Abstracts

Patients with temporal lobe epilepsy (TLE) have higher rates of depression and anxiety than patients with other focal epilepsies or generalized seizures. Memory problems are common among patients with mood and anxiety disorders as well as among patients with TLE. Given the high prevalence of mood and anxiety disorders and memory problems in patients with TLE, the present study sought to determine if presurgical mood and anxiety scores are useful in predicting memory change following anterior temporal lobectomy (ATL) and to ascertain if these scores have incremental validity over presurgical memory and intelligence scores. This retrospective study examined data from 174 patients with medically intractable TLE (Left=79; Right=95) seen for neuropsychological evaluations that included: Depression, Anxiety, Anxiety Related Disorders (ARD), and Mania subscales of the Personality Assessment Inventory; Beck Depression Inventory-II; General Memory Index (GENMEM) from the Wechsler Memory Scale-3rd Edition; and Full Scale IQ (FSIQ) from the Wechsler Adult Intelligence Scale-3rd Edition. All patients later underwent ATL for treatment of their epilepsy and completed postsurgical neuropsychological testing. Participants[apos] mean age and education were 34.25 (SD=11.51) and 12.84 (SD=2.11), respectively. The mean age of seizure onset was 14.92 (SD=12.25) and mean duration of seizures was 19.49 years (SD=12.59). There were no significant differences between the left and right groups in terms of age, race, sex, education, age of seizure onset, or seizure duration. Simple regression analyses were conducted with mood and anxiety as independent variables (IVs) and memory change score as the dependent variable (DV). A hierarchical regression analysis was then computed with presurgical GENMEM and FSIQ scores entered as IVs in step one, the five mood variables in step two, and GENMEM change as the DV. Regression analyses were conducted separately for left and right TLE patients. Results of the simple regression revealed that presurgical mood and anxiety scores were significant predictors of postsurgical change in GENMEM for left TLE but not right TLE patients. Of the mood variables, the ARD subscale made the largest contribution to the prediction. Similarly, hierarchical regression analyses demonstrated that mood and anxiety scores added significantly to the prediction of GENMEM change above and beyond the prediction made by presurgical GENMEM and FSIQ scores among left but not right TLE patients. Again, ARD made the largest contribution to this prediction. This study supports the clinical utility of presurgical mood and anxiety scores in predicting memory change following ATL in patients with left, but not right, TLE. Furthermore, this study demonstrates that mood and anxiety scores add significantly to the prediction of postsurgical memory change beyond the prediction made by presurgical memory scores.