About this Research Topic

Background

Epilepsy is a severe neurological condition that affects approximately 70 million people worldwide. It has been shown that both epilepsy itself and antiepileptic drugs can affect the functioning of the endocrine system, making it a good example of probable interactions.

The disease, directly or indirectly, is known to be associated with disorders of the gonadal, thyroid, and adrenal hormones, as well as loss of bone mass. In the case of catamenial epilepsy, epileptic seizures are closely linked to the perimenopausal period. This points to the great importance of changes in progesterone and oestrogen concentrations.

It has also been shown that tonic-clonic seizures and partial seizures rapidly increase the blood concentrations of some sex hormones, including prolactin, luteinizing hormone, and folliculotropic hormone. In addition, in some patients with epilepsy, permanent disturbances in the frequency of secretion of luteinizing hormone are observed, and this results in disturbed concentrations of other gonadal hormones, which in turn leads to fertility problems. Further, it has also been observed that epileptic seizures can cause a sudden increase in concentrations of hormones such as cortisol, growth hormone, adrenocorticotropic hormone (ACTH), triiodothyronine (T3), thyroxine (T4) as well as thyroid stimulating hormone (TSH).

Antiepileptic drugs (AED) used in the treatment of epilepsy, especially the classical drugs, may also be associated with endocrine disorders. One of the most common effects is disruption of not only the hypothalamic-pituitary-gonadal axis, but also of the hypothalamic-pituitary-thyroid axis. Abnormalities at the hypothalamic level are associated with changes in the neurotransmitters, GABA and glutamate, resulting in disturbed activities of other hormones. For instance, AED treatment alters the concentrations of various sex hormones in both males and females. Abnormal levels of testosterone and estradiol are observed. Among their side effects, many studies also point to thyroid dysfunction towards hypothyroidism. Clinical data indicate that AED treatment may reduce bone mass through various mechanisms, including direct effects on bone cells, resulting in increased bone turnover.

The available data clearly indicate that newer drugs contribute much less to endocrine disruption. Therefore, when choosing a suitable antiepileptic drug, it is also worth considering possible correlation with the endocrine system.

This Research Topic will compile novel research, reviews, and perspectives on the connection between epilepsy, AEDs, and the endocrine system. While the neuroendocrine system is of particular interest, research concerning other aspects of the relationship between epilepsy and endocrine function are welcome for consideration. Research focusing on thyroid dysfunction, the hypothalamic-pituitary-gonadal axis, hypothalamic-pituitary-thyroid axis, and neuroendocrine aspects are of particular interest.

**Dr. Maciej Gasior is VP of Clinical Development at Marinus Pharmaceuticals

Keywords: epilepsy, antiepileptic drugs, endocrinology, endocrine disorders, oestrogen, progesterone, hypothalamus, HPA axis, pregnancy, thyroid hormones, HPT Axis

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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