Postictal Psychosis in Epilepsy: A Clinicogenetic Study.


Journal

Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449

Informations de publication

Date de publication:
09 2021
Historique:
revised: 07 07 2021
received: 29 03 2021
accepted: 18 07 2021
pubmed: 22 7 2021
medline: 9 11 2021
entrez: 21 7 2021
Statut: ppublish

Résumé

Psychoses affecting people with epilepsy increase disease burden and diminish quality of life. We characterized postictal psychosis, which comprises about one quarter of epilepsy-related psychoses, and has unknown causation. We conducted a case-control cohort study including patients diagnosed with postictal psychosis, confirmed by psychiatric assessment, with available data regarding epilepsy, treatment, psychiatric history, psychosis profile, and outcomes. After screening 3,288 epilepsy patients, we identified 83 with psychosis; 49 had postictal psychosis. Controls were 98 adults, matched by age and epilepsy type, with no history of psychosis. Logistic regression was used to investigate clinical factors associated with postictal psychosis; univariate associations with a p value < 0.20 were used to build a multivariate model. Polygenic risk scores for schizophrenia were calculated. Cases were more likely to have seizure clustering (odds ratio [OR] = 7.59, p < 0.001), seizures with a recollected aura (OR = 2.49, p = 0.013), and a family history of psychiatric disease (OR = 5.17, p = 0.022). Cases showed predominance of right temporal epileptiform discharges (OR = 4.87, p = 0.007). There was no difference in epilepsy duration, neuroimaging findings, or antiseizure treatment between cases and controls. Polygenic risk scores for schizophrenia in an extended cohort of postictal psychosis cases (n = 58) were significantly higher than in 1,366 epilepsy controls (R Postictal psychosis occurs under particular circumstances in people with epilepsy with a heightened genetic predisposition to schizophrenia, illustrating how disease biology (seizures) and trait susceptibility (schizophrenia) may interact to produce particular outcomes (postictal psychosis) in a common disease. ANN NEUROL 2021;90:464-476.

Identifiants

pubmed: 34288049
doi: 10.1002/ana.26174
pmc: PMC9292039
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

464-476

Subventions

Organisme : NHGRI NIH HHS
ID : UM1 HG008895
Pays : United States
Organisme : Wellcome Trust
ID : 085475/B/08/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : G1100583
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NHGRI NIH HHS
ID : U01 HG009088
Pays : United States
Organisme : Medical Research Council
ID : G0901310
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 085475/Z/08/Z
Pays : United Kingdom

Informations de copyright

© 2021 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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Auteurs

Vera Braatz (V)

Department of Neurology, Neurological and Neurosurgical Clinic of Joinville, Joinville, Brazil.
Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.

Helena Martins Custodio (H)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Chalfont Centre for Epilepsy, Buckinghamshire, UK.

Costin Leu (C)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
Stanley Center of Psychiatric Research, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA.

Luigi Agrò (L)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Chalfont Centre for Epilepsy, Buckinghamshire, UK.

Baihan Wang (B)

Mental Health Neuroscience Research Department, Division of Psychiatry, University College London, London, UK.

Stella Calafato (S)

Mental Health Neuroscience Research Department, Division of Psychiatry, University College London, London, UK.

Genevieve Rayner (G)

Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
Department of Clinical Neuropsychology, Austin Health, Melbourne, Victoria, Australia.

Michael G Doyle (MG)

Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland.
FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.

Christian Hengsbach (C)

Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.

Francesca Bisulli (F)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE, delle Scienze Neurologiche di Bologna (EpiCARE reference center), Bologna, Italy.
Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.

Yvonne G Weber (YG)

Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
Department of Epileptology and Neurology, University of Aachen, Aachen, Germany.

Antonio Gambardella (A)

Department of Medical and Surgical Sciences, Institute of Neurology, University Magna Graecia, Catanzaro, Italy.

Norman Delanty (N)

Epilepsy Programme, Department of Neurology, Beaumont Hospital, Dublin, Ireland.
FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.
School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

Gianpiero Cavalleri (G)

FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of Molecular and Cellular Therapeutics and FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.

Jacqueline Foong (J)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.

Ingrid E Scheffer (IE)

University of Melbourne, Austin Health, and Royal Children's Hospital, Florey Institute and Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Samuel F Berkovic (SF)

Epilepsy Research Centre, Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.

Elvira Bramon (E)

Mental Health Neuroscience Research Department, Division of Psychiatry, University College London, London, UK.
Institute of Psychiatry, Psychology, & Neuroscience at King's College London, London, UK.
Institute of Cognitive Neuroscience, University College London, London, UK.

Simona Balestrini (S)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Chalfont Centre for Epilepsy, Buckinghamshire, UK.
Neuroscience Department, Children's Hospital 'Anna Meyer'-University of Florence, Florence, Italy.

Sanjay M Sisodiya (SM)

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.
Chalfont Centre for Epilepsy, Buckinghamshire, UK.

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