Epilepsy-Specific Anxiety: A Potential Clue to the Seizure Onset Zone

Clary, Heidi M. Munger

doi:10.1177/15357597221109345

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…As defined for epilepsy patients in the Diagnostic and Statistical Manual of Mental Disorders, anxiety is one of the most common psychiatric comorbidities as well as one of the most complex ones exhibiting a wide spectrum of manifestations from paroxysmal symptoms to epilepsy-specific anxiety and classic anxiety disorders (Munger Clary, 2022 ). However, the specific mechanisms underlying the comorbidity of epilepsy and anxiety are so far unclear.…”

Section: Introductionmentioning

confidence: 99%

Altered gut microbiota in temporal lobe epilepsy with anxiety disorders

Wei

Mai

et al. 2023

Front. Microbiol.

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IntroductionPatients with epilepsy are particularly vulnerable to the negative effects of anxiety disorders. In particular, temporal lobe epilepsy with anxiety disorders (TLEA) has attracted more attention in epilepsy research. The link between intestinal dysbiosis and TLEA has not been established yet. To gain deeper insight into the link between gut microbiota dysbiosis and factors affecting TLEA, the composition of the gut microbiome, including bacteria and fungi, has been examined.MethodsThe gut microbiota from 51 temporal lobe epilepsy patients has been subjected to sequencing targeting 16S rDNA (Illumina MiSeq) and from 45 temporal lobe epilepsy patients targeting the ITS-1 region (through pyrosequencing). A differential analysis has been conducted on the gut microbiota from the phylum to the genus level.ResultsTLEA patients' gut bacteria and fungal microbiota exhibited distinct characteristics and diversity as evidenced by high-throughput sequencing (HTS). TLEA patients showed higher abundances of Escherichia-Shigella (genus), Enterobacterales (order), Enterobacteriaceae (family), Proteobacteria (phylum), Gammaproteobacteria (class), and lower abundances of Clostridia (class), Firmicutes, Lachnospiraceae (family), Lachnospirales (order), and Ruminococcus (genus). Among fungi, Saccharomycetales fam. incertae sedis (family), Saccharomycetales (order), Saccharomycetes (class), and Ascomycota (phylum) were significantly more abundant in TLEA patients than in patients with temporal lobe epilepsy but without anxiety. Adoption and perception of seizure control significantly affected TLEA bacterial community structure, while yearly hospitalization frequency affected fungal community structures in TLEA patients.ConclusionHere, our study validated the gut microbiota dysbiosis of TLEA. Moreover, the pioneering study of bacterial and fungal microbiota profiles will help in understanding the course of TLEA and drive us toward preventing TLEA gut microbiota dysbiosis.

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Section: Introductionmentioning

confidence: 99%

Altered gut microbiota in temporal lobe epilepsy with anxiety disorders

Wei

Mai

et al. 2023

Front. Microbiol.

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“…Structural imaging reveals associations between anxiety symptoms and abnormalities in mesial temporal structures, particularly the amygdala [85]. Notably, individuals with HS have a higher risk of seizure anticipation anxiety [86]. Interestingly, a bidirectional relationship exists between anxiety and epilepsy.…”

Section: Anxiety Disorders: a Frequent Comorbidity In Tlementioning

confidence: 99%

Cognitive Disorders, Depression and Anxiety in Temporal Lobe Epilepsy: An Overview

Tani,

Adali

2024

JBM

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Partial epilepsies, originating in a specific brain region, affect about 60% of adults with epilepsy. Temporal lobe epilepsy (TLE) is the most prevalent subtype within this category, often necessitating surgical intervention due to its refractoriness to antiepileptic drugs (AEDs). Hippocampal sclerosis, a common underlying pathology, often exacerbates the severity by introducing cognitive and emotional challenges. This review delves deeper into the cognitive profile of TLE, along with the risk factors for cognitive disorders, depression, and anxiety in this population.

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“…Although there is no instrument specifically created to screen for AAS, the recently developed Epilepsy Anxiety Survey Instrument (EASI) may be of use in the clinic, as it includes questions addressing epilepsy-specific anxieties. 28 A 10-question subset of the EASI has been proposed for use as an epilepsy-specific anxiety screener termed the ESA (epilepsy-specific anxiety), but there is no established cut point to screen for AAS symptoms, and no brief validated screening tool is currently available. 29 The 10 EASI items pertaining to AAS (items 5, 7-9, 11-14, 16, 18) are listed in Table 2 and are each rated on the following scale over the past 2 weeks: 0: not at all, 1: several days, 2: more than half the days, and 3: nearly every day.…”

Section: Identification Of Aasmentioning

confidence: 99%

Section: Identification and Management Of Aas In The Clinicmentioning

confidence: 99%

Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon?

Kanner,

Carrazana,

Munger Clary

et al. 2024

Epileptic Disorders

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The diagnosis of epilepsy is associated with loss of predictability, which invariably results in the fear of when and if future seizures will occur. For a subset of patients with epilepsy (PWE), there may be a pathological persistent fear of seizure occurrence, resulting in limitations to daily activities through avoidant behaviors. Paradoxically, the research of anticipatory anxiety of seizures (AAS; also referred to as seizure phobia) has been practically nonexistent and, not surprisingly, this condition remains underrecognized by clinicians. The available data are derived from three small case series of patients followed in tertiary epilepsy centers. In this study, we review the available data on the reported clinical manifestations of AAS in PWE, and of the potential role of variables associated with it, such as personal and family psychosocial and psychiatric history and epilepsy‐related variables. In addition, we review the need for the creation of screening tools to identify patients at risk of AAS and discuss potential treatment strategies, which could be considered as part of the comprehensive management for PWE.

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Epilepsy-Specific Anxiety: A Potential Clue to the Seizure Onset Zone

Abstract: [Box: see text]

Cited by 6 publications

References 11 publications

Altered gut microbiota in temporal lobe epilepsy with anxiety disorders

Altered gut microbiota in temporal lobe epilepsy with anxiety disorders

Cognitive Disorders, Depression and Anxiety in Temporal Lobe Epilepsy: An Overview

Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon?

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