Day 2 :
Keynote Forum
Tatiana Falcone
Cleveland Clinic, USA
Keynote: Suicide risk in patients with Epilepsy
Time : 10:00-10:40
Biography:
Tatiana Falcone has graduated from Medical School, Epidemiology and Psychiatry from Universidad Pontificia Bolivariana Colombia. She continued her Psychiatry, Child and Adolescent Psychiatry Training and Neurophysiology at Cleveland Clinic for the last 7 years. She is the Director of Project CARE (Coordination Access Resources and Education for Children with Epilepsy, a federally funded initiative to improve quality of care and life in children of epilepsy. She is a Fellow of the APA, an active Member of the Physically Child committee at the AACAP and the Psychosocial Comorbidities committee at AES.
Abstract:
In 2010, 38,364 Americans of all ages committed suicide which translates to one death every 13.7 minutes. Suicide rates are high among young people, suicide accounts for 13% of all adolescent deaths annually. The reported rate of suicide in patients with epilepsy is around 12% compared to 1.1-1.2% in the general population. Death by suicide has been reported in 5% of adult patients with epilepsy compared to 1.4% in the general population. There is a 5-fold increase in the rate of suicide among patients with epilepsy and up to 25-fold higher in people with temporal lobe epilepsy. Results from meta-analyses also indicate that patients with epilepsy have an increased risk of suicidal ideation and behavior. In a study analyzing 76 cohorts of people with epilepsy (N=60,846), 13 of the cohorts were made up of children. Among the child cohorts, the overall percent of death by suicide was 1.3%. Overall, the standardized mortality ratio for epilepsy patients was 3.3 (95% CI 2.8-3.7), 190 deaths were observed compared with the 58.4 expected. Some of the risk factors associated with suicide are mood disorders, psychotic disorders, personality disorders, substance abuse, previous suicide attempts and critical life events. Other epilepsy specific risk factors are stigma of epilepsy and peri-ictal mood dysphoria. Epilepsy patients who commit suicide tend to have early onset epilepsy, high seizure frequency, AED polytherapy and history of MDD. The severity of depression is probably the most important risk factor. Early screening is important to identify patients with epilepsy at risk for suicide.
Keynote Forum
Ana Maria Sebastiao
University of Lisbon, Portugal
Keynote: Adenosine modulation of signaling at the tripartite synapse: Implications for Epilepsy
Time : 10:40-11:20
Biography:
Ana M Sebastião has completed his PhD in 1987 from the Gulbenkian Institute of Science and the New University of Lisbon. She is the Director of the Institute of Pharmacology and Neuroscience, Medical School, University of Lisbon, and of the Mind-Brain College of the University of Lisbon, Portugal. She has published more than full 140 papers quoted more than 4600 times, and has been serving as an Editorial Board Member of several journals. She also served as President of the Portuguese Neuroscience and Portuguese Pharmacological Societies as well as in the Executive Council of the Federation of European Pharmacological Societies.
Abstract:
Adenosine is an endogenous anti-epileptic substance, known for its ability to inhibit excitatory synaptic transmission. I will focus on recent work by our group aiming to elucidate how high affinity A1 (A1R) and A2A (A2AR) adenosine receptors affect not only excitatory but also inhibitory transmission at the hippocampus. A2ARs can directly interfere with the life-span of GABA at synapses, since GABA transport is facilitated by A2ARs in nerve endings and astrocytes, where A1R and A2AR act as tetramers to fine tune GABA uptake. A1R inhibits the function of GABAA receptors localized at perisynaptic/extrasynaptic compartments in excitatory and a subset of inhibitory neurons, being involved in the control of persistent tonic GABAergic responses. A2A Rs influence the GABAergic input to a subset of inhibitory neurons and promote synchronous pyramidal cell firing in hyperexcitable conditions. In addition, A2ARs enhance extrasynaptic AMPA receptor mediated responses, allow the sustained recruitment of calcium-permeable AMPA receptors after ischemia, leading to a long-lasting facilitation of excitatory synaptic transmission and trigger neurotrophic factor actions upon synaptic plasticity. These actions of adenosine contribute to fine-tune neuronal activity and to set the stage for plasticity, eventually influencing seizure-induced aberrant plasticity.
- Epilepsy
Location: Frederick Douglass
Chair
Elia M Pestana Knight
Cleveland Clinic, USA
Co-Chair
Long Jun Wu
Rutgers University, USA