Depression in epilepsy

Fiest, Kirsten M.; Dykeman, Jonathan; Patten, Scott B.; Wiebe, Samuel; Kaplan, Gilaad G.; Maxwell, Colleen J.; Bulloch, Andrew G. M.; Jetté, Nathalie

doi:10.1212/wnl.0b013e31827b1ae0

Cited by 348 publications

(254 citation statements)

References 49 publications

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“…A recent systematic review and meta-analysis of depression in 29,891 people with epilepsy showed an overall prevalence of active depression of 23.1%. 15 Cognitive impairment has long been associated with intractable epilepsy. A study in 136 patients with refractory epilepsy found that "cognitive decline was severe and occurred across a wide range of cognitive functions."…”

Section: Resultsmentioning

confidence: 99%

Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy

Salanova¹,

Witt²,

Worth³

et al. 2015

Neurology

638

617

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Objective: To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus (ANT) for treatment of localizationrelated epilepsy.Methods: This long-term follow-up is a continuation of a previously reported trial of 5-vs 0-V ANT stimulation. Long-term follow-up began 13 months after device implantation with stimulation parameters adjusted at the investigators' discretion. Seizure frequency was determined using daily seizure diaries.Results: The median percent seizure reduction from baseline at 1 year was 41%, and 69% at 5 years. The responder rate ($50% reduction in seizure frequency) at 1 year was 43%, and 68% at 5 years. In the 5 years of follow-up, 16% of subjects were seizure-free for at least 6 months. There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages. The Liverpool Seizure Severity Scale and 31-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by 1 year and at 5 years (p , 0.001).Conclusion: Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population. Classification of evidence:This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years. Approximately 3 million people in the United States have epilepsy and approximately 30% remain resistant to medical treatment. Some of these patients are candidates for resective surgery.1,2 For those who are not surgical candidates, or who continue to have seizures after surgery, neuromodulation may offer a viable therapeutic option. Several pilot studies, [3][4][5][6] and recent trials including the Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy (SANTE) trial 7 and a trial of responsive cortical stimulation, 8 have demonstrated reduction in seizures. The SANTE trial in 110 subjects with localization-related epilepsy found that seizures were significantly reduced by stimulation. 7 We now report the 5-year efficacy and safety outcomes of this trial.METHODS The SANTE trial 7 utilized a design with a 3-month baseline, 1-month postoperative recovery, followed by 3 months of double-blind treatment randomized to 5 V or 0 V of stimulation, then an open-label conversion of all subjects to 5-V stimulation for 9

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Section: Resultsmentioning

confidence: 99%

Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy

Salanova¹,

Witt²,

Worth³

et al. 2015

Neurology

638

617

View full text Add to dashboard Cite

show abstract

“…Moreover, depression represents one of the most common psychiatric disorders in PWE, with a point prevalence ranging from 12-37% in community settings [3]. In clinical studies, depressive symptoms in epilepsy have been associated with several variables such as poor seizure control, duration of epilepsy, having complex partial seizures or temporal lobe epilepsy, unemployment and the use of antiepileptic polytherapy.…”

Section: Editorialmentioning

confidence: 99%

Epilepsy and Psychiatric Disorders: Is There a Common Genetic Susceptibility?

Chentouf¹

2016

J Epilepsy

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“…December 22, 2014|Volume 4|Issue 4| WJP|www.wjgnet.com has often been reported, and epileptic patients frequently show depressive symptoms, but a recent systematic review and meta-analysis of nine studies including 29891 patients with epilepsy [40] reported a global prevalence of actual/past-year depression of only 23.1%. The high prevalence of depression found in our patients could be due to the fact that depression was diagnosed using a self-report instrument rather than clinical assessment.…”

mentioning

confidence: 99%

“…The high prevalence of depression found in our patients could be due to the fact that depression was diagnosed using a self-report instrument rather than clinical assessment. Significant heterogeneity in the results of ascertaining depression using different methods has been reported [40] . Overall, the current findings were only partially in line with those of Jehi et al [41] , who analyzed data from 1931 subjects affected by drug-resistant and medicallycontrolled epilepsy during one year of follow-up and found that depression, together with seizure severity, was a major predictor of QOL in epileptic patients.…”

mentioning

confidence: 99%

Factors associated with hopelessness in epileptic patients

Pompili¹,

Serafini²,

Innamorati³

et al. 2014

WJP

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in Epilepsy (QOLIE)-89. Patients were dichotomized into two categories: those affected by epilepsy with generalized tonic-clonic seizures vs those having epilepsy with partial seizures. RESULTS:The groups differed on the QOLIE Role Limitation/Emotional dimension. Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems than patients with other types of epilepsy (89.57 ± 25.49 vs 72.86 ± 36.38; t 63 = -2.16; P < 0.05). All of the respondents reported moderate to severe depression, and 21.7% of patients with generalized seizures and 28.6% of patients with other diagnoses had BHS total scores ≥ 9 indicating a higher suicidal risk. The study did not control for years of the illness. CONCLUSION:Patients with generalized seizures reported more limitations in common social/role activities related to emotional problems compared to patients with other types of seizures. Patients at increased suicide risk as evaluated by the BHS were older than those who had a lower suicidal risk. Future studies are required to further investigate the impact of hopelessness on the outcome of epileptic patients.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Epilepsy; Hopelessness; Suicide risk; Emotional problems; Social/role activities Core tip: The present study assessed factors associated with hopelessness, depression, and quality of life in a sample of 69 epileptic patients using standardized psychometric instruments. All of the participants reported moderate to severe depression, and 25% of the patients had Beck Hopelessness Scale total scores ≥ 9 indicating a higher suicidal risk. Although the study did not control for years of the illness which may limit the generalizability of findings, patients with generalized seizures experienced more limitations Factors associated with hopelessness in epileptic patients

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Depression in epilepsy

Cited by 348 publications

References 49 publications

Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy

Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy

Epilepsy and Psychiatric Disorders: Is There a Common Genetic Susceptibility?

Factors associated with hopelessness in epileptic patients

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