Activation of Functional Brain Networks in Children With Psychogenic Non-epileptic Seizures
Open accessAbstract
OBJECTIVES: Psychogenic non-epileptic seizures (PNES) have been hypothesized to emerge in the context of neural networks instability. To explore this hypothesis in children, we applied a graph theory approach to examine connectivity in neural networks in the resting-state EEG in 35 children with PNES, 31 children with other functional neurological symptoms (but no PNES), and 75 healthy controls. METHODS: The networks were extracted from Laplacian-transformed time series by a coherence connectivity estimation method. RESULTS: Children with PNES (vs. controls) showed widespread changes in network metrics: increased global efficiency (gamma and beta bands), increased local efficiency (gamma band), and increased modularity (gamma and alpha bands). Compared to controls, they also had higher levels of autonomic arousal (e.g., lower heart variability); more anxiety, depression, and stress on the Depression Anxiety and Stress Scales; and more adverse childhood experiences on the Early Life Stress Questionnaire. Increases in network metrics correlated with arousal. Children with other functional neurological symptoms (but no PNES) showed scattered and less pronounced changes in network metrics. CONCLUSION: The results indicate that children with PNES present with increased activation of neural networks coupled with increased physiological arousal. While this shift in functional organization may confer a short-term adaptive advantage-one that facilitates neural communication and the child's capacity to respond self-protectively in the face of stressful life events-it may also have a significant biological cost. It may predispose the child's neural networks to periods of instability-presenting clinically as PNES-when the neural networks are faced with perturbations in energy flow or with additional demands.
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The more common pattern of presentation in paediatric FND is that of cumulative common-place stressors that exceed the child's adaptive capacities to cope.
“Instead, the more common pattern of presentation is that of cumulative common-place stressors that exceed the child’s adaptive capacities to cope [38,56,66],”
From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [66]
The Results report more adverse childhood experiences among children with FND than among controls, and the Discussion describes stress-related arousal and the biological cost of prolonged adaptation. But the paper does not establish that cumulative commonplace stressors exceeding a child’s coping capacity are the more common presentation; its Discussion also emphasizes maltreatment among children with PNES. No page numbers are available in our copy. (LLM, conf=0.84)
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- Authors
- Radmanesh, M., Jalili, M., & Kozlowska, K.
- Affiliations
- RMIT University (AU)
- The University of Sydney (AU)
- Corresponding author
- Kozlowska, Kasia
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2020-08-25
- Volume
- 14
- Pages
- 339-339
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC7477327
- OpenAlex
- W3080642094
- Cited by
- 35
- References
- 86
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 11 · 2021: 5 · 2020: 1
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RMIT Research Repository (RMIT University Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Instituto Millenium
- Australian Research Council
- Sydney Medical School
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Keywords
- psychogenic non-epileptic seizures, functional neurological symptoms, resting-state EEG, brain network connectivity, network efficiency, network modularity, autonomic arousal, heart rate variability, anxiety, depression, stress, adverse childhood experiences, children
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