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New imagery markers for the diagnosis of psychogenic non epileptic seizures: Presentation of the first results of the EMOCRISES study

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Background Psychogenic non epileptic seizures (PNES) are paroxysmal events which look like epileptic seizures without paroxysmal neuronal activity. Actually, pathophysiology model of PNES, conceived from epidemiologic and pathopsychological data, have… Click to show full abstract

Background Psychogenic non epileptic seizures (PNES) are paroxysmal events which look like epileptic seizures without paroxysmal neuronal activity. Actually, pathophysiology model of PNES, conceived from epidemiologic and pathopsychological data, have shown a crucial role of dissociation and emotional processing in genesis and sustainability of PNES. Objectives To investigate the cerebral emotional processing in patients with PNES versus patients with post-traumatic stress disorder (PTSD) and healthy controls (HC). We hypothesize patients with PNES have different emotional processing, especially an hyperactivation of limbic system and hypoactivation of motor and executive control versus patient with PTSD and HC. We also supposed that we will find an hyperconnectivity between areas engaged in emotional processing (insula, limbic system) and motor and executive control in PNES versus PTSD and HC. Methods In the EMOCRISES study, we recruited three groups of subjects: women with PNES, women with PTSD, and HC. On Siemens 3 T MRI (Prisma), these subjects realized a resting-state task and four emotional paradigms: an event-related paradigm, a blocked-related paradigm ant two fast periodic visual stimulations. For pre-processing, we use SPM12 software and PhysIO toolbox (TAPAS) for emotional paradigm, and Connectivity toolbox for resting-state. Results were visualized with Anatomist from BrainVisa. Results We present the first results of resting-state and blocked-paradigm between HC and patients with PNES. Conclusion If our hypotheses are confirmed, we could use these results to better diagnose PNES and, maybe, find new therapeutic targets for transcranial magnetic stimulation.

Keywords: psychogenic non; first results; emocrises study; non epileptic; epileptic seizures; emotional processing

Journal Title: Neurophysiologie Clinique
Year Published: 2019

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