Serotonin Levels in the Serum of Persons with Onchocerciasis-Associated Epilepsy: A Case-Control Study

Vieri, Melissa Krizia; Hotterbeekx, An; Mandro, Michel; Fodjo, Joseph Nelson Siewe; Dusabimana, Alfred; Nyisi, Francoise; Mukendi, Déby; Gwatsvaira, Joe; Kumar‐Singh, Samir; Colebunders, Robert

doi:10.3390/pathogens10060720

Cited by 4 publications

(4 citation statements)

References 25 publications

(35 reference statements)

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“…In the context of the role of OV in the pathogenesis of NS, it was found that epilepsy was associated with low serotonin levels (β = −2.967; p = 0.017). High levels of serotonin (a neuromodulator) therefore do not seem to be involved in the pathogenesis of OAE (including NS) [35]. This study was of average and poor quality according to the NOS and DCP scales, respectively.…”

Section: Resultsmentioning

confidence: 99%

Mapping, Associated Factors, and Pathophysiology of Nodding Syndrome in Africa: A Systematic Review

Metanmo,

Dossa,

Ahmat

et al. 2024

Neuroepidemiology

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Introduction: Nodding Syndrome (NS) remains a poorly understood disorder. For a long time, it has been thought to be restricted to East Africa, however cases in Central Africa have been increasing over time. The objective of this systematic review (SR) was to provide a summary of the state of knowledge on NS to date. Methods: All original articles published on NS up to November 2021 were searched in four major databases and in the grey literature. Commentaries, editorials, book chapters, books, conference paper, qualitative studies that mentioned NS cases were also included. Data retrieved included study location, year of study and of publication, population characteristics, definition and diagnosis of NS, associated factors, and treatment if applicable. A meta-analysis of associated factors was performed where possible and results were presented as Odds Ratios and visualized as Forrest Plots. Geographic information systems were used for cartographic representations. The quality of the articles included was assessed. Results: Of the 876 articles initially identified, 67 (corresponding to 59 studies) were included in the SR. NS is only present in Central and East Africa. Interestingly, there were reports of NS in Central Africa prior to 2010, earlier than previously thought. The way NS diagnosis was established varies according to studies, and the 2012 WHO classification was used in only 60% of the studies. Approximately 11% of the articles did not meet the quality requirements set for this review. In our meta-analysis, the main factor associated with NS was onchocerciasis (OR = 8.8 [4.8, 15.9]). However, the pathophysiology of the disease remains poorly understood. The lack of common antiepileptic drugs is a significant barrier for the management of head nodding and associated epileptic seizures. Discussion/conclusion: The lack of an operational definition of NS is an obstacle to its diagnosis and thus to its appropriate treatment. Indeed, diagnostic difficulties might have led to false positives and false negatives which could have altered the picture of NS presented in this article. Treatment should take into account nutritional and psychological factors, as well as associated infections. Some risk factors deserve further investigation; therefore, we suggest a multicentric study with an etiological focus using a more operational definition of NS.

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Section: Resultsmentioning

confidence: 99%

Mapping, Associated Factors, and Pathophysiology of Nodding Syndrome in Africa: A Systematic Review

Metanmo,

Dossa,

Ahmat

et al. 2024

Neuroepidemiology

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“…Although several epidemiological studies have shown a potential association between epilepsy and infection with the filarial nematode O. volvulus in different African countries [2][3][4][5], the mechanisms inducing pathogenesis are still unknown. Within our study, we aimed to investigate different immune parameters, neurodegeneration markers and the O. volvulus biomarker NATOG in patients from endemic areas presenting with nodding syndrome or other epilepsy disorders with or without a concomitant O. volvulus infection, determined via PCR of skin snips.…”

Section: Discussionmentioning

confidence: 99%

“…OAE seems to start without any obvious cause, in previously healthy children, between the ages of 3-18 years. Cases are reported in areas of high ongoing or past onchocerciasis transmission in various regions of sub-Saharan Africa including Uganda, Tanzania, the Democratic Republic of the Congo, the Central African Republic, Cameroon and South Sudan [2][3][4][5]. OAE has public health implications in endemic regions; with more than 381,000 people estimated to be affected in 2015 [6].…”

Section: Introductionmentioning

confidence: 99%

Epilepsy and nodding syndrome in association with an Onchocerca volvulus infection drive distinct immune profile patterns

Arndts,

Kegele,

Massarani

et al. 2023

PLoS Negl Trop Dis

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Previous studies have described the association of onchocerciasis (caused by Onchocerca volvulus) with epilepsy, including nodding syndrome, although a clear etiological link is still missing. Cases are found in different African countries (Tanzania, South Sudan, Uganda, Democratic Republic of the Congo, Central African Republic and Cameroon). In our study we investigated immunological parameters (cytokine, chemokine, immunoglobulin levels) in individuals from the Mahenge area, Tanzania, presenting with either epilepsy or nodding syndrome with or without O. volvulus infection and compared them to O. volvulus negative individuals from the same endemic area lacking neurological disorders. Additionally, cell differentiation was performed using blood smears and systemic levels of neurodegeneration markers, leiomodin-1 and N-acetyltyramine-O, β-glucuronide (NATOG) were determined. Our findings revealed that cytokines, most chemokines and neurodegeneration markers were comparable between both groups presenting with epilepsy or nodding syndrome. However, we observed elevated eosinophil percentages within the O. volvulus positive epilepsy/nodding syndrome patients accompanied with increased eosinophilic cationic protein (ECP) and antigen-specific IgG levels in comparison to those without an O. volvulus infection. Furthermore, highest levels of NATOG were found in O. volvulus positive nodding syndrome patients. These findings highlight that the detection of distinct biomarkers might be useful for a differential diagnosis of epilepsy and nodding syndrome in O. volvulus endemic areas. Trial-registration: NCT03653975.

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“…Thus, this test cannot not discriminate between individuals who developed epilepsy, NS or remained healthy. Contrary to the application of the OAE criteria [7][8][9][10][11][12][13][14][15][16][17], studies investigating epilepsy/NS in context of an active OV infection are scarce. It has been shown that immunity and metabolism are strongly modulated in individuals who are actively infected with filarial nematodes (or helminths) in comparison to individuals that have cleared the infection [18][19][20].…”

mentioning

confidence: 99%

Active infection with Onchocerca volvulus and the linkage to epilepsy/nodding syndrome

Arndts,

Kegele,

Ritter

et al. 2024

PLoS Negl Trop Dis

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Serotonin Levels in the Serum of Persons with Onchocerciasis-Associated Epilepsy: A Case-Control Study

Cited by 4 publications

References 25 publications

Mapping, Associated Factors, and Pathophysiology of Nodding Syndrome in Africa: A Systematic Review

Mapping, Associated Factors, and Pathophysiology of Nodding Syndrome in Africa: A Systematic Review

Epilepsy and nodding syndrome in association with an Onchocerca volvulus infection drive distinct immune profile patterns

Active infection with Onchocerca volvulus and the linkage to epilepsy/nodding syndrome

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