Evidence map›Paper›PMID 40189511›Full record

ArticleBMC medicine2025

The response to anti-seizure medications and the development of pharmacoresistant epilepsy in malformations of cortical development.

Pu Miao, Meiping Ying, Ruotong Chen, Yuyu Yang, Yao Ding, Junming Zhu, Jianhua Feng, Jin Wang, Thandar Aung, Shuang Wang and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Pu MiaoDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Meiping YingDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Ruotong ChenDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Yuyu YangDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Yao DingDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Junming ZhuDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Jianhua FengDepartment of Pediatric, School of Medicine, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China.
Jin WangDepartment of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310018, China.
Thandar AungDepartment of Neurology, Epilepsy Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Shuang WangDepartment of Neurology, School of Medicine, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009, China. wangs77@zju.edu.cn.
Bo JinDepartment of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310018, China. jinbo0111@zju.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalformations of cortical development (MCD) are a group of congenital brain malformation disorders commonly associated with pharmacoresistant epilepsy (PRE). While studies often focus on surgery outcomes, the pharmacological treatment is still imperative and the odyssey to PRE remains underexplored. We aim to investigate the influence of anti-seizure medications (ASMs) on the development of PRE in this specific patient population.

methodsWe retrospectively included a cohort of epilepsy patients with MRI-confirmed MCD due to abnormal cell proliferation and apoptosis (group I, mainly FCD II), and abnormal neuronal migration (group II, mainly heterotopia, lissencephaly, and polymicrogyria) from March 2013 to June 2023. The clinical features of group I and group II were compared. Factors associated with PRE were analyzed. The time to development of PRE with different ASMs was assessed using Kaplan-Meier survival analysis.

resultsOf 259 enrolled patients with epilepsy and MRI-confirmed MCD (group I, n = 121; group II, n = 138), 73.4% met the criteria for PRE. The median duration of follow-up from seizure onset to the last visit or surgery was 103 months (IQR 45-174), with group I showing a significantly higher PRE rate than group II (90.1% vs. 58.7%, p = 0.000). Binomial regression analysis identified the significant predictors of PRE in MCD patients: high pretreatment seizure frequency (OR = 2.506), group II patients (OR = 0.248), and failure of the first ASM (OR = 5.885). Sodium channel blockers (SCBs) were the most prescribed initial ASMs and demonstrated a higher response rate than other ASMs. Kaplan-Meier analysis revealed that using SCBs as the first ASM significantly prolongs the time to PRE, with a median of 72 months for SCB users versus 48 months for non-SCB users.

conclusionsOur findings indicate a high prevalence of PRE that varies among different subtypes of MCD. Early appropriate selection of ASMs, particularly SCBs, can significantly delay the time to PRE onset, offering a promising strategy for managing this complex patient population. Tailoring pharmacological approaches is crucial for optimizing outcomes, and further research is warranted to optimize treatment strategies.

Indexed as

AnticonvulsantsDrug Resistant EpilepsyMalformations of Cortical DevelopmentAdolescentAdultChildChild, PreschoolFemaleHumansInfantMagnetic Resonance ImagingMaleRetrospective StudiesYoung AdultAnticonvulsantsMalformations of cortical developmentPharmacoresistant epilepsySodium channel blockers

Identifiers

PMID40189511
PMCPMC11974206

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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.