Quality of life after epilepsy surgery: How domain-specific cognitive changes impact QOL within the context of seizure outcome

Arrotta, Kayela; Thompson, Nicolas R.; Honomichl, Ryan; Najm, Imad; Bingaman, William; Busch, Robyn M.

doi:10.1016/j.yebeh.2022.108948

Cited by 5 publications

(11 citation statements)

References 25 publications

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“…These were published between 2009 and 2022. Nine studies were of prospective cohort design, 26‐34 two studies were randomized control trials, 25,35 one was a prospective case–control study, 36 and four were retrospective cohort studies 37‐40 . Two studies reported the same cohort at different follow‐up time points (1 year vs. 7.8 years); only the most recently published study was included in the final systematic review and meta‐analysis 32,41 .…”

Section: Resultsmentioning

confidence: 99%

“…Demographic data points extracted from the included 16 studies are presented in Table 1. Nine studies were conducted in high‐income countries or provinces, including five studies from the USA, 33,35,37,39,40 and one each from China, 27 Czech Republic, 28 Spain, 29 and Taiwan 26 . Six studies were conducted in middle‐income countries, including two studies from Brazil, 30,32 and one each from South Africa, 31 Thailand, 38 Iran, 36 and India 34 .…”

Section: Resultsmentioning

confidence: 99%

“…Data were not reported consistently for other patient variables across studies. From the data that were available, mean age at time of study enrollment was 35.2 years, 26,28,29,30,31,33,35,36,38,39 mean age at epilepsy onset was 17.9 years, 25,27,29,31,32,33,38,39,40 mean preoperative seizure frequency was 7.5 seizures per month, 25,27,29,32,34,35,38,39 and mean age at epilepsy surgery was 37.1 years 25,27,32,33,40 …”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies ( n = 14/16, 87.5) used epilepsy‐specific health‐related QoL questionnaires. Six studies ( n = 6/16, 37.5%) used QOLIE‐31, 27,28,29,32,37,39 four ( n = 4/16, 25.0%) used QOLIE‐89, 25,26,31,35 three ( n = 3/16, 18.8%) used QOLIE‐10, 33,34,40 and one ( n = 1/16, 6.3%) used ESI‐55 30 . Two studies used generic health‐related QoL questionnaires: one ( n = 1/16, 6.3%) used SF‐8, 38 and the other ( n = 1/16, 6.3%) used WHOQOL‐BREF 36 .…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen of the 16 studies reported postoperative seizure outcome following epilepsy surgery. Six studies used the Engel classification in reporting seizure outcomes, 28,31,32,36,38,39 whereas eight studies dichotomized outcomes into seizure‐free versus not seizure‐free 25,26,27,30,34,35,37,40 . At least half of the patients in each study attained favorable seizure outcomes (median = 68.0%, range = 50.0%–88.6%), that is, postoperatively they experienced either complete seizure freedom or freedom from disabling seizures.…”

Section: Resultsmentioning

confidence: 99%

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Impact of epilepsy surgery on quality of life: Systematic review and meta‐analysis

et al. 2023

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Improved quality of life (QoL) is an important outcome goal following epilepsy surgery. This study aims to quantify change in QoL for adults with drug‐resistant epilepsy (DRE) who undergo epilepsy surgery, and to explore clinicodemographic factors associated with these changes. We conducted a systematic review and meta‐analysis using Medline, Embase, and Cochrane Central Register of Controlled Trials. All studies reporting pre‐ and post‐epilepsy surgery QoL scores in adults with DRE via validated instruments were included. Meta‐analysis assessed the postsurgery change in QoL. Meta‐regression assessed the effect of postoperative seizure outcomes on postoperative QoL as well as change in pre‐ and postoperative QoL scores. A total of 3774 titles and abstracts were reviewed, and ultimately 16 studies, comprising 1182 unique patients, were included. Quality of Life in Epilepsy Inventory–31 item (QOLIE‐31) meta‐analysis included six studies, and QOLIE‐89 meta‐analysis included four studies. Postoperative change in raw score was 20.5 for QOLIE‐31 (95% confidence interval [CI] = 10.9–30.1, I2 = 95.5) and 12.1 for QOLIE‐89 (95% CI = 8.0–16.1, I2 = 55.0%). This corresponds to clinically meaningful QOL improvements. Meta‐regression demonstrated a higher postoperative QOLIE‐31 score as well as change in pre‐ and postoperative QOLIE‐31 score among studies of cohorts with higher proportions of patients with favorable seizure outcomes. At an individual study level, preoperative absence of mood disorders, better preoperative cognition, fewer trials of antiseizure medications before surgery, high levels of conscientiousness and openness to experience at the baseline, engagement in paid employment before and after surgery, and not being on antidepressants following surgery were associated with improved postoperative QoL. This study demonstrates the potential for epilepsy surgery to provide clinically meaningful improvements in QoL, as well as identifies clinicodemographic factors associated with this outcome. Limitations include substantial heterogeneity between individual studies and high risk of bias.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Impact of epilepsy surgery on quality of life: Systematic review and meta‐analysis

et al. 2023

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A survey of the prevalence and patterns of neuropsychological assessment practices across epilepsy surgery centers in India: Toward establishing a national guideline

Shah,

Rathore,

Radhakrishnan

et al. 2024

Epilepsia Open

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Neuropsychology plays an important role in optimizing epilepsy management, but there are no practice guidelines for low‐ and middle‐income countries with emerging services. The National Epilepsy Surgery Support Activity Network (NESSAN), a national working group that supports and optimizes epilepsy surgery programs in India, explored the present status of pre‐ and post epilepsy surgery neuropsychological assessment practices across India as an initial step in developing national evidence‐based test guidelines. An online survey was conducted using two questionnaires, one for neurologists and the second for neuropsychologists and speech–language pathologists working in epilepsy surgery centers. The questions to neurologists covered the setting, description, and nature of the neuropsychology services provided for adults and children as part of the epilepsy surgery program, and their perceptions about the importance and indications for neuropsychological assessment in epilepsy surgery. The questions to neuropsychologists inquired about their qualifications and training, pre‐ and postsurgical assessment procedures, and domain‐specific cognitive tests and scales for mood, quality of life, and language evaluations. Forty‐three centers responded, and neuropsychology services were available at three fourth of the centers, but a dedicated full‐time neuropsychologist was available in only 16% of centers. Ninety percent of the neurologists considered neuropsychological evaluation an indispensable part of presurgical evaluation. However, only a few of them believed that the results influenced their decision about the extent of resection and ruling against surgery. The survey found considerable heterogeneity in terms of qualifications and training of neuropsychologists, evaluation procedures, test protocols, and normative data that will need to be harmonized to ensure uniform practice across the country. We believe that the results from this survey provide a road map for implementing measures to minimize existing inadequacies and harmonize neuropsychology services in India and as well as in other countries with emerging neuropsychology services.Plain Language SummaryNeuropsychological assessment is an integral part of the pre‐ and post epilepsy surgery evaluations. In India, the National Epilepsy Surgery Support Activity Network (NESSAN), a body of multidisciplinary professionals, conducted a survey to examine existing neuropsychology practices. The responses from 43 centers across the country revealed considerable heterogeneity in tests and few trained and qualified neuropsychologists. In low‐ and middle‐income countries (LMIC) with emerging neuropsychology services, there is a need to have uniform test protocols, specialized training, and guidelines for optimizing neuropsychology services across all the epilepsy surgery centers.

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Epileptic-network-based prediction and control of seizures in humans

Lehnertz

Bröhl

Wrede

2023

Neurobiology of Disease

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Quality of life after epilepsy surgery: How domain-specific cognitive changes impact QOL within the context of seizure outcome

Cited by 5 publications

References 25 publications

Impact of epilepsy surgery on quality of life: Systematic review and meta‐analysis

Impact of epilepsy surgery on quality of life: Systematic review and meta‐analysis

A survey of the prevalence and patterns of neuropsychological assessment practices across epilepsy surgery centers in India: Toward establishing a national guideline

Epileptic-network-based prediction and control of seizures in humans

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