How Does Stress Increase Seizure Frequency In Epileptics?

It is well-known that people with a diagnosis of epilepsy have to face many challenges on an everyday basis. Among the various problems these people face, the most challenging is the unpredictable nature of this condition. There is no definite rule as to when an episode of seizure or epilepsy might occur. However, researchers have identified some of triggers that may invoke an abnormal activity in the neurons in the brain resulting in the person having an episode of seizure. Among these triggers, stress is believed to be the most common. There have been several studies done which state that people who mark stress as a major precipitant for a seizure episode tend to have a history of anxiety, depression, and childhood trauma when compared to epileptics who do not mark stress as a precipitating factor for an episode.[1,2,3]

A survey done on this topic has showed that most of the people with stress induced seizure had tried at least some form of stress reduction technique on their own and had seen improvement in the frequency of their episodes. In addition to that, there have been several small to moderate sized randomized clinical trials that utilized general stress reduction techniques and showed a great deal of promise in improving the outcomes of people with diagnosed epilepsy even though the results of some of these studies have not be consistent.[1,2,3]

Based on the results of the studies, researchers recommend that whenever physicians encounter a patient with epilepsy and report stress as a potential trigger such patients should be checked for an underlying mood disorder as well. Although there is no concrete evidence of a decreased seizure frequency with stress reduction techniques observed in many clinical trials, one thing that has been proven beyond doubts is a significant improvement in the quality of life of the patient.[1,2,3]

This makes the researchers believe that stress reduction techniques in a patient with epilepsy looks like a good add-on to the current standard treatments of this condition to improve the quality of life of the patient.[1,2,3] The article below highlights the role of stress in increasing the frequency of seizures in epilepsy patients.

How Does Stress Increase Seizure Frequency In Epileptics?

We all know that stress is a major precipitant in increasing the seizure frequency in epileptics. Researchers have now come up with a reason as to why this happens and in fact they have even found novel ways to prevent it. A new study published in the journal Science Signaling reveals how the abnormalities in the brain seen in people with epilepsy changes the way the brain reacts to increased stress resulting in increased frequency of seizures.[3]

Epilepsy is a pathological condition in which there is abnormality in electrical activity in the brain which results in a person having a seizure. The Epilepsy Foundation data estimates that around 3 million people in the United States have epilepsy and furthermore around 50 per 100,000 people develop it every year. It has been well-established that stress and anxiety are both common triggers of seizures in epileptics. Various clinical trials as mentioned above have shown that stress reduction techniques significantly improves the quality of life of a person with epilepsy and also decreases the risk of having a seizure [3].

While it is a common practice for neurologists to recommend epilepsy patients to avoid any stressful situations, there are many instances where this is not possible. This has prompted researchers to explore alternative options to decrease seizure frequency in epileptics in a stressful environment. Till now, researchers were not clear as to how stress triggered a seizure episode and so treatment for it was not available.[3]

However, now Michael Poulter, Ph.D., of the University of Western Ontario in Canada and his team of researchers have come very close to understanding the reason behind stress causing seizures in epilepsy patients. For their study, a mouse model was used and the researchers focused on activity of corticotropic releasing factor or CRF in the brains of rats without epilepsy. The corticotropin releasing factor or CRF is a neurotransmitter that triggers a behavioral response to stress.[3]

The researchers focused on how the CRF affected the piriform cortex which is the area of the brain that causes seizures in humans with epilepsy. The researchers observed that in rodents who did not have epilepsy the CRF reduced the activity in the piriform cortex. However, in rodents with epilepsy they found that the CRF increased activity in the piriform cortex. This prompted the researchers to explore the reason as to why this was happening.[3]

On further investigations, it was found that CRF altered the neuronal signalling in the brain of the rodents with epilepsy. They found that the CRF activated a protein called regulator of G protein signalling protein type 2 that changed the way the nerve communicated with each other in the piriform cortex thereby increasing seizure frequency.

The researchers concluded that if the CRF or the corticotropic releasing factor was blocked then it may be possible to prevent seizure occurrence in people with epilepsy under stressful situations.[3]

The researchers are also optimistic that their findings may have a bearing on the treatment for other neurological disorders like depression and schizophrenia, as these conditions might increase neurochemical activity that increase the severity of the symptoms.[3]

In conclusion, it is well-known that stress is a common trigger for seizures in people with epilepsy. However, till now it was not known as to why this happened. This was cleared by the research conducted using a mouse model where the activity of the corticotropin releasing factor or CRF in the piriform cortex, which is a neurotransmitter that triggers a behavioral response to stress, of the brain was analyzed closely by researchers.[3]

It showed that while in rats that did not have epilepsy, the CRF decreased the activity in the piriform cortex, while in rats with epilepsy it had the complete opposite effect and caused increased activity in the piriform cortex of the brain. It should be noted that seizures in epilepsy patients are caused due to abnormality in the piriform cortex of the brain.[3]

It was seen that there was clear change in the way the nerve cells communicated in rats with epilepsy due to CRF that activated certain proteins in the brain. The researchers concluded that if the CRF was blocked from the piriform cortex in people with epilepsy then it may help decrease the frequency of seizures in people with epilepsy.[3]

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