Thébault-Dagher Fanny, Herba Catherine M, Séguin Jean R, Muckle Gina, Lupien Sonia J, Carmant Lionel, Simard Marie-Noëlle, Shapiro Gabriel D, Fraser William D, Lippé Sarah
Department of Psychology, Université de Montréal, Marie-Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; Centre de recherche en neuropsychologie et cognition, Université de Montréal, Marie Victorin Building, 90 Vincent-D'Indy Avenue, Montreal, Quebec, Canada; CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada.
CHU Sainte-Justine Research Center, Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, Canada; Psychiatry Department, Université de Montréal, Roger-Gaudry Building, 2900 Edouard-Montpetit Boulevard, Montreal, Quebec, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street West, Montreal, Quebec, Canada.
Epilepsy Res. 2017 Sep;135:95-101. doi: 10.1016/j.eplepsyres.2017.06.001. Epub 2017 Jun 10.
Prenatal exposure to stress and fever are factors lowering seizure threshold in animal models. The fever effect on seizure threshold is well documented in human infants, however the associations between maternal perinatal stress and infants' susceptibility to seizures is unknown. This is the first study in humans to investigate longitudinally, whether in humans, the effect of maternal perinatal emotional symptoms such as stress, anxiety and depression that may trigger a biological stress response on age at first seizure occurrence.
The study sample is a subgroup drawn from a longitudinal follow up cohort (3D cohort study: Design, Develop, Discover, N=2366 mother-infant dyads). Twenty-nine otherwise healthy infants who had a febrile seizure (FS) episode before the last follow-up visit (around 24 months of age) were studied. Mothers completed questionnaires regarding their emotional health at each pregnancy trimester and at three months postpartum. The link between maternal emotional symptoms and infant age at first FS was assessed through correlations and multiple regressions.
We found that maternal anxiety symptoms during the second trimester of pregnancy are linked to the age at first FS (r(23)=-0.459, p=0.021) and explain 21.1% of its variance. Postnatal maternal depression symptoms at 3 months postpartum were also associated with the age at first FS (r(23)=-0.587, p=0.002) and explained an additional 17.6% of variance. Together, the variables explained 38.7% of the variance in age at first FS. Maternal perceived stress symptoms at 3 months postpartum were also linked to the age at first FS (r(23)=-0.418, p=0.038), however, stress did not significantly contribute to the variance of age at first FS..
Our results suggest a link between increased perinatal maternal emotional symptoms and the age at first FS. An earlier age at first FS may be the manifestation of a lower seizure threshold. Early first seizure occurrence is a risk factor for compromised neurological and cognitive development. Further studies should address the mechanisms by which perinatal maternal emotional symptoms may have an impact on seizure threshold in humans.
产前暴露于应激和发热是降低动物模型癫痫发作阈值的因素。发热对癫痫发作阈值的影响在人类婴儿中已有充分记录，然而，围产期母亲应激与婴儿癫痫易感性之间的关联尚不清楚。这是第一项在人类中进行纵向研究的，探究在人类中，母亲围产期的情绪症状（如应激、焦虑和抑郁）可能引发生物应激反应，对首次癫痫发作年龄的影响。
研究样本是从纵向随访队列（3D队列研究：设计、开发、发现，N = 2366对母婴）中抽取的一个亚组。研究了29名在最后一次随访（约24个月龄）前有热性惊厥（FS）发作的健康婴儿。母亲们在每个孕期和产后三个月完成了关于她们情绪健康的问卷。通过相关性分析和多元回归分析评估母亲情绪症状与首次FS发作时婴儿年龄之间的联系。
我们发现，孕期第二个月母亲的焦虑症状与首次FS发作时的年龄有关（r(23)= -0.459，p = 0.021），并解释了其21.1%的变异。产后3个月母亲的抑郁症状也与首次FS发作时的年龄有关（r(23)= -0.587，p = 0.002），并额外解释了17.6%的变异。这些变量共同解释了首次FS发作时年龄变异的38.7%。产后3个月母亲的感知应激症状也与首次FS发作时的年龄有关（r(23)= -0.418，p = 0.038），然而，应激对首次FS发作时年龄的变异没有显著贡献。
我们的结果表明，围产期母亲情绪症状增加与首次FS发作时的年龄之间存在联系。首次FS发作年龄较早可能是癫痫发作阈值较低的表现。早期首次癫痫发作是神经和认知发育受损的危险因素。进一步的研究应探讨围产期母亲情绪症状可能影响人类癫痫发作阈值的机制。
