Psychogenic Non-epileptic Seizures
Conditions
Brief summary
Currently, hypothetical models of understanding Psychogenic Non-epileptic Seizures (PNES) involve emotional dysregulation. The hypothesis of a disorder of emotional experience is mainly based on behavioral data and disturbance of autonomic responses in response to images in emotional content (Mignot et al 2015, in submission; Bakvis et al 2013). Various imaging studies have identified brain structures belonging to the limbic system in particular that seem functionally impaired in this population. These functional connectivity abnormalities are correlated with dissociation scores in PNES patients (Van der Kruijs et al 2012 and 2014). Investigators propose to specifically study the brain activity of PNES patients during tasks emotional content to identify the mechanisms involved in this emotional dysregulation. This work is essential to understanding the mechanisms and the development of new therapeutic strategies
Interventions
fMRI examination
BEHAVIORALpsychiatric evaluation
psychiatric evaluation
Sponsors
Central Hospital, Nancy, France
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Common Inclusion Criteria: * Female, * Right-handed * Affiliation to the French social security system, * Informed signing of the study consent. Specific Inclusion Criteria for PNES group : * PNES diagnosed by a neurologist specialized in epilepsy, based on clinical symptoms analysis and video-EEG recording, * Absence of concomitant epilepsy. Specific Inclusion Criteria for PTSD group : PTSD diagnosed by a psychiatrist, based on clinical symptoms as recorded in DSM5 (Diagnostic and Statistical Manual of Mental Disorders). Specific Inclusion Criteria for healthy controls : Healthy controls will be paired up with patients on age and level of schooling criteria.
Exclusion criteria
common criteria for all groups: * Neurological history or comorbidity (epilepsy included), * Current neurological treatment, * Posology change or introduction of psychoactive treatment dating back to less than a month, * Psychotic comorbidity (schizophrenia), * Addiction history apart for smoking, * History of head trauma, * Mental retardation, * Being the subject of articles L.1121-5 to L.1121-8 and L1122-1-2 of the French Code of Public Health (i.e. being a not responsible adult), * Lack of French language proficiency or inability to understand instructions, * Uncorrected visual impairment, * Any contraindication to MRI (pacemaker, ferromagnetic foreign body, claustrophobia, etc.). Specific
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Brain activity | 6 months after the last inclusion | To compare brain activity during emotional tasks in fMRI (Blood-Oxygen-Level-Dependent contrast sequences) between: patients suffering from PNES, patients suffering from PTSD and healthy controls, with age and education level matching. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Valence and intensity of the emotional images | 6 months after the last inclusion | To compare subjective experience rating across the three groups, during emotional pictures watching task; |
| Cerebral functional connectivity | 6 months after the last inclusion | To compare differences of cerebral functional connectivity (main physiological brain networks) in resting state fMRI across the tree groups |
| Dissociative Experience Scale (DES) questionnaire score and Toronto Alexithymia Scale (TAS20) questionnaire score | 6 months after the last inclusion | To study the correlation between cerebral activity and level of dissociation (DES) and alexithymia (TAS20) in PNES and PTSD groups |
Countries
France
Outcome results
None listed