Prevalence and impact of irritable bowel syndrome in people with epilepsy

Cámara-Lemarroy, Carlos R.; Escobedo-Zúñiga, Nicolás; Ortiz-Zacarías, Daniela; Peña-Avendaño, Juan J.; Villarreal-Garza, Estefanía; Díaz-Torres, Marco A.

doi:10.1016/j.yebeh.2016.05.041

Cited by 17 publications

(12 citation statements)

References 26 publications

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“…Recent meta-analyses have identified a bidirectional relationship between epilepsy and celiac disease [ 8 , 9 ], with improved seizure control observed in affected patients following the implementation of a gluten free diet [ 10 ]. Furthermore, population-based studies have identified a greater risk of epilepsy in adults with inflammatory bowel disease as well as irritable bowel syndrome [ 11 – 13 ]. Although a similar association has yet to be demonstrated in dogs, it is a firmly held belief among caregivers of dogs with epilepsy that diet and gastrointestinal health can influence the course of disease.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of fecal Lactobacillus populations in dogs with idiopathic epilepsy: a pilot study

2020

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Background: Idiopathic epilepsy is a common neurological disorder of dogs characterized by recurrent seizures for which no underlying basis is identified other than a presumed genetic predisposition. The pathogenesis of the disorder remains poorly understood, but environmental factors are presumed to influence the course of disease. Within the growing body of research into the microbiota-gut-brain axis, considerable attention has focused on the protective role of Lactobacilli in the development and progression of neurological disease. Investigations into the association between the gut microbiome and epilepsy are in their infancy, but some preliminary findings support a role for Lactobacilli in drug resistant epilepsy. To date, there are no published studies evaluating the gut microbiome in dogs with epilepsy. This pilot study was undertaken to evaluate fecal Lactobacillus populations in dogs with idiopathic epilepsy compared to healthy dogs. Results: Fecal samples were obtained from 13 pairs of dogs, consisting of a drug-naïve epileptic dog and a healthy dog from the same household and maintained on the same diet. Evaluation of large-scale microbial patterns based on 16S rRNA gene amplicon sequencing identified a household effect in the study population. Differential prevalence testing at the 16S rRNA gene sequence variant and genus levels did not identify any statistically significant differences between epileptic and control dogs. Quantitative PCR of Lactobacillus species isolated through culture revealed no statistically significant difference between the epileptic and control dogs (median concentration, 3.8 log 10 CFU/g feces and 4.6 log 10 CFU/g feces, respectively). Lactobacillus in culture was not killed by exposure to phenobarbital, potassium bromide, zonisamide, or levetiracetam. Conclusions: This pilot study did not identify any difference in large-scale microbial patterns or relative or absolute abundance of Lactobacillus species in drug-naïve epileptic dogs compared to healthy dogs. Further studies are warranted to evaluate the role of the gut microbiome in disease progression and treatment response in dogs with epilepsy. Lactobacilli in culture were not killed or inhibited from growing when exposed to phenobarbital, potassium bromide, zonisamide or levetiracetam, suggesting that antiepileptic drug administration is less likely to be a confounding factor in future studies evaluating the role of Lactobacillus in epilepsy.

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Section: Introductionmentioning

confidence: 99%

Evaluation of fecal Lactobacillus populations in dogs with idiopathic epilepsy: a pilot study

2020

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“…However, given that only few patients were not taking any medication during the study period, we could not completely exclude the impact of ASMs on FGID by properly comparing subjects on and off ASMs, which clearly represents a limitation of our study. In analyzing the different FGIDs, it was not possible to confirm a higher prevalence of IBS in PWE as compared with HS as suggested by Camara-Lemarroy et al (18). However, this discrepancy may be justified by the surprisingly low (3%) prevalence of IBS among control subjects in the aforementioned study.…”

Section: Fgid In Epilepsymentioning

confidence: 53%

Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence

et al. 2021

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Introduction: The complex relationship between the microbiota-gut-brain axis (MGBA) and epilepsy has been increasingly investigated in preclinical studies. Conversely, evidence from clinical studies is still scarce. In recent years, the pivotal role of MGBA dysregulation in the pathophysiology of functional gastrointestinal disorders (FGID) has been recognized. With this background, we aimed to investigate the prevalence of FGID in patients with epilepsy (PWE) and the possible impact of bowel movement abnormalities on seizure recurrence.Methods: A total of 120 PWE and 113 age-, sex-, and BMI-matched healthy subjects (HS) were consecutively enrolled. A questionnaire to evaluate the presence of FGID (according to Rome III diagnostic criteria) was administrated to all participants. In a subgroup of drug-resistant patients, we administered an ad-hoc questionnaire combining Bristol stool charts and seizure diaries to evaluate seizure trends and bowel movement changes.Results: A higher prevalence of FGID in PWE (62.5%) than in HS (39.8%) was found (p < 0.001). The most frequently observed disorder was constipation, which was significantly higher in PWE than in HS (43.3 vs. 21.2%, p < 0.001), and was not associated with anti-seizure medication intake according to multivariable analysis. In drug-resistant patients, most seizures occurred during periods of altered bowel movements, especially constipation. A significant weak negative correlation between the number of days with seizures and the number of days with normal bowel movements was observed (p = 0.04). According to multivariable logistic regression analysis, FGID was significantly associated with temporal lobe epilepsy as compared with other lobar localization (p = 0.03).Conclusions: Our clinical findings shed new light on the complex relationship between epilepsy and the MGBA, suggesting a bidirectional link between bowel movement abnormalities and seizure occurrence. However, larger studies are required to better address this important topic.

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“…Given the role of Na V 1.1 in both epilepsy and CVH, it is therefore reasonable to assume that a subset of epilepsy patients may be prone to FBDs. Indeed, an observational study on 65 people with epilepsy showed a significantly increased prevalence of IBS compared with controls (39). Conversely, a large-scale study found that IBS patients had greater cumulative incidence of epilepsy compared with the control cohort (40).…”

Section: Discussionmentioning

confidence: 99%

NaV1.1 inhibition can reduce visceral hypersensitivity

Salvatierra¹,

Castro²,

Erickson³

et al. 2018

JCI Insight

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Functional bowel disorder patients can suffer from chronic abdominal pain, likely due to visceral hypersensitivity to mechanical stimuli. As there is only a limited understanding of the basis of chronic visceral hypersensitivity (CVH), drug-based management strategies are ill defined, vary considerably, and include NSAIDs, opioids, and even anticonvulsants. We previously reported that the 1.1 subtype of the voltage-gated sodium (NaV; NaV1.1) channel family regulates the excitability of sensory nerve fibers that transmit a mechanical pain message to the spinal cord. Herein, we investigated whether this channel subtype also underlies the abdominal pain that occurs with CVH. We demonstrate that NaV1.1 is functionally upregulated under CVH conditions and that inhibiting channel function reduces mechanical pain in 3 mechanistically distinct mouse models of chronic pain. In particular, we use a small molecule to show that selective NaV1.1 inhibition (a) decreases sodium currents in colon-innervating dorsal root ganglion neurons, (b) reduces colonic nociceptor mechanical responses, and (c) normalizes the enhanced visceromotor response to distension observed in 2 mouse models of irritable bowel syndrome. These results provide support for a relationship between NaV1.1 and chronic abdominal pain associated with functional bowel disorders.

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Prevalence and impact of irritable bowel syndrome in people with epilepsy

Cited by 17 publications

References 26 publications

Evaluation of fecal Lactobacillus populations in dogs with idiopathic epilepsy: a pilot study

Evaluation of fecal Lactobacillus populations in dogs with idiopathic epilepsy: a pilot study

Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence

NaV1.1 inhibition can reduce visceral hypersensitivity

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