Preliminary Evidence for Limbic-Frontal Hyperexcitability in Psychogenic Nonepileptic Seizure Patients

Boutros, Nash N.; Kang, Seung Suk; Uysal, Utku; Urfy, Mian Z.; Zack, Thomas; Bowyer, Susan M.; Gustafson, Kathleen M.

doi:10.1177/1550059418792454

Cited by 4 publications

(4 citation statements)

References 37 publications

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“…Furthermore, focal coherence in the left caudate and putamen was significantly higher in the PNES group than in the control group, and this situation was associated with motor symptoms in PNES. 30…”

Section: Discussionmentioning

confidence: 99%

Quantitative EEG Findings in Patients With Psychogenic Nonepileptic Seizures

et al. 2020

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Objective. Psychogenic nonepileptic seizures (PNES), is one of the clinical manifestations of conversion disorder that epileptiform discharges do not accompany. Factors capable of increasing susceptibility to these seizures have not been adequately investigated yet. This study aims to investigate the quantitative electroencephalography (QEEG) findings for PNES by evaluating the resting EEG spectral power changes during the periods between seizures. Methods. Thirty-nine patients (29 females, 10 males) diagnosed with PNES (group 1) and 47 patients (23 females, 24 males) without any psychiatric diagnosis (group 2) were included in the study. The patients underwent a psychiatric examination at their first visit, were diagnosed and their EEGs were recorded. Using fast Fourier transformation (FFT), spectral power analysis was calculated for delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (15-30 Hz), high-beta (25-30 Hz), gamma-1 (31-40 Hz), gamma-2 (41-50 Hz), and gamma (30-80 Hz) frequency bands. Results. Six separate EEG band power, namely (C3-high beta, C3-gamma, C3-gamma-1, C3-gamma-2, P3-gamma, P3 gamma-1), were found to be higher in the patients diagnosed with PNES than in the control group. Conclusion. Our findings show that PNES correlate with high-frequency oscillations on central motor and somatosensory cortices.

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Section: Discussionmentioning

confidence: 99%

Quantitative EEG Findings in Patients With Psychogenic Nonepileptic Seizures

et al. 2020

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“…Through the search strategy, we could identify eighteen articles about brain connectivity abnormalities in patients with functional seizures (Table 1) [3,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. These studies have applied various methodologies including, functional magnetic resonance imaging (fMRI) in nine, electroencephalography (EEG) in five, magnetic resonance imaging (MRI) using diffusion tensor imaging (DTI) in three, and magnetoencephalography (MEG) in one study.…”

Section: Resultsmentioning

confidence: 99%

Brain connectivity abnormalities in patients with functional (psychogenic nonepileptic) seizures: A systematic review

Foroughi

Nazeri

Asadi‐Pooya

2020

Seizure

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The aim of the current endeavor was to systematically review the existing evidence on brain connectivity abnormalities in patients with functional seizures (FS). Methods: This systematic review was prepared according to the instructions of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE (accessed from PubMed) and Scopus from inception to April 4, 2020 were systematically searched. The following search strategy was implemented and these key words (in the title/abstract) were used: "connectivity" OR "network" AND "psychogenic" OR "dissociative" OR "nonepileptic". Results: Through the search strategy, we could identify eighteen articles. These studies have applied various methodologies and they could identify a variety of brain connectivity abnormalities in people with FS. However, none of these studies provided a high level of evidence. They were all small studies (none had a sample size of more than 21 patients). In addition, most of the studies did not match their cases and their controls with respect to the psychiatric comorbidities and other significant confounders. Conclusion: Abnormal functional connectivity between emotion processing areas of the brain with regions involved in executive control and cognitive performance, and the functional connections of the anterior cingulate cortex are of major interest and may be involved in the pathophysiology of FS. Pursuing the concept of brain connectivity abnormalities in patients with FS and comparing the findings with well-matched controls in welldesigned studies may result in a breakthrough in identifying the exact neurobiological origin of FS.

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“…Patients with FS were shown to have lower occipital alpha power compared to healthy controls in one study (39). In FS patients, fronto-temporal delta/theta power and mean coherence in these regions are higher than in controls, suggesting increased fronto-limbic excitability.…”

Section: Meg Studies In Fsmentioning

confidence: 96%

Functional Seizures and Chronic Pain: A Narrative Review of common Pathomechanisms and Clinical Implications

Kannan,

Patel,

Basilio

et al. 2024

Preprint

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Background Functional seizures (FS) manifest as episodic events, bearing superficial similarities to epileptic seizures and represent a major component of Functional Neurological Disorder (FND). FS frequently present with the co-morbidity of chronic pain and the pronounced clinical and epidemiological associations between these conditions suggest potential shared pathomechanisms. Although conventional neuroimaging and neurophysiological assessments do not detect abnormalities in either condition, advanced biophysical signal analyses offer potential biomarkers. Method We undertook comprehensive literature review encompassing studies employing EEG, MEG, functional MRI, PET, and SPECT in FS and chronic pain. Due to the heterogenous nature of the collected data, the results of data extraction and analysis are presented in the form of a narrative synthesis. Results Despite some limitations, altered neural network dynamics are evident in both FS and chronic pain, revealing intriguing common mechanisms. Both conditions exhibit overactivation in sensorimotor networks and alterations in the Default Mode Network (DMN), impacting self-awareness and pain perception. Emotional processing regions, like the anterior cingulate cortex and insula, were affected in both conditions. Furthermore, Thalamocortical dysrhythmia(TCD) offers an intriguing link, influencing pain perception and seizure-like activities. Finally, suppressed alpha oscillations, linked to sensory perception, are prevalent in both conditions. Conclusion We identified shared neural mechanisms and a possible novel explanation (TCD) for co-occurrence of FS and chronic pain. These necessitate further exploration in subsequent studies incorporating patients exhibiting both disorders concurrently. Such research direction holds the potential to introduce novel therapies for not only managing FS or chronic pain, but also managing FND.

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Preliminary Evidence for Limbic-Frontal Hyperexcitability in Psychogenic Nonepileptic Seizure Patients

Cited by 4 publications

References 37 publications

Quantitative EEG Findings in Patients With Psychogenic Nonepileptic Seizures

Quantitative EEG Findings in Patients With Psychogenic Nonepileptic Seizures

Brain connectivity abnormalities in patients with functional (psychogenic nonepileptic) seizures: A systematic review

Functional Seizures and Chronic Pain: A Narrative Review of common Pathomechanisms and Clinical Implications

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