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Sun F, Zhang G, Zhang X. Improvement of Tourette syndrome symptoms after intractable temporal lobe epileptic surgery: a case report. Int J Neurosci 2023; 133:806-811. [PMID: 34623200 DOI: 10.1080/00207454.2021.1990914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/25/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The comorbidities of either epilepsy or Tourette syndrome (TS) are heterogeneous. However, the co-occurrence of epilepsy and TS conditions is rarely encountered, let alone effective treatments that address both neurologic disorders at the same time. METHODS We report a 24-year-old female patient who was diagnosed with TLE and TS. She presented for seizure control. After evaluation with stereo-electroencephalography and electrocorticography monitoring, the patient underwent a resective surgery treatment and was followed for 9 months. RESULTS At the last follow-up, the patient remained seizure free and unexpectedly showed great improvement in TS symptoms and its psychiatric comorbidities. CONCLUSION This anecdotal case highlights the close association between TLE and TS and we suggest that epilepsy and TS share some common pathophysiologic mechanisms.
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Affiliation(s)
- Fengqiao Sun
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Xiaohua Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, China
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2
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Tallarico M, Pisano M, Leo A, Russo E, Citraro R, De Sarro G. Antidepressant Drugs for Seizures and Epilepsy: Where do we Stand? Curr Neuropharmacol 2023; 21:1691-1713. [PMID: 35761500 PMCID: PMC10514547 DOI: 10.2174/1570159x20666220627160048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/13/2022] [Accepted: 06/18/2022] [Indexed: 11/22/2022] Open
Abstract
People with epilepsy (PWE) are more likely to develop depression and both these complex chronic diseases greatly affect health-related quality of life (QOL). This comorbidity contributes to the deterioration of the QOL further than increasing the severity of epilepsy worsening prognosis. Strong scientific evidence suggests the presence of shared pathogenic mechanisms. The correct identification and management of these factors are crucial in order to improve patients' QOL. This review article discusses recent original research on the most common pathogenic mechanisms of depression in PWE and highlights the effects of antidepressant drugs (ADs) against seizures in PWE and animal models of seizures and epilepsy. Newer ADs, such as selective serotonin reuptake inhibitors (SRRI) or serotonin-noradrenaline reuptake inhibitors (SNRI), particularly sertraline, citalopram, mirtazapine, reboxetine, paroxetine, fluoxetine, escitalopram, fluvoxamine, venlafaxine, duloxetine may lead to improvements in epilepsy severity whereas the use of older tricyclic antidepressant (TCAs) can increase the occurrence of seizures. Most of the data demonstrate the acute effects of ADs in animal models of epilepsy while there is a limited number of studies about the chronic antidepressant effects in epilepsy and epileptogenesis or on clinical efficacy. Much longer treatments are needed in order to validate the effectiveness of these new alternatives in the treatment and the development of epilepsy, while further clinical studies with appropriate protocols are warranted in order to understand the real potential contribution of these drugs in the management of PWE (besides their effects on mood).
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Affiliation(s)
- Martina Tallarico
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Pisano
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonio Leo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rita Citraro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Li X, Wang Q, Zhang DW, Wu D, Zhang SW, Wei ZR, Chen X, Li W. Hippocampus RNA Sequencing of Pentylenetetrazole-Kindled Rats and Upon Treatment of Novel Chemical Q808. Front Pharmacol 2022; 13:820508. [PMID: 35345815 PMCID: PMC8957222 DOI: 10.3389/fphar.2022.820508] [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] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/01/2022] [Indexed: 12/04/2022] Open
Abstract
The expression of genes altered in epilepsy remains incomplete, particularly in the hippocampus, which exhibits exquisite vulnerability to epilepsy. Q808 is an innovation chemical compound that has potent anti-convulsant effect. Exploring its mechanism can not only explore the pathogenesis of epilepsy but also provide a theoretical basis for its clinical application. The present study aimed to use RNA sequencing (RNA-seq) to reveal the gene transcriptomic profile of chronic pentylenetetrazole (PTZ)-kindled seizure rats and the difference of the PTZ model rat before and after treatment with Q808. Quantitative real-time PCR (qRT-PCR) was performed to validate the RNA-seq results. The protein level was estimated with Western blot. Hippocampal transcriptomic analysis showed that 289 differentially expressed genes (DEGs) were confirmed in the PTZ-kindled seizure group compared with the vehicle control. Gene cluster analysis identified most of the DEGs linked to neuronal apoptosis, neurogenesis, neuronal projections, and neurotransmitter regulation. After analysis across the three groups, 23 hub genes and 21 pathways were identified, and qRT-PCR analysis confirmed that most of the mRNA levels of hub genes were consistent with the RNA-seq results. Q808 treatment increased the level of ACE, a GABA-related protein. Our analysis showed the comprehensive compendium of genes and pathways differentially expressed for PTZ-kindled seizure rats and upon Q808 treatment in PTZ-kindled seizure, which may provide a theoretical basis to explore the mechanism and unique efficacy of Q808 and the pathophysiology of epilepsy in the future.
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Affiliation(s)
- Xiang Li
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Qing Wang
- Jilin Provincial Academy of Traditional Chinese Medicine, Changchun, China
| | - Dian-Wen Zhang
- Jilin Provincial Academy of Traditional Chinese Medicine, Changchun, China
| | - Di Wu
- Jilin Provincial Academy of Traditional Chinese Medicine, Changchun, China
| | - Si-Wei Zhang
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Zheng-Ren Wei
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xia Chen
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Wei Li
- Jilin Provincial Academy of Traditional Chinese Medicine, Changchun, China
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Torun IE, Kılınc YB, Kilinc E. Endogenous and exogenous serotonin, but not sumatriptan, ameliorate seizures and neuroinflammation in the pentylenetetrazole-induced seizure model in rats. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:48-55. [PMID: 35239805 PMCID: PMC9651504 DOI: 10.1590/0004-282x-anp-2021-0101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/12/2021] [Indexed: 11/22/2022]
Abstract
ABSTRACT Background: Epilepsy has neuropsychiatric comorbidities such as depression, bipolar disorder, and anxiety. Drugs that target epilepsy may also be useful for its neuropsychiatric comorbidities. Objective: To investigate the effects of serotonergic modulation on pro-inflammatory cytokines and the seizures in pentylenetetrazole (PTZ)-induced seizure model in rats. Methods: Male Wistar rats were injected intraperitoneally with serotonin, selective serotonin reuptake inhibitor fluoxetine, 5-HT1B/D receptor agonist sumatriptan, or saline 30 min prior to PTZ treatment. Behavioral seizures were assessed by the Racine's scale. Concentrations of IL-1β, IL-6, and TNF-α in serum and brain tissue were determined by ELISA. Results: Serotonin and fluoxetine, but not sumatriptan, alleviated PTZ-induced seizures by prolonging onset times of myoclonic-jerk and generalized tonic-clonic seizures. The anti-seizure effect of fluoxetine was greater than that of serotonin. Likewise, serotonin and fluoxetine, but not sumatriptan, reduced PTZ-induced increases in the levels of IL-1β and IL-6 in both serum and brain tissue. None of the administered drugs including PTZ affected TNF-α concentrations. Conclusions: Our findings suggest that endogenous and exogenous serotonin exhibits anticonvulsant effects by suppressing the neuroinflammation. It seems that 5-HT1B/D receptors do not mediate anticonvulsant and anti-neuroinflammatory effects of serotonin.
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Gulyaeva NV. Stress-Associated Molecular and Cellular Hippocampal Mechanisms Common for Epilepsy and Comorbid Depressive Disorders. BIOCHEMISTRY (MOSCOW) 2021; 86:641-656. [PMID: 34225588 DOI: 10.1134/s0006297921060031] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The review discusses molecular and cellular mechanisms common to the temporal lobe epileptogenesis/epilepsy and depressive disorders. Comorbid temporal lobe epilepsy and depression are associated with dysfunction of the hypothalamic-pituitary-adrenocortical axis. Excessive glucocorticoids disrupt the function and impair the structure of the hippocampus, a brain region key to learning, memory, and emotions. Selective vulnerability of the hippocampus to stress, mediated by the reception of glucocorticoid hormones secreted during stress, is the price of the high functional plasticity and pleiotropy of this limbic structure. Common molecular and cellular mechanisms include the dysfunction of glucocorticoid receptors, neurotransmitters, and neurotrophic factors, development of neuroinflammation, leading to neurodegeneration and loss of hippocampal neurons, as well as disturbances in neurogenesis in the subgranular neurogenic niche and formation of aberrant neural networks. These glucocorticoid-dependent processes underlie altered stress response and the development of chronic stress-induced comorbid pathologies, in particular, temporal lobe epilepsy and depressive disorders.
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Affiliation(s)
- Natalia V Gulyaeva
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, 117485, Russia. .,Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, Moscow, 115419, Russia
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Vincentiis S, Alcantara JA, Rzezak P, Kerr DS, Gattaz WF, van der Linden H, Dos Santos B, Arruda F, Chaim-Avancini T, Serpa MH, Fernandes F, Moreno RA, Busatto GF, Alessi R, Demarque R, Valente KD. Genetic polymorphisms of the serotonin transporter are not related with depression in temporal lobe epilepsy caused by hippocampal sclerosis. Epilepsy Behav 2021; 117:107854. [PMID: 33639436 DOI: 10.1016/j.yebeh.2021.107854] [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: 01/11/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mood disorders are the most frequent psychiatric disorders in patients with temporal lobe epilepsy caused by hippocampal sclerosis (TLE-HS). The pathophysiological mechanisms in common between TLE and mood disorders include abnormalities in the serotonergic pathway. We aimed to evaluate the association between serotonin transporter genetic polymorphisms - 5-HTTLPR and 5-HTTVNTR - and the presence of mood disorders in patients with TLE-HS. METHODS We evaluated 119 patients with TLE-HS, with and without psychiatric disorder; 146 patients diagnosed with major depressive disorder (MDD), and 113 healthy volunteers. Individuals were genotyped for the 5-HTTLPR and 5-HTTVNTR polymorphisms. RESULTS No difference was observed between the TLE-HS groups, healthy controls, and MDD without epilepsy. There was a correlation between the 12-allele of the 5-HTTVNTR and the family history of patients with epilepsy with TLE-HS (p = 0.013). CONCLUSIONS In this study conducted in two Brazilian centers, the serotonin transporter polymorphisms evaluated cannot be associated with depressive disorder in patients with TLE-HS. Still, they do have some influence over some clinical characteristics of epilepsy in TLE-HS. These data may not be reproduced in other populations with distinct ethnic characteristics.
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Affiliation(s)
- Silvia Vincentiis
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil.
| | - Juliana A Alcantara
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Patricia Rzezak
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Daniel S Kerr
- Laboratory of Neuroscience (LIM-27), Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Wagner F Gattaz
- Laboratory of Neuroscience (LIM-27), Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil.
| | - Helio van der Linden
- Goiania Neurological Institute, Praça Gilson Alves de Souza, 140, Setor Bueno, Goiania, GO 74210-250, Brazil
| | - Bernardo Dos Santos
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Francisco Arruda
- Goiania Neurological Institute, Praça Gilson Alves de Souza, 140, Setor Bueno, Goiania, GO 74210-250, Brazil
| | - Tiffany Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Mauricio H Serpa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Fernando Fernandes
- Mood Disorders Unit (GRUDA), Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Ricardo A Moreno
- Mood Disorders Unit (GRUDA), Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Ruda Alessi
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Renata Demarque
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology, Institute and Department of Psychiatry, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Rua Dr. Ovidio Pires de Campos, 785, Cerqueira Cesar, Sao Paulo, SP 05403-010, Brazil.
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Osuntokun OS, Ademinkanra AJ, Atere TG, Olayiwola G, Adedokun KI, Adekomi DA. Graded doses of grape seed methanol extract attenuated ataxic movement, cerebellocortical toxicity, and impairment following chronic carbamazepine treatment in male Wistar rats. Epilepsy Behav 2021; 114:107484. [PMID: 33257291 DOI: 10.1016/j.yebeh.2020.107484] [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: 06/16/2020] [Revised: 08/13/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022]
Abstract
This study investigated the effects of chronic cotreatment of carbamazepine (CBZ) with grape seed methanolic extract (GSME) on the markers of neurotoxicity and motor coordination in male rats. Thirty male Wistar rats were randomized into 5 groups (n = 6) and treated orally with propylene glycol (PG 0.1 ml/day), CBZ (25 mg/kg), CBZ (25 mg/kg) + GSME (200 mg/kg), CBZ (25 mg/kg) + GSME (100 mg/kg), or CBZ (25 mg/kg) + GSME (50 mg/kg) for 28 days. Thereafter, the animals were subjected to motor-coordination tests and, eventually, sacrificed by cervical dislocation. The cranium was opened and the brain excised. The prefrontal cortex (PFC) and cerebellum were homogenized for the biochemical assessment, while representative brain was fixed in 10% neutral-buffered formalin for the histomorphological investigation. The results were presented as mean ± SEM, analyzed using one-way analysis of variance (ANOVA) and Student-Newman-Keuls post hoc analysis where appropriate, while p < 0.05 was considered statistically significant. Indices of motor coordination were significantly (p = 0.0014) impaired with a significant (p = 0.0001) increase in the concentration of malondialdehyde (MDA) in the PFC and cerebellar tissue. In addition, the activities of glutathione increased (p = 0.0001) significantly in the CBZ + GSME-treated rats. All these anomalies were attenuated in the CBZ + GSME treated rats. Coadministration of GSME with CBZ may ameliorate CBZ-induced neurotoxicity, histoarchitectural disorganization of PFC and cerebellum with resultant effect on fine motor actions.
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Affiliation(s)
- Opeyemi Samson Osuntokun
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University Osogbo, Nigeria.
| | - Adeniyi Jacob Ademinkanra
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University Osogbo, Nigeria
| | - Tope Gafar Atere
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University Osogbo, Nigeria
| | - Gbola Olayiwola
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Kabiru Isola Adedokun
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University Osogbo, Nigeria
| | - Damilare Adedayo Adekomi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University Osogbo, Nigeria
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Advances in Understanding CREB Signaling-Mediated Regulation of the Pathogenesis and Progression of Epilepsy. Clin Neurol Neurosurg 2020; 196:106018. [DOI: 10.1016/j.clineuro.2020.106018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/21/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022]
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9
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Novais F, Pestana LC, Loureiro S, Andrea M, Figueira ML, Pimentel J. Psychiatric disorders as predictors of epilepsy surgery outcome. Epilepsy Behav 2019; 100:106513. [PMID: 31639645 DOI: 10.1016/j.yebeh.2019.106513] [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: 03/05/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Our aim was to determine if a history of a mental disorder predicts a worst neurological outcome for patients undergoing epilepsy surgery. METHODS We conducted an ambispective observational study including people with refractory epilepsy who underwent resective surgery. Demographic, psychiatric, and neurological data were collected, before and one year after surgery. Presurgical interviews included a psychiatric evaluation and the determination of prevalent and lifetime psychiatric diagnosis. The one-year postsurgical outcome was classified according to the Engel Outcome Scale. Predictors of postsurgical Engel class were determined using an ordered logistic regression model. RESULTS A lifetime history of any mental disorder was a significant predictor of a higher Engel Class (p = 0.017). CONCLUSION This study shows that psychiatric lifetime diagnoses are associated with worse surgical outcome and highlighted the importance of the inclusion of these diagnoses in the evaluation of the potential success of the surgery.
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Affiliation(s)
- Filipa Novais
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal.
| | - Luís Câmara Pestana
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Susana Loureiro
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Mafalda Andrea
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal
| | - Maria Luísa Figueira
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - José Pimentel
- Department of Neurosciences and Mental Health, Neurology Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
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Doherty C, Hogue O, Floden DP, Altemus JB, Najm IM, Eng C, Busch RM. BDNF and COMT, but not APOE, alleles are associated with psychiatric symptoms in refractory epilepsy. Epilepsy Behav 2019; 94:131-136. [PMID: 30909076 PMCID: PMC8299517 DOI: 10.1016/j.yebeh.2019.02.032] [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: 11/03/2018] [Accepted: 02/28/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether three common genetic polymorphisms [apolipoprotein (APOE) ε4 (rs42938 and rs7412), brain derived neurotrophic factor (BDNF) Met (rs6265), and catechol-O-methyltransferase (COMT) Val (rs4680)] are associated with increased psychiatric symptomatology in individuals with pharmacoresistant epilepsy. METHODS One hundred forty-eight adults (Mage = 38 years; 53% female) with refractory epilepsy completed self-report measures of mood, anxiety, and/or personality/psychopathology. Mann-Whitney U, t-tests, and Fisher's exact tests were used to determine if APOE4, BDNF Val66Met, or COMT Val158Met are associated with increased psychiatric symptomatology in people with epilepsy. RESULTS As a group, BDNF Met carriers reported greater symptoms of depression on the Personality Assessment Inventory (PAI) than those without a Met allele (p = 0.004); COMT Val carriers reported greater symptoms on the PAI Schizophrenia (p = 0.007), Antisocial Features (p = 0.04), and Alcohol Problems (p = 0.03) scales than noncarriers. On the individual level, a significantly greater proportion of BDNF Met carriers demonstrated elevated PAI Depression scores compared to those without a Met allele (p = 0.046). There was also a larger proportion of COMT Val carriers with elevated PAI Anxiety scores as compared to those without a Val allele (p = 0.036). SIGNIFICANCE This retrospective cross-sectional study provides preliminary evidence for a genetic basis of psychiatric comorbidities in epilepsy and suggests that BDNF and COMT may play an important role in the pathophysiology of mental health problems in this vulnerable population.
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Affiliation(s)
- Christine Doherty
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States of America.
| | - Olivia Hogue
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America.
| | - Darlene P. Floden
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH,Department of Psychiatry & Psychology, Neurological Institute, Cleveland Clinic, Cleveland, OH
| | - Jessica B. Altemus
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Imad M. Najm
- Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, OH,Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America; Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.
| | - Robyn M. Busch
- Department of Psychiatry & Psychology, Neurological Institute, Cleveland Clinic, Cleveland, OH,Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, OH
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Beltrán JQ, Carrillo-Ruiz JD. Neurological Functional Surgery in Mexico: From Pre-Columbian Cranial Surgery to Functional Neurosurgery in the 21st Century. World Neurosurg 2019; 122:549-558. [DOI: 10.1016/j.wneu.2018.11.165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 01/28/2023]
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12
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Vrinda M, Arun S, Srikumar B, Kutty BM, Shankaranarayana Rao B. Temporal lobe epilepsy-induced neurodegeneration and cognitive deficits: Implications for aging. J Chem Neuroanat 2019; 95:146-153. [DOI: 10.1016/j.jchemneu.2018.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 12/12/2022]
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13
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Svob Strac D, Pivac N, Smolders IJ, Fogel WA, De Deurwaerdere P, Di Giovanni G. Monoaminergic Mechanisms in Epilepsy May Offer Innovative Therapeutic Opportunity for Monoaminergic Multi-Target Drugs. Front Neurosci 2016; 10:492. [PMID: 27891070 PMCID: PMC5102907 DOI: 10.3389/fnins.2016.00492] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 10/13/2016] [Indexed: 12/22/2022] Open
Abstract
A large body of experimental and clinical evidence has strongly suggested that monoamines play an important role in regulating epileptogenesis, seizure susceptibility, convulsions, and comorbid psychiatric disorders commonly seen in people with epilepsy (PWE). However, neither the relative significance of individual monoamines nor their interaction has yet been fully clarified due to the complexity of these neurotransmitter systems. In addition, epilepsy is diverse, with many different seizure types and epilepsy syndromes, and the role played by monoamines may vary from one condition to another. In this review, we will focus on the role of serotonin, dopamine, noradrenaline, histamine, and melatonin in epilepsy. Recent experimental, clinical, and genetic evidence will be reviewed in consideration of the mutual relationship of monoamines with the other putative neurotransmitters. The complexity of epileptic pathogenesis may explain why the currently available drugs, developed according to the classic drug discovery paradigm of "one-molecule-one-target," have turned out to be effective only in a percentage of PWE. Although, no antiepileptic drugs currently target specifically monoaminergic systems, multi-target directed ligands acting on different monoaminergic proteins, present on both neurons and glia cells, may represent a new approach in the management of seizures, and their generation as well as comorbid neuropsychiatric disorders.
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Affiliation(s)
| | - Nela Pivac
- Division of Molecular Medicine, Rudjer Boskovic InstituteZagreb, Croatia
| | - Ilse J. Smolders
- Department of Pharmaceutical Chemistry and Drug Analysis, Vrije Universiteit BrusselBrussels, Belgium
| | - Wieslawa A. Fogel
- Department of Hormone Biochemistry, Medical University of LodzLodz, Poland
| | | | - Giuseppe Di Giovanni
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, University of MaltaMsida, Malta
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Weng WC, Huang HL, Wong LC, Jong YJ, Yin YJ, Chen HA, Lee WT, Ho SY. Increased risks of tic disorders in children with epilepsy: A nation-wide population-based case-control study in Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:173-180. [PMID: 26585639 DOI: 10.1016/j.ridd.2015.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/18/2015] [Accepted: 10/22/2015] [Indexed: 06/05/2023]
Abstract
Both epilepsy and tic disorders may share common mechanisms with the involvement of abnormal cortical-basal ganglion circuit connection and dopaminergic dysfunction. However, the association between epilepsy and tic disorders has never been studied. This study investigated the risks of developing tic disorders among children with epilepsy using databases of a universal health insurance system in Taiwan. The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The study cohort included children with epilepsy between 2001 and 2007 (n=2629) and a three-fold age- and gender-matched controls (n=7887). All subjects were followed up for 3 years from the date of cohort entry to identify their admissions due to tic disorders (ICD-9-CM codes 307.2, 307.20-307.23). Cox hazard regression analysis was performed to estimate the effect of epilepsy on the occurrence of tics. The epilepsy cohort had a higher prevalence of tics (1.7% vs. 0.2%), and a 8.70-fold increased risk of developing a tic disorder compared with the controls (adjusted hazard ratio (AHR) 8.70, 95% confidence interval (CI) 4.26-16.37, p<0.001). Male patients were observed to have a higher risk of developing a tic disorder (AHR 1.90, 95% CI=1.04-3.46, p<0.001) compared to female individuals. Patients with multiple antiepileptic drugs treatment also exhibited higher crude OR for developing tic disorders. This nationwide population-based cohort study, for the first time, demonstrated that there is a significantly increased risk for tic disorders among children with epilepsy. We also found males, attention deficit disorder and the use of multiple AEDs to be independent risk factors of tic disorders. Closely evaluating possible tic disorders would be crucial for improving the outcome and life quality in children with epilepsy.
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Affiliation(s)
- Wen-Chin Weng
- Department of Pediatrics, National Taiwan University Hospital, and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hui-Ling Huang
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Lee Chin Wong
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
| | - Yuh-Jyh Jong
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Yun-Ju Yin
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan
| | - Hong-An Chen
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan
| | - Wang-Tso Lee
- Department of Pediatrics, National Taiwan University Hospital, and College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan.
| | - Shinn-Ying Ho
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
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15
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Rocha L, Alonso-Vanegas M, Martínez-Juárez IE, Orozco-Suárez S, Escalante-Santiago D, Feria-Romero IA, Zavala-Tecuapetla C, Cisneros-Franco JM, Buentello-García RM, Cienfuegos J. GABAergic alterations in neocortex of patients with pharmacoresistant temporal lobe epilepsy can explain the comorbidity of anxiety and depression: the potential impact of clinical factors. Front Cell Neurosci 2015; 8:442. [PMID: 25601827 PMCID: PMC4283637 DOI: 10.3389/fncel.2014.00442] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 12/08/2014] [Indexed: 01/12/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is a chronic neurodegenerative disease with a high prevalence of psychiatric disorders. Temporal neocortex contributes to either seizure propagation or generation in TLE, a situation that has been associated with alterations of the γ-amino-butyric acid (GABA) system. On the other hand, an impaired neurotransmission mediated by GABA in temporal neocortex has also been involved with the pathophysiology of psychiatric disorders. In spite of these situations, the role of the necortical GABA system in the comorbidity of TLE and mood disorders has not been investigated. The present study was designed to identify alterations in the GABA system such as binding to GABAA and GABAB receptors and benzodiazepine site, the tissue content of GABA and the expression of the mRNA encoding the α1–6, β1–3, and γ GABAA subunits, in the temporal neocortex of surgically treated patients with TLE with and without anxiety, and/or depression. Neocortex of patients with TLE and comorbid anxiety and/or depression showed increased expression of the mRNA encoding the γ2-subunit, reduced GABAB-induced G-protein activation in spite of elevated GABAB binding, and lower tissue content of GABA when compared to autopsy controls. Some of these changes significantly correlated with seizure frequency and duration of epilepsy. The results obtained suggest a dysfunction of the GABAergic neurotransmission in temporal neocortex of patients with TLE and comorbid anxiety and/or depression that could be also influenced by clinical factors such as seizure frequency and duration of illness.
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Affiliation(s)
- Luisa Rocha
- Department of Pharmacobiology, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV) , Mexico City , Mexico
| | - Mario Alonso-Vanegas
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
| | - Iris E Martínez-Juárez
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
| | - Sandra Orozco-Suárez
- Unit for Medical Research in Neurological Diseases, National Medical Center , Mexico City , Mexico
| | - David Escalante-Santiago
- Unit for Medical Research in Neurological Diseases, National Medical Center , Mexico City , Mexico
| | | | - Cecilia Zavala-Tecuapetla
- Department of Pharmacobiology, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV) , Mexico City , Mexico
| | | | | | - Jesús Cienfuegos
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
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16
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Rocha L, Alonso-Vanegas M, Martínez-Juárez IE, Orozco-Suárez S, Escalante-Santiago D, Feria-Romero IA, Zavala-Tecuapetla C, Cisneros-Franco JM, Buentello-García RM, Cienfuegos J. GABAergic alterations in neocortex of patients with pharmacoresistant temporal lobe epilepsy can explain the comorbidity of anxiety and depression: the potential impact of clinical factors. Front Cell Neurosci 2015. [PMID: 25601827 DOI: 10.3389/fnce1.2014.00442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is a chronic neurodegenerative disease with a high prevalence of psychiatric disorders. Temporal neocortex contributes to either seizure propagation or generation in TLE, a situation that has been associated with alterations of the γ-amino-butyric acid (GABA) system. On the other hand, an impaired neurotransmission mediated by GABA in temporal neocortex has also been involved with the pathophysiology of psychiatric disorders. In spite of these situations, the role of the necortical GABA system in the comorbidity of TLE and mood disorders has not been investigated. The present study was designed to identify alterations in the GABA system such as binding to GABAA and GABAB receptors and benzodiazepine site, the tissue content of GABA and the expression of the mRNA encoding the α1-6, β1-3, and γ GABAA subunits, in the temporal neocortex of surgically treated patients with TLE with and without anxiety, and/or depression. Neocortex of patients with TLE and comorbid anxiety and/or depression showed increased expression of the mRNA encoding the γ2-subunit, reduced GABAB-induced G-protein activation in spite of elevated GABAB binding, and lower tissue content of GABA when compared to autopsy controls. Some of these changes significantly correlated with seizure frequency and duration of epilepsy. The results obtained suggest a dysfunction of the GABAergic neurotransmission in temporal neocortex of patients with TLE and comorbid anxiety and/or depression that could be also influenced by clinical factors such as seizure frequency and duration of illness.
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Affiliation(s)
- Luisa Rocha
- Department of Pharmacobiology, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV) , Mexico City , Mexico
| | - Mario Alonso-Vanegas
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
| | - Iris E Martínez-Juárez
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
| | - Sandra Orozco-Suárez
- Unit for Medical Research in Neurological Diseases, National Medical Center , Mexico City , Mexico
| | - David Escalante-Santiago
- Unit for Medical Research in Neurological Diseases, National Medical Center , Mexico City , Mexico
| | | | - Cecilia Zavala-Tecuapetla
- Department of Pharmacobiology, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV) , Mexico City , Mexico
| | | | | | - Jesús Cienfuegos
- National Institute of Neurology and Neurosurgery "Manuel Velasco Suarez" , Mexico City , Mexico
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