The Relationship of Fatigue and Depression with Trace Element Levels in Epileptic Patients

Prevalence of depressive symptom and its associated factors among epilepsy patients in Amhara region, Ethiopia: cross-sectional study

BACKGROUND

Depressive symptom is the most common type of psychiatric co-morbidity among persons with epilepsy. Epilepsy patients are identified as at higher risk of suffering depressive symptom explicitly in low- and middle-income countries due to poor mental health care systems and financial burdens. The co-occurrence of depressive symptom among epilepsy patients deteriorates the prognosis of the disease and diminishes the quality of life of both the patients and their families. However, there is limited evidence on the prevalence of depressive symptom and associated factors in Ethiopia. Therefore, this study is intended to assess the prevalence of depressive symptom and associated factors among epilepsy patients attending in Amhara region, Ethiopia.

METHOD

A multi-center institution-based cross-sectional study was done among epilepsy patients attending at Amhara region, Ethiopia. The Hospital Anxiety Depression tool was used to assess depressive symptom. To determine the factors associated with depressive symptom, a binary logistic regression model was used. Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported in the multivariable binary logistic regression analysis.

RESULTS

About 406 participants were registered in the study with a response rate of 97.6%. The prevalence of depressive symptom among epilepsy patients was 53.9% [95%CI: 49.1%, 58.8%]. In the multivariable binary logistic regression analysis, taking polytherapy treatment [AOR = 1.87, 95% CI: 1.04, 3.36], perceived stigma [AOR = 5.73, 95%CI: 3.11, 10.55], poor antiepileptic medication adherence [AOR = 3.33, 95%CI: 1.30, 8.54] and having poor [AOR = 5.83, 95%CI: 2.44, 13.90] and moderate social support [AOR = 3.08, 95%CI: 1.34, 7.09] were significantly associated with depressive symptom.

CONCLUSIONS

This study revealed that the magnitude of depressive symptom among epilepsy patients in Ethiopia was relatively high and multiple factors determined the likelihood of depressive symptom. Thus, healthcare providers and concerned stakeholders should strengthen comprehensive health education to reduce the magnitude and consequences of depressive symptom among this segment of the population. Moreover, strong social support with special attention should be given to epilepsy patients.

Mammalian copper homeostasis: physiological roles and molecular mechanisms

In the past decade, evidence for the numerous roles of copper (Cu) in mammalian physiology has grown exponentially. The discoveries of Cu involvement in cell signaling, autophagy, cell motility, differentiation, and regulated cell death (cuproptosis) have markedly extended the list of already known functions of Cu, such as a cofactor of essential metabolic enzymes, a protein structural component, and a regulator of protein trafficking. Novel and unexpected functions of Cu transporting proteins and enzymes have been identified, and new disorders of Cu homeostasis have been described. Significant progress has been made in the mechanistic studies of two classic disorders of Cu metabolism, Menkes disease and Wilson's disease, which paved the way for novel approaches to their treatment. The discovery of cuproptosis and the role of Cu in cell metastatic growth have markedly increased interest in targeting Cu homeostatic pathways to treat cancer. In this review, we summarize the established concepts in the field of mammalian Cu physiology and discuss how new discoveries of the past decade expand and modify these concepts. The roles of Cu in brain metabolism and in cell functional speciation and a recently discovered regulated cell death have attracted significant attention and are highlighted in this review.

Research progress on correlations between trace element levels and epilepsy

Research investigating the correlation between human trace element levels and disease alterations is growing. Epilepsy, a common nervous system disease, has also been found to be closely related to abnormal levels of trace elements. Studies continue to explore mechanisms of various trace elements involved in epileptic seizures through experimental animal models of epilepsy. Thus, we reviewed the research progress on the correlation between trace element levels and epilepsy in recent years and found that the trace elements most closely related to epilepsy are mainly metal ions such as selenium, iron, copper, zinc, and manganese. These results indicate that the changes in some trace elements are closely related to the increase in epilepsy susceptibility. In addition, after treatment with drugs and a ketogenic diet, the concentration of trace elements in the serum of patients with epilepsy changes. In other words, the abnormality of trace element concentrations is of great significance in the occurrence and development of epilepsy. This article is a literature update on the potential role of trace element imbalance in the development of epilepsy, providing new references for the subsequent prevention and treatment of epilepsy.

Whole blood trace element and toxic metal concentration in dogs with idiopathic epilepsy and healthy dogs: A case-control study

Background

Idiopathic epilepsy (IE) is the most common neurological disease in dogs. Multiple genes and environmental factors interact to cause clinical signs, although the pathogenesis remains poorly understood. Extensive evidence from recent decades shows that trace elements play a role in epilepsy in humans, and recently it was shown for the first time that also dogs with IE have altered trace element status. On the other hand, toxic metals may cause seizures but research on their role in canine IE is lacking. Therefore, we aimed to investigate trace element and toxic metal concentrations in whole blood from dogs that had been diagnosed with IE and compare them to those of healthy dogs.

Materials and methods

Whole blood concentrations of trace elements (selenium, zinc, copper, manganese, iron, and chromium) and toxic metals (arsenic, cadmium, mercury, and lead) were analyzed from 19 dogs that had been diagnosed with IE by board-certified neurologists and 19 healthy control dogs using inductively coupled plasma mass spectrometry. The concentrations in study and control group were compared using the Mann-Whitney U test.

Results

Dogs diagnosed with IE had significantly higher blood copper concentration (P = 0.007), higher copper/zinc ratio (P = 0.04), and higher selenium concentration (P < 0.001), as well as lower chromium concentration (P = 0.01) when compared to healthy dogs. Treatment of IE with potassium bromide was associated with a significant elevation in blood arsenic concentration (P = 0.01).

Conclusion

In conclusion, the present results support the role of altered trace element status in dogs diagnosed with IE and suggest that copper, selenium, and chromium may be involved in the pathogenesis of canine epilepsy or seizures. The results also suggest that potassium bromide may alter arsenic metabolism in dogs.