Otabe Hiroyuki, Taniguchi Go, Iijima Keiya, Iwasaki Masaki
Department of Neurosurgery National Center Hospital, National Center of Neurology and Psychiatry Kodaira Japan.
Department of Psychiatry Saiseikai Konosu Hospital Konosu Japan.
PCN Rep. 2024 Apr 16;3(2):e193. doi: 10.1002/pcn5.193. eCollection 2024 Jun.
The influence of surgeries on psychiatric symptoms and personality traits is not well known in patients with intractable temporal lobe epilepsy (TLE). We investigated changes in personality traits with respect to postoperative seizure outcomes, etiology, side of surgery, and sex differences.
Clinical information was retrospectively collected for 44 patients whose Minnesota Multiphasic Personality Inventory (MMPI) was examined before and 1 year after surgical treatment for drug-resistant TLE. Postoperative changes in MMPI -scores were analyzed using a paired -test. Participants were divided into two groups based on postoperative seizure outcome, the presence or absence of hippocampal sclerosis (HS) as the etiology, side of surgery, and sex differences. The effect of these clinical factors on postoperative changes in MMPI -scores was evaluated using analysis of covariance (-values < 0.05).
The hypochondria (Hs) scale decreased significantly in all patients ( = 0.022). The postoperative seizure-free group had a significant decrease in the depression (D) scale ( = 0.037). The HS group had significant decreases in the D scale and the hysteria (Hy) scale ( = 0.016 and 0.004, respectively), and a significant increase in the masculinity-femininity (Mf) scale ( = 0.009). No significant differences existed between the sides of surgery or sex.
Depressive traits were improved in patients with postoperative seizure freedom. Depressive and hysterical traits were improved in patients with HS, which may be attributed to a reduction in anxiety and fear associated with aura. Most personality traits are not significantly changed or exacerbated by surgical treatment of TLE.
在难治性颞叶癫痫(TLE)患者中,手术对精神症状和人格特质的影响尚不清楚。我们研究了人格特质相对于术后癫痫发作结果、病因、手术侧别和性别差异的变化。
回顾性收集了44例药物难治性TLE患者的临床信息,这些患者在手术治疗前和术后1年接受了明尼苏达多相人格调查表(MMPI)检查。使用配对检验分析MMPI分数的术后变化。参与者根据术后癫痫发作结果、是否存在海马硬化(HS)作为病因、手术侧别和性别差异分为两组。使用协方差分析评估这些临床因素对MMPI分数术后变化的影响(P值<0.05)。
所有患者的疑病(Hs)量表显著下降(P = 0.022)。术后无癫痫发作组的抑郁(D)量表显著下降(P = 0.037)。HS组的D量表和癔症(Hy)量表显著下降(分别为P = 0.016和0.004),男性化-女性化(Mf)量表显著增加(P = 0.009)。手术侧别或性别之间无显著差异。
术后无癫痫发作的患者抑郁特质得到改善。HS患者的抑郁和癔症特质得到改善,这可能归因于与先兆相关的焦虑和恐惧的减少。大多数人格特质在TLE手术治疗后没有显著改变或加重。