Lei Chen

Background/Objectives: In Tibetan-inhabited plateau regions of western China, remoteness, uneven access to care, and preventable causes complicate epilepsy care. We assessed whether regional evidence supports an independent effect of chronic altitude exposure on epilepsy risk and identified healthcare priorities. Methods: We conducted a targeted narrative review of English-language journal articles published through 12 June 2026 (PubMed/MEDLINE, Web of Science Core Collection, citation tracking). Altitude-related evidence was evaluated against four prespecified, review-defined features; core sources underwent structured qualitative appraisal. Results: Three community surveys with differing case definitions and ascertainment reported prevalence estimates of 2.5–23.5 per 1000; the most recent (Daofu County, 2025) reported 4.4 per 1000 (95% confidence interval 3.7–5.1). No population-based incidence study of long-term residents was identified among the retrieved publications, and no identified resident-population study reported all four features. Regional studies documented parasitic, traumatic, and vascular etiologies, historical treatment gaps of 97–100%, and uneven diagnostic and workforce capacity. Among 127 Daofu participants assessed in detail, 33.1% were classified as receiving nonstandard treatment and 14.2% as untreated; 35.4% and 52.0% screened positive for depressive and anxiety symptoms. Conclusions: Current evidence neither establishes nor excludes an independent effect of chronic altitude exposure. It supports prospective evaluation of prevention, treatment continuity, diagnostic and referral services, workforce development, integrated mental health care, and surveillance.

Background/Objectives: Cognitive dysfunction is clinically relevant in epilepsy, and objective task-based measures could complement neuropsychological assessment, but visual working memory across graded loads and task-embedded gaze remain incompletely characterized. We quantified task-estimated capacity and performance using gaze-triggered change localization. Methods: We analyzed data from 222 adults with epilepsy, including focal and generalized epilepsy, and 133 healthy controls. Participants identified the changed item in a test array by sustained gaze; set size (2–7) followed a staircase procedure. Outcomes were three task-performance measures, two capacity-related measures, and eight eye-movement measures. Repeated-measure outcomes were analyzed with mixed-effect models and the capacity-related measures by ordinary least squares, with Benjamini–Hochberg correction. Results: Adults with epilepsy had lower mean set size and K at set size 4 (K4), lower accuracy, longer response time, and greater final gaze-to-target distance than controls (all q < 0.05; absolute Cohen’s d, 0.20–0.45). K4 was 2.66 versus 3.03 items. Differences persisted after adjustment for educational attainment and were directionally similar in focal and generalized epilepsy. No interaction between group and set size survived correction for task performance; group differences did not vary detectably across the observed load range. No eye-movement group difference survived correction. Conclusions: In a relatively large adult cohort, task-estimated visual working memory capacity and task performance were lower in epilepsy, without broad corrected group differences in the selected array-level eye-movement measures. By combining graded load with gaze-based response registration, the study characterizes the magnitude, load dependence, timing, and spatial precision of visual working memory performance differences within a single task.

Epilepsy represents a global public health challenge, with its burden distribution profoundly illuminating patterns of health inequality. Based on the Global Burden of Disease Study 2021 (GBD 2021) data, this review constructs a three‐dimensional analytical framework encompassing biological determinants, health system performance, and social determinants of health. Over the past three decades, although the absolute number of individuals with epilepsy worldwide has continued to increase, age‐standardized mortality rates have declined substantially. However, 87.9% of the associated disability‐adjusted life years (DALYs) are concentrated in low‐ and lower‐middle‐income countries (LMICs). China, with approximately 9–10 million people living with epilepsy, confronts a triple disparity encompassing regional disparities, urban‐rural gaps, and health system hierarchy barriers: mortality rates in western provinces are approximately nine times higher than those in eastern regions; the treatment gap in rural areas reaches 60%–90%; and primary care capacity deficits within the tiered diagnosis and treatment system create bottlenecks in case identification and referral. Concurrently, the disease spectrum is undergoing a profound transition, with an increasing burden of post‐stroke epilepsy in older adults, while special populations, including children and women, continue to face persistent challenges. Despite China's notable achievements in reducing mortality and establishing a tertiary epilepsy center network, multiple interacting factors perpetuate a vicious cycle of poverty, disease, and stigma among affected individuals. Future efforts require alignment with the World Health Organization Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP) to develop precision prevention and control strategies, thereby contributing the Chinese experience to global epilepsy governance.

Background: This study aimed to evaluate the potential efficacy and neurophysiological effects of Kuanxiong Aerosol (KXA) in preventing acute mountain sickness (AMS) during simulated high-altitude exposure. Methods: In this randomized, double-blind, placebo-controlled trial, 20 healthy volunteers underwent a 6-hour hypobaric hypoxia session (simulated 4000 m) after receiving either KXA or placebo. Outcomes included the Lake Louise Score (LLS), AMS incidence, physiological parameters (SpO ₂ , heart rate), cognitive performance (PMT, Symbol-Digit Modalities Test), and cerebral blood flow (CBF) measured by MRI. An exploratory post-hoc subgroup analysis was also conducted in nine participants who voluntarily received an additional KXA session in a self-controlled manner. Results: In the main trial, KXA administration was associated with a non-significant reduction in total LLS and a decrease in AMS incidence from 50% (placebo) to 30% (KXA). No significant differences were observed in SpO ₂ , cognitive tests, or global CBF. However, the KXA group showed a smaller increase and more stable heart rate profile over time. Exploratory regional CBF analyses revealed reduced perfusion in selected subregions of the limbic and control networks in the KXA group ( p < 0.05 uncorrected). In the post-hoc self-controlled subgroup (n = 9), KXA significantly reduced total LLS ( p = 0.037) and decreased AMS incidence from 44% to 0%, with trends toward improved cognitive performance. Conclusion: KXA shows preliminary potential for alleviating AMS symptoms under simulated high-altitude conditions, possibly through cardiac and regional cerebrovascular modulation. These findings support further investigation in larger, randomized controlled trials in real-world high-altitude settings to confirm efficacy and clarify the underlying mechanisms. Chinese clinical trial registry: ChiCTR2500105469.