Psychiatric comorbidity in relation to clinical characteristics of epilepsy: A retrospective observational study

Association between serum apolipoprotein E and cognitive function in Chinese patients with temporal lobe epilepsy

OBJECTIVE

To investigate the effect of serum apolipoprotein E (APOE) levels on cognitive function in patients with temporal lobe epilepsy (TLE).

METHODS

Clinical data were collected from 190 subjects including 110 TLE patients and 80 healthy people. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R) scale. Serum levels of APOE were measured using ELISA kits. Genotyping of APOE in peripheral blood was detected by microarray hybridization.

RESULTS

Patients with TLE had significantly lower ACE-R total score, memory and verbal fluency scores compared to the healthy group. Serum levels of APOE were significantly higher in TLE patients than in the healthy subjects. Serum APOE levels were significantly negatively correlated with ACE-R total score, memory and verbal fluency scores. The cognitive function score of TLE with APOE ε4 allele was lower than that of TLE without APOE ε4 allele.

SIGNIFICANCE

Our study showed that serum APOE levels were higher in TLE patients than in the healthy population. And serum APOE levels were associated with cognitive dysfunction in TLE patients. APOE ε4 allele carriers have poor cognitive function in TLE patients.

Genetic Epilepsies and Developmental Epileptic Encephalopathies with Early Onset: A Multicenter Study

The genetic causes of epilepsies and developmental and epileptic encephalopathies (DEE) with onset in early childhood are increasingly recognized. Their outcomes vary from benign to severe disability. In this paper, we wished to retrospectively review the clinical, genetic, EEG, neuroimaging, and outcome data of patients experiencing the onset of epilepsy in the first three years of life, diagnosed and followed up in four Italian epilepsy centres (Epilepsy Centre of San Paolo University Hospital in Milan, Child Neurology and Psychiatry Unit of AUSL-IRCCS di Reggio Emilia, Pediatric Neurology Unit of Vittore Buzzi Children's Hospital, Milan, and Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia). We included 168 patients (104 with monogenic conditions, 45 with copy number variations (CNVs) or chromosomal abnormalities, and 19 with variants of unknown significance), who had been followed up for a mean of 14.75 years. We found a high occurrence of generalized seizures at onset, drug resistance, abnormal neurological examination, global developmental delay and intellectual disability, and behavioural and psychiatric comorbidities. We also documented differing presentations between monogenic issues versus CNVs and chromosomal conditions, as well as atypical/rare phenotypes. Genetic early-childhood-onset epilepsies and DEE show a very wide phenotypic and genotypic spectrum, with a high risk of complex neurological and neuropsychiatric phenotypes.

Using the hospital anxiety and depression scale in people with epilepsy: Is overlapping symptomatology a problem?

The Hospital Anxiety and Depression Scale (HADS) is designed to screen for anxiety and depression in clinical settings. However, some items on the HADS may reflect symptoms associated with epilepsy and antiseizure medications rather than anxiety and depression. This study examined whether these items on the HADS contributed disproportionately to the reporting of anxiety and depression on the HADS in people with epilepsy (PWE). As part of a routine clinical assessment, 546 adults with epilepsy completed the HADS. In our sample, 56.2% reported elevated levels of anxiety, and 27.3% reported symptoms of depression with a score of 8 or more on the respective subscales. Scores on the anxiety and depression subscales were not associated with age, sex or epilepsy type. We did not find a relationship between endorsement of items related to panic, feelings of dread or butterflies in the stomach and a diagnosis of temporal lobe epilepsy. The most frequently endorsed item on the anxiety subscale of the HADS in the sample as a whole related to worrying thoughts, rather than the more somatic manifestations of anxiety. The item 'I feel as if I am slowed down' was endorsed by the majority of people with epilepsy and may not reflect a symptom of depression in this group. Careful analyses of the pattern of endorsement of specific items on the HADS may improve the sensitivity of this screening measure to the presence of depression in people with epilepsy.