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Article ; Online: Response: Assumptions and statistical inference.

Haneef, Zulfi / Skrehot, Henry C

2023 Volume 65, Issue 1, Page(s) 244–246

MeSH term(s)	Models, Statistical ; Data Interpretation, Statistical
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Letter
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17823
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Article ; Online: Neurostimulation in generalized epilepsy: A systematic review and meta-analysis.

Haneef, Zulfi / Skrehot, Henry C

Epilepsia

2023 Volume 64, Issue 4, Page(s) 811–820

Abstract: Objective: There are three neurostimulation devices available to treat generalized epilepsy: vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS). However, the choice between them is unclear due to lack of ... ...

Abstract	Objective: There are three neurostimulation devices available to treat generalized epilepsy: vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS). However, the choice between them is unclear due to lack of head-to-head comparisons. A systematic comparison of neurostimulation outcomes in generalized epilepsy has not been performed previously. The goal of this meta-analysis was to determine whether one of these devices is better than the others to treat generalized epilepsy. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review of PubMed, Embase, and Web of Science was performed for studies reporting seizure outcomes following VNS, RNS, and DBS implantation in generalized drug-resistant epilepsy between the first pivotal trial study for each modality through August 2022. Specific search criteria were used for VNS ("vagus", "vagal", or "VNS" in the title and "epilepsy" or "seizure"), DBS ("deep brain stimulation", "DBS", "anterior thalamic nucleus", "centromedian nucleus", or "thalamic stimulation" in the title and "epilepsy" or "seizure"), and RNS ("responsive neurostimulation" or "RNS" in the title and "epilepsy" or "seizure"). From 4409 articles identified, 319 underwent full-text reviews, and 20 studies were included. Data were pooled using a random-effects model using the meta package in R. Results: Sufficient data for meta-analysis were available from seven studies for VNS (n = 510) and nine studies for DBS (n = 87). Data from RNS (five studies, n = 18) were insufficient for meta-analysis. The mean (SD) follow-up durations were as follows: VNS, 39.1 (23.4) months; DBS, 23.1 (19.6) months; and RNS, 22.3 (10.6) months. Meta-analysis showed seizure reductions of 48.3% (95% confidence interval [CI] = 38.7%-57.9%) for VNS and 64.8% (95% CI = 54.4%-75.2%) for DBS (p = .02). Significance: Our meta-analysis indicates that the use of DBS may lead to greater seizure reduction than VNS in generalized epilepsy. Results from RNS use are promising, but further research is required.
MeSH term(s)	Humans ; Epilepsy/therapy ; Drug Resistant Epilepsy/therapy ; Seizures/therapy ; Epilepsy, Generalized/therapy ; Vagus Nerve Stimulation/methods ; Anterior Thalamic Nuclei ; Treatment Outcome
Language	English
Publishing date	2023-02-16
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17524
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Article ; Online: Todd Paralysis After Electroconvulsive Therapy-Letter to the Editor.

Josephs, Travis / Ballou, Emilia / Haneef, Zulfi / Asghar-Ali, Ali Abbas

The journal of ECT

2023 Volume 40, Issue 1, Page(s) 63–64

MeSH term(s)	Humans ; Electroconvulsive Therapy/adverse effects ; Paralysis/etiology
Language	English
Publishing date	2023-10-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1426385-3
ISSN	1533-4112 ; 1095-0680
ISSN (online)	1533-4112
ISSN	1095-0680
DOI	10.1097/YCT.0000000000000965
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Article ; Online: Vagus nerve stimulation and heart rate variability: A scoping review of a somatic oscillatory signal.

Wessel, Caitlin R / Karakas, Cemal / Haneef, Zulfi / Mutchnick, Ian

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2024 Volume 160, Page(s) 95–107

Abstract: The goal of this review is to synthesize the literature on vagus nerve stimulator (VNS)-related changes in heart rate variability (HRV) in patients with drug-resistant epilepsy (DRE) and assess the role of these changes in seizure relief. A scoping ... ...

Abstract	The goal of this review is to synthesize the literature on vagus nerve stimulator (VNS)-related changes in heart rate variability (HRV) in patients with drug-resistant epilepsy (DRE) and assess the role of these changes in seizure relief. A scoping literature review was performed with the following inclusion criteria: primary articles written in English, involved implantable VNS in humans, and had HRV as a primary outcome. Twenty-nine studies were retrieved, however with considerable heterogeneity in study methods. The overall depression in HRV seen in DRE patients compared to healthy controls persisted even after VNS implant, indicating that achieving "healthy" HRV is not necessary for VNS therapeutic success. Within DRE patients, changes in frequency domain parameters six months after VNS implant returned to baseline after a year. The mechanism of how VNS reduces seizure burden does not appear to be significantly related to alterations in baseline HRV. However, the subtlety of sympathetic/parasympathetic signaling likely requires a more structured approach to experimental and analytic techniques than currently found in the literature.
MeSH term(s)	Humans ; Heart Rate/physiology ; Vagus Nerve Stimulation/methods ; Drug Resistant Epilepsy/diagnosis ; Drug Resistant Epilepsy/therapy ; Seizures ; Implantable Neurostimulators ; Vagus Nerve ; Treatment Outcome
Language	English
Publishing date	2024-02-16
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2024.02.011
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Article ; Online: Psychiatric Comorbidities in Women Veterans with Epilepsy.

Sullivan-Baca, Erin / Rehman, Rizwana / Lorkiewicz, Sara A / Van Cott, Anne C / Haneef, Zulfi

Journal of women's health (2002)

2024 Volume 33, Issue 3, Page(s) 301–307

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Female ; Male ; United States/epidemiology ; Veterans/psychology ; Retrospective Studies ; Comorbidity ; Epilepsy/drug therapy ; Epilepsy/epidemiology ; Veterans Health
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1139774-3
ISSN	1931-843X ; 1059-7115 ; 1540-9996
ISSN (online)	1931-843X
ISSN	1059-7115 ; 1540-9996
DOI	10.1089/jwh.2023.0495
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Zs.A 3584: Show issues

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Article ; Online: Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis.

Skrehot, Henry C / Englot, Dario J / Haneef, Zulfi

Epilepsy & behavior : E&B

2023 Volume 142, Page(s) 109182

Abstract: Objectives: Different neurostimulation modalities are available to treat drug-resistant focal epilepsy when surgery is not an option including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS). Head-to- ... ...

Abstract	Objectives: Different neurostimulation modalities are available to treat drug-resistant focal epilepsy when surgery is not an option including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS). Head-to-head comparisons of efficacy do not exist between them nor are likely to be available in the future. We performed a meta-analysis on VNS, RNS, and DBS outcomes to compare seizure reduction efficacy for focal epilepsy. Methods: We systematically reviewed the literature for reported seizure outcomes following implantation with VNS, RNS, and DBS in focal-onset seizures and performed a meta-analysis. Prospective or retrospective clinical studies were included. Results: Sufficient data were available at years one (n = 642, two (n = 480), and three (n = 385) for comparing the three modalities with each other. Seizure reduction for the devices at years one, two, and three respectively were: RNS: 66.3%, 56.0%, 68.4%; DBS- 58.4%, 57.5%, 63.8%; VNS 32.9%, 44.4%, 53.5%. Seizure reduction at year one was greater for RNS (p < 0.01) and DBS (p < 0.01) compared to VNS. Conclusions: Our findings indicate the seizure reduction efficacy of RNS is similar to DBS, and both had greater seizure reductions compared to VNS in the first-year post-implantation, with the differences diminishing with longer-term follow-up. Significance: The results help guide neuromodulation treatment in eligible patients with drug-resistant focal epilepsy.
MeSH term(s)	Humans ; Retrospective Studies ; Prospective Studies ; Deep Brain Stimulation/methods ; Epilepsies, Partial/therapy ; Drug Resistant Epilepsy/therapy ; Seizures/therapy ; Vagus Nerve Stimulation/methods ; Treatment Outcome
Language	English
Publishing date	2023-03-25
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2023.109182
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Zs.A 5289: Show issues

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Article ; Online: Surgical Outcomes in Post-Traumatic Temporal Lobe Epilepsy: A Systematic Review and Meta-Analysis.

Ferreira, Liam D / Tabaeizadeh, Mohammad / Haneef, Zulfi

Journal of neurotrauma

2023 Volume 41, Issue 3-4, Page(s) 319–330

Abstract: Epilepsy surgery provides excellent benefits in post-traumatic epilepsy of the temporal lobe (PTE-TL), but outcomes relative to non-traumatic epilepsy of the temporal lobe (NTE-TL) are less favorable. Large well-designed studies are recommended to ... ...

Abstract	Epilepsy surgery provides excellent benefits in post-traumatic epilepsy of the temporal lobe (PTE-TL), but outcomes relative to non-traumatic epilepsy of the temporal lobe (NTE-TL) are less favorable. Large well-designed studies are recommended to further clarify the role of epilepsy surgery in PTE. It is unclear whether epilepsy surgery outcomes in PTE are as robust as described for drug resistant epilepsy (DRE) in general. Prior outcome studies in PTE are limited by small numbers, lack of a control group, or both. We performed a meta-analysis of studies in temporal lobe epilepsy (TLE) to evaluate post-surgical outcomes in those with PTE-TL and compare outcomes to those with NTE-TL. PubMed, EMBASE, and Web of Science databases were queried for studies reporting epilepsy surgery outcomes separately for PTE-TL and NTE-TL. Outcomes were divided into favorable (Engel Class I) or unfavorable (Engel Class II-IV) for comparison. Meta-analyses were performed to evaluate: 1) the proportion of Class I outcomes following epilepsy surgery in PTE-TL; and 2) calculate the odds of Class I surgical outcomes in PTE-TL compared with NTE-TL. Of 3669 articles that reported surgical outcomes in epilepsy, nine studies (
MeSH term(s)	Humans ; Epilepsy, Temporal Lobe/surgery ; Epilepsy ; Drug Resistant Epilepsy ; Outcome Assessment, Health Care ; Treatment Outcome ; Retrospective Studies ; Epilepsy, Post-Traumatic
Language	English
Publishing date	2023-10-20
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	645092-1
ISSN	1557-9042 ; 0897-7151
ISSN (online)	1557-9042
ISSN	0897-7151
DOI	10.1089/neu.2023.0084
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Article ; Online: Use of video alone for differentiation of epileptic seizures from non-epileptic spells: A systematic review and meta-analysis.

Karakas, Cemal / Ferreira, Liam D / Haneef, Zulfi

Seizure

2023 Volume 110, Page(s) 177–187

Abstract: Introduction: Review of videos (without electroencephalography) to differentiate epileptic seizures (ES) from non-epileptic spells (NES) may be helpful where epilepsy monitoring is not feasible. Previous studies of video-based diagnosis have suffered ... ...

Abstract	Introduction: Review of videos (without electroencephalography) to differentiate epileptic seizures (ES) from non-epileptic spells (NES) may be helpful where epilepsy monitoring is not feasible. Previous studies of video-based diagnosis have suffered from variable accuracy, sensitivity, and specificity. Methods: We systematically reviewed relevant literature in PubMed, Embase, and Web of Science from inception to September 2022, identifying articles that reported on the video-based diagnosis of ES and NES. In primary analysis, for each study, the most expert group was chosen when different groups of reviewers classified the videos (e.g., epilepsy specialists and general neurologists). In secondary analysis, we compared the diagnostic accuracy of different expertise levels (e.g., epileptologists, general neurologists, residents, medical students). Meta-analysis was performed to obtain pooled estimates of reliability measures. Results: From 5245 articles identified, 13 met the inclusion criteria, with cumulative data from 683 patients (696 videos) reviewed by 95 independent reviewers in primary analysis. Video alone had a strong ability to differentiate ES from NES as evidenced by the following metrics- area under the curve- 0.9 (considered "outstanding"), sensitivity- 82.2% (95% Confidence Interval [C.I], 80.2%-84.0%), specificity- 84.7% (C.I., 82.8%-86.5%), and diagnostic odds ratio- 24.7 (C.I., 11.5-52.9). The secondary analysis showed reviewer-dependent accuracy with epileptologists showing the highest accuracy (DOR 81.2, C.I., 90.0%-94.6%). Conclusions: Video alone has reliable diagnostic performance for differentiating ES from NES. Meta-analysis limitations include inter-study heterogeneity including variable video quality and reviewer expertise. Combined video-EEG remains the gold standard for the diagnosis of epilepsy and NES.
MeSH term(s)	Humans ; Reproducibility of Results ; Seizures/diagnosis ; Seizures/complications ; Epilepsy/diagnosis ; Epilepsy/complications ; Electroencephalography ; Monitoring, Physiologic ; Video Recording
Language	English
Publishing date	2023-06-29
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2023.06.022
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Article ; Online: Health care utilization of Hispanic/Latino veterans with epilepsy: A national population-based study.

Tantillo, Gabriela B / Sullivan-Baca, Erin / Rehman, Rizwana / López, María Raquel / Haneef, Zulfi

Epilepsia

2024

Abstract: Objective: Hispanic/Latino people with epilepsy are a growing population that has been understudied in clinical epilepsy research. U.S. veterans are at a higher risk of epilepsy due to greater exposures including traumatic brain injury. Hispanic/Latino ... ...

Abstract	Objective: Hispanic/Latino people with epilepsy are a growing population that has been understudied in clinical epilepsy research. U.S. veterans are at a higher risk of epilepsy due to greater exposures including traumatic brain injury. Hispanic/Latino Veterans with Epilepsy (HL-VWEs) represent a growing population; however the treatment utilization patterns of this population have been vastly understudied. Methods: HL-VWE were identified from administrative databases during fiscal year 2019. Variables compared between Hispanic and non-Hispanic VWEs included demographics, rurality, service era, utilization of clinical services/investigations, and service-connected injury. Chi-square and Student's t tests were used for comparisons. Results: Among 56 556 VWEs, 3247 (5.7%) were HL. HL-VWEs were younger (59.2 vs 63.2 years; p < .01) and more commonly urban-dwelling (81.6% vs 63.2%, p < .01) compared to non-HL-VWEs. They were also more likely to have served in recent missions such as the Persian Gulf War and post- 9/11 wars (p < .01). HL-VWEs had a higher utilization of all neurology services examined including neurology clinic visits, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, electroencephalography (EEG), epilepsy monitoring, and comprehensive epilepsy care (p < .01 for all). HL-VWEs were more likely to visit an emergency room or have seizure-related hospitalizations (p < .01). HL-VWEs were more likely to have a service-connected disability greater or equal to 50% (p < .01). Significance: This study is one of the largest cohorts examining HL-VWEs. We found higher utilization of services in neurology, epilepsy, and neuroimaging by HL-VWEs. HL-VWE are younger, more commonly urban-dwelling, and more likely to have served during recent combat periods and have higher amounts of service-connected disability. Given that the proportion of Hispanic veterans is projected to rise over time, more research is needed to provide the best interventions and mitigate the long-term impact of epilepsy on this diverse patient group.
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17948
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Zs.A 517: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Epilepsy surgery perceptions among general neurologists and epilepsy specialists: A survey.

Haneef, Zulfi / Patel, Kamakshi / Nguyen, Angela / Kayal, Gina / Martini, Sharyl R / Sullivan-Baca, Erin

Clinical neurology and neurosurgery

2024 Volume 237, Page(s) 108151

Abstract: Objective: Surgical intervention for drug-resistant epilepsy (DRE) is a safe and efficacious evidence-based treatment. Yet, neurologists have historically revealed hesitance in referring patients for surgical evaluations. The present study surveyed ... ...

Abstract	Objective: Surgical intervention for drug-resistant epilepsy (DRE) is a safe and efficacious evidence-based treatment. Yet, neurologists have historically revealed hesitance in referring patients for surgical evaluations. The present study surveyed general neurologists and epilepsy specialists to assess their views and process in referring patients for specialized epilepsy care and epilepsy surgery. Methods: A 14-item survey assessing epilepsy referrals and views of epilepsy surgery was distributed to all neurologists currently practicing in a large national integrated health system using REDCap. Responses were qualitatively analyzed and differences between general neurologists and epileptologists were assessed using chi-squared tests. Results: In total, 100 responses were received from 67 general neurologists and 33 epileptologists with several similarities and differences emerging between the two groups. Both groups endorsed surgery and neuromodulation as treatment options in DRE, felt that seizure frequency rather than duration was relevant in considering epilepsy surgery, and indicated patient preference as the largest barrier limiting epilepsy surgery. General neurologists were more likely to require ≥ 3 ASMs to fail to diagnose DRE compared to epileptologists (45% vs. 15%, p < 0.01) who more often required ≥ 2 ASMs to fail. Epileptologists were also more likely than neurologists to try a new ASM (75.8% vs. 53.7%, p < 0.05) or optimize the current ASM (75.8% vs. 49.3%, p < 0.05) in DRE. General neurologists were more likely to consider epilepsy surgery to be less efficacious (p = 0.001) or less safe (p < 0.05). Significance: Overall, neurologists appear to have generally positive opinions of epilepsy surgery, which is a change from prior literature and represents a changing landscape of views toward this intervention. Furthermore, epileptologists and general neurologists endorsed more similarities than differences in their opinions of surgery and steps to referral, which is another encouraging finding. Those gaps that remain between epileptologists and general neurologists, particularly in standards of ASM prescription, may be addressed by more consistent education about DRE and streamlining of surgical referral procedures.
MeSH term(s)	Humans ; Neurologists ; Epilepsy/diagnosis ; Epilepsy/surgery ; Drug Resistant Epilepsy ; Educational Status ; Emotions
Language	English
Publishing date	2024-02-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2024.108151
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