Evaluation of cortical magnetic resonance morphometry in patients with Psychogenic Nonepileptic Seizures

• Grant number: 23/02078-9
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): April 01, 2023
• Effective date (End): March 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Cendes
• Grantee: Lucas Gabriel Alves Figueiredo
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Associated research grant: 13/07559-3 - BRAINN - The Brazilian Institute of Neuroscience and Neurotechnology, AP.CEPID

Abstract

Psychogenic Non-Epileptic Seizures (PNES) are episodes of changes in consciousness and subjective experience accompanied by involuntary movements and reduced self-control. Due to the similarity, patients with PNES are often misdiagnosed and treated as if they had epilepsy, thus configuring iatrogenic measures. Furthermore, in addition to the difficulty of differentiating PNES from epilepsy, it is important to consider that there are patients who simultaneously present these two diseases. Despite being the subject of many studies over the past decade, the mechanisms underlying PNES remain unclear due to the complexity of this disease, and there are still doubts regarding the origins and neurological consequences of PNES. One of the approaches to try to better understand this pathology was through neuroimaging. Therefore, in recent years, there has been a significant increase in studies in the literature focusing on neuroimaging of PNES. Recent studies have pointed out that people with PNES have structural abnormalities on routine magnetic resonance imaging. However, the quality of available PNES-specific studies is generally low, with few examining neuropsychiatric findings in conjunction with neuroimaging findings. Objectives: to evaluate, by means of magnetic resonance imaging, the cortical morphometry - thickness, cortical surface area, gyrification and volume of subcortical structures - of patients with PNES and/or with epilepsy. Thus, the objective is to analyze whether there are changes and specific patterns of each of these diseases that collaborate to distinguish and identify them with greater precision. Subjects and methods: the medical records of a total of 100 patients will be reviewed, who will be divided into four groups. There will be three groups with 20 patients each and a control group with 40 individuals. The three groups of 20 patients will be separated according to the following criteria: patients with PNES only, patients with epilepsy only and patients with PNES and epilepsy. The selected epilepsy cases will be mesial temporal lobe epilepsy (MTLE). Patient data will be used anonymously. At no time will isolated information that can identify patients be used. All patients and controls signed an informed consent form approved by the Research Ethics Committee (REC) of UNICAMP. The data obtained will be tabulated, and the differences in proportion will be analyzed with Fisher's or Chi-Square test. Correlations will be made using the Pearson or Spearman correlation test, according to the characteristics of the variables (parametric or non-parametric).