The Impact of Domain-Specific Cognitive Changes on Quality of Life Within the Context of Seizure Outcome Following Surgery for Epilepsy
Abstract number :
V.092
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2021
Submission ID :
1826128
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Kayela Arrotta, PhD - Cleveland Clinic; Ryan Honomichl - Case Western Reserve University; Brittany Lapin - Cleveland Clinic; Imad Najm, MD - Cleveland Clinic; William Bingaman, MD - Cleveland Clinic; Robyn Busch, PhD - Cleveland Clinic
Rationale: Neurosurgery is an effective treatment option for pharmacoresistant epilepsy. Although post-surgical seizure freedom is considered the primary goal of epilepsy surgery, other factors that impact Quality of Life (QOL) are also important to consider, including post-surgical cognitive changes. The purpose of this study was to examine the impact of post-surgical cognitive changes on QOL in the context of seizure outcome.
Methods: Participants were 196 adults with focal epilepsy who underwent either frontal (n= 27) or temporal lobe (n=169) resection. Each participant completed pre- and post-surgical neuropsychological evaluations, and cognitive composites were constructed for the following domains: processing speed, verbal reasoning, perceptual reasoning, confrontation naming, verbal memory, and executive function. QOL was assessed using the Quality of Life in Epilepsy (QOLIE-10) questionnaire. Due to multicollinearity, six separate linear mixed-effects models were constructed to predict QOL based on the pre-post surgical change of each cognitive composite. Additional covariates included in the models were gender, age at seizure onset, education, time, an interaction between cognitive composite and time, depression based on Beck Depression Inventory II, operated lobe, and seizure status at six months.
Results: Of the 196 surgical patients (mean age 41.0±13.0, 57% female, 94% white), 158 (81%) were seizure-free six-months post-surgery. Overall, participants reported improved QOL following surgery (-5.6 points, p< 0.01). There were significant associations between change in QOL and change in all six cognitive composites. After adjustment for covariates, negative change in verbal memory and processing speed remained significantly associated with better post-surgical QOL. Significant interactions were found for executive function and perceptual reasoning measures, suggesting that participants with higher post-surgical executive function and perceptual reasoning also reported better QOL. Lower depression and seizure-freedom were significant predictors of better post-surgical QOL in all of the models.
Behavior