Depression and anxiety before and after temporal lobe epilepsy surgery

Background: Besides seizure control, quality of life (QoL) should be considered as an equally important outcome for epilepsy surgery service providers. The paucity of QoL reports from developing countries has enlarged the representation gap between wealthy countries and countries with fewer resources. In this study, we evaluated postoperative QoL in the Indonesian drug-resistant epilepsy cohort where the epilepsy surgery service faces limited resource availability.Methods: We evaluated the QoL in patients with temporal lobe epilepsy who underwent surgery in our epilepsy surgery center in Semarang, Indonesia, from 2001 until 2015. The follow–up period started in 2018 through 2019. Postoperative QoL, depression, and anxiety were evaluated with self-reporting questionnaires including the Quality of Life in Epilepsy Inventory-31, Beck Depression Inventory-II, and Zung Self-Rating Anxiety Scales.Results: Forty returned questionnaires were included in the analysis (male 25, 62.5%; mean age 27.6 ± 9.05 years). The seizure-free cohort (n = 22, 55.0%) reported higher scores in most QoL dimensions particularly adjustment, overall QoL, and seizure worry compared to those with persistent seizures. The overall QoL level was correlated with seizure freedom and surgery type. QoL dimensions were negatively correlated with anxiety and depression levels.Conclusions: Postoperative seizure freedom was a major factor of postoperative QoL level. Besides seizure freedom, anxiety and depression levels were also negatively correlated with QoL levels in the Indonesian population.

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Language network reorganization before and after temporal lobe epilepsy surgery

Journal of Neurosurgery ◽

10.3171/2020.4.jns193401 ◽

2020 ◽

pp. 1-9

Author(s):

Olivia Foesleitner ◽

Benjamin Sigl ◽

Victor Schmidbauer ◽

Karl-Heinz Nenning ◽

Ekaterina Pataraia ◽

...

Keyword(s):

Functional Connectivity ◽

Network Analysis ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Verbal Fluency ◽

Extent Of Resection ◽

Language Dominance ◽

Before And After ◽

Left And Right

OBJECTIVEEpilepsy surgery is the recommended treatment option for patients with drug-resistant temporal lobe epilepsy (TLE). This method offers a good chance of seizure freedom but carries a considerable risk of postoperative language impairment. The extremely variable neurocognitive profiles in surgical epilepsy patients cannot be fully explained by extent of resection, fiber integrity, or current task-based functional MRI (fMRI). In this study, the authors aimed to investigate pathology- and surgery-triggered language organization in TLE by using fMRI activation and network analysis as well as considering structural and neuropsychological measures.METHODSTwenty-eight patients with unilateral TLE (16 right, 12 left) underwent T1-weighted imaging, diffusion tensor imaging, and task-based language fMRI pre- and postoperatively (n = 15 anterior temporal lobectomy, n = 11 selective amygdalohippocampectomy, n = 2 focal resection). Twenty-two healthy subjects served as the control cohort. Functional connectivity, activation maps, and laterality indices for language dominance were analyzed from fMRI data. Postoperative fractional anisotropy values of 7 major tracts were calculated. Naming, semantic, and phonematic verbal fluency scores before and after surgery were correlated with imaging parameters.RESULTSfMRI network analysis revealed widespread, bihemispheric alterations in language architecture that were not captured by activation analysis. These network changes were found preoperatively and proceeded after surgery with characteristic patterns in the left and right TLEs. Ipsilesional fronto-temporal connectivity decreased in both left and right TLE. In left TLE specifically, preoperative atypical language dominance predicted better postoperative verbal fluency and naming function. In right TLE, left frontal language dominance correlated with good semantic verbal fluency before and after surgery, and left fronto-temporal language laterality predicted good naming outcome. Ongoing seizures after surgery (Engel classes ID–IV) were associated with naming deterioration irrespective of seizure side. Functional findings were not explained by the extent of resection or integrity of major white matter tracts.CONCLUSIONSFunctional connectivity analysis contributes unique insight into bihemispheric remodeling processes of language networks after epilepsy surgery, with characteristic findings in left and right TLE. Presurgical contralateral language recruitment is associated with better postsurgical language outcome in left and right TLE.

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P4.020 Psychiatric morbidity, quality of life anddisability in mesial temporal lobe epilepsy patients before and after epilepsy surgery

European Neuropsychopharmacology ◽

10.1016/s0924-977x(04)80444-9 ◽

2004 ◽

Vol 14 ◽

pp. S330-S331

Author(s):

E.S. Cankurtaran ◽

B. Ulug ◽

S. Saygý

Keyword(s):

Quality Of Life ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Psychiatric Morbidity ◽

Mesial Temporal Lobe Epilepsy ◽

Before And After ◽

Mesial Temporal Lobe

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Sleep before and after temporal lobe epilepsy surgery

Seizure ◽

10.1016/j.seizure.2012.01.007 ◽

2012 ◽

Vol 21 (4) ◽

pp. 260-265 ◽

Cited By ~ 16

Author(s):

Anna Serafini ◽

Callixte Kuate ◽

Philippe Gelisse ◽

Reana Velizarova ◽

Gian Luigi Gigli ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Before And After

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Default Mode Network Ventral Hub Connectivity Associated with Memory Impairment in Temporal Lobe Epilepsy Surgery

10.1101/2020.11.11.377929 ◽

2020 ◽

Author(s):

Elliot G. Neal ◽

Long Di ◽

You Jeong Park ◽

Austin Finch ◽

Ferdinand Korneli ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Default Mode Network ◽

Memory Task ◽

Network Connectivity ◽

Default Mode ◽

Non Invasive ◽

Before And After ◽

The Relationship

AbstractIn patients undergoing surgery for intractable temporal lobe epilepsy, the relationship between the default mode network and patients’ neurocognitive outcome remains unclear. The objective of this study is to employ non-invasive network mapping to identify the relationship between subdivisions of the default mode network and neurocognitive function before and after epilepsy surgery in patients with temporal lobe epilepsy.Twenty-seven medically patients with medically refractory temporal lobe epilepsy were prospectively enrolled and received resting state functional MRI and neuropsychological testing both pre- and post-operatively. Connectivity within the default mode network was modeled and average connectivity within the networks was calculated.Higher pre-operative connectivity in the ventral default mode network hub correlated with impaired baseline performance in a visual memory task. Post-operatively, a decrease in ventral but not dorsal default mode network connectivity was correlated with a deterioration of verbal and logical memory after surgery.Overall, higher connectivity in the ventral default mode network hub was associated with poor memory function in patients with temporal lobe epilepsy both before and after temporal lobe surgery. Pre-operatively, higher ventral connectivity was associated with worse visual function. Post-operatively, decreased connectivity of the ventral and dorsal default mode network was correlated with a greater decrease in logical and verbal memory when compared with the pre-operation baseline. An imbalance in default mode network connectivity towards the ventral stream and more widespread epilepsy networks may be used to predict memory impairments following surgical intervention and may lead to more tailored surgical decision making based on this non-invasive network modeling.

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Employment and quality of life in mesial temporal lobe epilepsy with hippocampal sclerosis: is there a change after surgical treatment?

Journal of Epilepsy and Clinical Neurophysiology ◽

10.1590/s1676-26492009000200008 ◽

2009 ◽

Vol 15 (2) ◽

pp. 89-93 ◽

Cited By ~ 4

Author(s):

Neide Barreira Alonso ◽

Auro Mauro Azevedo ◽

Ricardo Silva Centeno ◽

Laura M. F. Ferreira Guilhoto ◽

Luis Otávio Sales Ferreira Caboclo ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Hippocampal Sclerosis ◽

Mesial Temporal Lobe Epilepsy ◽

Before And After ◽

Mesial Temporal Lobe

PURPOSE: The aim of this study was to evaluate in patients with mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS): (1) employment patterns before and three years after epilepsy surgery and their impact in Quality of Life (QOL); (2) demographic and clinical variables associated with employment. METHODS: Data from 58 patients with diagnosis of refractory MTLE with HS who had corticoamygdalo-hippocampectomy were analyzed. The subjects answered to Brazilian validated version of the Epilepsy Surgery Inventory (ESI-55) before, and three years after surgery. In a semi-structured interview, sociodemographic and clinical characteristics were obtained. Changes in employment after surgery were classified in one of the three categories: (i) improvement status: those who were unemployed, no-formal employed, students, housewives and subjects who have never worked to employed category; (ii) unchanged status: no change in occupation; this category included subjects who were employed before and after the surgery, housewives, students, and the group who remained unemployed, receiving ill-health benefits or retired after the surgical treatment; and (iii) worsened status: loss of employment. RESULTS: Employment status did not show any significant change after surgery: in 51(87.9%) it remained unchanged, in six (10.3%) it improved, and one patient (1.7%), who was employed before the surgery, retired after that. In a subgroup of 22 patients employed after surgery, ten (45.5%) were seizure-free, seven (31.8%) had only rare auras, and five (22.7%) had seizures. In the group of improvement, 12 patients (70.5%) had no-formal employment and five (29.5%) had a formal job before surgery. After three years, 14 (63.6%) of 22 subjects were formally employed. Our data suggested that the employability was strongly correlated (p<0.05) with a positive perception of health-related quality of life measured by ESI-55, before and after surgical evaluation. CONCLUSION: Our study demonstrated in a homogeneous group of MTLE with HS, a modest, but positive relationship between surgical outcome and work gain, and that QOL had strong correlation with the fact of being employed.

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