Section for Epileptology, Department of Neurosurgery, University Hospital Freiburg im Breisgau, 79106 Freiburg, Germany.
Epilepsy Behav. 2009 Dec;16(4):622-8. doi: 10.1016/j.yebeh.2009.09.017. Epub 2009 Oct 30.
Recent research has pointed to the possibility of a bidirectional relationship between seizure frequency in epilepsy and depressive symptoms. The study described here investigated the relationship between preoperative depressive symptomatology and postoperative seizure outcome in a sample of patients with temporal (TLE) and frontal (FLE) lobe epilepsy.
A retrospective analysis was conducted on the data from 115 eligible patients with TLE (N=97) and FLE (N=18) and resections limited to one cortical lobe who were evaluated preoperatively and 1year after epilepsy surgery with respect to depressive symptoms (Beck Depression Inventory, BDI) and seizure outcome. The latter was assessed in terms of actual total seizure frequency as well as a dichotomous variable (seizure free vs. not seizure free) for the 1-year outcome. Repeated-measures analyses of variance and regression analyses were applied.
Seizure-free patients had significantly lower BDI scores preoperatively as well as postoperatively than patients who were not seizure free. In the regression analyses, the preoperative BDI score was a significant predictor of postoperative seizure frequency as well as seizure freedom. When only patients with TLE were analyzed, the results for the association between preoperative BDI and postoperative seizure frequency and seizure freedom remained consistent.
The present results provide evidence for a statistical bidirectionality of the relationship between depressive symptoms and postoperative seizure status in a mixed sample of patients with TLE and FLE. Possible reasons for this bidirectional association include an underlying common pathology in both depression and epilepsy, for example, structural changes or functional alterations in neurotransmitter systems.
最近的研究指出癫痫发作频率和抑郁症状之间可能存在双向关系。本研究调查了颞叶（TLE）和额叶（FLE）癫痫患者样本中术前抑郁症状与术后癫痫发作结果之间的关系。
对 115 名符合条件的 TLE（N=97）和 FLE（N=18）患者的数据进行回顾性分析，这些患者的皮质切除术仅限于一个脑叶，他们在癫痫手术后 1 年进行了术前和术后抑郁症状（贝克抑郁量表，BDI）和癫痫发作结果的评估。后者根据实际总发作频率和 1 年结局的二分变量（无发作与无发作）进行评估。应用重复测量方差分析和回归分析。
无发作患者的术前和术后 BDI 评分均显著低于未无发作患者。在回归分析中，术前 BDI 评分是术后癫痫发作频率和无发作的显著预测指标。当仅分析 TLE 患者时，术前 BDI 与术后癫痫发作频率和无发作之间的关联结果仍然一致。
本研究结果为 TLE 和 FLE 混合患者中抑郁症状与术后癫痫发作状态之间的统计学双向关系提供了证据。这种双向关联的可能原因包括抑郁和癫痫两者之间潜在的共同病理，例如神经递质系统的结构变化或功能改变。
