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Factors Affecting Cognition and Depression in Adult Patients with Epilepsy

BACKGROUND AND PURPOSE: Epilepsy patients are more likely to experience depressive symptoms and cognitive impairment compared to individuals in the general population. As the reasons for this are not definitively known, we sought to determine what factors correlate most strongly with cognition and a...

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Autores principales: Narayanan, Jaishree, Simon, Kelly Claire, Choi, Janet, Dobrin, Sofia, Rubin, Susan, Taber, Jesse, Wang, Charles, Pham, Anna, Chesis, Richard, Hadsell, Bryce, Epshteyn, Alexander, Wilk, Gary, Tideman, Samuel, Meyers, Steven, Frigerio, Roberta, Maraganore, Demetrius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Epilepsy Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251347/
https://www.ncbi.nlm.nih.gov/pubmed/32509545
http://dx.doi.org/10.14581/jer.19018
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author Narayanan, Jaishree
Simon, Kelly Claire
Choi, Janet
Dobrin, Sofia
Rubin, Susan
Taber, Jesse
Wang, Charles
Pham, Anna
Chesis, Richard
Hadsell, Bryce
Epshteyn, Alexander
Wilk, Gary
Tideman, Samuel
Meyers, Steven
Frigerio, Roberta
Maraganore, Demetrius
author_facet Narayanan, Jaishree
Simon, Kelly Claire
Choi, Janet
Dobrin, Sofia
Rubin, Susan
Taber, Jesse
Wang, Charles
Pham, Anna
Chesis, Richard
Hadsell, Bryce
Epshteyn, Alexander
Wilk, Gary
Tideman, Samuel
Meyers, Steven
Frigerio, Roberta
Maraganore, Demetrius
author_sort Narayanan, Jaishree
collection PubMed
description BACKGROUND AND PURPOSE: Epilepsy patients are more likely to experience depressive symptoms and cognitive impairment compared to individuals in the general population. As the reasons for this are not definitively known, we sought to determine what factors correlate most strongly with cognition and a screening test for depression in epilepsy patients. METHODS: Our study population included 379 adult patients diagnosed with epilepsy or seizure in our neurology clinic. We collected detailed demographic and clinical data during patient visits using structured clinical documentation support tools that we have built within our commercial electronic medical records system (Epic), including a depression score (Neurological Disorders Depression Inventory for Epilepsy, NDDIE) and cognition score test measures (specifically in this study, Mini-Mental State Examination [MMSE]). Medication, age, gender, body mass index, duration of epilepsy, seizure frequency, current number of anti-epileptic medications, years of education were assessed in relation to baseline score as well as change in score from initial visit to first annual follow-up. RESULTS: Of the analyzed factors, two statistically significant associations were found after correction for multiple testing. Male gender and lower anti-seizure medication count were associated with better mood, as assessed by NDDIE score, at initial visit. Specifically, male gender was associated with a 1.3 decrease in NDDIE and for each additional anti-seizure medication, there was an associated 1.2 increase in NDDIE. CONCLUSIONS: However, these factors were not associated with change in NDDIE score from initial to first annual follow-up visit. These findings, although interesting, are preliminary. Additionally, these findings were based on a homogenous (mainly Caucasian) clinic-based population and detailed information on previous medication use was lacking. Further work is needed to replicate these findings and to understand any mechanisms that may explain these associations.
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spelling pubmed-72513472020-06-05 Factors Affecting Cognition and Depression in Adult Patients with Epilepsy Narayanan, Jaishree Simon, Kelly Claire Choi, Janet Dobrin, Sofia Rubin, Susan Taber, Jesse Wang, Charles Pham, Anna Chesis, Richard Hadsell, Bryce Epshteyn, Alexander Wilk, Gary Tideman, Samuel Meyers, Steven Frigerio, Roberta Maraganore, Demetrius J Epilepsy Res Original Article BACKGROUND AND PURPOSE: Epilepsy patients are more likely to experience depressive symptoms and cognitive impairment compared to individuals in the general population. As the reasons for this are not definitively known, we sought to determine what factors correlate most strongly with cognition and a screening test for depression in epilepsy patients. METHODS: Our study population included 379 adult patients diagnosed with epilepsy or seizure in our neurology clinic. We collected detailed demographic and clinical data during patient visits using structured clinical documentation support tools that we have built within our commercial electronic medical records system (Epic), including a depression score (Neurological Disorders Depression Inventory for Epilepsy, NDDIE) and cognition score test measures (specifically in this study, Mini-Mental State Examination [MMSE]). Medication, age, gender, body mass index, duration of epilepsy, seizure frequency, current number of anti-epileptic medications, years of education were assessed in relation to baseline score as well as change in score from initial visit to first annual follow-up. RESULTS: Of the analyzed factors, two statistically significant associations were found after correction for multiple testing. Male gender and lower anti-seizure medication count were associated with better mood, as assessed by NDDIE score, at initial visit. Specifically, male gender was associated with a 1.3 decrease in NDDIE and for each additional anti-seizure medication, there was an associated 1.2 increase in NDDIE. CONCLUSIONS: However, these factors were not associated with change in NDDIE score from initial to first annual follow-up visit. These findings, although interesting, are preliminary. Additionally, these findings were based on a homogenous (mainly Caucasian) clinic-based population and detailed information on previous medication use was lacking. Further work is needed to replicate these findings and to understand any mechanisms that may explain these associations. Korean Epilepsy Society 2019-12-31 /pmc/articles/PMC7251347/ /pubmed/32509545 http://dx.doi.org/10.14581/jer.19018 Text en Copyright © 2019 Korean Epilepsy Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Narayanan, Jaishree
Simon, Kelly Claire
Choi, Janet
Dobrin, Sofia
Rubin, Susan
Taber, Jesse
Wang, Charles
Pham, Anna
Chesis, Richard
Hadsell, Bryce
Epshteyn, Alexander
Wilk, Gary
Tideman, Samuel
Meyers, Steven
Frigerio, Roberta
Maraganore, Demetrius
Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title_full Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title_fullStr Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title_full_unstemmed Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title_short Factors Affecting Cognition and Depression in Adult Patients with Epilepsy
title_sort factors affecting cognition and depression in adult patients with epilepsy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251347/
https://www.ncbi.nlm.nih.gov/pubmed/32509545
http://dx.doi.org/10.14581/jer.19018
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