Results of this cohort study reveal that suicidality at the time of focal epilepsy diagnosis was associated with future drug resistance and may be a marker of more severe neuropathology. Psychiatric screening at time of diagnosis may facilitate early identification of patients at risk for treatment refractory epilepsy syndromes.

ClinicalTrials.gov Identifier: NCT02126774.

Results of this cohort study reveal that suicidality at the time of focal epilepsy diagnosis was associated with future drug resistance and may be a marker of more severe neuropathology. Psychiatric screening at time of diagnosis may facilitate early identification of patients at risk for treatment refractory epilepsy syndromes.

ClinicalTrials.gov Identifier: NCT02126774.

ClinicalTrials.gov Identifier: NCT02978456.

Dental caries is a prevalent chronic disease influenced by both genetic and environmental factors, particularly dietary. Using a 2-sample Mendelian randomization (MR) approach with genome-wide association study data, this study examined the potential causal relationship between sugar preference, diabetes, and dental caries. The research seeks to clarify the influence of genetic predispositions and metabolic conditions, such as diabetes, on dental health. We conducted a 2-sample MR analysis using genome-wide significant single nucleotide polymorphisms (P < 5 × 10⁻⁸), linkage disequilibrium pruning (R2 < 0.001), and multiple MR methods including inverse-variance weighted, MR-Egger, robust adjusted profile score, and MR-PRESSO. Genetic variants associated with exposures were harmonized with outcome data using the 2 sample MR R package, and ambiguous palindromic single nucleotide polymorphisms were excluded. We found no strong evidence for a causal effect of genetically predicted sugar intake on dental caries. However, both type 1 and type 2 diabetes showed positive associations with caries experience, suggesting that metabolic conditions may contribute to caries risk independently of sugar intake. No significant genetic correlation was observed between sugar preference and diabetes, and Steiger filtering supported the directionality of our analysis. Findings from sensitivity analyses (e.g., leave-one-out, MR-PRESSO) confirmed the robustness of the results. Our findings suggest that the traditionally assumed causal role of sugar intake in dental caries may be overstated. Instead, they support a model in which genetic predispositions and metabolic disorders such as diabetes may play a more substantial role. These findings advocate for personalized dental care approaches that consider individual genetic predispositions and metabolic conditions, offering new insights for future research and clinical practice.

Microglia, the resident immune cells of the brain, play a critical role in maintaining homeostasis. In this study, we investigated changes in microglial phenotype associated with seizure susceptibility. Kainic acid (KA) was injected intraperitoneally, and when seizures reached Racine stage 4/5, administration was stopped, and mice were monitored for 60 min. Only mice that showed behavioral convulsive status epilepsy (SE) in the first experiment received a second KA injection 2 weeks later. Using this model, we observed changes in brain tissue and microglial phenotype according to seizure susceptibility. We also analyzed gene expression patterns associated with microglial phagocytosis in a publicly available hippocampal transcriptome microarray dataset (GSE88992) from mice injected with KA. After the initial low-dose KA repeat injection, the number of injections required to induce SE during the secondary injection was compared with the initial injection, and mice were categorized into seizure-resistant (SR, n = 26, no SE), seizure-tolerant (ST, n = 11, SE after ≥2 injections), and seizure-susceptible (SS, n = 15, SE after ≤2 injections) groups. Neuronal loss was observed in all seizure groups, but the extent varied across hippocampal regions. Microglial phenotypes in the hippocampus showed significant differences between groups. Immunofluorescence staining further confirmed that triggering receptor expressed on myeloid cells (TREM2) expression was increased in microglia in the SS group. Using a model that classifies seizure resistance, tolerance, and susceptibility, we observed significant differences in microglial phenotypes and TREM2 expressions between groups. This study highlights the role of microglia in the progression from first seizures to subsequent seizures, a critical step in the development of epilepsy.

본 연구는 서울시 자치구를 대상으로 주택가격 불평등이 1인당 지역 내 총생산 및 순인구 유입률에 미치는 영향을 실증적으로 분석하였다. 특히 자산효과이론과 상대적 박탈감 이론을 기반으로 아파트와 단독주택 가격 불평등이 지역경제와 인구 이동에 미치는 영향을 탐구하였다. 주택가격 불평등은 국토교통부가 제공한 2012～2019년 주택가격 데이터를 활용하여 측정하였다. 분석 결과, 아파트와 단독주택 가격 불평등 모두 1인당 지역 내 총생산에 유의미한 부정적 영향을 미치는 것으로 나타났다. 특히 아파트 가격 불평등과 단독주택 가격 불평등을 동시에 분석했을 때는 아파트 가격 불평등만 1인당 GRDP에 유의미한 부정적 영향을 미쳤다. 또한, 아파트 가격 불평등은 순인구 유입률에 유의미한 부정적 영향을 미치는 것으로 밝혀졌지만, 단독주택 가격 불평등은 순인구 유입률에 유의미한 영향을 미치지 않는 것으로 분석되었다. 본 연구는 아파트와 단독주택이라는 주택 유형별 불평등이 지역 경제와 인구 이동에 미치는 부정적 영향을 규명하고, 정책적 시사점을 제공함으로써 서울시 자치구 간 주택 불평등 완화 및 지역 경제 활성화에 기여할 수 있을 것으로 기대된다.

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical radiographic phenomenon characterized by thunderclap headaches and transient vasoconstriction of cerebral vessels, which typically resolve within 3 months of symptom onset. Although RCVS has been extensively studied in adults, research on this condition in pediatric populations is limited, likely due to its perceived rarity. This comprehensive review aims to bridge the knowledge gap by examining the clinical presentation, diagnostic methods, treatment strategies, and prognostic outcomes of pediatric RCVS cases, including two case reports contributed by the authors. This study demonstrates an inconclusive sex distribution of RCVS in children, attributed to the scarcity of comprehensive studies of this demographic. Additionally, we identified several predictors of adverse neurological outcomes in children with RCVS, including motor deficits, aphasia, hypertension, and renal disease. This study offers a thorough overview of RCVS in the pediatric population, providing valuable insights to inform future research in this area.