Depression and quality of life after anterior hippocampectomy in temporal lobe epilepsy: A prospective study.
TL;DR
Anterior hippocampectomy in patients with drug-resistant TLE was associated with significant early improvements in BDI-II and WHOQOL scores, and routine psychiatric screening and postoperative psychological support remain essential.
Abstract
Background
Temporal lobe epilepsy (TLE), frequently associated with mesial temporal sclerosis (MTS), is the most common form of focal epilepsy in adults and is often accompanied by depressive symptoms that impair quality of life. While anterior hippocampectomy is an established surgical approach for drug-resistant TLE, its postoperative psychiatric and psychosocial impact remains insufficiently studied, particularly in non-Western populations. This study assessed changes in depressive symptoms and quality of life following anterior hippocampectomy in a Middle Eastern cohort.
Methods
Depression was assessed preoperatively and at 1- and 3-month follow-up using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Beck Depression Inventory (BDI). Quality of life was measured using the World Health Organization Quality-of-Life (WHOQOL) scale.
Results
Forty patients were included, of whom 18/40 (45.0%) screened positive for depression at baseline. BDI scores decreased significantly over time (p = 0.011) and WHOQOL scores improved significantly across follow-up (p = 0.016). PNDDI-E scores showed a non-significant reduction over time (p = 0.055). 9/18 (50.0%) of patients who screened positive for depression preoperatively converted to screen-negative status at 3 months, while 4/22 (18.2%) of preoperatively screen-negative patients developed new screen-positive status. Improvements in BDI and WHOQOL scores were not significantly influenced by age, sex, education, or surgical laterality.
Conclusions
Anterior hippocampectomy in patients with drug-resistant TLE was associated with significant early improvements in BDI-II and WHOQOL scores. These findings should be regarded as preliminary given the small sample size, short follow-up, and absence of postoperative seizure outcome data. Given that a subset of patients may develop new or worsened depressive symptoms postoperatively, routine psychiatric screening and postoperative psychological support remain essential.