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Anxiety and depression symptoms disrupt resting state connectivity in patients with genetic generalized epilepsies
Author(s) -
Garcia Danielle dos Santos,
Polydoro Marina Sconzo,
Alvim Marina Kutsodontis Machado,
Ishikawa Akari,
Moreira José Carlos Vasques,
Nogueira Mateus Henrique,
Zanão Tamires Araújo,
Campos Brunno Machado,
Betting Luiz Eduardo Gomes Garcia,
Cendes Fernando,
Yasuda Clarissa L.
Publication year - 2019
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.14687
Subject(s) - anxiety , depression (economics) , epilepsy , default mode network , asymptomatic , psychology , beck anxiety inventory , beck depression inventory , dravet syndrome , resting state fmri , medicine , psychiatry , neuroscience , cognition , economics , macroeconomics
Summary Objective To analyze the lifetime trajectories in genetic generalized epilepsies (GGEs) and investigate the impact of symptoms of anxiety and depression on resting state functional connectivity (FC). Methods Seventy‐four GGE patients were classified according to the pharmacological response as seizure‐free (12 patients), pharmacoresistant (PhR; 14 patients), and fluctuating (FL; 48 patients). Fifty‐four subjects completed both the Beck Depression Inventory ( BDI ) and Beck Anxiety Inventory ( BAI ), and 38 also underwent 3‐T resting state functional magnetic resonance imaging. These 38 patients were subdivided into a positive group (13 patients with concurrent symptoms of depression and anxiety) and a negative group (21 asymptomatic patients and four with mild anxiety or depression symptoms). For FC analysis of resting state networks, we matched 38 healthy asymptomatic volunteers and used the UF2C toolbox running on MATLAB 2017/ SPM 12. Results The PhR group presented shorter duration of epilepsy ( P = 0.016) and follow‐up ( P < 0.001) compared to the FL group. The PhR group showed higher levels (median = 20) on the BAI and BDI . Myoclonic seizures were the most difficult to control, as 50% of subjects persisted with them at last appointment, compared to generalized tonic–clonic seizures and absence seizures (<40%). Patients with concurrent anxiety and depression symptoms were 7.7 times more likely to exhibit pharmacoresistant seizures, although an increase of 1 year of epilepsy duration was associated with a decrease in the odds of presenting pharmacoresistance by a factor of 0.9. Overall, FC was altered between default mode network ( DMN ) and visuospatial/dorsal attention. However, only the positive group displayed abnormal FC between DMN and left executive control network, and between salience and visuospatial/dorsal attention. Significance Our findings may help clinicians to have a better understanding of GGE clinical course and increase attention to the potential relationship of psychopathologies and brain connectivity.