DEPRESSION IN INTRACTABLE PARTIAL EPILEPSY VARIES BY LATERALITY OF FOCUS AND SURGERY
Abstract number :
2.143
Submission category :
Year :
2002
Submission ID :
3512
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Donna Broshek, Mark Quigg, Edward Bertram. Dept Psychiatry, University of Virginia, Charlottesville, VA; FED Comprehensive Epilepsy Program, Neurology, University of Virginia, Charlottesville, VA
RATIONALE: Depression has been reported to occur after surgical treatment for medically intractable partial epilepsy. The risk of pre- and postsurgical depression may vary by laterality of seizure focus and surgery. We reviewed the pre- and postsurgical psychological assessments and clinical courses of patients to identify those at highest risk for postsurgical mood disorders.
METHODS: Psychiatric status was assessed in a consecutive series of epilepsy patients before and one year after epilepsy surgery using Scale 2 of the Minnesota Multiphasic Personality Inventory (MMPI-2) and a clinical depression index (CDI) that scored the occurrence of depressive symptoms, psychiatric referral, or attempted/completed suicide.
RESULTS: Scale 2 MMPI-2 and the CDI correlated significantly (r = 0.297, p = 0.0005). Left (n = 43 subjects) and right (n = 50) surgery groups did not differ by sex, seizure outcome, age, education, age at first seizure, duration of epilepsy, or intellect. Patients with left-sided foci had a significant improvement in Scale 2 MMPI-2 scores after surgery despite a tendency for worse presurgical scores than right-sided patients, who in turn tended to show worsening in postsurgical Scale 2 scores. CDI scores diverged significantly postsurgically, with right hemisphere subjects experiencing more morbidity than left-sided subjects. Findings for the anterior temporal lobectomy subgroup (n = 79) were similar to the overall sample.
CONCLUSIONS: Patients undergoing right hemispheric epilepsy surgery are particularly susceptible to clinical depression despite more favorable presurgical personality assessments. Our findings support studies that show an interhemispheric modulation of depressive traits and symptoms.
[Supported by: Department of Neurology]