Hypermobility in patients with functional seizures: Toward a pathobiological understanding of complex conditions.


Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
07 2022
Historique:
received: 26 02 2022
revised: 13 04 2022
accepted: 16 04 2022
pubmed: 18 5 2022
medline: 22 6 2022
entrez: 17 5 2022
Statut: ppublish

Résumé

Functional seizures (FS), otherwise known as psychogenic nonepileptic seizures (PNES), are a common symptom presenting to neurology and epilepsy clinics. There is a pressing need for further research to understand the neurobiology of FS to develop mechanistically targeted treatments. Joint hypermobility is an expression of variation in connective tissue structure along a spectrum, and it has received increasing attention in functional neurological disorders, but there is lack of evidence of its relevance in FS. In the present study, forty-two patients with FS and a non-clinical comparison group of 34 age/sex-matched controls were recruited. Joint hypermobility of all participants was quantified using the Beighton scale. In our sample, 24 (57%) patients with FS, and 7 (21%) of the comparison group met criteria for joint hypermobility (p = 0.002). Our statistical model revealed that patients with FS showed a significant degree of hypermobility compared to the comparison group (odds ratio = 11.1; Confidence interval: 2.1-78.0, p = 0.008), even after controlling age, sex, anxiety, and depression. We found a significant association between FS and joint hypermobility, which was independent of anxiety and depression.

Sections du résumé

BACKGROUND
Functional seizures (FS), otherwise known as psychogenic nonepileptic seizures (PNES), are a common symptom presenting to neurology and epilepsy clinics. There is a pressing need for further research to understand the neurobiology of FS to develop mechanistically targeted treatments. Joint hypermobility is an expression of variation in connective tissue structure along a spectrum, and it has received increasing attention in functional neurological disorders, but there is lack of evidence of its relevance in FS.
METHODS
In the present study, forty-two patients with FS and a non-clinical comparison group of 34 age/sex-matched controls were recruited. Joint hypermobility of all participants was quantified using the Beighton scale.
RESULTS
In our sample, 24 (57%) patients with FS, and 7 (21%) of the comparison group met criteria for joint hypermobility (p = 0.002). Our statistical model revealed that patients with FS showed a significant degree of hypermobility compared to the comparison group (odds ratio = 11.1; Confidence interval: 2.1-78.0, p = 0.008), even after controlling age, sex, anxiety, and depression.
CONCLUSION
We found a significant association between FS and joint hypermobility, which was independent of anxiety and depression.

Identifiants

pubmed: 35580524
pii: S1525-5050(22)00159-7
doi: 10.1016/j.yebeh.2022.108710
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

108710

Subventions

Organisme : Medical Research Council
ID : MR/V037676/1
Pays : United Kingdom

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Akihiro Koreki (A)

Neurosciences Research Centre, St George's University of London, London, UK; Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan.

Jessica Eccles (J)

Brighton and Sussex Medical School, Sussex University, UK.

Sarah Garfinkel (S)

Institute of Cognitive Neuroscience, UCL, UK.

Hugo Critchley (H)

Brighton and Sussex Medical School, Sussex University, UK.

Sarah Cope (S)

Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK.

Niruj Agrawal (N)

Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK.

Mark Edwards (M)

Neurosciences Research Centre, St George's University of London, London, UK; Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK.

Mahinda Yogarajah (M)

Neurosciences Research Centre, St George's University of London, London, UK; Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Department of Clinical and Experimental Epilepsy, Institute of Neurology, UCL, National Hospital for Neurology and Neurosurgery, UCLH, Epilepsy Society, UK. Electronic address: m.yogarajah@ucl.ac.uk.

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