Interictal psychosis following temporal lobe surgery: dentate gyrus pathology

Thom, Maria; Kensche, Maria; Maynard, John; Liu, Joan; Reeves, Cheryl; Goc, Joanna; Marsdon, Derek; Fluegel, D; Foong, J

doi:10.1017/s0033291714000452

Cited by 8 publications

(3 citation statements)

References 97 publications

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“…Receptor expression does not necessarily equal functional activity, but given our results and evidences in the literature we assumed that such a relationship could exist in some circumstances. Despite our relatively small sample size, other studies exploring neuropathological aspects of different psychiatric comorbidities of epilepsy have been using even smaller series [73,74], and our results are in agreement with the recent NT receptors' literature.…”

Section: Discussionsupporting

confidence: 91%

Neurotrophin receptors expression in mesial temporal lobe epilepsy with and without psychiatric comorbidities and their relation with seizure type and surgical outcome

Kandratavicius

Hallak

Carlotti

et al. 2014

Acta Neuropathologica Communications

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Epilepsy and psychiatric comorbidities are frequently associated, but their common biological substrate is unknown. We have previously reported altered structural elements and neurotrophins (NTs) expression in mesial temporal lobe epilepsy (MTLE) patients with psychiatric comorbidities. NTs receptors can regulate neurotransmission and promote neuroplasticity, being important candidates in the regulation and manifestation of psychopatological states and seizure-related events. MTLE hippocampi of subjects without psychiatric history, MTLE + major depression, MTLE + interictal psychosis derived from epilepsy surgery, and control necropsies were investigated for p75 NTR , TrkB, TrkA, and TrkC immunohistochemistry. Increased expression of p75 NTR , decreased TrkA, unaltered TrkC, and complex alterations involving TrkB expression were seen in MTLE groups. Increased TrkB expression in patients without complete seizure remission and in those with secondarily generalized seizures was seen. Decreased p75 NTR expression associated with interictal psychosis, and increased TrkB in those with psychosis or major depression was also reported, although their p75 NTR /TrkB ratios were lower than in MTLE without psychiatric comorbidities. Our results provide evidence of alterations in expression of NTs receptors in the epileptogenic hippocampus that are differentially modulated in presence of psychiatric comorbidities. As already explored in animal models, even in chronic human MTLE increased TrkB expression, among other NT receptors alterations, may play a major role in seizure type, frequency and surgery outcome.

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Section: Discussionsupporting

confidence: 91%

Neurotrophin receptors expression in mesial temporal lobe epilepsy with and without psychiatric comorbidities and their relation with seizure type and surgical outcome

Kandratavicius

Hallak

Carlotti

et al. 2014

Acta Neuropathologica Communications

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“…In particular, increased GFAP in schizophrenia/psychotic symptoms could be closely related to increased neuroinflammatory markers [42], as well as to increased IL-1beta and IL-6 serum levels [43]. A recent study comparing MTLE hippocampi from patients with and without de novo psychosis (postoperative psychosis) analyzed GFAP expression and found no qualitative differences between groups [44]. In our present series, quantitative differences in GFAP between MTLE W and MTLE + P were also subtle, and major differences were seen in respect to the MTLE + D group.…”

Section: Discussionmentioning

confidence: 99%

Mesial temporal lobe epilepsy with psychiatric comorbidities: a place for differential neuroinflammatory interplay

Kandratavicius

Peixoto-Santos

Monteiro

et al. 2015

J Neuroinflammation

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BackgroundDespite the strong association between epilepsy and psychiatric comorbidities, few biological substrates are currently described. We have previously reported neuropathological alterations in mesial temporal lobe epilepsy (MTLE) patients with major depression and psychosis that suggest a morphological and neurochemical basis for psychopathological symptoms. Neuroinflammatory-related structures and molecules might be part of the altered neurochemical milieu underlying the association between epilepsy and psychiatric comorbidities, and such features have not been previously investigated in humans.MethodsMTLE hippocampi of subjects without psychiatric history (MTLEW), MTLE + major depression (MTLE + D), and MTLE + interictal psychosis (MTLE + P) derived from epilepsy surgery and control necropsies were investigated for reactive astrocytes (glial fibrillary acidic protein (GFAP)), activated microglia (human leukocyte antigen, MHC class II (HLA-DR)), glial metallothionein-I/II (MT-I/II), and aquaporin 4 (AQP4) immunohistochemistry.ResultsWe found an increased GFAP immunoreactive area in the molecular layers, granule cell layer, and cornus ammonis region 2 (CA2) and cornus ammonis region 1 (CA1) of MTLEW and MTLE + P, respectively, compared to MTLE + D. HLA-DR immunoreactive area was higher in cornus ammonis region 3 (CA3) of MTLE + P, compared to MTLE + D and MTLEW, and in the hilus, when compared to MTLEW. MTLEW cases showed increased MT-I/II area in the granule cell layer and CA1, compared to MTLE + P, and in the parasubiculum, when compared to MTLE + D and MTLE + P. Differences between MTLE and control, such as astrogliosis, microgliosis, increased MT-I/II, and decreased perivascular AQP4 in the epileptogenic hippocampus, were in agreement to what is currently described in the literature.ConclusionsNeuroinflammatory-related molecules in MTLE hippocampus show a distinct pattern of expression when patients present with a comorbid psychiatric diagnosis, similar to what is found in the pure forms of schizophrenia and major depression. Future studies focusing on inflammatory characteristics of MTLE with psychiatric comorbidities might help in the design of better therapeutic strategies.

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“…Our patient is exceptional given her normal pre-morbid psychiatric and personality profile, and a 10 year interval between epilepsy surgery and the psychosis. A recent study comparing patients with hippocampal sclerosis who developed post-surgical psychoses with a matched surgical group without psychosis, reported the onset of psychosis ranging from 2 to 36 months, with a mean of 10.3 months [2]. Most studies have reported seizure and psychosocial outcomes for follow up ranging between 2 and 5 years post-surgery and a few up to 10 years with almost no data about long term prognosis especially regarding psychiatric problems.…”

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confidence: 99%

A case of de novo psychosis ten years following successful epilepsy surgery

Vivekananda

Cock

Mula

2016

Seizure

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Interictal psychosis following temporal lobe surgery: dentate gyrus pathology

Abstract: The alterations in dentate gyrus pathology found in HS-P patients could indicate underlying differences in the cellular response to seizures. These mechanisms may predispose to the development of psychosis in epilepsy and warrant further investigation.

Cited by 8 publications

References 97 publications

Neurotrophin receptors expression in mesial temporal lobe epilepsy with and without psychiatric comorbidities and their relation with seizure type and surgical outcome

Neurotrophin receptors expression in mesial temporal lobe epilepsy with and without psychiatric comorbidities and their relation with seizure type and surgical outcome

Mesial temporal lobe epilepsy with psychiatric comorbidities: a place for differential neuroinflammatory interplay

A case of de novo psychosis ten years following successful epilepsy surgery

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