Glymphatic System Activity and Brain Morphology in Patients With Psychogenic Non-epileptic Seizures

Miho Ota; Daichi Sone; Yoko Shigemoto; Yukio Kimura; Hiroshi Matsuda; Noriko Sato

doi:10.7759/cureus.53072

Glymphatic System Activity and Brain Morphology in Patients With Psychogenic Non-epileptic Seizures

Cureus. 2024 Jan 27;16(1):e53072. doi: 10.7759/cureus.53072. eCollection 2024 Jan.

Authors

Miho Ota¹, Daichi Sone², Yoko Shigemoto², Yukio Kimura², Hiroshi Matsuda², Noriko Sato²

Affiliations

¹ Neuropsychiatry, University of Tsukuba, Tsukuba, JPN.
² Radiology, National Center of Neurology and Psychiatry, Kodaira, JPN.

Abstract

Background: To clarify the neural correlates underlying psychogenic non-epileptic seizures (PNES), we compared glymphatic system activity between patients with PNES and healthy participants using diffusion tensor imaging (DTI)-analysis along the perivascular space (ALPS) method.

Methods: The DTI scans were acquired from 16 patients with PNES and 25 healthy participants. We computed the DTI-ALPS index as an index of glymphatic system function and estimated the disease-related changes in the DTI-ALPS index and brain structures in PNES patients.

Results: There were no significant differences in the DTI-ALPS index between patients with PNES and healthy participants. On the other hand, patients with PNES had decreased fractional anisotropy values in the bilateral posterior cingula, a higher mean diffusivity value around the left insula, and a lower gray matter volume in the bilateral amygdalae compared with healthy participants.

Conclusions: Patients with PNES exhibited an impairment of white matter integrity and a reduction of gray matter volume, but no glymphatic-system changes. These findings will play a significant role in our comprehension of this complex illness.

Keywords: diffusion tensor image analysis along the perivascular space; glymphatic system; magnetic resonance imaging; psychogenic non-epileptic seizures; voxel-based morphometry.

Grants and funding

This study was supported by the following funding sources: the Japan Society for the Promotion of Science (KAKENHI Grant No. JP20K08068), and Intramural Research Grants (Nos. 3-10, and 4-5) for Neurological and Psychiatric Disorders from the National Center of Neurology and Psychiatry (Japan).