Clinical Correlation Advised: Measuring Functional Connectivity in PNES. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Perry, M. Scott; Papadelis, Christos
• Is Part Of: Epilepsy currents. Volume 21:Issue 1(2021)
• Page Start: 30
• Page End: 32
• Publication Date: 2021-01
• Subjects: Epilepsy -- Periodicals; 616.853005
• DOI: 10.1177/1535759720975436
• Languages: English
• ISSNs: 1535-7597

Abstract

Activation of Functional Brain Networks in Children With Psychogenic Non-Epileptic Seizures Radmanesh M, Jalili M, Kozlowska K. Front Hum Neurosci . 2020. doi:10.3389/fnhum.2020.00339 . Objectives: Psychogenic nonepileptic seizures (PNES) have been hypothesized to emerge in the context of neural networks instability. To explore this hypothesis in children, we applied a graph theory approach to examine connectivity in neural networks in the resting-state electroencephalogram in 35 children with PNES, 31 children with other functional neurological symptoms (but no PNES), and 75 healthy controls. Methods: The networks were extracted from Laplacian-transformed time series by a coherence connectivity estimation method. Results: Children with PNES (vs controls) showed widespread changes in network metrics: increased global efficiency (α and β bands), increased local efficiency (γ band), and increased modularity (γ and α bands). Compared to controls, they also had higher levels of autonomic arousal (eg, lower heart variability); more anxiety, depression, and stress on the Depression Anxiety and Stress Scales; and more adverse childhood experiences on the Early Life Stress Questionnaire. Increases in network metrics correlated with arousal. Children with other functional neurological symptoms (but no PNES) showed scattered and less pronounced changes in network metrics. Conclusion: The results indicate that children with PNES present with increased activation of neural networks coupled with increased physiological arousal. Although this shift in functional organization may confer a short-term adaptive advantage—one that facilitates neural communication and the child's capacity to respond self-protectively in the face of stressful life events—it may also have a significant biological cost. It may predispose the child's neural networks to periods of instability—presenting clinically as PNES—when the neural networks are faced with perturbations in energy flow or with additional demands.