Is lateralization concordance between preoperative video-EEG, ictal SPECT, and MRI to be associated with positive psychiatric outcomes after cortico-amygdalohippocampectomy in patients with pharmacoresistant temporal lobe epilepsy associated to mesial temporal sclerosis? A retrospective cohort study

• Published in: Epilepsy & behavior 2024-12, Vol.161, p.110115, Article 110115
• Main Authors: de Faria Dutra Andrade Karam, Bruna, Peres de Medeiros, Michael, Helena Neves Marques, Lucia, Maria de Araújo Filho, Gerardo
• Format: Article
• Language: English
• Subjects: Adult; Amygdala - diagnostic imaging; Amygdala - surgery; Cerebral Cortex - diagnostic imaging; Cohort Studies; Drug Resistant Epilepsy - diagnostic imaging; Drug Resistant Epilepsy - psychology; Drug Resistant Epilepsy - surgery; Electroencephalography - methods; Epilepsy surgery; Epilepsy, Temporal Lobe - diagnostic imaging; Epilepsy, Temporal Lobe - surgery; Female; Functional Laterality - physiology; Hippocampal Sclerosis; Hippocampus - diagnostic imaging; Hippocampus - pathology; Hippocampus - surgery; Humans; Magnetic Resonance Imaging; Male; Mental Disorders - diagnostic imaging; Mental Disorders - etiology; Mesial temporal lobe epilepsy; Middle Aged; Pharmacoresistant epilepsy; Psychiatric disorders in epilepsy; Psychiatric outcome; Retrospective Studies; Sclerosis - diagnostic imaging; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Young Adult
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2024.110115

•Pre-surgical variables were evaluated in patients with pharmacoresistant TLE-MTS aiming to investigate possible risk factors for the presence of PD after cortico-amygdalohippocampectomy (CAH).•A previous history of PD was directly associated with the development of post-surgical PD one year after CAH.•A concordant definition of the seizure onset zone (SOZ) across pre-surgical exams could be associated with a favorable post-surgical psychiatric outcome after CAH. The occurrence of comorbid psychiatric disorders (PD) in patients with pharmacoresistant temporal lobe epilepsy (TLE) associated to mesial temporal sclerosis (MTS) can be considered as a result of the complex interaction between biological and psychosocial factors, as well as the effects of antiseizure medications (ASM). Regarding biological aspects, despite the growing amount of knowledge, there is still a scarcity of data in literature clarifying whether a more precise definition of the seizure onset zone (SOZ) could be associated with a more favorable post-surgical psychiatric outcome. In the present study, the clinical and sociodemographic pre-surgical variables, including the results of neurophysiological and neuroimaging exams, were evaluated in patients with pharmacoresistant TLE-MTS aiming to investigate possible risk factors for the presence of PD after cortico-amygdalohippocampectomy (CAH). A retrospective cohort analysis of medical records from initially 106 pre-surgical patients with pharmacoresistant TLE-MTS with PD (n = 51; 48.1 %) and without PD (n = 55; 51.9 %) proceeded. Pre-surgical clinical and sociodemographic data were compared between both groups and the predictors for the presence of post-surgical PD were characterized up to one and two years after CAH. Seventeen patients (16 %) had lost their follow-up in the first year after surgery, and 89 (84 %) had completed the study. No clinical and sociodemographic differences were observed between both groups of patients (p > 0.05), except for a history of previous psychiatric treatment (p = 0.001). Eighteen patients (35.29 %) with pre-surgical history of PD had remission of PD after CAH, while eight (14.5 %) developed de novo PD. The previous history of PD was directly associated with the development of post-surgical PD one year after CAH (p