Possible biomarker to identify seizure-related stress found

WASHINGTON - A new research has found that reduced levels of brain-derived neurotrophic factor (BDNF)-a protein in the brain that encourages growth of neurons-may be a trait marker for individuals with psychogenic non-epileptic seizures (PNES).

Previous studies have shown decreased levels of BDNF in the serum of patients with psychiatric disorders such as major depressive disorder and conversion disorders.

W. Curt LaFrance of the Rhode Island Hospital led the study of three groups of patients-one group with confirmed PNES, one group with ES and one healthy control group.

The patients were also screened for comorbid depression as well, as past studies have suggested that chronic antidepressant use increases serum BDNF in patients with depression.

More than half (8 of 13) of the patients in the PNES group were diagnosed with mild depression and were taking psychotropic (antidepressant) medication.

LaFrance and his fellow colleagues from Brown University found decreased levels of serum BDNF in both the PNES and ES groups when compared to the healthy control group.

They believe these findings are significant as it is expected that the PNES patients taking antidepressant medications would have an increased level of serum BDNF.

There were no significant differences in the levels of serum BDNF among all the patients in the PNES group, whether they were taking antidepressants or not.

As a result, they believe that the reduced levels of BDNF may be a biomarker for PNES.

LaFrance said: “While BDNF may play a similar role in the pathophysiology of depression and PNES, the differential response of serum BDNF to antidepressants in patients with psychogenic nonepileptic seizures could highlight an important difference.

The fact that antidepressants did not increase serum BDNF levels in our study and that there were no BDNF differences between patients with PNES who were depressed and those who did not have depression would suggest that serum BDNF might represent a trait marker of PNES.”

The study also found decreased levels of BDNF in adult patients with epileptic seizures, unlike the elevated levels found in children with ES.

LaFrance noted: “A model that may provide a unifying hypothesis on the decreased serum BDNF findings in both seizure groups may not be related to seizures-it may be related to stress.

“Stress has been shown to lower BDNF, and a shared characteristic of patients with epilepsy or with nonepileptic seizures is fear of the next seizure. There may be great potential for biomarkers for PNES and for treatment response.”

The findings were published in Neurology, the medical journal of the American Academy of Neurology. (ANI)