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Proteomic Analysis of patients with Epileptic Seizure and Psychogenic Non-epileptic Seizure; a Cross-Sectional Study

Mohsen Parvareshi Hamrah, Mostafa Rezaei Tavirani, Monireh Movahedi, Sanaz Ahmadi Karvigh



Introduction: There is an increasing interest in the use of different biomarkers to help distinguish psychogenic non-epileptic seizure (PNES) from epileptic seizures (ES). This study aimed to evaluate the patterns of differentially expressed serum proteins in ES and PNES cases.

Methods: In this cross-sectional study, 4 patients with mesial temporal lobe epilepsy and 4 patients with PNES were selected from patients with history of recurrent seizures. Venous blood samples were obtained within 1 hour after seizure and serum proteomes as well as the extent of protein expression were analyzed.

Results:  361 proteins were identified; of these, expression of 197 proteins had altered. 110 (55.9%) proteins were down-regulated and 87 (44.1%) were up-regulated in the PNES samples compared to ES samples. The mean pI for deregulated proteins with 1.5 to 3 fold changes were 6.69 ± 1.68 in proteins with increasing expression in ES group and 5.88 ± 1.39 in proteins with increasing expression in PNES group (p = 0.008). The median and interquartile range (IQR) of molecular weight changes in proteins with 1.5 to 3 fold changes were 64 (22.0-86.0) in proteins whose expression had increased in ES group and 39.5 (26.0-61.5) in proteins whose expression had increased in PNES cases (p = 0.05). 

Conclusion: Several spots with differential expression were observed by comparing patients with ES against the PNES groups, which could be potential biomarkers of the disease. Damage to the blood-brain barrier is the most important difference between the two groups, thus identifying total protein changes offers a key to the future of differentiating ES and PNES patients.


Seizures; proteomics; biomarkers; diagnosis, differential


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DOI: https://doi.org/10.22037/aaem.v8i1.593

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.593.g714

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.593.g781