The relationships between obesity and epilepsy: A systematic review with meta-analysis

Yu-xuan Li; Wang Guo; Ruo-xia Chen; Xue-rui Lv; Yun Li

doi:10.1371/journal.pone.0306175

Peer Review History

Original SubmissionNovember 18, 2023
6 Feb 2024 Decision Letter - Dragan Hrncic, Editor Transfer Alert This paper was transferred from another journal. As a result, its full editorial history (including decision letters, peer reviews and author responses) may not be present. PONE-D-23-34820The relationships between obesity and Epilepsy:A systematic review with meta-analysisPLOS ONE Dear Dr. li, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== ACADEMIC EDITOR: - in addition to the comments of the reviewers, please do make following improvements: - formulation of the aim at the end of introduction section should be done better. emphasize that you are performing meta analysis. It's not enough to say that you are investigating "connection"-emphasize limitation of your study in discussion- make a take a home massage based on your results as a concluding paragraph (giving perspectives are fine, but make a clear conclusion). ============================== Please submit your revised manuscript by Mar 22 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. 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Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Dear Authors Thank you for this manuscript on the important topic of the relation between obesity annd epilepsy. The study was done to examine the correlation between obesity and epilepsy hence only case control studies were selected. I suggest studies of other research design could also be reviewed. The result should state the difference that were seen when the sensitivity analysis was done for the studies excluding hightest weight. What was the reason behind the subgroup analysis of years of publication and developed and developing countries? Also discussion has more part on various drug and their obesity inducing effects which can be tabulated for a better understanding. It would be more comprehensible if the studies are arranged in chronological order as per the year of publication. Thank you Best wishes ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Harsh Priya ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0306175.r001
Revision 1
8 May 2024 Author Response Response to Reviewers Dear editor, first of all,I would like to thank you and the reviewers for your review of our manuscript and your valuable suggestions for revision.We have carefully read your amendment comments and have carefully revised in response to the issues you have raised.We have marked the revised part of the manuscript in red font,and the specific content can be seen in the "Revised Manuscript with Track Changes".Below are our responses to your comments. 1.Responding to comments from academic editors: (1)formulation of the aim at the end of introduction section should be done better.emphasize that you are performing meta analysis.It's not enough to say that you are investigating "connection". Thank you very much for your valuable revision suggestions,so that we can further improve the article.After careful consideration,we have made corrections and additions.We have carefully considered your comments.First of all,we emphasize that we are conducting a meta-analysis,and further explain that the purpose of meta is to better explore the correlation between epilepsy and obesity,and further provide references forclinical diagnosis and treatment of epilepsy.Therefore,our study supplemented the possible influencing factors of obesity and epilepsy,and increased the practical reference value for clinical work.The changes formulated are detailed in the introduction section of the revised manuscript. (2)emphasize limitation of your study in discussion. Our study did have some limitations,and we have added a more detailed supplementary note.See the limitations section of the manuscript for details. (3)make a take a home massage based on your results as a concluding paragraph (giving perspectives are fine,but make a clear conclusion). I think you're right.We really don't seem to have a clear conclusion.We have added and modified the conclusions in the results section.See the research results sectionof the manuscript for details. 2.Respond to reviewer's comments: (1)The study was done to examine the correlation between obesity and epilepsy hence only case control studies were selected. I suggest studies of other research design could also be reviewed. In accordance with your suggestions,we have made careful revisions to our manuscript.Your suggestions are very helpful to improve the quality of our manuscripts.On the basis of the original case-control study,we added cohort studies,non-randomized controlled trials and cross-sectional studies,but after further screening,the cohort studies and non-randomized controlled trials were excluded after they failed to meet our screening conditions.After the final screening,we added a cross-sectional study to further expand our research.This makes our research more comprehensive and convincing. (2)The result should state the difference that were seen when the sensitivity analysis was done for the studies excluding hightest weight. We performed a sensitivity analysis by excluding the studies with the highest weight(Fig 5),and the results showed heterogeneity(p=0.008, I2=52%),indicating that the meta-analysis results may be unstable. (3)What was the reason behind the subgroup analysis of years of publication and developed and developing countries? We conducted subgroup analysis of the year of publication and the degree of development of the country in order to find the reasons for the heterogeneity of the meta-analysis results.First,different economic development in different publication years may affect the incidence of obesity and epilepsy.However,subgroups found that publication years were not related to the heterogeneity of meta-analysis results.Secondly,the subgroup analysis of developed and developing countries is also due to the consideration of the impact of economic issues on epilepsy and obesity.However,it is also found that the development level of a country has no significant correlation with the correlation between epilepsy and obesity,and the source of heterogeneity is not found.However,according to your suggestion,we have added some studies and conducted subgroup analysis on the publication years and economic development again,and found that the publication years and economic development level are the sources of heterogeneity.In order to better discuss the source of heterogeneity,we further conducted subgroup analysis and found that age was also the source of heterogeneity in our study. (4)Also discussion has more part on various drug and their obesity inducing effects which can be tabulated for a better understanding. Thank you very much for your advice.We have further increased the impact of various anti-epileptic drugs on obesity,which can indeed better understand and compare the impact of different drugs on obesity,and provide better reference value for clinical drug use.See Table 3 added to the manuscript for details (5)It would be more comprehensible if the studies are arranged in chronological order as per the year of publication. Thank you very much for your suggestion,we have revised it. Finally,thank you again for your valuable comments and those of the reviewers!At the same time,we hope that if you find any deficiencies again in the process of review,please kindly give us your valuable revision suggestions again,and we will continue to revise carefully.We look forward to publishing our articles on your magazine platform,and we will work harder for this.Looking forward to your good news. Yours sincerely, Yu-xuan Li Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China.18408832102 liyuxuandldx@163.com Attachments Attachment Submitted filename: Response to Reviewers.pdf https://doi.org/10.1371/journal.pone.0306175.r002
12 Jun 2024 Decision Letter - Dragan Hrncic, Editor The relationships between obesity and Epilepsy:A systematic review with meta-analysis PONE-D-23-34820R1 Dear Dr. li, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Prof.Dr. Dragan Hrncic, MD, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you to the authors. I am convinced with the step by step reply. All the requisite questions are sorted. It may be accepted. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No ******** https://doi.org/10.1371/journal.pone.0306175.r003
Formally Accepted
28 Jun 2024 Acceptance Letter - Dragan Hrncic, Editor PONE-D-23-34820R1 PLOS ONE Dear Dr. Li, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Dragan Hrncic Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0306175.r004

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