Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study

Pauli C, Schwarzbold ML, Diaz AP, Rodrigues de Oliveira Thais ME, Kondageski C, Linhares MN, Guarnieri R, Zingano B de L, Ben J, Nunes JC, Markowitsch HJ, et al. (2017)
EPILEPSIA 58(5): 755-763.

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Objectives: To investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug-resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) in Brazilian patients. Methods: Multiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) overall score 1year after ATL in 77 consecutive patients with unilateral MTLE-HS. Results: The overall QOLIE-31 score and all its subscale scores increased significantly (p<0.0001) 1year after ATL. In the final logistic regression model, absence of presurgical diagnosis of depression (adjusted odds ratio [OR] 4.4, 95% confidence interval [CI] 1.1-16.1, p=0.02) and a complete postoperative seizure control (adjusted OR 4.1, 95% CI 1.2-14.5, p=0.03) were independently associated with improvement equal to or greater than the MCIC in QOL after ATL. The overall model accuracy for MCIC improvement in the QOL was 85.6%, with a 95.2% of sensitivity and 46.7% of specificity. Significance: These results in Brazilian patients reinforce the external validation of previous findings in Canadian patients showing that presurgical depression and complete seizure control after surgery are independent predictors for meaningful improvement in QOL after ATL, and have implications for the surgical management of MTLE patients.
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Pauli C, Schwarzbold ML, Diaz AP, et al. Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. EPILEPSIA. 2017;58(5):755-763.
Pauli, C., Schwarzbold, M. L., Diaz, A. P., Rodrigues de Oliveira Thais, M. E., Kondageski, C., Linhares, M. N., Guarnieri, R., et al. (2017). Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. EPILEPSIA, 58(5), 755-763. doi:10.1111/epi.13721
Pauli, C., Schwarzbold, M. L., Diaz, A. P., Rodrigues de Oliveira Thais, M. E., Kondageski, C., Linhares, M. N., Guarnieri, R., Zingano, B. de L., Ben, J., Nunes, J. C., et al. (2017). Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. EPILEPSIA 58, 755-763.
Pauli, C., et al., 2017. Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. EPILEPSIA, 58(5), p 755-763.
C. Pauli, et al., “Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study”, EPILEPSIA, vol. 58, 2017, pp. 755-763.
Pauli, C., Schwarzbold, M.L., Diaz, A.P., Rodrigues de Oliveira Thais, M.E., Kondageski, C., Linhares, M.N., Guarnieri, R., Zingano, B. de L., Ben, J., Nunes, J.C., Markowitsch, H.J., Wolf, P., Wiebe, S., Lin, K., Walz, R.: Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study. EPILEPSIA. 58, 755-763 (2017).
Pauli, Carla, Schwarzbold, Marcelo Liborio, Diaz, Alexandre Paim, Rodrigues de Oliveira Thais, Maria Emilia, Kondageski, Charles, Linhares, Marcelo Neves, Guarnieri, Ricardo, Zingano, Bianca de Lemos, Ben, Juliana, Nunes, Jean Costa, Markowitsch, Hans J., Wolf, Peter, Wiebe, Samuel, Lin, Katia, and Walz, Roger. “Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study”. EPILEPSIA 58.5 (2017): 755-763.
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