Effects Of External Emotional On Brain Electrical Activity In Patients With Idiopathic Epilepsy Comorbidity With Depression

Background: Epilepsy is a common chronic disorder of the central nervoussystem. Epilepsy co-morbidity with depression has long been concerned by psychiatrist.The prevalence of depression in epilepsy ranges between10%-20%in patients withcontrolled epilepsy, and20%-60%in those with uncontrolled epilepsy. It is muchmore possible for people who have past history of depression to get epilepsy4-6foldedthan normal ones. Diagnosis, treatment and prevention of epilepsy comorbidity withdepression are of significance to parents’ psychological, physiological, and living statusdue to the severe effect to patients’ quality of life by the two diseases. Previous studiessuggested negative correlation between the duration of seizures and depression severity.Thus, we suspect that negative event as a stimulus may trigger or deteriorate seizureattack in patients suffered from epilepsy comorbidity with depression. To date, effectsof negative stimulation on brain electrical activity in patients with epilepsy anddepression remains unclear.Objective: To explorer electroencephalogram (EEG) changes in patients withidiopathic epilepsy and depression after stimulation with negative facial expressions,providing useful information for the diagnosis and treatment of idiopathic epilepsycomorbidity with depression.Methods:15patients with idiopathic epilepsy comorbidity with depression,6patients with idiopathic epilepsy not combined with depression, and8healthy subjectswere enrolled in the present study. We carried out a survey on their quality of life usingChinese version of Quality of life in Epilepsy Inventory (QOLIE-31) among threegroups. Neutral, positive and negative stimuli of facial expression were given to allsubjects, and changes in EEG was recorded then compared among them. Results: There was a significant positive correlation between frequency of seizureand HAMD scores (r=0.610, P=0.003). Compared with normal controls or patientswith epilepsy, patients with idiopathic epilepsy and depression showed a markeddecrease in QOLIE-31scores (P <0.05, respectively). The number of EEG slow waveincreased significantly in patients suffered from epilepsy comorbidity with or withoutdepression compared with normal controls (P<0.05, respectively). Additionally, asignificant positive correlation between numbers of slow wave and HAMD scores wasobserved （r=0.479，P=0.044）. There was no significant change in numbers of slowwave upon three types of facial expression stimuli either in normal controls or inpatients with epilepsy not combined with depression. Nevertheless, compared withneutral facial expression stimulation, negative stimulation induced a marked increase innumbers of slow wave in patients with epilepsy and depression (P <0.05).Conclusion: Increased numbers of slow wave in patients with idiopathic epilepsyand depression may result in reduction of seizure threshold, which is associated withhigh risk of seizure attack. Early detection and treatment of patients with idiopathicepilepsy and depression is therefore crucial. Numbers of slow wave upon negative facialexpression stimulation were much more than those upon neutral stimulation in patientswith idiopathic epilepsy and depression, suggesting that negative stimuli may triggereven deteriorate seizure attack. Appropriate instruction of daily life for these patientsmay be useful in reduction of seizure attack and improvement of quality of life.