Featured Publications
Do psychotropic drugs cause seizures?
Gopaul M, Altalib H. Do psychotropic drugs cause seizures? Epilepsy & Behavior Reports 2024, 27: 100679. PMID: 38881884, PMCID: PMC11179069, DOI: 10.1016/j.ebr.2024.100679.Peer-Reviewed Original ResearchAttention-deficit/hyperactivity disorderPsychiatric comorbiditiesPsychotropic medicationsTricyclic antidepressantsCNS stimulantsSerotonin reuptake inhibitorsConcurrent psychiatric disordersSeizure riskReuptake inhibitorsAttention-deficit/hyperactivityPsychiatric disordersPsychiatric symptomsIncreased seizure riskPsychotropic drugsBidirectional associationsAnticonvulsant effectsAntidepressantsIatrogenic seizuresAntipsychoticsTreatment outcomesDisordersHigh dosesClinical decision-makingSeizure onsetEpilepsyMortality among veterans with epilepsy: Temporal significance of traumatic brain injury exposure
Roghani A, Wang C, Henion A, Amuan M, Altalib H, LaFrance W, Baca C, Van Cott A, Towne A, Kean J, Hinds S, Kennedy E, Panahi S, Pugh M. Mortality among veterans with epilepsy: Temporal significance of traumatic brain injury exposure. Epilepsia 2024, 65: 2255-2269. PMID: 39119799, DOI: 10.1111/epi.18026.Peer-Reviewed Original ResearchTraumatic brain injuryIndex dateTraumatic brain injury exposureDocumented traumatic brain injuryHazard ratioVeterans Health AdministrationConfidence intervalsTraumatic brain injury diagnosisPost-9/11 veteransDefense Health AgencyCox proportional hazards modelsAssociated with earlier timeProportional hazards modelRetrospective cohort studyHealth careHealth AdministrationHealth agenciesCumulative mortality rateInjury exposureMortality riskMortality hazardCohort studyVeteransSignificant mortality riskHazards modelMood and Anxiety Disorders and Suicidality in Patients With Newly Diagnosed Focal Epilepsy
Kanner A, Saporta A, Kim D, Barry J, Altalib H, Omotola H, Jette N, O'Brien T, Nadkarni S, Winawer M, Sperling M, French J, Abou-Khalil B, Alldredge B, Bebin M, Cascino G, Cole A, Cook M, Detyniecki K, Devinsky O, Dlugos D, Faught E, Ficker D, Fields M, Gidal B, Gelfand M, Glynn S, Halford J, Haut S, Hegde M, Holmes M, Kalviainen R, Kang J, Klein P, Knowlton R, Krishnamurthy K, Kuzniecky R, Kwan P, Lowenstein D, Marcuse L, Meador K, Mintzer S, Pardoe H, Park K, Penovich P, Singh R, Somerville E, Szabo C, Szaflarski J, Thio K, Trinka E, Burneo J, Project A. Mood and Anxiety Disorders and Suicidality in Patients With Newly Diagnosed Focal Epilepsy. Neurology 2022, 100: e1123-e1134. PMID: 36539302, PMCID: PMC10074468, DOI: 10.1212/wnl.0000000000201671.Peer-Reviewed Original ResearchConceptsMajor depressive disorderFocal epilepsyBipolar disorderSuicidal ideationAnxiety disordersGeneral populationSuicidal attemptsPanic disorderMini International Neuropsychiatric InterviewPrevalence of moodInternational Neuropsychiatric InterviewLogistic regression analysisActive suicidal ideationComparable prevalence ratesSeverity Rating ScaleConsecutive adultsDepressive disorderNeuropsychiatric InterviewEpilepsy evaluationHigh prevalencePrevalence ratesTypes of moodPatientsPsychiatric diagnosisEpilepsyDorsal bed nucleus of stria terminalis in depressed and nondepressed temporal lobe epilepsy patients
Dhaher R, Bronen RA, Spencer L, Colic L, Brown F, Mian A, Sandhu M, Pittman B, Spencer D, Blumberg HP, Altalib H. Dorsal bed nucleus of stria terminalis in depressed and nondepressed temporal lobe epilepsy patients. Epilepsia 2022, 63: 2561-2570. PMID: 35883245, DOI: 10.1111/epi.17377.Peer-Reviewed Original ResearchConceptsTemporal lobe epilepsyDorsal bed nucleusTLE patientsEpilepsy patientsBed nucleusHC subjectsStria terminalisTemporal lobe epilepsy patientsMini International Neuropsychiatric InterviewMagnetic resonance imaging (MRI) scansTreatment-resistant depressionComprehensive Epilepsy CenterHealthy control subjectsStructural magnetic resonance imaging (MRI) scansResonance imaging scansNumber of patientsCase-control studyInternational Neuropsychiatric InterviewMajor depressive disorderCommon comorbid disordersHuman clinical studiesEpilepsy centersLobe epilepsyComorbid depressionControl subjectsSuicide and Seizures
Bornovski Y, Jackson-Shaheed E, Argraves S, Hitchins A, Tolchin B, Galluzzo D, Cheung KH, Goulet J, Skanderson M, Brandt CA, Pugh MJ, Altalib H. Suicide and Seizures. Neurology Clinical Practice 2021, 11: 372-376. PMID: 34840864, PMCID: PMC8610527, DOI: 10.1212/cpj.0000000000001070.Peer-Reviewed Original ResearchPsychogenic nonepileptic seizuresSuicide-related behaviorsCohort studyRates of suicideRelative riskHigh riskVeterans Health Administration (VHA) servicesRetrospective cohort studyComparison groupNational cohort studyStandardized mortality ratioGeneral veteran populationIllicit drug abusePosttraumatic stress disorderElectronic health recordsDecreased riskPsychotropic medicationsMortality ratioMajor depressionNonepileptic seizuresAlcohol abuseVeteran populationEpilepsySeizuresPoisson regressionSuicide Attempts of Muslims Compared With Other Religious Groups in the US
Awaad R, El-Gabalawy O, Jackson-Shaheed E, Zia B, Keshavarzi H, Mogahed D, Altalib H. Suicide Attempts of Muslims Compared With Other Religious Groups in the US. JAMA Psychiatry 2021, 78: 1041-1044. PMID: 34287614, PMCID: PMC8295887, DOI: 10.1001/jamapsychiatry.2021.1813.Peer-Reviewed Original ResearchEpilepsy quality performance in a national sample of neurologists and primary care providers: Characterizing trends in acute and chronic care management
Altalib H, McMillan KK, Padilla S, Pugh MJ. Epilepsy quality performance in a national sample of neurologists and primary care providers: Characterizing trends in acute and chronic care management. Epilepsy & Behavior 2021, 123: 108218. PMID: 34479039, DOI: 10.1016/j.yebeh.2021.108218.Peer-Reviewed Original ResearchConceptsPrimary care providersEpilepsy carePrimary careChronic careInjury preventionCare providersPsychosocial educationVeterans Affairs Healthcare SystemAnti-seizure medicationsMedication side effectsNew-onset seizuresTypes of seizuresChronic care managementHealthcare systemProportion of peopleChart reviewChart extractionAcute careMedication monotherapyNational sampleTreatment optionsSpecialty careCare measuresVA measurementsSide effectsMeasuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination
Altalib HH, Lanham HJ, McMillan KK, Habeeb M, Fenton B, Cheung KH, Pugh MJ. Measuring coordination of epilepsy care: A mixed methods evaluation of social network analysis versus relational coordination. Epilepsy & Behavior 2019, 97: 197-205. PMID: 31252279, DOI: 10.1016/j.yebeh.2019.05.023.Peer-Reviewed Original ResearchMeSH KeywordsDelivery of Health Care, IntegratedEpilepsyHealth PersonnelHealth ServicesHospitals, VeteransHumansModels, OrganizationalNeurologistsPatient Care TeamReferral and ConsultationSocial NetworkingSocial SupportSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsConceptsCoordination of careVeterans Affairs Healthcare SystemVA providersEpilepsy careNeurological careHealthcare systemHealthcare teamPrimary care providersModel of careCare team membersLarge healthcare systemVA healthcare systemMental health providersHealth professional networksRelational coordinationMixed-methods evaluationKey informant interviewsMultidisciplinary careEpilepsy centersNeurology settingCare scoresProvider teamCare mapCare providersVA facilities
2024
Reflections in Studying Impact of Functional Seizure Services on Health Care Utilization Outcomes
Altalib H. Reflections in Studying Impact of Functional Seizure Services on Health Care Utilization Outcomes. Neurology Clinical Practice 2024, 15: e200402. PMID: 39600561, PMCID: PMC11588420, DOI: 10.1212/cpj.0000000000200402.Peer-Reviewed Original ResearchFunctional neurological disorderHealth care utilization outcomesHealth care professionalsHealth care systemCare professionalsUtilization outcomesCare systemMental healthIatrogenic harmEpilepsy monitoring unit admissionsFunctional seizuresHigh-volume usersHealthUnit admissionCoordinated effortPeopleProfessionalsNeurological disordersHarmAdmissionNeurologyDistinct comorbidity phenotypes among post‐9/11 Veterans with epilepsy are linked to diverging outcomes and mortality risks
Pugh M, Clary H, Myers M, Kennedy E, Amuan M, Swan A, Hinds S, LaFrance W, Altalib H, Towne A, Henion A, White A, Baca C, Wang C. Distinct comorbidity phenotypes among post‐9/11 Veterans with epilepsy are linked to diverging outcomes and mortality risks. Epilepsia 2024 PMID: 39487827, DOI: 10.1111/epi.18170.Peer-Reviewed Original ResearchVeterans Health AdministrationCause of deathService membersLatent class analysisPost-9/11 service membersVeterans receiving careContinuity of careInterdisciplinary health teamComorbid phenotypesPost-9/11 veteransOverall patient careMitigate adverse outcomesHealth teamsEpilepsy diagnosisAssociated with mortalityHealth trajectoriesHealth AdministrationPatient carePost-traumatic stress disorderMortality outcomesDescriptive statisticsAnnual diagnosesChronic diseasesNational cohortMortality riskCognitive performance in functional seizures compared with epilepsy and healthy controls: a systematic review and meta analysis
Van Patten R, Austin T, Cotton E, Chan L, Bellone J, Mordecai K, Altalib H, Correia S, Twamley E, Jones R, Sawyer K, LaFrance W. Cognitive performance in functional seizures compared with epilepsy and healthy controls: a systematic review and meta analysis. The Lancet Psychiatry 2024, 11: 516-525. PMID: 38879275, DOI: 10.1016/s2215-0366(24)00132-9.Peer-Reviewed Original ResearchConceptsRisk of biasSystematic reviewHealthy comparisonGlobal cognitionMeta-analysisCognitive performanceDepartment of Veterans AffairsVeterans Health AdministrationFunctional seizuresIndividual studiesCognitive domainsModerate effect sizeProportion of womenNewcastle-Ottawa ScaleLeft temporal lobe epilepsyWeb of ScienceCognitive test dataWidespread cognitive impairmentVeterans AffairsEffects of multiple covariatesHealth AdministrationGrey literatureSeizure groupNewcastle-OttawaInclusion criteriaSemiology Consistency in Focal Epilepsy: Differences Between New-onset and Refractory Epilepsy (P3-1.007)
Okafor C, Herlopian A, Gopaul M, Chen Z, Altalib H. Semiology Consistency in Focal Epilepsy: Differences Between New-onset and Refractory Epilepsy (P3-1.007). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206535.Peer-Reviewed Original ResearchDoes Discharge Diagnosis Determine Risk of Death? Mortality Following Admission to Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE) Epilepsy Monitoring Units (EMUs) (P10-1.009)
Kellogg M, Amuan M, Hirschey J, LaFrance W, Haneef Z, Altalib H, Rehman R, Pugh M. Does Discharge Diagnosis Determine Risk of Death? Mortality Following Admission to Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE) Epilepsy Monitoring Units (EMUs) (P10-1.009). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204899.Peer-Reviewed Original ResearchReduced Subjective Cognitive Concerns With Neurobehavioral Therapy in Functional Seizures and Traumatic Brain Injury
Van Patten R, Chan L, Tocco K, Mordecai K, Altalib H, Cotton E, Correia S, Gaston T, Grayson L, Martin A, Fry S, Goodman A, Allendorfer J, Szaflarski J, LaFrance W. Reduced Subjective Cognitive Concerns With Neurobehavioral Therapy in Functional Seizures and Traumatic Brain Injury. Journal Of Neuropsychiatry 2024, 36: 197-205. PMID: 38481168, DOI: 10.1176/appi.neuropsych.20230138.Peer-Reviewed Original ResearchSubjective cognitive concernsTraumatic brain injuryObsessive-compulsive symptomsCognitive concernsNeurobehavioral therapyFunctional seizuresMental healthCognitive functionComparison groupCulturally diverse sampleBrain injuryGlobal mental healthObjective cognitionPerson's own perceptionDiverse sampleUsual treatmentParticipantsQuality of lifeSymptomsMultivariate regression modelSeizuresCognitionEveryday lifeBaselineNeurobehavior
2023
Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post–9/11 Era US Veterans
Henion A, Wang C, Amuan M, Altalib H, Towne A, Hinds S, Baca C, LaFrance W, Van Cott A, Kean J, Roghani A, Kennedy E, Panahi S, Pugh M. Role of Deployment History on the Association Between Epilepsy and Traumatic Brain Injury in Post–9/11 Era US Veterans. Neurology 2023, 101: e2571-e2584. PMID: 38030395, PMCID: PMC10791059, DOI: 10.1212/wnl.0000000000207943.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryDeployed veteransNondeployed veteransHigher oddsNeurologic conditionsBrain injuryEpilepsy impactDeployment-related traumatic brain injurySevere traumatic brain injuryEpilepsy risk factorsMild traumatic brain injuryVeterans Health AdministrationYears of careDeployment-related exposuresService membersService-connected disabilityHistory of deploymentHealthy warrior effectLogistic regression modelsDeployment historyMilitary service membersEpilepsy preventionICD-9/10TBI exposureAntiseizure medicationsImplementer report: ICD-10 code F44.5 review for functional seizure disorder
Ali S, Bornovski Y, Gopaul M, Galluzzo D, Goulet J, Argraves S, Jackson-Shaheed E, Cheung K, Brandt C, Altalib H. Implementer report: ICD-10 code F44.5 review for functional seizure disorder. BMJ Health & Care Informatics 2023, 30: e100746. PMID: 37730251, PMCID: PMC10514602, DOI: 10.1136/bmjhci-2023-100746.Peer-Reviewed Original ResearchConceptsPositive predictive valueSeizure disorderICD-10Single ICD codeEHR problem listElectronic health recordsChart reviewDiagnostic codesInternational ClassificationDiagnostic codingPredictive valueICD codesProblem listDiagnostic precisionHealth recordsDisordersNatural language processing algorithmEHR systemsLanguage processing algorithmReviewCliniciansDiseaseChanges in opioid prescribing in veterans with headache during the COVID‐19 pandemic: A regression discontinuity in time analysis
Wang K, Fenton B, Skanderson M, Black A, Becker W, Seng E, Anthony S, Guirguis A, Altalib H, Kimber A, Lorenze N, Scholten J, Graham G, Sandbrink F, Sico J. Changes in opioid prescribing in veterans with headache during the COVID‐19 pandemic: A regression discontinuity in time analysis. Headache The Journal Of Head And Face Pain 2023, 63: 1295-1303. PMID: 37596904, DOI: 10.1111/head.14605.Peer-Reviewed Original ResearchMorphine equivalent daily dosesVeterans Health AdministrationNumber of prescriptionsOpioid prescribingOpioid prescriptionsLong-term opioid therapyMME/dayRetrospective cohort studyEquivalent daily dosesCOVID-19 pandemicOpioid therapyPre-pandemic periodCohort studyDaily doseChronic painOutpatient visitsPrevious diagnosisDaily dosesMean ageSubgroup analysisHeadache disordersOpioid accessHealth AdministrationPrescribingCoronavirus diseaseImprovements in Montreal Cognitive Assessment scores after neurobehavioral therapy in adults with functional (nonepileptic) seizures and traumatic brain injury
Van Patten R, Chan L, Tocco K, Mordecai K, Altalib H, Twamley E, Gaston T, Grayson L, Martin A, Fry S, Goodman A, Allendorfer J, Correia S, Szaflarski J, LaFrance W. Improvements in Montreal Cognitive Assessment scores after neurobehavioral therapy in adults with functional (nonepileptic) seizures and traumatic brain injury. Journal Of Psychiatric Research 2023, 165: 282-289. PMID: 37549503, DOI: 10.1016/j.jpsychires.2023.07.038.Peer-Reviewed Original ResearchTraumatic brain injuryMental health symptomsNeurobehavioral therapyHealth symptomsSubjective cognitive difficultiesCo-occurring traumatic brain injuryEvidence-based psychotherapiesBrain injuryPre-post assessmentExecutive functionCognitive difficultiesCognitive performanceBaseline cognitive impairmentMontreal Cognitive Assessment scoreCognitive symptomsCognitionNES participantsCognitive Assessment scoreCognitive impairmentPositive changesMoCA scoresTotal score improvementBaseline sociodemographic factorsParticipantsAdultsUnderstanding headache classification coding within the veterans health administration using ICD-9-CM and ICD-10-CM in fiscal years 2014–2017
Fodeh S, Fenton B, Wang R, Skanderson M, Altalib H, Kuruvilla D, Schindler E, Haskell S, Brandt C, Sico J. Understanding headache classification coding within the veterans health administration using ICD-9-CM and ICD-10-CM in fiscal years 2014–2017. PLOS ONE 2023, 18: e0279163. PMID: 36598881, PMCID: PMC9812322, DOI: 10.1371/journal.pone.0279163.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationHeadache diagnosisICD-10-CMICD-10-CM diagnosisICD-10-CM codingSpecialty care clinicsSpecific headache diagnosesICD-9-CM codingDifferent headache typesICD-9-CMRace/ethnicityHeadache comorbidityHeadache NOSPatient ageCare clinicsChronic conditionsHeadache typesProvider typeSociodemographic factorsHealth AdministrationDiagnosisTwo yearsHeadachePatientsMigraine
2022
Comorbidity Phenotype Trajectories in Veterans Before and After Emergence of Epilepsy (S12.007)
Pugh M, LaFrance W, Hinds S, Towne A, Van Cott A, Baca C, Altalib H, Wang C. Comorbidity Phenotype Trajectories in Veterans Before and After Emergence of Epilepsy (S12.007). Neurology 2022, 98 DOI: 10.1212/wnl.98.18_supplement.1055.Peer-Reviewed Original Research