Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence
Introduction: The complex relationship between the microbiota-gut-brain axis (MGBA) and epilepsy has been increasingly investigated in preclinical studies. Conversely, evidence from clinical studies is still scarce. In recent years, the pivotal role of MGBA dysregulation in the pathophysiology of fu...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.705126/full |
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| author | Federica Avorio Federica Avorio Emanuele Cerulli Irelli Alessandra Morano Martina Fanella Biagio Orlando Mariarita Albini Luca M. Basili Gabriele Ruffolo Jinane Fattouch Mario Manfredi Emilio Russo Pasquale Striano Marilia Carabotti Anna T. Giallonardo Carola Severi Carlo Di Bonaventura |
| author_facet | Federica Avorio Federica Avorio Emanuele Cerulli Irelli Alessandra Morano Martina Fanella Biagio Orlando Mariarita Albini Luca M. Basili Gabriele Ruffolo Jinane Fattouch Mario Manfredi Emilio Russo Pasquale Striano Marilia Carabotti Anna T. Giallonardo Carola Severi Carlo Di Bonaventura |
| author_sort | Federica Avorio |
| collection | DOAJ |
| description | Introduction: The complex relationship between the microbiota-gut-brain axis (MGBA) and epilepsy has been increasingly investigated in preclinical studies. Conversely, evidence from clinical studies is still scarce. In recent years, the pivotal role of MGBA dysregulation in the pathophysiology of functional gastrointestinal disorders (FGID) has been recognized. With this background, we aimed to investigate the prevalence of FGID in patients with epilepsy (PWE) and the possible impact of bowel movement abnormalities on seizure recurrence.Methods: A total of 120 PWE and 113 age-, sex-, and BMI-matched healthy subjects (HS) were consecutively enrolled. A questionnaire to evaluate the presence of FGID (according to Rome III diagnostic criteria) was administrated to all participants. In a subgroup of drug-resistant patients, we administered an ad-hoc questionnaire combining Bristol stool charts and seizure diaries to evaluate seizure trends and bowel movement changes.Results: A higher prevalence of FGID in PWE (62.5%) than in HS (39.8%) was found (p < 0.001). The most frequently observed disorder was constipation, which was significantly higher in PWE than in HS (43.3 vs. 21.2%, p < 0.001), and was not associated with anti-seizure medication intake according to multivariable analysis. In drug-resistant patients, most seizures occurred during periods of altered bowel movements, especially constipation. A significant weak negative correlation between the number of days with seizures and the number of days with normal bowel movements was observed (p = 0.04). According to multivariable logistic regression analysis, FGID was significantly associated with temporal lobe epilepsy as compared with other lobar localization (p = 0.03).Conclusions: Our clinical findings shed new light on the complex relationship between epilepsy and the MGBA, suggesting a bidirectional link between bowel movement abnormalities and seizure occurrence. However, larger studies are required to better address this important topic. |
| first_indexed | 2024-12-20T15:18:29Z |
| format | Article |
| id | doaj.art-63dd5e34cad34e429cbf3f671c77bb01 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T15:18:29Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-63dd5e34cad34e429cbf3f671c77bb012022-12-21T19:36:07ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-08-011210.3389/fneur.2021.705126705126Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure OccurrenceFederica Avorio0Federica Avorio1Emanuele Cerulli Irelli2Alessandra Morano3Martina Fanella4Biagio Orlando5Mariarita Albini6Luca M. Basili7Gabriele Ruffolo8Jinane Fattouch9Mario Manfredi10Emilio Russo11Pasquale Striano12Marilia Carabotti13Anna T. Giallonardo14Carola Severi15Carlo Di Bonaventura16Epilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyNeurology Service, Therapeutic and Diagnostic Service Department, Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyNeurophysiology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyDepartment of Physiology and Pharmacology, Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyScience of Health Department, School of Medicine, University Magna Graecia, Calabria, ItalyInstitute for Research, Hospitalization, and Health Care (IRCCS) “G. Gaslini” Institute, Genoa, ItalyMedical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, Rome, ItalyEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, ItalyIntroduction: The complex relationship between the microbiota-gut-brain axis (MGBA) and epilepsy has been increasingly investigated in preclinical studies. Conversely, evidence from clinical studies is still scarce. In recent years, the pivotal role of MGBA dysregulation in the pathophysiology of functional gastrointestinal disorders (FGID) has been recognized. With this background, we aimed to investigate the prevalence of FGID in patients with epilepsy (PWE) and the possible impact of bowel movement abnormalities on seizure recurrence.Methods: A total of 120 PWE and 113 age-, sex-, and BMI-matched healthy subjects (HS) were consecutively enrolled. A questionnaire to evaluate the presence of FGID (according to Rome III diagnostic criteria) was administrated to all participants. In a subgroup of drug-resistant patients, we administered an ad-hoc questionnaire combining Bristol stool charts and seizure diaries to evaluate seizure trends and bowel movement changes.Results: A higher prevalence of FGID in PWE (62.5%) than in HS (39.8%) was found (p < 0.001). The most frequently observed disorder was constipation, which was significantly higher in PWE than in HS (43.3 vs. 21.2%, p < 0.001), and was not associated with anti-seizure medication intake according to multivariable analysis. In drug-resistant patients, most seizures occurred during periods of altered bowel movements, especially constipation. A significant weak negative correlation between the number of days with seizures and the number of days with normal bowel movements was observed (p = 0.04). According to multivariable logistic regression analysis, FGID was significantly associated with temporal lobe epilepsy as compared with other lobar localization (p = 0.03).Conclusions: Our clinical findings shed new light on the complex relationship between epilepsy and the MGBA, suggesting a bidirectional link between bowel movement abnormalities and seizure occurrence. However, larger studies are required to better address this important topic.https://www.frontiersin.org/articles/10.3389/fneur.2021.705126/fullgut-brain axisirritable bowel syndromedysbiosisepilepsydrug-resistancefunctional gastrointestinal disorder |
| spellingShingle | Federica Avorio Federica Avorio Emanuele Cerulli Irelli Alessandra Morano Martina Fanella Biagio Orlando Mariarita Albini Luca M. Basili Gabriele Ruffolo Jinane Fattouch Mario Manfredi Emilio Russo Pasquale Striano Marilia Carabotti Anna T. Giallonardo Carola Severi Carlo Di Bonaventura Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence Frontiers in Neurology gut-brain axis irritable bowel syndrome dysbiosis epilepsy drug-resistance functional gastrointestinal disorder |
| title | Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence |
| title_full | Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence |
| title_fullStr | Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence |
| title_full_unstemmed | Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence |
| title_short | Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence |
| title_sort | functional gastrointestinal disorders in patients with epilepsy reciprocal influence and impact on seizure occurrence |
| topic | gut-brain axis irritable bowel syndrome dysbiosis epilepsy drug-resistance functional gastrointestinal disorder |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.705126/full |
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