Prochaska Trinidi, Zeleke Helena, Minton Sean T, Powers Abigail, Michopoulos Vasiliki, Willie Jon T, Drane Daniel L, Jovanovic Tanja, van Rooij Sanne J H
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Neuroscience Graduate Program, Emory University, Atlanta, Georgia, USA.
Chronic Stress (Thousand Oaks). 2025 Mar 26;9:24705470251321953. doi: 10.1177/24705470251321953. eCollection 2025 Jan-Dec.
Depression, posttraumatic stress disorder (PTSD), and suicidality are more prevalent among people with seizures, but few studies exist in low-resourced minoritized populations. Existing knowledge of the overlapping neurocircuitry between seizure activity in limbic regions (eg, medial temporal lobe epilepsy) and PTSD also suggests that people with seizure histories may exhibit PTSD-like alterations in their fear-potentiated startle (FPS) responses. However, this hypothesis has yet to be systematically tested. Here, we leveraged a large study on stress and trauma to evaluate the prevalence of psychiatric conditions and FPS responses in a low-resourced minoritized population of individuals with a history of seizures.
Prevalence of self-reported PTSD symptoms, depression symptoms, suicidality, and history of suicide attempt were compared between people with and without self-reported seizures among a sample of 3012 predominantly racially marginalized and low-resourced civilians. We compared FPS responses in 13 people with a history of seizures to 13 rigorously matched seizure-free controls. FPS responses were measured using eyeblink data collected during a fear conditioning acoustic startle task.
Participants with a history of seizures showed significantly higher prevalence of depression symptoms, suicidality, history of suicide attempt, PTSD symptoms, and probable PTSD diagnosis than seizure-free controls, even after controlling for trauma load. Those with a history of seizures displayed heightened FPS responses and impaired fear discrimination which mimics that of PTSD.
These data concur with prior literature on people with a history of seizure activity being at higher risk for psychiatric symptomatology. Additionally, this study provides novel insights on the psychophysiological fear response in trauma-exposed people with a history of seizures, which could inform the identification and treatment of psychiatric vulnerability in these individuals.
抑郁症、创伤后应激障碍（PTSD）和自杀倾向在癫痫患者中更为普遍，但针对资源匮乏的少数族裔人群的研究较少。关于边缘区域癫痫活动（如内侧颞叶癫痫）与PTSD之间重叠神经回路的现有知识也表明，有癫痫病史的人在恐惧增强惊吓（FPS）反应中可能表现出类似PTSD的改变。然而，这一假设尚未得到系统验证。在此，我们利用一项关于压力和创伤的大型研究，评估有癫痫病史的资源匮乏少数族裔人群中精神疾病的患病率和FPS反应。
在3012名主要为种族边缘化且资源匮乏的平民样本中，比较了自我报告有癫痫发作和无癫痫发作的人群中自我报告的PTSD症状、抑郁症状、自杀倾向和自杀未遂史的患病率。我们将13名有癫痫病史的人与13名严格匹配的无癫痫发作对照者的FPS反应进行了比较。使用在恐惧条件性听觉惊吓任务中收集的眨眼数据来测量FPS反应。
即使在控制了创伤负荷之后，有癫痫病史的参与者在抑郁症状、自杀倾向、自杀未遂史、PTSD症状和可能的PTSD诊断方面的患病率显著高于无癫痫发作的对照者。有癫痫病史的人表现出增强的FPS反应和受损的恐惧辨别能力，这与PTSD患者相似。
这些数据与先前关于有癫痫发作史的人患精神症状风险更高的文献一致。此外，本研究为有癫痫病史的创伤暴露人群的心理生理恐惧反应提供了新的见解，这可为识别和治疗这些个体的精神易损性提供依据。
