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Çığrı E, İnan FÇ. Comparison of Serum Selenium, Homocysteine, Zinc, and Vitamin D Levels in Febrile Children with and without Febrile Seizures: A Prospective Single-Center Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030528. [PMID: 36980086 PMCID: PMC10047637 DOI: 10.3390/children10030528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/28/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE Febrile seizure is a complication that makes physicians and families uneasy when detected in children with a high fevers. This study aimed to compare children with febrile seizures and children without seizures in blood selenium, zinc, homocysteine, vitamin D, vitamin B12, and magnesium levels. MATERIALS AND METHODS The study group included sixty-one children between the ages of 1-5 who came to the pediatric emergency department with febrile seizure. The control group had 61 children with fever without seizure, who were compatible with the study group in age, sex, and elapsed time since the onset of fever. Blood samples were taken from the patients during their admission. Selenium, zinc, vitamin D, homocysteine, vitamin B12, and magnesium levels were measured, and the data of the two groups were compared. Additionally, patients in the study group had two subgroups, simple and complex febrile seizures, and their parameters were compared. RESULTS Selenium, zinc, vitamin D, and vitamin B12 levels were significantly lower in the study group than in the control group (p < 0.001), and there was no significant difference in homocysteine (p = 0.990) and magnesium levels (p = 0.787) between the two groups. Moreover, no significant difference was found between those with simple and complex febrile seizures in selenium, vitamin D, homocysteine, vitamin B12, and magnesium levels. CONCLUSIONS Elevated levels of selenium, zinc, vitamin D, and vitamin B12 in the blood of children with fevers help to prevent febrile seizures.
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Affiliation(s)
- Emrah Çığrı
- Faculty of Medicine, Kastamonu University, Kastamonu 37150, Turkey
| | - Funda Çatan İnan
- Faculty of Medicine, Kastamonu University, Kastamonu 37150, Turkey
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Thébault-Dagher F, Robles M, Herba CM, St-Pierre J, Brochen C, Muckle G, Lupien SJ, Séguin JR, Fraser WD, Vaillancourt C, Lippé S. Febrile seizure incidence and age at first occurrence are associated with changes in placental normalized gene expression: the '3D' pregnancy cohort study. J Neuroendocrinol 2021; 33:e13046. [PMID: 34648210 DOI: 10.1111/jne.13046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/30/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
Self-reported maternal prenatal stress (MPS) has been associated with earlier febrile seizure (FS) age of onset in offspring. Studies are needed to understand how the biological systems associated with exposure to psychological MPS are linked to seizure disorders in children. The present study aimed to investigate whether placental markers of MPS are linked to FS incidence and age at first occurrence. A subsample of children with FS (n = 28) and matched controls (n = 84), were drawn from the longitudinal 3D pregnancy cohort (N = 2366 mother-child dyads). Expression of placental genes associated with glucocorticoids, serotonin and fetal/placental growth were analysed from placental tissues, compared between groups and associated with age at first FS. Overall placental normalized gene expression was statistically different (p < .001). Children with FS showed overexpression of the serotonin transporter (mean difference = 0.61, 95% confidence interval [CI] = 0.9-1.13), connexin 43 (mean difference = 0.69, 95% CI = 0.30-1.09), zonula occludens-1 (mean difference = 0.84, 95% CI = 0.42-1.26) and underexpression of glucocorticoid receptor β (mean difference = 0.84, 95% CI = -1.49 to 0.19) and serotonin receptor 2B (mean difference = 1.57, 95% CI = -2.35 to 0.78) compared to controls. Increased expression of the serotonin transporter predicted 37.2% in variation of age at first FS. The correlation matrix showed pregnancy-specific anxiety during the second trimester was moderately associated with age at first FS (r = -0.38) but was not a significant predictor in the regression model. Although our current results do not display a significant effect of self-reported MPS on FS, the present study is the first to show that placental gene biomarkers usually known to be associated with MPS display different expressions in children with FS. Specifically, our results suggest that placental genes associated with the glucocorticoid, serotonergic and fetal/placental growth systems may be candidate mechanisms leading to increased vulnerability offspring in FS. Because self-reported MPS was not found as a significant predictor in our statistical models, future studies are needed to investigate the mechanisms causing the observed changes in placental genes and their association with seizure disorders.
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Affiliation(s)
- Fanny Thébault-Dagher
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada
| | - Morgane Robles
- INRS Armand-Frappier Santé Biotechnologique Research Center, Laval, QC, Canada
- Réseau intersectoriel de recherche en santé de l'Université du Québec, Québec, QC, Canada
| | - Catherine M Herba
- INRS Armand-Frappier Santé Biotechnologique Research Center, Laval, QC, Canada
- Réseau intersectoriel de recherche en santé de l'Université du Québec, Québec, QC, Canada
- Psychiatry and Addictology Department, University of Montreal, Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Joey St-Pierre
- INRS Armand-Frappier Santé Biotechnologique Research Center, Laval, QC, Canada
- Réseau intersectoriel de recherche en santé de l'Université du Québec, Québec, QC, Canada
| | - Celia Brochen
- INRS Armand-Frappier Santé Biotechnologique Research Center, Laval, QC, Canada
| | - Gina Muckle
- School of Psychology, Université Laval, Laval, QC, Canada
- CHU de Québec-Université Laval Research Center, Québec, QC, Canada
| | - Sonia J Lupien
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Psychiatry and Addictology Department, University of Montreal, Montreal, QC, Canada
- Center for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Jean R Séguin
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada
- Psychiatry and Addictology Department, University of Montreal, Montreal, QC, Canada
| | - William D Fraser
- Centre de recherche du CHU de Sherbrooke, Sherbrooke, QC, Canada
| | - Cathy Vaillancourt
- INRS Armand-Frappier Santé Biotechnologique Research Center, Laval, QC, Canada
- Réseau intersectoriel de recherche en santé de l'Université du Québec, Québec, QC, Canada
| | - Sarah Lippé
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada
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Liening AN, Epps SA. In Up to My Ears and Temporal Lobes: Effects of Early Life Stress on Epilepsy Development. Curr Top Behav Neurosci 2020; 55:17-40. [PMID: 33454921 DOI: 10.1007/7854_2020_190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Epilepsy and stress are each significant concerns in today's society, bearing heavy impacts on mental and physical health and overall quality of life. Unfortunately, the intersection between these is potentially even more concerning, as stress is a frequent trigger of seizures and may contribute to neural hyperexcitability. A growing body of research suggests a connection between early life stress (occurring in the prenatal or postnatal stage) and later development of epilepsy. While the larger part of this literature suggests that early life stress increases vulnerability for epilepsy development, there are a number of interacting factors influencing this relationship. These factors include developmental stage at which both stressor and seizure assessment occur, type of stressor, sex effects, and type of seizure (convulsive or non-convulsive). Additionally, a number of potential mechanisms have been identified, including activation of the hypothalamic-pituitary-adrenal axis, neuroinflammation, altered inhibitory/excitatory balance, and temporal lobe structures. Developing a clearer understanding of this relationship between early life stress and epilepsy, the factors that influence it, and underlying mechanisms that may serve as targets for intervention is crucial to improving quality of life for persons with epilepsy.
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Affiliation(s)
- Avery N Liening
- Department of Psychology, Whitworth University, Spokane, WA, USA
| | - S Alisha Epps
- Department of Psychology, Whitworth University, Spokane, WA, USA.
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Lopim GM, Gutierre RC, Silva EA, Arida RM. Physical exercise during pregnancy minimizes PTZ‐induced behavioral manifestations in prenatally stressed offspring. Dev Psychobiol 2019; 62:240-249. [DOI: 10.1002/dev.21895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 12/22/2022]
Affiliation(s)
| | | | - Eduardo Alves Silva
- Departamento de Fisiologia Universidade Federal de São Paulo São Paulo Brazil
| | - Ricardo Mario Arida
- Departamento de Fisiologia Universidade Federal de São Paulo São Paulo Brazil
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Thébault-Dagher F, Lafontaine MP, Knoth IS, Deguire F, Sheppard E, Cook R, Lagacé M, Gravel J, Lupien S, Lippé S. Febrile seizures and increased stress sensitivity in children: How it relates to seizure characteristics. Epilepsy Behav 2019; 95:154-160. [PMID: 31059921 DOI: 10.1016/j.yebeh.2019.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/08/2019] [Accepted: 03/13/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies suggest that the relationship between seizures and stress starts early in life. However, evidence of long-term altered stress reactivity following early-life seizures is lacking. Our objectives were to assess alterations in stress hormone reactivity in children with past febrile seizures (FS) and investigate how these alterations relate to clinical characteristics. METHOD This case-control study compared a convenience sample of children with simple FS (n = 24), complex FS (n = 18), and matched healthy controls (n = 42). Stress was induced by electrode placement for an electroencephalography (EEG) exam. Salivary cortisol to stress, using three samples collected before and after the stressor, was compared between groups and sex. The relationship between stress reactivity and clinical characteristics (i.e., FS duration, age at first FS, time since the last FS) was investigated. RESULTS Cortisol reactivity to stress was significantly different depending on study groups, F(1, 78) = 6.415, p = 0.003, η2p = 0.141, but not sex nor was there a significant interaction between group and sex (p ≥ 0.581). Participants with simple FS showed higher cortisol reactivity to stress (M = 14.936, Standard deviation (SD) = 26.852) compared with those with complex FS (M = -4.663, SD = 18.649, p = 0.015) and controls (M = -3.817, SD = 18.907, p = 0.003). There was no significant difference between participants with complex FS and controls (p > 0.999). Stress reactivity was not linked to clinical characteristics. CONCLUSIONS Children with past simple FS showed greater changes in salivary cortisol following stress, suggesting enhanced stress sensitivity. As similar results were not found in a population with complex FS, our study shows that stress alterations are not caused by seizure severity. Future studies are needed to investigate whether stress sensitivity may be premorbid to simple FS and may contribute to simple FS incidence.
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Affiliation(s)
- Fanny Thébault-Dagher
- Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Marc-Philippe Lafontaine
- Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Inga Sophia Knoth
- CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada
| | - Florence Deguire
- Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Emilie Sheppard
- Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Ramona Cook
- CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Maryse Lagacé
- CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
| | - Jocelyn Gravel
- CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada
| | - Sonia Lupien
- Psychiatry Department, Université de Montréal, Roger-Gaudry Building, 2900 Edouard-Montpetit Boulevard, Montreal, Quebec, Canada; Center for Studies on Human Stress, Institut universitaire en santé mentale de Montréal, 7331 Hochelaga Street, Montreal, Quebec, Canada.
| | - Sarah Lippé
- Department of Psychology, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
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Wiznitzer M. Mind the brain: the psychiatry of childhood seizures. THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:59-60. [PMID: 30528755 DOI: 10.1016/s2352-4642(18)30382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Max Wiznitzer
- Division of Pediatric Neurology, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA.
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Garg N, Joshi R, Medhi B. Cracking novel shared targets between epilepsy and Alzheimer's disease: need of the hour. Rev Neurosci 2018; 29:425-442. [PMID: 29329108 DOI: 10.1515/revneuro-2017-0064] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/12/2017] [Indexed: 12/14/2022]
Abstract
Epilepsy and Alzheimer's disease (AD) are interconnected. It is well known that seizures are linked with cognitive impairment, and there are various shared etiologies between epilepsy and AD. The connection between hyperexcitability of neurons and cognitive dysfunction in the progression of AD or epileptogenesis plays a vital role for improving selection of treatment for both diseases. Traditionally, seizures occur less frequently and in later stages of age in patients with AD which in turn implies that neurodegeneration causes seizures. The role of seizures in early stages of pathogenesis of AD is still an issue to be resolved. So, it is well timed to analyze the common pathways involved in pathophysiology of AD and epilepsy. The present review focuses on similar potential underlying mechanisms which may be related to the causes of seizures in epilepsy and cognitive impairment in AD. The proposed review will focus on many possible newer targets like abnormal expression of various enzymes like GSK-3β, PP2A, PKC, tau hyperphosphorylation, MMPs, caspases, neuroinflammation and oxidative stress associated with number of neurodegenerative diseases linked with epilepsy. The brief about the prospective line of treatment of both diseases will also be discussed in the present review.
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Affiliation(s)
- Nitika Garg
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 1600142, Punjab, India
| | - Rupa Joshi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 1600142, Punjab, India
| | - Bikash Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 1600142, Punjab, India, e-mail:
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Leung AK, Hon KL, Leung TN. Febrile seizures: an overview. Drugs Context 2018; 7:212536. [PMID: 30038660 PMCID: PMC6052913 DOI: 10.7573/dic.212536] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Background Febrile seizures are the most common neurologic disorder in childhood. Physicians should be familiar with the proper evaluation and management of this common condition. Objective To provide an update on the current understanding, evaluation, and management of febrile seizures. Methods A PubMed search was completed in Clinical Queries using the key terms ‘febrile convulsions’ and ‘febrile seizures’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Results Febrile seizures, with a peak incidence between 12 and 18 months of age, likely result from a vulnerability of the developing central nervous system to the effects of fever, in combination with an underlying genetic predisposition and environmental factors. The majority of febrile seizures occur within 24 hours of the onset of the fever. Febrile seizures can be simple or complex. Clinical judgment based on variable presentations must direct the diagnostic studies which are usually not necessary in the majority of cases. A lumbar puncture should be considered in children younger than 12 months of age or with suspected meningitis. Children with complex febrile seizures are at risk of subsequent epilepsy. Approximately 30–40% of children with a febrile seizure will have a recurrence during early childhood. The prognosis is favorable as the condition is usually benign and self-limiting. Intervention to stop the seizure often is unnecessary. Conclusion Continuous preventative antiepileptic therapy for the prevention of recurrent febrile seizures is not recommended. The use of intermittent anticonvulsant therapy is not routinely indicated. Antipyretics have no role in the prevention of febrile seizures.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Theresa Nh Leung
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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