Approximately 30%-40% of epilepsy patients do not respond well to adequate anti-seizure medications (ASMs), a condition known as pharmacoresistant epilepsy. The management of pharmacoresistant epilepsy remains an intractable issue in the clinic. Its early prediction is important for prevention and diagnosis. However, it still lacks effective predictors and approaches. Here, a classical model of pharmacoresistant temporal lobe epilepsy (TLE) was established to screen pharmacoresistant and pharmaco-responsive individuals by applying phenytoin to amygdaloid-kindled rats. Ictal electroencephalograms (EEGs) recorded before phenytoin treatment were analyzed. Based on ictal EEGs from pharmacoresistant and pharmaco-responsive rats, a convolutional neural network predictive model was constructed to predict pharmacoresistance, and achieved 78% prediction accuracy. We further found the ictal EEGs from pharmacoresistant rats have a lower gamma-band power, which was verified in seizure EEGs from pharmacoresistant TLE patients. Prospectively, therapies targeting the subiculum in those predicted as "pharmacoresistant" individual rats significantly reduced the subsequent occurrence of pharmacoresistance. These results demonstrate a new methodology to predict whether TLE individuals become resistant to ASMs in a classic pharmacoresistant TLE model. This may be of translational importance for the precise management of pharmacoresistant TLE.
Epilepsy, Temporal Lobe/diagnosis* ; Animals ; Drug Resistant Epilepsy/drug therapy* ; Electroencephalography/methods* ; Rats ; Anticonvulsants/pharmacology* ; Neural Networks, Computer ; Male ; Humans ; Phenytoin/pharmacology* ; Adult ; Disease Models, Animal ; Female ; Rats, Sprague-Dawley ; Young Adult ; Convolutional Neural Networks

Objective To explore the effect of tonifying kidney with traditional Chinese medicine together with estradiol valerate and clomiphene citrate on serum leptin levels in patients with polycystic ovarian syndrome. Method Two hundred and eight patients with PCOS were randomly divided into observation group (n=104) and control group (n=104). Patients in control group and observation group took estradiol valerate and clomiphene citrate, while patients in observation group took Shiying Minlin soup for three months. Crinosity, body temperature, acne&Skin diseases, and menoxenia were recorded; Leptin (LP) and five hormone including follicle stimulating hormone (FSH),luteinizing hormone (LH), prolactin (PRL), estradiol (E 2) and testosterone (T) are determined using euzymelinked immunosorbent assay. Results Crinosity, body temperature, acne&Skin diseases, and menoxenia were improved;the level of FSH, LH, PRL, E 2, T in both observation and control group decreased and the content in observation group are high than that in control group, while LH,T and E 2 are lower. Conclusion Treatment with tonifying kidney with traditional Chinese medicine on polycystic ovarian syndrome can decrease the level of FSH, LH, PRL, E 2, T and LP. Compared with western medicine, tonifying kidney with traditional Chinese medicine showed advantage in the terms of treatment on polycystic ovarian syndrome.