Evidence map›Paper›PMID 35985831›Full record

ArticleNeurology2022

Prevalence and Risk Factors for Pharmacoresistance in Children With Focal Cortical Dysplasia-Related Epilepsy.

Nathan T Cohen, Phat Chang, Xiaozhen You, Anqing Zhang, Kathryn A Havens, Chima O Oluigbo, Matthew T Whitehead, Taha Gholipour, William D Gaillard

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed
6.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 50 citations in OpenAlex.

  1. Article
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  7. Drug resistant epilepsy driven byEpilepsy & behavior reports · 2026
    Article
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  13. Combining interictal and ictal low-density EEG source imaging to delineate the epileptogenic zone in young children.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Article
  14. Review
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  18. Seminars in epileptology: Presurgical epilepsy evaluation.Epileptic disorders : international epilepsy journal with videotape · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Nathan T CohenFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C. ncohen@cnmc.org.ORCID 0000-0002-1410-3487
Phat ChangFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Xiaozhen YouFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.ORCID 0000-0003-3592-0985
Anqing ZhangFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Kathryn A HavensFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Chima O OluigboFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Matthew T WhiteheadFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Taha GholipourFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
William D GaillardFrom the Departments of Neurology (N.T.C., K.A.H.,W.D.G.), Neurosurgery (C.O.O.), Neuroradiology (M.T.W.), and the Center for Neuroscience Research (N.T.C., P.C., X.Y., A.Z., K.A.H., C.O.O., M.T.W., T.G., W.D.G.), Department of Neurology (N.T.C., K.A.H.,W.D.G.) and Neurosurgery (C.O.O.), Children's National Hospital, The George Washington University School of Medicine, Washington, D.C.
Neurology, Inc · US

Funding

Clinical and Translational Science Institute at Childrens NationalUL1TR001876 · NCATS · CHILDREN'S RESEARCH INSTITUTE · PI BELL, MICHAEL J · 2016 to 2021
$25.6M
Neurobehavioral Evaluation CoreP50HD105328 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI WILLIAM Davis GAILLARD · 2021 to 2026
$9.3M
NCATS NIH HHS UL1 TR001876NICHD NIH HHS P50 HD105328
6 · The paper itself

Abstract

BACKGROUND AND

objectivesFocal cortical dysplasia (FCD) is the most common cause of surgically remediable epilepsy in children. Little is known about the risk factors for the timing and development of pharmacoresistance in this population. This study sought to evaluate the prevalence and risk factors for pharmacoresistance in pediatric FCD-related epilepsy.

methodsIn this retrospective single-center cohort design, patients were identified from search of centralized radiology report database and a central epilepsy surgical database. Inclusion criteria consisted of 3T MRI-confirmed FCD from January, 2011, to January, 2020; ages 0 days to 22 years at MRI; and at least 18 months of documented follow-up after MRI, unless had single seizure or incidentally discovered FCD. Records were excluded if there was dual pathology (except for mesial temporal sclerosis), hemimegalencephaly, or tuberous sclerosis complex present in imaging or history.

resultsOne hundred forty-three patients with confirmed FCD met the inclusion criteria. One hundred twenty-four children had epilepsy (87% of patients with FCD) with median age at seizure onset 2.7 years (IQR 0.75-6 years, range 0-17 years). Twelve children (8.5%) had a single lifetime seizure (provoked or unprovoked) or recurrent provoked seizures. Seven children (4.9%) had incidental FCD. Ninety-two patients (74%) of those with epilepsy met criteria for pharmacoresistance. Of children with epilepsy of all types, 93 children (75%) were seizure-free at the last visit; 82 patients underwent epilepsy surgery, of whom 59 (72%) achieved seizure freedom. Seven percent (9/124) achieved seizure freedom with a second ASM and 5.6% (7/124) with a third or more ASMs. Failure of only 1 antiseizure medication is associated with enormous increased incidence and earlier development of pharmacoresistance (OR 346; 95% CI 19.6-6,100); Cox regression showed FCD lobar location, pathologic subtype, and age at seizure onset are not. DISCUSSION: Failure of 1 antiseizure medication is associated with substantial risk of pharmacoresistance. These data support an operational redefinition of pharmacoresistance, for surgical planning, in FCD-related epilepsy to the failure of 1 antiseizure medication and support early, potentially curative surgery to improve outcomes in this patient population.

Indexed as

EpilepsyEpilepsy, GeneralizedFocal Cortical DysplasiaMalformations of Cortical DevelopmentAdolescentBrain Damage, ChronicChildChild, PreschoolHumansInfantInfant, NewbornMagnetic Resonance ImagingPrevalenceRetrospective StudiesRisk FactorsSeizures

Identifiers

PMID35985831
PMCPMC9651467
OpenAlexW4292387045

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