Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Object The purpose of this study was to retrospectively assess the objective and subjective neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis (AHS). Methods Memory and executive functions were evaluated at baseline and at follow-up in 11 surgically treated patients and compared with 8 pharmacologically treated patients with temporal lobe epilepsy and bilateral AHS. The median follow-up duration was 16 months in the surgically treated patients and 80.5 months in the pharmacologically treated group. Subjective outcome was evaluated by questionnaires and included mood, quality of life, subjective memory, and activities of daily living. Results At the follow-up assessment, 82% of the surgically treated patients as opposed to 0% of the nonsurgery patients were seizure free. In the surgical group, nonverbal memory performance did not change significantly in any patient after surgery, but there was a floor effect in 55% of the surgical patients. Regarding verbal memory, 9% of the surgical patients improved while 73% declined, despite severe impairments already evident at baseline. In the nonsurgery control group, 13% of the patients declined in nonverbal memory (floor effect in 63%) and 25% declined in verbal memory (floor effect in 25%) at follow-up. None of the controls improved at follow-up. Executive functions remained unchanged on an impaired level in both groups. At follow-up, the patient groups did not differ significantly with respect to mood, quality of life, subjective memory, or activities of daily living. However, in most aspects, surgically treated patients reported a slightly better subjective outcome than pharmacologically treated patients and a significantly improved quality of life. Conclusions These results suggest that beyond benefits concerning seizure control, surgically treated patients with bilateral AHS, despite already poor baseline performance, are still at risk for severe postoperative decline in memory. In the light of predominantly minor benefits on a subjective level, the findings put the overall outcome of epilepsy surgery in bilateral AHS patients into perspective.

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Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.114 ◽

2020 ◽

pp. 1-8

Author(s):

S. Patel ◽

M. Clancy ◽

H. Barry ◽

N. Quigley ◽

M. Clarke ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Epilepsy Surgery ◽

Refractory Epilepsy ◽

Post Surgery ◽

Axis I ◽

Patients With Epilepsy ◽

The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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Z-score neurofeedback, heart rate variability biofeedback, and brain coaching for older adults with memory concerns

Restorative Neurology and Neuroscience ◽

10.3233/rnn-201053 ◽

2020 ◽

pp. 1-29

Author(s):

Kyle D. Meeuwsen ◽

Kayleah M. Groeneveld ◽

Linda A. Walker ◽

Anna M. Mennenga ◽

Rachel K. Tittle ◽

...

Keyword(s):

Quality Of Life ◽

Boot Camp ◽

Relative Power ◽

Z Score ◽

Subjective Memory Complaints ◽

Subjective Memory ◽

Memory Complaints ◽

Anxiety Depression

Background: The three-month, multidomain Memory Boot Camp program incorporates z-score neurofeedback (NFB), heart rate variability (HRV) biofeedback, and one-on-one coaching to teach memory skills and encourage behavior change in diet, sleep, physical fitness, and stress reduction. Objective: This prospective trial evaluates the Memory Boot Camp program for adults ages 55 to 85 with symptoms of Mild Cognitive Impairment (MCI) and subjective memory complaints. Methods: Participants were evaluated via the Montreal Cognitive Assessment (MoCA), NeuroTrax Global Cognitive Index, measures of anxiety, depression, sleep, quality of life, quantitative electroencephalography (QEEG), and HRV parameters at four timepoints: baseline, pre-program, post-program, and follow-up. The trial included a three-month waiting period between baseline and pre-program, such that each participant acted as their own control, and follow-up took place six months after completion of the program. Results: Participants’ MoCA scores and self-reported measures of anxiety, depression, sleep quality, and quality of life improved after treatment, and these changes were maintained at follow-up. Physiological changes in HRV parameters after treatment were not significant, however, breathing rate and QEEG parameters were improved at post-program and maintained at follow-up. Finally, participants’ improvement in MoCA score over the treatment period was correlated with their improvement in two brain oscillation parameters targeted by the z-score NFB protocol: relative power of delta and relative power of theta. Conclusions: Trial results suggest that the Memory Boot Camp program is a promising treatment strategy for older adults with symptoms of MCI and subjective memory complaints.

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Depression, quality of life, activities of daily living, and subjective memory after deep brain stimulation in Parkinson disease—A reliable change index analysis

International Journal of Geriatric Psychiatry ◽

10.1002/gps.5184 ◽

2019 ◽

Vol 34 (11) ◽

pp. 1698-1705 ◽

Cited By ~ 2

Author(s):

Gisela Pusswald ◽

Patrick Wiesbauer ◽

Walter Pirker ◽

Klaus Novak ◽

Thomas Foki ◽

...

Keyword(s):

Quality Of Life ◽

Deep Brain Stimulation ◽

Parkinson Disease ◽

Brain Stimulation ◽

Daily Living ◽

Reliable Change Index ◽

Subjective Memory ◽

Index Analysis ◽

Deep Brain

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Epilepsziasebészeti beavatkozások eredményei a Pécsi Epilepszia Centrumban 2005 és 2016 között

Orvosi Hetilap ◽

10.1556/650.2019.31321 ◽

2019 ◽

Vol 160 (7) ◽

pp. 270-278 ◽

Cited By ~ 1

Author(s):

Katalin Nóra Lőrincz ◽

Beáta Bóné ◽

Márton Tóth ◽

Réka Horváth ◽

Norbert Kovács ◽

...

Keyword(s):

Quality Of Life ◽

Epilepsy Surgery ◽

Employment Status ◽

Postoperative Outcome ◽

Seizure Freedom ◽

Neurologic Disease ◽

Exact Test ◽

Epileptic Patients

Abstract: Introduction: Epilepsy as a chronic, severe neurologic disease significantly influences the quality of life of the epileptic patients. In candidates well selected for surgery, the seizure freedom is realistically achievable, and the quality of life can be further improved with complex individual rehabilitation. Aim: We aimed to evaluate the postoperative outcome of patients who underwent epilepsy surgery between 2005 and 2016 at the Epilepsy Center at Pécs. Method: We evaluated seizure status at regular follow-up visits after surgery and the quality of life using questionnaires focusing on employment and social status. Results: 76% of the 72 patients who underwent surgical resection for epilepsy were free from disabling seizures , and 10% had rare disabling seizures (almost seizure-free), 7% experienced worthwhile improvement and 7% had no worthwhile improvement. Comparing the employment status of patients free from disabling seizures to patients not free from disabling seizures, we found that the employment status is significantly influenced by seizure freedom (p<0.01, Fisher’s exact test). While 67% of seizure-free patients were employed, only 19% of patients not free from disabling seizures were hired. Conclusion: Our results resemble the international tendencies and success rate, proving epilepsy surgery as an available, valid and effective treatment in well selected patients. Orv Hetil. 2019; 160(7): 270–278.

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B-06 Attention and Verbal Memory Declines after Epilepsy Surgery Associated with Restricted Improvements in Cognitive, Energy and Medication Related Aspects of Quality of Life in Latino People with Epilepsy

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.89 ◽

2019 ◽

Vol 34 (6) ◽

pp. 950-950

Author(s):

S Neaves ◽

J Smith

Keyword(s):

Quality Of Life ◽

Los Angeles ◽

Epilepsy Surgery ◽

Verbal Memory ◽

Digit Span ◽

Verbal Learning ◽

Well Being ◽

Spanish Speaking ◽

Medication Effects

Abstract Objective Explore neuropsychological and quality of life outcomes of epilepsy surgery in an underserved, primarily immigrant, Spanish-speaking cohort of people with epilepsy (PWE). Methods Pre- and postsurgical Neuropsychological Screening Battery for Hispanics (NeSBHIS) and Quality of Life in Epilepsy-31 (QOLIE-31; Spanish Version) results were compared for 22 adult Latinos (females = 50%), from Mexico (81.8%), El Salvador (9.1%) and Guatemala (9.1%). All participants were part of a comprehensive epilepsy center in Los Angeles. Mean surgical age was 33.5 years (SD = 8.5), while mean education was 8.7 years (SD = 3.1). Seizures were exclusively lateralized to right (59.1%) and left hemispheres (40.9%). Results One-tailed, paired t-tests demonstrated statistically significant differences between pre- and postsurgical raw scores for Digit Span, t(21) = -2.52, p = 0.02 (presurgical M = 8.05, SD = 1.70; postsurgical M = 7.32, SD = 1.43), and the Auditory Verbal Learning Test (AVLT) Delayed Recall, t(21) = -2.99, p < 0.01 (presurgical M=10.00, SD=2.51; postsurgical M = 8.55 SD = 2.61). Respective effect sizes were moderate (d = .54; d = .64). QOLIE-31 scores improved on all subscales, as expected. Significant changes |p < 0.05| were found on most QOLIE-31 subscales, i.e., Seizure Worry, Emotional Well-Being, Social Function and Overall Quality of Life. Remaining subscales did not significantly improve, i.e., Energy/Fatigue, Cognitive and Medication Effects. Conclusions Attention and verbal memory declines after epilepsy surgery were associated with limited improvements on QOLIE-31 subscales of Cognitive, Energy/Fatigue and Medication Effects in Latino PWE. Previous studies have not simultaneously examined neuropsychological and QOLIE-31 outcomes after epilepsy surgery in this unique, underserved, Spanish-speaking population. Further investigation is warranted.

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Predictors of quality of life after resective extratemporal epilepsy surgery in adults in long-term follow-up

Seizure ◽

10.1016/j.seizure.2009.04.010 ◽

2009 ◽

Vol 18 (7) ◽

pp. 498-503 ◽

Cited By ~ 22

Author(s):

Alaa Eldin Elsharkawy ◽

Theodor May ◽

Rupprecht Thorbecke ◽

Alois Ebner

Keyword(s):

Quality Of Life ◽

Epilepsy Surgery ◽

Long Term Follow Up

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Prognostic Factors for Mortality, Activity of Daily Living and Quality of Life in Taiwanese Older Patients within 1 Year following Hip Fracture Surgery

Journal of Personalized Medicine ◽

10.3390/jpm12010102 ◽

2022 ◽

Vol 12 (1) ◽

pp. 102

Author(s):

Ming-Hsiu Chiang ◽

Yu-Yun Huang ◽

Yi-Jie Kuo ◽

Shu-Wei Huang ◽

Yeu-Chai Jang ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Hip Fracture ◽

Daily Living ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Hip Fracture Surgery ◽

Fracture Surgery

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

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Smartphone app as a follow-up tool after cardiac rehabilitation: Single-arm feasibility study (Preprint)

10.2196/preprints.12679 ◽

2018 ◽

Author(s):

Pernille Lunde ◽

Birgitta Blakstad Nilsson ◽

Astrid Bergland ◽

Asta Bye

Keyword(s):

Quality Of Life ◽

Health Status ◽

Cardiac Rehabilitation ◽

Potential Effect ◽

Goal Achievement ◽

Recruitment Rate ◽

Floor Effect

BACKGROUND Long-term maintenance of preventive activities is fundamental for achieving improved outcomes of cardiac rehabilitation (CR). Despite this, it is shown to be a major challenge for many patients to follow recommendations and thereby adhere to a heart-friendly lifestyle. Smartphone applications (apps) have been emphasized as potential tools to promote preventive activities after attendance in a CR program. Before commencing a trial to assess the potential effect of using an app for long-term adherence to preventive activities after attendance in CR, a study to assess the feasibility of the intervention is warranted. OBJECTIVE To assess the feasibility of an intervention where an app is used as a tool enabling individualized and monitored follow-up for patients after attendance in a CR program. METHODS Experimental, pre-post single arm trial, lasting for 12 weeks. All patients received access to an app aimed to guide people to change or to maintain a heart friendly lifestyle. During the study period, they got weekly, individualized follow-up through the app, based on their own goalsetting. Feasibility outcome assessed were adherence to the intervention, recruitment rate, resource requirements and efficacy regarding capability to detect a difference on quality of life (QoL), health status and perceived goal achievement as well as evaluating ceiling and floor effect in these outcomes. Criteria’s for success were preset to be able to evaluate whether the intervention were feasible in a potential future RCT. RESULTS All 14 patients included in the study used the app to promote preventive activities throughout the study. Satisfaction with the technology were high and the patients found the technology based follow-up intervention both useful and motivational. In total, 71% of the patients completed CR were eligible for a potential RCT as well as for the present study. Ceiling effect was achieved in more than 50% of the patients in questionnaires evaluating quality of life (SF-36 and COOP/WONCA) and health status (EQ-5D). Overall self-rated health status (EQ VAS) and perceived goal achievement were found to be able to detect a difference through the study. CONCLUSIONS Individual follow-up intervention through an app after attendance in CR is feasible. All patients used the app for preventive activities and found the follow-up intervention through an app as both useful and motivating for adherence to a heart-friendly lifestyle. Several points of guidance from the patients in the current study has been taken along and have contributed to the final design of the RCT now in the field.

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Assessment of patient-reported outcomes after polytrauma: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017571 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017571 ◽

Cited By ~ 2

Author(s):

Irmela Gnass ◽

Michaela Ritschel ◽

Silke Andrich ◽

Silke Kuske ◽

Kai Moschinski ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Activities Of Daily Living ◽

Daily Living ◽

Patient Reported Outcomes ◽

Short Term ◽

Patient Reported

IntroductionSurvivors of polytrauma experience long-term and short-term burden that influences their lives. The patients’ view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments’ application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function).Methods and analysisThe systematic review protocol is developed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials and the trials registers ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched. Keywords, for example, ‘polytrauma’, ‘multiple trauma’, ‘quality of life’, ‘activities of daily living’ or ‘pain’ will be used. Publications published between January 2005 and the most recent date (currently: August 2016) will be included. In order to present the latest possible results, an update of the search is conducted before publication. The data extraction and a content analysis will be carried out systematically. A critical appraisal will be performed.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be published in a peer-reviewed publication.PROSPERO registration numberCRD42017060825.

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