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Predicting psychogenic non-epileptic seizures from serum levels of neuropeptide Y and adrenocorticotropic hormone

Published online by Cambridge University Press:  01 April 2019

Alessandro Miani Open the ORCID record for Alessandro Miani [Opens in a new window] ,
Anders Sune Pedersen ,
Charlotte Ulrikka Rask ,
Lori Uber-Zak ,
Paul J. Zak  and
Michael Winterdahl Open the ORCID record for Michael Winterdahl [Opens in a new window]
Alessandro Miani
Affiliation:
Department of Nuclear Medicine and PET Center, Aarhus University, Denmark
Anders Sune Pedersen
Affiliation:
Department of Nuclear Medicine and PET Center, Aarhus University, Denmark
Charlotte Ulrikka Rask
Affiliation:
Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Denmark
Lori Uber-Zak
Affiliation:
Department of Neurology, Loma Linda University Medical Center, Loma Linda, CA, USA
Paul J. Zak
Affiliation:
Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, USA
Michael Winterdahl*
Affiliation:
Department of Nuclear Medicine and PET Center, Aarhus University, Denmark
*
Author for correspondence: Michael Winterdahl, Associated Professor in Neuroimaging, Department of Nuclear Medicine and PET Center, Aarhus University, Nørrebrogade 44, DK-8000 Aarhus C, Denmark. Tel: (+45) 7846 3016; Fax: (+45) 7846 3020; E-mail: michael.winterdahl@clin.au.dk
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Abstract

Objective

Patients with psychogenic non-epileptic seizures (PNES) may present with convulsive events that are not accompanied by epileptiform brain activity. Video-electroencephalography (EEG) monitoring is the gold standard for diagnosis, yet not all patients experience convulsive episodes during video-EEG sessions. Hence, we aimed to construct a predictive model in order to detect PNES from serum hormone levels, detached from an evaluation of patients’ convulsive episodes.

Methods

Fifteen female patients with PNES and 60 healthy female controls participated in the study, providing blood samples for hormone analysis. A binomial logistic regression model and the leave-one-out cross-validation were employed.

Results

We found that levels of neuropeptide Y and adrenocorticotropic hormone were the optimal combination of predictors, with over 90% accuracy (area under the curve=0.980).

Conclusions

The ability to diagnose PNES irrespective of convulsive events would represent an important step considering its feasibility and affordability in daily clinical practice.

Keywords

adrenocorticotropic hormonediagnosisneuropeptide Yseizuresserum
Type
Short Communication
Information
Acta Neuropsychiatrica , Volume 31 , Issue 3 , June 2019 , pp. 167 - 171
Copyright
© Scandinavian College of Neuropsychopharmacology 2019 

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