Co wpływa na jakość życia pacjentów z epilepsją oporną na leki? Znaczenie objawów klinicznych, stanu emocjonalnego i funkcji poznawczych
What shapes health-related quality of life in drug-resistant epilepsy? Clinical, emotional, and cognitive predictors
W skrócie
Badanie wykazało, że jakość życia pacjentów z epilepsją oporną na leki zależy nie tylko od częstości napadów, ale również od depresji, zdolności rozpoznawania swoich emocji i funkcjonowania pamięci. Pacjenci mający trzy lub więcej napadów tygodniowo zgłaszali znacznie gorszą jakość życia. Badacze zaproponowali, aby leczenie epilepsji obejmowało nie tylko kontrolę napadów, ale także opiekę nad zdrowiem psychicznym i funkcjami umysłowymi pacjenta.
Oryginalny abstract (angielski)
PURPOSE: Clinical and psychological factors associated with health-related quality of life (HRQoL) in drug-resistant epilepsy (DRE) are well established; however, the contribution of alexithymia and specific neurocognitive domains remains less well characterized. This study aimed to examine clinical, emotional, and neuropsychological correlates of HRQoL in patients with focal DRE, with particular emphasis on alexithymia and cognitive functioning. METHODS: Thirty-two patients with frontal lobe epilepsy (FLE) and 38 with mesial temporal lobe epilepsy (mTLE) underwent comprehensive clinical, cognitive, and psychological assessment. HRQoL was evaluated using the QOLIE-31. Cognitive performance across multiple domains was evaluated using standardized instruments, while psychological outcomes were assessed using the DASS-42 and TAS-20. Hierarchical multiple regression analyses were performed to identify predictors of HRQoL. RESULTS: Patients with higher weekly seizure frequency reported significantly poorer HRQoL, particularly those experiencing three or more seizures per week. Hierarchical regression analyses identified seizure frequency (β = -0.46, p < 0.001), externally oriented thinking (EOT) (β = -0.27, p < 0.05), depression (β = -0.28, p < 0.05), and working memory performance (β = 0.30, p < 0.05) as independent predictors of overall HRQoL, while seizure burden, emotional distress, EOT, and cognitive performance differentially predicted specific HRQoL domains. CONCLUSION: HRQoL in DRE is influenced by clinical, emotional, and cognitive factors. Beyond seizure burden, mood disturbances, alexithymia, and neuropsychological performance are linked to HRQoL, underscoring the need for a holistic, patient-centered approach that addresses emotional and cognitive functioning alongside seizure control.