Predicting mood decline following temporal lobe epilepsy surgery in adults.
Adult
Affect
Age Factors
Anterior Temporal Lobectomy
Clinical Decision Rules
Cognition
Comorbidity
Depression
/ epidemiology
Depressive Disorder, Major
/ epidemiology
Drug Resistant Epilepsy
/ epidemiology
Epilepsy, Temporal Lobe
/ epidemiology
Female
Functional Laterality
Humans
Male
Malformations of Cortical Development
/ epidemiology
Marital Status
Mental Disorders
/ epidemiology
Middle Aged
Postoperative Complications
/ epidemiology
Risk Factors
depression
epilepsy
epilepsy surgery
neuropsychology/behavior
psychiatric comorbidities
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
19
10
2020
revised:
05
12
2020
accepted:
07
12
2020
pubmed:
20
1
2021
medline:
20
4
2021
entrez:
19
1
2021
Statut:
ppublish
Résumé
To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy. Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100). All data were combined to develop a final model to predict postoperative mood decline (N = 592). Internal validation with bootstrap resampling was performed. A clinically significant increase in depressive symptoms was defined as a 15% increase in Beck Depression Inventory-Second Edition score and a postoperative raw score > 11. Fourteen percent of patients in the Cleveland Clinic cohort and 22% of patients in the external cohort experienced clinically significant increases in depressive symptoms following surgery. The final prediction model included six predictor variables: psychiatric history, resection side, relationship status, verbal fluency score, age at preoperative testing, and presence/absence of malformation of cortical development on magnetic resonance imaging. The model had an optimism-adjusted c-statistic of .70 and good calibration, with slight probability overestimation in higher risk patients. Clinicians can utilize our nomogram via a paper tool or online calculator to estimate the risk of postoperative mood decline for individual patients prior to temporal lobe epilepsy surgery.
Identifiants
pubmed: 33464568
doi: 10.1111/epi.16800
pmc: PMC8216427
mid: NIHMS1705409
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
450-459Subventions
Organisme : NINDS NIH HHS
ID : R21 NS107739
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS035140
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS065838
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS083976
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS124585
Pays : United States
Organisme : NINDS NIH HHS
ID : R56 NS065838
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS097719
Pays : United States
Organisme : Cleveland Clinic Epilepsy Center
Organisme : NINDS NIH HHS
ID : R03 NS111180
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS038455
Pays : United States
Organisme : American Academy of Neurology's Medical Student Research Scholarship
Organisme : NINDS NIH HHS
ID : F31 NS111883
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2021 International League Against Epilepsy.
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