Department of Biomedical Engineering, The University of Melbourne, Melbourne, Victoria, Australia.
Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Epilepsia. 2022 Jul;63(7):1682-1692. doi: 10.1111/epi.17253. Epub 2022 Apr 26.
Emerging evidence has shown that ambient air pollution affects brain health, but little is known about its effect on epileptic seizures. This work aimed to assess the association between daily exposure to ambient air pollution and the risk of epileptic seizures.
This study used epileptic seizure data from two independent data sources (NeuroVista and Seer App seizure diary). In the NeuroVista data set, 3273 seizures were recorded using intracranial electroencephalography (iEEG) from 15 participants with refractory focal epilepsy in Australia in 2010-2012. In the seizure diary data set, 3419 self-reported seizures were collected through a mobile application from 34 participants with epilepsy in Australia in 2018-2021. Daily average concentrations of carbon monoxide (CO), nitrogen dioxide (NO ), ozone (O ), particulate matter ≤10 μm in diameter (PM ), and sulfur dioxide (SO ) were retrieved from the Environment Protection Authority (EPA) based on participants' postcodes. A patient-time-stratified case-crossover design with the conditional Poisson regression model was used to determine the associations between air pollutants and epileptic seizures.
A significant association between CO concentrations and epileptic seizure risks was observed, with an increased seizure risk of 4% (relative risk [RR]: 1.04, 95% confidence interval [CI]: 1.01-1.07) for an interquartile range (IQR) increase of CO concentrations (0.13 parts per million), whereas no significant associations were found for the other four air pollutants in the whole study population. Female participants had a significantly increased risk of seizures when exposed to elevated CO and NO , with RRs of 1.05 (95% CI: 1.01-1.08) and 1.09 (95% CI: 1.01-1.16), respectively. In addition, a significant association was observed between CO and the risk of subclinical seizures (RR: 1.20, 95% CI: 1.12-1.28).
Daily exposure to elevated CO concentrations may be associated with an increased risk of epileptic seizures, especially for subclinical seizures.
新出现的证据表明，环境空气污染会影响大脑健康，但人们对其对癫痫发作的影响知之甚少。本研究旨在评估每日暴露于环境空气污染与癫痫发作风险之间的关系。
本研究使用了来自两个独立数据源（NeuroVista 和 Seer App 癫痫发作日记）的癫痫发作数据。在 NeuroVista 数据集中，2010-2012 年期间，来自澳大利亚的 15 名耐药性局灶性癫痫患者使用颅内脑电图（iEEG）记录了 3273 次癫痫发作。在癫痫发作日记数据集中，2018-2021 年期间，通过澳大利亚的一个移动应用程序收集了 34 名癫痫患者的 3419 次自我报告的癫痫发作。根据参与者的邮政编码，从环境保护局（EPA）检索到一氧化碳（CO）、二氧化氮（NO ）、臭氧（O ）、直径≤10μm 的颗粒物（PM ）和二氧化硫（SO ）的日平均浓度。采用患者时间分层病例交叉设计和条件泊松回归模型来确定空气污染物与癫痫发作之间的关系。
CO 浓度与癫痫发作风险之间存在显著关联，CO 浓度每增加一个四分位距（IQR）（0.13ppm），癫痫发作风险增加 4%（相对风险 [RR]：1.04，95%置信区间 [CI]：1.01-1.07），而在整个研究人群中，其他四种空气污染物均未发现显著关联。女性参与者在暴露于高浓度 CO 和 NO 时癫痫发作的风险显著增加，RR 分别为 1.05（95%CI：1.01-1.08）和 1.09（95%CI：1.01-1.16）。此外，还观察到 CO 与亚临床癫痫发作风险之间存在显著关联（RR：1.20，95%CI：1.12-1.28）。
每日暴露于升高的 CO 浓度可能与癫痫发作风险增加相关，尤其是与亚临床癫痫发作相关。
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