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Chen Z, Yu W, Xu R, Karoly PJ, Maturana MI, Payne DE, Li L, Nurse ES, Freestone DR, Li S, Burkitt AN, Cook MJ, Guo Y, Grayden DB. Ambient air pollution and epileptic seizures: a panel study in Australia. Epilepsia 2022; 63:1682-1692. [PMID: 35395096 PMCID: PMC9543609 DOI: 10.1111/epi.17253] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Emerging evidence has shown that ambient air pollution affects brain health, but little is known about its effect on epileptic seizures. This work aimed to assess the association between daily exposure to ambient air pollution and the risk of epileptic seizures. METHODS This study used epileptic seizure data from two independent data sources (NeuroVista and Seer App seizure diary). In the NeuroVista dataset, 3273 seizures were recorded using intracranial electroencephalography (iEEG) from 15 participants with refractory focal epilepsy in Australia in 2010-2012. In the seizure diary dataset, 3419 self-reported seizures were collected through a mobile application from 34 participants with epilepsy in Australia in 2018-2021. Daily average concentrations of carbon monoxide (CO), nitrogen dioxide (NO2 ), ozone (O3 ), particulate matter ≤10 μm in diameter (PM10 ), and sulfur dioxide (SO2 ) were retrieved from the Environment Protection Authority (EPA) based on participants' postcodes. A patient-time-stratified case-crossover design with the conditional Poisson regression model was used to determine the associations between air pollutants and epileptic seizures. RESULTS A significant association between CO concentrations and epileptic seizure risks was observed, with an increased seizure risk of 4% (relative risk [RR]: 1.04, 95% confidence interval [CI]: 1.01-1.07) for an interquartile range (IQR) increase of CO concentrations (0.13 parts per million), while no significant associations were found for the other four air pollutants in the whole study population. Females had a significantly increased risk of seizures when exposing to elevated CO and NO2 , with RR of 1.05 (95% CI: 1.01-1.08) and 1.09 (95% CI: 1.01-1.16), respectively. Additionally, a significant association was observed between CO and the risk of subclinical seizures (RR: 1.20, 95% CI: 1.12-1.28). SIGNIFICANCE Daily exposure to elevated CO concentrations may be associated with the increased risk of epileptic seizures, especially for subclinical seizures.
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Affiliation(s)
- Zhuying Chen
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia
| | - Wenhua Yu
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Philippa J Karoly
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia.,Graeme Clark Institute, The University of Melbourne, VIC, Australia
| | - Matias I Maturana
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia.,Seer Medical, Melbourne, VIC, Australia
| | - Daniel E Payne
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia.,Seer Medical, Melbourne, VIC, Australia
| | - Lyra Li
- Graeme Clark Institute, The University of Melbourne, VIC, Australia
| | - Ewan S Nurse
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia.,Seer Medical, Melbourne, VIC, Australia
| | | | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Anthony N Burkitt
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia
| | - Mark J Cook
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia.,Graeme Clark Institute, The University of Melbourne, VIC, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - David B Grayden
- Department of Biomedical Engineering, The University of Melbourne, VIC, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, VIC, Australia.,Graeme Clark Institute, The University of Melbourne, VIC, Australia
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Fernandes MJS, Carletti CO, Sierra de Araújo LF, Santos RC, Reis J. Respiratory gases, air pollution and epilepsy. Rev Neurol (Paris) 2019; 175:604-613. [PMID: 31519304 DOI: 10.1016/j.neurol.2019.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 12/29/2022]
Abstract
A growing number of studies have shown that exposure to air pollutants such as particulate matter and gases can cause cardiovascular, neurodegenerative and psychiatric diseases. The severity of the changes depends on several factors such as exposure time, age and gender. Inflammation has been considered as one of the main factors associated with the generation of these diseases. Here we present some cellular mechanisms activated by air pollution that may represent risk factors for epilepsy and drug resistance associated to epilepsy.
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Affiliation(s)
- M J S Fernandes
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - C O Carletti
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - L F Sierra de Araújo
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - R C Santos
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - J Reis
- Service de Neurologie, Centre Hospitalier Universitaire, Hôpital de Hautepierre, 1, avenue Molière, 67200 Strasbourg, France
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