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Hadzic A, Andersson S. Non-ictal, interictal and ictal déjà vu: a systematic review and meta-analysis. Front Neurol 2024; 15:1406889. [PMID: 38966090 PMCID: PMC11223632 DOI: 10.3389/fneur.2024.1406889] [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] [Received: 03/25/2024] [Accepted: 05/27/2024] [Indexed: 07/06/2024] Open
Abstract
Background Déjà vu, French for "already seen," is a phenomenon most people will experience at least once in their lifetime. Emerging evidence suggests that déjà vu occurs in healthy individuals (as "non-ictal déjà vu") and in epilepsy patients during seizures (as "ictal déjà vu") and between seizures (as "interictal déjà vu"). Although the ILAE has recognized déjà vu as a feature of epileptic seizures, it is notably absent from the ICD-11. A lack of evidence-based research may account for this omission. To our knowledge, this study represents the first systematic review and meta-analysis on déjà vu experiences. Through detailed examinations of non-ictal, interictal and ictal déjà vu, we seek to highlight possible clinical implications. Rethinking the status quo of ictal déjà vu could potentially lead to earlier interventions and improve outcomes for epilepsy patients. Methods This study was registered in PROSPERO (ID: CRD42023394239) on 5 February 2023. Systematic searches were conducted across four databases: EMBASE, MEDLINE, PsycINFO, and PubMed, from inception to 1 February 2023, limited to English language and human participants. Studies were included/excluded based on predefined criteria. Data was extracted according to the PICO framework and synthesized through a thematic approach. Meta-analyses were performed to estimate prevalence's of the phenomena. Study quality, heterogeneity, and publication bias were assessed. Results Database searching identified 1,677 records, of which 46 studies were included. Meta-analyses of prevalence showed that non-ictal déjà vu was experienced by 0.74 (95% CI [0.67, 0.79], p < 0.001) of healthy individuals, whereas interictal déjà vu was experienced by 0.62 (95% CI [0.48, 0.75], p = 0.099) and ictal déjà vu by 0.22 (95% CI [0.15, 0.32], p = 0.001) of epilepsy patients. Examinations of phenomenological (sex, age, frequency, duration, emotional valence, and dissociative symptoms) and neuroscientific (brain structures and functions) data revealed significant variations between non-ictal, interictal and ictal déjà vu on several domains. Conclusion This systematic review and meta-analysis do not support the notion that non-ictal, interictal and ictal déjà vu are homogenous experiences. Instead, it provides insight into ictal déjà vu as a symptom of epilepsy that should be considered included in future revisions of the ICD-11. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394239, CRD42023394239.
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Affiliation(s)
- Alena Hadzic
- Section for Clinical and Cognitive Neuroscience, Department of Psychology, University of Oslo, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Stein Andersson
- Section for Clinical and Cognitive Neuroscience, Department of Psychology, University of Oslo, Oslo, Norway
- Psychosomatic Medicine and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Alencar SD, Cendes F, de Morais ABCG, Ribeiro VCAF, Frota NAF, Pinto LF. Déjà vu in idiopathic generalized epilepsy: A systematic review. Seizure 2024; 118:53-57. [PMID: 38640571 DOI: 10.1016/j.seizure.2024.03.015] [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: 09/15/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/21/2024] Open
Abstract
INTRODUCTION Déjà vu (DV), a French term meaning "already seen," refers to inappropriate sensation of familiarity in the present moment, as if it had been experienced before without a specific recollection of when or where. Traditionally, DV has been closely associated with focal seizures originating from the medial temporal lobe. However, there are occasional reports of DV occurring in idiopathic generalized epilepsies (IGEs). The objective of our study was to assess the presence and frequency of DV in individuals with IGE. METHODS We used the Preferred Reporting Items for Systematic Review and Meta-Analysis for protocols (PRISMA-P) and searched PubMed and Embase from January 2000 to July 2022. RESULTS 5 studies were included with a total of 1177 IGE and 1026 with temporal lobe epilepsy (TLE) patients. The frequency of DV in IGE ranged from 0 to 11 %, and the average was 3 %, compared to 19.6 % in TLE. Broadly, 40 % of patients with IGE reported some type of aura. EEG correlation of DV in IGE was not appropriately evaluated in the studies. CONCLUSION Clinicians should be aware that individuals with IGE may experience DV and other types of auras. Recognizing these auras is crucial in order to avoid misdiagnosing IGE as focal epilepsy. This is important to prevent unnecessary investigations and incorrect treatment decisions.
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Aitken CBA, Jentzsch I, O'Connor AR. Towards a conflict account of déjà vu: The role of memory errors and memory expectation conflict in the experience of déjà vu. Neurosci Biobehav Rev 2023; 155:105467. [PMID: 37979736 DOI: 10.1016/j.neubiorev.2023.105467] [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: 05/10/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
Déjà vu can be defined as conflict between a subjective evaluation of familiarity and a concurrent evaluation of novelty. Accounts of the déjà vu experience have not explicitly referred to a "conflict account of déjà vu" despite the acceptance of conflict-based definitions of déjà vu and relatively recent neuroimaging work that has implicated brain areas associated with conflict as underpinning the experience. Conflict monitoring functioning follows a similar age-related trajectory to déjà vu with a peak in young adulthood and a subsequent age-related decline. In this narrative review of the literature to date, we consider how déjà vu is defined and how this has influenced the understanding of déjà vu. We also review how déjà vu can be understood within theories of recognition memory and cognitive control. Finally, we summarise the conflict account of déjà vu and propose that this account of the experience may provide a coherent explanation as to why déjà vu experiences tend to decrease with age in the non-clinical population.
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Affiliation(s)
- Courtney B A Aitken
- School of Psychology & Neuroscience, University of St Andrews, United Kingdom.
| | - Ines Jentzsch
- School of Psychology & Neuroscience, University of St Andrews, United Kingdom
| | - Akira R O'Connor
- School of Psychology & Neuroscience, University of St Andrews, United Kingdom
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Sammarra I, Martino I, Caligiuri ME, Giugno A, Fortunato F, Labate A, Gambardella A. The impact of one-year COVID-19 containment measures in patients with mesial temporal lobe epilepsy: A longitudinal survey-based study. Epilepsy Behav 2022; 128:108600. [PMID: 35151188 PMCID: PMC8801317 DOI: 10.1016/j.yebeh.2022.108600] [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: 12/27/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND We assessed levels of depression, anxiety, stress, anhedonia, somatization, psychological distress, sleep, and life quality in patients with mesial temporal lobe epilepsy (MTLE) after one year of containment measures started in Italy to stem the COVID-19 pandemic. METHODS We consecutively enrolled 51 patients with MTLE, administering an online survey that compared the year before and after the COVID-19 propagation. We analyzed clinical data (e.g., seizure frequency, life quality) and neuropsychological assessment through Somatic Symptom Scale-8 (SSS-8), Beck Depression Inventory (BDI-2), State-Trait Anxiety Inventory (STAI-Y), Depression, Anxiety and Stress Scale (DASS-21), Pittsburgh Sleep Quality Index (PSQI), Snaith-Hamilton Pleasure Scale (SHAPS), Impact of Event Scale-Revised (IES-R). The BDI-2 and STAI-Y scores were compared to those acquired in the same patients before the COVID-19 outbreak. RESULTS Comparing our population with MTLE before and after COVID-19 outbreak, we found a significant worsening in life quality (p = 0.03), SSS-8 (p = 0.001), BDI-2 (p = 0.032), and STAI-Y scores (p < 0.001). After one year of pandemic, 88.2% of patients obtained pathological scores at PSQI, 19.6% at SHAPS, 29.4% at IES-R. Reduction of life quality correlated with anxiety, depression, stress, and somatization. Higher levels of anhedonia correlated with stress, depression, and anxiety. Somatization correlated with depression, anxiety, and sleep quality. Distress levels correlated with anxiety, somatization, and depression. CONCLUSIONS We demonstrated a significant worsening of depression, anxiety, life quality, and somatization in patients with MTLE after one year of COVID-19 beginning. Concomitantly, results suggest that the pandemic had a negative impact on sleep quality, psychological distress, and anhedonia, but not on epilepsy itself.
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Affiliation(s)
- Ilaria Sammarra
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Iolanda Martino
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Alessia Giugno
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
| | - Angelo Labate
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
| | - Antonio Gambardella
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy; Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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Zatloukalova E, Mikl M, Shaw DJ, Marecek R, Sakalosova L, Kuratkova M, Mitterova K, Sklenarova B, Brazdil M. Insights into déjà vu: Associations between the frequency of experience and amplitudes of low-frequency oscillations in resting-state functional magnetic resonance imaging. Eur J Neurosci 2021; 55:426-437. [PMID: 34907615 DOI: 10.1111/ejn.15570] [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: 04/13/2021] [Revised: 10/31/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
The phenomenon of déjà vu (DV) has intrigued scientists for decades, yet its neurophysiological underpinnings remain elusive. Brain regions have been identified in which morphometry differs between healthy individuals according to the frequency of their DV experiences. This study built upon these findings by assessing if and how neural activity in these and other brain regions also differ with respect to DV experience. Resting-state fMRI was performed on 68 healthy volunteers, 44 of whom reported DV experiences (DV group) and 24 who did not (NDV group). Using multivariate analyses, we then assessed the (fractional) amplitude of low-frequency fluctuations (fALFF/ALFF), a metric that is believed to index brain tissue excitability, for five discrete frequency bands within sets of brain regions implicated in DV and those comprising the default mode network (DMN). Analyses revealed significantly lower values of fALFF/ALFF for specific frequency bands in the DV relative to the NDV group, particularly within mesiotemporal structures, bilateral putamina, right caudatum, bilateral superior frontal cortices, left lateral parietal cortex, dorsal and ventral medial prefrontal cortex, and the posterior cingulate cortex. The pattern of differences in fALFF/ALFF measures between the brains of individuals who have experienced DV and those who have not provides new neurophysiological insights into this phenomenon, including the potential role of the DMN. We suggest that the erroneous feeling of familiarity arises from a temporary disruption of cortico-subcortical circuitry together with the upregulation of cortical excitability.
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Affiliation(s)
- Eva Zatloukalova
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic
| | - Michal Mikl
- Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Daniel Joel Shaw
- Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Radek Marecek
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Sakalosova
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marie Kuratkova
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Kristyna Mitterova
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Barbora Sklenarova
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic
| | - Milan Brazdil
- Brno Epilepsy Center, 1st Department of Neurology, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Full Member of the ERN EpiCARE, Brno, Czech Republic.,Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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