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PRS performance was assessed through lifetime risk models, age\u2010at\u2010onset stratifications, and phenome\u2010wide association studies (PheWASs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PRS performance varied substantially by cohort, epilepsy type, and age at onset. GGE PRS had the strongest effect on GGE in Epi25\u2010TWN (per\u2010unit odds ratio [OR]\u2009=\u20091.65 [95% confidence interval (CI) =\u20091.24\u20132.23],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20098.3\u2009\u00d7\u200910\n                      <jats:sup>\u22124<\/jats:sup>\n                      ,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20093.2%) but a weaker effect in TWB\u2010NHIRD and TPMI (ORs\u2009=\u20091.09\u20131.13 [95% CI = .98\u20131.23],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002\u2013.057,\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u2009.14%\u2013.22%). FE PRS effects on FE were more consistent but modest (ORs\u2009=\u20091.02\u20131.16 [95% CI = .97\u20131.33]). No prognostic value of PRS was found in predicting epilepsy from syncope or unspecified seizures. Individuals in the top 5% GGE PRS had &gt;4\u2010fold increased risk in Epi25\u2010TWN but &lt;1.5\u2010fold in the others. Restricting to earlier onset cases strengthened PRS signals in population cohorts, particularly for GGE, with PheWAS analysis revealing epilepsy\u2010specific associations. PRS effects were generally comparable but attenuated relative to European studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Cohort design and phenotyping accuracy strongly influence the assessment of the predictive value of epilepsy PRS, highlighting caution in clinical interpretation. Incorporating richer phenotypic data and more diverse GWASs will be crucial to enhancing its applicability and clinical potential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70353","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:34:21Z","timestamp":1782398061000},"page":"4939-4953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Variability in epilepsy polygenic risk prediction across Taiwanese population and clinical cohorts"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8866-5005","authenticated-orcid":false,"given":"Yi\u2010Syuan","family":"Ke","sequence":"first","affiliation":[{"name":"Institute of Health Data Analytics and Statistics College of Public Health, National Taiwan University  Taipei 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