Reduced serum level of THDOC, an anticonvulsant steroid, in women with perimenstrual catamenial epilepsy.
OBJECTIVE
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 gamma-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.
Tuveri
Antonella
A
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy.
Paoletti
Anna Maria
AM
Orrù
Marisa
M
Melis
Gian Benedetto B
GB
Marotto
Maria Francesca
MF
Zedda
Pierina
P
Marrosu
Francesco
F
Sogliano
Cristiana
C
Marra
Carla
C
Biggio
Giovanni
G
Concas
Alessandra
A
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D015992:Body Mass Index; D003687:Dehydroepiandrosterone / Q000097:blood; D003900:Desoxycorticosterone / Q000031:analogs & derivatives* / Q000096:biosynthesis / Q000097:blood / Q000172:deficiency; D004569:Electroencephalography; D004827:Epilepsy / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control; D004958:Estradiol / Q000172:deficiency; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D011280:Pregnanolone / Q000097:blood; D011284:Pregnenolone / Q000097:blood; D017697:Premenopause / Q000097:blood; D011293:Premenstrual Syndrome / Q000097:blood* / Q000453:epidemiology*; D011374:Progesterone / Q000096:biosynthesis / Q000097:blood; D018079:Receptors, GABA / Q000378:metabolism
D000927:Anticonvulsants; D018079:Receptors, GABA; D003900:Desoxycorticosterone; D003687:Dehydroepiandrosterone; C009413:tetrahydrodeoxycorticosterone; D011374:Progesterone; D004958:Estradiol; D011284:Pregnenolone; D011280:Pregnanolone; D006854:Hydrocortisone