{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:17:16Z","timestamp":1784927836978,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005032","name":"Funda\u00e7\u00e3o Bial","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with epilepsy have increased vascular risk, and the use of antiseizure medications (ASM) seems to be a contributing factor. We aimed to analyze the differences in vascular risk profiles among epilepsy patients treated with ASM that exhibit varying interactions with the cytochrome P450 enzyme system, using surrogate sonographic markers of vascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective longitudinal observational study including patients with epilepsy on ongoing, stable ASM for more than 1 year and a control group. Patients were subdivided into four groups according to ASM enzyme interactions (strong inducers\u2013group 1; weak inducers\u2013group 2; non\u2010inducers\u2013group 3; and inhibitors\u2013group 4). Clinical data, blood tests, and ultrasound studies assessing cerebral blood flow (CBF), carotid intima\u2010media complex thickness (CA\u2010IMT), pulsatility index (PI), and the presence of atherosclerotic carotid plaques were collected at baseline and after 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 159 participants were included, comprising 126 patients with epilepsy and 33 controls. The proportion of female participants was 56.0%, the median age was 46\u2009years (IQR 38, 54), and 64.0% had vascular risk factors. CBF was higher in controls than in epilepsy patients at both baseline and 1\u2010year follow\u2010up (675 vs. 560\u2009mL\/100gr\/min in group 1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). After 1 year, PI was higher in groups 1 and 2 than in controls (0.86 and 0.90 vs. 0.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). At baseline, group 1 presented a higher number of carotid plaques compared to group 3 (13 vs. 2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). The progression of CBF, CA\u2010IMT and PI over a 1\u2010year period did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Patients with epilepsy showed an overall decrease in CBF, whereas the enzyme\u2010inducing group had a higher number of carotid plaques and higher PI, which may reflect an increased risk of macro and microvascular disease. These data emphasize the importance of comprehensive care addressing vascular risk factors in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70333","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:19:41Z","timestamp":1783167581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Epilepsy and vascular risk: Evaluation of the influence of antiseizure medications on atherosclerotic disease"],"prefix":"10.1002","author":[{"given":"Cristiana","family":"Silva","sequence":"first","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3962-3080","authenticated-orcid":false,"given":"Francisco","family":"Barros","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Faustino","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5199-6210","authenticated-orcid":false,"given":"Jo\u00e3o Andr\u00e9","family":"Sousa","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-6780","authenticated-orcid":false,"given":"Joana","family":"Jesus\u2010Ribeiro","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade de Sa\u00fade Local da Regi\u00e3o de Leiria  Leiria Portugal"},{"name":"Faculty of Medicine, Center of Investigation on Environment, Genetics, and Oncobiology (CIMAGO) University of Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas","family":"Cunha","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"},{"name":"Unidade de Monitoriza\u00e7\u00e3o de Epilepsia e Sono Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Martins","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0720-7616","authenticated-orcid":false,"given":"Pedro","family":"Correia","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade Do Alto Minho  Viana do Castelo Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Cruto","sequence":"additional","affiliation":[{"name":"Neurology Department, Hospital Pedro Hispano Unidade Local de Sa\u00fade de Matosinhos  Matosinhos Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Coelho","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Aveiro  Aveiro Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Xavier","sequence":"additional","affiliation":[{"name":"Mestrado Em Estat\u00edstica M\u00e9dica Universidade de Aveiro  Aveiro Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"J\u00f3ia","sequence":"additional","affiliation":[{"name":"Unidade de Ensaios Cl\u00ednicos Do Centro Acad\u00e9mico e Cl\u00ednico de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Sargento\u2010Freitas","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Silva","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-8667","authenticated-orcid":false,"given":"Rute","family":"Teot\u00f3nio","sequence":"additional","affiliation":[{"name":"Neurology Department Unidade Local de Sa\u00fade de Coimbra  Coimbra Portugal"},{"name":"Neurology Department Unidade Local de Sa\u00fade Do Alto Minho  Viana do Castelo 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