Long-term association between seizure outcome and depression after resective epilepsy surgery
Long-term association between seizure outcome and depression after resective epilepsy surgery
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DOI：
10.1212/wnl.0b013e31823a0c90
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发表时间：
2011-11-29
期刊：
影响因子：
9.9
通讯作者：
Spencer, S. S.
中科院分区：
文献类型：
--
作者：
Hamid, H.;Liu, H.;Spencer, S. S.
目的：本研究探讨了长期的癫痫手术结果和抑郁症状的变化之间的关联。方法：成年人参加了1996年和2001年之间的一项多中心前瞻性研究，以评估切除性癫痫手术的结果。术前和术后3、12、24、48和60个月，使用贝克抑郁量表（BDI）评估抑郁症状的程度和抑郁病例状态（无、轻度或中度/重度）。进行了混合模型重复测量分析，调整癫痫发作的位置，性别，年龄，种族，教育和癫痫control.Results的协变量：共373名受试者，256人进行了评估，在基线和5年后手术。基线时，164例（64.1%）无抑郁，34例（13.3%）轻度抑郁，58例（22.7%）中度至重度抑郁。5年后，198例（77.3%）无抑郁，20例（7.8%）轻度抑郁，38例（14.8%）中度至重度抑郁。术后5年，癫痫控制良好的受试者BDI评分较基线的平均变化降幅大于癫痫控制一般和癫痫控制较差的受试者（分别为p = 0.0006和p = 0.02）。癫痫控制良好的患者比癫痫控制不佳的患者BDI评分降低更大（p = 0.02），与正常癫痫发作对照组相比，（p = 0.055）。虽然研究参与者的抑郁症状有初步改善，但平均而言，在切除手术后，只有癫痫控制良好或极好的患者情绪才有持续的长期改善。神经病学（R）2011;77：1.972-1976
Objective: This study explored the association between long-term epilepsy surgery outcome and changes in depressive symptoms.Methods: Adults were enrolled between 1996 and 2001 in a multicenter prospective study to evaluate outcomes of resective epilepsy surgery. The extent of depressive symptoms and depression case status (none, mild, or moderate/severe) were assessed using the Beck Depression Inventory (BDI) preoperatively and 3, 12, 24, 48, and 60 months postoperatively. A mixed-model repeated-measures analysis was performed, adjusting for covariates of seizure location, gender, age, race, education, and seizure control.Results: Of the total 373 subjects, 256 were evaluated at baseline and 5 years after surgery. At baseline, 164 (64.1%) were not depressed, 34 (13.3%) were mildly depressed, and 58 (22.7%) had moderate to severe depression. After 5 years, 198 (77.3%) were not depressed, 20 (7.8%) were mildly depressed, and 38 (14.8%) were moderately to severely depressed. Five years after surgery, the reduction in mean change from baseline in BDI score was greater in subjects with excellent seizure control than in the fair and poor seizure control groups (p = 0.0006 and p = 0.02 respectively). Those with good seizure control had a greater reduction in BDI score than the poor seizure control group (p = 0.02) and borderline significant reduction compared with the fair seizure control group (p = 0.055).Conclusion: Although study participants had initial improvement in depressive symptoms, on average, after resective surgery, only patients with good or excellent seizure control had sustained long-term improvement in mood. Neurology (R) 2011;77:1.972-1976