مقاله انگلیسی رایگان در مورد ارتباط بین ارائه محیطی آفت کش ها و صرع – الزویر 2018

There is increasing evidence of an association between long-term environmental exposure to pesticides and neurodegenerative disorders; however, the relationship with epilepsy has not been addressed thus far. This study was aimed at determining the prevalence and risk of developing epilepsy among people from South-East Spain living in areas of high vs. low exposure to pesticides based on agronomic data. The study population consisted of 4007 subjects with a diagnosis of epilepsy and 580,077 control subjects adjusted for age, sex and geographical area. Data were collected from hospital records of the Spanish health care system (basic minimum dataset) between the years 1998 and 2010. The prevalence of epilepsy was significantly higher in areas of greater pesticide use relative to areas of lesser use. Overall, an increased risk of epilepsy was observed in the population living in areas of high vs. low use of pesticides (OR:1.65; p <0.001). Although this study was exploratory in nature, the results suggest that environmental exposure to pesticides might increase the risk of having epilepsy.

INTRODUCTION

Epilepsy is the most common severe neurological disorder (Sander, 2003) affecting 0.5–1%, of the world population, with a lifetime incidence of 1–3% (MichaelTitus et al., 2010). It is estimated that 70 million patients around the world are diagnosed with epilepsy at any stage of life (OMS, 2015) as the disease can occur at any age, from birth to childhood and also among adults, including the older age groups (Rados, 2005). However, the occurrence, prevalence, and burden of epilepsy vary widely throughout the world (Banerjee et al., 2009), showing higher rates in developing countries than in developed countries (Perucca et al., 2001; Preux and Druet-Cabanac, 2005) as 90% of patients are thought to live in Africa, Asia, and Latin America (Houinato et al., 2013). In Spain, there are around 400,000 diagnosed epilepsy cases with 12,400 to 22,000 people showing symptoms for the first time every year. The majority of them are children, between 6 and 14 years old, with a rate of 3.7 cases per 1000 inhabitants (SEN, 2009). Risk factors for epilepsy are multiple and include genetic background, trauma, brain tumor, metabolic disturbances, infections, autoimmune reactions, and chemical exposures (Jovel et al., 2018; Pauschek et. al. 2016). Nevertheless, epilepsy likely result from interactions between the genetically-determined seizure threshold, underlying predisposing medical conditions or metabolic disorders, and acute triggers (Guberman and Bruni, 1999). Acquired epilepsy usually develops in three phases: injury (brain insult), epileptogenesis (latency) and chronic epilepsy (spontaneous recurrent seizure) (Raza et al., 2004). A number of chemicals may cause seizures by a variety of molecular mechanisms and pathways. In addition, exposure to some chemicals during critical periods of development can disrupt neurodevelopment and potentiate the response to toxicants later in life (Ramsdell, 2010). In this regard, animals have shown to be more prone to generate seizures when stimulated in critical developmental periods (Stanojlović et al., 2013).