| Basal hypercortisolism and trauma in patients with psychogenic nonepileptic seizures. | |
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MedLine Citation:
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PMID: 19889016 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Several studies have indicated that psychogenic nonepileptic seizures (PNES) are associated with psychological trauma, but only a few studies have examined the associations with neurobiologic stress systems, such as the hypothalamus-pituitary-adrenal (HPA) axis and its end-product cortisol. We tested several relevant HPA-axis functions in patients with PNES and related them to trauma history. METHODS: Cortisol awakening curve, basal diurnal cortisol, and negative cortisol feedback (using a 1 mg dexamethasone suppression test) were examined in 18 patients with PNES and 19 matched healthy controls (HCs) using saliva cortisol sampling on two consecutive days at 19 time points. Concomitant sympathetic nervous system (SNS) activity was assessed by analyzing saliva alpha-amylase (sAA). RESULTS: Patients with PNES showed significantly increased basal diurnal cortisol levels compared to HCs. This effect was driven mainly by patients reporting sexual trauma who showed a trend toward higher cortisol levels as compared to patients without a sexual trauma report. Importantly, the increased basal diurnal cortisol levels in patients were not explained by depression, medication, or smoking, or by current seizures or group differences in SNS activity. DISCUSSION: This is the first study showing that basal hypercortisolism in patients with PNES is independent of the acute occurrence of seizures. In addition, basal hypercortisolism was more pronounced in traumatized patients with PNES as compared to nontraumatized patients with PNES. These findings suggest that HPA-axis activity provides a significant neurobiologic marker for PNES. |
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Authors:
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Patricia Bakvis; Philip Spinhoven; Erik J Giltay; Jarl Kuyk; Peter M Edelbroek; Frans G Zitman; Karin Roelofs |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-11-03 |
Journal Detail:
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Title: Epilepsia Volume: 51 ISSN: 1528-1167 ISO Abbreviation: Epilepsia Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-06-11 Completed Date: 2010-06-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2983306R Medline TA: Epilepsia Country: United States |
Other Details:
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Languages: eng Pagination: 752-9 Citation Subset: IM |
Affiliation:
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SEIN, Epilepsy Institute in the Netherlands, Heemstede, The Netherlands. pbakvis@sein.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Biological Markers Circadian Rhythm / physiology* Cushing Syndrome / diagnosis*, physiopathology Dexamethasone / diagnostic use Electroencephalography Female Humans Hydrocortisone / analysis*, blood Hypothalamo-Hypophyseal System / physiopathology Male Pituitary-Adrenal System / physiopathology Saliva / chemistry* Salivary alpha-Amylases / analysis Seizures / diagnosis*, metabolism, physiopathology Sex Factors Sex Offenses / psychology, statistics & numerical data Stress, Psychological / physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 50-02-2/Dexamethasone; 50-23-7/Hydrocortisone; EC 3.2.1.1/Salivary alpha-Amylases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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