Anxiety symptoms in epilepsy: Salient issues for future research

This paper reviews the distinct symptom profile, epidemiology, pathogenesis, assessment, and treatment of anxiety disorders. It highlights emerging neuroimaging research in mood and anxiety disorders in people with epilepsy. While structural neuroimaging has implicated frontal temporal grey matter structures in mood and anxiety disorders, diffusion tensor imaging and magnetic resonance spectroscopy (MRS) show promise in elucidating white matter changes. In addition, future MRS studies may demonstrate changes in glutamate and gamma-aminobutyric acid (GABA) levels in these regions and hopefully help inform response to treatment.

Research highlights
► Mood and anxiety disorders profoundly impacts quality of life and is strongly associated with suicide in epilepsy.
► Mood and anxiety disorders are often co-morbid and may be both treated with selective serotonin reuptake inhibitors.
► Frontal temporal and amygdalar circuits are most strongly implicated in mood and anxiety disorders, respectively.