Stress regulation in drug-resistant epilepsy

Iliana Kotwas, Aileen McGonigal, Mireille Bastien-Toniazzo, Fabrice Bartolomei, Jean-Arthur Micoulaud-Franchi
Epilepsy & Behavior. 2017-06-01; 71: 39-50
DOI: 10.1016/j.yebeh.2017.01.025

PubMed
Read on PubMed



1. Epilepsy Behav. 2017 Jun;71(Pt A):39-50. doi: 10.1016/j.yebeh.2017.01.025. Epub
2017 May 8.

Stress regulation in drug-resistant epilepsy.

Kotwas I(1), McGonigal A(2), Bastien-Toniazzo M(3), Bartolomei F(2),
Micoulaud-Franchi JA(4).

Author information:
(1)Laboratoire Parole et Langage UMR 7309, Aix-Marseille Université, Marseille,
France. Electronic address: .
(2)Service de Neurophysiologie Clinique, Centre Hospitalo Universitaire de la
Timone, 264, rue Saint-Pierre, 13005 Marseille, France; Unité mixte INSERM
Epilepsie et Cognition UMR 751, 27 Bd Jean Moulin, 13385 Marseille Cedex 05,
France.
(3)Laboratoire Parole et Langage UMR 7309, Aix-Marseille Université, Marseille,
France.
(4)Service d’explorations fonctionnelles du système nerveux, Clinique du sommeil,
CHU de, Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France; USR CNRS 3413
SANPSY, CHU Pellegrin, Université de Bordeaux, France.

The prevalence of psychological distress, especially depressive and anxiety
disorders, is higher in epilepsy than in other chronic health conditions. These
comorbid conditions contribute even more than epileptic seizures themselves to
impaired quality of life in patients with epilepsy (PWE). The link between these
comorbidities and epilepsy appears to have a neurobiological basis, which is at
least partly mediated by stress through psychological and pathophysiological
pathways. The impact of stress in PWE is also particularly important because it
is the most frequently reported seizure trigger. It is therefore crucial for
clinicians to take stress-related conditions and psychiatric comorbidities into
account when managing PWE and to propose clinical support to enhance self-control
of stress. Screening tools have been specially designed and validated in PWE for
depressive disorders and anxiety disorders (e.g. NDDI-E, GAD-7). Other
instruments are useful for measuring stress-related variables (e.g. SRRS, PSS,
SCS, MHLCS, DSR-15, ERP-R, QOLIE-31) in order to help characterize the individual
“stress profile” and thus orientate patients towards the most appropriate
treatment. Management includes both pharmacological treatment and
nonpharmacological methods for enhancing self-management of stress (e.g.
mindfulness-based therapies, yoga, cognitive-behavioral therapies, biofeedback),
which may not only protect against psychiatric comorbidities but also reduce
seizure frequency.

Copyright © 2017 Elsevier Inc. All rights reserved.

DOI: 10.1016/j.yebeh.2017.01.025
PMID: 28494323 [Indexed for MEDLINE]

Know more about