Abstracts

Rationale: Quality of life (QOL) after epilepsy surgery can vary considerably depending on many factors (e.g., degree of seizure relief, cognitive decline, mood, seizure worry, social support). In previous studies, left temporal lobe epilepsy patients endorse higher levels of anxiety and rate QOL lower, while right TLE patients endorse lower anxiety and rate QOL higher. The current study further investigated these lateralized differences in QOL and depression in epilepsy surgery patients by examining specific QOL subdomains, viz., Overall QOL, Role Functioning, Cognition, and severity of depression before and after temporal lobectomy. Methods: Sixty-nine temporal lobectomy patients (LTL = 40; RTL = 29) underwent baseline and post-surgical neuropsychological assessment at the Medical College of Georgia with a mean age of 34 years (SD=12.5); 12 years of education (SD=2); seizure duration of 17.5 years (SD=12.6); and a FSIQ of 87 (SD=14.6). Patients were administered the WAIS-III to assess intelligence; self-ratings on the QOLIE-89; and the Beck Depression Inventory (BDI) as part of a larger neuropsychological battery, both pre- (Pre TL) and post-temporal lobectomy (Post TL). There were no significant differences between the LTL and RTL groups with regard to age, education, FSIQ, seizure duration, or surgical outcome. Results: Pre TL analyses revealed no significant differences between LTLs and RTLs on the BDI or any of the QOLIE-89 scales examined. In contrast, Post TL analyses revealed significant differences between LTLs and RTLs on the BDI (p = .003), which slightly worsened in LTLs and greatly improved in RTLs, and Overall Quality of Life (p = .009), which stayed the same in LTLs and improved in RTLs. In addition, there were slight improvements in Work/Driving/Social Function in both LTLs and RTLs (p = .001). QOLIE Memory scores did not change in LTLs and improved in RTLs (p = .007). There were no significant differences in Attention/Concentration or Language although there were slight improvements in both groups. With regard to mood, there were no significant differences between groups on the BDI before surgery (p = .99), but after surgery significantly more LTL patients had elevated BDI scores compared to RTLs (p = .001). Conclusions: LTL patients had significantly lower self-ratings on important quality of life domains (viz., overall QOL, work/driving/social function, and memory) compared with RTL patients following surgery. Examination of the performances of each group pre- to post-surgery showed that LTLs generally did not change on their QOL ratings while RTLs improved across all QOL domains examined. As previous studies have suggested, it is possible the presence of depression among LTLs are driving their lower QOL ratings.