Serum serotonin levels as a potential biomarker of SUDEP risk
Abstract number :
1.454
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2018
Submission ID :
542952
Source :
www.aesnet.org
Presentation date :
12/1/2018 6:00:00 PM
Published date :
Nov 5, 2018, 18:00 PM
Authors :
Arun Murugesan, Case Western Reserve University & Northeast Ohio Medical University; M R Sandhya Rani, Case Western Reserve University; Laura Vilella, Case Western Reserve University; Nuria Lacuey, University Hospitals, Case Western University School of M
Rationale: We previously reported that serum serotonin (5-HT) levels in generalized convulsive seizures (GCS) were significantly higher post-ictally than in the inter-ictal state compared to focal seizures. However, given the critical role of 5-HT in breathing modulation and arousal, its influence on human peri-ictal breathing features is unknown. The aim of the study was to determine the relationship between serum 5-HT levels, ictal central apnea (ICA), and post-convulsive central apnea (PCCA) in epileptic seizures. Methods: We prospectively evaluated video electroencephalography (VEEG), plethysmography, capillary oxygen saturation (SpO2) and electrocardiography for 52 patients (55 seizures) enrolled in a multicenter study of SUDEP. Post-ictal and inter-ictal venous blood samples were collected after a clinical seizure for measurement of serum 5-HT levels. Seizures were classified according to the ILAE 2017 seizure classification. We analyzed seizures with and without ICA (n=55) and generalized convulsive seizures (GCS) with and without PCCA (n=29). Results: Post-ictal serum 5-HT levels were significantly increased over inter-ictal levels for seizures without ICA (p=0.01), compared to seizures with ICA (p=0.21). In GCS without PCCA, serum 5-HT levels were significantly increased post-ictally compared to inter-ictal levels (p=<0.001) but not in seizures with PCCA (p=0.24). Post-ictal minus inter-ictal 5-HT levels also differed between the two groups with and without PCCA (p=0.01). Increased heart rate was accompanied by increased serum 5-HT levels (post-ictal minus inter-ictal) after seizures without PCCA (p=0.04) compared to those with PCCA (p=0.83). Conclusions: The data suggest that significant seizure-related increases in serum 5-HT levels are associated with a lower incidence of seizure-related breathing dysfunction, and may confer protection against deleterious phenomena leading to SUDEP. Funding: Samden D Lhatoo is funded by the Center for SUDEP Research: NIH/NINDS U01-NS090405 and NIH/NINDS U01-NS090407.