Clinical determinants of psychopathological outcomes after epilepsy surgery

Abstract

Objectives: People with refractory epilepsy submitted to surgery may improve or deteriorate their cognitive and emotional functions. The aim of this study was to determine the predictors of longitudinal changes in psychopathological symptomatology, one year after epilepsy surgery, considering clinical and demographic characteristics.

Methods: People with refractory epilepsy referred to epilepsy surgery were included in this ambispective study. Psychiatric evaluations were made before surgery and one year after the procedure. Demographic, psychiatric, and neurological data were recorded. Linear regression was used to analyze longitudinal data regarding the Global Severity Index and 9 symptom dimensions of Symptom Checklist-90 (SCL-90).

Results: Seventy-six people were included. Bilateral epileptogenic zone, lack of remission of disabling seizures, and deep brain stimulation, targeting the anterior nucleus of the thalamus (ANT-DBS), were the most important predictors of an increase in SCL-90 scores, after surgery.

Conclusion: Some individual factors may have an impact on the development or worsening of the previous psychopathology. This study identifies clinical aspects associated with greater psychological distress, after surgery. These patients may benefit from more frequent psychiatric routine assessments for early detection.