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Abstract Details

Improving Post-Operative Psychiatric Outcomes in Surgical Epilepsy Patients
Epilepsy/Clinical Neurophysiology (EEG)
P1 - Poster Session 1 (8:00 AM-9:00 AM)
Psychiatric disorders (PD) represent a substantial comorbidity in epilepsy, affecting 1 in 3 patients (PWE). PD may be overlooked in preliminary evaluations despite their ability to exacerbate epilepsy, impair quality of life (QOL), and worsen preexisting psychiatric diagnoses (PPDx). This study aims to determine the effect of epilepsy surgery (ES) on incidences of psychiatric comorbidity and identify potential predictors of outcome.
Accurately forecasting post-operative (PO) psychopathology is beneficial for achieving a better, sustainable QOL in the long-term.

18 patients who underwent ES at the NIH in the past 5 years were identified from our database. Reviewed factors include presence of PPDx and location of epileptogenicity. The QOLIE-31, NDDI-E, and GAD7 questionnaires were administered at 3 timepoints: Baseline (BL), 3 Months (3M) PO, 1 year (1Y) PO. Patients were organized into limbic (LB) vs non-limbic (NL) categories based on involvement of the amygdala and hippocampus—vital for emotional regulation. Education, employment, and driving status were evaluated with demographics.

NL patients saw improvement in QOLIE score (p=0.0012) over time as did PWE with PPDx (p<0.0001) who were unemployed (p=0.0066). Least Square-Mean (LSM) was lower at BL (PPDx: LSM=39.3) than at follow-up (LSM=62.0 at 3M, 61.3 at 1Y). Irrespective of PPDx, there was no change in NDDI-E score over time (p=0.4633). There was significant reduction in GAD7 scores among non-driving patients (p=0.0461) with a higher LSM at BL (10.0) than at follow-up (4.9 at 3M, 2.2 at 1Y).

Patients with PPDx and those not driving or employed at BL saw significant improvement in their overall QOL and anxiety PO; however, patients without PPDx did not. NL patients saw the greatest improvement in QOL, suggesting intact emotional regulation compared to those with resected limbic structures. ES may improve mood symptoms and QOL in PWE dealing with a greater burden of PD or lacking independence.

Tandees Najimi (National Institutes of Health)
Ms. Najimi has received research support from National Institutes of Health's Intramural Research Program.