Focal epilepsy with fear-related behavior as primary presentation in Boerboel dogs

Semiautomatic volumetry of the temporal lobes of the brain and correlation with electroencephalography results in dogs with assumed idiopathic epilepsy

BACKGROUND

Lesions causing refractory epilepsy, often associated with temporal lobe epilepsy (TLE), can be undetectable on standard magnetic resonance imaging (MRI) in dogs. Automated brain volumetry, widely used in human medicine, can now be applied in veterinary medicine because of the availability of brain atlases.

OBJECTIVES

This study aimed to develop an automatic volumetry method, translate the outcomes into the assessment of temporal lobe volumes in dogs with idiopathic epilepsy, and correlate the results with the electroencephalography (EEG) data of epileptiform discharges (EDs).

ANIMALS

Thirty-one dogs of various breeds with dominant temporal lobe discharge.

METHODS

Retrospective, observational study. The MRI and EEG examination results of dogs referred for neurological diagnosis data between 2016 and 2021 were retrospectively analyzed. An automated volumetry method was developed, which allowed the evaluation of temporal lobe volumes of the dogs. The asymmetric ratio (AR) was then estimated, and the results were correlated with the EEG EDs.

RESULTS

12/31 (38%; 95% CI: 21.8%-57.8%) dogs had an asymmetric ratio >6%. Among them, reduction in temporal lobe volumes correlated with the side of the EEG EDs in 7 cases. There was no statistical correlation between temporal lobe volume changes and ED location.

CONCLUSIONS AND CLINICAL IMPORTANCE

Preliminary volumetric analysis of the temporal lobes indicates the presence of volume differences between the lobes in some dogs with idiopathic epilepsy. Diagnosis of TLE in dogs based on MRI volumetry in correlation with EEG examination, especially for dogs with drug-resistant epilepsy, can influence the development of new therapeutic options, such as surgery.

Pathophysiology of drug-resistant canine epilepsy

Drug resistance continues to be a major clinical problem in the therapeutic management of canine epilepsies with substantial implications for quality of life and survival times. Experimental and clinical data from human medicine provided evidence for relevant contributions of intrinsic severity of the disease as well as alterations in pharmacokinetics and -dynamics to failure to respond to antiseizure medications. In addition, several modulatory factors have been identified that can be associated with the level of therapeutic responses. Among others, the list of potential modulatory factors comprises genetic and epigenetic factors, inflammatory mediators, and metabolites. Regarding data from dogs, there are obvious gaps in knowledge when it comes to our understanding of the clinical patterns and the mechanisms of drug-resistant canine epilepsy. So far, seizure density and the occurrence of cluster seizures have been linked with a poor response to antiseizure medications. Moreover, evidence exists that the genetic background and alterations in epigenetic mechanisms might influence the efficacy of antiseizure medications in dogs with epilepsy. Further molecular, cellular, and network alterations that may affect intrinsic severity, pharmacokinetics, and -dynamics have been reported. However, the association with drug responsiveness has not yet been studied in detail. In summary, there is an urgent need to strengthen clinical and experimental research efforts exploring the mechanisms of resistance as well as their association with different etiologies, epilepsy types, and clinical courses.

Genome-wide association analysis of idiopathic epilepsy in the Belgian shepherd

Background

Idiopathic epilepsy (IE) is a common neurological disorder in the domestic dog, and is defined as repeated seizure activity having no identifiable underlying cause. Some breeds, such as the Belgian shepherd dog, have a greater prevalence of the disorder. Previous studies in this and other breeds have identified ADAM23 as a gene that confers risk of IE, although additional loci are known to exist. The present study sought to identify additional loci that influence IE in the Belgian shepherd dog.

Results

Genome-wide association studies (GWAS) revealed a significant association between IE and CFA 14 (p < 1.03 E− 08) and a suggestive association on CFA 37 (p < 2.91 E− 06) in a region in linkage disequilibrium with ADAM23. Logistic regression identified a 2-loci model that demonstrated interaction between the two chromosomal regions that when combined predicted IE risk with high sensitivity.

Conclusions

Two interacting loci, one each on CFAs 14 and 37, predictive of IE in the Belgian shepherd were identified. The loci are adjacent to potential candidate genes associated with neurological function. Further exploration of the region is warranted to identify causal variants underlying the association. Additionally, although the two loci were very good at predicting IE, they failed to capture all the risk, indicating additional loci or incomplete penetrance are also likely contributing to IE expression in the Belgian shepherd dog.

Making the Case for Multi-Axis Assessment of Behavioural Problems

Simple Summary

Companion animals can experience behavioural and mental health problems that are similar to those we see in people. These problems are influenced by many factors, including an animal’s genetic background, its rearing environment, the environment it lives in, and the social relationships it has with people and other animals. This paper proposes a model for collecting and organising information about all of the factors that contribute to behavioural and mental health problems in companion animals, in order to produce a comprehensive, structured assessment of them.

Abstract

The systematic classification of human mental health disorders and behavioural problems in companion animals face the same challenges. These disorders and problems are complex, multi-factorial, and can interfere with the individual’s ability to function within society, a social or family environment. Classification systems are reductive, they discard a lot of critical information, and can be overly focused on the presenting problem, inflexible and obstructive to new research. As a result, human psychiatry is moving away from classification systems and toward a clinical and research model based on dimensional characteristics that encompass the full range from normal to abnormal, and include multiple sources of influence from genetic, to environmental and psychosocial. In this paper, we set out a multi-axis model for the collection and organisation of information about companion animal behaviour problem cases that avoids some of the limitations of classification systems, is aligned with the current research approach in human psychiatry, and assists the clinician in making a complete and thorough assessment of a case.

Focal epilepsy with fear-related behavior as primary presentation in Boerboel dogs

Background

Focal seizures with fear as a primary ictal manifestation, their diagnostic challenges, and impact on quality of life are well described in human medicine. Reports focusing on ictal fear‐like behavior in animals are scarce.

Objective

To describe the clinical and histopathological characteristics of a novel focal epilepsy in Boerboel dogs.

Animals

Five client‐owned Boerboel littermates presented for evaluation of sudden episodes of severe fear‐related behavior.

Methods

Clinical examination, complete blood cell count, routine blood biochemistry, and urinalysis were performed in all dogs. Magnetic resonance imaging (MRI) scans of the brain were performed in 3 affected Boerboels. In addition, in 2 affected Boerboels, metabolic screening, cerebrospinal fluid (CSF) analysis, and necropsy were performed.

Results

Onset of signs was 3 months of age in all affected Boerboels. All Boerboels howled loudly, had an extremely fearful facial expression and trembled during seizures. All affected Boerboels also had autonomic or motor signs. Results of laboratory investigations, diagnostic imaging, and metabolic screening were generally unremarkable. Histopathology showed moderate numbers of single large vacuoles in the perikaryon of neurons throughout the brain, specifically in the deeper cerebral cortical regions. Family history, pedigree analysis, and the homogenous phenotype were suggestive of autosomal recessive inheritance.

Conclusions and Clinical Importance

The observed paroxysmal fear‐related behavior represents a newly recognized hereditary focal epilepsy in dogs with distinctive clinical and histopathologic features. Veterinarians should be aware that sudden episodes of unusual behavior can represent focal epilepsy.