Amygdala subfield and prefrontal cortex abnormalities in patients with functional seizures
Nilab Nasrullah1, Wesley T Kerr2, John M Stern3
1Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Neurology Clinic, Karolinska University Hospital, Stockholm, Sweden.
Epilepsy & Behavior : E&B
|June 25, 2023
Summary
Functional seizures (FS) show distinct neuroanatomic changes in the amygdala and hippocampus. These findings in functional seizures may help identify biomarkers for diagnosis and treatment.
Area of Science:
- Neuroimaging
- Neurology
- Psychiatry
Background:
- Functional seizures (FS) present as seizure-like episodes without underlying epileptic activity, with unclear causes and brain associations.
- Previous brain imaging studies suggested cerebral changes in FS, but without elucidating the pathophysiology.
- This study focused on investigating specific neuroanatomic changes within the amygdala and hippocampus in individuals with FS.
Purpose of the Study:
- To investigate neuroanatomic differences in amygdala and hippocampus subregions between patients with functional seizures (FS) and seizure-naïve controls (SNC).
- To explore potential correlations between observed neuroanatomic changes and conditions like chronic stress and depression.
- To assess the potential of these findings as future biomarkers for FS diagnosis and treatment.
Main Methods:
- Retrospective analysis of T1 MRI scans from 37 female patients with FS and 37 age-matched female SNCs.
- Utilized FreeSurfer software (version 7.1) for detailed analysis of whole-brain cortical thickness, subcortical volumes, and amygdala/hippocampus subfields.
- Employed multivariable linear models for group comparisons.
Main Results:
- No significant differences in overall amygdala and hippocampus volumes between FS and SNC groups.
- Significant reductions in right lateral amygdala volume and thinning of the left superior frontal gyrus in patients with FS.
- Increased volumes observed in the right central and medial amygdala, left anterior amygdala, and left dentate gyrus of the hippocampus in the FS group.
Conclusions:
- The study confirms neuroanatomic associations in the amygdala and hippocampus in functional seizures.
- The observed pattern of volumetric and thickness changes aligns with cerebral alterations seen in chronic stress and depression.
- Further research and validation of these neuroanatomic findings could lead to the development of diagnostic and therapeutic biomarkers for FS.
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