Evidence map›Paper›PMID 37414567›Full record

ArticleNeurology2023

Predictive Power of Interictal Epileptiform Discharges in Fitness-to-Drive Evaluation.

Heinz Krestel, David R Schreier, Elmaze Sakiri, Andreas von Allmen, Yasmina Abukhadra, Arto Nirkko, Maja Steinlin, Felix Rosenow, Rune Markhus, Gaby Schneider and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Heinz KrestelFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway. heinz.krestel@yale.edu.ORCID 0000-0001-8742-0232
David R SchreierFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.ORCID 0000-0001-6088-2015
Elmaze SakiriFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Andreas von AllmenFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Yasmina AbukhadraFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Arto NirkkoFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Maja SteinlinFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Felix RosenowFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.ORCID 0000-0002-3989-7471
Rune MarkhusFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Gaby SchneiderFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Caroline JagellaFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.
Johannes MathisFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.ORCID 0000-0002-3422-2715
Hal BlumenfeldFrom the Departments of Neurology (H.K., Y.A., C.J., H.B.), Neuroscience (H.B.), and Neurosurgery (H.B.), Yale School of Medicine, New Haven, CT; Epilepsy Center Frankfurt Rhine-Main (H.K., F.R.), University Hospital Frankfurt, Center for Personalized Translational Epilepsy Research (CePTER), and Institute of Mathematics (G.S.), Department of Computer Science and Mathematics, Goethe University, Frankfurt, Germany; Department of Neurology (D.R.S., A.N., J.M.); Departments of Cardiology (E.S.) and Pediatric Neurology (M.S.), Bern University Hospital and University of Bern; Neurocenter Lucerne (A.N.), Switzerland; and National Centre for Epilepsy (R.M.), Division of Clinical Neuroscience Oslo University Hospital, Norway.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThis study aimed to evaluate and predict the effects of interictal epileptiform discharges (IEDs) on driving ability using simple reaction tests and a driving simulator.

methodsPatients with various epilepsies were evaluated with simultaneous EEGs during their response to visual stimuli in a single-flash test, a car-driving video game, and a realistic driving simulator. Reaction times (RTs) and missed reactions or crashes (miss/crash) during normal EEG and IEDs were measured. IEDs, as considered in this study, were a series of epileptiform potentials (>1 potential) and were classified as generalized typical, generalized atypical, or focal. RT and miss/crash in relation to IED type, duration, and test type were analyzed. RT prolongation, miss/crash probability, and odds ratio (OR) of miss/crash due to IEDs were calculated.

resultsGeneralized typical IEDs prolonged RT by 164 ms, compared with generalized atypical IEDs (77.0 ms) and focal IEDs (48.0 ms) ( DISCUSSION: IED-associated miss/crash probability and RT prolongation were comparably well detected by all tests. Long focal IED bursts carry a low risk, while generalized typical IEDs are the primary cause of miss/crash. We propose a cumulative 20% miss/crash risk at an RT prolongation of 90.3 ms as a clinically relevant IED effect. The IED-associated OR in the simulator approximates the effects of sleepiness or low blood alcohol level while driving on real roads. A decision aid for fitness-to-drive evaluation was created by providing the expected RT prolongations and misses/crashes when IEDs of a certain type and duration are detected in routine EEG.

Indexed as

EpilepsyVideo GamesElectroencephalographyHumansOdds RatioProbability

Identifiers

PMID37414567
PMCPMC10501101

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.