The influence of temperature and genomic variation on intracranial EEG measures in people with epilepsy

Author:

McNicholas Olivia C1,Jiménez-Jiménez Diego23,Oliveira Joana F A12,Ferguson Lauren45,Bellampalli Ravishankara23,McLaughlin Charlotte1,Chowdhury Fahmida Amin12,Martins Custodio Helena23ORCID,Moloney Patrick23,Mavrogianni Anna4,Diehl Beate12,Sisodiya Sanjay M23ORCID

Affiliation:

1. Sir Jules Thorn Telemetry Unit, National Hospital for Neurology and Neurosurgery , London WC1N 3BG , UK

2. Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology , London WC1N 3BG , UK

3. Chalfont Centre for Epilepsy , Buckinghamshire SL9 0RJ , UK

4. Institute for Environmental Design and Engineering, The Bartlett School of Environment, Energy and Resources, University College London , London WC1H 0NN , UK

5. Department for Environmental Health, Harvard T.H. Chan School of Public Health , Boston, MA 02115 , USA

Abstract

Abstract Heatwaves have serious impacts on human health and constitute a key health concern from anthropogenic climate change. People have different individual tolerance for heatwaves or unaccustomed temperatures. Those with epilepsy may be particularly affected by temperature as the electroclinical hallmarks of brain excitability in epilepsy (inter-ictal epileptiform discharges and seizures) are influenced by a range of physiological and non-physiological conditions. Heatwaves are becoming more common and may affect brain excitability. Leveraging spontaneous heatwaves during periods of intracranial EEG recording in participants with epilepsy in a non–air-conditioned telemetry unit at the National Hospital for Neurology and Neurosurgery in London from May to August 2015–22, we examined the impact of heatwaves on brain excitability. In London, a heatwave is defined as three or more consecutive days with daily maximum temperatures ≥28°C. For each participant, we counted inter-ictal epileptiform discharges using four 10-min segments within, and outside of, heatwaves during periods of intracranial EEG recording. Additionally, we counted all clinical and subclinical seizures within, and outside of, heatwaves. We searched for causal rare genetic variants and calculated the epilepsy PRS. Nine participants were included in the study (six men, three women), median age 30 years (range 24–39). During heatwaves, there was a significant increase in the number of inter-ictal epileptiform discharges in three participants. Five participants had more seizures during the heatwave period, and as a group, there were significantly more seizures during the heatwaves. Genetic data, available for eight participants, showed none had known rare, genetically-determined epilepsies, whilst all had high polygenic risk scores for epilepsy. For some people with epilepsy, and not just those with known, rare, temperature-sensitive epilepsies, there is an association between heatwaves and increased brain excitability. These preliminary data require further validation and exploration, as they raise concerns about the impact of heatwaves directly on brain health.

Funder

Epilepsy Society

Amelia Roberts

University College London

University College London Grand Challenges Climate Crisis Special Initiative

Publisher

Oxford University Press (OUP)

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