test, chi(2) test and multiple logistic analysis, the variables associated with psychiatric comorbidities were determined, and the impact on quality of life was analyzed.

RESULT(1) The total rate of emotional and behavioral comorbidities was 57.7% (82/142), the frequency of depressive disorder, anxiety disorder and ADHD was 14.8%, 44.4% and 17.6%, respectively. The suicidal ideation occasionally occurred in 5.6% of the cases and 0.7% of cases often had the ideation, but no suicidal action was found in any case. (2) Risk factors for the emotional and behavioral disorders: multiple logistic analysis indicated that age, gender and epilepsy illness-related variables were not relative to the comorbidities, P > 0.05, there were interactions among the disorders. (3) The impact on the quality of life: The emotional and behavioral conditions were associated with the low quality of life, which was significantly lower in epileptic children with co-morbid disorder compared to non-comorbidities epilepsy group. Especially negative impact on the total score of quality of life and four sub-items such as overall quality, emotional well-being, cognitive and social function, P < 0.001. There were also significant differences between the two groups in the other three sub-items including fear for seizure attack, energy/fatigue and medication effects (P < 0.05).

CONCLUSIONSThe frequency of emotional and behavioral disorders including depress disorder, anxiety disorder and ADHD was considerably high in children with epilepsy. Age, gender and epilepsy illness-related variables are not associated with the emotional and behavioral comorbidities, which interfere with each other. Emotional and behavioral disorder is one of the negative factors to the quality of life in epileptic patients. Neuropsychological assessment and treatment are important for improvement of the quality of life in children with epilepsy.

Attention Deficit Disorder with Hyperactivity ; epidemiology ; Child ; Child Behavior Disorders ; epidemiology ; pathology ; Comorbidity ; Emotions ; Epilepsy ; epidemiology ; psychology ; Female ; Humans ; Quality of Life ; Surveys and Questionnaires

Many functional magnetic resonance imaging (fMRI) studies have revealed the deactivation phenomenon of default mode network in the patients with epilepsy; however, nearly not any of the reports has focused on the dorsal attention network of epilepsy. In this paper, independent component analysis (ICA) was used to isolate the dorsal attention network of 16 patients with temporal lobe epilepsy (TLE) and of 20 healthy normals; and a goodness-of-fit analysis was applied at the individual subject level to choose the interesting component. Intra-group analysis and inter-group analysis were performed. The results indicated that the dorsal attention network included bilateral intraparietal sulcus, middle frontal gyrus, human frontal eye field, posterior lobe of right cerebellum, etc. The TLE group showed decreased functional connectivity in most of the dorsal attention regions with the predominance in the bilateral intraparietal sulcus, middle frontal gyrus, and posterior lobe of right cerebellum. These data suggested that the intrinsic organization of the brain function might be disrupted in TLE. In addition, the decrease of goodness-of-fit scores suggests that activity in the dorsal attention network may ultimately prove a sensitive biomarker for TLE.
Adolescent ; Adult ; Attention ; physiology ; Attention Deficit and Disruptive Behavior Disorders ; etiology ; physiopathology ; Brain Mapping ; Epilepsy, Temporal Lobe ; pathology ; physiopathology ; psychology ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Image Processing, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Nerve Net ; physiopathology ; Principal Component Analysis ; methods ; Young Adult