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Febrile seizures and increased stress sensitivity in children: How it relates to seizure characteristics
Fanny Thébault-Dagher1, Marc-Philippe Lafontaine1, Inga Sophia Knoth2
1Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
Insights
Children with a history of simple febrile seizures (FS) exhibit heightened stress hormone reactivity. This enhanced stress sensitivity was not observed in children with complex FS, suggesting seizure severity does not drive these alterations.
Area of Science:
- Neuroscience
- Pediatrics
- Endocrinology
Background:
- Early-life stress and its long-term impact on stress reactivity are increasingly recognized.
- Limited evidence exists on altered stress responses in children following early-life seizures.
- Febrile seizures (FS) are common in childhood, with potential long-term implications.
Purpose of the Study:
- To evaluate stress hormone (cortisol) reactivity in children with a history of febrile seizures (FS).
- To compare stress reactivity between children with simple FS, complex FS, and healthy controls.
- To explore the relationship between altered stress reactivity and clinical characteristics of FS.
Main Methods:
- A case-control study involving children with simple FS (n=24), complex FS (n=18), and matched healthy controls (n=42).
- Experimental stressor: electrode placement for electroencephalography (EEG) examination.
- Measurement: salivary cortisol levels assessed via three samples collected pre- and post-stressor.
Main Results:
- Significant differences in cortisol reactivity to stress were observed between study groups (p=0.003).
- Children with simple FS demonstrated significantly higher cortisol reactivity compared to complex FS (p=0.015) and controls (p=0.003).
- No significant difference in stress reactivity was found between complex FS and control groups (p>0.999); reactivity was not linked to clinical FS characteristics.
Conclusions:
- Children with a history of simple febrile seizures exhibit enhanced stress sensitivity, indicated by greater salivary cortisol changes post-stress.
- This heightened stress sensitivity appears specific to simple FS and not related to seizure severity (complex FS).
- Further research is warranted to determine if this stress sensitivity is a pre-existing factor or a consequence of simple FS.
Background:
Studies suggest that the relationship between seizures and stress starts early in life. However, evidence of long-term altered stress reactivity following early-life seizures is lacking. Our objectives were to assess alterations in stress hormone reactivity in children with past febrile seizures (FS) and investigate how these alterations relate to clinical characteristics.
Method:
This case-control study compared a convenience sample of children with simple FS (n = 24), complex FS (n = 18), and matched healthy controls (n = 42). Stress was induced by electrode placement for an electroencephalography (EEG) exam. Salivary cortisol to stress, using three samples collected before and after the stressor, was compared between groups and sex. The relationship between stress reactivity and clinical characteristics (i.e., FS duration, age at first FS, time since the last FS) was investigated.
Results:
Cortisol reactivity to stress was significantly different depending on study groups, F(1, 78) = 6.415, p = 0.003, η2p = 0.141, but not sex nor was there a significant interaction between group and sex (p ≥ 0.581). Participants with simple FS showed higher cortisol reactivity to stress (M = 14.936, Standard deviation (SD) = 26.852) compared with those with complex FS (M = -4.663, SD = 18.649, p = 0.015) and controls (M = -3.817, SD = 18.907, p = 0.003). There was no significant difference between participants with complex FS and controls (p > 0.999). Stress reactivity was not linked to clinical characteristics.
Conclusions:
Children with past simple FS showed greater changes in salivary cortisol following stress, suggesting enhanced stress sensitivity. As similar results were not found in a population with complex FS, our study shows that stress alterations are not caused by seizure severity. Future studies are needed to investigate whether stress sensitivity may be premorbid to simple FS and may contribute to simple FS incidence.
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