QOLIE-31 Scores Research Articles

Impact of the socioeconomic crisis in Lebanon on people with epilepsy.

The economic crisis in Lebanon, which began in 2019, has affected the healthcare system and patients' incomes. The aim of this study was to analyze the obstacles faced by people with epilepsy (PWE) during this crisis and to assess its impact on their quality of life. The method used was a cross-sectional study conducted among PWE aged 18-65 years, who were asked to complete a comprehensive questionnaire covering sociodemographic aspects, clinical aspects, the impact of the economic crisis, and the QOLIE-31 (version 1.0), validated in English and Arabic, which assesses the quality of life of PWE. 71 patients were included in the study with an average age of 35.2 years [23.5; 62.5] (53.5% were males). Their average QOLIE-31 score was 50.3 (+/- 17.9). A significant proportion (71%) of patients reported difficulties during the crisis, with 25% reporting having had seizure-related injuries in the years 2022-2023 and 36.6% reporting an increase in seizure frequency compared to that prior to 2020. Moreover, many patients had to change (33.8%) or discontinue (18.3%) antiseizure medications, due to drug shortages, rising costs, and high gas prices. To mitigate these challenges, patients sought solutions such as obtaining medications from abroad (34%) or through donations (8%) or purchasing from the black market (8%). Low quality of life was associated with unemployment, low education level, the presence of focal seizures with impaired awareness or generalized seizures, polytherapy, seizure-related injuries, and medication changes during the economic crisis. These results highlight the considerable challenges faced by PWE in Lebanon during the economic crisis, emphasizing the negative effect of the crisis on their quality of life and seizure control. This study analyzed the obstacles faced by 71 people with epilepsy during Lebanon's economic crisis and showed that many patients had to change (33.8%) or discontinue (18.3%) antiseizure medications, due to drug shortages, rising costs, and high gas prices. To mitigate these challenges, patients sought solutions such as obtaining medications from abroad (34%) or through donations (8%) or purchasing from the black market (8%). This affected their quality of life. In fact, low quality of life was associated with unemployment, low education level, focal seizures with impaired awareness or generalized seizures, polytherapy, seizure-related injuries, and medication changes.

The effectiveness and safety of bevacizumab in improving the efficacy of antiseizure medication in treating refractory epilepsy induced by stereotactic radiosurgery in meningiomas

Background: Refractory epilepsy (RE) increases rapidly after stereotactic radiosurgery (SRS), but the reports on RE treatment are rare, with various methods and efficacy. In recent years, bevacizumab (BEV) has been widely used as it is effective in eliminating intracranial oedema and reducing radioactive damage. The aim of this study was to evaluate the application of additional BEV to RE after SRS in the real world. Methods: Seizure freedom and seizure response were defined as 100% and > 50% reduction in seizure frequency at baseline and 6-, 9- and 12-month follow-ups. The sustained seizure-free (SSF), sustained seizure response (SSR) was used to assess the effectiveness of BEV. The number of anti-seizure medications (ASM), seizure severity (NH3), and epilepsy quality of life rating scale (QOLIE-31) scores were compared before and 12 months after treatment. Results: Forty-one patients were included from January 2020 to December 2022. During the 1-year follow-up, 5 patients (12.2%) achieved SSF lasting 12 months, and 4.9% and 7.3% enjoyed SSF more than 6 months and 9 months, respectively. Twelve patients (29.3%) achieved SSR lasting for 12 months, and 19.5% and 24.4% of the study cohort achieved SSR more than 6 months and 9 months, respectively. Patients’ ASM, NH3, and QOLIE-31 scores significantly improved 12 months after treatment, and the adverse reactions were controllable. Conclusion: This study is the first to explore and report the additional use of BEV in the treatment of RE after SRS in meningiomas. BEV was effective and safe in the treatment of SRS-induced RE.

Vitamin D deficiency and effect of treatment on seizure frequency and quality of life parameters in patients with drug-resistant epilepsy: A randomized clinical trial.

This study was undertaken to assess the effect of treatment of vitamin D deficiency in drug-resistant epilepsy. We conducted a multicenter, double-blind, placebo-controlled, randomized clinical trial, including patients aged ≥15 years with drug-resistant focal or generalized epilepsy. Patients with 25-hydroxyvitamin D (25[OH]D) < 30 ng/mL were randomized to an experimental group (EG) receiving vitamin D3 (cholecalciferol, 100 000 IU, five doses in 3 months) or a control group (CG) receiving matched placebo. During the open-label study, EG patients received 100 000 IU/month for 6 months, whereas CG patients received five doses in 3 months then 1/month for 3 months. Monitoring included seizure frequency (SF), 25(OH)D, calcium, albumin, creatinine assays, and standardized scales for fatigue, anxiety-depression, and quality of life (Modified Fatigue Impact Scale [M-FIS], Hospital Anxiety and Depression Scale, Quality of Life in Epilepsy [QOLIE-31]) at 3, 6, and 12 months. The primary efficacy outcome was the percentage of SF reduction compared to the reference period and CG at 3 months. Secondary outcomes were SF and bilateral tonic-clonic seizure (BTCS) reduction, scale score changes, and correlations with 25(OH)D during the follow-up. Eighty-eight patients were enrolled in the study (56 females, aged 17-74 years), with median baseline SF per 3 months = 16.5 and ≥2 antiseizure medications in 88.6%. In 75 patients (85%), 25(OH)D was <30 ng/mL; 40 of them were randomly assigned to EG and 34 to CG. After the 3-month blinded period, SF reduction did not significantly differ between groups. However, during the open-label period, SF significantly decreased (30% median SF reduction, 33% responder rate at 12 months). BTCSs were reduced by 52%. M-FIS and QOLIE-31 scores were significantly improved at the whole group level. SF reduction correlated with 25(OH)D > 30 ng/mL for >6 months. Despite no proven effect after the 3-month blinded period, the open-label study suggests that long-term vitamin D3 supplementation with optimal 25(OH)D may reduce SF and BTCSs, with a positive effect on fatigue and quality of life. These findings need to be confirmed by further long-term studies. ClinicalTrials.gov identifier: NCT03475225 (03-22-2018).

Clinical efficacy of Baijin pills in the treatment of generalized tonic-clonic seizure epilepsy with cognitive impairment

BACKGROUND The generalized tonic-clonic seizure (GTCS) is the most usual variety of epileptic seizure. It is mainly characterized by strong body muscle rigidity, loss of consciousness, a disorder of plant neurofunction, and significant damage to cognitive function. The effect of antiepileptic drugs on cognition should also be considered. At present, there is no effective treatment for patients with epilepsy, but traditional Chinese medicine has shown a significant effect on chronic disease with fewer harmful side effects and should, therefore, be considered for the therapy means of epilepsy with cognitive dysfunction. AIM To investigate the clinical efficacy of Baijin pills for treating GTCS patients with cognitive impairment. METHODS This prospective study enrolled patients diagnosed with GTCS between January 2020 and December 2023 and separate them into two groups (experimental and control) using random number table method. The control group was treated with sodium valproate, and the experimental group was Baijin pills and sodium valproate for three months. The frequency and duration of each seizure, the Montreal Cognitive Assessment Scale (MoCA), and the Quality of Life Rating Scale (QOLIE-31) were recorded before and after treatment. RESULTS There were 85 patients included (42 in the control group and 43 in the experimental group). After treatment, the seizure frequency in the experimental group was significantly reduced (P &lt; 0.05), and seizure duration was shortened (P &lt; 0.01). The total MoCA score in the experimental group significantly increased compared to before treatment (P &lt; 0.01), and the sub-item scores, except naming and abstract generalization ability, significantly increased (P &lt; 0.05), whereas the total MoCA score in the control group significantly decreased after treatment (P &lt; 0.05). The QOLIE-31 score of the experimental group increased significantly after treatment compared to before treatment (P &lt; 0.01). CONCLUSION Baijin pills have a good clinical effect on epilepsy with cognitive dysfunction.

Effects of intensive psychological intervention on treatment compliance, psychological status, and quality of life of patients with epilepsy.

Epilepsy is a nervous system disease characterized by recurrent attacks, a long disease course, and an unfavorable prognosis. It is associated with an enduring therapeutic process, and finding a cure has been difficult. Patients with epilepsy are predisposed to adverse moods, such as resistance, anxiety, nervousness, and anxiety, which compromise treatment compliance and overall efficacy. To explored the influence of intensive psychological intervention on treatment compliance, psychological status, and quality of life (QOL) of patients with epilepsy. The clinical data of 105 patients with epilepsy admitted between December 2019 and July 2023 were retrospectively analyzed, including those of 50 patients who underwent routine intervention (control group) and 55 who underwent intensive psychological intervention (research group). Treatment compliance, psychological status based on the Self-Rating Anxiety Scale (SAS) and Depression Scale Self-Rating Depression Scale (SDS) scores, hope level assessed using the Herth Hope Scale (HHS), psychological resilience evaluated using the Psychological Resilience Scale, and QOL determined using the QOL in Epilepsy-31 Inventory (QOLIE-31) were comparatively analyzed. Treatment compliance in the research group was 85.5%, which is significantly better than the 68.0% of the control group. No notable intergroup differences in preinterventional SAS and SDS scores were identified (P > 0.05); however, after the intervention, the SAS and SDS scores decreased significantly in the two groups, especially in the research group (P < 0.05). The two groups also exhibited no significant differences in preinterventional HHS, Connor-Davidson Resilience Scale (CD-RISC), and QOLIE-31 scores (P > 0.05). After 6 months of intervention, the research group showed evidently higher HHS, CD-RISC, tenacity, optimism, strength, and QOLIE-31 scores (P < 0.05). Intensive psychological intervention enhances treatment compliance, psychological status, and QOL of patients with epilepsy.

Quality of life predictors among Moroccan adults with epilepsy

PurposeThis study aimed to determine the factors associated with quality of life (QOL) in adult patients living with epilepsy in Morocco. Methods110 patients with epilepsy aging 18 years old were interviewed using the standard and validated Moroccan version of the Quality of Life in Epilepsy inventory with 31 items (QOLIE-31). Descriptive statistics, one-way ANOVA, and multivariate regression were used for data analysis. ResultsThe mean age of the patients was 35.70 years old (standard deviation (SD)12.2). The mean total score of QOLIE-31 was 43.6±10.2. The highest mean±SD score was the medication effects subscale 52.3±12.1, and the lowest was the overall quality of life subscale 39.2±13.2. Patients with no seizure episode during the last month had a better mean total score of QOLIE-31 (47.6±10.5) than the study participants having a seizure in the last month (40.6±8.9, p≤0.001). These data supported that presence of seizure in the past 4 weeks (β=4.626, CI95 % 1.123; 8.130), memory disorders (β=10.025, IC 95 % 2.811; 17.239), seizure trigger factors such as forgetting to take antiepileptic drugs (AEDs) (β=5.205, IC 95 % 1.769; 8.641), personal problems (β=4.957, IC 95 % 0.604; 9.310), low monthly income (<2000MAD, 194.94$: β= −9.937, IC 95 % −18.536; −1.338), (2000–5000MAD, 194.94$- 487.35$: β= −24.804, IC 95 % −43.171; −6.437), and employment (β= −4.291, IC 95 % −7.976; −0.605) were the factors associated with QOL. SignificanceThe overall QOL of patients with epilepsy was low. This study showed that the presence of seizures, memory disorders, monthly income, trigger factors, and employment status were QOL predictors for epileptic patients.

Comparative retrospective analysis: exploring the quality of life of people with epilepsy in two cohorts

People with epilepsy (PWE) are reported to have a lower quality of life (QOL). QOL among PWE were primarily observed through cross-sectional studies, and there is little information about the progression of QOL among PWE over the years. This study aimed to investigate the changes in QOL among PWE at a tertiary referral centre. A retrospective observational study was conducted among PWE from the Neurology clinic at the University Malaya Medical Centre. Data were extracted from the Quality of Life in Epilepsy Inventory (QOLIE-31) database for 2016, 2017, and 2020. A total of 88 subjects were included in Cohort 1 (2016 vs. 2017) and Cohort 2 (2017 vs. 2020), respectively. There was a significant improvement in mean scores of QOLIE-31 in Cohort 1 (57.7±12.2 vs. 63.2±14.2; p&lt;0.001), in terms of seizure worry, emotional well-being, cognitive functioning, medication effects and social function (p&lt;0.05, respectively). However, significant deterioration was observed in Cohort 2 (67.1±15.6 vs. 63.1±14.9; p=0.008), in terms of seizure worry and cognitive functioning (p&lt;0.05, respectively). Based on the calculated Jacobson Reliable Change Index (RCI) for the QOLIE-31 score, 28.4% from Cohort 2 experienced deterioration of QOL as compared to those from Cohort 1 (8%) (p&lt;0.001), which was most likely attributed to the COVID-19 pandemic. This study provides insights into the change of QOL among PWE in Malaysia over time, encompassing the COVID-19 pandemic period.

Brain network entropy, depression, and quality of life in people with traumatic brain injury and seizure disorders.

Traumatic brain injury (TBI) often precedes the onset of epileptic (ES) or psychogenic nonepileptic seizures (PNES) with depression being a common comorbidity. The relationship between depression severity and quality of life (QOL) may be related to resting-state network complexity. We investigated these relationships in adults with TBI-only, TBI + ES, or TBI + PNES using Sample Entropy (SampEn), a measure of physiologic signals complexity. Adults with TBI-only (n = 60), TBI + ES (n = 21), or TBI + PNES (n = 56) completed the Beck Depression Inventory-II (BDI-II; depression symptom severity) and QOL in Epilepsy (QOLIE-31) assessments and underwent resting-state functional magnetic resonance imaging (rs-fMRI). SampEn values derived from six resting state functional networks were calculated per participant. Effects of group, network, and group-by-network-interactions for SampEn were investigated with a mixed-effects model. We examined relationships between BDI-II, QOL, and SampEn of each of the networks. Groups did not differ in age, but there was a higher proportion of women with TBI + PNES (p = 0.040). TBI + ES and TBI-only groups did not differ in BDI-II or QOLIE-31 scores, while the TBI + PNES group scored worse on both measures. The fixed effects of the model revealed significant differences in SampEn values across networks (lower SampEn for the frontoparietal network compared to other networks). The likelihood ratio test for group-by-network-interactions was significant (p = 0.033). BDI-II was significantly negatively associated with Overall QOL scale scores in all groups, and significantly negatively associated with network SampEn values only in the TBI + PNES group. Only TBI + PNES had significant relationships between depression symptom severity and network SampEn values indicating that the resting state network complexity is related to depression severity in this group but not in TBI + ES or TBI-only. The brain has a complex network of internal connections. How well these connections work may be affected by TBI and seizures and may underlie mental health symptoms including depression; the worse the depression, the worse the quality of life. Our study compared brain organization in people with TBI, people with epilepsy after TBI, and people with nonepileptic seizures after TBI. Only people with nonepileptic seizures after TBI showed a relationship between how organized their brain connections were and how bad was their depression. We need to better understand these relationships to develop more impactful, effective treatments.

Work productivity, quality of life, and care needs: An unfolding epilepsy burden revealed in the Australian Epilepsy Project pilot study.

Epilepsy is a common and serious neurological disorder. This cross-sectional analysis addresses the burden of epilepsy at different stages of the disease. This pilot study is embedded within the Australian Epilepsy Project (AEP), aiming to provide epilepsy support through a national network of dedicated sites. For this analysis, adults aged 18-65 years with first unprovoked seizure (FUS), newly diagnosed epilepsy (NDE), or drug-resistant epilepsy (DRE) were recruited between February-August 2022. Baseline clinicodemographic data were collected from the participants who completed questionnaires to assess their quality of life (QOLIE-31, EQ-5D-5L), work productivity (Work Productivity and Activity Impairment [WPAI]), and care needs. Univariate analysis and multivariate regression was performed. 172 participants formed the study cohort (median age 34, interquartile range [IQR]: 26-45), comprising FUS (n = 44), NDE (n = 53), and DRE (n = 75). Mean QOLIE-31 score was 56 (standard deviation [SD] ± 18) and median EQ-5D-5L score was 0.77 (IQR: 0.56-0.92). QOLIE-31 but not EQ-5D-5L scores were significantly lower in the DRE group compared to FUS and NDE groups (p < 0.001). Overall, 64.5% of participants participated in paid work, with fewer DRE (52.0%) compared with FUS (76.7%) and NDE (72.5%) (p < 0.001). Compared to those not in paid employment, those in paid employment had significantly higher quality of life scores (p < 0.001). Almost 5.8% of participants required formal care (median 20 h/week, IQR: 12-55) and 17.7% required informal care (median 16 h/week, IQR: 7-101). Epilepsy is associated with a large burden in terms of quality of life, productivity and care needs. This is a pilot study from the Australian Epilepsy Project (AEP). It reports health economic data for adults of working age who live with epilepsy. It found that people with focal drug-resistant epilepsy had lower quality of life scores and were less likely to participate in paid employment compared to people with new diagnosis epilepsy. This study provides important local data regarding the burden of epilepsy and will help researchers in the future to measure the impact of the AEP on important personal and societal health economic outcomes.

Family support in adults with epilepsy.

The perception of family support in chronic disease can be relevant. To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

Long-term quality of life in patients with focal seizures treated with adjunctive eslicarbazepine acetate

By controlling seizures, anti-seizure medications can improve health-related quality of life (HRQOL). Data from a post-hoc pooled analysis of adjunctive eslicarbazepine acetate (ESL) was used to describe HRQOL measures, including overall quality of life, seizure worry, emotional well-being, energy/fatigue, cognitive functioning, medication effects, social function, and overall score over a period of up to one year. Patients who completed a double-blind treatment phase (Part 1) of these trials were eligible to enter the open label extension (OLE; Part 2). Patients who continued into the OLE initiated adjunctive ESL at 800 mg/day for 1 month before investigators could titrate dosages based on efficacy and tolerability. HRQOL was measured at baseline and at the last assessment using the Quality of Life in Epilepsy Inventory (QOLIE-31) in all patients who entered the 1-year OLE and in patients who completed the 1-year OLE. The mean QOLIE-31 scores and mean change in scores were analyzed using paired t-tests. The percentage of patients with improvements in QOLIE-31 scores beyond the minimally important change (MIC) threshold from baseline to end of 1-year OLE is described. Of 1410 patients in the intent-to-treat population, 1120 patients continued to part 2, and 795 patients completed the OLE. In patients who entered the OLE, mean improvements in scores for seizure worry, overall quality of life, emotional well-being, medication side effects, social functioning, and total score were statistically significant. In patients who completed the OLE, the mean change to final assessment was statistically significantly improved for all QOLIE categories. In patients who entered the OLE with a final assessment, the percentage of patients meeting the MIC for social functioning was the highest (46.9%), followed by medication effects (44.9%), and seizure worry (42.9%). Patients who completed the OLE with a final assessment found a similar rank ordering in QOLIE scale improvements compared with those who entered the OLE with a final assessment. For both sets of patient groups, the least number of subjects met MIC criteria for the energy/fatigue QOLIE category. Treatment with therapeutic doses of adjunctive ESL in patients with focal seizures was associated with improvements in HRQOL for a period of up to one year.

Association between depressive and anxious symptoms with cognitive function and quality of life in drug-resistant epilepsy

•Depressive/anxious disorders and cognitive impairment are frequent comorbidities in epilepsy and have a more deleterious effect in DRE.•Studies concerning the relationship between anxiety and depression and cognitive performance in DRE are scarce.•Higher scores in HADS are associated with lower QOLIE-31 scores and might be considered as predictors of QOL in DRE.•A relationship between anxious and depressive symptoms -measured with HADS and SCL-90R- and cognition might not exist.•There remains an unexplored study area regarding this relationship which requires more attention to improve the assessment of DRE.

Quality of life in epilepsy: comparison between Indonesian version of QOLIE-10 and QOLIE-31

Quality of Life in Epilepsy Inventory 10 (QOLIE-10) and QOLIE-31 is used to measure patient’s quality of life. While longer version of QOLIE-31 is thought to have higher validity and reliability, QOLIE-10 is shorter and more practical to use in clinical setting. This study aimed to compare Indonesian version of QOLIE-10 and QOLIE-31. This was a cross sectional study conducted at Dr. Moewardi General Hospital, Surakarta, Indonesia. Participant were asked to complete the Indonesian version of QOLIE-10 and QOLIE-31, and data obtained then analysed to find the correlation between QOLIE-10 and QOLIE-31. A total of 51 epilepsy patients were included on this study. We observed correlation of 0.41 to 0.84 (p&amp;lt;0.05) for each item of QOLIE-10 with their respective QOLIE-31 subscale. We also found correlation value of 0.898 (p=.000) between total score of QOLIE-10 and QOLIE-31 showing strong positive correlation of two questionnaire. Independent T-sample test on QOLIE-10 and QOLIE-31 T-score result of p=.361, showing no statistical difference between two questionnaires. Frequency of seizure is correlated with patients’ quality of life. QOLIE-10 has strong positive correlation to QOLIE-31, which make it a useful tool to assess epilepsy patients’ quality of life.

Improvement in health perception but not quality of life with an antiseizure medication intervention in people with epilepsy in Guinea: A cohort study

Background: This study assesses perceptions of quality of life (QOL) and overall health in people with epilepsy (PWE) in Guinea after a clinical intervention providing modified and new antiseizure medicine (ASM) regimens. Methods: Participants 12 years and older diagnosed with active epilepsy were prospectively and consecutively enrolled at two health centers in the Republic of Guinea (one urban, one rural) in 2022. 95% of participants were prescribed new/increased ASM doses, and interviewed for QOL and overall health perceptions at enrollment and three- and six-month follow ups. Univariate and linear mixed models were used to evaluate effects on QOL and overall health over time. Results: The mean QOLIE-31 score (±SD) among 148 Guinean PWE (82 male, 66 female; mean age 27.3; 137 with >1 seizure in prior year) was 51.7 ± 12.8 at enrollment, 57.6 ± 16.0 after three months (n = 116), and 52.2 ± 9.9 after six months (n = 87). Overall health scores were 53.1 ± 26.9, 72.6 ± 21.5, and 65.7 ± 20.2 respectively. After three months, PWE had improved overall health and QOLIE-31 scores (p<0.0001, p = 0.003), but these improvements persisted for overall health and not QOLIE-31 after six months (p = 0.001, p = 0.63). Seizure freedom (prior 30 days) was 26% initially, and 62 (42%) of the remaining PWE experiencing seizures achieved seizure freedom at either the first or second follow-ups. Conclusions: A noticeable discrepancy exists between Guinean PWE's self-rated perceptions of QOL and overall health. Purely clinical interventions may not be sufficient to improve QOL, especially in people that experience severe, previously-untreated epilepsy in lower income settings.

Impact of epilepsy surgery on quality of life: Systematic review and meta-analysis.

Improved quality of life (QoL) is an important outcome goal following epilepsy surgery. This study aims to quantify change in QoL for adults with drug-resistant epilepsy (DRE) who undergo epilepsy surgery, and to explore clinicodemographic factors associated with these changes. We conducted a systematic review and meta-analysis using Medline, Embase, and Cochrane Central Register of Controlled Trials. All studies reporting pre- and post-epilepsy surgery QoL scores in adults with DRE via validated instruments were included. Meta-analysis assessed the postsurgery change in QoL. Meta-regression assessed the effect of postoperative seizure outcomes on postoperative QoL as well as change in pre- and postoperative QoL scores. A total of 3774 titles and abstracts were reviewed, and ultimately 16 studies, comprising 1182 unique patients, were included. Quality of Life in Epilepsy Inventory-31 item (QOLIE-31) meta-analysis included six studies, and QOLIE-89 meta-analysis included four studies. Postoperative change in raw score was 20.5 for QOLIE-31 (95% confidence interval [CI] = 10.9-30.1, I2 = 95.5) and 12.1 for QOLIE-89 (95% CI = 8.0-16.1, I2 = 55.0%). This corresponds to clinically meaningful QOL improvements. Meta-regression demonstrated a higher postoperative QOLIE-31 score as well as change in pre- and postoperative QOLIE-31 score among studies of cohorts with higher proportions of patients with favorable seizure outcomes. At an individual study level, preoperative absence of mood disorders, better preoperative cognition, fewer trials of antiseizure medications before surgery, high levels of conscientiousness and openness to experience at the baseline, engagement in paid employment before and after surgery, and not being on antidepressants following surgery were associated with improved postoperative QoL. This study demonstrates the potential for epilepsy surgery to provide clinically meaningful improvements in QoL, as well as identifies clinicodemographic factors associated with this outcome. Limitations include substantial heterogeneity between individual studies and high risk of bias.

Long-Term Quality of Life in Patients With Focal Seizures Treated With ESL: Pooled Analysis From 3 Phase III Open-Label Extension Studies (P11-1.009)

<h3>Objective:</h3> Data from a post-hoc pooled analysis was used to describe changes in health-related quality of life (HRQOL) measures during treatment with eslicarbazepine acetate (ESL). <h3>Background:</h3> ESL is approved for the treatment of focal seizures. HRQOL may be improved by controlling seizures. <h3>Design/Methods:</h3> Data from 3 randomized clinical trials were pooled for this post-hoc analysis. After completing the double-blind portion, patients were eligible to enter the 1-year open-label extension (OLE), which began immediately after the maintenance period or after a 4-week taper period. ESL was initiated at 400 or 800 mg/day, titrated in 400mg increments to a maximum 1600 mg/day. HRQOL was measured at baseline and last assessment using the Quality of Life in Epilepsy Inventory (QOLIE-31). Mean QOLIE-31 scores and mean change in scores were analyzed (t-test). The percentage of patients with QOLIE-31 score improvements beyond the minimal important change (MIC) threshold (baseline to final assessment) is described. <h3>Results:</h3> Of 959 patients who entered, 677 patients completed the OLE. Mean change in seizure worry, overall quality of life, emotional well-being, medication side effects, social functioning, and total score were significantly improved for patients who entered the OLE. Mean change ranged from 0.76 (energy/fatigue) to 4.93 (seizure worry). Mean change in all QOLIE-31 categories was significantly improved in patients who completed the OLE, ranging from 2.16 (cognitive functioning) to 6.58 (seizure worry). The highest percentage of patients reached the MIC threshold in social functioning (46.8%–48.9%), followed by medication effects (43.8%–47.4%), and seizure worry (42.1%–45.3%) in patients who entered the OLE and who completed the OLE, respectively. The lowest number of subjects met MIC criteria for energy/fatigue in both patient groups. <h3>Conclusions:</h3> Treatment with therapeutic doses of adjunctive ESL in patients with focal seizures for a period of up to one year was associated with improvements in HRQOL. <b>Disclosure:</b> Dr. Cantu has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc.. Dr. Krishnaiengar has nothing to disclose. Dr. Thomases has received personal compensation for serving as an employee of Sunovion Pharmaceuticals. Darshan Mehta has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc. . Ms. Hall has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc.. Ian Zhang has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc.. Helena Gama has received personal compensation for serving as an employee of Bial-Portela &amp; Cª S.A.. Ana Pereira has received personal compensation for serving as an employee of BIAL, Portela &amp; Cª S.A.. Todd Grinnell, PhD has received personal compensation for serving as an employee of Sunovion Pharmaceuticals Inc..

31-item Quality of Life in Epilepsy Inventory: Translation and validation in Vietnamese

This study aimed to translate the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) into Vietnamese and validate the translation. The inventory was translated through “forward – backward” translation, and culturally adapted for standardization. To ensure the reliability of the inventory, the internal consistency and the temporal consistency was determined. Clinical variables were tested for discriminant validity by comparing their scores. Cronbach’s alpha coefficient ranged from 0.91 to 0.57, with the lowest in the Overall quality of life subscale. Test-retest reliability showed high reproducibility with intra-class correlation coefficients ranging from 0.72 to 0.87 (p&lt;0.001). The mean score of QOLIE-31 was 71.31. Further, the study used the statistical differences of QOLIE-31 scores in the drug-resistant group to show discriminant validity. The Vietnamese QOLIE-31 is a reliable and valid instrument as proven by the statistical data and can be used to assess quality of life in people with epilepsy.

Suicide risk in epilepsy: Clinical variables, psychiatric disorders, and social support.

To explore the relationship between suicide risk, the perception of social support and quality of life (QoL), and with the clinical variables of adult people with epilepsy (PWEs). A total of 98 consecutive PWEs cared for in the outpatient setting, with a mean age of 48.1±15.9 years, having had epilepsy for 26.4±16.4 years and 48 (48.9%) female cases participated in this study. The MINI suicide module, the Social support satisfaction scale (SSSS), the Quality of life in epilepsy inventory (QOLIE-31), and the Hospital anxiety and depression scale (HADS) were used. A logistic regression was conducted to assess the factors associated with the suicide risk. Suicide risk was present in 33 cases. Younger age, earlier age at epilepsy onset, depression and anxiety in the HADS scale, and lower MMSE, QOLIE-31, and SSSS scores were significantly associated with suicide risk in the univariate analysis. The logistic regression analysis identified that lower scores in the MMSE (OR 0.826, 95%CI 0.705-0.969), presence of anxiety (OR 0.197, CI 0.073-0.530), and a low perception regarding satisfaction with family (OR 0.953, CI 0.920-0.988) are the factors associated with the highest risk of suicide. Suicide risk and recurrence of a suicide attempt was high in the PWEs. Suicide risk was associated with clinical variables, the presence of anxiety and the perception of less social support from the family.

STUDY OF INTER-RELATIONSHIP BETWEEN QUALITY OF LIFE AND COGNITION IN PEOPLE WITH EPILEPSY CROSS SECTIONAL STUDY FROM NORTH COASTAL ANDHRA PRADESH

Objective: To study the Inter – relationship between Quality of life and Cognitive dysfunction in People with Epilepsy and to identify the factors that influence Cognition and QOL in PWE. Methods: We analyzed the factors that were independently associated with QOLIE-31, MMSE and MOCA scores which included demographic and clinical variables using Chi square, ANOVA and Multivariate regression analysis. Pearson coefficient calculator to know the interrelationship between QOLIE-3 scores, MMSE and MOCA. Results: We found a significant association between polytherapy, TLE and LRE with QOLIE-31 scores (p value being 0.0007 and &lt;0.00001 respectively). We found a significant association between low MMSE scores and long duration of epilepsy more than 6 years( p: 0.001 and 0.002), statistically highly significant association when compared with TLE and LRE (p: 0.000). However MOCA showed strong positive correlation with QOLIE-31 scores when compared with MMSE. We found a moderate positive correlation with r value being 0.6 and a significant p value being &lt;0.0001. Correlation between MOCA and QOLIE 31 score showed a significant positive correlation with an r value of 0.7 and a P value of &lt;0.0000. Correlation between total MMSE and MOCA scores showed a significant positive correlation of r value being 0.8, p value being 0.000. Conclusion: Polytherapy, Long duration of Epilepsy, Temporal Lobe and other Focal Epilepsies, Poor Quality of Life standards are all independent factors determining the Cognitive dysfunction. There seems to be bidirectional relationship between Quality of Life and Cognitive dysfunction. MOCA seems to be superior to MMSE for Neurocognitive screening in PWE.

Social support for and features of Chinese adults with epilepsy

BackgroundThe lack of social support for adults with epilepsy (AWEs) is receiving increased attention, as it may result in low quality of life. This study was aimed to confirm the demographic characteristics of and clinical factors associated with social support for AWEs.MethodsAWEs were consecutively recruited from our hospital. The 10-term Social Support Rating Scale (SSRS) was used to measure social support. A linear regression analysis with stepwise selection was performed to analyze the independent variables associated with social support for AWEs.ResultsIn total, 165 AWEs were consecutively included in the present study. Linear regression analysis showed that the marital status (t = -3.550, β = -0.272, P = 0.001), the age at onset (t = 2.545, β = 0.192, P = 0.012), and the QOLIE-31 score (t = 3.144, β = 0.221, P = 0.002) were independent variables associated with social support for AWEs.ConclusionsOur findings suggest that the poor social support is associated with childhood onset of epilepsy and the unmarried status. This study also confirmed a negative influence of low social support on quality of life in AWEs.