Management of people with epilepsy during the COVID-19 pandemic:a national survey among epileptologists in China

Background:Compared to the healthy people,people with comorbid medical conditions are more vulnerable in the context of the coronavirus disease 2019(COVID-19)pandemic,including the people with epilepsy.Besides a consensus recommendation by multi-national epilepsy specialists,the situation of the epilepsy management during the pandemic has seldom been reported.Methods:The China Association Against Epilepsy carried out an online nationwide survey among its board members in April 2020.One hundred and thirty board members from 22 provinces,5 autonomous regions,and 4 municipalities across China responded to the questionnaires.They reported the situation of clinical practice and gave opinions on the management of people with epilepsy between January 13th and March 31st,2020,a time period concentrated with confirmed COVID-19 cases.Results:The proportions of patients consulting through telephone or online(88.4%)and of patients with regular case review(93.9%)were highest in the high-risk area,as reported by the responders.The patients in the high-risk area were more likely to have increased episodes of seizures(17.7%),aggravated psychological disorders(30.2%),and less accessibility to anti-seizure medications(ASMs)(77.2%).Regular ASMs supply(74.6%),medical consultation(69.2%),and psychological aids(29.2%)were urgently needed for people with epilepsy.Conclusions:This study demonstrated the most common dilemma faced by people with epilepsy in policy circumstances during the COVID-19 epidemic in China.The opinions raised by Chinese epileptologists may provide reference for epilepsy care in other countries.

Head-to-head comparison of plasma and PET imaging ATN markers in subjects with cognitive complaints

Background Gaining more information about the reciprocal associations between different biomarkers within the ATN(Amyloid/Tau/Neurodegeneration)framework across the Alzheimer’s disease(AD)spectrum is clinically relevant.We aimed to conduct a comprehensive head-to-head comparison of plasma and positron emission tomography(PET)ATN biomarkers in subjects with cognitive complaints.Methods A hospital-based cohort of subjects with cognitive complaints with a concurrent blood draw and ATN PET imaging(18F-florbetapir for A,18F-Florzolotau for T,and 18F-fluorodeoxyglucose[18F-FDG]for N)was enrolled(n=137).Theβ-amyloid(Aβ)status(positive versus negative)and the severity of cognitive impairment served as the main outcome measures for assessing biomarker performances.Results Plasma phosphorylated tau 181(p-tau181)level was found to be associated with PET imaging of ATN biomarkers in the entire cohort.Plasma p-tau181 level and PET standardized uptake value ratios of AT biomarkers showed a similarly excellent diagnostic performance for distinguishing between Aβ+and Aβ−subjects.An increased tau burden and glucose hypometabolism were significantly associated with the severity of cognitive impairment in Aβ+subjects.Additionally,glucose hypometabolism-along with elevated plasma neurofilament light chain level-was related to more severe cognitive impairment in Aβ−subjects.Conclusion Plasma p-tau181,as well as 18F-florbetapir and 18F-Florzolotau PET imaging can be considered as interchangeable biomarkers in the assessment of Aβstatus in symptomatic stages of AD.18F-Florzolotau and 18F-FDG PET imaging could serve as biomarkers for the severity of cognitive impairment.Our findings have implications for establishing a roadmap to identifying the most suitable ATN biomarkers for clinical use.