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Volume 25
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Article

Dissimilar Changes in Serum Cortisol after Epileptic and Psychogenic Non-Epileptic Seizures: A Promising Biomarker in the Differential Diagnosis of Paroxysmal Events?

by
Flora Rider
1,
Alexander Turchinets
1,
Tatyana Druzhkova
1,
Georgii Kustov
1,
Alla Guekht
1,2 and
Natalia Gulyaeva
1,3,*
1
Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, Moscow 107076, Russia
2
Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow 117997, Russia
3
Laboratory of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow 117485, Russia
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2024, 25(13), 7387; https://doi.org/10.3390/ijms25137387
Submission received: 18 May 2024 / Revised: 9 June 2024 / Accepted: 17 June 2024 / Published: 5 July 2024
(This article belongs to the Special Issue Molecular and Cellular Mechanisms of Epilepsy—3rd Edition)
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Abstract

The hypothalamic–pituitary–adrenal axis is known to be involved in the pathogenesis of epilepsy and psychiatric disorders. Epileptic seizures (ESs) and psychogenic non-epileptic seizures (PNESs) are frequently differentially misdiagnosed. This study aimed to evaluate changes in serum cortisol and prolactin levels after ESs and PNESs as possible differential diagnostic biomarkers. Patients over 18 years with ESs (n = 29) and PNESs with motor manifestations (n = 45), captured on video-EEG monitoring, were included. Serum cortisol and prolactin levels as well as hemograms were assessed in blood samples taken at admission, during the first hour after the seizure, and after 6, 12, and 24 h. Cortisol and prolactine response were evident in the ES group (but not the PNES group) as an acute significant increase within the first hour after seizure. The occurrence of seizures in patients with ESs and PNESs demonstrated different circadian patterns. ROC analysis confirmed the accuracy of discrimination between paroxysmal events based on cortisol response: the AUC equals 0.865, with a prediction accuracy at the cutoff point of 376.5 nmol/L 0.811 (sensitivity 86.7%, specificity 72.4%). Thus, assessments of acute serum cortisol response to a paroxysmal event may be regarded as a simple, fast, and minimally invasive laboratory test contributing to differential diagnosis of ESs and PNESs.
Keywords: epilepsy; epileptic seizures (ESs); psychogenic non-epileptic seizures (PNESs); hypothalamic–pituitary–adrenal (HPA) axis; cortisol; prolactin; lymphocytes epilepsy; epileptic seizures (ESs); psychogenic non-epileptic seizures (PNESs); hypothalamic–pituitary–adrenal (HPA) axis; cortisol; prolactin; lymphocytes

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MDPI and ACS Style

Rider, F.; Turchinets, A.; Druzhkova, T.; Kustov, G.; Guekht, A.; Gulyaeva, N. Dissimilar Changes in Serum Cortisol after Epileptic and Psychogenic Non-Epileptic Seizures: A Promising Biomarker in the Differential Diagnosis of Paroxysmal Events? Int. J. Mol. Sci. 2024, 25, 7387. https://doi.org/10.3390/ijms25137387

AMA Style

Rider F, Turchinets A, Druzhkova T, Kustov G, Guekht A, Gulyaeva N. Dissimilar Changes in Serum Cortisol after Epileptic and Psychogenic Non-Epileptic Seizures: A Promising Biomarker in the Differential Diagnosis of Paroxysmal Events? International Journal of Molecular Sciences. 2024; 25(13):7387. https://doi.org/10.3390/ijms25137387

Chicago/Turabian Style

Rider, Flora, Alexander Turchinets, Tatyana Druzhkova, Georgii Kustov, Alla Guekht, and Natalia Gulyaeva. 2024. "Dissimilar Changes in Serum Cortisol after Epileptic and Psychogenic Non-Epileptic Seizures: A Promising Biomarker in the Differential Diagnosis of Paroxysmal Events?" International Journal of Molecular Sciences 25, no. 13: 7387. https://doi.org/10.3390/ijms25137387

APA Style

Rider, F., Turchinets, A., Druzhkova, T., Kustov, G., Guekht, A., & Gulyaeva, N. (2024). Dissimilar Changes in Serum Cortisol after Epileptic and Psychogenic Non-Epileptic Seizures: A Promising Biomarker in the Differential Diagnosis of Paroxysmal Events? International Journal of Molecular Sciences, 25(13), 7387. https://doi.org/10.3390/ijms25137387

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