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1. Post-traumatic factors are involved in the evolution of the number of seizures in patients with PNES

Author

Julien Biberon, Martine Lemeles Martin, Jan Chrusciel, Stéphane Sanche, Marion Gagny, Louis Maillard, Louise Grenevald, Anne Thiriaux, Coraline Hingray, Bertrand de Toffol, Raymund Schwan, Wissam El Hage, Irina Klemina, Mylène Meyer, Jean François Visseaux, Centre Psychothérapique de Nancy [Laxou] (CPN), Service de neurologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de Recherche en Automatique de Nancy (CRAN), Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL), Centre Hospitalier de Troyes, UMR 1253 IBrain Imagerie & Cerveau Equipe 3 'Imagerie, Biomarqueurs & Thérapie' (IBT), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Reims (CHU Reims), Service de Neurophysiologie Clinique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), UMR 1253 IBrain Imagerie & Cerveau Equipe 1 : 'Psychiatrie Neuro-Fonctionnelle' (PNF), and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
Dissociation (neuropsychology), PNES, Dissociative Disorders, [SPI.AUTO]Engineering Sciences [physics]/Automatic, Stress Disorders, Post-Traumatic, 03 medical and health sciences, Behavioral Neuroscience, Epilepsy, 0302 clinical medicine, Alexithymia, Seizures, medicine, Psychogenic disease, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Depression (differential diagnoses), business.industry, PTSD, Electroencephalography, medicine.disease, Prognosis, Seizure, Anxiety Disorders, Neurology, Structured interview, Anxiety, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Dissociation, Clinical psychology
Abstract

International audience; Objective: The purpose of this prospective study was to identify predictive factors of the evolution of the number of seizures.Methods: We included 85 individuals with a diagnosis of Psychogenic Nonepileptic Seizure (PNES) who completed at least two clinical interviews spaced by 6 months during a 24-month follow-up. Participants underwent a structured interview with an experimented clinician in PNES to complete standardized evaluation and validated scales. We collected sociodemographic and clinical data on PNES (number of seizures, duration of the disease), anxiety, depression, history of traumas, alexithymia, dissociation, and post-traumatic stress disorder (PTSD). We used a multivariate linear regression analysis to predict the characteristics independently associated with the evolution of the number of seizures in percentage.Results: Dissociation score was significantly associated with a negative evolution of the number of seizures (p < 0.002). Conversely, the diagnosis of PTSD at inclusion was correlated to a positive evolution of the number of seizures (p < 0.029).Conclusion: Dissociation was related to a more pejorative evolution of the number of seizures while PTSD diagnosis was associated with a decreased number of seizures. It is therefore essential to improve detection and treatment of post-traumatic dissociation. Further studies are required to understand the impact of PTSD on the evolution of the number of seizures.

Published
2020
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2. Explanatory factors of quality of life in psychogenic non-epileptic seizure

Author

Stéphane Sanchez, Bertrand de Toffol, Wissam El-Hage, Irina Klemina, Julien Biberon, Martine Lemeles Martin, Jean François Visseaux, Raymund Schwan, Coraline Hingray, Louise Grenevald, Jan Chrusciel, Anne Thiriaux, Mylène Meyer, Louis Maillard, Marion Gagny, Centre Psychothérapique de Nancy [Laxou] (CPN), UMR 1253 IBrain Imagerie & Cerveau Equipe 3 'Imagerie, Biomarqueurs & Thérapie' (IBT), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de Troyes, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Service de neurologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Reims (CHU Reims), Service de Neurophysiologie Clinique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), CCSD, Accord Elsevier, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), and Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)

Subjects
PNES, [SDV]Life Sciences [q-bio], Psychiatric comorbidity, Stress Disorders, Post-Traumatic, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Alexithymia, Seizures, Psychogenic non-epileptic seizures, medicine, Mental health consultation, Psychogenic disease, Humans, Child, business.industry, General Medicine, Patient data, medicine.disease, Prognosis, Mental health, Anxiety Disorders, humanities, 3. Good health, [SDV] Life Sciences [q-bio], Neurology, Quality of Life, Mental health care, Anxiety, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Clinical psychology
Abstract

International audience; Objective: Previous studies showed that patients with Psychogenic Non-Epileptic Seizures (PNES) have poor quality of life (QoL). This study explored the explicative factors of the QoL at the time of diagnosis and monitored changes over the two years of follow-up.Methods: We evaluated 107 participants with a diagnosis of Psychogenic Non-Epileptic Seizure (PNES), every 6 months for 24 months. Quality of life (QoL) was evaluated using the QOLIE-31 and SF-36 scales (respectively specific and generic scales of QoL). Positive evolution of QoL was defined by the increase in the score of overall QoL using QOLIE-31 sub-scale from baseline to the last interview of the patient. We also collected for each patient data on psychiatric dimensions (childhood abuse, history of traumatic events, post-traumatic stress disorder (PTSD), depression, anxiety, alexithymia, and dissociation), clinical evolution of seizures and the number of mental health consultations.Results: According to the QOLIE-31 and the SF-36, depression (p ≤ 0.001), anxiety (p < 0.001), alexithymia (p ≤ 0.001), and dissociation (p ≤ 0.004) were related to QoL at the time of the diagnosis. According to SF-36 (mental and physical), PTSD was also significantly associated with QoL (p < 0.05). The number of seizures or the co-occurrence of epilepsy did not influence QoL. Positive evolution of QoL was linked to the number of consultations for mental health issues (p = 0.02).Significance: Post-traumatic dimensions (PTSD, dissociation), alexithymia and psychiatric comorbidities (depression and anxiety disorders) seem to alter QoL in people with PNES. The current study suggests that mental health care improves QoL of patients with PNES.

Published
2020
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