Samzadeh Mojdeh, Papuć Ewa, Furtak-Niczyporuk Marzena, Rejdak Konrad
Department of Neurology, Medical University of Lublin, 20-954 Lublin, Poland.
Department of Public Health, Medical University of Lublin, 20-954 Lublin, Poland.
J Clin Med. 2020 Oct 19;9(10):3354. doi: 10.3390/jcm9103354.
The effects of status epilepticus on the orexin/hypocretin system have yet to be investigated. The present study aimed to assay orexin-A/hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized convulsive status epilepticus (GCSE). The study groups included 20 GCSE patients, 24 patients diagnosed with epilepsy but remaining in remission (ER), and 25 normal controls (CTR). Diagnostic lumbar puncture was performed in GCSE patients within 3-10 days of seizure cessation, as well as in the ER and to CTR subjects. Among all GCSE patients, the outcome was graded according to the modified Rankin Scale (mRS) at 1-month follow-up. Orexin-A levels were measured in unextracted CSF samples, using a commercial radioimmunoassay. There was a significant overall difference in median CSF orexin-A concentrations between GCSE, RE, and CTR patients ( < 0.001). The lowest concentrations were noted in the GCSE group compared to ER ( < 0.001) or CTR ( < 0.001). CSF orexin-A levels in GCSE patients inversely correlated with clinical outcome as assessed on the mRS at 1-month follow-up ( = -0.55; = 0.1). In conclusion, CSF orexin-A levels may serve as a biomarker of increased turn-over of the peptide or post-SE neuronal damage, and implicates the orexin system in the pathogenesis of SE.
癫痫持续状态对食欲素/下丘脑泌素系统的影响尚未得到研究。本研究旨在测定全身性惊厥性癫痫持续状态（GCSE）患者脑脊液（CSF）中的食欲素-A/下丘脑泌素-1。研究组包括20例GCSE患者、24例诊断为癫痫但处于缓解期（ER）的患者以及25名正常对照者（CTR）。在GCSE患者癫痫停止发作后的3至10天内，以及ER组和CTR组受试者中进行了诊断性腰椎穿刺。在所有GCSE患者中，在1个月随访时根据改良Rankin量表（mRS）对结果进行分级。使用商业放射免疫分析法在未提取的脑脊液样本中测量食欲素-A水平。GCSE患者、RE患者和CTR患者的脑脊液食欲素-A浓度中位数总体上存在显著差异（<0.001）。与ER组（<0.001）或CTR组（<0.001）相比，GCSE组的浓度最低。GCSE患者脑脊液食欲素-A水平与1个月随访时mRS评估的临床结果呈负相关（=-0.55；=0.1）。总之，脑脊液食欲素-A水平可能作为该肽周转率增加或癫痫持续状态后神经元损伤的生物标志物，并提示食欲素系统参与癫痫持续状态的发病机制。
