Long-Term Seizure, Quality of Life, Depression, and Verbal Memory Outcomes in a Controlled Mesial Temporal Lobe Epilepsy Surgical Series Using Portuguese-Validated Instruments

Dias, Luis Augusto; Angelis, Geisa de; Teixeira, Wagner Afonso; Casulari, Luíz Augusto

doi:10.1016/j.wneu.2017.05.004

Cited by 13 publications

(13 citation statements)

References 44 publications

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“…The few long-term studies showing QOL improvement after epilepsy surgery focused on statistically significant changes in QOL survey in epilepsy (n = 50, MTLE), 26 with a retrospective design with substantial follow-up missing. 16,27 The Using distributional methods, 14,17 most of the MTLE-HS patients had a MCIC of QOL by specific inventory for epilepsy one year after epilepsy surgery. [11][12][13][14] The highest rates of MCIC were in the domains seizure worry and social functioning.…”

Section: Discussionmentioning

confidence: 99%

“…The present study highlights the absence of depression at longterm assessment as the only significant predictor of QOL, but not the occurrence of pre-surgical depression. Pre-surgical psychiatric diagnoses, [10][11][12][13]16,30 and the presence of depression before surgery have been associated with a worse QOL outcome one year after surgery, 11,16 which is a relatively short period. It might be possible that considering a longer time of follow-up and, for most of the patients, more extended time of better seizure control, the influence of pre-surgical variables become less relevant.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, it is possible that, after the first few years of surgery, QOL becomes stable as a result of a "ceiling" effect, when the patients have reached the average population mean. 16 The relationship between epilepsy and depression is widely known, and especially among MTLE-HS patients, some mechanisms are hypothesized. The altered hippocampal structure and function may promote limbic-cortical dysfunction, which all contribute to depression symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…3,[11][12][13][14] The literature has shown that depressive symptoms may better predict QOL than lack of seizure control among patients with refractory epilepsy. 3,15,16 Pre-surgical depression has been reported as predicting lack of QOL improvement one year after epilepsy surgery, [11][12][13][14] and little is known about predictors of QOL changes long after epilepsy surgery. 16 Moreover, information about minimum clinically important change (MCIC) of QOL improvement is also scarce.…”

Section: Introductionmentioning

confidence: 99%

“…3,15,16 Pre-surgical depression has been reported as predicting lack of QOL improvement one year after epilepsy surgery, [11][12][13][14] and little is known about predictors of QOL changes long after epilepsy surgery. 16 Moreover, information about minimum clinically important change (MCIC) of QOL improvement is also scarce. [12][13][14] MCIC means relevant change for the patient.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life long after temporal lobe epilepsy surgery

et al. 2021

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Objectives: To identify variables independently associated with a meaningful improvement in QOL long after surgical treatment of drug-resistant MTLE-HS patients. Material & Methods:We prospectively evaluated 72 consecutive MTLE-HS surgically treated patients and analyzed pre and post-surgical variables independently associated with a meaningful improvement in QOL evaluated by the Quality of Life in Epilepsy-31 (QOLIE-31) overall score, and its domain scores determined at follow-up after 36 to 131 months (mean 93 months) after surgery. Results:The mean overall QOLIE-31 score and its subdomain scores improved significantly after surgery (p < 0.01), and 55 patients (76.4%) had a meaningful QOL improvement. Being seizure-free (Engel IA) after surgery showed a non-significant association (OR 2.63, CI 95% 0.53 to 13.05, p = 0.23) and lower depressive symptoms a significant association (OR 4.15, CI 95% 1.19 to 14.53, p = 0.03) with meaningful improvement of QOL.Conclusions: Patients with MTLE-HS who underwent epilepsy surgery show a sustained, meaningful improvement in their QOL. Pre-surgical variables do not predict long-term QOL improvement after surgery. Lower levels of depressive symptoms at postoperative evaluation are associated with meaningful QOL improvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality of life long after temporal lobe epilepsy surgery

et al. 2021

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Inhibition of RhoA/Rho kinase signaling pathway by fasudil protects against kainic acid‐induced neurite injury

et al. 2021

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Aim: RhoA/Rho kinase pathway is essential for regulating cytoskeletal structure.Although its effect on normal neurite outgrowth has been demonstrated, the role of this pathway in seizure-induced neurite injury has not been revealed. The research examined the phosphorylation level of RhoA/Rho kinase signaling pathway and to clarify the effect of fasudil on RhoA/Rho kinase signaling pathway and neurite outgrowth in kainic acid (KA)-treated Neuro-2A cells and hippocampal neurons.Method: Western blotting analysis was used to investigate the expression of key proteins of RhoA/Rho kinase signaling pathway and the depolymerization of actin. After incubated without serum to induce neurite outgrowth, Neuro-2A cells were fixed, and immunofluorescent assay of rhodamine-phalloidin was applied to detect the cellular morphology and neurite length. The influence of KA on neurons was detected in primary hippocampal neurons. Whole-cell patch clamp was conducted in cultured neurons or hippocampal slices to record action potentials.Result: KA at the dose of 100-200 μmol/L induced the increase in phosphorylation of Rho-associated coiled-coil-containing protein kinase and decrease in phosphorylation of Lin11, Isl-1 and Mec-3 kinase and cofilin. The effect of 200 μmol/L KA was peaked at 1-2 hours, and then gradually returned to baseline after 8 hours. Pretreatment with Rho kinase inhibitor fasudil reversed KA-induced activation of RhoA/Rho kinase pathway and increase in phosphorylation of slingshot and 14-3-3, which consequently reduced the ratio of G/F-actin. KA treatment induced inhibition of neurite outgrowth and decrease in spines both in Neuro-2a cells and in cultured hippocampal neurons, and pretreatment with fasudil alleviated KA-induced neurite outgrowth inhibition and spine loss. Conclusion:These data indicate that inhibiting RhoA/Rho kinase pathway might be a potential treatment for seizure-induced injury.

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Quality of life, psychiatric symptoms, and stigma perception in three groups of persons with epilepsy

Deleo¹,

Quintas²,

Pastori³

et al. 2020

Epilepsy & Behavior

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Long-Term Seizure, Quality of Life, Depression, and Verbal Memory Outcomes in a Controlled Mesial Temporal Lobe Epilepsy Surgical Series Using Portuguese-Validated Instruments

Abstract: Our study found that, although surgical treatment was effective, its impact on social indicators was modest. Moreover, the self-reported quality of life relied not only on seizure control but also on depressive symptoms and antiepileptic drug burden.

Cited by 13 publications

References 44 publications

Quality of life long after temporal lobe epilepsy surgery

Quality of life long after temporal lobe epilepsy surgery

Inhibition of RhoA/Rho kinase signaling pathway by fasudil protects against kainic acid‐induced neurite injury

Quality of life, psychiatric symptoms, and stigma perception in three groups of persons with epilepsy

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