Journal Article

Cortisol fluctuations relate to interictal epileptiform discharges in stress sensitive epilepsy

Jolien S. van Campen, E. Lorraine Hompe, Floor E. Jansen, Demetrios N. Velis, Willem M. Otte, Fia van de Berg, Kees P. J. Braun, Gerhard H. Visser, Josemir W. Sander, Marian Joels and Maeike Zijlmans

in Brain

Published on behalf of The Guarantors of Brain

Volume 139, issue 6, pages 1673-1679
Published in print June 2016 | ISSN: 0006-8950
Published online March 2016 | e-ISSN: 1460-2156 | DOI: https://dx.doi.org/10.1093/brain/aww071
Cortisol fluctuations relate to interictal epileptiform discharges in stress sensitive epilepsy

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  • Neuropathology
  • Disorders of the Nervous System
  • Sleep Medicine

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People with epilepsy often report seizures precipitated by stress. This is believed to be due to effects of stress hormones, such as cortisol, on neuronal excitability. Cortisol, regardless of stress, is released in hourly pulses, whose effect on epileptic activity is unknown. We tested the relation between cortisol levels and the incidence of epileptiform abnormalities in the electroencephalogram of people with focal epilepsy. Morning cortisol levels were measured in saliva samples obtained every 15 min. Interictal epileptiform discharges were determined in the same time periods. We investigated the relationship between cortisol levels and the epileptiform discharges distinguishing persons with from those without stress-precipitated seizures (linear mixed model), and analysed the contribution of individual, epilepsy and recording characteristics with multivariable analysis. Twenty-nine recordings were performed in 21 individuals. Cortisol was positively related to incidence of epileptiform discharges (β = 0.26, P = 0.002) in people reporting stress-sensitive seizures, but not those who did not report stress sensitivity (β = −0.07, P = 0.64). The relationship between cortisol and epileptiform discharges was positively associated only with stress sensitivity of seizures (β = 0.31, P = 0.005). The relationship between cortisol levels and incidence of interictal epileptiform discharges in people with stress-sensitive seizures suggests that stress hormones influence disease activity in epilepsy, also under basal conditions.

Keywords: seizures; spikes; EEG; HPA-axis; ultradian

Journal Article.  4093 words.  Illustrated.

Subjects: Neuropathology ; Disorders of the Nervous System ; Sleep Medicine

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