Interictal Anxiety in People with Epilepsy with and Without Anxiety Auras
Abstract number :
2.338
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2023
Submission ID :
507
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Carmela Casaburi, BA – Columbia University Irving Medical Center
Catherine Schevon, MD, PhD – Columbia University Irving Medical Center; Nahal Heydari, MA – Columbia University Irving Medical Center; Lisa Bateman, MD – Cedars-Sinai Health System; Marla Hamberger, PhD – Columbia University Irving Medical Center
Rationale:
The prevalence of anxiety among people with epilepsy has come to the forefront in recent years. However, the extent to which day-to-day anxiety might be related to seizure auras, either physiologically or psychologically, is unknown. We compared self-rated anxiety in daily living between patients with anxiety auras and those with non-anxiety, sensory auras. We also explored the region of seizure onset in these two groups. We hypothesized that people with epilepsy and anxiety auras would have greater interictal anxiety than those without anxiety auras (sensory auras).
Methods:
Participants were 22 adults with refractory epilepsy (18 women) undergoing surgical evaluation, ages 18-60 years (mean age: 34.2 ± 11.0; mean FSIQ: 85.2 ± 18.5). The Anxiety Aura group (n = 12) included those who specifically used the terms “anxiety,” “fear,” or “panic” in describing their auras. Patients in the Sensory Aura group (n = 8) described their aura as a bodily sensation such as cold, pain, auditory or visual distortions, or tingling. As part of their comprehensive neuropsychological evaluation, all patients completed the Symptom Checklist 90-R (SCL-90-R). This is a 90 item, self-report symptom inventory regarding psychological symptoms during last seven days. Multivariate ANOVA was used to compare groups on demographic data and SCL-90-R and test scores.
Results:
Seizure aura groups did not differ with regard to Age (Anxiety Group: 33.9 ± 11.3, Sensory Group: 31.5 ± 10.7, p. = .66), Education level (Anxiety Group: 12.5 ± 4.4, Sensory Group: 13.5 ± 2.8, p = .90), FSIQ (Anxiety Group: 83.1 ± 11.0, Sensory Group: 93.9 ± 24.2, p = .78), and Age of seizure onset (Anxiety Group: 18.4 ± 12.1, Sensory Group: 9.8 ± 6.9, p = .055). By contrast, the Anxiety Aura patient group (t score: 64.2 ± 12.1) endorsed significantly greater everyday anxiety compared to the Sensory Aura group (t score: 52.0 ± 15.7; p = .03). The seizure onset zones for patients with Anxiety Auras were categorized as five right temporal, five left temporal, and one frontal non-lateralized. The seizure onset zone for patients with Sensory Auras were categorized as four right temporal, two left temporal, one temporal bilateral, one right frontotemporal, and one non-localized.
Conclusions:
Consistent with our hypothesis, the Anxiety Aura patient group endorsed significantly more symptoms of everyday anxiety than the Sensory Aura patient group. These results: 1) highlight an association between seizure auras and interictal anxiety, raising questions regarding both psychological and physiological influences of interictal anxiety, and 2) underscore the importance of screening for anxiety symptoms in people with epilepsy.
Funding: CURE Epilepsy (CAS, LBM)
R01 NS 35140 (MJH)
Behavior