Link between stress and brain activation in patients with seizure

A study reported here at the 66th American Epilepsy Society Annual Meeting has identified a significant difference in the brain response to stress in patients who believe stress is an important factor in their seizure control compared to patients who do not hold this belief.

Many epilepsy patients believe that stress is a factor in their seizure control, while many other epilepsy patients do not have this perception. To better understand the potential role of stress among these patients, researchers in the Departments of Neurology and Psychiatry and Behavioral Neuroscience at the University of Cincinnati conducted a functional neuroimaging study of patients with left temporal lobe epilepsy under imposed psychosocial stress. (Abstract #1.184)

All subjects in the study were given math exercises to complete, initially simple problems during the control task and difficult problems during the stress task. Subjects were provided with positive feedback during the simple math problems and negative feedback during the difficult ones regardless of how well they were doing.

Both patient groups responded to the math exercises with similar accuracy and response times. But patients who perceived stress to be important in seizure control showed greater brain activation during the stressful compared to non-stressful conditions. The activation was seen both bilaterally (in the superior temporal gyrus, posterior cingulate and parietal areas) and unilaterally (in the left insula) in subjects who believe stress to be important in their seizure control; whereas an increase in activation was not observed in the comparison group.

According to study author Jane B. Allendorfer, Ph.D., in the Department of Neurology, University of Alabama at Birmingham (previously at the University of Cincinnati where the study was conducted), "Our study is the first to show a relationship between stress and brain activation in patients who believe stress to be a factor in seizure control compared to patients who do not have this perception. We also hypothesize that the difference in brain activation patterns may be related to why some epilepsy patients have seizures more frequently than do other patients."