Informations générales (source: ClinicalTrials.gov)
Depression, Stress and Vulnerability Factors in Drug Resistant Focal Epilepsies
Interventional
N/A
Assistance Publique Hopitaux De Marseille (Voir sur ClinicalTrials)
février 2017
février 2021
29 juin 2024
Psychiatric disturbances, notably depression, occur frequently as co-morbid conditions
with epilepsy. A complex, probably bidirectional relationship between epilepsy and
depression has been postulated. Both epilepsy and depression also interact with stressful
life events, but only some patients develop these disorders after a stressful event,
indicating the possibility of a "vulnerable" population. Animal and human studies have
looked at the role of brain derived neurotrophic factor (BDNF) in this context. Low serum
and/or CSF levels of BDNF are associated with higher incidence of depression, and thus
indicate the vulnerable population.
Animal studies of BDNF have looked specifically at the relation between epilepsy and
depression using a novel "double hit" design. After chronic stress exposure, measurement
of BDNF levels allowed identification of 2 sub-groups: a vulnerable population and
non-vulnerable population. A "second hit" of kainic acid induced status epilepticus (SE)
was then applied to both the vulnerable and non-vulnerable populations. Only the
vulnerable population exposed to SE developed a depression-like profile.
In a proof of concept approach we propose studying the relation between epilepsy,
depression, anxiety and stressful life events, using serum BDNF levels in patients with
pharmacoresistant epilepsy. Evaluation of epilepsy type and co-morbid psychiatric profile
will be performed in 150 subjects. By comparing BDNF levels for different epilepsy
subgroups to BDNF levels for healthy subjects and for depressed subjects without
epilepsy, we hope to identify whether risk of co-morbid depression and/or anxiety in
epilepsy may be predicted using BDNF levels. In addition, in a subgroup of 25 patients,
we propose a pilot study in which cortisol and C-reactive protein will be measured in
addition to BDNF.
Etablissements
| Les établissements hors Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Assistance Publique Hôpitaux de Marseille - 13354 - Marseille - France | Aïleen Mc Gonigal, MD | Contact (sur clinicalTrials) | |||
| Chu Tours - Tours - France | Bertrand DE TOFFOL, MD/PhD | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- Definite diagnosis of epilepsy, of any type (partial or generalised) and at any
stage from diagnosis onwards
- Known or unknown etiology (symptomatic or cryptogenic epilepsy)
- Definite diagnosis of epilepsy, of any type (partial or generalised) and at any
stage from diagnosis onwards
- Known or unknown etiology (symptomatic or cryptogenic epilepsy)
- Psychogenic non-epileptic seizures
- Psychotic disorders and bipolar disorders