Hadzic Alena, Andersson Stein
Section for Clinical and Cognitive Neuroscience, Department of Psychology, University of Oslo, Oslo, Norway.
Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway.
Front Neurol. 2024 Jun 20;15:1406889. doi: 10.3389/fneur.2024.1406889. eCollection 2024.
Déjà vu, French for "already seen," is a phenomenon most people will experience at least once in their lifetime. Emerging evidence suggests that déjà vu occurs in healthy individuals (as "non-ictal déjà vu") and in epilepsy patients during seizures (as "ictal déjà vu") and between seizures (as "interictal déjà vu"). Although the ILAE has recognized déjà vu as a feature of epileptic seizures, it is notably absent from the ICD-11. A lack of evidence-based research may account for this omission. To our knowledge, this study represents the first systematic review and meta-analysis on déjà vu experiences. Through detailed examinations of non-ictal, interictal and ictal déjà vu, we seek to highlight possible clinical implications. Rethinking the status quo of ictal déjà vu could potentially lead to earlier interventions and improve outcomes for epilepsy patients.
This study was registered in PROSPERO (ID: CRD42023394239) on 5 February 2023. Systematic searches were conducted across four databases: EMBASE, MEDLINE, PsycINFO, and PubMed, from inception to 1 February 2023, limited to English language and human participants. Studies were included/excluded based on predefined criteria. Data was extracted according to the PICO framework and synthesized through a thematic approach. Meta-analyses were performed to estimate prevalence's of the phenomena. Study quality, heterogeneity, and publication bias were assessed.
Database searching identified 1,677 records, of which 46 studies were included. Meta-analyses of prevalence showed that non-ictal déjà vu was experienced by 0.74 (95% CI [0.67, 0.79], < 0.001) of healthy individuals, whereas interictal déjà vu was experienced by 0.62 (95% CI [0.48, 0.75], = 0.099) and ictal déjà vu by 0.22 (95% CI [0.15, 0.32], = 0.001) of epilepsy patients. Examinations of phenomenological (sex, age, frequency, duration, emotional valence, and dissociative symptoms) and neuroscientific (brain structures and functions) data revealed significant variations between non-ictal, interictal and ictal déjà vu on several domains.
This systematic review and meta-analysis do not support the notion that non-ictal, interictal and ictal déjà vu are homogenous experiences. Instead, it provides insight into ictal déjà vu as a symptom of epilepsy that should be considered included in future revisions of the ICD-11.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394239, CRD42023394239.
“似曾相识”在法语中是“已经见过”的意思，是一种大多数人在一生中至少会经历一次的现象。新出现的证据表明，似曾相识在健康个体中会出现（作为“非发作期似曾相识”），在癫痫患者发作期间（作为“发作期似曾相识”）以及发作间期（作为“发作间期似曾相识”）也会出现。尽管国际抗癫痫联盟（ILAE）已将似曾相识认定为癫痫发作的一个特征，但它在《国际疾病分类第11版》（ICD - 11）中却明显缺失。缺乏循证研究可能是造成这一遗漏的原因。据我们所知，本研究是对似曾相识体验的首次系统评价和荟萃分析。通过对非发作期、发作间期和发作期似曾相识的详细研究，我们试图突出其可能的临床意义。重新审视发作期似曾相识的现状可能会带来更早的干预措施，并改善癫痫患者的治疗效果。
本研究于2023年2月5日在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023394239）注册。对四个数据库进行系统检索：EMBASE、MEDLINE、PsycINFO和PubMed，检索时间从建库至2023年2月1日，仅限于英文文献和人类参与者。根据预先设定的标准纳入/排除研究。按照PICO框架提取数据，并通过主题分析进行综合。进行荟萃分析以估计这些现象的发生率。评估研究质量、异质性和发表偏倚。
数据库检索共识别出1677条记录，其中46项研究被纳入。发生率的荟萃分析表明，0.74（95%置信区间[0.67, 0.79]，P < 0.001）的健康个体经历过非发作期似曾相识，而0.62（95%置信区间[0.48, 0.75]，P = 0.099）的癫痫患者经历过发作间期似曾相识，0.22（95%置信区间[0.15, 0.32]，P = 0.001）的癫痫患者经历过发作期似曾相识。对现象学（性别、年龄、频率、持续时间、情感效价和解离症状）和神经科学（脑结构和功能）数据的研究揭示了非发作期、发作间期和发作期似曾相识在几个领域存在显著差异。
本系统评价和荟萃分析不支持非发作期、发作间期和发作期似曾相识是同质体验的观点。相反，它为将发作期似曾相识作为癫痫的一种症状提供了见解，应考虑在ICD - 11的未来修订中纳入。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394239，CRD42023394239
