Mood disorders in familial epilepsy: A test of shared etiology.
Mood disorders in familial epilepsy: A test of shared etiology.
复制标题
家族性癫痫的情绪障碍：共同病因学的测试。
DOI：
10.1111/epi.13985
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发表时间：
2018
期刊：
影响因子：
5.6
通讯作者：
Heiman,GaryA
中科院分区：
文献类型：
--
作者：
Insel,BeverlyJ;Ottman,Ruth;Heiman,GaryA
情绪障碍是癫痫最常见的共病，但原因尚不清楚。一种可能的解释是癫痫和情绪障碍的共同遗传易感性。我们测试了这一假设，通过评估终身患病率的情绪障碍的亲属与非癫痫在家庭中包含多个人与癫痫，并比较研究结果与率从一般人群sample.MethodsThe复合国际诊断访谈进行了管理，192个人从60个家庭，其中包括110名参与者与癫痫的原因不明（50例局灶性癫痫[FE]，42例全身性癫痫[GE]，6例FE和GE，12例无法分类）和82例无癫痫的亲属（RWOE）。通过logistic回归计算有癫痫与无癫痫的参与者中心境障碍终生患病率的比值比（OR），使用广义估计方程来解释家族聚集性。标准化患病率比（SPRs）被用来比较患病率在家庭成员与一般populationrates.ResultsCompared RWOE，OR为情绪障碍显着增加参与者FE（OR = 2.4，95%置信区间[CI] = 1.1 - 5.2），但不是在那些与GE（OR = 1.0，95%CI = 0.4 - 2.2）。此外，在有≥1个FE亲属的癫痫患者中，情绪障碍的患病率增加。与一般人群的发病率相比，情绪障碍在FE患者中显著增加，但在GE患者中没有增加。RWOE的发生率也有所增加，但并不显著（SPR = 1.4，P = .14）。这些结果与癫痫和心境障碍的共同遗传易感性假设一致，但提示（1）这种效应可能仅限于FE，（2）情绪障碍和癫痫的共同遗传效应可能仅限于癫痫个体，即对于那些癫痫的遗传风险是“渗透性的”。
ObjectiveMood disorders are the most common comorbid conditions in epilepsy, but the cause remains unclear. One possible explanation is a shared genetic susceptibility to epilepsy and mood disorders. We tested this hypothesis by evaluating lifetime prevalence of mood disorders in relatives with and without epilepsy in families containing multiple individuals with epilepsy, and comparing the findings with rates from a general population sample.MethodsThe Composite International Diagnostic Interview was administered to 192 individuals from 60 families, including 110 participants with epilepsy of unknown cause (50 focal epilepsy [FE], 42 generalized epilepsy [GE], 6 FE and GE, 12 unclassifiable) and 82 relatives without epilepsy (RWOE). Odds ratios (ORs) for lifetime prevalence of mood disorders in participants with versus without epilepsy were computed through logistic regression, using generalized estimation equations to account for familial clustering. Standardized prevalence ratios (SPRs) were used to compare prevalence in family members with general population rates.ResultsCompared with RWOE, ORs for mood disorders were significantly increased in participants with FE (OR = 2.4, 95% confidence interval [CI] = 1.1‐5.2) but not in those with GE (OR = 1.0, 95% CI = 0.4‐2.2). In addition, prevalence of mood disorders was increased in individuals with epilepsy who had ≥1 relative with FE. Compared with general population rates, mood disorders were significantly increased in individuals with FE but not in those with GE. Rates were also increased in RWOE, but not significantly so (SPR = 1.4,P= .14).SignificanceThese findings are consistent with the hypothesis of shared genetic susceptibility to epilepsy and mood disorders, but suggest (1) the effect may be restricted to FE, and (2) the shared genetic effect on risk of mood disorders and epilepsy may be restricted to individuals with epilepsy, that is, to those in whom the genetic risk for epilepsy is “penetrant.”