Psychiatric Outcomes in Patients Undergoing Laser Interstitial Thermal Therapy vs. Temporal Lobectomy
Abstract number :
2.178
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2021
Submission ID :
1826394
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Mishu Sharma, MD - University of Texas Southwestern Medical Center; Kan Ding, MD - Associate Professor, Neurology, University of Texas Southwestern Medical Center; Irina Podkorytova, MD - Assistant Professor, Neurology, University of Texas Southwestern Medical Center; Ghazala Perven, MD - Assistant Professor, Neurology, University of Texas Southwestern Medical Center
Rationale: Psychiatric comorbidities significantly impact quality of life after surgical intervention for intractable temporal lobe epilepsy (TLE). While postoperative psychiatric outcomes after temporal lobectomy have been investigated with mixed results, outcomes after minimally invasive Laser Interstitial Thermal Therapy (LITT) have not been well-elucidated. As thermal ablation with LITT has become an increasingly popular alternative to temporal lobectomy in selected patients, we aim to evaluate psychiatric outcomes in patients who have undergone LITT compared to temporal lobectomy.
Methods: A retrospective chart review of 46 patients with TLE who had undergone either temporal lobectomy or LITT at a Level 4 epilepsy center between 2015 to 2020 was conducted. Those patients who had temporal lobectomy after LITT were stratified into the temporal lobectomy arm for analysis of postoperative psychiatric outcomes. The primary outcome was the incidence of worsening psychiatric symptoms as determined by: 1) requirement of additional psychiatric medications; 2) increased frequency of hospital admissions for worsening psychiatric symptoms; 3) de novo development of psychiatric symptoms; or 4) documented worsening of psychiatric symptoms by a treating neurologist or psychiatrist. Psychiatric conditions included in the study were depression, anxiety, bipolar disorder, and psychosis.
Results: 29 patients who underwent temporal lobectomy and 17 patients who underwent LITT were included in the analysis. Both cohorts were well-matched for mean age (44.8 vs. 41.4 years for temporal lobectomy vs. LITT, respectively), gender (48.3 vs. 47.1% female), and mean age of seizure onset (25.4 vs. 17.9 years). The average follow-up duration postoperatively was 2.3 years. 79.3% of patients who underwent temporal lobectomy and 88.2% of those that underwent LITT had an Engel score of 1-2. Postoperatively, the incidence of worsening psychiatric symptoms between temporal lobectomy and LITT was 10/29 (34.5%) vs. 3/17 (17.7%), respectively (p=0.31).
Conclusions: LITT is not associated with an increased risk of postoperative worsening of psychiatric outcomes compared to temporal lobectomy. Patients undergoing either intervention for TLE require close follow-up and monitoring for psychiatric stability postoperatively.
Funding: Please list any funding that was received in support of this abstract.: The authors received no financial support for the research, authorship, or publication of this abstract.
Cormorbidity (Somatic and Psychiatric)