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Longitudinal Study Finds That Quality of Life Improves in Years Following Surgery; Mood Improves Most During First Year

July 29, 2020

Published in Epilepsy & Behavior

Highlights

  • Quality of life improves years after surgery, whereas mood improves first year.
  • Seizure freedom is a strong predictor of quality of life change.
  • Frontal resection had superior improvement in [quality of life measures] PHQ-9 and possibly QOLIE-10.

Abstract

Objective: This study investigated self-reported longitudinal quality of life (QOL) and symptoms of depression and anxiety in patients who had resective surgery. The study characterized the extent, sustainability, and longitudinal trajectory of psychosocial postsurgical outcomes.

Methods: This retrospective study included adults who underwent resective epilepsy surgery in Cleveland Clinic Epilepsy Center between 2008 and 2013. Clinic visits were between October 2007 and December 2014.

Results: The study included 229 adults, of whom 178 had complete follow-up with data from all three time points. Following surgery, scores on Quality of life in epilepsy inventory (QOLIE-10), Patient health questionnaire (PHQ-9), and General anxiety disorder (GAD-7) improved significantly with time. Seizure freedom was strongly correlated with improved QOL (p = 0.001), while depressive symptoms showed a non-statistically significant correlation with worse QOL. Patients who underwent frontal resection had significantly superior QOL and depression symptom improvement compared with temporal resections during full data analysis, but only significant depression symptom improvement on secondary analysis of complete follow-up patients only.

Significance: This study provides a longitudinal perspective of quality of life (QOL) and psychological symptoms in patients with post-resective epilepsy with a cohort with 38% extratemporal cases. Results illustrate positive trajectory of psychosocial outcomes post-surgery with early QOL and mood improvement, and years of further QOL gains. Frontal lobe surgery patients may have superior improvement in some psychosocial measures compared with temporal lobe surgery patients.