{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T22:30:51Z","timestamp":1788647451108,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100024075","name":"Region Syddanmark","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010809","name":"Jascha Fonden","doi-asserted-by":"publisher","award":["2022\u20100278"],"award-info":[{"award-number":["2022\u20100278"]}],"id":[{"id":"10.13039\/100010809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeck Foundation","doi-asserted-by":"publisher","award":["R434\u20102023\u2010342"],"award-info":[{"award-number":["R434\u20102023\u2010342"]}],"id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Idiopathic generalized epilepsy (IGE) in adults comprise juvenile myoclonic epilepsy (JME), juvenile absence epilepsy (JAE), and epilepsy with generalized tonic\u2013clonic seizures alone (EGTCS), which are defined by their seizure types but also cover a broad endophenotype of symptoms. Controversy exists on whether adult IGE is a group of distinct diseases or a clinical spectrum of one disease. Here, we used a deeply phenotyped cohort to test the hypothesis that IGE comprises three distinct clinical entities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients (&gt;18\u2009years old) with IGE were recruited between 2016 and 2020 at Odense University Hospital and the Danish Epilepsy Center. Complete data were available for basic demographics, imaging, social status, and treatment response. Subjects were offered neuropsychological screening (including symptoms of psychiatric disease). Electroencephalograms (EEGs) were reanalyzed, and missing data were imputed. After selecting the features and normalizing the data, the dataset and an identical randomized dataset were subjected to\n                      <jats:italic>k<\/jats:italic>\n                      \u2010means cluster analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The dataset comprised 502 patients and 22 distinct nonoverlapping clinical features. Elbow and gap analyses revealed an optimal number of clusters of 1; the features with the highest eigenvalues were age at diagnosis and self\u2010reported executive dysfunction. Applying\n                      <jats:italic>k<\/jats:italic>\n                      \u2010means clustering yielded three low\u2010quality clusters as assessed by silhouette score (mean = .400\u2009\u00b1\u2009.01). The corresponding mean silhouette score for the randomized control dataset was .390 (\u00b1.002). Age at diagnosis was associated with the epileptic discharges on EEG and treatment response. Self\u2010reported executive dysfunction showed associations with psychiatric symptoms and impulsivity. JME, JAE, and EGTCS were loosely associated with the clusters (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u2009.088,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002) but showed a specific distribution within a matrix defined by age at diagnosis and self\u2010reported executive dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>IGE in adults is best described as a continuum of symptoms, where age at diagnosis and executive dysfunction are two main factors explaining most of its clinical variability. The seizure\u2010defined syndromes cover different patient groups within the clinical spectrum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18225","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T09:35:08Z","timestamp":1735205708000},"page":"700-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Unsupervised clustering of a deeply phenotyped cohort of adults with idiopathic generalized epilepsy"],"prefix":"10.1111","volume":"66","author":[{"given":"Line","family":"Gavnholt","sequence":"first","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Gesche","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-555X","authenticated-orcid":false,"given":"Emanuele","family":"Cerulli Irelli","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1565-6948","authenticated-orcid":false,"given":"Thomas","family":"Kr\u00f8ig\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Neurophysiology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie Bloch","family":"Mangaard","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Di Bonaventura","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-2514","authenticated-orcid":false,"given":"Guido","family":"Rubboli","sequence":"additional","affiliation":[{"name":"Danish Epilepsy Center, member of European Reference Network EpiCARE  Dianalund Denmark"},{"name":"Institute of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"R\u00f6ttger","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Computer Science University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph Patrick","family":"Beier","sequence":"additional","affiliation":[{"name":"Department of Neurology Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Open Patient Data Explorative Network Odense University Hospital  Odense Denmark"},{"name":"Brain Research\u2013Interdisciplinary Guided Excellence Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17236"},{"key":"e_1_2_12_3_1","first-page":"3","volume-title":"Idiopathic generalized epilepsies: clinical, experimental and genetic aspects","author":"Wolf 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