Abstract Details

Title Mood and Quality of Life in Patients Treated with Brain-responsive Neurostimulation: The Value of Earlier Intervention

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S25 - Epilepsy/Clinical Neurophysiology (EEG) 2 (1:12 PM-1:24 PM)

Poster/Presentation
Number 002

Objective

Frequent focal-onset seizures (FOS) can be associated with progressive impairments in mood and quality of life (QOL). Thus, we tested whether patients who began treatment with brain-responsive neurostimulation earlier in the course of their medically intractable epilepsy had greater improvements in mood and QOL.

Background Brain-responsive neurostimulation with the RNS System (NeuroPace, Mountain View CA) has been demonstrated to be safe and effective in reducing the frequency of FOS in adults with medically refractory focal epilepsy (Heck et al., 2014). In clinical trials, treatment also resulted in improvements in mood and multiple domains of QOL (Meador et al., 2015). Here, we compared these improvements in individuals who began treatment “early” (within 10 years of epilepsy onset) to those who began treatment “late” (beyond 20 years of epilepsy onset).

Design/Methods Mood was assessed using the Beck Depression Inventory-II (BDI), and QOL was assessed using the Quality of Life in Epilepsy Inventory (QOLIE-89) overall score and the derived epilepsy-targeted, cognitive, mental, and physical subscales. For each patient, baseline scores (3-months pre-treatment) were compared to treatment year 2 for the BDI and to treatment year 9 for the QOLIE. Paired 2-tailed T-tests were used to test for a significant change in each score relative to baseline for each group, and two-sample 1-tailed T-tests were used to test for differences between groups.

Results Patients treated with brain-responsive stimulation earlier in the course of their epilepsy had significant improvements in mood and QOL that were not seen in patients treated later in the course of their epilepsy, despite similar durations of treatment and improvements in seizure rates across the 2 groups.

Conclusions These results suggest that early intervention maximizes the opportunity for improvements in mood and QOL; if treatment is delayed for too long, improvements in mood and QOL may no longer be possible.

Authors/Disclosures
David W. Loring, PhD, FAAN (Emory Univ, Dept of Neurology) PRESENTER	Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. Dr. Loring has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE. The institution of Dr. Loring has received research support from NIH. Dr. Loring has received publishing royalties from a publication relating to health care.
	No disclosure on file
Kimford J. Meador, MD, FAAN (Stanford University School of Medicine)	The institution of Dr. Meador has received research support from NIH. The institution of Dr. Meador has received research support from Eisai. The institution of Dr. Meador has received research support from Medtronics. The institution of Dr. Meador has received research support from The Epilepsy Consortium.
Andres M. Kanner, MD, FAAN (University of Miami, Miller School of Medicine, Department of Neurology)	Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. Dr. Kanner has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsy Foundation of America. Dr. Kanner has received personal compensation in the range of $500-$4,999 for serving as a Lecture at International meeting with Eisai.
	No disclosure on file
Martha Morrell, MD, FAAN (NeuroPace/Stanford University)	Dr. Morrell has received personal compensation for serving as an employee of NeuroPace. Dr. Morrell has stock in NeuroPace. The institution of Dr. Morrell has received research support from National Institutes of Health.

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