Abstracts

Rationale: Limited information exists regarding affective outcome following stereotactic laser ablation (SLA) for the treatment of refractory temporal lobe epilepsy (TLE). Prior studies in our center documented that, within one to 6 months following the procedure, post-surgical psychiatric morbidity is greater for patients undergoing left sided ablation and those with pre-existing psychiatric conditions. We investigated changes in symptoms of depression and anxiety using patient endorsed questionnaires 6-12 months post-surgically. Methods: 18 patients (8 female) ranging in age from 22 to 70 (mean age= 42, SD=13.41) with 8 to 16 years of education (mean=11.39, SD= 2.63) underwent SLA (right= 8, left= 10). All but 2 of the participants completed the Beck Depression (BDI-II) and Beck Anxiety Inventories (BAI) before the ablation and 6-12 months following the procedure. Change in overall BDI-II and BAI scores were reviewed and associations between reported mood and anxiety symptoms and various demographic variables and side of ablation were evaluated. Results: 8 subjects had a pre-SLA score above the BDI-II cut-off score of 13, with the mean for this subset reflecting moderate to severe levels of depression (Pre BDI-II=27.87, SD=12.42). A significant reduction in BDI-II scores was reported (BDI-II M=14.37, SD=13.27) following ablation (p=.05, ?2=.43) with 5 out of the 8 patients demonstrating a reduction to minimal severity. Two subjects reported an increase from minimal to mild or moderate depressive severity. On the BAI, 7 patients endorsed pre-operative BAI cut-off score of 9 or higher (BAI M=19.14, SD=8.82). As a group, a significant reduction in anxiety symptoms (p=.02, ?2=.60) was endorsed (Post BAI M=10.57, SD=7.89). None of the subjects reported worsening of anxiety symptoms. Change in self-reported symptoms of depression and anxiety were not correlated with side of ablation, age, or educational level. Most of the subjects who reported elevated depression or anxiety pre-SLA were females. Two subjects experienced acute mood dysregulation within 1 month of the SLA procedure requiring outpatient psychiatric care. At their 6-12 month follow-up, 1 patient reported moderate levels of depression and minimal anxiety, and the other minimal symptoms of depression and anxiety. Conclusions: Overall, in our series, patients with elevated depression or anxiety prior to SLA tend to report an improvement in mood 6-12 months after the procedure. Improvement in mood at 6-12 month follow-up was not related to side of ablation or demographic variables. Funding: N/A