Abstracts

RATIONALE: The prevalence of depression is increased in people with epilepsy, and depression and health-related qualtiy of life (HRQOL) are closely correlated, but the interrelationship of cerebral dysfunction, depression, HRQOL, and recurrent seizures is poorly understood. We utilized proton magnetic resonance spectroscopy (1HMRS) to study the association of mesial temporal lobe metabolic function with mood status and HRQOL. METHODS: We evaluated 33 patient with refractory temporal lobe epilepsy using 1HMRS to determine the spatial extent of voxels with abnormal NAA/choline+creatine ratios within the temporal lobes. We then used reliable and valid instruments to assess depressive symptoms (Profile of Mood States-POMS) and HRQOL (QOLIE-89). Partial correlation and regression analyses were utilized to compare 1HMRS and clinical variables (independent variables) to mood status and HRQOL (dependent variables). RESULTS: The patients had a mean age of 35 years and a mean age at epilepsy onset of 15 years. They averaged 14 seizures/month and were on an average of 2 medications. 1HMRS had the strongest correlation with both HRQOL (r=-0.62, p<0.0001) and depression (r=0.45, p<0.01) of any variables included in the analysis. After controlling for the relative effects of all independent variables, seizure frequency, employment, drivng, and number of medications were not significantly associated with depression or HRQOL. CONCLUSIONS: The extent of 1HMRS abnormalities in the temporal lobes is a strong, independent predictor of HRQOL and depression in patients with temporal lobe epilepsy. These findings emphasize the close but independent association of HRQOL and mood with temporal lobe dysfunction. The utility of 1HMRS may include identification of patients at risk for depression or poor HRQOL. This study was supported by NIH grant NS01794