癫痫手术后一年的共病冲动性

Comorbid impulsivity after one year of epilepsy surgery.

作者信息

González Stivala Ernesto, Sarudiansky Mercedes, Wolfzun Camila, Giagante Brenda, Oddo Silvia, Seoane Pablo, Kochen Silvia, D'Alessio Luciana

机构信息

Universidad de Buenos Aires, Facultad de Medicina, Instituto de Biología Celular y Neurociencias (IBCN-CONICET), Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Medicina, Centro de Epilepsia del Hospital Ramos Mejía, Buenos Aires, Argentina; Centro de Epilepsia del Hospital El Cruce, Estudios en Neurociencias y Sistemas Complejos (ENyS-CONICET), Buenos Aires, Argentina.

Universidad de Buenos Aires, Facultad de Psicología, Buenos Aires, Argentina.

出版信息

Epilepsy Behav. 2021 Oct 1;124:108331. doi: 10.1016/j.yebeh.2021.108331.

DOI:10.1016/j.yebeh.2021.108331

PMID:34607216

Abstract

BACKGROUND

Psychiatric comorbidities in patients with drug-resistant epilepsy (DRE) are frequently observed before and after epilepsy surgery. Impulsivity, defined as behaviors that are poorly conceived, are also frequent among patients with epilepsy. The aim of this study was to determine the presence of comorbid impulsivity in patients with DRE after one year of epilepsy surgery.

METHODS

Patients who underwent epilepsy surgery for DRE and completed the postsurgical assessment protocol one year after surgery were included. All patients underwent a presurgical protocol comprising of neurological, psychiatric, neuropsychological, video-EEG and MRI assessments. The psychiatric evaluation was performed before and one year after surgery using SCID-I, SCID-II, GAF scale of DSM IV, and Beck Depression Inventory II. One year after surgery, Barratt Impulsiveness Scale 11, and Engel classification of seizures, were administered.

RESULTS

A total of 38 patients were included in this study, 21 women (55.3%) and 17 men (44.7%), mean age 36 years (SD = 9.4). Higher impulsivity was associated with a worse epilepsy seizure outcome (p < 0.05), one year after surgery. According to the multiple linear regression analysis, a worse epilepsy seizure outcome was associated with higher levels of nonplanning impulsivity (p < 0.05) (p < 0.05, β -0.5, r 0.25). The GAF score was negatively associated with motor score (p < 0.05, β -0.584, r 0.42) and with the total BIS-11 score (p < 0.05, β -0.557, r 0.39).

CONCLUSIONS

Impulsivity has been associated with a worse post-surgical seizure outcome. Larger studies about impulsivity might confirm these preliminary findings.

摘要

背景

耐药性癫痫（DRE）患者在癫痫手术前后经常出现精神共病。冲动行为被定义为缺乏深思熟虑的行为，在癫痫患者中也很常见。本研究的目的是确定癫痫手术后一年的DRE患者中是否存在共病冲动行为。

方法

纳入因DRE接受癫痫手术并在术后一年完成术后评估方案的患者。所有患者均接受了包括神经、精神、神经心理、视频脑电图和MRI评估在内的术前方案。术前和术后一年使用DSM-IV的SCID-I、SCID-II、GAF量表和贝克抑郁量表II进行精神评估。术后一年，使用巴拉特冲动量表11和癫痫发作的恩格尔分类法进行评估。

结果

本研究共纳入38例患者，其中女性21例（55.3%），男性17例（44.7%），平均年龄36岁（标准差=9.4）。术后一年，较高的冲动性与较差的癫痫发作结果相关（p<0.05）。根据多元线性回归分析，较差的癫痫发作结果与较高水平的非计划性冲动相关（p<0.05）（p<0.05，β-0.5，r 0.25）。GAF评分与运动评分呈负相关（p<0.05，β-0.584，r 0.42），与BIS-11总分呈负相关（p<0.05，β-0.557，r 0.39）。