Systematic review of structural and functional brain alterations in psychosis of epilepsy

Abstract

Epilepsy ABSTRACTThis systematic review critically assesses structural and functional neuroimaging studies of psychosis of epilepsy (POe). we integrate findings from 18 studies of adults with POe to examine the prevailing view that there is a specific relationship between temporal lobe epilepsy (TLe) and POe, and that mesial temporal lobe pathology is a biomarker for POe. Our results show: (1) conflicting evidence of volumetric change in the hippocampus and amygdala; (2) distributed structural pathology beyond the mesial temporal lobe; and (3) changes in frontotemporal functional network activation. These results provide strong evidence for a revised conceptualisation of POe as disorder of brain networks, and highlight that abnormalities in mesial temporal structures alone are unlikely to account for its neuropathogenesis. Understanding POe as a disease of brain networks has important implications for neuroimaging research and clinical practice. Specifically, we suggest that future neuroimaging studies of POe target structural and functional networks, and that practitioners are vigilant for psychotic symptoms in all epilepsies, not just TLe.

Activation of Functional Brain Networks in Children With Psychogenic Non-epileptic Seizures

“…This study advances the conceptualization of PNES as a stress system disorder-a disorder of neural network dysregulation that manifests in the context of increased brain-body arousal. In this respect, PNES may, in time, be categorized alongside other seizure types: epileptic seizures where network function is disrupted by paroxysmal electrical discharges and where the long-term neuropsychiatric complications arise because of neural network dysregulation (Vaessen et al, 2013;Allebone et al, 2018); seizures secondary to hypoglycemia where network function is disrupted by changes in electrolyte concentrations in neurons and depletion of energy resources (Arieff et al, 1974); and hypoxic seizures where network function is disrupted by lack of oxygen and inability to maintain energy flow (Gastaut, 1974).…”

Neuroimaging-based brain-age prediction in diverse forms of epilepsy: a signature of psychosis and beyond

“…It might also suggest that the mechanism underlying the increased brain age in TLE would be different from that in psychosis. In fact, there is no solid agreement in brain volumetry in psychosis of epilepsy due to partly conflicting results of past studies [27] and there has recently been an attempt to detect network abnormalities beyond mere morphology [28]. Considering the importance of early detection and intervention for psychosis [29], more specific and individual-level biomarkers are desirable.…”

Disrupted White Matter Integrity and Structural Brain Networks in Temporal Lobe Epilepsy With and Without Interictal Psychosis

“…The prevalence in TLE is high, up to 19% (7). Several neuroimaging studies tried to clarify the pathological changes of psychosis in epilepsy (8). A few studies using structural MRI suggested hippocampal tail atrophy (9) as well as abnormal aging (10) in TLE patients with psychosis.…”

“…A few studies using structural MRI suggested hippocampal tail atrophy (9) as well as abnormal aging (10) in TLE patients with psychosis. However, according to a recent systematic review (8), the results of morphological studies are not consistent, and little is known about other advanced imaging modalities.…”