scholarly journals Functional MRI-based study of emotional experience in patients with psychogenic non-epileptic seizures: Protocol for an observational case-control study–EMOCRISES study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262216
Author(s):  
Pierre Fauvé ◽  
Louise Tyvaert ◽  
Cyril Husson ◽  
Emmanuelle Hologne ◽  
Xiaoqing Gao ◽  
...  
Keyword(s):  
Resting State ◽  
Visual Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Emotional Experience ◽  
Brain Mri ◽  
Epileptic Seizures ◽  
Healthy Controls ◽  
Post Traumatic Stress ◽  
Functional Brain ◽  
Post Traumatic

Background Psychogenic non epileptic seizures (PNES) are a frequent, disabling and costly disorder for which there is no consensual caring. They are considered as a dissociative disorder and they share many common characteristics with post-traumatic stress disorder (PTSD). Nevertheless, their pathophysiology is still unclear. In this study, we plan to obtain new data comparing functional brain activity of participants suffering from PNES, from PTSD and healthy controls via functional brain MRI during resting state and under emotional visual stimulation. The protocol presented hereunder describes an observational study with no direct treatment implication. Nevertheless, it could lead to a better understanding of PNES and to identifying targets for specialised cares of post-traumatic or dissociative disorders, like repetitive transcranial magnetic stimulation. Methods & analysis This is a prospective, single-centre, interventional, non-randomized, open, controlled and exploratory clinical study. It will involve 75 adult French, right-handed women in 3 groups, either suffering from PNES or PTSD, or healthy controls. An informed consent will be signed by each participant. All of them will be given psychiatric tests to assess dissociation and alexithymia, psychopathological profile and history, and emotional recognition. Each participant will undergo a functional brain MRI. We will record anatomical images and five functional imaging sequences including emotional periodic oscillatory stimulation, standard emotional stimulation, Go / No Go task under emotional stimulation, and resting state. Analysis will include a descriptive analysis of all participants and the treatment for functional magnetic resonance imaging images of each sequence. Registration, ethics & dissemination This study was approved the regional Protection of Persons Committee under the reference 16.10.01 and by the French National Medical Security Agency under the reference 2016-A01295-46. The protocol and results will be published in peer-reviewed academic medical journals and disseminated to research teams, databases, specialised media and concerned patients’ organisations.

Impact of comorbid post traumatic stress disorder on multiple sclerosis in military veterans: A population-based cohort study

2021 ◽  
pp. 135245852110583
Author(s):  
Mark Leekoff ◽  
William Culpepper ◽  
Shan Jin ◽  
Terry Lee-Wilk ◽  
Mitchell Wallin
Keyword(s):  
Multiple Sclerosis ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Military Veterans ◽  
Brain Mri ◽  
Population Based ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Impact

Background: Very little is known regarding the impact of post traumatic stress disorder (PTSD) on the course of multiple sclerosis (MS). Objectives: To explore the impact of pre-existing PTSD on MS relapses, magnetic resonance imaging (MRI) activity, and disability in a large population-based cohort. Methods: Military Veterans with MS and PTSD prior to symptom onset (MSPTSD, n = 96) were identified using the Department of Veterans Affairs MS databases. MSPTSD cases were matched to MS controls without PTSD ( n = 95). Number of relapses, number of new T2 lesions and new gadolinium lesions on brain MRI, and neurological disability were abstracted between 2015 and 2019. Results: The mean annualized relapse rate was greater in the MSPTSD group versus controls (0.23 vs 0.06, respectively; p < 0.05), as was the annualized mean number of new T2 and gadolinium-enhancing lesions on brain MRI (0.52 vs 0.16 and 0.29 vs 0.08, respectively; p < 0.05). Disability accrual (time to Disability Status Scale 6.0) was more rapid (23.7 vs 29.5 years, p < 0.05) in relapsing MS patients with PTSD. Conclusion: Patients with MSPTSD have higher disease activity and reach disability endpoints more rapidly than controls. This is the first study to show PTSD as a potentially modifiable risk factor for MS relapses, MRI activity, and disability.

Functional Wounds of an Invisible Injury

2020 ◽  
pp. 347-358
Author(s):  
Benjamin T. Dunkley ◽  
Margot J. Taylor
Keyword(s):  
Resting State ◽  
Psychological Injury ◽  
Threat Perception ◽  
Post Traumatic Stress ◽  
Ventral Medial Prefrontal Cortex ◽  
Behavioral Dysfunction ◽  
Oscillatory Power ◽  
Post Traumatic ◽  
Analytical Approaches ◽  
The Brain

In this chapter we review magnetoencephalography (MEG) studies of post-traumatic stress disorder (PTSD). The work reviewed spans multiple analytical approaches, including task-evoked and induced studies, primarily examining cognitive and behavioral dysfunction in the disorder, as well as resting-state studies of regional oscillatory power and synchrony. Disordered memory, elevated threat perception, and dysfunctional emotional control are primary symptoms of PTSD, but there are also secondary “knock-on” effects to cognition and executive functioning that can be debilitating. MEG approaches have proved to be a powerful way to examine maladaptive neural circuits underlying these deficits in PTSD, particularly the brain networks involving the hippocampi, amygdalae, and ventral medial prefrontal cortex. Finally, the authors briefly discuss these findings in relation to mild traumatic brain injury, a physical as opposed to psychological injury that can nevertheless leave mental wounds that exhibit a similar presentation to PTSD, and how MEG can be used to tease apart these different types of trauma.

Therapist with PNES, USA

2020 ◽  
pp. 282-286
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Mental Health ◽  
Private Practice ◽  
Epileptic Seizures ◽  
Mental Health Disorders ◽  
Health Conditions ◽  
Post Traumatic Stress ◽  
The World ◽  
Post Traumatic ◽  
Health Disorders ◽  
Anxiety Depression

This chapter examines the personal experience of a Therapist with Psychogenic Non-Epileptic Seizures (PNES). As a Therapist in private practice, the Therapist strongly believed that to end the stigma of mental health conditions, she needed to own her own mental health disorders. The Therapist could not sit across from her clients every day and tell them not to be ashamed of their debilitating Anxiety, Depression, or Post-Traumatic Stress Disorder (PTSD) and yet hide her own mental illness from the world. As such, the therapist spoke openly on social media about mental health and her own journey, and the Therapist shared positive messages about the disorders she treated—that is, until the therapist’s own experience crossed over from the garden variety “Anxiety and Depression” that she saw every day into a much less widely known disorder, PNES. Then, the Therapist became less of a Therapist and more of a patient, trying to maintain some sort of sanity and perspective afforded to her from her years of training as a therapist.

Neurologist, 1 year’s experience, USA

2020 ◽  
pp. 278-281
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Epileptic Seizures ◽  
Severe Malnutrition ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Behavioral Healthcare ◽  
Post Traumatic ◽  
Children And Young Adults ◽  
Chronic Nausea

This chapter discusses how a neurologist started a Psychogenic Non-Epileptic Seizures (PNES) clinic. As an Epileptologist, the Neurologist would be best equipped to care for children and young adults who present with non-epileptic seizures. Patients with PNES often fall through the cracks because their condition lies between the land of Psychiatry and Neurology. The Neurologist hoped to serve patients with PNES who were lost in the gap between traditional Neurology and behavioral healthcare. Six months after its inception, a patient came to the newly established PNES clinic. The Neurologist learned from the chart review that the patient had been in inpatient Psychiatry care on more than one occasion several years prior. She had been treated for Depression and Post-Traumatic Stress Disorder (PTSD) from repeated sexual and verbal abuse from a family member. Her somatic symptom–related disorder developed shortly after discharge from her first psychiatric inpatient care several years ago, which manifested as chest pain, dizziness, fainting, chronic nausea, chronic abdominal pain, eating disorder, severe malnutrition, headache, weakness, and PNES. The chapter then argues that each patient in the PNES clinic brings unique challenges that require a creative and individualized solution.

scholarly journals Neuromodulation Strategies in Post-Traumatic Stress Disorder: From Preclinical Models to Clinical Applications

2019 ◽  
Vol 9 (2) ◽  
pp. 45 ◽  
Author(s):  
Flavia Gouveia ◽  
Darryl Gidyk ◽  
Peter Giacobbe ◽  
Enoch Ng ◽  
Ying Meng ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Post Traumatic Stress ◽  
Adequate Response ◽  
Lifetime Prevalence Rate ◽  
Post Traumatic ◽  
Fear And Anxiety ◽  
Deep Brain

Post-traumatic stress disorder (PTSD) is an often debilitating disease with a lifetime prevalence rate between 5–8%. In war veterans, these numbers are even higher, reaching approximately 10% to 25%. Although most patients benefit from the use of medications and psychotherapy, approximately 20% to 30% do not have an adequate response to conventional treatments. Neuromodulation strategies have been investigated for various psychiatric disorders with promising results, and may represent an important treatment option for individuals with difficult-to-treat forms of PTSD. We review the relevant neurocircuitry and preclinical stimulation studies in models of fear and anxiety, as well as clinical data on the use of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and deep brain stimulation (DBS) for the treatment of PTSD.

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