Soncin Lisa-Dounia, Belquaid Sara, McGonigal Aileen, Giusiano Bernard, Bartolomei Fabrice, Faure Sylvane
Université Côte d'Azur, LAPCOS, France; Aix Marseille Univ, INSERM, INS, Int Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France.
Université Côte d'Azur, LAPCOS, France.
Epilepsy Behav. 2023 Oct;147:109396. doi: 10.1016/j.yebeh.2023.109396. Epub 2023 Aug 22.
Epilepsy is often linked to various psychiatric symptoms, with anxiety, depression, and interictal dysphoric disorders being the most prevalent. Few studies have investigated posttraumatic stress disorder (PTSD) in epilepsy, but they suggest a notable prevalence of PTSD. PTSD is known to be associated with cognitive impairments, particularly memory and executive functions. Our proposed exploratory study aims to investigate executive attentional control and emotional inhibition in patients with drug-resistant epilepsy (DRE) who exhibit PTSD symptoms compared with a healthy control group. Additionally, some PWE can manage their seizures using emotional and cognitive strategies, we find it relevant to explore the connection between their regulation abilities, cognitive control performance, and PTSD symptoms. We included 54 PWE and 60 healthy participants. They completed anxiety and depression scales as well as two questionnaires assessing PTSD symptoms and a questionnaire that measured the perceived self-control of seizures. We measured executive control using an executive control task (Attention Network Test, ANT) and an emotional Go/No-Go task. We found a positive correlation between PTSD scores (PDS-5) and performance at the ANT task. In contrast, in the emotional inhibition (Go/No-Go) task, behavioral inhibition errors were positively correlated with PTSD scores, specifically with hypervigilance symptoms in PTSD+ patients. There was a positive correlation between response reaction times in an aversive condition and PTSD scores: the more severe the PTSD symptoms, the faster the PWE identified stimuli in the angry face condition of the Go/No-Go task. Regarding perceived seizure control, we found correlations between alertness and PTSD symptoms associated with seizure anticipation during the inter- and peri-ictal periods. Patients with PTSD symptoms reported better seizure control. Our findings suggest that epilepsy patients with PTSD experience cognitive changes such as heightened executive attentional control, weakened emotional inhibition, and improved seizure control perception.
癫痫常与各种精神症状相关，其中焦虑、抑郁和发作间期烦躁障碍最为常见。很少有研究调查癫痫患者中的创伤后应激障碍（PTSD），但这些研究表明PTSD的患病率相当高。已知PTSD与认知障碍有关，尤其是记忆和执行功能。我们提议的探索性研究旨在调查与健康对照组相比，表现出PTSD症状的耐药性癫痫（DRE）患者的执行注意力控制和情绪抑制情况。此外，一些癫痫患者可以使用情绪和认知策略来控制癫痫发作，我们认为探索他们的调节能力、认知控制表现和PTSD症状之间的联系很有意义。我们纳入了54名癫痫患者和60名健康参与者。他们完成了焦虑和抑郁量表以及两份评估PTSD症状的问卷，还有一份测量癫痫发作自我控制感的问卷。我们使用执行控制任务（注意力网络测试，ANT）和情绪Go/No-Go任务来测量执行控制。我们发现PTSD评分（PDS-5）与ANT任务的表现呈正相关。相反，在情绪抑制（Go/No-Go）任务中，行为抑制错误与PTSD评分呈正相关，特别是与PTSD+患者的过度警觉症状相关。在厌恶条件下的反应反应时间与PTSD评分之间存在正相关：PTSD症状越严重，癫痫患者在Go/No-Go任务的愤怒面孔条件下识别刺激的速度越快。关于癫痫发作控制感，我们发现警觉性与发作间期和发作期癫痫发作预期相关的PTSD症状之间存在相关性。有PTSD症状的患者报告癫痫控制更好。我们的研究结果表明，患有PTSD的癫痫患者会经历认知变化，如执行注意力控制增强、情绪抑制减弱和癫痫发作控制感改善。
