Depression, Stress and Vulnerability Factors in Drug Resistant Focal Epilepsies
Psychiatric disturbances, notably depression, occur frequently as co-morbid conditions with epilepsy. A complex, probably bidirectional relationship between epilepsy and depression has been postulated. Both epilepsy and depression also interact with stressful life events, but only some patients develop these disorders after a stressful event, indicating the possibility of a "vulnerable" population. Animal and human studies have looked at the role of brain derived neurotrophic factor (BDNF) in this context. Low serum and/or CSF levels of BDNF are associated with higher incidence of depression, and thus indicate the vulnerable population.
Animal studies of BDNF have looked specifically at the relation between epilepsy and depression using a novel "double hit" design. After chronic stress exposure, measurement of BDNF levels allowed identification of 2 sub-groups: a vulnerable population and non-vulnerable population. A "second hit" of kainic acid induced status epilepticus (SE) was then applied to both the vulnerable and non-vulnerable populations. Only the vulnerable population exposed to SE developed a depression-like profile.
In a proof of concept approach we propose studying the relation between epilepsy, depression, anxiety and stressful life events, using serum BDNF levels in patients with pharmacoresistant epilepsy. Evaluation of epilepsy type and co-morbid psychiatric profile will be performed in 150 subjects. By comparing BDNF levels for different epilepsy subgroups to BDNF levels for healthy subjects and for depressed subjects without epilepsy, we hope to identify whether risk of co-morbid depression and/or anxiety in epilepsy may be predicted using BDNF levels. In addition, in a subgroup of 25 patients, we propose a pilot study in which cortisol and C-reactive protein will be measured in addition to BDNF.
研究概览
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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-
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Marseille、法国、13354
- 招聘中
- Assistance Publique Hopitaux de Marseille
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接触:
- Aïleen Mc Gonigal, MD
- 邮箱:aileen.mcgonigal@ap-hm.fr
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Tours、法国
- 尚未招聘
- CHU Tours
-
接触:
- Bertrand DE TOFFOL, MD/PhD
- 邮箱:bertrand.detoffol@univ-tours.fr
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Definite diagnosis of epilepsy, of any type (partial or generalised) and at any stage from diagnosis onwards
- Known or unknown etiology (symptomatic or cryptogenic epilepsy)
Exclusion Criteria:
- Psychogenic non-epileptic seizures
- Psychotic disorders and bipolar disorders
学习计划
研究是如何设计的?
设计细节
- 主要用途:诊断
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:Epileptic patient
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Patient will answer self-questionner on Depression
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Depression
大体时间:24 months
|
Score assessment of Becks Depression Inventory sacle
|
24 months
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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