Zahra Sadat-Hossieny, MD

All Publications

• Effects of antiepileptic drugs on cognition Post-traumatic Epilepsy Meador , K., Sadat-Hossieny, Z. 2021: 169-179
• Folate fortification of food: Insufficient for women with epilepsy. Epilepsy & behavior : E&B Sadat-Hossieny, Z. n., Robalino, C. P., Pennell, P. B., Cohen, M. J., Loring, D. W., May, R. C., Block, T. n., Swiatlo, T. n., Meador, K. J. 2021; 117: 107688

  Abstract

  Folic acid supplementation during the periconceptual period has been shown to improve cognitive outcomes in children of women with epilepsy taking anti-seizure medications (ASMs). The dose of folic acid necessary to provide positive cognitive outcomes is unclear. In many countries including the United States, food is fortified with folic acid, but no data exist on how food fortification may affect cognition in children with fetal-ASM exposure. This study evaluated the effect of dietary folate from natural folates plus folic acid fortification, separate from folic acid vitamin supplements, on age-6 year IQ in children with fetal-ASM exposure.Data from the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study were retrospectively analyzed for this investigation. Assessment of nutrient intake was conducted using the Block Food Frequency Questionnaire-98. The primary outcome of the present study was to assess association of maternal prepregnancy nutrient levels to child age-6 IQ.Folate from food alone without supplement was not associated with improvement of age-6 IQ in children with fetal ASM exposure (95% CI: -11.7-2.3, p = 0.187). Periconceptual folate supplement use was associated with a 10.1-point higher age-6 IQ (95% CI: 5.2-15.0, p < .001). Total combined folate from food plus supplement also showed that higher intake of folate was associated with higher age-6 IQ (Coefficient: 4.5, 95% CI: 2.0-6.9, p < .001). Six other nutrients from food and supplements were analyzed (Vitamin C, Vitamin D, Vitamin E, Omega 3, Gamma Tocopherol, and Vitamin B12) and had no significant association with age 6-IQ.Dietary content of folate, even in a country where food is fortified with folic acid, is not sufficient to provide improved cognitive outcomes for children of women taking ASMs during pregnancy. Folate supplementation is needed for significant improvement in cognitive outcomes, specifically age-6 IQ.

  View details for DOI 10.1016/j.yebeh.2020.107688

  View details for PubMedID 33636531

• Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments. Seizure Helmstaedter, C., Sadat-Hossieny, Z., Kanner, A. M., Meador, K. J. 2020

  Abstract

  This is the second of two narrative reviews on cognitive disorders in epilepsy (companion manuscript: Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations). Its focus is on the clinical targets, indications, and the selection of neuropsychological test instruments. Cognitive assessment has become an essential tool for the diagnosis and outcome control in the clinical management of epilepsy. The diagnostics of basic and higher brain functions can provide valuable information on lateralized and localized brain dysfunctions associated with epilepsy, its underlying pathologies and treatment. In addition to the detection or verification of deficits, neuropsychology reveals the patient's cognitive strengths and, thus, information about the patient reserve capacities for functional restitution and compensation. Neuropsychology is an integral part of diagnostic evaluations mainly in the context of epilepsy surgery to avoid new or additional damage to preexisting neurocognitive impairments. In addition and increasingly, neuropsychology is being used as a tool for monitoring of the disease and its underlying pathologies, and it is suited for the quality and outcome control of pharmacological or other non-invasive medical intervention. This narrative review summarizes the present state of neuropsychological assessments in epilepsy, reveals diagnostic gaps, and shows the great need for education, homogenization, translation and standardization of instruments.

  View details for DOI 10.1016/j.seizure.2020.09.031

  View details for PubMedID 33172763

• Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations. Seizure Kanner, A. M., Helmstaedter, C. n., Sadat-Hossieny, Z. n., Meador, K. n. 2020

  Abstract

  This is the first of two narrative reviews on cognitive disorders in epilepsy (companion publication : Cognitive disorders in epilepsy II: Clinical Targets, Indications and Selection of Test Instruments). Its focus is on clinical experience, real-world evidence, and clinical recommendations. Cognitive disorders are a common comorbidity in children and adults with epilepsy. These cognitive disturbances may preceed the onset of seizures and are multifactorial including contributions by pre-existing brain damage, seizures, interictal epileptic discharges, and treatments including medications and surgery. Comorbid cognitive impairments can have a negative impact on the quality of life in people with epilepsy. They are under-identified and frequently not treated. Comorbid psychiatric disorders, such as ADHD can also contribute to a worse cognitive performance and can benefit from pharmacotherapy with CNS stimulants. Likewise, mood disorders cause a subjective perception of poor memory and attention, which can be reversed with antidepressants of the SSRI family. This narrative review discusses these issues from a real-world clinical perspective in children and adults with newly diagnosed and chronic epilepsy. The need for further research to understand and treat these disorders is noted.

  View details for DOI 10.1016/j.seizure.2020.10.009

  View details for PubMedID 33127274

• Plateau waves of intracranial pressure mimicking seizure in a patient with fungal meningitis Wu, T., Sadat-Hossieny, Z., Gold, C. LIPPINCOTT WILLIAMS & WILKINS. 2019

  View details for Web of Science ID 000475965901049

• Role of Cerebrospinal Fluid Protein and Laboratory Testing in Guillain Barre Syndrome Saba, K., Sadat-Hossieny, Z., Arnold, W., Elsheikh, B., Kline, D., Stino, A. LIPPINCOTT WILLIAMS & WILKINS. 2019

  View details for Web of Science ID 000475965901358

• Pharmacological Agents in Aneurysmal Subarachnoid Hemorrhage: Successes and Failures CLINICAL NEUROPHARMACOLOGY Behrouz, R., Sadat-Hosseiny, Z. 2015; 38 (3): 104–8

  Abstract

  Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating condition with high mortality. Proper management of this complex disease requires early surgical intervention followed by medical therapy. Pharmacological agents that unequivocally improve outcomes in aSAH are scarce.The authors performed an exhaustive query of several databases including MEDLINE, the CENTRAL Register of Controlled Trials, and the Cochrane Database of Systematic Reviews for specific evidence on key medications that have been used in the treatment of aSAH.The bulk of the data available pertained to the following medications: calcium channel blockers, magnesium, statins, antifibrinolytics, aspirin, glucocorticoids, clazosentan, and tirilazad. Except for calcium channel blockers, the authors could not find any hard evidence that any of these agents affected outcome to a tangible degree. Aspirin may have some promise in prevention of aneurysm rupture and incidence of aSAH, but more substantive data are needed to conclusively corroborate this.Investigational efforts to attain outcome-modifying agents have had dubious results, but the inquest for discovery should not discontinue.

  View details for DOI 10.1097/WNF.0000000000000085

  View details for Web of Science ID 000354655200004

  View details for PubMedID 25970278