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Lesica S, Luu H, Lawrence M. Performance validity in a presurgical epilepsy population. Clin Neuropsychol 2024:1-13. [PMID: 39138860 DOI: 10.1080/13854046.2024.2391128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
Objective: This study examined the performance validity test (PVT) pass/fail rate in a sample of presurgical epilepsy candidates; assessed whether performance validity was associated with reduced performance across cognitive domains; investigated the relationship between performance validity and self-report mood questionnaires; and assessed whether PVT performance was associated with demographic or clinical factors (i.e. sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications). Methods: One hundred and eighty-three presurgical epilepsy candidates were examined. Each patient's assessment battery included a stand-alone performance validity measure and two embedded validity measures. Results: PVT failure rate in this sample (10%) was associated with reduced performance on all neurocognitive measures: Full Scale IQ (FSIQ; r = -0.26), CVLT-II Total Learning (r = -0.36) and Long Delay Free Recall (LDFR; r = -0.38), BVMT-R Delayed Recall (r = -0.28), and Wisconsin Card Sorting Test (Categories Completed; r = -0.32). In addition, PVT failure rate was associated with elevated scores on the Beck Anxiety Inventory (r = .22) but not on the Beck Depression Inventory (BDI-II; r = .14). Correlations that were significant at the α = 0.05 level maintained significance following post hoc Bonferroni correction. The valid and invalid groups did not differ significantly in sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications. Conclusions: Results from this study suggest that PVT performance was not impacted by demographic or clinical factors and therefore may be a reliable indicator of performance validity in a presurgical epilepsy sample.
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Affiliation(s)
- Sofia Lesica
- Corewell Health, Grand Rapids, MI, USA
- Central Michigan University, Mount Pleasant, MI, USA
| | - Hien Luu
- Corewell Health, Grand Rapids, MI, USA
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Soto-Angona Ó, Fortea A, Fortea L, Martínez-Ramírez M, Santamarina E, López FJG, Knudsen GM, Ona G. Do classic psychedelics increase the risk of seizures? A scoping review. Eur Neuropsychopharmacol 2024; 85:35-42. [PMID: 38917636 DOI: 10.1016/j.euroneuro.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/27/2024] [Accepted: 05/01/2024] [Indexed: 06/27/2024]
Abstract
Seizures are a concerning adverse event frequently associated with the use of psychedelics, and hence, studies involving these substances tend to exclude patients with past history of epilepsy. This is especially relevant because epileptic seizures are markedly increased in the population suffering from mental disorders, and psychedelic assisted therapy is being researched as a promising treatment for several of them. To determine the extent of the current literature on the relationship between classic psychedelics and seizures, a scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). The search was conducted in PubMed, Web of Science, Google scholar, LILACS and Scielo, and both animal and human models were included. A total of 16 publications on humans, and 11 on animals, were found. The results are heterogeneous, but globally suggest that psychedelics may not increase the risk of seizures in healthy individuals or animals in the absence of other drugs. However, concomitant use of other substances or drugs, such as kambo or lithium, could increase the risk of seizures. Additionally, these conclusions are drawn from data lacking sufficient external validity, so they should be interpreted with caution. Future paths for research and a summary on possible neurobiological underpinnings that might clarify the relationship between classical psychedelics and seizures are also provided.
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Affiliation(s)
- Óscar Soto-Angona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Adriana Fortea
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Lydia Fortea
- Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Department of Medicine, University of Barcelona, Institute of Neuroscience, Barcelona, Spain
| | - María Martínez-Ramírez
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Estevo Santamarina
- Epilepsy Unit. Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | | | - Gite Moos Knudsen
- Neurobiology Research Unit, Rigshospitalet and Dept. Clinical Medicine, University of Copenhagen, Denmark
| | - Genís Ona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Universitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Tarragona, Catalonia, Spain.
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Talıbov T, İnci M, Ismayılov R, Elmas S, Büyüktopçu E, Kepenek AO, Şirin G, Polat I, Özkan M, Bebek N. The relationship of psychiatric comorbidities and symptoms, quality of life, and stigmatization in patients with epilepsy. Epilepsy Behav 2024; 156:109838. [PMID: 38768552 DOI: 10.1016/j.yebeh.2024.109838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/17/2024] [Accepted: 05/11/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE Research around the frequency of psychiatric diseases and psychosocial consequences caused by seizures and stigmatization in patients with epilepsy is important, in terms of multidimensional evaluation of the condition, increasing quality of life, and controlling the frequency of seizures. This prospective study aimed to evaluate relationship between comorbid psychiatric diseases and clinical and sociodemographic data, patients' quality of life and perceived stigma in patients with epilepsy. METHODS In this prospective single-center study, we evaluated clinical and demographic data, and characteristics of epilepsy. We used the Symptom Check List 90-Revised (SCL-90-R) as a screening test for psychiatric comorbidities and the Mini International Neuropsychiatric Interview (MINI) test for patients who had an SCL90-R general symptom index (GSI) score of ≥1. The frequency of psychiatric comorbidities, the association between comorbid psychiatric disorders and quality of life, and the level of stigmatization in patients with epilepsy was assessed using the Quality of Life in Epilepsy Inventory (QOLIE-10) and Perceived Stigma Scale. RESULTS SCL90-R GSI scores of ≥1 were found in 122 of 300 patients. Psychiatric comorbidities were found in 24.8% (n = 69) of patients with epilepsy in the MINI test, major depression was found in 16.9 %, (n = 47), and generalized anxiety disorder was the most common (5.7 %, n = 16). The number of anti-seizure medications (p = 0.007), high seizure frequency (p = 0.01), seizure in previous 12 months (p = 0.003), history of epilepsy surgery (p = 0.032) and psychiatric disease (p < 0.001), and high perceived stigma (p < 0.001) and QOLIE-10 (p < 0.001) scores were all correlated with psychiatric comorbidities. CONCLUSIONS According to the results of our study, an important correlation was determined between psychiatric comorbidities and a history of psychiatric disease, poor quality of life, and high perceived stigma scores in patients with epilepsy. This suggests that screening patients for comorbid psychiatric conditions in epilepsy outpatient clinics is critical, as is establishing a strong collaboration with the psychiatry clinic, to reduce psychosocial issues and the economic burden of stigmatization and improve quality of life.
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Affiliation(s)
- Tural Talıbov
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
| | - Meltem İnci
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Rashad Ismayılov
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Sibel Elmas
- Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Emiralp Büyüktopçu
- Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Ata Onur Kepenek
- Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Görkem Şirin
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - Irmak Polat
- Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Mine Özkan
- Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Nerses Bebek
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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Aljafen BN, Alneseyan R, Muayqil T, Alkhateeb MO, Aldosari MM, Alsermani A, Alnakhli L, Althomali R, Alnami R, Alqahtani R, Ibrahim L, Babtain F. Evaluating the prevalence and risk factors for depression in patients with temporal lobe epilepsy with hippocampal sclerosis: A cross-sectional multicenter study. Epilepsy Behav 2024; 154:109782. [PMID: 38636108 DOI: 10.1016/j.yebeh.2024.109782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/12/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Epilepsy frequently accompanies Major Depressive Disorder (MDD). Notably, people with temporal lobe epilepsy and hippocampal sclerosis may face an increased susceptibility to MDD, as evidence indicates the involvement of the limbic system in the development of emotional symptoms. OBJECTIVES To determine the prevalence and predictors of depression in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and compare them to those of other epilepsy types. METHODS A sample of 293 epilepsy patients, including 159 non-TLE-HS and 134 TLE-HS, were recruited from three hospitals. Of these, 215 completed a two-section electronic survey. The first section collected demographic and epilepsy data, while the second used the Arabic version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). RESULTS Of 215 patients, 104 (48%) had TLE-HS-38 with right TLE-HS (37%), 56 with left TLE-HS (54%), and 10 with bilateral TLE-HS (10%). The prevalence and severity of depression was assessed with an NDDI-E score of 15 or higher identified 35 patients (16%) with MDD. Valproic acid and lamotrigine were associated with higher NDDI-E scores. No such associations were found for levetiracetam or carbamazepine. Polytherapy in TLE-HS showed a significant correlation with daily poor concentration. CONCLUSION We explored the differences in depression prevalence between TLE-HS and other epilepsy types and concluded they are minimal but slightly higher in TLE-HS. Predictors of depression such as seizure frequency and disease duration influenced MDD prevalence in TLE-HS. Lamotrigine and valproate were linked to higher NDDI-E scores.
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Affiliation(s)
- Bandar N Aljafen
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Ruwa Alneseyan
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Taim Muayqil
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mashael O Alkhateeb
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Alfasial University, Riyadh, Saudi Arabia
| | - Mubarak M Aldosari
- Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Aya Alsermani
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Lujain Alnakhli
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Renad Althomali
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Razan Alnami
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Ruba Alqahtani
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Lama Ibrahim
- College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Fawzi Babtain
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Proverbio AM, Cesati F. Neural correlates of recalled sadness, joy, and fear states: a source reconstruction EEG study. Front Psychiatry 2024; 15:1357770. [PMID: 38638416 PMCID: PMC11024723 DOI: 10.3389/fpsyt.2024.1357770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction The capacity to understand the others' emotional states, particularly if negative (e.g. sadness or fear), underpins the empathic and social brain. Patients who cannot express their emotional states experience social isolation and loneliness, exacerbating distress. We investigated the feasibility of detecting non-invasive scalp-recorded electrophysiological signals that correspond to recalled emotional states of sadness, fear, and joy for potential classification. Methods The neural activation patterns of 20 healthy and right-handed participants were studied using an electrophysiological technique. Analyses were focused on the N400 component of Event-related potentials (ERPs) recorded during silent recall of subjective emotional states; Standardized weighted Low-resolution Electro-magnetic Tomography (swLORETA) was employed for source reconstruction. The study classified individual patterns of brain activation linked to the recollection of three distinct emotional states into seven regions of interest (ROIs). Results Statistical analysis (ANOVA) of the individual magnitude values revealed the existence of a common emotional circuit, as well as distinct brain areas that were specifically active during recalled sad, happy and fearful states. In particular, the right temporal and left superior frontal areas were more active for sadness, the left limbic region for fear, and the right orbitofrontal cortex for happy affective states. Discussion In conclusion, this study successfully demonstrated the feasibility of detecting scalp-recorded electrophysiological signals corresponding to internal and subjective affective states. These findings contribute to our understanding of the emotional brain, and have potential applications for future BCI classification and identification of emotional states in LIS patients who may be unable to express their emotions, thus helping to alleviate social isolation and sense of loneliness.
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Affiliation(s)
- Alice Mado Proverbio
- Cognitive Electrophysiology Lab, Department of Psychology, University of Milano-Bicocca, Milan, Italy
- NEURO-MI Milan Center for Neuroscience, Milan, Italy
| | - Federico Cesati
- Cognitive Electrophysiology Lab, Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Alemam S, Bokhari SA, Hasan SF, Al Ammour S, Hussein B, Elnoor M. A Case of Treatment-Resistant Schizophrenia With Mesial Temporal Sclerosis: A Case Report. Cureus 2023; 15:e49623. [PMID: 38161891 PMCID: PMC10755633 DOI: 10.7759/cureus.49623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Mesial temporal sclerosis (MTS) is one of the most common causes of treatment-resistant epilepsy, especially temporal lobe epilepsy (TLE). Various psychiatric symptoms are common with temporal lobe epilepsy. However, the least established symptoms were psychotic symptoms. Furthermore, treatment-resistant schizophrenia is a significant proportion of schizophrenia patients who have failed treatment with at least two different antipsychotics, resulting in poor outcomes and a significant negative impact on the patient's life. In our case report, psychotic symptoms and abnormal behaviors were explained by schizophrenia for more than 17 years in a 32-year-old female, while the diagnosis of temporal lobe epilepsy with mesial temporal sclerosis was missed, resulting in incomplete treatment, which led to a deterioration of her quality of life for years. This case aims to shed light on TLE rare manifestations and to discuss the proper investigations and treatment that might increase the quality of life of these patients. Underlining the necessity for more research in treatment-resistant schizophrenia, this unusual case underscores the importance of exploring the underlying biological, psychological, and social risk factors. It also emphasizes the need to focus additional attention on formulating proper investigation strategies for the susceptible patient population.
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Affiliation(s)
- Shokry Alemam
- Psychiatry, Al Amal Psychiatric Hospital, Dubai, ARE
| | | | - Safa F Hasan
- Psychiatry, Al Amal Psychiatric Hospital, Dubai, ARE
| | | | - Basma Hussein
- Psychiatry, Al Amal Psychiatric Hospital, Dubai, ARE
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Zubareva OE, Sinyak DS, Kalita AD, Griflyuk AV, Diespirov GP, Postnikova TY, Zaitsev AV. Antiepileptogenic Effects of Anakinra, Lamotrigine and Their Combination in a Lithium-Pilocarpine Model of Temporal Lobe Epilepsy in Rats. Int J Mol Sci 2023; 24:15400. [PMID: 37895080 PMCID: PMC10607594 DOI: 10.3390/ijms242015400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Temporal lobe epilepsy is a common, chronic disorder with spontaneous seizures that is often refractory to drug therapy. A potential cause of temporal lobe epilepsy is primary brain injury, making prevention of epileptogenesis after the initial event an optimal method of treatment. Despite this, no preventive therapy for epilepsy is currently available. The purpose of this study was to evaluate the effects of anakinra, lamotrigine, and their combination on epileptogenesis using the rat lithium-pilocarpine model of temporal lobe epilepsy. The study showed that there was no significant difference in the number and duration of seizures between treated and untreated animals. However, the severity of seizures was significantly reduced after treatment. Anakinra and lamotrigine, alone or in combination, significantly reduced neuronal loss in the CA1 hippocampus compared to the control group. However, the drugs administered alone were found to be more effective in preventing neuron loss in the hippocampal CA3 field compared to combination treatment. The treatment alleviated the impairments in activity level, exploratory behavior, and anxiety but had a relatively weak effect on TLE-induced impairments in social behavior and memory. The efficacy of the combination treatment did not differ from that of anakinra and lamotrigine monotherapy. These findings suggest that anakinra and lamotrigine, either alone or in combination, may be clinically useful in preventing the development of histopathological and behavioral abnormalities associated with epilepsy.
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Affiliation(s)
| | | | | | | | | | | | - Aleksey V. Zaitsev
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, 194223 Saint Petersburg, Russia; (O.E.Z.); (D.S.S.); (A.D.K.); (A.V.G.); (G.P.D.); (T.Y.P.)
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8
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Sobregrau P, Baillès E, Carreño M, Donaire A, Boget T, Setoain X, Bargalló N, Rumià J, V Sánchez Vives M, Pintor L. Psychiatric and psychological assessment of patients with drug-resistant epilepsy and psychogenic nonepileptic seizures (PNES) with no response to previous treatments. Epilepsy Behav 2023; 145:109329. [PMID: 37453292 DOI: 10.1016/j.yebeh.2023.109329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Psychogenic nonepileptic seizures (PNES) are common imitators of epileptic seizures. Refractoriness to antiseizure medication hinders the differential diagnosis between ES and PNES, carrying deleterious consequences in patients with PNES. Psychiatric and psychological characteristics may assist in the differential diagnosis between drug-resistant epilepsy (DRE) and PNES. Nevertheless, current comprehensive psychiatric and psychological descriptive studies on both patient groups are scarce and with several study limitations. This study provides a comprehensive psychiatric and psychological characterization of Spanish patients with DRE and PNES. METHOD A cross-sectional and comparative study was completed with 104 patients with DRE and 21 with PNES. Psychiatric and psychological characteristics were assessed with the HADS, SCL-90-R, NEO-FFI-R, PDQ-4+, COPE, and QOLIE-31 tests. Parametric and non-parametric tests were used, and regression models were fit to further explore factors affecting patients' life quality. RESULTS Patients with PNES had greater levels of somatization and extraversion and were associated with benzodiazepine intake. Patients with DRE showed greater narcissistic personality disorder symptoms than those with PNES. In patients with DRE, difficulty in performing basic needs-related tasks and greater psychological distress severity and seizure frequency were associated with poorer life quality. In contrast, being a woman, having a psychiatric disorder history, and greater psychiatric symptoms' intensity were associated with poorer life quality in patients with PNES. CONCLUSION Patients with DRE and PNES share similar psychiatric and psychological characteristics, with only very few being significantly different.
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Affiliation(s)
- Pau Sobregrau
- Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain; Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain.
| | - Eva Baillès
- Health Psychology Unit, Psychiatry Department, Vall d'Hebron, Barcelona 08035, Spain
| | - Mar Carreño
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Antonio Donaire
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Teresa Boget
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - Xavier Setoain
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Núria Bargalló
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Jordi Rumià
- Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain
| | - María V Sánchez Vives
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain; Department of Cognition, Development and Educational Psychology, Faculty of Psychology, University of Barcelona (UB), Barcelona 08007, Spain
| | - Luís Pintor
- Department of Psychiatry, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Clinical Institute of Neurosciences, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Epilepsy Unit, Neurology Department, University Hospital Clinic of Barcelona (HCP), Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University Hospital Clinic of Barcelona, Barcelona 08036, Spain
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9
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Firoozjah MH, Homayouni A, Shahrbanian S, Shahriari S, Janinejad D. Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in adolescent athletes during Covid19 pandemic. BMC Public Health 2022; 22:1444. [PMID: 35906564 PMCID: PMC9334982 DOI: 10.1186/s12889-022-13816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/19/2022] [Indexed: 12/02/2022] Open
Abstract
The following study investigates the correlational relationship between behavioral activation/inhibition systems, lifestyle and mental disorders in Adolescent Athletes during the Covid-19 pandemic. Methods: Research methods are descriptive and correlational; “Of the eligible participants who were available during a COVID-19 quarantine period from June through August 2020 (N = 180), the Krejcie and Morgan Sampling Method was used to simplify the process of determining the sample size for a finite population [46], resulting in a calculation of N = 130 sample participants. to respond to Carver & White’s Behavioral activation/inhibition systems Scale (BIS/BAS), Mille’s Lifestyle Questionnaire and Goldberg & Williams’s General Health Questionnaire (GHQ-12). Data was analyzed using linear regression analysis and Pearson’s correlation coefficient. Results: Findings showed a positive correlation of statistical significance between behavioral inhibition systems (BIS) and mental disorders in Adolescent Athletes at the 0.01 level and a negative correlation of statistical significance between scaling components of the behavioral activation systems (BAS), lifestyle and mental disorders in Adolescent Athletes at the 0.05 level. Conclusions: Analyzing the data, it can thus be concluded that whilst behavioral inhibition and activation systems seem to work together to significantly predict mental disorders, lifestyle cannot.
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Affiliation(s)
| | - Alireza Homayouni
- Department of Psychology, Bandargaz Branch, Islamic Azad University, Bandargaz, Iran
| | - Shahnaz Shahrbanian
- Department of Sport Science, Faculty of Humanities, Tarbiat Modarres University, Tehran, Iran
| | - Shaghayegh Shahriari
- Department of Psychology, Bandargaz Branch, Islamic Azad University, Bandargaz, Iran
| | - Diana Janinejad
- Undergraduate Psychology/Cognitive Sciences Researcher, University of California Irvine, California, USA
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10
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Shih YC, Chou CC, Lu YJ, Yu HY. Reliability and validity of the traditional Chinese version of the GAD-7 in Taiwanese patients with epilepsy. J Formos Med Assoc 2022; 121:2324-2330. [PMID: 35584970 DOI: 10.1016/j.jfma.2022.04.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is the second most common psychiatric comorbidity of epilepsy. GAD has a negative impact on seizure control, and it is underrecognized. The Generalized Anxiety Disorder 7-item (GAD-7) questionnaire is useful for screening GAD in patients with epilepsy (PWE). This study aimed to validate the traditional Chinese version of the GAD-7 for Taiwanese patients by obtaining data on adult PWE from our hospital. METHOD PWE were recruited from the Taipei Veterans General Hospital from April 2017 to January 2020. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was used for the psychiatric assessment. The traditional Chinese version of the GAD-7 and the Beck Anxiety Inventory were included as self-rated psychiatric evaluation. To investigate the psychometric properties, internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were conducted to assess the utility of the Taiwanese version of the GAD-7. RESULTS We recruited 109 patients in the present study. Seventeen patients (15.9%) had GAD according to the MINI. The mean GAD-7 score was 10.28 ± 10.68. All the GAD-7 items were significantly and positively associated with the corrected overall GAD-7 score (Cronbach's alpha = 0.928, p < 0.0001). The cut-off point for the GAD-7 in ROC curve analysis was 7. The patients with GAD were more likely to be female and single. CONCLUSION The traditional Chinese version of the GAD-7 is a reliable and valid self-report questionnaire for detecting GAD in Taiwanese PWE.
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Affiliation(s)
- Yen-Cheng Shih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yi-Jiun Lu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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11
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Yıldız Miniksar D, Kılıç B, Kılıç M, Miniksar ÖH, Topçu Y, Aydın K. Evaluation of suicide probability in children and adolescents with epilepsy. Pediatr Int 2022; 64:e15130. [PMID: 35510727 DOI: 10.1111/ped.15130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND We aimed to examine suicide probability, factors affecting suicide, and personality traits of children and adolescents diagnosed with epilepsy, and to compare their results with those of children without epilepsy. METHODS Fifty-six children diagnosed with epilepsy and 56 control children, aged 11-16 years, were evaluated by using the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria, the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version, the Child Depression Inventory, the Suicide Probability Scale (SPS), and the Personality Inventory for DSM-5 - Brief Form - Children (PID-5-BF) scales. Factors predicting suicide risk in children with epilepsy were analyzed. RESULTS The mean age, SPS total score, and hopelessness subscale score, PID-5-BF total score as well as disinhibition and psychoticism subscale scores of the epilepsy group were significantly higher than those of the control group (P < 0.05). There was no significant difference between the groups in terms of the Child Depression Inventory, and other subscales of the Suicide Probability Scales and PID-5-BF scales. The SPS total score was higher in patients with comorbid psychiatric diseases, those using psychiatric drugs, and girls (P < 0.05). An ANCOVA analysis indicated that the most important factor that predicted the probability of suicide and its subscale scores was the level of depression, and the presence of epilepsy was not predictive. CONCLUSIONS We found a high probability of suicide and personality pathology in children with epilepsy but the main predictor of suicide probability was the level of depression, not the presence of epilepsy.
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Affiliation(s)
| | - Betül Kılıç
- Pediatric Neurology, Medipol University Hospital, Istanbul, Turkey
| | - Mahmut Kılıç
- Department of Public Health, Bozok University, Yozgat, Turkey
| | | | - Yasemin Topçu
- Pediatric Neurology, Medipol University Hospital, Istanbul, Turkey
| | - Kürşad Aydın
- Pediatric Neurology, Medipol University Hospital, Istanbul, Turkey
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12
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Hopp J, Pahlavan A, Richert M, Grimes K, Turlington K, Cassady M, Kvarta MD, Thompson SM. Peri-Ictal Changes in Depression and Anxiety in Persons With Epileptic and Non-epileptic Seizures. Front Psychiatry 2022; 13:912697. [PMID: 35935419 PMCID: PMC9353188 DOI: 10.3389/fpsyt.2022.912697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We tested the hypothesis that epileptic, but not non-epileptic, seizures would produce an improvement in comorbid depression and anxiety symptoms in the peri-ictal period, much like the antidepressant effects of electroconvulsive therapy. METHODS We examined depression and anxiety symptoms in patients admitted to an inpatient unit for continuous video electroencephalography as part of routine clinical care. Patients completed three questionnaires that included the Beck Depression Inventory-II (BDI), Montgomery Asberg Depression Rating Scale (MADRS), and Beck Anxiety Inventory (BAI) after admission, in the 24 h following a seizure, then again 2 weeks after the last seizure. RESULTS In patients with epilepsy, depression and anxiety scores improved in the 24 hrs following a seizure (change in BDI = 24%; change in MADRS = 19%; change in BAI = 21%) but returned toward baseline after 2 weeks. In patients with non-epileptic seizures, depression and anxiety scores also improved in the 24 hrs following a psychogenic non-epileptic seizure (change in BDI = 17%, change in MADRS = 27%, change in BAI = 36%). There was a greater improvement in depression and anxiety scores in patients with focal-onset epilepsy (BDI = 30%, MADRS = 22%, BAI = 30%) compared to generalized seizure onset (BDI = 6%, MADRS = 12%, BAI = 8%). CONCLUSION We conclude that single seizures can result in transient improvements in mood. Because seizures need not be generalized or epileptic to exert this effect, the underlying mechanisms are uncertain.
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Affiliation(s)
- Jennifer Hopp
- Division of Epilepsy, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Autusa Pahlavan
- Division of Epilepsy, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mary Richert
- Division of Epilepsy, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kathryn Grimes
- Division of Epilepsy, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kate Turlington
- Department of Pediatrics, University of Virginia, Charlottesville, VA, United States
| | - Maureen Cassady
- Division of Epilepsy, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mark D Kvarta
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Scott M Thompson
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, United States
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13
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Chaudhury S, Gandhi S, Menon P, Jagtap B, Saldanha D. Prevalence and correlates of psychiatric comorbidity in patients with epilepsy: A cross-sectional hospital-based study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_654_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Hyun SC, Kim D. Common Practices in Clinical Electroencephalography. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.4.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Soon-Chul Hyun
- Department of Neurology, Samsung Medical Center, Seoul, Korea
| | - Dongyeop Kim
- Department of Neurology, Samsung Medical Center, Seoul, Korea
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15
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Scangos KW, Khambhati AN, Daly PM, Owen LW, Manning JR, Ambrose JB, Austin E, Dawes HE, Krystal AD, Chang EF. Distributed Subnetworks of Depression Defined by Direct Intracranial Neurophysiology. Front Hum Neurosci 2021; 15:746499. [PMID: 34744662 PMCID: PMC8566975 DOI: 10.3389/fnhum.2021.746499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022] Open
Abstract
Major depressive disorder is a common and disabling disorder with high rates of treatment resistance. Evidence suggests it is characterized by distributed network dysfunction that may be variable across patients, challenging the identification of quantitative biological substrates. We carried out this study to determine whether application of a novel computational approach to a large sample of high spatiotemporal resolution direct neural recordings in humans could unlock the functional organization and coordinated activity patterns of depression networks. This group level analysis of depression networks from heterogenous intracranial recordings was possible due to application of a correlational model-based method for inferring whole-brain neural activity. We then applied a network framework to discover brain dynamics across this model that could classify depression. We found a highly distributed pattern of neural activity and connectivity across cortical and subcortical structures that was present in the majority of depressed subjects. Furthermore, we found that this depression signature consisted of two subnetworks across individuals. The first was characterized by left temporal lobe hypoconnectivity and pathological beta activity. The second was characterized by a hypoactive, but hyperconnected left frontal cortex. These findings have applications toward personalization of therapy.
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Affiliation(s)
- Katherine Wilson Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ankit N. Khambhati
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Patrick M. Daly
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Lucy W. Owen
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Jeremy R. Manning
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Josiah B. Ambrose
- Kaiser Permanente Redwood City Medical Center, Redwood City, CA, United States
| | - Everett Austin
- Kaiser Permanente Redwood City Medical Center, Redwood City, CA, United States
| | - Heather E. Dawes
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew D. Krystal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Edward F. Chang
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
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16
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Wei Z, Ren L, Yang L, Liu C, Cao M, Yang Q, Liu X, Liu Y, Deng Y. The relationship between social anxiety and felt stigma in patients with epilepsy: A network analysis. Seizure 2021; 92:76-81. [PMID: 34474329 DOI: 10.1016/j.seizure.2021.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Felt stigma and social anxiety are both common in patients with epilepsy (PWE) and they share an important relationship. Here in the present study, we investigated how social anxiety and different concepts of felt stigma relate to each other in PWE in order to provide some suggestions for the prevention and intervention of social anxiety and felt stigma in PWE. METHODS A total of 189 patients with epilepsy were enrolled in our study. Social anxiety was evaluated with the Liebowitz social anxiety scale. Felt stigma was evaluated with the Kilifi stigma scale for epilepsy. The data were subjected to network analysis. RESULTS The findings indicated that eight edges with the strongest regularized partial correlations existed in the network, such as the edge between S3 "Embarrassed" and S4 "Disappointed", and the edge between S14 "Discriminate" and S15 "Outcast". In addition, S10 "Inferior" and S11 "Avoid" had the highest strength and predictability. The flow network of social anxiety indicated that most concepts of felt stigma were directly connected with social anxiety. The strongest edge existed between S8 "Uncomfortable" and social anxiety, while S6 "Society" and S5 "Rewarding life" were also closely connected with social anxiety. CONCLUSION The current study highlighted the critical central concept S10 "Inferior" and critical concepts associated with social anxiety, including S8 "Uncomfortable", S6 "Society" and S5 "Rewarding life". The findings revealed in this study may offer some help in the clinical prevention and intervention of felt stigma and social anxiety in PWE. However, all of the conclusions above need further confirmatory studies to validate them.
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Affiliation(s)
- Zihan Wei
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China
| | - Lei Ren
- Department of Clinical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, PR China
| | - Lei Yang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China
| | - Chao Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China
| | - Mi Cao
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China
| | - Qun Yang
- Department of Clinical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, PR China
| | - Xufeng Liu
- Department of Clinical Psychology, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, PR China.
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China.
| | - Yanchun Deng
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, PR China.
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17
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Smit DJA, Andreassen OA, Boomsma DI, Burwell SJ, Chorlian DB, de Geus EJC, Elvsåshagen T, Gordon RL, Harper J, Hegerl U, Hensch T, Iacono WG, Jawinski P, Jönsson EG, Luykx JJ, Magne CL, Malone SM, Medland SE, Meyers JL, Moberget T, Porjesz B, Sander C, Sisodiya SM, Thompson PM, van Beijsterveldt CEM, van Dellen E, Via M, Wright MJ. Large-scale collaboration in ENIGMA-EEG: A perspective on the meta-analytic approach to link neurological and psychiatric liability genes to electrophysiological brain activity. Brain Behav 2021; 11:e02188. [PMID: 34291596 PMCID: PMC8413828 DOI: 10.1002/brb3.2188] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/12/2021] [Accepted: 04/30/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND PURPOSE The ENIGMA-EEG working group was established to enable large-scale international collaborations among cohorts that investigate the genetics of brain function measured with electroencephalography (EEG). In this perspective, we will discuss why analyzing the genetics of functional brain activity may be crucial for understanding how neurological and psychiatric liability genes affect the brain. METHODS We summarize how we have performed our currently largest genome-wide association study of oscillatory brain activity in EEG recordings by meta-analyzing the results across five participating cohorts, resulting in the first genome-wide significant hits for oscillatory brain function located in/near genes that were previously associated with psychiatric disorders. We describe how we have tackled methodological issues surrounding genetic meta-analysis of EEG features. We discuss the importance of harmonizing EEG signal processing, cleaning, and feature extraction. Finally, we explain our selection of EEG features currently being investigated, including the temporal dynamics of oscillations and the connectivity network based on synchronization of oscillations. RESULTS We present data that show how to perform systematic quality control and evaluate how choices in reference electrode and montage affect individual differences in EEG parameters. CONCLUSION The long list of potential challenges to our large-scale meta-analytic approach requires extensive effort and organization between participating cohorts; however, our perspective shows that these challenges are surmountable. Our perspective argues that elucidating the genetic of EEG oscillatory activity is a worthwhile effort in order to elucidate the pathway from gene to disease liability.
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Affiliation(s)
- Dirk J A Smit
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Scott J Burwell
- Department of Psychology, Minnesota Center for Twin and Family Research, University of Minnesota, Minneapolis, MN, USA.,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - David B Chorlian
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry, Downstate Health Sciences University, Brooklyn, NY, USA
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research (NORMENT), Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Reyna L Gordon
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Jeremy Harper
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Ulrich Hegerl
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe Universität Frankfurt am Main, Frankfurt, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,LIFE - Leipzig Research Center for Civilization Diseases, Universität Leipzig, Leipzig, Germany.,IU International University, Erfurt, Germany
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Philippe Jawinski
- LIFE - Leipzig Research Center for Civilization Diseases, Universität Leipzig, Leipzig, Germany.,Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erik G Jönsson
- TOP-Norment, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Outpatient Second Opinion Clinic, GGNet Mental Health, Apeldoorn, The Netherlands
| | - Cyrille L Magne
- Psychology Department, Middle Tennessee State University, Murfreesboro, TN, USA.,Literacy Studies Ph.D. Program, Middle Tennessee State University, Mufreesboro, TN, USA
| | - Stephen M Malone
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry, Downstate Health Sciences University, Brooklyn, NY, USA.,Department of Psychiatry, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Torgeir Moberget
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry, Downstate Health Sciences University, Brooklyn, NY, USA
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | | | - Edwin van Dellen
- Department of Psychiatry, Department of Intensive Care Medicine, Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marc Via
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, and Institute of Neurosciences (UBNeuro), Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia.,Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
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18
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Balzekas I, Sladky V, Nejedly P, Brinkmann BH, Crepeau D, Mivalt F, Gregg NM, Pal Attia T, Marks VS, Wheeler L, Riccelli TE, Staab JP, Lundstrom BN, Miller KJ, Van Gompel J, Kremen V, Croarkin PE, Worrell GA. Invasive Electrophysiology for Circuit Discovery and Study of Comorbid Psychiatric Disorders in Patients With Epilepsy: Challenges, Opportunities, and Novel Technologies. Front Hum Neurosci 2021; 15:702605. [PMID: 34381344 PMCID: PMC8349989 DOI: 10.3389/fnhum.2021.702605] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Intracranial electroencephalographic (iEEG) recordings from patients with epilepsy provide distinct opportunities and novel data for the study of co-occurring psychiatric disorders. Comorbid psychiatric disorders are very common in drug-resistant epilepsy and their added complexity warrants careful consideration. In this review, we first discuss psychiatric comorbidities and symptoms in patients with epilepsy. We describe how epilepsy can potentially impact patient presentation and how these factors can be addressed in the experimental designs of studies focused on the electrophysiologic correlates of mood. Second, we review emerging technologies to integrate long-term iEEG recording with dense behavioral tracking in naturalistic environments. Third, we explore questions on how best to address the intersection between epilepsy and psychiatric comorbidities. Advances in ambulatory iEEG and long-term behavioral monitoring technologies will be instrumental in studying the intersection of seizures, epilepsy, psychiatric comorbidities, and their underlying circuitry.
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Affiliation(s)
- Irena Balzekas
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
- Mayo Clinic Medical Scientist Training Program, Rochester, MN, United States
| | - Vladimir Sladky
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czechia
| | - Petr Nejedly
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- The Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czechia
| | - Benjamin H. Brinkmann
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Daniel Crepeau
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Filip Mivalt
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Electrical Engineering and Communication, Department of Biomedical Engineering, Brno University of Technology, Brno, Czechia
| | - Nicholas M. Gregg
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Tal Pal Attia
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Victoria S. Marks
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
| | - Lydia Wheeler
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Tori E. Riccelli
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Jeffrey P. Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Brian Nils Lundstrom
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Kai J. Miller
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Jamie Van Gompel
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Vaclav Kremen
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czechia
| | - Paul E. Croarkin
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Worrell
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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19
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Hermann BP, Struck AF, Dabbs K, Seidenberg M, Jones JE. Behavioral phenotypes of temporal lobe epilepsy. Epilepsia Open 2021; 6:369-380. [PMID: 34033251 PMCID: PMC8166791 DOI: 10.1002/epi4.12488] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/21/2021] [Accepted: 03/28/2021] [Indexed: 12/17/2022] Open
Abstract
Objective To identity phenotypes of self‐reported symptoms of psychopathology and their correlates in patients with temporal lobe epilepsy (TLE). Method 96 patients with TLE and 82 controls were administered the Symptom Checklist 90‐Revised (SCL‐90‐R) to characterize emotional‐behavioral status. The nine symptom scales of the SCL‐90‐R were analyzed by unsupervised machine learning techniques to identify latent TLE groups. Identified clusters were contrasted to controls to characterize their association with sociodemographic, clinical epilepsy, neuropsychological, psychiatric, and neuroimaging factors. Results TLE patients as a group exhibited significantly higher (abnormal) scores across all SCL‐90‐R scales compared to controls. However, cluster analysis identified three latent groups: (1) unimpaired with no scale elevations compared to controls (Cluster 1, 42% of TLE patients), (2) mild‐to‐moderate symptomatology characterized by significant elevations across several SCL‐90‐R scales compared to controls (Cluster 2, 35% of TLE patients), and (3) marked symptomatology with significant elevations across all scales compared to controls and the other TLE phenotype groups (Cluster 3, 23% of TLE patients). There were significant associations between cluster membership and demographic (education), clinical epilepsy (perceived seizure severity, bitemporal lobe seizure onset), and neuropsychological status (intelligence, memory, executive function), but with minimal structural neuroimaging correlates. Concurrent validity of the behavioral phenotype grouping was demonstrated through association with psychiatric (current and lifetime‐to‐date DSM IV Axis 1 disorders and current treatment) and quality‐of‐life variables. Significance Symptoms of psychopathology in patients with TLE are characterized by a series of discrete phenotypes with accompanying sociodemographic, cognitive, and clinical correlates. Similar to cognition in TLE, machine learning approaches suggest a developing taxonomy of the comorbidities of epilepsy.
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Affiliation(s)
- Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Aaron F Struck
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Neurology, William S Middleton Veterans Administration Hospital, Madison, WI, USA
| | - Kevin Dabbs
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mike Seidenberg
- Department of Psychology, Rosalind Franklin University of Science and Medicine, North Chicago, IL, USA
| | - Jana E Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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20
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Benevides ML, Costa Nunes J, Guarnieri R, Melo H, Lunardi M, Neves Linhares M, Kupek E, Wolf P, Lin K, Walz R. Anxiety and depressive symptoms long after mesial temporal epilepsy surgery: A prospective study. Epilepsy Behav 2021; 118:107936. [PMID: 33839452 DOI: 10.1016/j.yebeh.2021.107936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Anxiety and depressive symptoms are prevalent in patients with refractory mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) before and after anterior temporal lobectomy (ATL). AIMS (1) To follow the levels of anxiety and depressive symptoms long-term after ATL among patients with refractory MTLE-HS; (2) To identify pre- and postsurgical variables associated with the levels of anxiety and depressive symptoms after surgery. METHODS We compared the levels of anxiety and depressive symptoms determined by the Hospital Anxiety and Depression Scale (HADS) before and long after ATL (mean 104 months, range 70-130) in 41 consecutive patients refractory MTLE-HS. The last follow-up was between September 2018 and March 2020. We also determined pre- and postsurgical variables independently associated with the HADS scores after surgery. RESULTS The scores of HADS and its subdomains related to anxiety and depression decreased significantly (p < 0.01) after ATL. After multiple linear regressions, the HADS-Anxiety scores before surgery (B = 0.47, CI 95% 0.20 to 0.75, p = 0.001) and at follow-up after surgery (B = 0.07, CI 0.00 to 0.14, p = 0.05) remain independently and positively associated with HADS-Anxiety scores after surgery. The HADS-Depression scores after surgery were independently positively associated with HADS-Depression scores before surgery (B = 0.39, CI 95% 0.10 to 0.76, p = 0.01) and worse seizure control after surgery (B = 1.55, CI 95% 0.23 to 2.87, p = 0.02). CONCLUSION Anxiety and depressive symptoms in patients with MTLE-HS significantly improved after ATL. Presurgical levels of anxiety and depressive symptoms, respectively, were positively associated with the postsurgical levels of those symptoms. Length of follow-up is associated with anxiety, and worse seizure control is associated with depressive symptoms after ATL. The results have implications for the surgical management of MTLE-HS patients.
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Affiliation(s)
- Maria Luiza Benevides
- Department of Neurology, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina (SC), Brazil; Graduate Program in Translational Neuroscience, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil.
| | - Jean Costa Nunes
- Graduate Program in Translational Neuroscience, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Division of Neuropathology, HU, UFSC, Florianópolis, SC, Brazil; Neurodiagnostic Brasil - Diagnósticos em Neuropatologia, Florianópolis, SC, Brazil; Psychiatry Division, Internal Medicine Department, HU, UFSC, Florianópolis, Brazil
| | - Ricardo Guarnieri
- Department of Neurology, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina (SC), Brazil; Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Graduate Program in Neuroscience, UFSC, Florianópolis, Brazil
| | - Hiago Melo
- Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Graduate Program in Neuroscience, UFSC, Florianópolis, Brazil
| | - Mariana Lunardi
- Department of Neurology, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina (SC), Brazil; Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Marcelo Neves Linhares
- Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Neurosurgery Division, Surgery Department, HU, UFSC, Florianópolis, Brazil; Neurosurgery Service, Governador Celso Ramos Hospital, Florianópolis, Brazil
| | - Emil Kupek
- Neurology Division, Internal Medicine Department, HU, UFSC, Florianópolis, Brazil; Departament of Public Health, UFSC, Florianópolis, SC, Brazil
| | - Peter Wolf
- Graduate Program in Medical Sciences, UFSC, Florianópolis, SC, Brazil
| | - Kátia Lin
- Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Neurology Division, Internal Medicine Department, HU, UFSC, Florianópolis, Brazil; Graduate Program in Medical Sciences, UFSC, Florianópolis, SC, Brazil
| | - Roger Walz
- Graduate Program in Translational Neuroscience, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Center for Applied Neuroscience, University Hospital (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil; Graduate Program in Neuroscience, UFSC, Florianópolis, Brazil; Neurology Division, Internal Medicine Department, HU, UFSC, Florianópolis, Brazil; Graduate Program in Medical Sciences, UFSC, Florianópolis, SC, Brazil
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21
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Suleymanova EM. Behavioral comorbidities of epilepsy and neuroinflammation: Evidence from experimental and clinical studies. Epilepsy Behav 2021; 117:107869. [PMID: 33684786 DOI: 10.1016/j.yebeh.2021.107869] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 12/24/2022]
Abstract
Currently, a significant amount of data is accumulated showing that neuroinflammation is one of the key processes in the development of brain pathology in trauma, neurodegenerative diseases, and epilepsy. Various brain insults, such as prolonged seizure activity, trigger the activation of microglia and astrocytes in the brain. These cells, in turn, begin to synthesize pro-inflammatory cytokines. The inflammatory response to the insult causes a cascade of processes leading to a wide range of pathological effects, including changes in neuronal excitability, long-term plastic changes, astrocyte dysfunction, impaired blood-brain barrier (BBB) permeability, and neurodegeneration. These effects may ultimately contribute to the development of chronic spontaneous seizures. On the other hand, neuroinflammation contributes to the pathogenesis of a number of neuropsychiatric disorders. Therefore, neuroinflammation can be a link between epilepsy and its comorbidities, such as mood and anxiety disorders and memory impairment. The mechanisms behind these behavioral and cognitive impairments remain not fully understood. In this paper, clinical evidence of an important role of neuroinflammation in epilepsy and potentially comorbid neurological disorders is reviewed, as well as possible mechanisms of its involvement in the pathogenesis of these conditions obtained from experimental data.
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Affiliation(s)
- Elena M Suleymanova
- Institute of Higher Nervous Activity and Neurophysiology of RAS, 117485 Butlerova 5A, Moscow, Russia.
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22
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Lima EM, Gois J, Paiva ML, Vincentiis S, Moschetta S, Valente KDR. Anxiety symptoms are the strongest predictor of quality of life in temporal lobe epilepsy. Seizure 2021; 88:78-82. [PMID: 33838568 DOI: 10.1016/j.seizure.2021.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE It is established that the severity of depressive and anxiety symptoms is associated with poorer quality of life (QOL) in persons with drug-resistant epilepsy. We aimed to verify the presence of subsyndromic depressive episodes (SDEs) and subsyndromic anxiety episodes (SAEs) in persons with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) compared to healthy controls and to determine the impact of depressive and anxiety symptoms on patients' QOL. METHODS We prospectively evaluated 35 persons with TLE-HS and 90 healthy controls. QOL was assessed by the Epilepsy Surgery Inventory (ESI) and QOL in Epilepsy Inventory-31 (QOLIE-31). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess symptoms, and SDEs and SAEs diagnosis were made considering the total scores of BDI (<9) and STAI-Trait (<49), respectively. RESULTS Persons with TLE-HS had higher symptoms on BDI, STAI-S, and STAI-T. They have 3.011 greater odds of presenting SDEs and 7.056 times odds, SAEs. The depressive and anxiety symptoms, added in the model with epilepsy-related factors, accounted for a significant increase in the variance in several aspects of QOL. Anxiety-trait symptoms are the most critical individual determinant of the QOL. CONCLUSION Our results demonstrated that persons with TLE-HS had greater odds of presenting SDE and SAE than healthy controls. Besides, there was a relationship between anxiety and depressive symptoms and worse QOL in TLE-HS. It is essential to be aware of psychiatric symptoms, even though these symptoms do not meet the criteria to be considered a "disorder."
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Affiliation(s)
- Ellen Marise Lima
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil.
| | - Juliana Gois
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Maria Luisa Paiva
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Silvia Vincentiis
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Sylvie Moschetta
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Kette Dualibi Ramos Valente
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
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Sadanandan N, Saft M, Gonzales-Portillo B, Borlongan CV. Multipronged Attack of Stem Cell Therapy in Treating the Neurological and Neuropsychiatric Symptoms of Epilepsy. Front Pharmacol 2021; 12:596287. [PMID: 33815100 PMCID: PMC8010689 DOI: 10.3389/fphar.2021.596287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/15/2021] [Indexed: 11/13/2022] Open
Abstract
Epilepsy stands as a life-threatening disease that is characterized by unprovoked seizures. However, an important characteristic of epilepsy that needs to be examined is the neuropsychiatric aspect. Epileptic patients endure aggression, depression, and other psychiatric illnesses. Therapies for epilepsy can be divided into two categories: antiepileptic medications and surgical resection. Antiepileptic drugs are used to attenuate heightened neuronal firing and to lessen seizure frequency. Alternatively, surgery can also be conducted to physically cut out the area of the brain that is assumed to be the root cause for the anomalous firing that triggers seizures. While both treatments serve as viable approaches that aim to regulate seizures and ameliorate the neurological detriments spurred by epilepsy, they do not serve to directly counteract epilepsy's neuropsychiatric traits. To address this concern, a potential new treatment involves the use of stem cells. Stem cell therapy has been employed in experimental models of neurological maladies, such as Parkinson's disease, and neuropsychiatric illnesses like depression. Cell-based treatments for epilepsy utilizing stem cells such as neural stem cells (NSCs), mesenchymal stem cells (MSCs), and interneuron grafts have been explored in preclinical and clinical settings, highlighting both the acute and chronic stages of epilepsy. However, it is difficult to create an animal model to capitalize on all the components of epilepsy due to the challenges in delineating the neuropsychiatric aspect. Therefore, further preclinical investigation into the safety and efficacy of stem cell therapy in addressing both the neurological and the neuropsychiatric components of epilepsy is warranted in order to optimize cell dosage, delivery, and timing of cell transplantation.
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Affiliation(s)
| | | | | | - Cesar V. Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, United States
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24
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Sair A, Şair YB, Saracoğlu İ, Sevincok L, Akyol A. The relation of major depression, OCD, personality disorders and affective temperaments with Temporal lobe epilepsy. Epilepsy Res 2021; 171:106565. [PMID: 33535159 DOI: 10.1016/j.eplepsyres.2021.106565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/22/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In patients with temporal lobe epilepsy (TLE), studies demonstrate frequent comorbidity with mood disorders, personality disorders (especially obsessive-compulsive disorder) and major depression, but there are conflicting findings. This study aimed to investigate psychiatric comorbidities and affective temperament among TLE patients and to explore the relationships between obsessive compulsive disorder, other personality disorders, major depression and affective temperament in order to clarify the mediator effect of TLE in these relationships. METHODS Thirty patients with TLE and 30 healthy volunteers were included. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), Hamilton Anxiety (HAM-A) scale, Hamilton Depression (HAM-D) scale, Beck Suicidal Ideation Scale (BSSI) and Yale Brown Obsession Compulsion Scale (YBOCS) were applied and evaluated by a psychiatrist. Additionally, all individuals completed The Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). RESULTS Patients with temporal lobe epilepsy had higher scores in TEMPS-A, HAM-A, HAM-D, YBOCS and BSSI. Major depression, obsessive compulsive disorder and dependent and antisocial personality disorders were prevalent in patients. With respect to affective temperaments, depressive, cyclothymic and anxious temperaments were associated with obsessive compulsive disorder comorbidity; whereas, depressive and anxious temperaments were found to be associated with major depression comorbidity in patients with TLE. Furthermore, cluster A and cluster C personality disorders were associated with affective temperaments in patients with TLE. Affective temperaments had no correlation with illness duration, seizure frequency, depression severity and suicidal thoughts, but obsessions and compulsions. Suicidal thoughts were associated with obsessions and compulsions. CONCLUSION Affective temperaments are core personality traits with biological background and they may provide a foundation for psychiatric disorders, especially mood disorders. Considering that TLE originates from abnormalities in brain circuitry, it may form a basis for psychiatric disorders. Therefore, psychiatric evaluation to determine comorbidities may be beneficial to increase the quality of life of patients with TLE.
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Affiliation(s)
- Ahmet Sair
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Yaşan Bilge Şair
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - İrem Saracoğlu
- Residant at Psychiatry Department, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Levent Sevincok
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Ali Akyol
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
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25
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Tsigebrhan R, Fekadu A, Medhin G, Newton CR, Prince MJ, Hanlon C. Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia. PLoS One 2021; 16:e0238137. [PMID: 33471799 PMCID: PMC7817054 DOI: 10.1371/journal.pone.0238137] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/10/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Evidence from high-income countries demonstrates that co-morbid mental disorders in people with epilepsy adversely affect clinical and social outcomes. However, evidence from low-income countries is lacking. The objective of this study was to measure the association between co-morbid mental disorders and quality of life and functioning in people with epilepsy. METHODS A facility-based, community ascertained cross-sectional survey was carried out in selected districts of the Gurage Zone, Southern Ethiopia. Participants were identified in the community and referred to primary health care (PHC) clinics. Those diagnosed by PHC workers were recruited. Co-morbid mental disorders were measured using a standardised, semi-structured clinical interview administered by mental health professionals. The main outcome, quality of life, was measured using the Quality of Life in Epilepsy questionnaire (QOLIE-10p). The secondary outcome, functional disability, was assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-2). RESULTS The prevalence of comorbid mental disorders was 13.9%. Comorbid mental disorders were associated with poorer quality of life (Adjusted (Adj.) β -13.27; 95% CI -23.28 to-3.26) and greater disability (multiplier of WHODAS-2 score 1.62; 95% CI 1.05, 2.50) after adjusting for hypothesised confounding factors. Low or very low relative wealth (Adj. β = -12.57, 95% CI -19.94 to-5.20), higher seizure frequency (Adj.β coef. = -1.92, 95% CI -2.83 to -1.02), and poor to intermediate social support (Adj. β coef. = -9.66, 95% CI -16.51 to -2.81) were associated independently with decreased quality of life. Higher seizure frequency (multiplier of WHODAS-2 score 1.11; 95% CI 1.04, 1.19) was associated independently with functional disability. CONCLUSION Co-morbid mental disorders were associated with poorer quality of life and impairment, independent of level of seizure control. Integrated and comprehensive psychosocial care is required for better health and social outcomes of people with epilepsy.
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Affiliation(s)
- Ruth Tsigebrhan
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Global Health & Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Girmay Medhin
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Aklilu-Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charles R. Newton
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, United Kingdom
| | - Martin J. Prince
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Charlotte Hanlon
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Abstract
There is increasing recognition that epilepsy can be associated with a broad spectrum of comorbidities. While epileptic seizures are an essential element of epilepsy in children, there is a spectrum of neurological, mental health and cognitive disorders that add to the disease burden of childhood epilepsy resulting in a decreased quality of life. The most common comorbid conditions in childhood epilepsy include depression, anxiety, autism spectrum disorders, sleep disorders, attention deficits, cognitive impairment, and migraine. While epilepsy can result in comorbidities, many of the comorbidities of childhood have a bi-directional association, with the comorbid condition increasing risk for epilepsy and epilepsy increasing the risk for the comorbid condition. The bidirectional feature of epilepsy and the comorbidities suggest a common underlying pathological basis for both the seizures and comorbid condition. While recognition of the comorbid conditions of pediatric epilepsies is increasing, there has been a lag in the development of effective therapies partly out of concern that drugs used to treat the comorbid conditions could increase seizure susceptibility. There is now some evidence that most drugs used for comorbid conditions are safe and do not lower seizure threshold. Unfortunately, the evidence showing drugs are effective in treating many of the childhood comorbidities of epilepsy is quite limited. There is a great need for randomized, placebo-controlled drug trials for efficacy and safety in the treatment of comorbidities of childhood epilepsy.
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Affiliation(s)
- Gregory L Holmes
- Department of Neurological Sciences, Larner College of Medicine, University of Vermont, Stafford Hall, 118C, Burlington, VT, 05405, USA.
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27
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Campos-Fernández D, Fonseca E, Olivé-Gadea M, Quintana M, Abraira L, Seijo-Raposo I, Santamarina E, Toledo M. The mediating role of epileptic seizures, irritability, and depression on quality of life in people with epilepsy. Epilepsy Behav 2020; 113:107511. [PMID: 33129044 DOI: 10.1016/j.yebeh.2020.107511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Psychiatric comorbidity is common in epilepsy and has a considerable impact on patient quality of life (QoL). This study aimed to analyze the relationship between seizure frequency, irritability, and depression and describe how they mediate each other's effect on QoL in epilepsy. METHODS This is a cross-sectional study of consecutive adults seen at an outpatient epilepsy clinic of a tertiary hospital in Barcelona, Spain. All the patients were evaluated for psychiatric comorbidity and administered the State-Trait Anger Expression Inventory-2 (STAXI-2), the Hospital Anxiety and Depression Scale (HADS), and the Quality Of Life in Epilepsy Inventory-10 (QOLIE-10). Mediation analysis with multiple linear regression followed by the Sobel test was performed. RESULTS We studied 157 patients. Seizure frequency (R = -0.193, P = .053), irritability (R = 0.216, P = .039), and depression (R = -0.598, P < .001) had all a negative effect on QoL. In the adjusted linear regression model, depression was the only independent predictor of impaired QoL (B = -2.453 [95% confidence interval (CI): -3.161, -1.744], P < .001). The Sobel test showed that depression exerted a significant mediating effect on seizure frequency (Z = -1.984; P = .047) and irritability (Z = -3.669; P < .001) in their influence on QoL. CONCLUSION Depression is an independent predictor of worse QoL and significantly mediated the effects of irritability and poor seizure control on QoL impairment in patients with epilepsy.
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Affiliation(s)
- Daniel Campos-Fernández
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Elena Fonseca
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Marta Olivé-Gadea
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Manuel Quintana
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Laura Abraira
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Iván Seijo-Raposo
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Estevo Santamarina
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Manuel Toledo
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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28
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Jiang S, Pei H, Huang Y, Chen Y, Liu L, Li J, He H, Yao D, Luo C. Dynamic Temporospatial Patterns of Functional Connectivity and Alterations in Idiopathic Generalized Epilepsy. Int J Neural Syst 2020; 30:2050065. [PMID: 33161788 DOI: 10.1142/s0129065720500653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The dynamic profile of brain function has received much attention in recent years and is also a focus in the study of epilepsy. The present study aims to integrate the dynamics of temporal and spatial characteristics to provide comprehensive and novel understanding of epileptic dynamics. Resting state fMRI data were collected from eighty-three patients with idiopathic generalized epilepsy (IGE) and 87 healthy controls (HC). Specifically, we explored the temporal and spatial variation of functional connectivity density (tvFCD and svFCD) in the whole brain. Using a sliding-window approach, for a given region, the standard variation of the FCD series was calculated as the tvFCD and the variation of voxel-wise spatial distribution was calculated as the svFCD. We found primary, high-level, and sub-cortical networks demonstrated distinct tvFCD and svFCD patterns in HC. In general, the high-level networks showed the highest variation, the subcortical and primary networks showed moderate variation, and the limbic system showed the lowest variation. Relative to HC, the patients with IGE showed weaken temporal and enhanced spatial variation in the default mode network and weaken temporospatial variation in the subcortical network. Besides, enhanced temporospatial variation in sensorimotor and high-level networks was also observed in patients. The hyper-synchronization of specific brain networks was inferred to be associated with the phenomenon responsible for the intrinsic propensity of generation and propagation of epileptic activities. The disrupted dynamic characteristics of sensorimotor and high-level networks might potentially contribute to the driven motion and cognition phenotypes in patients. In all, presently provided evidence from the temporospatial variation of functional interaction shed light on the dynamics underlying neuropathological profiles of epilepsy.
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Affiliation(s)
- Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Haonan Pei
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Yang Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Yan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Linli Liu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Jianfu Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Hui He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, P. R. China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035, Chengdu P. R. China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, P. R. China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035, Chengdu P. R. China
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Avalos JC, Silva BA, Tevés Echazu MF, Rosso B, Besocke AG, Del Carmen Garcia M. Quality of life in patients with epilepsy or psychogenic nonepileptic seizures and the contribution of psychiatric comorbidities. Epilepsy Behav 2020; 112:107447. [PMID: 32947249 DOI: 10.1016/j.yebeh.2020.107447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/15/2020] [Accepted: 08/16/2020] [Indexed: 11/29/2022]
Abstract
UNLABELLED Epilepsy is a common neurological disorder, and psychogenic nonepileptic seizures (PNES) is an important differential diagnosis. Psychiatric comorbidities are prevalent among people with epilepsy (PWE). Additionally, lower quality of life (QoL) in people with PNES compared with PWE was reported with higher rates of general psychiatric comorbidity. Although there are previous studies evaluating the QoL in patients with epilepsy, this study is unique and compelling because it represents a study comparing PNES and PWE on QoL, depression, and anxiety in a Spanish-speaking group of Argentine patients. The aim of this study was to analyze self-reported anxiety and depression in PWE and PNES and to establish the impact on QoL. METHODS This is a cross-sectional study; QoL was measured using the Quality of Life in Epilepsy Inventory (QOLIE-31). To study anxiety and depression, the Hospital Anxiety and Depression Scale (HADS) was administered. Clinical and complementary data were recorded. RESULTS Psychogenic nonepileptic seizures scored significantly higher in anxiety and depression and with lower levels of QoL compared with PWE. Anxiety and depression had a negative correlation with QoL. CONCLUSION Nonepileptic seizures have an even greater impact on QoL than epileptic seizures, and this could be influenced by psychiatric comorbidities. These findings corroborate what other studies in English-speaking nations that have found regarding the impact of psychopathology on QoL in those with PNES and further support the importance of assessing for psychiatric comorbidities to tailor treatment.
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Affiliation(s)
- Juan Carlos Avalos
- Epilepsy Center, Department of Neurology, Italian Hospital, Buenos Aires, Argentina.
| | | | - Maria F Tevés Echazu
- Epilepsy Center, Department of Neurology, Italian Hospital, Buenos Aires, Argentina.
| | - Bárbara Rosso
- Epilepsy Center, Department of Neurology, Italian Hospital, Buenos Aires, Argentina.
| | - Ana Gabriela Besocke
- Epilepsy Center, Department of Neurology, Italian Hospital, Buenos Aires, Argentina.
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YAŞAR AB, SAYMAN C, ERDOĞAN TAYCAN S, ÇETİNKAYA Y, GÜNDÜZ A, TİRELİ H. The association between temperament features and childhood traumas in patients with juvenile myoclonic epilepsy. Turk J Med Sci 2020; 50:1314-1322. [PMID: 32512675 PMCID: PMC7491261 DOI: 10.3906/sag-1912-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/06/2020] [Indexed: 11/04/2022] Open
Abstract
Background/aim Epilepsy is a common chronic neurological problem that impairs daily activities, functionality, and quality of life. Childhood traumas (CTs) are known to be critical factors in the onset or development of many psychiatric and medical disorders. They also play a critical role in the development of temperament and personality. This study aimed to investigate the association between CTs and common temperament patterns and features seen in epilepsy patients. Materials and methods The study included 38 patients who were diagnosed with juvenile myoclonic epilepsy (JME) and volunteered to participate in the study. In addition to the sociodemographic form and questions on disease features, Structured Clinical Interview for DSM-IV Axis I Disorders, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS-A), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to all participants. In the present study, a cut-off value of 35 was used for the CTQ scale. The patients with CTQ scores lower than 35 (50%, n = 19, Group 1) and the patients with CTQ scores above 35 (50%, n = 19, Group 2) were compared. Results The comparison of TEMPS-A and its subscale scores in the JME patients in the groups with CTQ scores above or below a cut-off value detected significant differences between the groups in depressive and irritable temperament scores. The mean BDI scores were also different between the two groups. Furthermore, a significant positive correlation was detected between the disease duration, anxiety, and depression scores in the JME patients. A significant relationship was detected between the emotional neglect subscale score of the JME patients and the BDI scores. A significant positive correlation was found between the total disease duration, BDI, and BAI. Significant moderate-level relationships were found between the BDI score and irritable, depressive, cyclothymic, and anxious temperaments and between the BAI score and irritable, depressive, cyclothymic, and anxious temperaments. Conclusion Several temperamental features of JME patients are related to CTs. More depressive symptoms are seen in JME patients with higher disease durations.
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Affiliation(s)
| | - Ceyhun SAYMAN
- Department of Norology, Haydarpaşa Numune Training and Research Hospital, İstanbulTurkey
| | - Serap ERDOĞAN TAYCAN
- Department of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbulTurkey
| | - Yılmaz ÇETİNKAYA
- Department of Norology, Haydarpaşa Numune Training and Research Hospital, İstanbulTurkey
| | - Anıl GÜNDÜZ
- Department of Clinical Psychology, İstanbul Kent University, İstanbulTurkey
| | - Hülya TİRELİ
- Department of Norology, Haydarpaşa Numune Training and Research Hospital, İstanbulTurkey
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31
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Shih YC, Chou CC, Lu YJ, Chou YH, Yu HY. Reliability and validity of the Taiwanese version of the Neurological Disorders Depression Inventory for Epilepsy (Tw-NDDI-E). Seizure 2020; 81:53-57. [PMID: 32745948 DOI: 10.1016/j.seizure.2020.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/19/2020] [Accepted: 07/24/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Depression is the most commonly seen psychiatric co-morbidity of epilepsy. Depression in patients with epilepsy (PWE) is underrecognized. The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) is a useful tool to screen for major depressive episodes (MDEs) in PWE. This study validated the Taiwanese version of the NDDI-E using data from adult PWE in our hospital. METHOD PWE were recruited from the Taipei Veterans General Hospital from April 2017 to December 2019. The Chinese version of the NDDI-E for the Taiwanese population and the Beck Depression Inventory-II (BDI-II) were completed as part of the self-rated psychiatric assessments. The mood disorder module of the Mini International Neuropsychiatric Interview (MINI) was completed as part of the psychiatric assessment before the self-rated assessment. Internal consistency, external validation, and receiver operator characteristic (ROC) curve analysis were used to assess the utility of the Taiwanese version of the NDDI-E. RESULTS We recruited 109 patients during the 33-month study period. The mean age was 33.1 ± 8.94 years old. The mean NDDI-E score was 12.32 ± 4.96. The mean BDI-II score was 13.26 ± 12.77. All NDDI-E items were significantly positively associated with the corrected overall NDDI-E score (Cronbach's alpha = 0.902, r = 0.825, p < 0.0001). The cut-off point for the NDDI-E determined with receiver operating characteristic (ROC) curve analysis is 15 (sensitivity = 85.0%, specificity = 87.64%). CONCLUSION The Chinese version of the NDDI-E adapted for the Taiwanese population is a reliable and valid self-reported questionnaire for detecting MDE in Taiwanese PWE.
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Affiliation(s)
- Yen-Cheng Shih
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chen Chou
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Jiun Lu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hsiang-Yu Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Brain Research Centre, National Yang-Ming University, Taipei, Taiwan.
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32
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Paiva ML, Lima EM, Siqueira IB, Rzezak P, Koike C, Moschetta SP, Vincentiis S, Alessi R, Khafif TC, Mendoza M, Valente KD. Seizure control and anxiety: Which factor plays a major role in social adjustment in patients with Juvenile Myoclonic Epilepsy? Seizure 2020; 80:234-239. [PMID: 32663782 DOI: 10.1016/j.seizure.2020.06.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. METHODS We prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. RESULTS Patients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). CONCLUSION Patients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.
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Affiliation(s)
- Maria Luisa Paiva
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Ellen Marise Lima
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Isabelle Bimbatti Siqueira
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Patricia Rzezak
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Camila Koike
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Sylvie P Moschetta
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Silvia Vincentiis
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Rudá Alessi
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Tatiana Cohab Khafif
- Bipolar Disorder Program, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Melanie Mendoza
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil.
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Tareke M, Birehanu M, Amare D, Abate A. Common mental illness among epilepsy patients in Bahir Dar city, Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0227854. [PMID: 31971965 PMCID: PMC6977727 DOI: 10.1371/journal.pone.0227854] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Common mental illness has a substantial impact on seizure control and negatively affects the overall quality of life among individuals with epilepsy. However, there is a dearth of studies that examined the associated factors of common mental illness among epilepsy patients in Ethiopia, particularly in the study area. This study aimed to assess the magnitude and factors associated with common mental disorders in epilepsy patients who attended government health institutions in Bahir Dar city, Ethiopia. METHOD Health institution based cross-sectional study was conducted using a systematic sampling technique among people living with epilepsy in Bahir Dar City Administration. Common mental illness was assessed using a self-reporting questionnaire and a semi-structured questionnaire was employed to collect data on socio-demographic and clinical related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. RESULTS The magnitude of comorbid common mental illness among people living with epilepsy was found 35.4%. High magnitude of common mental illness was reported among females (39.9%) when compared to males (32.3%). The most prevalent common mental disorders symptoms include being worried, unhappy feeling, trouble thinking clearly, and difficult to enjoy daily activities. Family history of epilepsy, frequent seizures attacks, side effects of antiepileptic drugs, lack of social support and not adherent to antiepileptic drugs were factors associated with common mental illness. CONCLUSIONS Common mental illness was found to be prevalent among people living with epilepsy. Therefore, it is recommended that great attention should be given to mental illness besides controlling seizure attacks.
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Affiliation(s)
- Minale Tareke
- Psychiatry Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Minychil Birehanu
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegne Amare
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Andargie Abate
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Nogueira MH, Pimentel da Silva LR, Vasques Moreira JC, de Rezende TJR, Zanão TA, de Campos BM, Yasuda CL, Cendes F. Major Depressive Disorder Associated With Reduced Cortical Thickness in Women With Temporal Lobe Epilepsy. Front Neurol 2020; 10:1398. [PMID: 32010051 PMCID: PMC6979005 DOI: 10.3389/fneur.2019.01398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Major Depressive Disorder (MDD) is highly prevalent in patients with mesial temporal lobe epilepsy (MTLE), especially in women, carrying significant morbidity. This study aimed to investigate the cortical thickness (CT) abnormalities associated with MDD in women with MTLE and hippocampal atrophy (HA). Also, we investigated the impact of MDD upon the volumes of the hippocampus and amygdala in these patients. Methods: We included 50 women with MTLE and HA (20 left, LMTLE; 30 right, RMTLE), 41 healthy women in the control group, and 15 women with MDD without epilepsy. MTLE patients were subdivided into three groups: MTLE-without-MDD (23 MTLE patients without MDD), MTLE-mild-MDD (nine MTLE patients with mild symptoms of MDD), and MTLE-severe-MDD (18 MTLE patients with moderate to severe symptoms of MDD). The five groups were balanced for age (p = 0.56). All participants had high-resolution 3D T1-weighted images in a 3T scanner. We used FreeSurfer 6.0 for volumetry and CT parcellation. All participants were submitted to a clinical psychological evaluation through the Structured Clinical Interview for DSM-IV (SCID-IV) and completed the Beck Depression Inventory (BDI-II). Results: We identified a smaller ipsilateral amygdala volume (p = 0.04) in the MTLE-severe-MDD group when compared to the control group. Our results presented a reduced ipsilateral lateral orbitofrontal cortex (p = 0.02) in the MTLE-severe-MDD in comparison to the MTLE-mild-MDD group. We also identified a thinner ipsilateral fusiform gyrus (p < 0.01) in the MTLE-severe-MDD compared to both MTLE-without-MDD and control groups. A reduced CT of the contralateral superior frontal gyrus (p = 0.02) was observed in the MTLE-severe-MDD in comparison to the MTLE-mild-MDD group. Conclusions: The identification of areas with reduced CT and atrophy of the ipsilateral amygdala in women with MTLE and MDD suggest that the cortical thinning in the network of the paralimbic system is related to the co-occurrence and intensity of depressive symptoms in this group.
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Affiliation(s)
- Mateus Henrique Nogueira
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Luciana Ramalho Pimentel da Silva
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - José Carlos Vasques Moreira
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Thiago Junqueira Ribeiro de Rezende
- The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil.,Laboratory of Medical Physics, University of Campinas - UNICAMP, Campinas, Brazil
| | - Tamires Araújo Zanão
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Brunno Machado de Campos
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Clarissa Lin Yasuda
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
| | - Fernando Cendes
- Laboratory of Neuroimaging, Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil.,The Brazilian Institute of Neuroscience and Neurotechnology - BRAINN, University of Campinas - UNICAMP, Campinas, Brazil
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Kilicaslan EE, Türe HS, Kasal Mİ, Çavuş NN, Akyüz DA, Akhan G, Besiroglu L. Differences in obsessive-compulsive symptom dimensions between patients with epilepsy with obsessive-compulsive symptoms and patients with OCD. Epilepsy Behav 2020; 102:106640. [PMID: 31805512 DOI: 10.1016/j.yebeh.2019.106640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/28/2019] [Accepted: 09/28/2019] [Indexed: 01/24/2023]
Abstract
Clinical correlates of obsessive-compulsive symptoms (OCS) were evaluated in 100 adult consecutive outpatients with epilepsy, using the Obsessive-Compulsive Inventory (OCI-R), Beck Depression Inventory (BDI), Dissociative Experiences Scale (DES-II), and the Schizotypal Personality Questionnaire (SPQ). Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) was applied to determine the types and severity of OCS to the 45 patients with epilepsy who were over 21 points on the OCI-R scale and 30 patients who were with diagnosed obsessive-compulsive disorder (OCD) among the patients in the psychiatry outpatient clinic, as a control group. As a result, it was found that patients with epilepsy with OCS tend to have more symmetry/exactness obsessions and compulsions, whereas patients with OCD had significantly more contamination/cleaning and aggressiveness obsessions and compulsions. In addition, OCS was found to be significantly higher in temporal lobe epilepsy (TLE) and extratemporal epilepsy than generalized epilepsy. However, OCS were correlated with depression, dissociation, and schizotypy in patients with epilepsy, while only depression was predictive when regression analysis was performed for OCS. This study is the first study to compare patients with OCD with patients with epilepsy in terms of the nature of OCS and first identified the differences in OCS dimensions between patients with epilepsy with OCS and patients with OCD.
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Affiliation(s)
- Esin Evren Kilicaslan
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Psychiatry Department, Basin Sitesi, 35150 Izmir, Turkey.
| | - H Sabiha Türe
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Neurology Department, Basin Sitesi, 35150 Izmir, Turkey
| | - Meltem İzci Kasal
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Psychiatry Department, Basin Sitesi, 35150 Izmir, Turkey
| | - Nebile Nur Çavuş
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Psychiatry Department, Basin Sitesi, 35150 Izmir, Turkey
| | - Dilek Altın Akyüz
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Neurology Department, Basin Sitesi, 35150 Izmir, Turkey
| | - Galip Akhan
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Neurology Department, Basin Sitesi, 35150 Izmir, Turkey
| | - Lutfullah Besiroglu
- Izmir Katip Celebi University, Atatürk Education and Training Hospital, Psychiatry Department, Basin Sitesi, 35150 Izmir, Turkey
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Comparison of psychiatric comorbidities and impact on quality of life in patients with epilepsy or psychogenic nonepileptic spells. Epilepsy Behav 2020; 102:106649. [PMID: 31759316 DOI: 10.1016/j.yebeh.2019.106649] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Psychiatric comorbidity is common in people with epilepsy (PWE) and psychogenic nonepileptic spells (PNES). These comorbidities can be detrimental to quality of life (QOL) and are often underdiagnosed and undertreated. Some types of epilepsy, such as focal temporal lobe epilepsy (TLE), have been associated with higher rates of psychiatric comorbidity. This study examined the impact of psychiatric comorbidity on QOL in patients admitted to two level 4 epilepsy monitoring units (EMUs). METHODS In this prospective observational study, 200 patients admitted to two level 4 EMUs completed standardized surveys including the Quality of Life in Epilepsy (QOLIE-31-P), Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire (PHQ-9), and Beck Depression Inventory-II (BDI-II). Hierarchal multiple regression was performed to assess impact on QOL. RESULTS Of the 200 participants, 113 had a diagnosis of epilepsy, 36 had a diagnosis of PNES, and 51 were excluded for nondiagnostic evaluation or dual diagnosis. Of those with epilepsy, 65 had TLE, 28 had focal extratemporal lobe epilepsy (ETLE), and 20 had nonfocal epilepsy. Patients with PNES had higher self-reported anxiety and depression levels (GAD-7: p = 0.04, PHQ-9: p < 0.01; BDI-II: p < 0.01) but similar QOL to PWE (p = 0.78). Using hierarchal multiple regression, symptoms of anxiety and depression were significant predictors of lower QOL in PWE but not in patients with PNES. There was no difference in QOL in those with ETLE and TLE. CONCLUSIONS Our findings suggest that self-reported anxiety and depression symptoms are common in patients admitted to level 4 EMUs regardless of diagnosis and play an important role in predicting QOL in PWE. Our findings emphasize the importance of routinely screening all EMU patients for psychiatric comorbidity.
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Han SH, Kim KT, Ryu HU, Lee SA, Cho YJ, Kim JH, Kang KW, Shin DJ, Lee GH, Hwang KJ, Kim YS, Kim JB, Kim JE, Lee SY, Seo JG. Factors associated with social anxiety in South Korean adults with epilepsy. Epilepsy Behav 2019; 101:106569. [PMID: 31675602 DOI: 10.1016/j.yebeh.2019.106569] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to examine social anxiety in South Korean adults with epilepsy and to identify associated factors. METHOD This was a cross-sectional, multicenter study in South Korea. Social anxiety was assessed using short forms of the Social Phobia Scale (SPS-6) and Social Interaction Anxiety Scale (SIAS-6). The SPS-6 scores ≥9 and SIAS-6 scores ≥12 were considered indicative of social phobia and social interaction anxiety, respectively. The Patient Health Questionnaire-9 (PHQ-9); Stigma Scale-Revised (SS-R); Disclosure Management Scale; Family Adaptation, Partnership, Growth, Affection, Resolve (F-APGAR) scale; and a questionnaire assessing knowledge about epilepsy were also used. RESULTS Of a total of 219 patients with epilepsy, 21% and 11% had SPS-6 scores ≥9 and SIAS-6 scores ≥12, respectively. In logistic regression analysis, SPS-6 scores ≥9 were independently associated with SS-R scores of 4-9 (odds ratio [OR]: 8.626, 95% confidence interval [CI]: 2.515-29.587, p = .001), SS-R scores 1-3 (OR: 5.496, 95% CI: 1.757-17.197, p = .003), and PHQ-9 scores ≥10 (OR: 4.092, 95% CI: 1.823-9.185, p = .001). In contrast, SIAS-6 scores ≥12 were related only to PHQ-9 scores ≥10 (OR: 8.740, 95% CI: 3.237-23.599, p < .001). Belonging to a dysfunctional family and lack of knowledge about epilepsy tended to be associated with social phobia (p = .071) and social interaction anxiety (p = .090), respectively. Epilepsy-related variables were not related to social anxiety. CONCLUSION Social anxiety is not rare in patients with epilepsy. In this study, social phobia was associated with perceived stigma and depressive symptoms, whereas social interaction anxiety was related only to depressive symptoms in patients with epilepsy.
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Affiliation(s)
- Su-Hyun Han
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Han Uk Ryu
- Department of Neurology, Chonbuk National University School of Medicine, Jeonju, Republic of Korea
| | - Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Yang-Je Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Hyun Kim
- Department Neurology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Kyung-Wook Kang
- Department of Neurology, Chonnam National University Hospital, Kwangju, Republic of Korea
| | - Dong Jin Shin
- Department of Neurology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - Gha Hyun Lee
- Departments of Neurology, Pusan National University School of Medicine, Pusan, Republic of Korea
| | - Kyoung Jin Hwang
- Department of Neurology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Jung Bin Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji-Eun Kim
- Department of Neurology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Seo-Young Lee
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Malpas CB, Wang AD, Leong M, Johnstone B, Rayner G, Kalincik T, Kwan P, O'Brien TJ, Velakoulis D. Abbreviated assessment of psychopathology in patients with suspected seizure disorders. Epilepsy Behav 2019; 100:106530. [PMID: 31665694 DOI: 10.1016/j.yebeh.2019.106530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/11/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE Psychopathology is common in patients undergoing investigation for seizure-related disorders. Psychometric examination using self-report instruments, such as the Symptom Checklist 90 - Revised (SCL-90-R), can assist diagnosis. The SCL-90-R, however, is a lengthy instrument and might not be tolerated by all patients. We assessed several abbreviated forms of the SCL-90-R in patients undergoing video encephalographic monitoring (VEM). METHOD Six hundred eighty-seven patients completed the SCL-90-R, and scores were computed for the full SCL-90-R and five abbreviated forms. Correlations and mean differences were computed between different forms. Classification accuracy was assessed via receiver operating characteristic (ROC) curves, and measurements models were examined using confirmatory factor analysis (CFA). RESULTS All abbreviated forms were strongly correlated with the SCL-90-R for general psychopathology (r = 0.93-0.99), depression (r = 0.89-0.95), anxiety (r = 0.97-0.98), psychosis (r = 0.95-0.99), and obsessive-compulsive symptoms (r = 0.97). Classification performance was similar across forms for depression and anxiety, with high negative predictive values (0.90-0.94) and lower positive predictive values (0.34-0.38). Classification performance for psychotic and obsessive-compulsive disorders was poor. Differences were observed between the full SCL-90-R and its abbreviated forms across most domains (d = 0.00-0.65). The published measurement model was most strongly validated for the SCL-27, SCL-14, and the SCL-K-9. CONCLUSIONS These five SCL-90-R abbreviated forms show high convergent validity with the full version. In patients undergoing investigation for seizure-related disorders, the Brief Symptom Inventory full form (BSI) or short form (BSI-18) is most appropriate where screening for both depression and anxiety is required. The SCL-K-9 is appropriate when only a single measure of global psychological distress is required. None of the instruments were able to detect psychotic or obsessive-compulsive symptoms with great accuracy. Caution should be exercised when making direct comparisons across the different forms.
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Affiliation(s)
- Charles B Malpas
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia.
| | - Albert D Wang
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Michelle Leong
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Benjamin Johnstone
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Genevieve Rayner
- Department of Medicine (Austin Health), The University of Melbourne, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Tomas Kalincik
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia
| | - Patrick Kwan
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Dennis Velakoulis
- Department of Psychiatry, Royal Melbourne Hospital, Australia; Department of Psychiatry, The University of Melbourne, Australia
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Kalilani L, Friesen D, Murray P. Treatment patterns in patients with a new diagnosis of epilepsy and psychiatric comorbidities. Epilepsy Behav 2019; 99:106405. [PMID: 31487669 DOI: 10.1016/j.yebeh.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/02/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective of this study was to describe antiepileptic drug (AED) treatment patterns in patients with epilepsy, with and without psychiatric comorbidities. METHODS This was a retrospective claims-based cohort study using Truven Health MarketScan databases (Commercial and supplemental Medicare, calendar years 2012-2017; Medicaid, 2012-2016). Persons met epilepsy diagnostic criteria, had an index date (first epilepsy diagnosis) with a preceding 2-year baseline (<1 year for persons of 1 to <2 years of age; none for persons <1 year), and continuous medical and pharmacy enrolment without epilepsy/seizure diagnosis or AED prescription during baseline. Based on presence/absence of psychiatric diagnosis codes in the baseline period, persons were classified into two cohorts: with or without psychiatric comorbidities. Outcomes included percentage of treated persons (AED prescription), type, duration, and outcome of first-line AED treatment. RESULTS There were 18,062 persons in each cohort with and without psychiatric comorbidities, matched by age, sex, and insurance type, who met selection (or inclusion) criteria. More patients with psychiatric comorbidities were prescribed an AED after diagnosis (57.6% vs. 52.8%), and had at least two AEDs prescribed during follow-up (16.7% vs. 11.4%) than patients without psychiatric comorbidities. Most patients with and without psychiatric comorbidities prescribed AED monotherapy as first-line treatment (73.0% vs. 78.7%). Levetiracetam was the most common AED prescribed less frequently in patients with than without psychiatric comorbidities (40.8% vs. 56.7%). More patients with psychiatric comorbidities changed first-line AED treatment than patients without psychiatric comorbidities. CONCLUSION The presence of psychiatric comorbidities may impact treatment decisions in newly diagnosed persons with epilepsy to optimize patient outcomes.
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Affiliation(s)
- Linda Kalilani
- UCB Pharma, 8010 Arco Corporate Drive, Raleigh, NC 27617, USA.
| | - David Friesen
- UCB Pharma, 2 Kinross Ave, Ascot, Berkshire SL5 9EP, London, UK.
| | - Paul Murray
- UCB Pharma, Cheltenham, Gloucestershire, UK.
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Margolis SA, Gonzalez JS, Faria C, Kenney L, Grant AC, Nakhutina L. Anxiety disorders in predominantly African American and Caribbean American adults with intractable epilepsy: The role of perceived epilepsy stigma. Epilepsy Behav 2019; 99:106450. [PMID: 31419635 DOI: 10.1016/j.yebeh.2019.106450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Anxiety disproportionately affects people with epilepsy (PWE) and leads to poor outcomes. Yet, risk factors are not well understood especially among underserved groups. This cross-sectional study aimed to identify epilepsy-specific predictors of anxiety disorders in predominantly African American and Caribbean American PWE. MATERIALS AND METHODS The prevalence of anxiety disorders was established via diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)). We identified the extent to which aspects of seizure burden (seizure frequency, seizure severity, convulsive vs. nonconvulsive seizures), seizure worry, and perceived epilepsy stigma were associated with anxiety disorder diagnosis. Finally, logistic regression assessed the overall and independent contributions of significant risk factors. RESULTS There were 60 participants (62% women, 52% African American, 27% Caribbean American, 20% Hispanic/Latino) with an average of 2 seizures per month. Nearly half of the sample (43%) had ≥1 anxiety disorder, with 62% of affected individuals qualifying for agoraphobia. Those with anxiety disorders tended to have convulsive seizures (p = 0.037) and endorsed greater seizure worry (p = 0.012), more general symptoms of anxiety (p = 0.005), and worse perceived epilepsy stigma (p = 0.003). Logistic regression accounted for 28% to 37.6% of the variance in anxiety disorder diagnostic status and correctly classified 73% of cases; however, only perceived epilepsy stigma made a unique contribution. CONCLUSIONS Anxiety disorders were prevalent in these predominantly African American and Caribbean American PWE. Epilepsy-specific risk factors included convulsive seizures, seizure worry, and perceived epilepsy stigma. Interventions aimed at treating anxiety disorders in diverse PWE may especially benefit from targeting stigma beliefs.
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Affiliation(s)
- Seth A Margolis
- Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA; Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St., Providence, RI 02903, USA.
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave., Bronx, NY 10461, USA; Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Ave., Bronx, NY 10461, USA
| | - Caylin Faria
- Bridgewater State University, 131 Summer St., Bridgewater, MA 02324, USA
| | - Lauren Kenney
- Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA
| | - Arthur C Grant
- State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA
| | - Luba Nakhutina
- State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA
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Zhu X, Yao Y, Li X, Dong J, Zhang A. Alteration of GABAergic signaling is associated with anxiety-like behavior in temporal lobe epilepsy mice. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:141-148. [PMID: 30951784 DOI: 10.1016/j.pnpbp.2019.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 03/20/2019] [Accepted: 03/29/2019] [Indexed: 12/18/2022]
Abstract
Temporal lobe epilepsy (TLE), which is one of the most common neurological diseases, is accompanied by a high incidence of psychiatric disorders. Among these psychiatric disorders, anxiety is one of the major psychiatric comorbidities in epilepsy patients. However, anxiety in epilepsy patients often remains unrecognized and untreated. It is believed that the inhibitory networks of γ-aminobutyric acid (GABA) neurotransmission play pivotal roles in the modulation of emotion and mood responses in both physiological and pathological conditions. The impairment of neurotransmission mediated by GABAergic signaling is related to the pathophysiology of anxiety. However, it remains unclear whether and how GABAergic signaling modulates anxiety responses in the context of an epileptic brain. In the present study, we sought to determine the role of inhibitory networks of GABAergic signaling in the anxiety-like behavior of epileptic mice. Our results show epileptic mice exhibited increased anxiety-like behavior, and this increased anxiety-like behavior was accompanied by a decrease in GABAergic interneurons and an increase in GABA type A receptor (GABAAR) β3 subunit (GABRB3) expression in the hippocampus. Furthermore, the activation of GABAARs produced an anxiolytic-like effect, while the inhibition of GABAARs elicited an anxiogenic-like effect in the epileptic mice, suggesting that the alteration of GABAergic signaling is associated with anxiety-like behavior in epileptic mice. Thus, targeting GABAergic signaling in the epileptic brain may provide an effective anxiolytic treatment in epilepsy patients.
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Affiliation(s)
- Xinjian Zhu
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China.
| | - Yuanyuan Yao
- Department of Pharmacology, Medical School of Southeast University, Nanjing, China
| | - Xiaolin Li
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jingde Dong
- Department of Geriatric Neurology, Nanjing Brain Hospital Affiliated with Nanjing Medical University, Nanjing, China
| | - Aifeng Zhang
- Department of Pathology, Medical School of Southeast University, Nanjing, China
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Pope RA, Thompson PJ, Rantell K, Stretton J, Wright MA, Foong J. Frontal lobe dysfunction as a predictor of depression and anxiety following temporal lobe epilepsy surgery. Epilepsy Res 2019; 152:59-66. [DOI: 10.1016/j.eplepsyres.2019.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/05/2019] [Accepted: 03/09/2019] [Indexed: 11/26/2022]
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Huang P, Zheng-Dao D, Sun BM, Pan YX, Zhang J, Wang T, Liu W, Jin HY, Zhan SK. Bilateral anterior capsulotomy enhances medication compliance in patients with epilepsy and psychiatric comorbidities. CNS Neurosci Ther 2019; 25:824-831. [PMID: 30868752 PMCID: PMC6630004 DOI: 10.1111/cns.13118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/31/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022] Open
Abstract
Objectives Patients with epilepsy and refractory comorbid psychiatric disorders often experience functional impairments and a lower quality of life as well as showing a lack of compliance with anti‐epileptic medication regimens. We reasoned that widespread clinical benefits could be gained if the psychiatric comorbidities among these patients were reduced. In this study, we assessed the utility of anterior capsulotomy in managing medication‐refractory comorbid psychotic symptoms and aggression in patients with epilepsy. Methods In this retrospective case series, we evaluated the clinical outcomes of 13 epilepsy patients with severe psychiatric comorbidities who had received bilateral anterior capsulotomy. Clinical outcome assessments were performed at 1 week, 6 months, 1 year, and several years after surgery focusing on: (a) severity of psychotic symptoms, as assessed by the 18‐item Brief Psychiatric Rating Scale and the Positive and Negative Syndrome Scale; (b) severity of impulsivity and aggression, measured by the Barratt Impulsiveness Scale‐11 and the Buss‐Perry Aggression Scale; and (c) social function and quality of life, assessed by the Social Disability Screening Scale and the Quality of Life in Epilepsy. Results After anterior capsulotomy, patients displayed significant improvements of psychotic symptoms, as well as of impulsivity and aggression, along with improvements of social function and quality of life. The clinical benefits to patients were evident within 6 months after surgery and remained stable or continued to improve at a much slower rate thereafter. Furthermore, after anterior capsulotomy all patients complied with epilepsy interventions that they did not comply with prior to surgery. No significant side effects or complications occurred during the study. Conclusion Anterior capsulotomy seems to be a safe and effective treatment for epilepsy patients with otherwise intractable comorbid psychotic symptoms and aggression. Moreover, this neurosurgical treatment may improve the patients' social function, quality of life, and compliance with anti‐epilepsy medication regimens.
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Affiliation(s)
- Peng Huang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deng Zheng-Dao
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bo-Min Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Xin Pan
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai-Yan Jin
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi-Kun Zhan
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Lebedeva AV, Avedisova AS, Kustov GV, Gersamiya AG, Kaymovskiy IL, Rider FK, Trifonov IS, Pashnin EV, Malkhasyan EA, Guekht AB, Krylov VV. [Prognosis for surgical treatment of pharmacoresistant epilepsy: the role of mental and cognitive disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:27-36. [PMID: 30698541 DOI: 10.17116/jnevro201811810227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This review focuses on the role of mental and cognitive disorders in the prognosis for surgical treatment of pharmacoresistant epilepsy. The authors analyze historical aspects of the surgical treatment of epilepsy and present current data on the prognosis of operative intervention with respect to seizure control, cognitive functioning, and psychiatric disorders. The psychiatrist's role in the structure of preoperative and postoperative management of patients is considered.
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Affiliation(s)
- A V Lebedeva
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - A S Avedisova
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia; Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - G V Kustov
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - A G Gersamiya
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | | | - F K Rider
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - I S Trifonov
- Evdokimov Moscow State University of Medical Dentisitry, Moscow, Russia
| | - E V Pashnin
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - E A Malkhasyan
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - A B Guekht
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - V V Krylov
- Evdokimov Moscow State University of Medical Dentisitry, Moscow, Russia; Sklifosovsky Research Institute of Emergensy Medicine, Moscow, Russia
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Kuladee S, Prachason T, Srisopit P, Trakulchang D, Boongird A, Wisajan P, Jullagate S. Prevalence of psychiatric disorders in Thai patients with epilepsy. Epilepsy Behav 2019; 90:20-24. [PMID: 30500484 DOI: 10.1016/j.yebeh.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/15/2018] [Accepted: 11/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many studies have shown that the prevalence of psychiatric disorders in patients with epilepsy (PWE) appears higher than that in general population. However, most epidemiological studies regarding psychiatric comorbidities among PWE were conducted in Western countries. This work aimed to determine the prevalence of psychiatric disorders in Thai PWE, including potential variables that could be associated with psychiatric disorders. METHODS A cross-sectional study was conducted at Ramathibodi Hospital. A total of 170 patients (aged 18 years or older) diagnosed as having epilepsy by a neurologist were recruited at the outpatient neurology clinic. Demographic and clinical characteristics were collected. Participants were evaluated for any psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, using a structured diagnostic interview. The prevalence of psychiatric disorders was determined. The associations between potential variables and the presence of psychiatric disorders in PWE were analyzed using chi-square or Fisher's exact tests, t-test, and logistic regression. RESULTS Among 170 patients, 43 (25.3%) fulfilled diagnostic criteria for one or more psychiatric disorders. The prevalence of depressive disorders was shown to be highest at 17.1%, followed by psychotic disorders (8.2%), bipolar disorder (7.1%), anxiety disorders (5.3%), and obsessive-compulsive disorder (OCD) (2.9%). Electroencephalogram (EEG) abnormalities in the temporal lobe was found to be a significant predictor of having psychiatric disorders in PWE (adjusted odds ratio (OR): 4.01, 95% confidence interval (CI): 1.47-10.92, P-value = 0.007). CONCLUSIONS The prevalence of psychiatric disorders among Thai PWE was higher than that in general population. Screening for psychiatric disorders in PWE is recommended, especially among those who have EEG abnormalities in the temporal lobe.
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Affiliation(s)
- Sanchai Kuladee
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Thanavadee Prachason
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Porntip Srisopit
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Dussanee Trakulchang
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Apisit Boongird
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pattarabhorn Wisajan
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sudawan Jullagate
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Endermann M. Lebensqualität bei Epilepsie: Ein Überblick zum Forschungsstand – Teil 1: Konzeption, Forschungsschwerpunkte, Fragebogenentwicklung. ZEITSCHRIFT FUR EPILEPTOLOGIE 2018. [DOI: 10.1007/s10309-018-0220-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fekih-Romdhane F, AbdelAziz IB, Ridha R, Zouari M, Cheour M. Étude des tempéraments affectifs chez des patients épileptiques en Tunisie. ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2017.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van den Berg L, de Weerd A, Reuvekamp M, Hagebeuk E, van der Meere J. Executive and behavioral functioning in pediatric frontal lobe epilepsy. Epilepsy Behav 2018; 87:117-122. [PMID: 30115605 DOI: 10.1016/j.yebeh.2018.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Epilepsy, as a chronic and neurological disease, is generally associated with an increased risk for social and emotional behavior problems in children. These findings are mostly derived from studies on children with different epilepsy types. However, there is limited information about the associations between frontal lobe epilepsy (FLE) and cognitive and behavioral problems. The aim of this study was to examine relationships between FLE and executive and behavioral functioning reported by parents and teachers. MATERIAL AND METHODS Teachers and parents of 32 children (18 boys, 14 girls, mean age 9; 2 years ±1;6) with a confirmed diagnosis of FLE completed the Behavioral Rating Inventory of Executive Function (BRIEF), the Child Behavior Checklist (CBCL), and Teacher Report Form (TRF). RESULTS About 25 to 35% of the parents and teachers rated children in the abnormal range of the main scales of the BRIEF, CBCL, and TRF. Teachers tend to report more metacognition problems, whereas parents tend to report more behavior regulation problems. Children with left-sided FLE showed more problems than children with bilateral or right-sided FLE. The whole range of executive dysfunctioning is linked to behavioral dysfunctioning in FLE, but ratings vary across settings and informants. The epilepsy variables age of onset, lateralization, drug load, and duration of epilepsy had only a small and scattered contribution. CONCLUSION Ratings on the BRIEF, CBCL, and TRF are moderately to highly correlated, suggesting a (strong) link between executive and behavioral functioning. Subtle differences between parents and teachers ratings suggest different executive function demands in various settings.
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Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands; Rijksuniversiteit Groningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712, TS, Groningen, Netherlands.
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Marieke Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Eveline Hagebeuk
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Jaap van der Meere
- Rijksuniversiteit Groningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712, TS, Groningen, Netherlands
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Zubareva OE, Kovalenko AA, Karyakin VB, Kalemenev SV, Lavrent’eva VV, Magazanik LG, Zaitsev AV. Changes in the Expression of Genes of the Glutamate Transporter and Subunits of the NMDA and AMPA Receptors in the Rat Amygdala in the Lithium–Pilocarpine Model of Epilepsy. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418030170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Bipolar I disorder and interictal personality syndrome have many overlapping characteristics that are difficult to distinguish. There is scant literature focused on interictal personality syndrome and no case reports to date detailing patients with comorbid bipolar pathology. We describe an individual with a history of bipolar I disorder who developed right temporal lobe epilepsy after several head injuries. He subsequently exhibited symptoms consistent with interictal personality syndrome that were independent of his bipolar symptomatology. Better understanding of these disorders can lead to improved diagnosis and symptom management. The similarities may also point to a partially shared neuropathology.
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