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Neurochemicals of Limbic System and Thalamofrontal Cortical Network: Are They Different Between Patients With Idiopathic Generalized Epilepsy and Psychogenic Nonepileptic Seizure? Publisher Pubmed



Simani L1 ; Raminfard S2 ; Asadollahi M3 ; Roozbeh M4 ; Ryan F5 ; Rostami M6
Authors
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Authors Affiliations
  1. 1. Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Advanced Medical Technologies and Equipment Institute, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Epilepsy, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Centre for Research in Neuroscience, The Research Institute of the McGill University Health Center, Montreal, QC, Canada
  6. 6. Iran Faculty of Psychology and Education, Allameh Tabataba'I University, Tehran, Iran

Source: Epilepsy and Behavior Published:2020


Abstract

Objective: Thalamofrontal cortical network and limbic system are proposed to be involved in psychogenic nonepileptic seizure (PNES) and idiopathic generalized epilepsy (IGE). This study aimed to investigate neurochemical changes in prefrontal cortex, thalamus, and limbic circuits in patients with PNES and IGE. We also analyzed the interaction between cognitive functions and neurochemical changes in both groups. Methods: Hydrogen proton magnetic resonance spectroscopy (1H-MRS) was used to measure N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), glutamate–glutamine (Glx), and myo-inositol (MI). The voxels were placed on the bilateral dorsolateral prefrontal cortex (DLPFC), dorsomedial prefrontal cortex (DMPFC), anterior cingulate cortex (ACC), and thalamus. Attention and inhibitory control, as well as general intelligence status, were investigated using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) and the Wechsler Adult Intelligence Scale (WAIS), respectively, in patients with PNES and IGE, as well as healthy volunteers. Results: The 1H-MRS showed a decreased ratio of NAA/Cr in the right and left thalamus, right DMPFC, and right ACC in patients with IGE and PNES. Furthermore, a decrease of the NAA/Cr ratio in the left DMPFC and an increase of NAA/Cr ratio in the right DLPFC were observed in patients with PNES compared with the controls. The patient groups had a decreased ratio of Cho/Cr in right ACC compared with the healthy subjects. Moreover, the NAA/Cr ratio in the left thalamus and left DMPFC was correlated with seizure frequency in patient groups. Reduced NAA/Cr ratio in the right ACC and left DLPFC were also correlated with poor IVA-CPT scores. Conclusion: This study highlighted the dysfunction in prefrontal-thalamic–limbic circuits and impairment in neurocognition in patients with PNES and IGE. © 2020 Elsevier Inc.
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