Department of Neurology, Leiden University Medical Center, PO BOX 9600, Leiden, 2300 RC, The Netherlands.
Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands.
J Neurooncol. 2021 May;153(1):89-98. doi: 10.1007/s11060-021-03747-1. Epub 2021 Apr 6.
AEDs have been associated with depression, anxiety, and cognitive impairment, all frequent complications of glioma and its subsequent treatment, with considerable morbidity and an adverse effect on health-related quality of life. This study aimed to determine the independent association between AED use and self-reported depression, anxiety, and subjective cognitive impairment in glioma patients.
In this multicenter cross-sectional study, depression and anxiety were assessed with the HADS and subjective cognitive impairment was assessed with the MOS-CFS. Univariable logistic regression analyses were performed on all potential confounding predictor variables. Potential confounders were included in the multivariable analyses if p-value < 0.1, to evaluate whether use of AEDs was independently related to depression, anxiety, and/or subjective cognitive impairment.
A total of 272 patients were included. Prevalence of depression differed significantly between patients not using (10%) and using AEDs (21%, unadjusted Odds Ratio [uOR] = 2.29 [95%CI 1.05-4.97], p = 0.037), but after correction for confounders the statistical significant difference was no longer apparent (adjusted Odds Ratio [aOR] = 1.94 [95%CI 0.83-4.50], p = 0.125). Prevalences of anxiety (aOR = 1.17 [95%CI 0.59-2.29], p = 0.659) and subjective cognitive impairment (aOR = 0.83 [95%CI 0.34-2.04], p = 0.684) did not differ significantly before or after adjustment of confounders between patients not using (19% and 16%, respectively) and using AEDs (26% and 21%, respectively).
Our results indicate AED use was not independently associated with concurrent depression, anxiety, or subjective cognitive impairment in glioma patients. Alternative factors seem to have a greater contribution to the risk of developing neuropsychiatric symptoms in glioma patients.
AED 与抑郁、焦虑和认知障碍有关,这些都是胶质瘤及其后续治疗的常见并发症,会导致相当大的发病率和对健康相关生活质量的不利影响。本研究旨在确定 AED 使用与胶质瘤患者报告的抑郁、焦虑和主观认知障碍之间的独立关联。
在这项多中心横断面研究中,使用 HADS 评估抑郁,使用 MOS-CFS 评估主观认知障碍。对所有潜在混杂预测变量进行单变量逻辑回归分析。如果 p 值 < 0.1,则将潜在混杂因素纳入多变量分析,以评估 AED 使用是否与抑郁、焦虑和/或主观认知障碍独立相关。
共纳入 272 例患者。未使用 AED 组(10%)和使用 AED 组(21%)的抑郁发生率差异有统计学意义(未校正优势比 [uOR] = 2.29 [95%CI 1.05-4.97],p = 0.037),但在校正混杂因素后,统计学差异不再明显(校正优势比 [aOR] = 1.94 [95%CI 0.83-4.50],p = 0.125)。焦虑(aOR = 1.17 [95%CI 0.59-2.29],p = 0.659)和主观认知障碍(aOR = 0.83 [95%CI 0.34-2.04],p = 0.684)的发生率在未使用 AED 组(分别为 19%和 16%)和使用 AED 组(分别为 26%和 21%)之间,在校正混杂因素前后差异均无统计学意义。
我们的结果表明,AED 使用与胶质瘤患者的抑郁、焦虑或主观认知障碍之间无独立相关性。替代因素似乎对胶质瘤患者发生神经精神症状的风险有更大的贡献。