Absence seizures and their relationship to depression and anxiety: Evidence for bidirectionality

Abstract

Absence seizures (AS), presenting as short losses of consciousness with staring spells, are a common manifestation of childhood epilepsy that is associated with behavioral, emotional, and social impairments. It has also been suggested that patients with AS are more likely to suffer from mood disorders such as depression and anxiety. This systematic review and meta-analysis synthesizes human and animal models that investigated mood disorders and AS. Of the 1019 scientific publications identified, 35 articles met the inclusion criteria for this review. We found that patients with AS had greater odds of developing depression and anxiety when compared to controls (odds ratio = 4.93, 95% confidence interval = 2.91-8.35, p < .01). The included studies further suggest a strong correlation between AS and depression and anxiety in the form of a bidirectional relationship. The current literature emphasizes that these conditions likely share underlying mechanisms, such as genetic predisposition, neurophysiology, and anatomical pathways. Further research will clarify this relationship and ensure more effective treatment for AS and mood disorders.

ILAE definition of the Idiopathic Generalized Epilepsy Syndromes: Position statement by the ILAE Task Force on Nosology and Definitions

“…Development is typically normal, although children with CAE may have specific learning difficulties and ADHD; both may be subtle and easily missed 27,55–59 . Higher rates of depression and anxiety are also noted 60,61 . Neurological examination and head size are normal.…”

“…Persons with JAE have higher rates of ADHD and learning problems, even if seizures are well controlled 59,84,85 . Higher rates of depression and anxiety are also noted 61 …”

“…27,[55][56][57][58][59] Higher rates of depression and anxiety are also noted. 60,61 Neurological examination and head size are normal.…”

Cannabinoid 1/2 Receptor Activation Induces Strain-Dependent Behavioral and Neurochemical Changes in Genetic Absence Epilepsy Rats From Strasbourg and Non-epileptic Control Rats

“…The burden of the commodities is even higher in people with non-convulsive epilepsy. Indeed, recent studies have demonstrated that the majority (60%) of children with childhood absence epilepsy (CAE) also suffer from various neuropsychiatric comorbidities ( Glauser et al, 2013 ; Cnaan et al, 2017 ), including anxiety, mood disorders, and attention and learning deficits, which may precede the epilepsy diagnosis and persist, or even be aggravated, after full pharmacological control of the seizures ( Crunelli et al, 2020 ; Gruenbaum et al, 2021 ).…”

Glutamate Efflux across the Blood–Brain Barrier: New Perspectives on the Relationship between Depression and the Glutamatergic System

“…Other neurological conditions that are caused or exacerbated by BBB disruption and glutamate excitotoxicity and have an association with depression include Parkinson’s disease [ 84 ], Huntington’s disease [ 85 ], amyotrophic lateral sclerosis [ 86 , 87 ], multiple sclerosis [ 75 , 88 ], Alzheimer’s disease [ 89 , 90 , 91 , 92 ], epilepsy [ 93 , 94 , 95 ], aging [ 77 ] and schizophrenia [ 96 , 97 ]. There are likely interpolations to be made to similar conditions for which the association between BBB or depression lacks conclusive data [ 75 ], such as in hepatic encephalopathy [ 98 ] and brain tumors [ 99 ].…”