Exploring Changes in Depression, Anxiety, and Seizure Outcome After Minimum Invasive Surgery for Mesial Temporal Lobe Epilepsy
Abstract number :
2.306
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2022
Submission ID :
2205139
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Edward Valentin, PhD – Emory University School of Medicine; Adam Dickey, MD, PhD – Emory University; Taylor Shade, BS – Emory University; Kelsey Hewitt, PsyD – Emory University; Karanbir Padda, MD – Emory University; Rebecca Fasano, MD – Emory University; Daniel Drane, PhD – Emory University
Rationale: Stereotactic laser amygdalohippocampotomy (SLAH) is a minimally invasive surgical treatment for medically refractory temporal lobe epilepsy (TLE). The primary hypothesis of this study was that patients who are seizure free after SLAH will have reduced depression or anxiety symptomatology relative to patients who are not seizure free. We also explored whether changes in depression or anxiety are related to the laterality of surgery, or whether the patients had a lesion targeted by surgery.
Methods: Medical records of 37 TLE patients who underwent SLAH were retrospectively reviewed with Beck Depression Inventory-II (BDI) and Beck Anxiety Inventory (BAI) pre- and post-operatively. We computed a change in BDI or BAI as the follow-up score minus the preoperative score. We calculated an unpaired t-test to evaluate whether the mean change in BDI or BAI varied with clinical variables of (1) Engel I outcome or not, (2) left or right-sided surgery, (3) lesional status
Results: We demonstrated that the mean change in BDI of -7.4 in seizure free patients was significantly lower than the mean change in BDI of -0.2 in non-seizure free patients (p=0.014, unpaired t-test). The mean change in BAI of -2.2 in seizure free patients was not significantly different from the mean change in BAI of -1.9 in non-seizure free patients (p=0.9, unpaired t-test). There were no significant differences in the change in BDI or BAI with laterality of surgery or the lesional status of the patient.
Conclusions: We found a statistically significant and clinically relevant reduction in depression symptoms in patients who were seizure free after SLAH, compared to those we are not seizure free. Limitations of our study is that the BDI and BAI measures are self-reported scores and that we had a relatively small sample size. Further work with a larger cohort will be required to predict psychiatric outcomes after surgery.
Funding: EMV and DLD were funded by R01 NS088748
Behavior