Reduced serum level of THDOC, an anticonvulsant steroid, in women with perimenstrual catamenial epilepsy
Abstract
Summary: Purpose: Seizure exacerbation in catamenial epilepsy (CE) is associated with the decrease in progesterone secretion and increase in estradiol secretion during the premenstrual period. Moreover, experimental evidence suggests that tetrahydrodeoxycorticosterone (THDOC), a positive modulator of the type A receptor for γ‐aminobutyric acid (GABA), and dehydroepiandrosterone sulfate (DHEAS), a negative modulator of this receptor, might play a crucial role in modulating seizure frequency during the menstrual cycle. Following these studies it seems of interest to investigate possible variations, among other hormonal parameters, of THDOC and DHEAS in CE patients. Methods: The serum concentrations of progesterone (P4), pregnenolone, allopregnanolone (AP), THDOC, DHEAS, cortisol, and DHEAS/cortisol ratio were measured throughout the menstrual cycle at the 7th, 11th, 15th, 19th, 23rd, and 27th day from the onset of spontaneous menstrual blood loss in young premenopausal women with CE (n = 17) and age‐matched controls (n = 13). Results: At each time of the study, the serum concentration of THDOC and the DHEAS/cortisol ratio were lower (p < 0.05) in women with CE than in control women. The concentrations of P4, pregnenolone, and AP did not differ between the two groups of subjects. Conclusions: The reduced serum concentration of THDOC and the reduced DHEAS/cortisol ratio detected throughout the menstrual cycle in women with CE might play a role in CE. Moreover, the peculiar pattern of CE seizure exacerbation might suggest that these neuroendocrine variations are worth investigating in other epileptic syndromes, particularly in those characterized by relevant and uncontrolled variations in seizure frequency.
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Catamenial epilepsy is characterized by perimenstrual seizure exacerbation, involving altered levels of anticonvulsant THDOC, proconvulsant DHEA-S and cortisol, and premenstrual allopregnanolone withdrawal.
“In this context, one of the most investigated condition is catamenial epilepsy, characterized by perimenstrual seizure exacerbation, involving altered levels of anticonvulsant THDOC, proconvulsant DHEA-S and cortisol [146], and premenstrual allopregnanolone withdrawal [147].”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [146]
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- Authors
- Tuveri, A., Paoletti, A. M., Orrù, M., Melis, G. B. B., Marotto, M. F., Zedda, P., Marrosu, F., Sogliano, C., Marra, C., Biggio, G., & Concas, A.
- Affiliations
- University of Cagliari (IT)
- Corresponding author
- Concas, Alessandra
- ORCID
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2008-07
- Volume
- 49
- Issue
- 7
- Pages
- 1221-1229
- ISSN
- 0013-9580 (ISSN-L)
- 1528-1167
- OpenAlex
- W2088783016
- Cited by
- 63
- References
- 55
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 5 · 2013: 7 · 2012: 5
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Funders
- Università di Cagliari
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Keywords
- catamenial epilepsy, tetrahydrodeoxycorticosterone, dehydroepiandrosterone sulfate, menstrual cycle, progesterone, allopregnanolone, pregnenolone, GABA-A receptor modulation, seizure exacerbation
- MeSH terms
- Adult, Anticonvulsants, Dehydroepiandrosterone, Desoxycorticosterone, Electroencephalography, Epilepsy, Estradiol, Female, Humans, Hydrocortisone, Pregnanolone, Pregnenolone, Premenstrual Syndrome, Progesterone, Body Mass Index, Premenopause, Receptors, GABA
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