Mukhtar Iqra
Faculty of Pharmacy, Iqra University, Karachi, Pakistan.
Prog Neuropsychopharmacol Biol Psychiatry. 2025 Jan 10;136:111135. doi: 10.1016/j.pnpbp.2024.111135. Epub 2024 Sep 3.
Epilepsy is a complex neurological disorder characterized not only by seizures but also by significant neuropsychiatric comorbidities, affecting approximately one-third of those diagnosed. This review explores the intricate relationship between epilepsy and its associated psychiatric and cognitive disturbances, with a focus on the role of inflammation. Recent definitions of epilepsy emphasize its multifaceted nature, linking it to neurobiological, psychiatric, cognitive, and social deficits. Inflammation has emerged as a critical factor influencing both seizure activity and neuropsychiatric outcomes in epilepsy patients. This paper critically examines how dysregulated inflammatory pathways disrupt neurotransmitter transmission and contribute to depression, mood disorders, and anxiety prevalent among individuals with epilepsy. It also evaluates current therapeutic approaches and underscores the potential of anti-inflammatory therapies in managing epilepsy and related neuropsychiatric conditions. Additionally, the review highlights the importance of the anti-inflammatory effects of anti-seizure medications, antidepressants, and antipsychotics and their therapeutic implications for mood disorders. Also, the role of ketogenic diet in managing epilepsy and its psychiatric comorbidities is briefly presented. Furthermore, it briefly discusses the role of the gut-brain axis in maintaining neurological health and how its dysregulation is associated with epilepsy. The review concludes that inflammation plays a pivotal role in linking epilepsy with its neuropsychiatric comorbidities, suggesting that targeted anti-inflammatory interventions may offer promising therapeutic strategies. Future research should focus on longitudinal studies comparing outcomes between epileptic patients with and without neuropsychiatric comorbidities, the development of diagnostic tools, and the exploration of novel anti-inflammatory treatments to better manage these complex interactions.
癫痫是一种复杂的神经系统疾病，其特征不仅在于癫痫发作，还在于显著的神经精神共病，约三分之一的确诊患者会受到影响。本综述探讨了癫痫与其相关的精神和认知障碍之间的复杂关系，重点关注炎症的作用。癫痫的最新定义强调了其多方面的性质，将其与神经生物学、精神、认知和社会缺陷联系起来。炎症已成为影响癫痫患者癫痫发作活动和神经精神结局的关键因素。本文批判性地研究了失调的炎症途径如何破坏神经递质传递，并导致癫痫患者中普遍存在的抑郁、情绪障碍和焦虑。它还评估了当前的治疗方法，并强调了抗炎治疗在管理癫痫和相关神经精神疾病方面的潜力。此外，综述强调了抗癫痫药物、抗抑郁药和抗精神病药物的抗炎作用及其对情绪障碍的治疗意义。此外，还简要介绍了生酮饮食在管理癫痫及其精神共病方面的作用。此外，它还简要讨论了肠脑轴在维持神经健康中的作用以及其失调与癫痫的关联。综述得出结论，炎症在将癫痫与其神经精神共病联系起来方面起着关键作用，这表明有针对性的抗炎干预可能提供有前景的治疗策略。未来的研究应侧重于比较有和没有神经精神共病的癫痫患者结局的纵向研究、诊断工具的开发以及探索新型抗炎治疗方法，以更好地管理这些复杂的相互作用。
